Long-term effectiveness of group-based diabetes self-management on glycosylated haemoglobin for people with type 2 diabetes in community: a protocol of systematic review and meta-analysis

INTRODUCTION

The rapid rise in the prevalence of diabetes has a negative impact on patients' quality of life. Diabetes self-management group education is cost-effective and efficient for patients to control blood glucose. However, there are no consistent standards for self-management group education, and its long-term effects (≥12 months) are unclear. Although a few systematic reviews evaluated the long-term effects, they did not make clear provisions on the content of self-management, and the number and sample size of included studies were small, which may lead to misclassification bias and reporting bias. Therefore, we plan to conduct this systematic review to evaluate the long-term effects of self-management group education and determine the effects of different self-management characteristics on glycosylated haemoglobin (HbA1c).

METHODS AND ANALYSIS

We will retrieve Chinese databases (Wanfang, Chinese Hospital Knowledge Warehouse) and English databases (PubMed, ScienceDirect, EMBASE, Web of Science, Bailian Platform, Cochrane Central Register of Controlled Trials, Google Scholar) for randomly controlled trials and cluster randomly controlled trials of which participants are adults with type 2 diabetes mellitus. We will manually search citation lists and trial registries, and consult authors to obtain relevant articles. The retrieval time range will be from the establishment of the database to July 2020 to avoid omitting relevant studies. The primary outcome will be HbA1c. The secondary outcomes will be fasting plasma glucose, postprandial blood glucose, total cholesterol, triglyceride, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, systolic blood pressure, diastolic blood pressure, body mass index, waist circumference and death event. Two reviewers will independently conduct article screening and assessment of risk of bias, with a third reviewer arbitrating if necessary. We will give priority to the use of meta-analysis to evaluate the pooled effects of all outcomes. For the outcomes of unrecognised sources of heterogeneity, missing data and less than three related studies, narrative synthesis approach will be used.

ETHICS AND DISSEMINATION

Ethical approval is not required for this systematic review. We plan to present the findings in a peer-reviewed scientific journal, relevant and responsible organisations, and training meetings.

PROSPERO REGISTRATION NUMBER

CRD42020209011.

[Association analysis of famine exposure during early life and risk of hypertension in adulthood]

Objective: To explore the relationship between exposure to famine in early life and the risk of hypertension in adulthood. Methods: The medical data of Yichang Health Management Big Data Center from 2018 to 2019 were analyzed. A retrospective cohort study design was adopted, with hypertension as the study outcome, and different life periods exposed to the Great Famine in China were divided into groups. Multivariate logistic regression model was used to analyze the relationship between famine exposure in early life and hypertension in adulthood. At the same time, the interaction between gender and famine exposure was analyzed. Results: The age of 142 016 subjects was (60. 56±4.43). Among them, men accounted for 46.36% (65 845/142 016) and women accounted for 53.64% (76 171/142 016). There are 42 575(29.98%), 19 644(13.83%), 28 405(20.00%), 28 305(19.93%), 23 087 (19.93%) in non-famine exposure group, fetal famine exposure group, early childhood famine exposure group and late childhood famine exposure group, respectively. The prevalence of hypertension was 17.57% (24 947 cases). Multivariate logistic regression model analysis showed that after adjusting for related confounding factors, compared with non-famine exposure group, the risk of hypertension in fetal, early childhood, middle childhood and late childhood famine exposure group was higher and the OR (95%CI) values were 1.16 (1.11-1.22), 1.27 (1.21-1.33), 1.54 (1.47-1.60) and 1.84 (1.76-1.92), respectively. There was an interaction between sex and famine exposure group (P<0.001). The above association is stronger among women than among men. Conclusion: Famine exposure in early life may increase the risk of hypertension in adulthood, and the risk of women is greater than that of men.

Factors Influencing the Initiation Time of Forensic Psychiatric Assessment of Criminal Cases in Hunan Province

