Association of the triglyceride-glucose index with early-onset atherosclerotic cardiovascular disease events and all-cause mortality: a prospective cohort study

BACKGROUND

The association between the triglyceride glucose (TyG) index and the risk of early-onset atherosclerotic cardiovascular disease (ASCVD) events or all-cause mortality in young and middle-aged people is not fully elucidated.

METHODS

The present study included 64,489 young and middle-aged people who participated in the 2006 Kailuan Study physical examination. Multivariate Cox proportional hazards models and restricted cubic spline curves were used to assess the association of TyG index with early-onset ASCVD events and all-cause mortality.

RESULTS

During a median of 11-year follow-up, 1984 (3.08%) participants experienced at least one ASCVD event and 1,392 (2.16%) participants experienced all-cause death. A higher TyG index was significantly associated with a higher risk of early-onset ASCVD events (HR: 1.61, 95% CI 1.38-1.89) and all-cause mortality (HR: 1.39, 95% CI 1.17-1.65), respectively. For each unit increase in TyG index, the risk of early-onset ASCVD events increased by 20%. In addition, there was a non-linear association between the TyG index and early-onset ASCVD events (P for non-linear < 0.01), and a linear association between TyG index and all-cause mortality (P for non-linear = 0.476).

CONCLUSIONS

A higher TyG index is significantly associated with an increased incidence of early-onset ASCVD events and all-cause mortality in a young and middle-aged population from North China.

Effect of quercetin on granulosa cells development from hierarchical follicles in chicken

1. The bioflavonoid quercetin is a biologically active component, but its functional regulation of granulosa cells (GCs) during chicken follicular development is little studied. To investigate the effect of quercetin on follicular development in laying hens, an in vitro study was conducted on granulosa cells from hierarchical follicles treated with quercetin.2. The effect of quercetin on cell activity, proliferation and apoptosis of granulosa cells was detected by CCK-8, EdU and apoptosis assays. The effect on progesterone secretion from granulosa cells was investigated by enzyme-linked immunosorbent assay (ELISA). Expression of proliferating cell nuclear antigen (PCNA) mRNA and oestrogen receptors (ERs), as well as the expression of steroid acute regulatory protein (StAR), cytochrome P450 cholesterol side chain cleavage enzyme (P450scc) and 3β-hydroxysteroid dehydrogenase (3β-HSD) mRNA during progesterone synthesis, were measured by real-time quantitative polymerase chain reaction (RT-qPCR). PCNA, StAR and CYP11A1 protein expression levels were detected using Western blotting (WB).3. The results showed that treatment with quercetin in granulosa cells significantly enhanced cell vitality and proliferation, reduced apoptosis and promoted the expression of gene and protein levels of PCNA. The levels of progesterone secretion increased significantly following quercetin treatment, as did the expression levels of StAR and CYP11A1 using the Western Blot (WB) method.4. The mRNA expression levels of ERα were significantly upregulated in the 100 ng/ml and 1000 ng/ml quercetin-treated groups, while there was no significant difference in expression levels of ERβ mRNA.

Seasonal patterns of miRNA and mRNA expression profiles in the testes of plateau zokors (Eospalax baileyi)

The gonads of seasonal breeding animals undergo periodic annual changes in morphology, physiological hormones, and gene expression levels. To clarify the regulatory mechanism of miRNAs in the seasonal testicular development and spermatogenesis of plateau zokors, the miRNA expression profiles in their testicles during breeding and non-breeding seasons were analyzed. In total, 447 miRNAs, including 366, 81, and 167 known, novel, and differentially expressed (DE) miRNAs, respectively, were determined in the testes. Compared to the non-breeding season, 90 DE miRNAs were upregulated and 77 DE miRNAs were downregulated during the breeding season. By analysing the miRNA and mRNA expression profiles, we predicted 2096 significant target mRNAs. According to the miRNA-mRNA interaction network, target mRNAs with DE miRNAs were related to testicular development and spermatogenesis. GO indicated that target mRNAs were enriched in spermatogenesis, cell differentiation, multicellular biological development, and flagellated sperm movement and were associated with regulating testicular development and spermatogenesis. KEGG suggested that target mRNAs were enriched in lipid and fructose metabolism and provided energy and material for spermatogenesis. The target mRNA of rno-miR-24-3p was determined to be Polyubiquitin-B (UBB). Our results provide a reference for revealing the mechanism by which miRNAs regulate testicular development and spermatogenesis in plateau zokors, which has important implications for understanding the regulation of seasonal reproduction in animals.

Atrial fibrillation increases the risk of new-onset myocardial infarction amongst working-age population: a propensity-matched study

OBJECTIVE

The aim of this study was to investigate the association between atrial fibrillation (AF) and new-onset myocardial infarction (MI) among a working-age population in an industrial city of North China.

METHODS

In total 77,670 participants aged under 60 years were selected for this cohort study. Participants were divided into an AF group (n = 121) and a non-AF group (n = 74,565) based on their medical histories. Thereafter, 121 participants from the AF group were propensity-matched with 363 participants from the non-AF group. All participants were followed up from June 2006 to December 2020; new-onset MI was regarded as the endpoint of this study. Multivariate Cox proportional hazards regression analysis models were designed to analyze the correlation between AF and new-onset MI.

RESULTS

During the 14-year follow-up, eight cases of new-onset MI were documented in the AF group, while five cases were documented in the non-AF group. The cumulative incidence of new-onset MI in the AF group (7.40%) was markedly higher than in the non-AF group (1.41%; p < 0.001). Atrial fibrillation was associated with an increased risk of new-onset MI in both univariate analysis (hazard ratio: 5.202, 95% confidence interval [CI]: 1.700-15.913) and multivariable-adjusted analysis (hazard ratio: 5.335, 95% CI: 1.683-16.910).

CONCLUSION

Atrial fibrillation increased the risk of new-onset MI amongst working-age individuals in an industrial city of North China.

