The impact of vitamin D on the etiopathogenesis and the progression of type 1 and type 2 diabetes in children and adults

Diabetes is a common chronic metabolic disease with complex causes and pathogenesis. As an immunomodulator, vitamin D has recently become a research hotspot in the occurrence and development of diabetes and its complications. Many studies have shown that vitamin D can reduce the occurrence of diabetes and delay the progression of diabetes complications, and vitamin D can reduce oxidative stress, inhibit iron apoptosis, promote Ca2+ influx, promote insulin secretion, and reduce insulin resistance. Therefore, the prevention and correction of vitamin D deficiency is very necessary for diabetic patients, but further research is needed to confirm what serum levels of vitamin D3 are maintained in the body. This article provides a brief review of the relationship between vitamin D and diabetes, including its acute and chronic complications.

[Research on epidemiological characteristics of pneumonia and correlative factors of length of hospitalization in the elderly aged 60 years and older in Ningbo]

Objective: To investigate the epidemiological characteristics of pneumonia and the related factors of the length of hospitalization of pneumonia in the elderly aged 60 years and older in Ningbo in 2019. Methods: Data on hospitalized cases of pneumonia in the elderly aged 60 years and older in Ningbo in 2019 were collected through the regional health information platform, and the population data of Ningbo in 2019 were obtained through the Zhejiang Provincial Bureau of Statistics. A descriptive epidemiological analysis was conducted on hospitalized cases of pneumonia in the elderly population, and factors related to the length of hospitalization were explored. Results: A total of 15 956 hospitalized cases of pneumonia aged 60 years and older were reported in Ningbo in 2019, and the incidence of pneumonia requiring hospitalization was 1.02% (15 956/1 571 431). The incidence was 1.13% (8 613/760 357) in males and 0.83% (6 759/811 074) in females, and the ratio of male to female cases was 1.27∶1. The highest incidence was found in the ≥80 age group (2.52%), and the lowest incidence was found in the 60-69 age group (0.58%). March, February, and January were the peak period of pneumonia hospitalization. The main types of pneumonia diagnosed were not specified (65.12%), followed by bacterial pneumonia (34.60%). The M(Q1, Q3) of hospitalized patients with pneumonia was 9 (7, 13) days. The results of multivariate logistic regression analysis showed that gender (female: OR=0.911, 95%CI: 0.849-0.978) and older age (70-79 years old: OR=1.211, 95%CI: 1.111-1.321; ≥80 years old group: OR=1.486, 95%CI: 1.365-1.617), settlement method (self-payment: OR=0.567, 95%CI: 0.464-0.691), higher level of hospitals (Grade Ⅱ: OR=1.902,95%CI:1.723-2.100; Grade Ⅲ: OR=1.546,95%CI:1.407-1.698) were associated with the length of hospitalization for pneumonia in people aged 60 years and older in Ningbo. Conclusions: Hospitalization with pneumonia in people aged 60 years and older was high in winter and spring, men and older adults were in high-risk groups in Ningbo in 2019. Gender, age, billing method, and level of hospitals may be related factors to the length of hospitalization for pneumonia.

Metabolites of the gut microbiota may serve as precise diagnostic markers for sarcopenia in the elderly