Abstract

Objective To discuss the related factors influencing the initiation time of forensic psychiatric assessment by analysis of the initiation time of forensic psychiatric assessment of criminal cases in Hunan Province. Methods Related data in assessment files of criminal cases accepted by 8 forensic psychiatric assessment institutions in Hunan Province from January 1, 2011 to December 31, 2016 were extracted. The Logistic regression analysis was used to explore the factors influencing the initiation time of forensic psychiatric assessment. After using property score matching （PSM） to control the influence of confounding factors, the efficiency of public security organs to initiate assessments of suspects with （without） mental disorders and with （without） responsibilities were compared. Results A total of 4 346 cases were included. The Logistic regression analysis suggested that the factors independently related to the initiation time of assessment include： cause of assessment, nationality of the assessed, history of diagnosis and treatment of mental illnesses, history of crimes, history of drug abuse, and status of alcohol consumption before the crime （all P<0.05）. The initiation time of assessment of suspects diagnosed with mental disorder was shorter than those with none （P<0.05）; the initiation time of assessment of suspects without criminal responsibility was shorter than those with responsibility （P<0.05）. After using PSM to control confounding factors, the differences above still existed. Conclusion The cause of assessment, nationality of the assessed, history of diagnosis and treatment of mental illnesses, history of crimes, history of drug abuse, and status of alcohol consumption before the crime are factors that influence the efficiency of public security organs to initiate forensic psychiatric assessments. Under the current assessment initiation mode, forensic psychiatric assessment of suspects who have mental disorders, especially those with no responsibility may be given priority to initiate.

Anaerobic digestion of elephant grass hydrolysate: Biogas production, substrate metabolism and outlet effluent treatment

Elephant grass (Pennisetum purpureum) acid hydrolysate was used as substrate for anaerobic digestion for the first time. Within short period (ten days), the organic materials (sugars and organic acids) in the elephant grass hydrolysate could be utilized efficiently for stable biogas production that the COD removal, biogas yield, and CH₄ content were 91.3 ± 2.0%, 0.561 ± 0.014 m³/kg _COD consumption, and 68.1 ± 4.6%, respectively throughout this bioprocess. During anaerobic digestion, almost no volatile fatty acids (VFAs) was accumulated (merely <0.1 g/L acetic acid was found) and the outlet pH was very stable (7.3 ± 0.1). Meanwhile, the furans including furfural and 5-hydroxymethylfurfural (HMF) existing in the inlet substrate could be degraded. After anaerobic digestion, the outlet effluent was treated by combination of Fe-C micro-electrolysis and Fenton reaction to remove 93.1% of residual COD and 98.6% of color. Considering the performance, cost, operation, and environmental influence, this technology is suitable for industrial treatment of waste elephant grass.

[Impact of cessation of antiviral therapy at delivery on postpartum liver function in mothers with chronic hepatitis B virus infection]

Objective: To investigate the impact of immediate cessation of antiviral therapy on postpartum liver function and the factors influencing postpartum abnormality in mothers with chronic hepatitis B virus infection. Methods: A retrospective cohort study was conducted. One hundred eighty-eight pregnant women with HBV DNA level > 2×106 IU/ml were enrolled from June 2014 to June 2018. Demographic information and clinical data of liver function and HBV DNA load during gravidity, intrapartum and postpartum period were collected. According to the antiviral treatment recommendations during pregnancy, the women were divided into three groups, namely, tenofovir (TDF), telbivudine (LdT) and control group. Liver function abnormalities among the three groups were compared within 6 months after delivery, and the factors influencing abnormal liver function were analyzed by unconditional logistic regression. Results: Of the 188 cases, 72 cases were in the TDF group, 80 cases in the LdT group, and 36 cases in the control group. Pregnant women in the TDF and LdT groups received oral TDF (300 mg/d) and LdT (600 mg/d) from 28 ± 4 weeks of gestation till delivery. Among the 188 patients, 30 (16.0%) had abnormal postpartum liver function abnormality. The incidence of postpartum liver function abnormality [alanine aminotransferase (ALT) > 2 × upper limit of normal (ULN)] in the TDF, LdT, and control groups was 19.4%, 12.5%, and 16.7%, respectively. The postpartum peak levels of ALT (median, range) in the three groups were 34.5 (12.0-946.0) U/L, 37.5 (12.0-733.8) U/L, and 39.0 (7.0-513.0) U/L, respectively. There was no significant difference between the two indexes among the three groups (P > 0.05). There was no statistically significant difference in the degree of postpartum liver function abnormalities between the three groups (P = 0.944). Most of the liver function abnormalities were mild to moderate (2 × ULN≤ALT < 10 × ULN), and usually resolved spontaneously or by treatment. Univariate and multivariate analysis showed that baseline ALT level during pregnancy was an independent factor associated with postpartum liver function abnormality (OR = 1.031, CI 95%: 1.005-1.058; χ(2) = 5.340, P = 0.021), whereas age, antiviral therapy, HBeAg-positivity, baseline HBV DNA levels, gravidity, parity, preterm delivery and delivery mode were not significantly associated with postpartum liver function abnormality. Conclusion: Cessation of antiviral therapy after delivery did not significantly increase the risk of postpartum liver function abnormality in pregnant women with chronic HBV infection. The ALT level during pregnancy is a factor influencing postpartum liver function abnormality.