Environmental and climatic drivers of phenotypic evolution and distribution changes in a widely distributed subfamily of subterranean mammals

How environmental factors shape species morphology and distributions is a key issue in ecology, especially in similar environments. Species of Myospalacinae exhibit widespread distribution spanning the eastern Eurasian steppe and the extreme adaptation to the subterranean environment, providing an excellent opportunity for investigating species responses to environmental changes. At the national scale, we here use geometric morphometric and distributional data to assess the environmental and climatic drivers of morphological evolution and distribution of Myospalacinae species in China. Based on phylogenetic relationships of Myospalacinae species constructed using genomic data in China, we integrate geometric morphometrics and ecological niche models to reveal the interspecific variation of skull morphology, trace the ancestral state, and assess factors influencing interspecific variation. Our approach further allows us to project future distributions of Myospalacinae species throughout China. We found that the interspecific morphology variations were mainly concentrated in the temporal ridge, premaxillary-frontal suture, premaxillary-maxillary suture, and molars, and the skull morphology of the two current species in Myospalacinae followed the ancestral state; temperature and precipitation were important environmental variables influencing skull morphology. Elevation, temperature annual range, and precipitation of warmest quarter were identified as dominant factors affecting the distribution of Myospalacinae species in China, and their suitable habitat area will decrease in the future. Collectively, environmental and climate changes have an effect on skull phenotypes of subterranean mammals, highlighting the contribution of phenotypic differentiation in similar environments in the formation of species phenotypes. Climate change will further shrink their habitats under future climate assumptions in the short-term. Our findings provide new insights into effects of environmental and climate change on the morphological evolution and distribution of species as well as a reference for biodiversity conservation and species management.

Comparative analysis of microRNA and messengerRNA expression profiles in plateau zokor testicular cells under reproductive suppression

Introduction

Reproductive suppression is an adaptive strategy that affects the success rate and reproductive efficiency in animals, which in turn affects population continuation and evolution. However, no studies on the miRNAs in testicular development and spermatogenesis regulatory mechanisms under reproductive suppression have been reported.

Methods

In this study, the differentially expressed (DE) miRNAs, miRNA-mRNA interaction network and function of the plateau zokor testicular cells of non-breeders and breeders during the breeding season were comprehensively analyzed by transcriptomics.

Results

In total, 381 known and 94 novel miRNAs were determined. Compared with that in the breeders, 70 downregulated and 68 upregulated DE miRNAs were identified in the non-breeders. We predicted 1670 significant target mRNAs by analyzing the miRNA and mRNA expression profiles. According to the miRNA-mRNA interaction network, the target mRNAs of the DE miRNAs were related to testicular development and spermatogenesis. GO indicate that the target mRNAs were related to testicular development and spermatogenesis. KEGG indicate that pathways of target mRNAs enrichment related to testicular development, spermatogenesis, and energy metabolism. PROK2 was determined as the target mRNA of rno-miR-143-3p.

Discussion

Our study offers a basis for the regulatory mechanisms of miRNAs in testicular development and spermatogenesis in plateau zokor under reproductive suppression and offers a reference for reproductive regulation.

SLC7A11-associated ferroptosis in acute injury diseases: mechanisms and strategies

Ferroptosis is a kind of iron-dependent renewal programmed death. Its main mechanism is to catalyze the unsaturated fatty acids highly expressed on the cell membrane under the effect of divalent iron, to produce lipid peroxidation, thus inducing cell death. SLC7A11 is a known iron death-related factor. It has been proved that iron death is involved in the occurrence and development of acute diseases, but the specific mechanism is unknown. The purpose of this review is to highlight the regulatory properties of SLC7A11 and gain a deeper understanding of its role in ferroptosis-related acute injury diseases. This is a narrative review. PubMed was used as the main source to randomly implement literature search strategy to index Scopus articles. No specific terms are used. Studies have shown that SLC7A11 may affect the sensitivity of cells to iron ptosis by regulating it at the transcriptional or post-transcriptional level, which is related to the pathology of many acute injury diseases, such as acute lung injury (ALI), acute kidney injury (AKI), acute liver injury, myocardial ischemia-reperfusion injury, and acute cerebral hemorrhage. In order to clarify this point, more and more researchers turn their attention to the study of the specific mechanism between SLC7A11 and ferroptosis-related acute injury diseases. In summary, this review summarized some specific mechanisms by which ferroptosis could be controlled by SLC7A11 and clarified the underlying mechanisms of a series of diseases caused by SLC7A11-associated ferroptosis. It also provided more scientific justification for the clinical application of targeting ferroptosis in preventing and treating various diseases.

A study on the control path of financial research resource allocation based on Rahman model

The participation of scientific research firms in transactions (research results) is a prerequisite for allocation of financial resources. Resources are allocated to projects with the greatest positive impact on social welfare. In this respect, the Rahman model is a useful method for allocating financial resources. It considers the dual productivity of a system and recommends allocating financial resources to the system with greatest absolute advantage. In this study, when the dual productivity of system 1 has an absolute advantage over that of system 2, the higher-level government will still allocate all financial resources to system 1, even if its total efficiency of research savings is lower than that of system 2. However, when the research conversion rate of system 1 is at a relative disadvantage but its total efficiency of research savings and dual productivity are both at a relative advantage, there may be a change in the government's allocation of financial resources. If the initial government decision time occurs before the jump point, system 1 will be allocated all resources until it reaches the jump point, but no resources once the jump point is crossed. Furthermore, the government will allocate all financial resources to system 1 if its dual productivity, total efficiency of research savings, and research conversion rate are at a relative advantage. Collectively, these results provide a theoretical basis and practical guidance for research specialization and resource allocation.