Sarcopenia, a disease recognized by the World Health Organization, has posed a great challenge to the world in the current aging society. The vital role of the gut microbiome through the gut-muscle axis in sarcopenia is increasingly recognized. However, the working mechanisms by which the gut microbiota functions have not been fully explored in the multi-omics field. Here, we designed a cross-sectional study that recruited patients (n = 32) with sarcopenia and healthy old adults (n = 31). Diagnosis of sarcopenia was based on the Asian Working Group for Sarcopenia (AWGS) in 2019 criteria. Muscle mass was represented by appendicular skeletal muscle mass measured by using direct segmental multi-frequency bioelectrical impedance and muscle strength was evaluated using the handgrip strength. The Short Physical Performance Battery, the 5-time Chair Stand Test, and the 4-metre Walk Test were used to assess physical performance. Shotgun metagenomic sequencing was used to profile the gut microbiome in order to identify its construction and function. Metabolome based on untargeted metabolomics was applied to describe the features and structure of fecal metabolites. In clinical indexes including triglycerides and high-density lipoprotein cholesterol, we noted a significant decrease in triglycerides (TG) and a significant increase in high-density lipoprotein cholesterol (HDL-C) in patients with sarcopenia. Appendicular skeletal muscle mass of patients with sarcopenia was lower than the health group. Based on intestinal metagenomic and fecal metabolomic profiles, we found that the gut microbiome and metabolome were disturbed in patients with sarcopenia, with significant decreases in bacteria such as Bifidobacterium longum, Bifidobacterium pseudocatenulatum, and Bifidobacterium adolescentis, as well as metabolites such as shikimic acid. Also, we plotted supervised classification models at the species level of gut bacteria (AUC = 70.83-88.33) and metabolites (AUC = 92.23-98.33) based on machine learning, respectively. Based on the gut-muscle axis network, a potential mechanism is proposed along the gut microbiome - key metabolites - clinical index, that Phascolarctobacterium faecium affects appendicular skeletal muscle mass, calf circumference, handgrip strength, and BMI via Shikimic acid metabolites. This study elucidates the potential mechanisms by which the gut microbiome influences the progress of sarcopenia through metabolites and provides a meaningful theoretical foundation for reference in the diagnosis and treatment of sarcopenia.

[Epidemiological characteristics and spatiotemporal distribution of schizophrenia in Ningbo, 2018-2022]

Objective: To explore the temporal and spatial distribution characteristics of reported incidence of schizophrenia in Ningbo from 2018 to 2022 and to provide a scientific basis for rational allocation of mental health resources and comprehensive prevention and treatment of schizophrenia. Methods: The reported incidence data of schizophrenia from 2018 to 2022 were collected from Ningbo's mental health information management system, and the reported incidence was calculated by township. The spatial correlation analysis and the spatiotemporal scan analysis were used to study the spatiotemporal distribution of schizophrenia. Results: The reported incidence of schizophrenia decreased from 2018 to 2022, with 4 133 new cases reported, and the annual average reported incidence was 9.76/100 000. Global and local spatial autocorrelation analysis showed positive spatial correlations and hot spots in 2018-2020. The space-time scan analysis showed an incidence cluster in Dongqiao Town, Haishu District, during 2018-2019. The RR was 2.46, and the log-likelihood ratio was 256.89. Conclusions: The reported incidence of schizophrenia in Ningbo has obvious temporal and spatial aggregation, and the high incidence area explored can provide clues for further research on the correlation between environmental factors and the incidence of schizophrenia and has certain guiding significance for the rational allocation of mental health resources in Ningbo.

Duplicated adrenal veins in primary aldosteronism misdiagnosed with ectopic aldosteronoma due to apparent bilateral aldosterone suppression

BACKGROUND

Primary aldosteronism (PA) is considered the number one aetiology for secondary hypertension. Apart from confirmatory tests and localisation of PA determined by computed tomography (CT), adrenal venous sampling (AVS) is used to define whether aldosterone hypersecretion occurs inside one or both adrenal glands. However, even correctly-performed AVS may lead to undiagnostic results such as apparent bilateral adrenal suppression (apparent bilateral aldosterone suppression), in which the adrenal aldosterone-to-cortisol ratios (AC ratios) are decreased bilaterally compared to the peripheral blood sample, with several causes contributing to it.

CASE DESCRIPTION

Here, we describe the case of a 48-year-old man who was referred to our department for further investigation with a history of refractory hypertension, hypokalaemia, and aortic dissection. His hypertension and hypokalaemia were initially attributed to ectopic aldosteronoma due to his adrenal CT scan and AVS results. However, the correct diagnosis of an adenoma with duplicated right adrenal veins (duplicated adrenal veins) due to apparent bilateral aldosterone suppression was confirmed during surgery.