Difference of trace element exposed routes and their health risks between agriculture and pastoral areas in Bay County Xinjiang, China

The concentration level related to toxicities of trace elements in drinking water, rice, wheat flour, and their associated negative impacts on human health have become an emergent issue in China. Because Xinjiang is the largest province in China with the majority of arable pasture land available for cultivation, it is important to analyze the concentrations of trace elements in relation to their toxicities in water, rice, and wheat flour and to investigate the health risk differences between agricultural and pastoral areas in Bay County, Xinjiang. The study results showed that (1) metal concentrations from drinking water, rice, and wheat flour were within the permissible limits; (2) concentration levels of trace elements and their total risk from drinking water and rice were higher in the agricultural areas than those in the pastoral areas, whereas concentration levels of trace elements and their total risk from wheat flour were higher in the pastoral areas than those in the agricultural areas; (3) the concentration level of the trace elements in rice were higher than in the wheat flour, but the risk from the wheat flour was higher than the risk from rice; (4) total non-cancer risk from the flour (HI_f) in both areas exceeded the respective safe reference doses; (5) total cancer risk from the wheat flour, rice, and water exceeded the safety limit (1 × 10^-4); (6) for the exposed population, arsenic was suggested as the most evident pollutant leading to carcinogenic concerns regarding the water, rice, and wheat flour; (7) the risk index from the wheat flour made up the highest percentage both in the total cancer risk and the non-cancer risk, followed by rice and then water; and (8) the human health risk was attributed to influence from the local environment in the agriculture areas, while it was attributed to the external environment in the pastoral areas. Graphical abstract.

Middle hepatic vein reconstruction in adult right lobe living donor liver transplantation improves recipient survival

BACKGROUND

The efficacy and necessity of middle hepatic vein (MHV) reconstruction in adult-to-adult right lobe living donor liver transplantation (LDLT) remain controversial. The present study aimed to evaluate the survival beneficiary of MHV reconstructions in LDLT.

METHODS

We compared the clinical outcomes of liver recipients with MHV reconstruction (n = 101) and without MHV reconstruction (n = 43) who underwent LDLT using right lobe grafts at our institution from January 2006 to May 2017.

RESULTS

The overall survival (OS) rate of recipients with MHV reconstruction was significantly higher than that of those without MHV reconstruction in liver transplantation (P = 0.022; 5-yr OS: 76.2% vs 58.1%). The survival of two segments (segments 5 and 8) hepatic vein reconstruction was better than that of the only one segment (segment 5 or segment 8) hepatic vein reconstruction (P = 0.034; 5-yr OS: 83.6% vs 67.4%). The survival of using two straight vascular reconstructions was better than that using Y-shaped vascular reconstruction in liver transplantation with two segments hepatic vein reconstruction (P = 0.020; 5-yr OS: 100% vs 75.0%). The multivariate analysis demonstrated that MHV tributary reconstructions were an independent beneficiary prognostic factor for OS (hazard ratio=0.519, 95% CI: 0.282-0.954, P = 0.035). Biliary complications were significantly increased in recipients with MHV reconstruction (28.7% vs 11.6%, P = 0.027).

CONCLUSIONS

MHV reconstruction ensured excellent outflow drainage and favored recipient outcome. The MHV tributaries (segments 5 and 8) should be reconstructed as much as possible to enlarge the hepatic vein anastomosis and reduce congestion.

[Mean blood pressure among the adults in China 2010-2012: based on the results of mercury sphygmomanometer and converted electronic sphygmomanometer]

