[Association between obesity and risk for all-cause mortality in patients with type 2 diabetes]

Objective: To investigate the association between obesity and the risk for all-cause mortality in type 2 diabetes (T2DM) patients. Methods: The participants were from a rural community-based T2DM patient cohort in Zhejiang Province. The study used the data collected from baseline survey in 2016 and follow-up until December 31, 2021. A total of 10 310 participants were included, excluding those who were lost in follow-up or had incomplete data in follow-up. According to BMI and waist circumference, the study subjects were divided into 6 groups: low body weight, normal body weight, simple abdominal obesity, simple body obesity, complex overweight and complex obesity. Cox proportional hazards regression model was used to analyze hazard ratios (HRs) of all-cause mortality and their 95%CIs in T2DM patients with different obesity status. Results: The cumulative follow-up period was 57 049.47 person-years with an average follow-up of (5.53±0.89) person-years. During this period, 971 subjects died. The death density was 1 702.03/100 000 person-years. After adjusting for confounders, low-weight patients had a 104% increased risk for all-cause death compared with normal-weight patients (HR=2.04, 95%CI:1.42-2.92). The risk for all-cause death decreased by 34% (HR=0.66, 95%CI: 0.53-0.82), 22% (HR=0.78,95%CI: 0.66-0.92), 38% (HR=0.62, 95%CI: 0.49-0.78) in the patients with simple body obesity, complex overweight and complex obesity, respectively, there was no significant difference for all-cause death in the patients with simple abdominal obesity alone. In subgroup analysis, the risk of all-cause mortality increased in low-weight T2DM patients of different sexes and ages, the mortality risk in women with complex obesity was 50% lower than that in the women with normal body weight, but there was no significant difference in men in the comparison between complex obesity group and normal body weight group. The risk for all-cause mortality was significantly lower in ≥65 years old patients with simple body obesity, complex overweight and complex obesity than in patients with normal body weight (HR=0.61, 95%CI: 0.48-0.78; HR=0.76, 95%CI: 0.63-0.91; HR=0.56,95%CI: 0.42-0.73), there was no significant difference in the patients aged <65 years. There was no significant change in sensitivity analysis. Conclusions: There was an "obesity paradox" in the risk for all-cause mortality in T2DM patients. The risk of all-cause mortality in the low-weight patients was significantly higher than that in normal-weight patients, and the risk for death in the patients with simple body obesity or complex overweight and obesity were significantly lower.

Association between metabolic syndrome severity score and cardiovascular disease: results from a longitudinal cohort study on Chinese adults

Objective

This study aimed to quantify the severity of metabolic syndrome(MetS) and investigate its association with cardiovascular disease(CVD) risk on Chinese adults.

Methods

13,500 participants from the Zhejiang Adult Chronic Disease Study were followed up between 2010 and 2021. A continuous MetS severity score derived from the five components of MetS was used to quantify MetS severity, and the association between MetS severity and the risk of incident CVD was assessed using Cox proportional hazard and restricted cubic spline regression.

Results

Both the presence and severity of MetS were strongly associated with CVD risk. MetS was related to an increased risk of CVD (hazard ratio(HR):1.700, 95% confidence interval(CI): 1.380-2.094). Compared with the hazard ratio for CVD in the lowest quartile of the MetS severity score, that in the second, third, and highest quartiles were 1.812 (1.329-2.470), 1.746 (1.265-2.410), and 2.817 (2.015-3.938), respectively. A linear and positive dose-response relationship was observed between the MetS severity and CVD risk (P for non-linearity = 0.437). Similar results were found in various sensitivity analyses.

Conclusion

The MetS severity score was significantly associated with CVD risk. Assessing MetS severity and further ensuring intervention measures according to the different severities of MetS may be more useful in preventing CVD.

Association between glycated hemoglobin and risk of all-cause mortality in community patients with type 2 diabetes: A prospective cohort study

AIMS/INTRODUCTION

To analyze the association between HbA1c level and the risk of all-cause mortality in community patients with type 2 diabetes mellitus, and to provide a scientific basis for the management of type 2 diabetes mellitus in the community.

MATERIALS AND METHODS

Based on a Zhejiang rural community type 2 diabetes mellitus cohort, a total of 10,310 patients with type 2 diabetes mellitus with complete baseline and follow-up data were selected. The Cox proportional hazards regression model and the restricted cubic spline model were used to evaluate the relationship between the HbA1c level and the risk of all-cause mortality.

RESULTS

During a mean follow-up of 5.5 years, 971 patients died. With HbA1c levels of 6.5-7.0% as the reference, after adjusting for relevant confounding factors, the HR(95%CI) of all-cause mortality with HbA1c levels of <5.5%, 5.5-6.5%, 7.0-8.0%, 8.0-9.0%, and ≥9.0% were 1.53 (1.08-2.15), 0.97 (0.79-1.21), 1.14 (0.92-1.41), 1.44 (1.14-1.83), and 2.08 (1.68-2.58), respectively. The HbA1c level was associated with the risk of all-cause mortality in a "J-shaped" manner. The risk of all-cause mortality was lowest when the HbA1c was 6.5-7.0%, and increased significantly when the HbA1c was ≥ 8.0% and the HbA1c was < 5.5% (P < 0.05). The risk of all-cause death in the HbA1c 5.5-6.5% group and the 7.0-8.0% group was not significant compared with the reference group (P > 0.05).

CONCLUSIONS

The HbA1c levels were associated with the risk of all-cause mortality in type 2 diabetes mellitus in a "J-shaped" manner, a too high or a too low HbA1c level could increase the risk of death. Attention should be paid to the individual evaluation of patients and the setting of appropriate glycemic control goals.

Establishment of lactate-metabolism-related signature to predict prognosis and immunotherapy response in patients with colon adenocarcinoma

The outcome of colon adenocarcinoma (COAD) patients remains dismal, and lactate metabolism has been characterized to promote tumor development and immune evasion. Based on the above background, it is worthwhile to explore novel prognostic and therapeutic biomarkers for COAD patients from the aspect of lactate metabolism. Above all, 228 available lactate-metabolism-related genes (LMRGs) were acquired, and the landscape of copy number variation and the expression difference of mRNA levels between colon normal and tumor samples were investigated among these LMRGs. Importantly, eight overall survival (OS)-involved LMRGs were then distinguished by means of univariate Cox regression analysis in both GSE40967 and TCGA-COAD data sets. Subsequently, prognostic risk scores were established, integrating seven OS-related LMRGs by LASSO Cox regression analysis in the GSE40967 set, and then verified in the TCGA-COAD cohort. From the comprehensive analyses, COAD patients with high risk had comparatively more inferior survival probability in all populations of the study, and they tended to have more severe clinicopathological features with the risk score increasing. Moreover, by integrating age, AJCC T and pathological stage, and risk score, we constructed a prognostic nomogram that demonstrated great prediction effectiveness for OS of COAD patients. Furthermore, the potential effect of various risk score on tumor immune was assessed from enrichment of immune-related pathways, tumor-infiltrating immune cells, and expression levels of immune checkpoints separately. We could draw a conclusion that COAD patients with higher lactate-metabolism-related risk scores may acquire an immunosuppressive tumor microenvironment, which subsequently led to immune escapes and poor prognoses. Conclusively, all findings in the present study illustrate a great prognostic value of the lactate-metabolism-related risk signature, providing more in-depth insights into the indispensable function of lactate metabolism in prognosis and tumor immunity of COAD.

Circulating microRNAs (miR-16, miR-22, miR-122) expression and early diagnosis of hepatocellular carcinoma

Purpose

Circulating microRNA (miRNA) has been reported to have diagnostic value in multiple tumors. To identify serum miRNAs for early diagnosis of hepatocellular carcinoma (HCC), we analyzed the differential miRNA expression between HCC patients and controls.

Methods

Real‐time reverse transcription polymerase chain reaction (RT‐PCR) was carried out to detect serum miR‐16, miR‐22, and miR‐122 expression in 100 HCC patients and 100 controls (including hepatitis B, liver cirrhosis, liver metastases, hepatic hemangioma, health group, and each of them had 20 subjects). The miRNA expression results were combined with alpha‐fetoprotein (AFP) to evaluate the diagnostic efficacy in HCC through receiver operating characteristic (ROC) curve. And the target genes were predicted through bioinformatics methods.

Results

Compared with controls, the expression of miR‐16 and miR‐122 significantly increased in early‐stage HCC patients, while no significant changes were detected in miR‐22. The ROC curve analysis demonstrated that miR‐16 and miR‐122 had a high diagnostic efficacy (AUC 0.798 and 0.759), and it was improved when combined with AFP (AUC 0.862). When compared with each of the five groups in the controls, the results showed that miR‐16 of HCC was significantly higher than liver cirrhosis (AUC 0.936), liver metastases, and health; miR‐122 was significantly higher than liver metastases, hepatitis B, and health. Moreover, 175 and 101 potential target genes were regulated by miR‐16 and miR‐122, respectively. And most of the target genes were enriched in the PI3K, MAPK, FoxO signaling pathways, and pathways in cancer.

Conclusion

Our findings illustrate that both circulating miR‐16 and miR‐122 can provide value for early diagnosis of HCC and they are potential biomarkers for the early‐stage HCC.