CONCLUSION

AVS is the gold standard accepted for PA subtyping, but sometimes when apparent bilateral aldosterone suppression is present, it can give ambiguous results. Duplicated right adrenal veins, may impact results, thus, AVS may not accurately provide evidence of unilateral hypersecretion for all PA patients. Repeat AVS or adrenal surgery can provide worthwhile diagnostic conclusions.

Chemical and Cellular Formation of Reactive Oxygen Species from Secondary Organic Aerosols in Epithelial Lining Fluid

INTRODUCTION

Oxidative stress mediated by reactive oxygen species (ROS) is a key process for adverse aerosol health effects. Secondary organic aerosols (SOA) account for a major fraction of particulate matter with aerodynamic diameter ≤2.5 µm (PM2.5). PM2.5 inhalation and deposition into the respiratory tract causes the formation of ROS by chemical reactions and phagocytosis of macrophages in the epithelial lining fluid (ELF), but their relative contributions are not well quantified and their link to oxidative stress remains uncertain. The specific aims of this project were (1) elucidating the chemical mechanism and quantifying the formation kinetics of ROS in the ELF by SOA; (2) quantifying the relative importance of ROS formation by chemical reactions and macrophages in the ELF.

METHODS

SOA particles were generated using reaction chambers from oxidation of various precursors including isoprene, terpenes, and aromatic compounds with or without nitrogen oxides (NOx). We collected size-segregated PM at two highway sites in Anaheim, CA, and Long Beach, CA, and at an urban site in Irvine, CA, during two wildfire events. The collected particles were extracted into water or surrogate ELF that contained lung antioxidants. ROS generation was quantified using electron paramagnetic resonance (EPR) spectroscopy with a spin-trapping technique. PM oxidative potential (OP) was also quantified using the dithiothreitol assay. In addition, kinetic modeling was applied for analysis and interpretation of experimental data. Finally, we quantified cellular superoxide release by RAW264.7 macrophage cells upon exposure to quinones and isoprene SOA using a chemiluminescence assay as calibrated with an EPR spin-probing technique. We also applied cellular imaging techniques to study the cellular mechanism of superoxide release and oxidative damage on cell membranes.

RESULTS

Superoxide radicals (·O2-) were formed from aqueous reactions of biogenic SOA generated by hydroxy radical (·OH) photooxidation of isoprene, β-pinene, α-terpineol, and d-limonene. The temporal evolution of ·OH and ·O2- formation was elucidated by kinetic modeling with a cascade of aqueous reactions, including the decomposition of organic hydroperoxides (ROOH), ·OH oxidation of primary or secondary alcohols, and unimolecular decomposition of α-hydroxyperoxyl radicals. Relative yields of various types of ROS reflected the relative abundance of ROOH and alcohols contained in SOA, which generated under high NOx conditions, exhibited lower ROS yields. ROS formation by SOA was also affected by pH. Isoprene SOA had higher ·OH and organic radical yields at neutral than at acidic pH. At low pH ·O2- was the dominant species generated by all types of SOA. At neutral pH, α-terpineol SOA exhibited a substantial yield of carbon-centered organic radicals (R·), while no radical formation was observed by aromatic SOA.

Organic radicals in the ELF were formed by mixtures of Fe2+ and SOA generated from photooxidation of isoprene, α-terpineol, and toluene. The molar yields of organic radicals by SOA were 5-10 times higher in ELF than in water. Fe2+ enhanced organic radical yields by a factor of 20-80. Ascorbate mediated redox cycling of iron ions and sustained organic peroxide decomposition, as supported by kinetic modeling reproducing time- and concentration-dependence of organic radical formation, as well as by additional experiments observing the formation of Fe2+ and ascorbate radicals in mixtures of ascorbate and Fe3+. ·OH and superoxide were found to be efficiently scavenged by antioxidants.