Objective: To analyze the average systolic blood pressure (SBP) and diastolic blood pressure (DBP) among adults aged 18 years old and above in China between 2010 and 2012; and to compare the difference in the results measured by mercury sphygmomanometer and converted electronic sphygmomanometer. Methods: The data was collected from Chinese Nutrition and Health Surveillance in 2010-2012. 120 428 adults aged 18 years old and above were selected from 150 survey counties (districts) of 31 provinces in China Mainland, by multi-stage stratified and probability proportion to size (PPS) cluster randomization sampling method. The average blood pressure value was calculated from three systolic and diastolic blood pressure readings measured by mercury sphygmomanometer. The value of Electronic Sphygmomanometer was converted by regression formula. Age-standardized results were calculated incorporating a complex sample weighting using the population data from the National Bureau of Statistics in 2009. Results: The overall adjusted mean of SBP based on the value of mercury sphygmomanometer among Chinese adults aged 18 years old and above was 122 mmHg (1 mmHg=0.133 kPa), 124 mmHg in men and 120 mmHg in women. The average SBP value was separately 115, 127, and 137 mmHg in groups of adults aging 18-44, 45-59 and ≥60 years old. The average SBP was 122 mmHg in urban and 122 mmHg in rural areas. Mean DBP was 78 mmHg, 79 mmHg in men and 76 mmHg in women. The average DBP was separately 75, 81, and 81 mmHg in groups of adults aging 18-44, 45-59 and ≥60 years old. The average DBP was 78 mmHg in urban and 77 mmHg in rural areas. The overall adjusted mean of SBP based on converted electronic device was 129 mmHg,130 mmHg in men and 127 mmHg in women, respectively. The mean of SBP was separately122, 134, and 143 mmHg in groups of adults aging 18-44, 45-59 and ≥60 years old. Mean SBP was both 129 mmHg in urban and in rural areas. Mean DBP was 76 mmHg, 78 mmHg in men and 75 mmHg in women, respectively. The average DBP was separately 74, 79, and 79 mmHg in groups of adults aging 18-44, 45-59 and ≥60 years old. The average DBP was both 76 mmHg in urban and rural areas. Conclusion: The average SBP and DBP was different between the mercury sphygmomanometer and converted electronic device. However, the results from both measures showed that the blood pressure was higher in men than in women, the blood pressure increased with the increase of age, and there was no difference between urban and rural areas.

[Prevalence and characteristics of overweight and obesity in Chinese children aged 0-5 years]

Objective: To study the prevalence and characteristics of overweight and obesity among Chinese children aged 0-5 years, in 2010-2013. Methods: Data was from the'China Nutrition and Health Surveillance-0-5-Years-Old Children and Lactating Women'project in 2013. Stratified multistage cluster sampling method was used to select 55 districts/counties from 30 provinces (autonomous regions, municipalities) with the sample size of children as 32 862. Definition of overweight and obesity were according to both the WHO 2006 growth standard in children less than 5-year-old and the WHO 2007 growth reference in children of 5-years-old. Results: were calculated by complex weight based on national census from the National Bureau of Statistics in 2010. Results The overall prevalence of overweight was 8.4% among the 0-5-year-old in 2013, with 9.4% in boys and 7.2% in girls. Both of the rates from urban and rural areas were the same, as 8.4%. The prevalence rates of overweight in the 0-, 6-, 12-, 24-, 36-, 48- and 60-71 months age groups appeared as 13.0%, 11.1%, 8.3%, 6.0%, 4.8%, 3.9% and 15.9%, respectively. The rates of overweight in low, medium and high income families were 8.0%, 8.8% and 8.9%, respectively. The prevalence of obesity was 3.1% among the 0-5-year-old, with 3.6% in boys and 2.5% in girls. There was no significant difference seen in urban (3.3%) and rural areas (2.9%). The prevalence rates for obesity in the 0-, 6-, 12-, 24-, 36-, 48- and 60-71 months age groups were 5.8%, 3.8%, 2.5%, 1.6%, 1.2%, 1.3% and 7.8%, respectively. The rates of obesity in low, medium and high income families were 2.8%, 3.3% and 3.5%, respectively. Conclusion: The prevalence rates of both overweight and obesity were increasing among the 0-5-year-olds in China, suggesting that it is necessary to timely conduct the surveillance and intervention programs on overweight and obesity in this target population.

Fast Startup of Semi-Pilot-Scale Anaerobic Digestion of Food Waste Acid Hydrolysate for Biogas Production

In this study, a fast startup of semi-pilot-scale anaerobic digestion of food waste acid hydrolysate for biogas production was carried out for the first time. During the period of fast startup, more than 85% of chemical oxygen demand (COD) can be degraded, and even more than 90% of COD can be degraded during the later stage of anaerobic digestion. During this anaerobic digestion process, the biogas yield, the methane yield, and the CH₄ content in biogas were 0.542 ± 0.056 m³/kg_{COD consumption}, 0.442 ± 0.053 m³/kg_{COD consumption}, and 81.52 ± 3.05%, respectively, and these values were high and stable. Besides, the fermentation pH was very stable, in which no acidification was observed during the anaerobic digestion process (outlet pH was 7.26 ± 0.05 for the whole anaerobic digestion). Overall, the startup of this anaerobic digestion can be completed in a short period (the system can be stable 2 days after the substrate was pumped into the bioreactor), and anaerobic digestion of food waste acid hydrolysate is feasible and attractive for industrial treatment of food waste and biogas production.