LINC00630 promotes cholangiocarcinoma cell proliferation, migration and invasion by mediating the miR-199a/FGF7 axis

Cholangiocarcinoma (CCA) is a type of cancer with a relatively low morbidity, but poor prognosis. Aberrant long non-coding RNA (lncRNA) expression has been observed in the pathological development of CCA. In the present study, lncRNA long intergenic non-protein coding RNA 630 (LINC00630) was found to be significantly upregulated in CCA tissues and cultured cells. LINC00630 expression was positively associated with histological differentiation, TNM stage and lymph node invasion. Short hairpin RNA (sh)-LINC00630 transfection could effectively decrease CCA cell proliferation, migration and invasion. Further investigations found that LINC00630 could interact with microRNA (miR)-199a, which specifically targeted fibroblast growth factor 7 (FGF7) for degradation. FGF7 overexpression restored the sh-LINC00630 transfection-induced decrease in CCA cell proliferation, migration and invasion. In conclusion, LINC00630 significantly promoted CCA cell proliferation, migration and invasion by upregulating FGF7 through miR-199a sponging.

Prospective study: Aldehyde dehydrogenase 2 gene is associated with cardio-cerebrovascular complications in type 2 diabetes patients

AIMS/INTRODUCTION

Most studies have shown that aldehyde dehydrogenase 2 (ALDH2) mutations were associated with cardio-cerebrovascular complications of diabetes based on cross-sectional investigations, but few studies based on cohorts were carried out. The aim of this study was to explore the correlation between the ALDH2 gene and the occurrence of and death from cardio-cerebrovascular complications in type 2 diabetes patients through a prospective cohort study.

MATERIALS AND METHODS

According to a community-based and disease-based prospective cohort study design, a baseline cohort of 10,339 persons with type 2 diabetes was established in 2016, and the occurrence of and death from cardio-cerebrovascular complications were followed up until December 2018. A total of 2,500 diabetes patients without cardio-cerebrovascular complications were randomly selected from the baseline cohort to detect the rs671 polymorphism of the ALDH2 gene. Cox regression analysis was carried out on the effect of different ALDH2 rs671 single-nucleotide polymorphisms on the risk and survival time of cardio-cerebrovascular complications among diabetes patients.

RESULTS

There were 215 cardio-cerebrovascular complications, including 10 deaths, that occurred in the 2,500 diabetes patients during the follow-up period. Cox regression analysis showed that rs671 GA/AA genotype, sex (male), poor control of high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, blood pressure and glycated were risk factors, whereas drinking alcohol was a protective factor for cardio-cerebrovascular complications (P < 0.05). After adjusting for age and sex, the risk of the rs671 GA/AA genotype was 1.314-fold (95% confidence interval 1.000-1.727) that of the GG genotype.

CONCLUSION

The G-A mutation of ALDH2 rs671 is a risk factor for the occurrence of and death from cardio-cerebrovascular complications in type 2 diabetes patients. Further studies with larger cohorts and longer follow up will be necessary to reveal a consensus.

Escherichia coli AraJ boosts utilization of arabinose in metabolically engineered cyanobacterium Synechocystis sp. PCC 6803

Lignocellulosic biomass can serve as an inexpensive and renewable source of carbon for the biosynthesis of commercially important compounds. L-arabinose is the second most abundant pentose sugar present in the plant materials. Model cyanobacterium Synechocystis sp. PCC 6803 is incapable of catabolism of L-arabinose as a source of carbon and energy. In this study, all the heterologous genes expressed in Synechocystis were derived from Escherichia coli K-12. Initially we constructed four Synechocystis strains that expressed AraBAD enzymes involved in L-arabinose catabolism, either in combination with or without one of the three arabinose transporters, AraE, AraFGH or AraJ. Among the recombinants, the strain possessing AraJ transporter was observed to be the most efficient in terms of dry biomass production and L-arabinose consumption. Later, an additional strain was generated by the expression of AraJ in the AraE-possessing strain. The resultant strain was shown to be advantageous over its parent. This study demonstrates that AraJ, a protein with hitherto unknown function plays a role in the uptake of L-arabinose to boost its catabolism in the transgenic Synechocystis strains. The work also contributes to the current knowledge regarding metabolic engineering of cyanobacteria for the utilization of pentose sugars.

BCDnet: Parallel heterogeneous eight-class classification model of breast pathology

Breast cancer is the cancer with the highest incidence of malignant tumors in women, which seriously endangers women's health. With the help of computer vision technology, it has important application value to automatically classify pathological tissue images to assist doctors in rapid and accurate diagnosis. Breast pathological tissue images have complex and diverse characteristics, and the medical data set of breast pathological tissue images is small, which makes it difficult to automatically classify breast pathological tissues. In recent years, most of the researches have focused on the simple binary classification of benign and malignant, which cannot meet the actual needs for classification of pathological tissues. Therefore, based on deep convolutional neural network, model ensembleing, transfer learning, feature fusion technology, this paper designs an eight-class classification breast pathology diagnosis model BCDnet. A user inputs the patient's breast pathological tissue image, and the model can automatically determine what the disease is (Adenosis, Fibroadenoma, Tubular Adenoma, Phyllodes Tumor, Ductal Carcinoma, Lobular Carcinoma, Mucinous Carcinoma or Papillary Carcinoma). The model uses the VGG16 convolution base and Resnet50 convolution base as the parallel convolution base of the model. Two convolutional bases (VGG16 convolutional base and Resnet50 convolutional base) obtain breast tissue image features from different fields of view. After the information output by the fully connected layer of the two convolutional bases is fused, it is classified and output by the SoftMax function. The model experiment uses the publicly available BreaKHis data set. The number of samples of each class in the data set is extremely unevenly distributed. Compared with the binary classification, the number of samples in each class of the eight-class classification is also smaller. Therefore, the image segmentation method is used to expand the data set and the non-repeated random cropping method is used to balance the data set. Based on the balanced data set and the unbalanced data set, the BCDnet model, the pre-trained model Resnet50+ fine-tuning, and the pre-trained model VGG16+ fine-tuning are used for multiple comparison experiments. In the comparison experiment, the BCDnet model performed outstandingly, and the correct recognition rate of the eight-class classification model is higher than 98%. The results show that the model proposed in this paper and the method of improving the data set are reasonable and effective.

[Association between body mass index changes and other risk factors for cardiovascular disease in patients with type 2 diabetes mellitus]

Objectives: To investigate the association between body mass index (BMI) changes and other risk factors for cardiovascular disease in patients with type 2 diabetes mellitus (T2DM). Methods: Based on the T2DM cohort in rural communities of Zhejiang province, baseline and follow up information of height, weight, blood pressure, glycated hemoglobin (HbA1c), TC, TG, LDL-C and HDL-C of the T2DM patients were collected. After excluding those who died during the follow-up period, lost follow-up or had incomplete information, a total of 8 953 T2DM patients were included in the final analysis. Multiple linear regression and Cox proportional hazards regression models were used for analysis. Results: At baseline survey, 40.97% of the T2DM patients were overweight and obese. Compared with those with normal BMI, the SBP, DBP and TG level were significantly higher, while HDL-C level was significantly lower in the overweight and obese T2DM patients (P<0.01). During the follow-up period, the blood glucose control rate in the patients increased by 15%, and the levels of HbA1c decreased in the patients with different BMI changes at different degrees. Compared with the patients who kept normal BMI, the HbA1c level decrease had a smaller range, while the SBP and DBP increase had a larger range in the patients with persistent overweight and obesity, and their substandard rates of HbA1c, SBP, DBP, TG, HDL-C levels were 1.142 (1.057-1.233) times, 1.123 (1.055-1.196) times, 1.220 (1.128-1.320) times, 1.400 (1.282-1.528) times and 1.164 (1.069-1.267) times higher. The changes of blood pressure, blood lipids and other related indicators in the patients whose BMI became abnormal were similar to those of the patients with persistent overweight and obesity; Compared with the patients whose BMI were kept normal, the differences in changes and substandard rate of blood glucose level, blood pressure level in the patients whose BMI became normal were not significant (P>0.05). The change value of BMI was positively correlated with the change value of SBP, DBP, TG and LDL-C, while negatively correlated with the change value of HDL-C (P<0.05). Conclusions: Abnormal changes in BMI are associated with the adverse changes of blood glucose level, blood pressure, and blood lipids level and other cardiovascular disease risk factors. Keeping normal BMI would benefit the positive outcome of cardiovascular adverse factors.

Response of the microbial community to phosphate-solubilizing bacterial inoculants on Ulmus chenmoui Cheng in Eastern China

Phosphate-solubilizing bacteria (PSB) have beneficial effects on plant health and soil composition. To date, studies of PSB in soil have largely been performed under field or greenhouse conditions. However, less is known about the impact of introducing indigenous PSB in the field, including their effects on the local microbial community. In this study, we conducted greenhouse and field experiments to explore the effects of the addition of indigenous PSB on the growth of Chenmou elm (Ulmus chenmoui) and on the diversity and composition of the bacterial community in the soil. We obtained four bacterial isolates with the highest phosphate-solubilizing activity: UC_1 (Pseudomonas sp.), UC_M (Klebsiella sp.), UC_J (Burkholderia sp.), and UC_3 (Chryseobacterium sp.). Sequencing on the Illumina MiSeq platform showed that the inoculated PSB did not become the dominant strains in the U. chenmoui rhizosphere. However, the soil bacterial community structure was altered by the addition of these PSB. The relative abundance of Chloroflexi decreased significantly in response to PSB application in all treatment groups, whereas the populations of several bacteria, including Proteobacteria and Bacteroidetes, increased. Network analysis indicated that Chloroflexi was the most strongly negatively correlated with Proteobacteria, whereas Proteobacteria was strongly positively correlated with Bacteroidetes. Our findings indicate that inoculation with PSB (UC_1, UC_M, UC_J, and UC_3) can improve the growth of U. chenmoui and regulate its rhizosphere microbial community. Therefore, inoculation with these bacterial strains could promote the efficient cultivation and production of high-quality plant materials.