[The effect of Wendler Glottoplasty to elevate vocal pitch in transgender women]

Objective: To evaluate the effect of Wendler Glottoplasty to elevate vocal pitch in transgender women. Methods: The voice parameters of pre-and 3-month post-surgery of 29 transgender women who underwent Wendler Glottoplasty in department of otorhinolaryngology head and neck surgery of Beijing Friendship Hospital from January, 2017 to October, 2020 were retrospectively analyzed. The 29 transgender women ranged in age from 19-47 (27.0±6.3) years old. Subjective evaluation was performed using Transsexual Voice Questionnaire for Male to Female (TVQ^MtF). Objective parameters included fundamental frequency (F₀), highest pitch, lowest pitch, habitual volume, Jitter, Shimmer, maximal phonation time (MPT), noise to harmonic ratio (NHR) and formants frequencies(F1, F2, F3, F4). SPSS 25.0 software was used for statistically analysis. Results: Three months after surgery, the score of TVQ^MtF was significantly decreased [(89.9±14.7) vs. (50.4±13.6), t=11.49, P<0.001]. The F₀ was significantly elevated [(152.7±23.3) Hz vs. (207.7±45.9) Hz, t=-6.03, P<0.001]. Frequencies of F1, F2 and F3 were significantly elevated. No statistical difference was observed in the frequencies of F4. The highest pitch was not significantly altered while the lowest pitch was significantly elevated [(96.8±17.7) Hz vs. (120.0±28.9) Hz, t=-3.71, P=0.001]. Habitual speech volume was significantly increased [(60.0±5.2) dB vs. (63.6±9.6) dB, t=-2.12, P=0.043]. Jitter, Shimmer, NHR and MPT were not obviously altered (P>0.05). Conclusions: Wendler Glottoplasty could notably elevate the vocal pitch, formants frequencies and degree of vocal femininity in transgender women without affecting phonation ability and voice quality. It can be an effective treatment modality for voice feminization.

Atrial fibrillation is an independent risk factor for new-onset myocardial infarction: a prospective study

BACKGROUND

Atrial fibrillation (AF) and myocardial infarction (MI) share common cardiovascular risk factors, therefore coexistence of AF and MI is very common, in addition, both AF and MI aggravate and exacerbate each other through multiple pathological processes. The aim of this study is to investigate whether AF increases the risk of new-onset MI.

METHODS

In total 171,086 participants from an industrial city in North China were selected and enrolled in this prospective cohort study, participants were divided into the AF group or the non-AF group according to their medical history. 1542 participants from the AF group were propensity-matched with 4626 participants from the non-AF group. All the participants were followed up every 2 years from June 2006 to December 2020, the median follow-up was 14.25 years and the endpoint of this study was new-onset MI. The association between AF and new-onset MI was analysed by using both univariate and multivariate Cox proportional hazards regression analysis.

RESULTS

New-onset MI was documented in 56 cases from the AF group and 98 cases from the non-AF group, respectively, the cumulative incidence of new-onset MI in the AF group (3.73%) was significantly higher than that in the non-AF group (2.23%) (p < 0.01). In a univariate analysis, AF was associated with an increased risk of new-onset MI (hazard ratio: 1.73, 95% confidence interval: 1.24-2.40), in two multivariable-adjusted analyses, AF was still associated with an increased risk of new-onset MI (hazard ratio: 1.78, 95% confidence interval, 1.28-2.47).

CONCLUSIONS

AF is an independent risk factor for new-onset MI in an industrial population of North China.

POS1332 TOWARD SAFER GLUCOCORTICOID THERAPY OF POLYMYALGIA RHEUMATICA

Background

SPI-62 is a potent 11β-hydroxysteroid dehydrogenase type 1 (HSD-1) inhibitor entering Phase 2 development as adjunctive therapy to prednisolone in polymyalgia rheumatica, as well as for treatment of Cushing’s syndrome and autonomous cortisol secretion. HSD-1, an intracellular enzyme, activates glucocorticoids in target tissues in which glucocorticoid medicines are associated with morbidity including liver, adipose, muscle, and skin. In Phase 1 clinical trials SPI-62 was generally well tolerated and associated with maximal liver and brain HSD-1 inhibition.

Objectives

To demonstrate mitigation by SPI-62 of corticosterone (CORT) adverse effects in mouse.

Methods

C57BL/6 male mice (age 7 weeks; n=14 per group) were administered CORT (100 g/mL in drinking water) and SPI-62 (by gavage in 0.5% HPMC; 0, 1, or 10 mg/kg/day or 10 mg/kg twice daily) for 35 days. A control group received no CORT or SPI-62. Body weight was assessed daily and food consumption twice weekly. Whole body muscle and fat amounts were measured at Days 0, 14, and 28 using an EchoMRI-130H body composition analyzer. Blood samples for fasting glucose and insulin were obtained at Days 1 (pre-dose), 15, 29, and 35. An open field test was conducted on Day 22. A grip strength test was performed on Day 28. After sacrifice on Day 36, gonadal, subcutaneous, retroperitoneal, and mesenteric fat, quadriceps, and tibialis anterior were dissected and weighed, and skin was formalin fixed and paraffin embedded.

Results

One control mouse died due to accidental gavage injury. Two mice who received CORT + 0.5% HPMC died on Days 11 and 19. CORT resulted in increased food consumption which was normalized by SPI-62 in a dose-dependent manner. CORT-treated mice showed reduced body weight gain for 2 weeks then accelerated body weight gain. SPI-62 prevented body weight gain acceleration in a dose-dependent manner. CORT effects on dermal thickness and structure were less prominent in mice who also received SPI-62. No effect of CORT or SPI-62 was observed in the open field test. SPI-62 prevented CORT adverse effects of insulin resistance, increased adiposity, skeletal myoatrophy, and grip strength reduction (Table 1).

Table 1.

Observed percentage difference of treatment group mean, compared to control group mean, in CORT-treated mice

SPI-62 treatmentnone1 mg/kg1x/day10 mg/kg1x/day10 mg/kg2x/dayHOMA-IR Day 15+422+428+104+8HOMA-IR Day 29+788+472+204+14HOMA-IR Day 35+3620+1270+324+92Body fat content Day 14*+110+72-13-7Body fat content Day 28*+166+102+63-12Gonadal fat weight*+151+74+39-1Subcutaneous fat weight*+471+121+83+7Retroperitoneal fat weight*+227+89+36+25Mesenteric fat weight*+240+133+124+71Body muscle content Day 14*-10-70+1Body muscle content Day 28*-15-8-6+3Quadriceps weight*-54-43-24-16Tibialis anterior weight*-35-29-5+5Grip strength-12+16+15+26

*Normalized by body weight.