Lumping kinetics of ABE fermentation wastewater treatment by oleaginous yeast Trichosporon cutaneum

Lumping kinetics models were built for the biological treatment of acetone-butanol-ethanol (ABE) fermentation wastewater by oleaginous yeast Trichosporon cutaneum with different fermentation temperatures. Compared with high temperature (33°C, 306 K) and low temperature (23°C, 296 K), medium temperature (28°C, 301 K) was beneficial for the cell growth and chemical oxygen demand (COD) degradation during the early stage of fermentation but the final yeast biomass and COD removal were influenced little. By lumping method, the materials in the bioconversion network were divided into five lumps (COD, lipid, polysaccharide, other intracellular products, other extracellular products), and the nine rate constants (k₁-k₉) for the models can well explain the bioconversion laws. The Gibbs free energy (G) for this bioconversion was positive, showing that it cannot happen spontaneous, but the existence of yeast can after the chemical equilibrium and make the bioconversion to be possible. Overall, the possibility of using lumping kinetics for elucidating the laws of materials conversion in the biological treatment of ABE fermentation wastewater by T. cutaneum has been initially proved and this method has great potential for further application.

Pulverization characteristics of coal affected by magmatic intrusion and analysis of the abnormal gas desorption index on drill cuttings

The gas desorption index of drill cuttings is a basic index that measures the initial desorption capacities of coal seams and predicts coal seam gas outbursts. Following a long period of gas drainage in the No.7 coal seam of the No.86 mining area in the Haizi coal mine, the gas desorption index of drill cuttings was still found to be much higher than the threshold value for outburst risks. This abnormal phenomenon led to the present study of the rational selection of test methods and objects in this context. In this study, particle size distribution, pore structure and gas desorption characteristics of coal samples in anomalous areas were analyzed. We found that desorption characteristics are related to particle size and particle size varies in relation to tectonic stress and magmatic intrusions. It appears that the anomalous readings are related to particle size of the coal, resulting from tectonic/magmatic pulverization. Furthermore, measured particle size of drill cuttings is not actually reflective of coal particle size – larger particles may be comprised of multiple smaller particles. The results show that coal samples with particle size <1 mm accounts for 76.3% of total samples and coal samples with particle size >1 mm only accounts for 23.7% of total samples. The porosity and total pore volume increase as the particle size decreases. The specific surface area increases with decreasing pore diameter. Transitional pores and micropores increase the specific surface area of the coal sample considerably. The desorption capacity increases with decreasing particle size. The additional tectonic stress caused by magmatic intrusion has a crushing effect, and 1–3 mm particles used in test were composed of a large amount of smaller particles, eventually resulting in abnormal gas desorption index phenomena. Therefore, we proposed an improved method for measuring the gas desorption index of pulverized coal.

[Effects of saliva contamination on bond strength of resin-resin interfaces]

OBJECTIVE

To estimate the bond strength between different resin composite interfaces, and to evaluate the effect of saliva contamination and management with the contamination on the bond strength.

METHODS

Two commercial resin composites containing different types of fillers (AP-X: barium-glass; P60: quartz) were tested in this study. The basic composite blocks were made of AP-X. After wet-ground flatted, the experimental groups were divided into three groups according to the surface treatment: (1)Direct bonding group: the bonding surface was rinsed with distilled water for 20 s, then dried with oil-free air for 20 s; (2)Saliva contamination group: the bonding surface was bathed in saliva for 30 min, then distilled water was rinsed for 20 s and dried with oil-free air for 20 s; (3)Saliva contamination and 75% ethanol wiping group: bonding surface bathed in saliva for 30 min, then wipe the surface with 75% ethanol, distilled water rinse for 20 s and dry with oil-free air for 20 s; The control group was made of the basic composite bulks of AP-X directly bonding with composite P60. Cut each resin block into 1 mm×1 mm×14 mm sticks, observing the micro-structures and detecting the micro-tensile strength of the resin composite interfaces. The bonding strength was measured using micro-tensile tester, then calculated and statistically analyzed by one-way ANOVA.