Blue rubber bleb nevus syndrome with the complication of intussusception: A case report and literature review

RATIONALE

Blue rubber bleb nevus syndrome (BRBNS) is an extremely rare disorder characterized by multifocal venous malformations involving various organs such as the skin and gastrointestinal tract. Severe complications of BRBNS, such as intussusception, volvulus, and intestinal infarction are rarer and require surgery. This report describes a 33-year-old male of BRBNS complicated with intussusception that was successfully diagnosed and treated with surgery.

PATIENT CONCERNS

A 33-year-old Chinese man presented with persistent, colicky pain accompanied by nausea, abdominal distension, and dizziness. The patient presented with sporadic bluish nodules on his skin involving his head, neck, thorax, abdomen, and planta pedis.

DIAGNOSES

BRBNS with the complication of intussusception.

INTERVENTIONS

An emergency laparotomy was performed, and postoperative management included blood transfusions and oral iron supplementation for 2 weeks.

OUTCOMES

The patient's postoperative course of hospitalization was uneventful. During the 4-month follow-up, the patient showed no signs of intussusception recurrence.

LESSONS

Patients diagnosed with BRBNS who present with acute abdominal pain and distension should raise suspicion for the presence of intussusception, which requires emergent surgical intervention.

Dietary mannan oligosaccharide ameliorates cyclic heat stress-induced damages on intestinal oxidative status and barrier integrity of broilers

This study investigated protective effects of mannan oligosaccharide (MOS) inclusion on growth performance, intestinal oxidative status, and barrier integrity of cyclic heat-stressed broilers. A total of 240 one-day-old chicks were allocated into 3 treatments of 10 replicates each. Control broilers reared at a thermoneutral temperature were fed a basal diet, whereas broilers in heat stress and MOS groups raised at a cyclic high temperature (32 to 33°C for 8 h/d) were given the basal diet supplemented with 0 or 250 mg/kg MOS, respectively. Compared with control group, heat stress decreased (P < 0.05) average daily gain and feed conversion ratio during grower, finisher, and entire periods, average daily feed intake during finisher and entire periods, and ileal superoxide dismutase activity at 42 D, whereas increased (P < 0.05) rectal temperature at 21 and 42 D and jejunal malondialdehyde content at 42 D. Dietary MOS increased (P < 0.05) average daily gain, average daily feed intake, and feed conversion ratio during finisher and entire periods, but decreased (P < 0.05) jejunal malondialdehyde concentration of heat-stressed broilers at 42 D. Heat stress decreased (P < 0.05) jejunal villus height (VH) and claudin-3 gene expression at 21 D, and VH and VH: crypt depth (CD) ratio in jejunum and ileum as well as mRNA abundances of jejunal mucin 2 and occludin, and ileal mucin 2, zonula occludens-1, and occludin, and claudin-3 at 42 D, whereas increased (P < 0.05) serum D-lactate acid content at 21 and 42 D, and serum diamine oxidase activity and jejunal CD at 42 D. The MOS supplementation increased (P < 0.05) jejunal VH at 21 D, VH and VH: CD of jejunum and ileum at 42 D, mRNA abundances of jejunal occludin and ileal mucin 2, zonula occludens-1, and occludin at 42 D, whereas reduced (P < 0.05) ileal CD at 42 D. These results suggested that MOS improved growth performance, and oxidative status and barrier integrity in the intestine of broilers under cyclic heat stress.

Analysis of differential expression profile of miRNA in peripheral blood of patients with lung cancer

PURPOSE

To identify potential molecular targets for lung cancer intervention and diagnosis, we analyzed the differential miRNA expression of peripheral blood between lung cancer patients and healthy controls.

METHODS

Three pairs of cases' and controls' peripheral blood samples were evaluated for miRNA expression by microarray. 12 miRNAs were selected for RT-PCR validation and target genes prediction. In addition, 4 miRNAs were selected for future validation by RT-PCR in a large sample of 145 cases and 55 frequency-matched healthy controls.

RESULTS

A total of 338 differentially expressed miRNAs were screened and identified by microarray. According to the fold changes, the top ten upregulated miRNAs were hsa-miR-124-3p, hsa-miR-379-5p, hsa-miR-3655, hsa-miR-450b-5p, hsa-miR-29a-5p, hsa-miR-200a-3p, hsa-miR-542-3p, hsa-miR-138-5p, hsa-miR-219a-2-3p, and hsa-miR-4701-3p, and the top ten downregulated miRNAs were hsa-miR-34c-5p, hsa-miR-135a-5p, hsa-miR-132-3p, hsa-miR-3178, hsa-miR-4449, hsa-miR-4999-3p, hsa-miR-1246, hsa-miR-4424, hsa-miR-1252-5p, and hsa-miR-24-2-5p. RT-PCR verification of the 12 miRNAs revealed that 5 of 8 upregulated miRNAs, 2 of 4 downregulated miRNAs showed a significant difference between the cases and controls (P < .05). A large number of target genes and their functional set showed overlapping among the 453 predicted target genes of the 12 miRNAs (P < .01). RT-PCR in the large sample confirmed the significant differential expression level of hsa-miR-29a-5p, hsa-miR-135a-5p, hsa-miR-542-3p, and hsa-miR-4491 between cases and controls (P < .05), and three of these microRNA, except hsa-miR-29a-5p, were significant after Bonferroni correction for adjustment of multiple comparisons.

CONCLUSION

There was a significant difference in miRNAs expression in the peripheral blood between lung cancer patients and healthy controls, and 4 miRNAs were validated by a large-size sample.

Synthetic Biology Approaches to the Sustainable Production of p-Coumaric Acid and Its Derivatives in Cyanobacteria

The photosynthetic cyanobacteria are promising candidates for the sustainable production of a plethora of plant secondary metabolites, which are beneficial to human health but are difficult to produce and purify in other systems. This chapter focuses on genetic engineering of Synechocystis PCC 6803 for production of p-coumaric acid and its derivatives. Cyanobacterial engineering approaches are briefly reviewed. Strategies to increase production yield are discussed, including codon optimization of genes expressing enzymatic proteins and a laccase-coding gene knockout from Synechocystis genome which degrades polyphenols.

Activation of the Oxidative Pentose Phosphate Pathway is Critical for Photomixotrophic Growth of a hik33-Deletion Mutant of Synechocystis sp. PCC 6803

The histidine kinase Hik33 plays a central role in acclimation to changing environments in cyanobacteria. Deletion of hik33 induces a strong stress-like response in Synechocystis sp. PCC 6803 (Synechocystis) as represented by repressed photoautotrophic growth and photosynthesis, and differential expression of stress-responsive proteins. In contrast, the photomixotrophic growth of the hik33-deletion mutant (Δhik33) with glucose as the exogenous carbon source is only marginally repressed. To investigate how glucose rescues the growth of Δhik33, the proteomes of the photomixotrophically growing wild-type (WT) and the mutant strains of Synechocystis are quantitatively analyzed. It is found that glucose induces upregulation of the oxidative pentose phosphate (OPP) pathway. Depletion of glucose-6-phosphate dehydrogenase (G6PDH), which catalyzes the first and the rate-limiting step of the OPP pathway, significantly inhibits the photomixotrophic growth of Δhik33 but not of the WT. The result suggests that the OPP pathway, which is usually nonfunctional in the photomixotrophically growing WT, plays a major role in the photomixotrophic growth of Δhik33.

CYP2E1 and GSTM1 gene polymorphisms, environmental factors, and the susceptibility to lung cancer

OBJECTIVE

To investigate the relationships between the CYP2E1 RsaI polymorphism, GSTM1 polymorphism, and the susceptibility to lung cancer, along with the interactions between environmental factors and these genes.

METHODS

A case-control study was carried out to explore the independent effect of gene polymorphisms on risk of lung cancer, and the combined effects of gene loci. The stratification analysis of age, sex, smoking, and drinking combined with positive loci was also analyzed, and any interaction was identified.

RESULTS

The logistic regression analysis showed that there were statistical relationships between the CYP2E1 RsaI TT genotype and lung cancer, GSTM1 (-) and lung cancer. The combined effect's analysis of these 2 loci showed that, with an increase in the number of risk alleles, the risk of lung cancer also increased (supposing 0 risk allele as the reference group). Subjects carrying 3 risk alleles had the highest risk of developing lung cancer with an adjusted OR = 10.38 (95% CI 2.10-51.35). Stratified analysis showed that, in women, nonsmoking subjects, or nondrinking subjects, the combined effects could increase the risk of lung cancer; no heterogeneity was found between these layers except sex. The interaction analysis showed that, supposing the male, GSTM1 (+) genotype as the reference, the female, GSTM1 (-) genotype had a significantly increased risk of lung cancer (OR = 2.17 [1.01-4.70]); when the non-smoking, GSTM1 (+) genotype subjects was the reference group, smoking, GSTM1 (+) genotype subjects and smoking, GSTM1 (-) genotype subjects had significantly higher risk of lung cancer (OR = 2.00 [1.01-3.96], OR = 2.89 [1.28-6.54]).