Conclusion

SPI-62 prevented several CORT adverse effects in mouse, demonstrating that blockade of local intracellular glucocorticoid activation by a HSD-1 inhibitor in target tissues can mitigate glucocorticoid toxicity. These results suggest that SPI-62 has potential to similarly mitigate adverse effects of glucocorticoid medications in human. A placebo-controlled Phase 2 clinical trial has been initiated to compare prednisolone effects with and without SPI-62. Up to 48 patients diagnosed with polymyalgia rheumatica, on stable prednisolone 10 mg daily for at least 2 weeks, and with stable disease inactivity based on acute phase biomarkers will continue prednisolone 10 mg daily for 4 weeks, during which they will receive SPI-62 or placebo for 2 weeks each. Acute phase and other immune function biomarkers, symptom measures, and biomarkers of prednisolone adverse effects will be assessed at baseline and after each 2-week period. After analysis of data from a first cohort of 12 patients the prednisolone dose might be adjusted, in blinded fashion, during the SPI-62 period to maintain equipotency on acute phase biomarker suppression.

Disclosure of Interests

Xingyu Pan: None declared, Qiongqiong Hou: None declared, Jiahui Xu: None declared, Yake Ma: None declared, Jiawen Li: None declared, Min Li: None declared, Jing Su: None declared, Xuerou Shi: None declared, William Bracken Consultant of: Sparrow Pharmaceuticals, David Katz Shareholder of: Sparrow Pharmaceuticals, Employee of: Sparrow Pharmaceuticals

[Construction of a nomogram model for predicting 2-year survival rate of small cell lung cancer based on more comprehensive variables]

Objective: To construct a novel prognostic nomogram model based on more comprehensive variables for patients with small-cell lung cancer (SCLC). Methods: The data of 722 patients with SCLC confirmed by pathology in Affiliated Cancer Hospital of Shanxi Medical University from January 2015 to December 2018 were retrospectively analyzed [including 592 males and 130 females, aged from 23 to 82(61±9) years]. A random seed count of 133 was used to divide those patients into training set (n=422) and validation set (n=300). Kaplan-Meier was used for survival curves analysis and univariate Log-rank test was used for evaluating the influence of clinical variables on the prognosis of sclc, variables with P<0.05 in univariate analysis were included in a multivariate Cox regression model. The nomogram was constructed based on the variables which P<0.05 in multivariate analysis. Receiver operating characteristic (ROC) curve, calibration by Integrated Brier score (IBS) and clinical net benefit by decision curve analysis (DCA) were used to evaluate model discriminative power, prediction error value, and clinical net benefit, and compared with the American Joint Committee on Cancer 8th TNM. Results: Male, abnormal monocyte (MON) counts, abnormal neuron specific enolase (NSE), abnormal cytokeratin 19 fragment (Cyfra211), M1a stage, M1b stage, M1c stage, radiotherapy (RT), chemotherapy ≥4 cycles and prophylactic cranial irradiation (PCI) were prognostic factors for SCLC[HR(95%CI)=1.39(1.00-1.92), 1.29(1.02-1.63), 1.41(1.11-1.80), 2.02(1.48-2.76), 1.09(0.77-1.55), 1.44(0.94-2.22), 2.01(1.49-2.71), 0.75(0.57-0.98), 0.40(0.31-0.51)and 0.42(0.26-0.68), respectively, all P<0.05]. The area under ROC curve (AUC) of the nomogram in training set and validation set were 0.814(95%CI: 0.765-0.862)and 0.787 (95%CI: 0.725-0.849), which were higher than TNM [0.616(95%CI: 0.558-0.674) and 0.648(95%CI: 0.581-0.715)].The calibration curve showed a good correlation between the nomogram prediction and actual observation for the 2-year overall survival (OS). IBS indicted a lower prediction error rate (training set: 0.132 vs 0.169; validation set: 0.138 vs 0.169). DCA showed a wider threshold range than TNM (training set: 0.01-0.96 vs 0.01-0.85, validation set: 0.01-0.94 vs 0.01-0.86) and a greater improvement of the clinical net benefit (in training set the nomogram had a greater clinical benefit than TNM in the range of 0.19-0.96, and remained in validation set in the range of 0.19-0.94). Conclusion: The established nomogram model for predicting 2-year OS in patients with SCLC based on 8 variables, including gender, MON, NSE, Cyfra211, M stage, RT, CT cycles and PCI can be used for an more accurately prognosis prediction and reference for therapeutic regimen selection.

A donor-DNA-free CRISPR/Cas-based approach to gene knock-up in rice

Structural variations (SVs), such as inversion and duplication, contribute to important agronomic traits in crops¹. Pan-genome studies revealed that SVs were a crucial and ubiquitous force driving genetic diversification^2-4. Although genome editing can effectively create SVs in plants and animals^5-8, the potential of designed SVs in breeding has been overlooked. Here, we show that new genes and traits can be created in rice by designed large-scale genomic inversion or duplication using CRISPR/Cas9. A 911 kb inversion on chromosome 1 resulted in a designed promoter swap between CP12 and PPO1, and a 338 kb duplication between HPPD and Ubiquitin2 on chromosome 2 created a novel gene cassette at the joint, promoter_Ubiquitin2::HPPD. Since the original CP12 and Ubiquitin2 genes were highly expressed in leaves, the expression of PPO1 and HPPD in edited plants with homozygous SV alleles was increased by tens of folds and conferred sufficient herbicide resistance in field trials without adverse effects on other important agronomic traits. CRISPR/Cas-based genome editing for gene knock-ups has been generally considered very difficult without inserting donor DNA as regulatory elements. Our study challenges this notion by providing a donor-DNA-free strategy, thus greatly expanding the utility of CRISPR/Cas in plant and animal improvements.

[Clinical analysis of 234 esophageal foreign bodies]

Objective: To explore the clinical characteristics and treatment methods of esophageal foreign body. Method: The clinical data of 234 patients with esophageal foreign bodies admitted to our department from January 2015 to August 2018 were retrospectively analyzed, including course time, foreign body types, surgical methods, imaging manifestations and treatment related complications. Result: The diagnosis of esophageal foreign bodies was confirmed by esophageal CT or esophageal barium meal X-ray examination before operation in 234 patients. Course time varied from 3 hours to 7 days, and the jujube nucleus was the most common food-borne foreign body.223 patients underwent esophagoscopic exploration and foreign body removal under general intravenous anesthesia, 11 of them had no definite esophageal foreign body, 22 had esophageal perforation and periesophagitis. After removal of foreign body, the nasogastric feeding tube was inserted. About 10 days later, the nasogastric feeding tube was removed when they got healthy. Nine cases underwent cervical abscess incision and drainage under general anesthesia. The average postoperative hospital day was 11 days. Conclusion: The rigid esophagoscopy is a safe and effective method for the esophageal foreign bodies. And neck abscess incision must be necessary,when they suffered from esophageal perforation with neck abscess and other serious complications.