Wildfire PM mainly generated ·OH and R· with minor contributions from superoxide and oxygen-centered organic radicals (RO·). PM OP was high in wildfire PM, exhibiting very weak correlation with radical forms of ROS. These results were in stark contrast with PM collected at highway and urban sites, which generated much higher amounts of radicals dominated by ·OH radicals that correlated well with OP. By combining field measurements of size-segregated chemical composition, a human respiratory tract model, and kinetic modeling, we quantified production rates and concentrations of different types of ROS in different regions of the ELF by considering particle-size-dependent respiratory deposition. While hydrogen peroxide (H2O2) and ·O2- production were governed by Fe and Cu ions, ·OH radicals were mainly generated by organic compounds and Fenton-like reactions of metal ions. We obtained mixed results for correlations between PM OP and ROS formation, providing rationale and limitations of the use of oxidative potential as an indicator for PM toxicity in epidemiological and toxicological studies.

Quinones and isoprene SOA activated nicotinamide adenine dinucleotide phosphate (NADPH) oxidase in macrophages, releasing massive amounts of superoxide via respiratory burst and overwhelming the superoxide formation by aqueous chemical reactions in the ELF. The threshold dose for macrophage activation was much smaller for quinones compared with isoprene SOA. The released ROS caused lipid peroxidation to increase cell membrane fluidity, inducing oxidative damage and stress. Further increases of doses led to the activation of antioxidant response elements, reducing the net cellular superoxide production. At very high doses and long exposure times, chemical production became comparably important or dominant if the escalation of oxidative stress led to cell death.

CONCLUSIONS

The mechanistic understandings and quantitative information on ROS generation by SOA particles provided a basis for further elucidation of adverse aerosol health effects and oxidative stress by PM2.5. For a comprehensive assessment of PM toxicity and health effects via oxidative stress, it is important to consider both chemical reactions and cellular processes for the formation of ROS in the ELF. Chemical composition of PM strongly influences ROS formation; further investigations are required to study ROS formation from various PM sources. Such research will provide critical information to environmental agencies and policymakers for the development of air quality policy and regulation.

Genome-wide association study of fasting proinsulin, fasting insulin, 2-hour postprandial proinsulin, and 2-hour postprandial insulin in Chinese Han people

INTRODUCTION

Fasting proinsulin (FPI) and fasting insulin (FI) have been demonstrated to be associated with impaired b cell function, T2DM, and insulin resistance. This genome-wide association study (GWAS) was performed to contribute to our understanding of the genetic basis of FPI, FI, 2-hour postprandial proinsulin (2hPI), and 2-hour postprandial insulin (2hI) of the pathophysiology of prediabetes in the Chinese population.

MATERIAL AND METHODS

The levels of fasting plasma glucose (FPG), FPI, FI, 2hPI, and 2hI were examined by an automatic biochemical analyser. The Applied BiosystemsTM AxiomTM Precision Medicine Diversity Array, the Gene Titan Multi-Channel instrument, and Axiom Analysis Suite 6.0 Software were used for genotyping. Imputation was performed with IMPUTE 2.0 software from HapMap, 1000 Genomes Phase 3 as a reference panel.

RESULTS

Six single nucleotide polymorphisms (SNPs) in DLG1-AS1, SORCS1, and CTAGE11P for FPI, and 27 SNPs in ZNF718, MARCHF2, and HNRNPM for 2hPI reached genome-wide significance. Genome-wide significance was reached for associations of 6 SNPs in KRT71 to FI. Also, 14 SNPs in UBE2U, ABO, and GRID1-AS1 were genome-wide significant in their relationship with 2hI. Among these, the genetic loci of CTAGE11P, MARCHF2, KRT71, and ABO have the strongest association with FPI, 2hPI, FI, and 2hI.