CONCLUSION

CYP2E1 RsaI TT genotype was a protective factor against the development of lung cancer, while GSTM1 (-) genotype was a risk factor for lung cancer. Increases in the number of the risk alleles also increased lung cancer risk. GSTM1 (-) genotype, sex, and smoking status might interact in the incidence of lung cancer.

Translating Divergent Environmental Stresses into a Common Proteome Response through the Histidine Kinase 33 (Hik33) in a Model Cyanobacterium

The histidine kinase Hik33 plays important roles in mediating cyanobacterial response to divergent types of abiotic stresses including cold, salt, high light (HL), and osmotic stresses. However, how these functions are regulated by Hik33 remains to be addressed. Using a hik33-deficient strain (Δhik33) of Synechocystis sp. PCC 6803 (Synechocystis) and quantitative proteomics, we found that Hik33 depletion induces differential protein expression highly like that induced by divergent types of stresses. This typically includes downregulation of proteins in photosynthesis and carbon assimilation that are necessary for cell propagation, and upregulation of heat shock proteins, chaperons, and proteases that are important for cell survival. This observation indicates that depletion of Hik33 alone mimics divergent types of abiotic stresses, and that Hik33 could be important for preventing abnormal stress response in the normal condition. Moreover, we found most proteins of plasmid origin were significantly upregulated in Δhik33, though their biological significance remains to be addressed. Together, the systematically characterized Hik33-regulated cyanobacterial proteome, which is largely involved in stress responses, builds the molecular basis for Hik33 as a general regulator of stress responses.

Long noncoding RNA CCAT1 polymorphisms are associated with the risk of colorectal cancer

Colorectal cancer associated transcript 1 (CCAT1) is a novel long noncoding RNA, whose overexpression is evident in both early phase of tumorigenesis and later disease stages in colorectal cancer (CRC). No study has explored the relationship between CCAT1 polymorphisms and CRC risk. In the present study, a case-control study was conducted to investigate the association between CCAT1 polymorphisms and CRC risk in Chinese population. We identified that CCAT1 rs67085638 polymorphism was associated with an increased risk of CRC (OR = 1.72, 95%CI = 1.14-2.58, P = 0.009 in heterozygote codominant model; OR = 1.67, 95%CI = 1.13-2.47, P = 0.010 in dominant model). Moreover, CCAT1 rs7013433 polymorphism was associated with late clinical stage (OR = 1.82, 95%CI = 1.16-2.86, P = 0.009 in heterozygote codominant model; OR = 1.72, 95%CI = 1.13-2.63, P = 0.012 in dominant model). Our finding proposed a link between CCAT1 polymorphisms with CRC risk as well as different clinical stages.

Translating Divergent Environmental Stresses into a Common Proteome Response through Hik33 in a Model Cyanobacterium

The histidine kinase Hik33 plays important roles in mediating cyanobacterial response to divergent types of abiotic stresses including cold, salt, high light (HL), and osmotic stresses. However, how these functions are regulated by Hik33 remains to be addressed. Using a hik33-deficient strain (Δhik33) of Synechocystis sp. PCC 6803 (Synechocystis) and quantitative proteomics, we found that Hik33 depletion induces differential protein expression highly similar to that induced by divergent types of stresses. This typically includes downregulation of proteins in photosynthesis and carbon assimilation that are necessary for cell propagation, and upregulation of heat shock proteins, chaperons, and proteases that are important for cell survival. This observation indicates that depletion of Hik33 alone mimics divergent types of abiotic stresses, and that Hik33 could be important for preventing abnormal stress response in the normal condition. Moreover, we found the majority of proteins of plasmid origin were significantly upregulated in Δhik33, though their biological significance remains to be addressed. Together, the systematically characterized Hik33-regulated cyanobacterial proteome, which is largely involved in stress responses, builds the molecular basis for Hik33 as a general regulator of stress responses.

[Morbidity and mortality of malignant tumor in Zhejiang province, 2014]

OBJECTIVE

To analyze the morbidity and mortality of malignant tumor in Zhejiang province in 2014.

METHODS

The data were collected from Zhejiang provincial chronic disease surveillance system in 2014. The crude rate, age-standardized rate, cumulative rate(0-74 years old), cut rate(35-64 years old), age-specific and area-specific morbidity/mortality as well as the constitution of top 10 leading cancers were then calculated and analyzed. The age-standardized rate was calculated according to the standard population in China in 1982 and the Segi' s world standard population.

RESULTS

The crude morbidity was 348.80/100 000(370.74/100 000 in males and 326.51/100 000 in females). The age-standardized morbidity according to the standard population in China and according to world standard population were 168.84/100 000 and 217.23/100 000 respectively, the cumulative morbidity was 24.66% and the cut morbidity was 376.40/100 000. Age-specific morbidity in age group 0-34 years remained low; however, the morbidity increased obviously in age group ≥35 years, increased more rapidly in age group ≥50 years and finally reached the peak in age group 80-84 years(1 618.20/100 000). The morbidity of malignant tumor, age-standardized morbidity(China standard)and age-standardized morbidity(world standard)were 381.81/100 000, 185.15/100 000 and 236.27/100 000 respectively in urban area, and 330.23/100 000 , 159.47/100 000 and 206.29/100 000, respectively in rural area. The crude mortality was 189.08/100 000(248.57/100 000 in males, 128.72/100 000 in females), and the age-standardized mortality according to China population and world population were 97.56/100 000 and 135.54/100 000 respectively. The cumulative mortality was 15.08%, and the cut mortality was 162.75/100 000. Age-specific mortality increased in age group 45-49 years(92.29/1000 000)and reached the peak in age group ≥85 years(2 263.70/100 000). The mortality was higher in rural area(190.60/100 000)than in urban area(186.38/100 000). The leading cancers were lung cancer, colorectum cancer, thyroid cancer, stomach cancer and liver cancer, accounting for 58.64% of the total. Lung cancer, liver cancer, stomach cancer, colorectum cancer and esophagus cancer were the major cancers causing deaths, accounting for 70.72% of all the total.

CONCLUSION

The leading cancers were lung cancer, colorectum cancer, thyroid cancer, stomach cancer and liver cancer in Zhejiang in 2014, close attention should be paid to thyroid cancer in women. The disease burden of malignant tumor is increasing,it is necessary for health department to take effective measures to reduce the disease burden caused by malignant tumor.

Correction: Associations of ACE Gene Insertion/Deletion Polymorphism, ACE Activity, and ACE mRNA Expression with Hypertension in a Chinese Population

[This corrects the article DOI: 10.1371/journal.pone.0075870.].

Metabolic Engineering and Comparative Performance Studies of Synechocystis sp. PCC 6803 Strains for Effective Utilization of Xylose

Wood sugars such as xylose can be used as an inexpensive carbon source for biotechnological applications. The model cyanobacterium Synechocystis sp. PCC 6803 lacks the ability to catabolize wood sugars as an energy source. Here, we generated four Synechocystis strains that heterologously expressed XylAB enzymes, which mediate xylose catabolism, either in combination with or without one of three xylose transporters, namely XylE, GalP, or Glf. Except for glf, which is derived from the bacterium Zymomonas mobilis ZM4, the heterologous genes were sourced from Escherichia coli K-12. All of the recombinant strains were able to utilize xylose in the absence of catabolite repression. When xylose was the lone source of organic carbon, strains possessing the XylE and Glf transporters were most efficient in terms of dry biomass production and xylose consumption and the strain lacking a heterologous transporter was the least efficient. However, in the presence of a xylose-glucose mixed sugar source, the strains exhibited similar levels of growth and xylose consumption. This study demonstrates that various bacterial xylose transporters can boost xylose catabolism in transgenic Synechocystis strains, and paves the way for the sustainable production of bio-compounds and green fuels from lignocellulosic biomass.

[Association between type 2 diabetes mellitus and risk of cancers: a cohort study]

OBJECTIVE

To understand the association between type 2 diabetes and the risk of cancers.

METHODS

Data related to type 2 diabetes mellitus (T2DM) cases and cancer cases were collected from Zhejiang Chronic Disease Surveillance Information and Management System (CDSIMS) , between January 1, 2007 and December 31, 2013. Cumulative incidence and relative risk (RR) with 95% confidence interval (CI) were calculated.

RESULTS

From 2007 to 2013, a total of 327 268 T2DM and 7 435 cancer cases were respectively reported and 778 439 person-years completed the followed-up program. Among the T2DM patients, incidence of cancers was 955.12 per 100 000, with standardized incidence as 458.05 per 100 000. Compared with people without T2DM, the risk of cancer incidence increased in T2DM patients (RR=1.68, 95%CI: 1.68-1.70). Risk appeared the highest in 20-39 year age group but decreased when the increase of age. In addition, the increased risk was still significant in T2DM patients aged ≥60 years (RR=1.21, 95%CI: 1.18-1.25).

CONCLUSION

Results from the study suggested that T2DM was associated with the increased risk of cancers, statistically.

[The association between socioeconomic status and blood pressure control in diagnosed hypertension patients]

OBJECTIVE

To explore the association between socioeconomic status (SES) and blood pressure control in diagnosed hypertension patients.