[Role of sleep apnea monitoring management platform in the treatment of patients with obstructive sleep apnea hypopnea syndrome]

Objective:To investigate the clinical significance and value of the sleep apnea monitoring management platform in the treatment of patients with obstructive sleep apnea hypopnea syndrome (OSAHS) by comparing with the traditional continuous positive airway pressure (CPAP) card reader mode.Method:A total of 48 severe adult OSAHS patients from Department of Otorhinolaryngology Head and Neck Surgery-Sleep Medical Center of the Third People's Hospital of Honghe during the period of Nov. 2015 to Aug. 2016 were collected in this prospective study. All of them were diagnosed by PSG and treated with nasal continuous positive airway pressure. They were randomly divided into group A (n=24) and group B (n=24). Group A and B were treated with the traditional CPAP card reader mode and the sleep apnea monitoring management platform respectively. During the follow-up, the compliance, mean blood oxygen saturation, titration pressure, Epworth sleepiness scale after 1, 3, 6 and 12 month treatment were compared between two groups. Ttest was used to analyze the difference. Statistical significance was set at P <0.05.Result:Statistical analysis showed that there were significant difference in the compliance of using CPAP, mean blood oxygen saturation and Epworth sleepiness scale score between the two groups (P < 0.05), but the titration pressure had no difference between the two groups (P>0.05).Conclusion:Compared the sleep apnea monitoring management platform with traditional CPAP card reader mode in the treatment of OSAHS patients, the former could solve the problems during the CPAP use in time, improve the compliance of using CPAP, and which could increase the efficacy of CPAP. Thus, the sleep apnea monitoring management platform is of more clinical value and deserve promotion.

[Analysis of olfactory dysfunction after endoscopic and microscopic endonasal transsphenoidal surgery for pituitary adenoma]

Objective:To analyze the clinical data of patients with olfactory dysfunction after endoscopic or microscopic endonasal transsphenoidal approach,and to screen out the possible related factors,to guide clinical diagnosis and treatment,and to improve the patients' quality of life.Method:In the retrospective study,we analyze patients' data,and follow up them with telephone,records the olfactory levels before and after surgery. In the prospective study,five odors were applied to test the olfactory function before the surgery,then one week,3 weeks and 6 weeks after that. The results were statistically analyzed.Result:In the retrospective study,olfactory dysfunction occurred in 67.74%,47.37%in MTS group and ETS group. The olfactory disorder had no significant difference (P>0.05) among MTS group and ETS group after surgery. And the analysis of factors showed no significant difference. In the prospective study,there is significant difference between the preoperative results and postoperative results about the operative side and nonoperative side in ETS group and MTS group (P<0.05). In all results,there is no significant difference between operative side and nonoperative side in ETS group and MTS group (P>0.05).Conclusion:There is olfactory dysfunction after transsphenoidal surgery to resect pituitary adenomas. To prepare the nasal condition well preoperatively,protect the nasal structure intraoperatively and aplicate appropriate treatment postoperatively may reduce the incidence of olfactory disorder.

Clinical and Imaging Characteristics of Arteriopathy Subtypes in Children with Arterial Ischemic Stroke: Results of the VIPS Study

BACKGROUND AND PURPOSE

Childhood arteriopathies are rare but heterogenous, and difficult to diagnose and classify, especially by nonexperts. We quantified clinical and imaging characteristics associated with childhood arteriopathy subtypes to facilitate their diagnosis and classification in research and clinical settings.

MATERIALS AND METHODS

The Vascular Effects of Infection in Pediatric Stroke (VIPS) study prospectively enrolled 355 children with arterial ischemic stroke (2010-2014). A central team of experts reviewed all data to diagnose childhood arteriopathy and classify subtypes, including arterial dissection and focal cerebral arteriopathy-inflammatory type, which includes transient cerebral arteriopathy, Moyamoya disease, and diffuse/multifocal vasculitis. Only children whose stroke etiology could be conclusively diagnosed were included in these analyses. We constructed logistic regression models to identify characteristics associated with each arteriopathy subtype.

RESULTS

Among 127 children with definite arteriopathy, the arteriopathy subtype could not be classified in 18 (14%). Moyamoya disease (n = 34) occurred mostly in children younger than 8 years of age; focal cerebral arteriopathy-inflammatory type (n = 25), in children 8-15 years of age; and dissection (n = 26), at all ages. Vertigo at stroke presentation was common in dissection. Dissection affected the cervical arteries, while Moyamoya disease involved the supraclinoid internal carotid arteries. A banded appearance of the M1 segment of the middle cerebral artery was pathognomonic of focal cerebral arteriopathy-inflammatory type but was present in <25% of patients with focal cerebral arteriopathy-inflammatory type; a small lenticulostriate distribution infarct was a more common predictor of focal cerebral arteriopathy-inflammatory type, present in 76%. It remained difficult to distinguish focal cerebral arteriopathy-inflammatory type from intracranial dissection of the anterior circulation. We observed only secondary forms of diffuse/multifocal vasculitis, mostly due to meningitis.

CONCLUSIONS

Childhood arteriopathy subtypes have some typical features that aid diagnosis. Better imaging methods, including vessel wall imaging, are needed for improved classification of focal cerebral arteriopathy of childhood.

[The research progress of LGR4 in the eye development and related diseases]

LGR4, also known as GPR48, is a member of the leucine-rich, G protein-coupled receptor family. It is widely expressed in tissues of the reproductive system, urinary system, sensory organs, digestive system, and central nervous system. LGR4 plays an important role in the development of various organs and cancer development and progression by modulating multiple signaling pathways. Recent studies have revealed that LGR4 is related with many kinds of human diseases such as gastrointestinal carcinomas. Eye development is a dynamic process regulated by a number of growth factors and cytokines. LGR4 is extensively expressed in the eyes in a finely tuned spatiotemporal pattern. Mice lacking LGR4 have been found to display anterior segment dysgenesis, including microphthalmia, iris hypoplasia, iridocorneal angle malformation and corneal dysgenesis, cataract and other defects. Here we review the role of LGR4 in the eye development and related molecular mechanisms. (Chin J Ophthalmol, 2017, 53: 236-240).