RESULTS

Scanning electronic microscope observation revealed that the control group as well as the direct bonding subgroups, two different resin tags were in good contact with each other. The saliva contamination subgroups had lots of gaps or craters, indicating saliva might have been trapped in the composite buildup and wiping the surface with 75% ethanol had no effect. The micro-tensile bond strength of the control group was (84.07±1.57) MPa and significantly higher than all the other 3 experimental subgroups(P<0.001). In experimental groups, the micro-tensile strength of 3 subgroups was (76.08±2.42) MPa, (70.98±2.33) MPa and (71.08±2.33) MPa, respectively. The saliva contamination subgroup was significant lower than the direct bonding subgroup(P<0.001), but no statistical significance with the ethanol wiping subgroup(P=0.893).

CONCLUSION

The bond strength of inner polymerization of resin-resin was greater, but decreased after resin composites interfacial bonding. Saliva contamination reduced the tensile bond strength between resin composites surface, wiping the surface with 75% ethanol had no effect.

[Coronary Angiography in Isolated Hearts and Its Forensic Application]

OBJECTIVES

To check the isolated heart by coronary angiography to discover the location, nature and degree of the coronary artery lesions more accurately and increase the comprehensive evaluation ability of cardiovascular disease.

METHODS

Ten fresh isolated hearts with different causes of death were extracted and injected with barium sulphate as contrast substance by ring injector, then developed under Xper FD20 angiography equipment. The obtained pictures and image data were handled by three-dimensional angiography images with the software attached to the angiography equipment. The coronary artery tissues were HE stained and observed by microscope. The HE staining results were compared with the angiographic results.

RESULTS

The imaging data obtained from the 10 cases for examination showed 8 cases without coronary artery stenosis and 2 cases with Ⅲ, Ⅳ coronary artery stenosis, which were consistent with HE staining results of coronary artery organization and the both results were confirmed.

CONCLUSIONS

Isolated coronary angiography has an unique advantage for accurate grading of classification of coronary artery stenosis, examination of vascular malformation and tiny lesions, which can provide reference for the localization of small lesions and basis during the autopsy for identification conclusion.

Utilization of corncob acid hydrolysate for bacterial cellulose production by Gluconacetobacter xylinus

In this study, corncob acid hydrolysate was used as a substrate for bacterial cellulose (BC) production by Gluconacetobacter xylinus. After 2 weeks' static fermentation, a BC yield of 4 g/L could be obtained. Both effects of medium composition and fermentation condition on the BC production were evaluated. Most extra substrates (carbon and nitrogen sources) except mannitol, butyric acid, and levulinic acid showed no effect on the improvement of BC yield. Fermentation condition including fermentation mode, inoculation concentration, and initial pH showed certain influence on the BC yield and thus should be well controlled. The analysis by field emission scanning electron microscope (FE-SEM), Fourier transform infrared spectroscopy (FTIR), and X-ray diffraction (XRD) showed that the BC sample had obvious nano-network structure, clear functional groups that were found in cellulose, and relatively high crystallinity and crystallinity index value. Moreover, the BC sample had great water-holding capacity. Overall, corncob acid hydrolysate could be one promising substrate for BC production.

ZIP4, a novel determinant of tumor invasion in hepatocellular carcinoma, contributes to tumor recurrence after liver transplantation

BACKGROUND AND PURPOSE

Recently, evidence that Zinc transporter ZRT/IRT-like protein 4 (ZIP4) is involved in invasiveness and apoptosis has emerged in pancreatic cancer and prostate cancer. Our aim was to assess the role of ZIP4 in invasiveness, migration and apoptosis of hepatocellular carcinoma (HCC). The prognostic value of ZIP4 in HCC after liver transplantation was evaluated.

METHODS

The role of ZIP4 in HCC was investigated by overexpressing ZIP4 in BEL7402 and HepG2 cells and inhibiting ZIP4 in HuH-7 and HepG2 cells, using overexpression and shRNA plasmids in vitro studies. Immunohistochemical analysis was used to evaluate ZIP4 expression in HCC tissues from 60 patients undergoing liver transplantation, 36 cirrhotic tissue samples, and 6 normal tissue samples. Prognostic significance was assessed using the Kaplan-Meier method and the log-rank test.

RESULTS

Specific suppression of ZIP4 reduced cell migration and invasiveness, whereas ZIP4 overexpression caused increases in cell migration and invasiveness. Furthermore, overexpression of ZIP4 resulted in increased expression of pro-metastatic genes (MMP-2, MMP-9) and decreased expression of pro-apoptotic genes (caspase-3, caspase-9, Bax). In contrast, suppression of ZIP4 resulted in an opposite effect. ZIP4 was more highly expressed in tumor tissues than non-tumor tissues (P < 0.0001). ZIP4 expression was significantly associated with tumor recurrence (P = 0.002), tumor node metastasis stage (P = 0.044), Child-Turcotte-Pugh score (P = 0.042), and tumor size (P = 0.022). Univariate analysis showed that ZIP4 expression was significantly associated with overall survival (P = 0.020) and tumor-free survival (P = 0.049). Multivariate analysis revealed that ZIP4 was an independent predictor of overall survival (P = 0.037) after liver transplantation.