CONCLUSIONS

The genetic variants of CTAGE11P, MARCHF2, KRT71, and ABO are significantly correlated with FPI, 2hPI, FI, and 2hI, respectively, in Chinese Han people. These genetic variants may serve as new biomarkers for the prevention of prediabetes.

[Effectiveness of precise prevention and control strategies of dynamic zero COVID-19 in Ningbo, Zhejiang province]

Objective: To evaluate effectiveness of the precise prevention and control strategies of dynamic zero COVID-19 in Ningbo, Zhejiang province. Methods: Based on the incidence data of COVID-19 and case epidemiological survey report in Ningbo in December 2021, the incidence curve of COVID-19 was generated and a dynamics model was developed to estimate the case number of under different intervention measures. The basic reproduction number (R₀) and real-time reproduction number (R_t) were calculated to evaluate intervention effect. Results: A total of 74 cases of COVID-19 had been confirmed in Ningbo as of 17 December, 2021. The R₀ was estimated to be 4.3. With the strengthening of prevention and control measures, the R_t showed a gradual downward trend, dropping to below 1.0 on December 11 and 0.4 on December 14. The model fitting results showed that the actual case number was close to the estimated case number (76 cases) when the effectiveness of intervention was 90%. The number of cases decreased by 98.4% compared with that if no intervention was taken. Conclusion: The precise prevention and control strategies of dynamic zero COVID-19 have obvious effect, which can facilitate the rapid control of COVID-19 epidemic in Ningbo.

Genetic Variants Relate to Fasting Plasma Glucose, 2-Hour Postprandial Glucose, Glycosylated Hemoglobin, and BMI in Prediabetes

Diabetes mellitus (DM) is a chronic disease that seriously threatens human health. Prediabetes is a stage in the progression of DM. The level of clinical indicators including fasting plasma glucose (FPG), 2-h postprandial glucose (2hPG), and glycosylated hemoglobin (HbA1C) are the diagnostic markers of diabetes. In this genome-wide association study (GWAS), we aimed to investigate the association of genetic variants with these phenotypes in Hainan prediabetes. In this study, we recruited 451 prediabetes patients from the residents aged ≥18 years who participated in the National Diabetes Prevalence Survey of the Chinese Medical Association in 2017. The GWAS of FPG, 2hPG, HbA1C, and body mass index (BMI) in prediabetes was analyzed with a linear model using an additive genetic model with adjustment for age and sex. We identified that rs13052524 in MRPS6 and rs62212118 in SLC5A3 were associated with 2hPG in Hainan prediabetes (p = 4.35 × 10^-6, p = 4.05 × 10^-6, respectively). Another six variants in the four genes (LINC01648, MATN1, CRAT37, and SLCO3A1) were related to HbA1C. Moreover, rs11142842, rs1891298, rs1891299, and rs11142843 in TRPM3/TMEM2 and rs78432036 in MLYCD/OSGIN1 were correlated to BMI (all p < 5 × 10^-6). This study is the first to determine the genome-wide association of FPG, 2hPG, and HbA1C, which emphasizes the importance of in-depth understanding of the phenotypes of high-value susceptibility gene markers in the diagnosis of prediabetes.

An Investigation on the Risk Factors of Thyroid Diseases in Community Population in Hainan

BACKGROUND

In recent years, the incidence of thyroid diseases has increased significantly, which has seriously affected people's work and life. The purpose of this study was to explore the epidemiological characteristics of thyroid diseases and autoantibodies.

METHOD

According to the principle of overall sampling, resident residents ≥18 years and who will not move within 5 years are randomly selected. A total of 2136 eligible individuals were divided into case and control groups according to whether they have thyroid disease. Finally, the impact of potential risk factors on thyroid diseases was evaluated.