Evolution and heterogeneity of non-hereditary colorectal cancer revealed by single-cell exome sequencing

Recently single-cell whole-exome sequencing (scWES) has deeply expanded and sharpened our knowledge of cancer evolution and subclonality. Herein, with scWES and matched bulk whole-exome sequencing (bulk WES) on two colorectal cancer (CRC) patients with normal or adenomatous polyps, we found that both the adenoma and cancer were of monoclonal origin, and both shared partial mutations in the same signaling pathways, but each showed a specific spectrum of heterogeneous somatic mutations. In addition, the adenoma and cancer further developed intratumor heterogeneity with the accumulation of nonrandom somatic mutations specifically in GPCR, PI3K-Akt and FGFR signaling pathways. We identified novel driver mutations that developed during adenoma and cancer evolution, particularly in OR1B1 (GPCR signaling pathway) for adenoma evolution, and LAMA1 (PI3K-Akt signaling pathway) and ADCY3 (FGFR signaling pathway) for CRC evolution. In summary, we demonstrated that both colorectal adenoma and CRC are monoclonal in origin, and the CRCs further diversified into different subclones with heterogeneous mutation profiles accumulating in GPCR, PI3K-Akt and FGFR signaling pathways. ScWES provides evidence for the importance of mutations in certain pathways that would not be as apparent from bulk sequencing of tumors, and can potentially establish whether specific mutations are mutually exclusive or occur sequentially in the same subclone of cells.

The antibody-based CA125-targeted maintenance therapy for the epithelial ovarian cancer: a meta-analysis

OBJECTIVES

To assess the effect and toxicity of CA125-targeted antibody used as maintenance therapy for advanced epithelial ovarian cancer (EOC).

MATERIALS AND METHODS

Two reviewers searched PubMed, Medline, Embase, VIP databases, and the references of selected articles for randomized controlled trials comparing maintenance CA125-targeted antibody treatment with placebo/observation. One-, two-, three-, and five-year overall survival (OS) and progression free survival (PFS) were collected. Incidence and severity of adverse events were extracted. Meta-analysis of combined risk ratio (RR) for OS , PFS, and toxicity were conducted.

RESULTS

Four trials including 1,259 women were identified. Meta-analysis showed the combined RR was 1.02 (95% CI, 0.85-1.22) for three-year OS and 0.98 (95% CI, 0.70-1.39) for the three-year PFS. This review found that abagovomab and oregovomab caused toxicity no more than placebo.

CONCLUSIONS

CA125-targeted antibody used as maintenance therapy alone is not more effective than placebo but they were safe as maintenance therapy.

A longitudinally split rabbit segmental gracilis to simulate penile erectile function: anatomic basis and animal models

OBJECTIVE

The gracilis was once applied in reconstructing erectile function but its appearance was bulky. We aimed to design a model meeting the requirements of both reducing volume and retaining function.

MATERIALS AND METHODS

The gracilis muscles of 6 rabbits were harvested, applied colorful vascular perfusion and modified Sihler's intramuscular nerve staining. According to their intramuscular nerves and blood vessels, 9 rabbit right gracilis muscles were then longitudinally split into two halves. The anterior muscle bundle was selected as the functional unit and blood supply.

RESULTS

The intramuscular nerves and vessels were simultaneously presented on a same specimen. Their relationship suggested gracilis muscle to be composed of two relatively independent subunits. The reconstructed penis survived well, simulating erectile action satisfactorily.

DISCUSSION

The penis model reconstructed with longitudinally split rabbit segmental gracilis myocutaneous flap had met the requirements of both restoring erectile function and improving the appearance.

The impact of oral consumption of Lactobacillus plantarum P-8 on faecal bacteria revealed by pyrosequencing

Lactobacillus plantarum P-8 (Lp-8) is a novel probiotic bacterium showing beneficial effects in human. The current study is a follow-up work of a previous clinical trial, and it aimed at understanding the mechanism of the observed desirable effects by evaluating the change in faecal bacterial structure at phylogenetic level. The genomic DNAs used for 16S rRNA polymerase chain reaction (PCR)-pyrosequencing were obtained from the previous clinical trial. Briefly, 33 recruited subjects were given a single daily oral dose of Lp-8 (6×1010 cfu) for 4 weeks. Faecal genomic DNAs were extracted from samples collected before (day 0) and after (day 28) Lp-8 consumption from the subjects. Our results show that the consumption of Lp-8 did not result in major change in the faecal bacterial structure by principal coordinate analysis. However, multivariate analysis of variance and analysis of UniFrac metric distances at day 0 and day 28 revealed significant difference in the faecal bacterial structure upon Lp-8 treatment. Thus, the difference lied on the less abundant rather than the predominant lineages. At genus level, the relative abundance of 5 Firmicutes genera (Leuconostoc, Lactobacillus, Sporacetigenium, Blautia and Staphylococcus) significantly increased after Lp-8 consumption, whereas 3 Proteobacteria genera (Shigella, Escherichia and Enterobacter) decreased (P<0.05). 60 key responding lineages could be identified at operational taxonomic unit (OTU) level by redundancy analysis. Among them, the abundance of 18 OTUs showed significant difference (P<0.05), while 12 OTUs exhibited modest change (0.05<P<0.01) upon treatment. Our study identified a shift in the faecal bacterial structure upon Lp-8 administration, which may explain some of the previously observed beneficial effects.