METHODS

The database of Zhejiang provincial survey on metabolic syndrome which implemented in 2010 in which prior hypoertensive patients were brought into this sutdy. Descriptive statistics were applied to test the distributive differences of relevant factors (age, sex, marital status, hypertension duration, BMI, education level, per capita household yearly income, smoking, alcohol drinking, fruit and vegetable intake) between patients with optimally-controlled blood pressure and those without. The SES of diagnosed hypertension patients was measured separately by two common indicators: education level and the per capita household yearly income. Univariate and multivariate logistic regression models were used to differentiate the association between those two SES indicators and blood pressure control, and the trend of the association was also tested.

RESULTS

Totally, 2 394 hypertension patients were diagnosed and identified. Of the patients analysed, the overall mean was (61.53 ± 10.64) years, and 55.7% (1 334 cases) had ≤ 5 years' disease duration. 1 090 achieved optimal blood pressure control, which accounted for a proportion of 45.5%. 1 676 had elementary school education and below, accounting for 70.1%. The patients with per capita household yearly income of < 5 000 Yuan and 5 000-14 999 Yuan groups were 401 (29.4%) and 690 (50.5%) respectively. 416 (17.4%) were smokers and 541 (22.6%) were alcohol drinkers. Based on the statistical tests, we found that the distributions of age, marital status, hypertension duration, body mass index, smoking and alcohol drinking were different between two groups (t or χ² values were 4.57, 5.44, 6.40, 6.21, 5.99, 3.98, respectively, all P values were < 0.05). Optical blood pressure control in higer education level group was significantly better than that of in lower education level (χ² = 12.65, P < 0.001), and there was no statistical significance association between per capita household yearly income and optimal blood pressure control (χ² = 2.78, P = 0.249). Multivariate logistic regression models revealed that, of those two SES indicators, a positive association was shown between education level and optimal blood pressure control: compared with patients in the category of 'elementary school and below, those of 'junior high school and above observed an OR of 1.40 (95% CI: 1.09-1.81). And in further trend χ² test, we identified a trend of such association (χ² trend = 12.74, P = 0.002). However, no significant association has been recognized between per capita household yearly income and optimal blood pressure control: compared with patients in the category of < 5 000 Yuan group, those of 5 000-14 999 Yuan and ≥ 15 000 Yuan groups had OR of 0.93 (95% CI: 0.72-1.20) and 1.04 (95% CI: 0.83-1.31) respectively.

CONCLUSION

Among all diagnosed hypertension patients, those with lower education level have poorer blood pressure control and should be labelled as the key population for intense health education and standardized management to improve their blood pressure control status.

Cyanobacteria as cell factories to produce plant secondary metabolites

Cyanobacteria represent a promising platform for the production of plant secondary metabolites. Their capacity to express plant P450 proteins, which have essential functions in the biosynthesis of many plant secondary metabolites, makes cyanobacteria ideal for this purpose, and their photosynthetic capability allows cyanobacteria to grow with simple nutrient inputs. This review summarizes the advantages of using cyanobacteria to transgenically produce plant secondary metabolites. Some techniques to improve heterologous gene expression in cyanobacteria are discussed.

A novel high light-inducible carotenoid-binding protein complex in the thylakoid membranes of Synechocystis PCC 6803

Synechocystis sp. PCC 6803 is a model cyanobacterium extensively used to study photosynthesis. Here we reveal a novel high light-inducible carotenoid-binding protein complex (HLCC) in the thylakoid membranes of Synechocystis PCC 6803 cells exposed to high intensity light. Zeaxanthin and myxoxanthophyll accounted for 29.8% and 54.8%, respectively, of the carotenoids bound to the complex. Using Blue-Native PAGE followed by 2D SDS-PAGE and mass spectrometry, we showed that the HLCC consisted of Slr1128, IsiA, PsaD, and HliA/B. We confirmed these findings by SEAD fluorescence cross-linking and anti-PsaD immuno-coprecipitation analyses. The expression of genes encoding the protein components of the HLCC was enhanced by high light illumination and artificial oxidative stress. Deletion of these proteins resulted in impaired state transition and increased sensitivity to oxidative and/or high light stress, as indicated by increased membrane peroxidation. Therefore, the HLCC protects thylakoid membranes from extensive photooxidative damage, likely via a mechanism involving state transition.

[Prevalence of dyslipidemia among non-overweight adults and related factors in Zhejiang]

OBJECTIVE

To understand the prevalence of dyslipidemia among non-overweight adults and related factors in Zhejiang province.

METHODS

A total of 10 868 non-overweight adults (aged ≥18 years and BMI<24.0 kg/m²) included in a population-based cross-sectional survey on metabolic syndrome in Zhejiang province in 2010 were selected to conduct questionnaire survey, health examination and blood fat detection.

RESULTS

The overall prevalence of dyslipidemia in this population was 41.38%. The prevalence was significantly higher in males (43.19%) than in females (39.84%) (χ² = 12.53, P < 0.001). The prevalence of dyslipidemia significantly decreased in males (trend χ² = 47.61, P < 0.001) but increased in females (trend χ² = 3.88, P < 0.05) with age. There was no significant difference in the prevalence between urban area (41.21%) and rural area (41.49%) (χ² = 0.08, P = 0.774). Multiple logistic regression analysis showed that sex, family history of chronic diseases, smoking, alcohol use, high meat and egg diet, cooking with animal oil, physical activity, central obesity and BMI were factors related to prevalence of dyslipidemia.

CONCLUSION

The prevalence of dyslipidemia was high among the non-overweight adults in Zhejiang, and family history, smoking, high-fat diet, physical inactivity, central obesity seemed to be the major risk factors.

[Current status regarding the levels of risks on cardiovascular diseases among the hypertensives in Zhejiang]

OBJECTIVE

To assess the cardiovascular disease-related risk levels among hypertensive people in Zhejiang.

METHODS

Subjects were selected from local residents aged ≥18 years old, using the multi stage stratified-random sampling method. All participants accepted physical examinations including blood tests for lipids, fasting blood glucose, 2 hours blood glucose and physical measurements for obesity and blood pressure in the year 2010.

RESULTS

Totally, 17 437 subjects were finally included in the study, in which 5 227 were diagnosed as having hypertension, with 'grade one hypertension' the majority. Cardiovascular disease-related risk factors would include older age (male >55 years, female >65 years), smoking, abnormal fasting glucose, impaired glucose tolerance, abnormal TC, abnormal HDL-C, abdominal obesity and obesity, with rates as 42.78% , 20.89%, 5.31%, 8.35%, 9.87%, 35.66%, 40.55% and 13.93%. Most of the hypertensive people had two (30.44%) or three risk factors (29.96%). Proportions of low, medium, high or very high risks were 9.70% , 47.71% , 18.81% and 23.78% , respectively in those people with hypertension. Significant differences on cardiovascular risk stratification were found between age groups, sex and regions. There were also statistically significant differences noticed, regarding the levels of cardiovascular disease related risks between in patients aware or unaware of the diseases, under control or uncontrolled of the situation.

CONCLUSION

People under high risk or very high risk on cardiovascular disease did exist in Zhejiang, especially in those 60-year-olds, males and urban residents.

[Joint association among physical activity, sedentary leisure time, job intensity, adiposity and the risks of diabetes in adult population of Zhejiang province]

OBJECTIVE

To investigate the joint association of adiposity, physical activity, sedentary leisure time and job intensity on diabetes and impaired glycoregulation.

METHODS

Data was from the 2010 Zhejiang survey and 17 437 adults ( ≥18 years) were examined. Logistic regression was used in this cross-sectional study.

RESULTS

Under the same level of sedentary leisure time, adiposity anticipants showed an OR of 2.52-2.75 times for people with diabetes than those with normal or underweight BMI, and anticipants with highest WC having an OR of 2.09-3.71 times than those with the lowest WC. With the same level of physical activity, those adiposity anticipants had an OR of 2.19-5.98 times for diabetes than those with normal or underweight BMI, and anticipants with the highest WC had an OR of 3.10-6.25 times than those with the lowest WC. Anticipants who had no physical activity but with adiposity. BMI had an OR of 3.21 times than those with normal or underweight BMI, but there was no significant difference between diabetes and BMI in those that practising physical activities. Within the 3 levels of physical activity, participants that practising no physical activity, had an OR of 1.68-4.23 times for diabetes than those who were physically active when WC was used as a measure for adiposity.

CONCLUSION

Controlling weight and waist seemed more important than improving physical activity or reducing sedentary leisure time in the prevention program on diabetes. WC was better measure on the risks for adiposity-related diabetes than BMI, especially when physical activity was under consideration.

PfsR is a key regulator of iron homeostasis in Synechocystis PCC 6803

Iron is an essential cofactor in numerous cellular processes. The iron deficiency in the oceans affects the primary productivity of phytoplankton including cyanobacteria. In this study, we examined the function of PfsR, a TetR family transcriptional regulator, in iron homeostasis of the cyanobacterium Synechocystis PCC 6803. Compared with the wild type, the pfsR deletion mutant displayed stronger tolerance to iron limitation and accumulated significantly more chlorophyll a, carotenoid, and phycocyanin under iron-limiting conditions. The mutant also maintained more photosystem I and photosystem II complexes than the wild type after iron deprivation. In addition, the activities of photosystem I and photosystem II were much higher in pfsR deletion mutant than in wild-type cells under iron-limiting conditions. The transcripts of pfsR were enhanced by iron limitation and inactivation of the gene affected pronouncedly expression of fut genes (encoding a ferric iron transporter), feoB (encoding a ferrous iron transporter), bfr genes (encoding bacterioferritins), ho genes (encoding heme oxygenases), isiA (encoding a chlorophyll-binding protein), and furA (encoding a ferric uptake regulator). The iron quota in pfsR deletion mutant cells was higher than in wild-type cells both before and after exposure to iron limitation. Electrophoretic mobility shift assays showed that PfsR bound to its own promoter and thereby auto-regulated its own expression. These data suggest that PfsR is a critical regulator of iron homeostasis.