CONCLUSIONS

ZIP4 could promote migration, invasiveness, and suppress apoptosis in hepatocellular carcinoma, and represent a novel predictor of poor prognosis and therapeutic target for patients with HCC who undergo liver transplantation.

Beneficial Effect of Acetic Acid on the Xylose Utilization and Bacterial Cellulose Production by Gluconacetobacter xylinus

In this work, acetic acid was found as one promising substrate to improve xylose utilization by Gluconacetobacter xylinus CH001. Also, with the help of adding acetic acid into medium, the bacterial cellulose (BC) production by G. xylinus was increased significantly. In the medium containing 3 g l(-1) acetic acid, the optimal xylose concentration for BC production was 20 g l(-1). In the medium containing 20 g l(-1) xylose, the xylose utilization and BC production by G. xylinus were stimulated by acetic acid within certain concentration. The highest BC yield (1.35 ± 0.06 g l(-1)) was obtained in the medium containing 20 g l(-1) xylose and 3 g l(-1) acetic acid after 14 days. This value was 6.17-fold higher than the yield (0.21 ± 0.01 g l(-1)) in the medium only containing 20 g l(-1) xylose. The results analyzed by FE-SEM, FTIR, and XRD showed that acetic acid affected little on the microscopic morphology and physicochemical characteristics of BC. Base on the phenomenon observed, lignocellulosic acid hydrolysates (xylose and acetic acid are main carbon sources present in it) could be considered as one potential substrate for BC production.

Effects of loop electrosurgical excision procedure or cold knife conization on pregnancy outcomes

PURPOSE

To explore the effects of cervical loop electrosurgical excision procedure (LEEP) or cold knife conization (CKC) on pregnancy outcomes.

MATERIALS AND METHODS

Patients with cervical intraepithelial neoplasia (CIN) who wanted to become pregnant and received LEEP or CKC were considered as the treatment groups. Women who wanted to become pregnant and only underwent colposcopic biopsy without any treatments were considered as the control group. The pregnancy outcomes were observed and compared in the three groups.

RESULTS

Premature delivery rate was higher (p = 0.048) in the CKC group (14/36, 38.88%) than in control group (14/68, 20.5%) with a odds ratio (OR) of 2.455 (1.007 - 5.985); and premature delivery was related to cone depth, OR was significantly increased when the cone depth was more than 15 mm. There was no significant difference in premature delivery between LEEP (10 / 48, 20.83%) and the control groups. The average gestational weeks were shorter (p = 0.049) in the CKC group (36.9 +/- 2.4) than in the control group (37.8 +/- 2.6), but similar in LEEP (38.1 +/- 2.4) and control groups. There were no significant differences in cesarean sections between the three groups. The ratio of neonatal birth weight less than 2,500 g was significantly higher (p = 0.005) in the CKC group (15/36) than in the control group (10/68), but similar in the LEEP and control groups.

CONCLUSION

Compared with CKC, LEEP is relatively safe. LEEP should be a priority in the treatment of patients with CIN who want to become pregnant.

Major influence of renal function on hyperlipidemia after living donor liver transplantation

AIM: To investigate the impact of renal and graft function on post-transplant hyperlipidemia (PTHL) in living donor liver transplantation (LDLT).

METHODS: A total of 115 adult patients undergoing LDLT from January 2007 to May 2009 at a single center were enrolled. Data were collected and analyzed by the China Liver Transplant Registry retrospectively. PTHL was defined as serum triglycerides ≥ 150 mg/dL or serum cholesterol ≥ 200 mg/dL or the need for pharmacologic treatment at the sixth month after LDLT. Early renal dysfunction (ERD) was defined as serum creatinine ≥ 2 mg/dL and/or the need for renal replacement therapy in the first post-transplant week.