RESULTS

The overall prevalence of thyroid disease was 58.3%, and there was a significant difference in the prevalence of thyroid disease between women and men (p = 0.004). Except for the age group ≥70 years, with the increase in age, the prevalence gradually increased (p < 0.05). Participants with positive thyroid autoantibodies (TPOAb or TgAb) had a higher prevalence than participants with negative autoantibodies. The positive rate of autoantibodies in women was higher than that in men (p < 0.05). UIC (p = 0.004) and free thyroid hormone (FT4) (p = 0.001) levels of men were higher than those of women, and the TSH level of women was higher than that of men (p = 0.002). The regression analysis showed that women, older age, and family history of thyroid disease were independent risk factors for thyroid disease.

CONCLUSION

The prevalence of thyroid diseases in Hainan was high. Women are more susceptible to thyroid disease than men, and the prevalence increased with age.

A de novo pure 21q22.3 deletion in a 9-year-old boy with buried penis: a case report and literature review

21q deletion has been associated with a wide range of clinical signs, from very mild to severe phenotypes, and with the progress of genetic technology, more patients with this deletion are being diagnosed. This study reports on a 9-year-old boy with a terminal deletion of 4.5 Mb on chromosome 21 in the locus of chr21: 43531239-48119895 (GRCh37/hg19). Dark skin, a buried penis, small testes, dental caries, microcephaly, a low auricle, mental and intellectual retardation, balance disorder and pituitary and callosum dysplasia were observed. The results of a literature review and observation of similar abnormalities, including hypoplasia of corpus callosum, in two patients with non-overlapping deletion regions suggest that there are multiple gene loci regulating brain development on 21q. By comparing the overlapped deletion region in 21q22.3 cases of brain anomalies and/or gonadal dysgenesis, we concluded there were two overlapped microdeletion regions (chr21:43531239-43792093 and chr21:46625055-46884297) that may be related to brain and gonadal development. The same 16.49 Mb deletion of chr21:31578129-48119895 (GRCh37/hg19) was shared in 10 cases, and 24 cases shared the same 5.59 Mb deletion of chr21:42478130-48119895 (GRCh37/hg19) in DECIPHER (Database of Chromasomal Imbalance and Phenotype in Humans using Ensembl Resources), suggesting these were two commonly deleted regions of pure partial 21q. Those patients with the same breakpoints had different phenotypes suggesting the heterogeneity of 21q deletion.

The Impact of Different Insulin-Related Measures on the Risk of Prediabetes Among the Chinese Han Population

INTRODUCTION

Diabetes mellitus (DM) has a serious impact on people's lives in the world. Interventions that affect risk factors for prediabetes can prevent and reduce diabetes occurrence. Proinsulin (PI), true insulin (TI), and proinsulin to insulin ratio (PI/TI) are risk factors for diabetes. The roles of these indicators in prediabetes are unclear. This study aimed to evaluate the impact of PI, TI, PI/TI, 2-h proinsulin (2hPI), 2-h true insulin (2hTI), and 2hPI/2hTI on the risk of prediabetes among the Chinese Han population.

METHODS

This cross-sectional study recruited 1688 subjects including 718 prediabetes cases and 970 non-prediabetes controls from Hainan Affiliated Hospital of Hainan Medical University. The cases involved 292 men and 426 women. The controls involved 324 men and 646 women. The mean age was 53.62 ± 12.43 years in the prediabetes group and 44.24 ± 12.87 years in the non-prediabetes group.

RESULTS

Our results showed that PI, TI, PI/TI, 2hPI, 2hTI, and 2hPI/2hTI were significantly correlated with prediabetes (all p < 0.05). Logistic regression analysis revealed that PI (OR 1.022, 95% CI 1.014-1.031, p = 0.00011), TI (OR 1.005, 95% CI 1.003-1.007, p = 0.00012), PI/TI (OR 1.517, 95% CI 1.080-2.131, p = 0.016), and 2hTI (OR 1.000, 95% CI 1.000-1.001, p = 0.002) were significantly associated with an increased risk of prediabetes. Receiver operating characteristic curve (ROC) analysis indicated that the area under the ROC curve (AUC) of the combination (PI + TI + PI/TI + 2hPI + 2hTI + 2hPI/2hTI) in diagnosing prediabetes was 0.627, which was larger than the diagnostic value of HOMA-IR (AUC 0.614) and HOMA-β (AUC 0.387).