[Study on the relationship between level of glucose metabolism and risk of cancer incidents]

OBJECTIVE

To explore the relationship between level of glucose metabolism and risk of cancer incidents.

METHODS

10 079 aged ≥ 40, local residents in Jiashan were enrolled by stratified cluster sampling method in 2011. All the subjects accepted retrospective investigation on incidents of diabetes mellitus and cancers plus blood testing for level of glucose metabolism. Differences between glucose metabolism level and cancer incidence were analyzed by trend Chi-square test.

RESULTS

The prevalence of cancers in female diabetes mellitus patients was 268.79 per 100 000, higher than in males-124.31 per 100 000 (χ² = 4.012 2, P < 0.05). The incidence rates of cancers in groups of normal glucose regulation (NGR), impaired glucose regulation (IGR), and diabetes mellitus (DM) patients were 77.32 per 100 000, 115.40 per 100 000 and 204.08 per 100 000, respectively. The incidence of cancers in local residents who were older than 40 years had increased with the decrease of glucose regulation ability. The subjects were divided into three groups by FPG, 2h-PG and HbA1c levels respectively and the incident risks on cancers under each index increased 30.0%, 39.0% and 62.4%, respectively. Compared to the general population, the cancer incidence in DM group increased 1.67 times and 2.62 times increase in women but did not show significant difference in men (χ² = 0.524 0, P > 0.05). Breast and colorectal cancers were the most common tumors that accompanied with DM, and their incidence increased along with the decrease of glucose regulation ability. The incidence rates of breast and colorectal cancer in T2DM were 2.36 and 1.87 times more than in general population, and the incidence rates of female patients had an increase of 2.53 and 6.74 times, respectively.

CONCLUSION

The cancer incidence was higher in DM group than in the non-DM group while the incidence rates of both breast and colorectal cancer were relevant to the levels of glucose metabolism.

[Analysis of survival rate of breast, cervical, and ovarian cancer patients during 2005-2010 in Zhejiang province, China]

OBJECTIVE

To provide reference information for prognosis and control of female cancers by analyzing survival rates of breast, cervical and ovarian cancer patients during 2005-2010 in Zhejiang province.

METHODS

The morbidity and mortality data of 18 133 breast, cervical and ovarian cancer patients whose information were registered in health surveillance zone during 2005-2010 in Zhejiang were analyzed. The December 31(st), 2012 was set as the deadline of survival time. Observed survival rate (OS) and relative survival rate (RS) were calculated using SURV3.01 software and comparison between survival rates was conducted through Hakulinen's likely hood ratio test.

RESULTS

The 5-year OS of breast cancer, cervical cancer, and ovarian cancer were 76.89%, 70.79%, 2.59%, respectively during 2005-2010 in Zhejiang province. The 5-year RS of the three cancers were 80.26%, 73.89%, 55.17%, respectively. The 5-year RS of breast cancer, cervical cancer, and ovarian cancer in urban area were 83.11%, 77.87%, and 57.22% and 78.00%, 72.21%, and 53.83% in rural areas, respectively. The overall RS of urban patients was higher than the rural's (χ(2) = 24.98, 11.55 and 6.62, respectively, all P values < 0.05). The 5-year RS of breast cancer, which was grouped by age, showed that the 15-44 years group was the highest (83.40%), while 65-77 years group was the lowest (74.67%). The 5-year RS of cervical cancer decreased with age, with a 41.73% decrease from 83.83% (15-44 years group) to 42.10% ( ≥ 75 years group). The 15-44 years group showed the highest 5-year RS of ovarian cancer (74.30%), while ≥ 75 years group was the lowest (41.80%).

CONCLUSION

The prognosis of breast cancer and cervical cancer were relatively optimistic, while the ovarian cancer was not. The prognosis of female cancer patients in urban areas were better than in rural areas.

Optimal cut-off points for two-step strategy in screening of undiagnosed diabetes: a population-based study in China

To identify optimal cut-off points of fasting plasma glucose for two-step strategy in screening of undiagnosed diabetes in Chinese people, data were selected from two cross-sectional studies of Metabolic Syndrome in Zhejiang Province of China, Zhejiang Statistical Yearbook (2010), and published literatures. Two-step strategy was used among 17437 subjects sampled from population to screen undiagnosed diabetes. Effectiveness (proportion of cases identified), costs (including medical and non-medical costs), and efficiency (cost per case identified) of these different two-step screening strategies were evaluated. This study found the sensitivities of all the two-step screening strategies with further Oral Glucose Tolerance Test (OGTT) at different Fasting Plasma Glucose (FPG) cut-off points from 5.0 to 7.0 (mmol/L) ranged from 0.66 to 0.91. For the FPG point of 5.0 mmol/L, 91 percent of undiagnosed cases were identified. The total cost of detecting one undiagnosed diabetes case ranged from 547.1 to 1294.5 CNY/case, and the strategy with FPG at cut-off point of 6.1 (mmol/L) resulted in the least cost. Considering both sensitivity and cost of screening diabetes, FPG cut-off point at 5.4 mmol/L was optimized for the two-step strategy. In conclusion, different optimal cut-off points of FPG for two-step strategy in screening of undiagnosed diabetes should be used for different screening purposes.

Transgenic expression of delta-6 and delta-15 fatty acid desaturases enhances omega-3 polyunsaturated fatty acid accumulation in Synechocystis sp. PCC6803

BACKGROUND

Polyunsaturated fatty acids (PUFAs), which contain two or more double bonds in their backbone, are the focus of intensive global research, because of their nutritional value, medicinal applications, and potential use as biofuel. However, the ability to produce these economically important compounds is limited, because it is both expensive and technically challenging to separate omega-3 polyunsaturated fatty acids (ω-3 PUFAs) from natural oils. Although the biosynthetic pathways of some plant and microalgal ω-3 PUFAs have been deciphered, current understanding of the correlation between fatty acid desaturase content and fatty acid synthesis in Synechocystis sp. PCC6803 is incomplete.

RESULTS

We constructed a series of homologous vectors for the endogenous and exogenous expression of Δ6 and Δ15 fatty acid desaturases under the control of the photosynthesis psbA2 promoter in transgenic Synechocystis sp. PCC6803. We generated six homologous recombinants, harboring various fatty acid desaturase genes from Synechocystis sp. PCC6803, Gibberella fujikuroi and Mortierella alpina. These lines produced up to 8.9 mg/l of α-linolenic acid (ALA) and 4.1 mg/l of stearidonic acid (SDA), which are more than six times the corresponding wild-type levels, at 20°C and 30°C. Thus, transgenic expression of Δ6 and Δ15 fatty acid desaturases enhances the accumulation of specific ω-3 PUFAs in Synechocystis sp. PCC6803.

CONCLUSIONS

In the blue-green alga Synechocystis sp. PCC6803, overexpression of endogenous and exogenous genes encoding PUFA desaturases markedly increased accumulation of ALA and SDA and decreased accumulation of linoleic acid and γ-linolenic acid. This study lays the foundation for increasing the fatty acid content of cyanobacteria and, ultimately, for producing nutritional and medicinal products with high levels of essential ω-3 PUFAs.

[Multilevel regression analysis on regional-cluster and risk factors of blood pressure among adult residents in Zhejiang province]

OBJECTIVE

Using multilevel analysis model to analyze the regional-cluster and risk factors of blood pressure among adult residents in Zhejiang province.

METHODS

Totally, 17 437 residents were studied through a multi-stage cluster random sampling method from 60 streets/townships. Risk factors on SBP and DBP were analyzed through a two-level regression model, respectively.

RESULTS

The average blood pressure in males appeared as: SBP (125.14±17.90) mmHg, DBP (80.02±10.07) mmHg, compared with SBP (123.36±20.20) mmHg, DBP (77.42±10.09) mmHg in females. The average blood pressure in urban areas were SBP (126.29 ± 19.46) mmHg, DBP (79.64±10.20) mmHg, compared with SBP (122.82±18.86) mmHg, DBP (77.99±10.08) mmHg in rural areas, with differences statistically significant (P < 0.001), between the two areas. Pearson correlation coefficients between SBP, SDP and age were 0.44 and 0.21(P < 0.001), respectively. 5.24% variation of the SBP and 4.96% variation of the DBP were attributed to the environmental factors. Factors as age, gender, hypertension in family history, taking medication for blood pressure, physical exercise, smoking, alcohol drinking, BMI, waist, FPG, TG and TC at the individual level. were associated with both SBP and SDP (P < 0.05). Family income seemed to be related to SBP. Education, reducing salt intake, intensity of occupation would affect on DBP. Influence of FPG and TC on SBP varied among streets/townships while relation between TC and DBP also varied.

CONCLUSION

The distribution of blood pressure showed regional-cluster phenomenon. Strategies for different regions directed to prevent hypertension should consider the individual factors such as age, BMI, FPG, TG, TC, the regional factors and the sensitivity of different population to factors.

[Factors associated with awareness, treatment and control on diabetes in Zhejiang]

OBJECTIVE

To investigate factors associated with awareness, treatment and control of diabetes in Zhejiang.