Reduction of Lactobacillus in the milks of cows with subclinical mastitis

Clinical and subclinical bovine mastitis are the most frequent diseases encountered on dairy farms worldwide, which cause significant economic loss and veterinary cost. The mastitic disease status is associated with increases in both milk bacterial pathogens and somatic cell count (SCC). Although it is well established that the mastitic pathogens generally correlate with the milk SCC, to our knowledge, the correlation between the probiotic genus, Lactobacillus, and the mastitic causative bacteria and SCC have not been determined previously. Thus, in this study, milk samples from 12 mild and 28 severe subclinical mastitic dairy cows were collected from the same farm. The overall milk bacterial load was quantified with the total plate count method. The Lactobacillus genus and 4 common clinical and subclinical mastitic pathogens (Escherichia coli, Staphylococcus aureus, Streptococcus agalactiae, and Trueperella pyogenes) in the sampled milk were enumerated by quantitative PCR. Mild and severe subclinical mastitic samples were distinctly separated on the principal component analysis score plot generated based on the quantities of these 5 target bacteria, suggesting that clear differences existed in the microbiological composition between the two sample groups. Based on comparison with the pairwise Mann-Whitney test, the mild subclinical mastitic dairy cows had a significantly higher amounts of lactobacilli (P=0.0175), but lower E. coli (P=0.0002), S. aureus (P<0.0001), S. agalactiae (P=0.0001) and T. pyogenes (P=0.0044) quantities, while an opposite trend occurred in the severe subclinical mastitic group. The negative correlation between Lactobacillus and the pathogenic bacteria, as well as the SCC, was confirmed with Spearman correlation analysis. Data generated from the current study may hint to a close relationship between Lactobacillus and the health of bovine udder.

The construction of cDNA library and the screening of related antigen of ascitic tumor cells of ovarian cancer

OBJECTIVE

To construct the cDNA library of the ascites tumor cells of ovarian cancer, which can be used to screen the related antigen for the early diagnosis of ovarian cancer and therapeutic targets of immune treatment.

MATERIALS AND METHODS

Four cases of ovarian serous cystadenocarcinoma, two cases of ovarian mucinous cystadenocarcinoma, and two cases of ovarian endometrial carcinoma in patients with ascitic tumor cells which were used to construct the cDNA library. To screen the ovarian cancer antigen gene, evaluate the enzyme, and analyze nucleotide sequence, serological analysis of recombinant tumor cDNA expression libraries (SEREX) and suppression subtractive hybridization technique (SSH) techniques were utilized. The detection method of recombinant expression-based serological mini-arrays (SMARTA) was used to detect the ovarian cancer antigen and the positive reaction of 105 cases of ovarian cancer patients and 105 normal women's autoantibodies correspondingly in serum.

RESULTS

After two rounds of serologic screening and glycosides sequencing analysis, 59 candidates of ovarian cancer antigen gene fragments were finally identified, which corresponded to 50 genes. They were then divided into six categories: (1) the homologous genes which related to the known ovarian cancer genes, such as BARD 1 gene, etc; (2) the homologous genes which were associated with other tumors, such as TM4SFI gene, etc; (3) the genes which were expressed in a special organization, such as ILF3, FXR1 gene, etc; (4) the genes which were the same with some protein genes of special function, such as TIZ, ClD gene; (5) the homologous genes which possessed the same source with embryonic genes, such as PKHD1 gene, etc; (6) the remaining genes were the unknown genes without the homologous sequence in the gene pool, such as OV-189 genes.

CONCLUSION

SEREX technology combined with SSH method is an effective research strategy which can filter tumor antigen with high specific character; the corresponding autoantibodies of TM4SFl, ClD, TIZ, BARDI, FXRI, and OV-189 gene's recombinant antigen in serum can be regarded as the biomarkers which are used to diagnose ovarian cancer. The combination of multiple antigen detection can improve diagnostic efficiency.

Synthesis and Interfacial Properties of Dialkylbenzenesulfonates for Producting Low Interfacial Tensions

A new method of synthesis a series of pure dialkylbenzene sulfonates is described. The benzene ring carries a major alkyl substituent, consisting of a linear chain of sixteen carbon atoms long, and one additional methyl group. Products are charactered by EI-MS and 1H NMR. Experimental investigations have been conducted to explore the interfacial tension behavior of crude oil with dialkylbenzenesulfonates. The effects of various parameters such as surfactant concentration, salinity concentration on the interfacial tension of crude oil-water were investigated in detail. The transient low interfacial tensions in crude oil/alkali system were caused by the synergistic effects between surfactant and the active species generated at interface, but surfactant molecules plays the dominant role at equilibrium.

Is symptom relief associated with reduction in gastric retention after gastric electrical stimulation treatment in patients with gastroparesis? A sensitivity analysis with logistic regression models

BACKGROUND

Enterra gastric electrical stimulation (GES) is an alternative treatment for gastroparesis (GP) when standard medical therapy fails. The aims of this study were to evaluate the association between total symptom score (TSS) and reduction in gastric retention (GR) after GES by GP etiology and to examine the sensitivity of the association to varying cutpoints used to define GR and TSS improvement.

METHODS

Gastric retention assessed with a standardized (99m) Tc radio-labeled egg meal and TSS measured by a five-point Likert scale in 221 GP patients treated with Enterra GES therapy for at least 1 year were analyzed. Bivariate chi-square test and multivariable logistic regression with all possible cutpoints were used to assess the consistency of association and quantitate the relationship across three GP etiologies.

KEY RESULTS

Symptom relief in diabetic GP was more likely attributable to GR reduction as indicated by the consistently significant odds ratios (P < 0.01) across all cutpoints. The association in idiopathic GP was inconclusive because odds ratios were sensitive to cutpoints with P-values ranging from 0.01 to 0.47. No association was found for patients with post surgical gastroparesis (P > 0.1 for all cutpoints). Patient age, gender, baseline TSS and baseline GR had no significant effect at 5% level on clinical improvement regardless of cutpoints for GR.

CONCLUSIONS & INFERENCES

Association between clinical improvements and GR reduction following GES treatment depends on patient etiology and was able to be demonstrated in diabetic GP. The association for idiopathic GP was inconclusive and no such association was found for post surgical GP across all possible cutpoint combinations.

A Bayesian hierarchical assessment of gastric emptying with the linear, power exponential and modified power exponential models

BACKGROUND

Many studies assessed gastric retention over time utilizing different models, mostly with scintigraphic measures at varied endpoints from limited number of normal volunteers. With a standardized 4-h gastric emptying (GE) protocol, we compared model fit by the linear, power exponential (PE), and modified power exponential (MPE) models to contrast differences in GE among different groups based on clinical diagnosis and gender.

METHODS

We retrospectively collected 320 patient records with four consecutive hourly scintigraphic measures of percent intragastric residual at the Kansas University Medical Center. We obtained parameter estimates with the Bayesian hierarchical models using informative priors from previous research.