CONCLUSIONS

Our study showed that PI, TI, PI/TI, and 2hTI could significantly enhance the risk of prediabetes in the Chinese Han population, which suggested that PI, TI, PI/TI, and 2hTI might be available risk factors for prediabetes.

X-linked hypophosphatemic rickets caused by a de novo PHEX gene variation in a family

X-linked hypophosphatemic rickets (XLH) is caused by inactivating mutations in the PHEX gene and is the most common form of hereditary rickets. The treatment is more complicated compared with the general rickets. A family were admitted to the Department of Endocrinology, Hainan General Hospital in 2018. The proband was a 3-year-6-month-old female, Han nationality. She was admitted to hospitalization for bilateral knee valgus and walking instability. The patient's parents were not in consanguineous marrige, and there was no similar medical history in the family. The patient presented with "O" leg, bracelet sign, chicken breast, and low blood phosphorus. Typical change of rickets also appeared in her X-ray examination. The DNAs of the peripheral blood were extracted from the patient and her parents. All coding exons and flanking regions of PHEX gene in the patient were amplified by PCR, and the mutant sites of the family members were testified by a generation sequencing. A heterozygous variation (c.1482+5G>C) affecting splicing outcome was detected at the splicing region of intron 13 of PHEX gene in the patient. The variation has been included in the human gene mutation database (HGMD). No variation was found in the proband's parents, the PHEX gene in the patient was a de novo variation. Our research provided reference for the future genetic counseling for this patient and enriched the research data on the relationship between genotype and clinical manifestations.

Research Progress on Pathological Fibrosis of Sinoatrial Node

Abstract

Human heart rhythm is mainly regulated and controlled by the sinoatrial node. Fibrosis plays an important regulating role in adjusting the structural and functional integrity of the sinoatrial node pacemaker complex. In physiological state, the fibrosis degree of sinoatrial node is negatively correlated with heart rate, positively correlated with age and heart size, and can maintain a relatively stable heart rate. Pathological fibrosis of sinoatrial node can induce various types of arrhythmias which can result in sudden death. Determination of the mechanisms related to sinoatrial node pathological fibrosis could provide a target for clinical treatment of sinoatrial node fibrosis and diagnosis basis for forensic pathologists. This paper reviews the main mechanism of sinoatrial node pathological fibrosis, including abnormal activation of cardiac fibroblast cells in sinoatrial node, hyperplasia of epicardial adipose tissue, calcium clock disorder, artery stenosis, etc., introduces the test methods, diagnostic criteria as well as its role in sudden cardiac death and discusses the potential application, to provide reference for relevant research and application.

Low prevalence of vitamin D deficiency in adult residents in Hainan, the tropical island province of China

BACKGROUND

Vitamin D deficiency is considered to be a global health problem. The purpose of this study was to evaluate the prevalence of vitamin D deficiency and analyze its related factors among adult residents in Hainan, a tropical island province of southern China.

METHODS

A total of 1,700 healthy adults, aged 18-86 years (617 men and 1,073 women), were enrolled in our cross-sectional descriptive study. Binomial logistic regression analyses were performed to identify possible predictors of vitamin D status.

RESULTS

The average serum 25-hydroxyvitamin D [25(OH)D] concentration was 37.66±10.77 ng/mL (males 43.60±11.8 ng/mL, females 34.20±8.40 ng/mL; I<0.001). The proportions of vitamin D sufficiency [25(OH)D ≥30 ng/mL], insufficiency [20 ng/mL ≤25(OH)D <30 ng/mL], and deficiency [25(OH)D <20 ng/mL] were 76.6%, 20.5%, and 2.9%, respectively. Vitamin D deficiency in the young, middle-aged, and elderly groups were 4.2%, 2.7%, and 1.7%, respectively. Vitamin D sufficiency was found to be positively associated with male sex (P<0.0001), age >40 years (P=0.014), habitation in a rural area (P<0.0001), summer/autumn seasons (P<0.0001), and having <13 years of formal education (P<0.0001).