RESULTS: In 115 eligible patients, the incidence of PTHL was 24.3%. Recipients with PTHL showed a higher incidence of post-transplant cardiovascular events compared to those without PTHL (17.9% vs 4.6%, P = 0.037). Serum creatinine showed significant positive correlations with total serum triglycerides, both at post-transplant month 1 and 3 (P < 0.01). Patients with ERD had much higher pre-transplant serum creatinine levels (P < 0.001) and longer duration of pre-transplant renal insufficiency (P < 0.001) than those without ERD. Pre-transplant serum creatinine, graft-to-recipient weight ratio, graft volume/standard liver volume ratio, body mass index (BMI) and ERD were identified as risk factors for PTHL by univariate analysis. Furthermore, ERD [odds ratio (OR) = 9.593, P < 0.001] and BMI (OR = 6.358, P = 0.002) were identified as independent risk factors for PTHL by multivariate analysis.

CONCLUSION: Renal function is closely associated with the development of PTHL in LDLT. Post-transplant renal dysfunction, which mainly results from pre-transplant renal insufficiency, contributes to PTHL.

FOXC1 contributes to microvascular invasion in primary hepatocellular carcinoma via regulating epithelial-mesenchymal transition

The existence of microvascular invasion (MVI) formation is one of the most important risk factors predicting poor outcome in hepatocellular carcinoma (HCC) and its mechanism remains largely unknown. Epithelial-Mesenchymal Transition (EMT) has been suggested to be involved in many steps of the invasion-metastasis cascade. To elucidate the possible contribution of EMT to MVI, we initially evaluated the expression of 8 EMT-related transcription factors (TFs) in HCC patients with or without MVI and found that FOXC1 expression was significantly higher in patients with MVI than those without MVI (P < 0.05). Knockdown of FOXC1 expression in HCC cells resulted in a partial conversion of their EMT progresses, mainly regulating the mesenchymal component. Ectopic expression of snail, twist or TGF-β1 could induce expression of FOXC1, but none of the expression of snail, twist, slug or TGF-β was consistently down-regulated in response to FOXC1 silencing, suggesting FOXC1 might operate the downstream of other EMT regulators. In addition, knockdown of FOXC1 expression led to cytoskeleton modification accompanied by decreased ability of cell proliferation, migration, and invasion. Meanwhile, some matrix metalloproteinases (MMPs) and VEGF-A were also simultaneously down-regulated. Together, our findings demonstrate that FOXC1 is one of candidate predictive markers of MVI, and that inhibition of FOXC1 expression can partially reverse EMT program, offering a potential molecular therapeutic target for reducing tumor metastasis in HCC patients.

Effect of Zn impurity in K0.8Fe(2-δ-x)Zn(x)Se2

A series of K(0.8)Fe(2-δ-x)Zn(x)Se(2) single-crystal samples with nominal compositions 0 ≤ x ≤ 0.05 were grown and their physical properties were measured in order to study the effect of Zn impurity. It is found that the Zn impurity (x ≤ 0.02) does not affect the superconducting transition temperature T(c) significantly. Meanwhile the hump in resistivity which corresponds to the transition from the insulating to metallic phase quickly shifts towards low temperatures. The results imply that there should be a phase separation in this system and Zn impurity causes the enhancement of the insulating phase. The negligible effect of Zn impurity on T(c) suggests an s-wave pairing in the superconducting phase. Meanwhile there is a possibility that the Zn impurity may selectively enter into the insulting phase.

A study of molecular epidemiology of adenovirus of types 3 and 7 on infant pneumonia in northern China

This paper analysed 102 strains of adenovirus types 3(Ad3) and 7(Ad7) causing infant pneumonia from 1976 to 1988 in northern China. Two genotypes of Ad7, 7b and 7d, were identified by using restriction endonucleases, BamHI, BcLI, BgLI, SmaI, XbaI and HindIII. 3 genotypes of Ad3, 3I, 3II and 3III, were identified by using BgLII and BamHI. Of 56 Ad7 strains, 34 were 7b (76.8%) spread over last 10 years; 13 7d(23.2%) occurred from 1982, together with 7b. Of 46 Ad3 strains, 42 3I(91.3%) spread over the past 12 years. 3II and 3III scattered all over these years. Ad3I and Ad7b were the dominant genotypes. The results indicated that Ad7d tended to increase with time from 1982. It is possible that Ad7d will become dominant genotype and replace Ad7b.

Identification of the types of adenovirus isolates with monoclonal antibodies

The types of 59 isolates of adenovirus (Adv) which were isolated between winter, 1984 and spring, 1986 were identified by type-specific monoclonal antibodies (McAb) against Adv types 3 and 7. The results showed that the method could not only identify the types of Adv, but also discover the changes of their subtypes with time. The tedious neutralization test can be replaced by this simple method.