METHODS

Subjects under study were selected among local residents aged ≥ 18 years old by multi stage stratified-random sampling method. All participants received physical examinations including blood tests for lipids, fasting blood glucose, 2 h blood glucose and physical measurements for obesity and blood pressure in the year 2010.

RESULTS

Totally, 17 437 residents were finally included in the study, including 1529 patients with diabetes. The rates of awareness, treatment and control of diabetes among the subjects under study, were 59.19%, 46.63% and 23.87%, respectively. Rate of treatment in patients with awareness of diabetes and the rate of under control among patients with treated diabetes were 78.78% and 51.19% respectively. Data from multivariate logistic regression method showed that factors as older age, having family history of diabetes were associated with higher awareness of diabetes, being alcohol drinker and obese patients with lower awareness etc. Treatment rate was significantly higher among those patients with primary education than those under situations as illiteracy, hypertension and longer course of diabetes. The control rate was significantly lower among patients with longer course of diabetes and dyslipidemia.

CONCLUSION

Low rate on awareness, treatment and control of diabetes need to be changed.

[Association between dyslipidemia and different subtypes of hypertension among Zhejiang population in 2010]

OBJECTIVE

To explore the association between dyslipidemia and different subtypes of hypertension among Zhejiang population.

METHODS

From June to October in 2010, 19 113 local residents aged ≥ 18 years old were selected among 7571 families from fifteen counties in Zhejiang by four stage stratified-random sampling method. A self-designed questionnaire was adopted to collect information on demographic characteristics, physical activity and life style. At the same time, physical examinations including height, weight, blood pressure and blood lipids were carried out.

RESULTS

A total of 19 113 participants completed the interviews, physical examinations and collected the blood samples.Excluding those who did not meet the criteria, 14 731 were finally enrolled in the study. The prevalence rates of isolated systolic hypertension (ISH), isolated diastolic hypertension (IDH), systolic and diastolic hypertension (SDH) were 7.16% (1055/14 731, standardized rate:5.46%), 4.60% (677/14 731, standardized rate:4.41%), 7.09% (1045/14 731, standardized rate:5.75%), respectively. Among normal blood pressure group, subjects with normal TC, high TC and abnormal TC were separately 10 571 (88.43%), 1173 (9.81%) and 210 (1.76%); subjects with normal HDL-C and low HDL-C were separately 6885 (57.60%) and 5069 (42.40%); subjects with normal TG, high TG, abnormal TG were separately 9952 (79.91%), 1213 (10.15%) and 1189(9.95%).In ISH group, subjects with normal TC, high TC and abnormal TC were separately 826 (78.29%), 188 (17.82%) and 41 (3.89%); subjects with normal HDL-C and low HDL-C were separately 666(63.13%) and 389 (36.87%); subjects with normal TG, high TG and abnormal TG were separately 737 (69.86%), 150 (14.22%) and 168 (15.92%). Multi factor analysis showed that high TG and abnormal TG were associated with ISH (OR (95%CI):1.43 (1.16-1.76), 1.65 (1.34-2.03) respectively). Among IDH group, subjects with normal TC, high TC, abnormal TC were separately 556(82.13%), 99(14.62%) and 22 (3.25%); subjects with normal HDL-C, low HDL-C were separately 335 (49.48%) and 342 (50.52%); subjects with normal TG, high TG, and abnormal TG separately were 402 (59.38%), 107 (15.81%) and 168 (24.82%). The multi factor analysis showed that high TG and abnormal TG could increase the risk of IDH (OR(95%CI):1.57 (1.24-1.98), 2.18 (1.76-2.70) respectively). Among SDH group, subjects with normal TC, high TC and abnormal TC were 817 (78.18%), 193 (18.47%) and 35 (3.35%); subjects with normal HDL-C and abnormal HDL-C were separately 599 (57.32%) and 446 (42.68%); subjects with normal TG, high TG, abnormal TG were separately 675 (64.59%), 164 (15.69%) and 206 (19.71%). The multi factor analysis showed that high TC, high TG and abnormal TG were also associated with the increased risk of SDH (OR (95%CI):1.38 (1.14-1.67), 1.43(1.18-1.75), 1.73 (1.43-2.10) respectively).

CONCLUSION

Dyslipidemia is an important factor of different subtypes of hypertension among Zhejiang population, especially triglycerides. Dyslipidemia screening should be strengthened to reduce the risk of cardiovascular diseases.

Associations of ACE gene insertion/deletion polymorphism, ACE activity, and ACE mRNA expression with hypertension in a Chinese population

Background

The present study was designed to explore the association of angiotensin converting enzyme (ACE) gene insertion/deletion (I/D, rs4646994) polymorphism, plasma ACE activity, and circulating ACE mRNA expression with essential hypertension (EH) in a Chinese population. In addition, a new detection method for circulating ACE mRNA expression was explored.

Methods

The research was approved by the ethics committee of Zhejiang Provincial Center for Disease Prevention and Control. Written informed consent was obtained prior to the investigation. 221 hypertensives (cases) and 221 normotensives (controls) were interviewed, subjected to a physical examination, and provided blood for biochemical and genetic tests. The ACE mRNA expression was analyzed by real time fluorescent quantitative Reverse Transcription PCR (FQ-RT-PCR). We performed logistic regression to assess associations of ACE I/D genotypes, ACE activity, and ACE mRNA expression levels with hypertension.

Results

The results of the multivariate logistic regression analysis showed that the additive model (ID, DD versus II) of the ACE genotype revealed an association with hypertension with adjusted OR of 1.43(95% CI: 1.04-1.97), and ACE ID genotype with adjusted OR of 1.72(95% CI: 1.01-2.92), DD genotype with adjusted OR of 1.94(95% CI: 1.01-3.73), respectively. In addition, our data also indicate that plasma ACE activity (adjusted OR was 1.13(95% CI: 1.08-1.18)) was significantly related to hypertension. However, the plasma ACE mRNA expressions were not different between the cases and controls.

Conclusion

ACE I/D polymorphism and ACE activity revealed significant influence on hypertension, while circulating ACE mRNA expression was not important factors associated with hypertension in this Chinese population. The detection of circulating ACE mRNA expression by FQ-RT-PCR might be a useful method for early screening and monitoring of EH.

Factors associated with prevalence, awareness, treatment and control of hypertension among adults in Southern China: a community-based, cross-sectional survey

The aim of this study was to investigate factors associated with prevalence, awareness, treatment and control of hypertension in southern China. A cross-sectional, population-based survey was conducted in 180 villages across 15 counties in southern China from July to November 2010. Totally, 17437 persons completed all of the questionnaires, measurement examination and blood specimen collection. Adjusted rate of hypertension was 22.59% (95%CI: 22.52%-22.66%), for men 23.36% (95%CI: 23.25%-23.47%) and for women 21.77% (95%CI: 21.68%-21.86%). Multivariate logistic regression showed that old age, education attainment, alcohol use, diabetes, obesity, high TC and high TG were associated with hypertension. Among the hypertensive individuals, 54.33% were aware of their hypertension, and 46.34% were currently taking antihypertensive medication, but only 18.26% had their blood pressure controlled. Among all the hypertensive subjects, awareness was more common in those who were female, living in the urban, old age, low education attainment, diabetes, overweight, obese, Low HDL-C. Among the subjects aware of their diagnosis of hypertension, medication treatment was more common in those living in the urban, old age, nonsmoker and diabetes. Among the individuals who receiving medication treatment, controlled hypertension were less common in those living in the urban, young age, low education attainment, overweight and obese. Despite high rate of hypertension, awareness, treatment and control of hypertension still need to be strengthened.

Association between socioeconomic status and obesity in a Chinese adult population

BACKGROUND

Existing studies which regarding to the association between individual socioeconomic status (SES) and obesity are still scarce in developing countries. The major aim of this study is to estimate such association in an adult population which was drawn from an economically prosperous province of China.

METHODS

Study population was determined by multilevel randomized sampling. Education and income were chosen as indicators of individual SES, general obesity and abdominal obesity were measured by body mass index (BMI) and waist circumference (WC). Descriptive statistical methods were used to depict overall and factor-specific distributions of general and abdominal obesity among 16,013 respondents. Two-step logistic regression models were fitted on gender basis.

RESULTS

The age-and-sex adjusted rates of general overweight, general obesity, abdominal overweight and abdominal obesity in study population were 28.9% (95%CI: 27.9%-29.9%), 7.5% (95%CI: 7.0%-8.1%), 32.2% (95%CI: 31.2%-33.3%) and 12.3% (95%CI: 11.6%-13.1%), respectively. Based on model fitting results, a significant inverse association between education and obesity only existed in women, while in men, income rather than education was positively related to obesity.

CONCLUSIONS

The atypical SES-obesity relationship we found reflected the on-going social economy transformation in affluent regions of China. High-income men and poorly-educated women were at higher risk of obesity in Zhejiang province, thus merit intense focuses.

[Prevalence and risk factors of pre-hypertension among adults of Zhejiang province]

OBJECTIVE

To access the prevalence rates of pre-hypertensive patients at different stages and its associated risk factors among adults of Zhejiang province.

METHODS

Study subjects were selected among local residents aged ≥ 18 years from 15 counties by multi stage stratified cluster random sampling method, from July to November, 2010. Each participant was required to complete questionnaire, physical examination and testing for overnight fasting blood specimen.