KEY RESULTS

The PE or MPE model captured the time dependent GE rate better than the linear model. The estimated GE rates more than doubled for those without gastroparesis compared to patients diagnosed with gastroparesis. Males tended to empty gastric content faster but were not significantly different from females at the 5% level.

CONCLUSIONS & INFERENCES

The point estimates and 95% credible interval for GE rates obtained with the PE and MPE models may provide an alternative diagnostic tool for clinicians since it utilizes gastric emptying scintigraphy measures at multiple endpoints which may be sensitive to different aspects of the disease. No agreement in lag phases was obtained by the three models based on respective definitions from previous researches, but similar results would be obtained with the PE and MPE models if both defined lag phase by back projecting the regression lines to the same gastric retention level.

An evaluation of resident exposure to respirable particulate matter and health economic loss in Beijing during Beijing 2008 Olympic Games

Previous epidemiological studies showed that air pollutants, especially respirable particulate matter, including PM(10), could impose harmful effects on human health. The assessment of the effects of PM(10) on mortality and morbidity makes an important basis for enhancing pollution control efforts, and for protecting public health. In this study, we measured the levels of Beijing residents' exposure to PM(10) during three different time periods around the Beijing Olympic Games held in 2008, and calculated the economic cost associated with human health. A comparative analysis of human exposure to PM(10) and associated health economics was also made to see the difference between 2005 and 2008. GIS technology was employed to interpolate the distribution of population and PM(10) data collected by 27 stations at a scale of 1kmx1km. Study results show that Beijing's population is distributed in a highly inhomogeneous manner, with the majority of people dwelling in the city proper. During the Olympic Games, population-weighted PM(10) exposure came down by 46% and 19% respectively, compared with the pre-OG and the post-OG periods. Consequently, the economic cost associated with human health during the Games came down by 38% and 16% respectively, compared with the pre-OG and the post-OG periods. Comparative analysis shows that during the Olympic Games, both PM(10) and the economic cost associated with health as a proportion of GDP sat at the bottom of the 4-year statistics, indicating that in addition to favorable weather conditions, enhanced traffic and emission control policies and measures have produced a noticeable effect on PM(10) reduction.

Association of the status of interstitial cells of Cajal and electrogastrogram parameters, gastric emptying and symptoms in patients with gastroparesis

Our goal was to investigate associations between the status of interstitial cells of Cajal (ICC) and electrogastrogram (EGG) parameters, gastric emptying and symptoms in a large cohort of patients with gastroparesis. Forty-one patients with refractory gastroparesis who were referred for gastric electrical stimulation (GES) underwent full thickness gastric (antrum) biopsy during the surgery to place the GES device. The biopsy samples were stained with c-kit and scored for the presence of ICC based on criteria obtained from 10 controls. All patients underwent EGG recordings, a 4-h standardized scintigraphic gastric emptying study and symptom assessment prior to the surgery. Based on antral biopsy, 15 patients (36%) had almost no ICC (ICC- group) and 26 patients had adequate cell numbers (ICC+ group). EGG recordings in the ICC- group displayed significantly less normal slow waves than in the ICC+ group both in the fasting and fed states. Tachygastria in the ICC- group was significantly more than in the ICC+ group both in the fasting (32 +/- 8%vs 11 +/- 2%) and fed states (27 +/- 9%vs 12 +/- 2%). There was no statistical difference in gastric emptying, symptom severity of gastroparesis, aetiology, age and gender between the two groups. Severely depleted ICC occurs in up to 36% of gastroparetic patients and significantly correlates with an abnormal EGG. Severely depleted ICC does not correlate with the severity of gastroparesis as assessed by gastric emptying or symptom status but did result in a poorer symptomatic response to GES. These data suggest that the EGG may have a role for predicting ICC status during clinical evaluation of gastroparetic patients.

Association between changes in symptoms and gastric emptying in gastroparetic patients treated with gastric electrical stimulation

To investigate whether there is an association between gastric emptying rate and symptom improvement in gastroparetic patients treated with gastric electrical stimulation (GES), we retrospectively reviewed 63 gastroparetic patients who received GES therapy for at least 1 year. Patient characteristics, seven upper gastrointestinal (GI) symptoms and 4-h standardized gastric emptying test (GET) were evaluated at baseline and at 1 year of GES. All symptoms were significantly reduced (P < 0.001). Mean gastric retention was reduced by 7% (P = 0.102) for measurement at 4 h. Of the 63 patients, 14 had their GET normalized and 49 remained delayed after 1 year. Normalized GET patients had a similar symptom improvement as those whose GET remained delayed. Of all upper GI symptoms, the improvements in vomiting (P = 0.04), nausea (P = 0.002) and epigastric pain (P = 0.001) were significantly correlated with reduction in 4-h gastric retention between baseline and 12 months of GES therapy for patients with normalized gastric emptying but there were no correlations with any symptoms and change in gastric emptying for those patients who remained delayed. In summary, overall gastric emptying is not significantly accelerated at 4 h after successful symptomatic improvement with GES but nausea, vomiting and epigastric pain can be correlated with normalization of GET in a subset of patients.

The effect of contact lens induced oedema on the accuracy of Goldmann tonometry in a mature population

AIM

To determine the effect of contact lens induced oedema on the accuracy of Goldmann tonometry measurements of intraocular pressure (IOP) in mature subjects.

METHODS

22 healthy subjects aged between 50 and 60 years were recruited. Corneal curvature, IOP, and central corneal thickness (CCT) were measured before and after two hours of monocular closed eye wear of a thick hydroxyethyl methacrylate (HEMA) contact lens. Measurements were then repeated at 20 minute intervals for one hour after lens removal.

RESULTS

Both CCT (+54.1 mum) and IOP (+2.7 mm Hg) increased significantly after lens wear (p<0.001, paired t test with Bonferroni correction). For the hour following lens removal, the measured IOP was correlated to the increase in CCT (r = 0.84, p<0.001), at a rate of 1.0 mm Hg/10 mum (95% confidence interval, 0.8 to 1.2 mm Hg/10 mum, linear mixed model analysis).

CONCLUSIONS

A relatively small increase in CCT from contact lens induced corneal oedema caused an overestimation error in Goldmann tonometry measurements of IOP in healthy mature subjects.