RESULTS

17 437 residents were surveyed including 8169 males and 9268 females. The overall prevalence of prehypertension was 34.39%. The prevalence of pre-hypertension appeared to be higher in males (38.57%) than in females (30.70%) (χ(2) = 119.36, P < 0.0001). The prevalence of pre-hypertension decreased with the increase of age in males who were above 25 year olds (χ(2) = 76.94, P < 0.0001) and in females who were above 45 year olds (χ(2) = 114.66, P < 0.0001). The prevalence of pre-hypertension appeared to be higher in the rural (35.60%) than in the urban (32.39%) areas (χ(2) = 18.69, P < 0.0001). Data from multivariable logistic regression showed that factors as being male, aged older than 35 years of age, with waist circumference as ≥ 85 cm for men and ≥ 80 cm for women, body mass index ≥ 25.0 kg/m(2) and triglyceride ≥ 1.7 mmol/L were risk factors of pre-hypertension while having had higher education was a protective factor.

CONCLUSION

Pre-hypertension was prevalent among adults residents in Zhejiang province. Factors as overweight, obesity, dyslipidemia appeared to be major risk factors for pre-hypertension.

RpaA regulates the accumulation of monomeric photosystem I and PsbA under high light conditions in Synechocystis sp. PCC 6803

The response regulator RpaA was examined by targeted mutagenesis under high light conditions in Synechocystis sp. PCC 6803. A significant reduction in chlorophyll fluorescence from photosystem I at 77 K was observed in the RpaA mutant cells under high light conditions. Interestingly, the chlorophyll fluorescence emission from the photosystem I trimers at 77 K are similar to that of the wild type, while the chlorophyll fluorescence from the photosystem I monomers was at a much lower level in the mutant than in the wild type under high light conditions. The RpaA inactivation resulted in a dramatic reduction in the monomeric photosystem I and the D1 protein but not the CP47 content. However, there is no significant difference in the transcript levels of psaA or psbA or other genes examined, most of which are involved in photosynthesis, pigment biosynthesis, or stress responses. Under high light conditions, the growth of the mutant was affected, and both the chlorophyll content and the whole-chain oxygen evolution capability of the mutant were found to be significantly lower than those of the wild type, respectively. We propose that RpaA regulates the accumulation of the monomeric photosystem I and the D1 protein under high light conditions. This is the first report demonstrating that inactivation of a stress response regulator has specifically reduced the monomeric photosystem I. It suggests that PS I monomers and PS I trimers can be regulated independently for acclimation of cells to high light stress.

Detection of α-fetoprotein and glypican-3 mRNAs in the peripheral blood of hepatocellular carcinoma patients by using multiple FQ-RT-PCR

This work aimed to investigate the correlation of the expression of α-fetoprotein (AFP) and glypican-3 (GPC3) mRNAs in the peripheral blood with primary hepatocellular carcinoma (HCC) and HCC metastasis by using multiple fluorescence quantitative reverse transcriptase-polymerase chain reaction (FQ-RT-PCR). Peripheral blood samples from 100 patients with HCC were collected. The positive expression rates of AFP mRNA of HCC, hepatitis B, and cirrhosis patients were 56, 5, and 10%, respectively. AFP mRNA was not detected in healthy subjects, hepatic hemangioma, or hepatic metastasis patients' samples. Those of GPC3 mRNA of HCC patients were 76%. GPC3 mRNA was not detected in healthy subjects, hepatitis B, cirrhosis, hepatic hemangioma, or hepatic metastasis patients' samples. In HCC patients' samples, the combined positive rate of AFP and GPC3 mRNA expressions was 81%. The relative expression levels of GPC3 mRNA in the metastasis group and nonmetastasis group were 0.98±0.38 and 0.72±0.26, respectively, and showed significantly different (P=0.001). However, no significant difference was observed in the AFP mRNA expression levels (P=0.134). In conclusion, the sensitivity of HCC diagnosis can be improved by combined detection of AFP and GPC3 mRNA expressions. GPC3 mRNA is HCC-specific, and may indicate HCC metastasis.

IsiA is required for the formation of photosystem I supercomplexes and for efficient state transition in synechocystis PCC 6803

Iron deficiency and other stress conditions strongly impact photosynthetic apparatus in photosynthetic organisms. Two novel chlorophyll (Chl)-containing supercomplexes (F4 and F5) in addition to the photosystem (PS) I trimers (F3) were observed by sucrose gradient ultracentrifugation in Synechocystis PCC 6803 under extensive iron starvation. 77K fluorescence and Western blot analyses of these supercomplexes revealed that they all contained IsiA. The F4 was identified as an IsiA-PSI-PSII supercomplex, while the F5 was assigned as an IsiA-PSI supercomplex. Deletion of isiA resulted in diminishing the PSI trimers (including the PSI trimers in iron-replete cells) and the two novel PSI supercomplexes (F4 and F5), and a significant reduction in the saturated whole-chain electron transport rate. However, the maximum PSII activities remained at levels similar to those of the wild type under various light conditions. The isiA^- mutant was defective in state transition and sensitive to high light. The sensitivity of the isiA^- mutant to high light was correlated with a higher level of membrane peroxidation. These results demonstrated that IsiA is required for the formation of PSI trimers and other higher complexes, and that IsiA is critical for efficient state transition.

The high light-inducible polypeptides stabilize trimeric photosystem I complex under high light conditions in Synechocystis PCC 6803

The high light-inducible polypeptides (HLIPs) are critical for survival under high light (HL) conditions in Synechocystis PCC 6803. In this article, we determined the localization of all four HLIPs in thylakoid protein complexes and examined effects of hli gene deletion on the photosynthetic protein complexes. The HliA and HliB proteins were found to be associated with trimeric photosystem I (PSI) complexes and the Slr1128 protein, whereas HliC was associated with PsaL and TMP14. The HliD was associated with partially dissociated PSI complexes. The PSI activities of the hli mutants were 3- to 4-fold lower than that of the wild type. The hli single mutants lost more than 30% of the PSI trimers after they were incubated in intermediate HL for 12 h. The reduction of PSI trimers were further augmented in these cells by the increase of light intensity. The quadruple hli deletion mutant contained less than one-half of PSI trimers following 12-h incubation in intermediate HL. It lost essentially all of the PSI trimers upon exposure to HL for 12 h. Furthermore, a mutant lacking both PSI trimers and Slr1128 showed growth defects similar to that of the quadruple hli deletion mutant under different light conditions. These results suggest that the HLIPs stabilize PSI trimers, interact with Slr1128, and protect cells under HL conditions.

Suppression of the lethality of high light to a quadruple HLI mutant by the inactivation of the regulatory protein PfsR in Synechocystis PCC 6803

A regulatory gene, designated pfsR (photosynthesis, Fe homeostasis and stress-response regulator), was discovered by a genetic screen in Synechocystis PCC 6803. Deletion of the gene from a high light-sensitive strain lacking four hli genes (4Xhli) restored viability to the parental strain under high light conditions. The quintuple mutant pfsR-/4Xhli retained photosystem-II and oxygen evolution capacity at levels similar to the wild-type levels under high light conditions. The transcripts of the two bfr genes (encoding bacterioferritin) were found to be constitutively up-regulated, whereas the transcripts of ho1 gene (encoding a heme oxygenase) were greatly down-regulated in high light upon deletion of pfsR. Under intermediate high intensity light, the pfsR deletion strains accumulated carotenoids and chlorophyll a to a significantly higher level than their corresponding parental strains. An exacerbated, transient increase in oxygen evolution during the early hours of high light acclimation and a somewhat increased steady-state level of photosystem-II-mediated oxygen evolution observed in the 4Xhli strain were brought back to the wild-type levels upon deletion of pfsR from the strain. The pfsR deletion mutants were found to be less sensitive to iron limitation under low light conditions and to suffer less lipid peroxidation following exposure to high light. Therefore, inactivation of PfsR resulted in tighter control of iron availability, which in turn reduced oxidative stress during photosynthesis in high light. These studies have revealed a critical role of PfsR in regulation of iron homeostasis and stress response.

Control of photosynthetic and high-light-responsive genes by the histidine kinase DspA: negative and positive regulation and interactions between signal transduction pathways

We have deleted a gene for a sensor histidine kinase, dspA (or hik33), in the cyanobacterium Synechocystis sp. strain PCC6803. In low and moderate light, the mutant grew slowly under photoautotrophic conditions, with a doubling time of approximately 40 h, and had severely reduced photosynthetic oxygen evolution. When the mutant was maintained in low or moderate light in the presence of glucose, its growth rate was only somewhat lower than that of wild-type cells. However, the mutant was light sensitive and rapidly died in high light. Furthermore, levels of many transcripts encoding genes associated with photosynthesis were altered in the mutant relative to wild-type Synechocystis sp. strain PCC6803 both in low light and following exposure to high light. There was constitutive expression of several high-light-inducible genes, including hli, psbAIII, and gpx2; there was little increased accumulation of sodB mRNA in high light; and the cells failed to accumulate cpcBA and psaAB mRNAs in low light in the presence of glucose, although a normal decline in the levels of these mRNAs was observed during exposure to high light. These results suggest that DspA is involved in controlling sets of photosynthetic and high-light-responsive genes, either directly or indirectly. These and other results, some of which are presented in a companion paper (C.-J. Tu, J. Shrager, R. Burnap, B. L. Postier, and A. R. Grossman, J. Bacteriol. 186:3889-3902, 2004), suggest that DspA acts as a global regulator that helps coordinate cellular metabolism with growth limitations imposed by environmental conditions.