CONCLUSIONS

Our study was the first to assess the vitamin D status and analyze related factors among adult residents in Hainan Province, China. We found that vitamin D deficiency has low prevalence in this population, suggesting that before developing a strategy for the clinical use of vitamin D supplements in a region, the levels of vitamin D in generally healthy populations of that region should be assessed, to avoid unnecessary supplementation.

[Seroepidemiology of pertussis in healthy population in Ningbo, 2019]

Objective: To understand the seroepidemiological characteristics of pertussis in healthy population in Ningbo, and estimate the overall incidence of pertussis. Methods: A cross-sectional survey method was used in this study. A total of 1 206 healthy residents in 9 age groups were stratified randomly selected from 3 counties of Ningbo. Serum samples were collected from the subjects, and the pertussis toxin immunoglobulin G antibody (PT-IgG) levels were measured quantitatively by enzyme-linked immunosorbent assay (ELISA). Results: The mean PT-IgG seropositive rate in the subjects was 0.91% (95%CI:0.45%-1.63%) with a geometric mean titer (GMT) of 3.10 (95%CI:2.86-3.36) IU/ml. The seropositive rates ranged from 0.00% to 1.68%, and the GMTs ranged from 2.08 IU/ml to 5.28 IU/ml in 9 age groups. The incidence rate of pertussis was estimated to be 4 572.81 per 100 000 in age group ≥5 years (95%CI:1 807.30 per 100 000-9 348.12 per 100 000), and the peak of estimated incidence rates were found in age group 5- years (9 301.62 per 100 000, 95%CI:1 121.77 per 100 000-33 154.68 per 100 000) and age group ≥50 years old (8 967.02 per 100 000, 95%CI: 1 059.45 per 100 000-31 845.94 per 100 000). Conclusions: The actual incidence of pertussis was high in Ningbo in 2019. As a result of waning immunity after vaccination, pertussis can occur in adolescents and adults. The pertussis surveillance should be strengthened and the pertussis vaccination strategy should be improved.

[Study on transmission dynamic of 15 clusters of COVID-2019 cases in Ningbo]

Objective: To describe the basic characteristics of clusters of coronavirus diseases 2019 (COVID-19) cases in Ningbo, Zhejiang province, and evaluate the generation time (Tg) and basic reproduction number (R(0)) of COVID-19. Methods: The basic information and onset times of the clusters of COVID-19 cases in Ningbo were investigated, the inter-generational interval of the cases were fitted by using gamma distribution, and the R(0) was calculated based on the SEIR model. Results: In the 15 clusters of COVID-19 cases, a total of 52 confirmed cases, 5 cases of nucleic acid-positive asymptomatic cases. The cases occurred from January 23 to February 4, the cases were mainly women. The incubation period was (6.11±3.38) days, and the median was 5 days. The Tg was (6.93±3.70) days. There were no significant differences in Tg between age group<60 years and age group 60 years and above, and between men and women (P=0.551). According to the Tg calculated in this paper, the R(0) of COVID-19 in Ningbo was 3.06 (95%CI: 2.64- 3.51); according to the reported case transmission interval of 7.5 days in the literature, the R(0) was 3.32 (95%CI: 2.51-9.38). Conclusion: There is no age and gender specific differences in the Tg of clusters of COVID-19 cases in Ningbo, and COVID-19 has high infectivity and spreading power in early phase.

Induction of long-term glycemic control in a type 2 diabetic patient for 11 years by intensive lifestyle intervention

Can diabetes be reversed? Yes! The weight loss due to intensive lifestyle intervention leads to the recovery of islet β cell function, thus changing the natural course of type 2 diabetes.

[The mechanism study of ouabain in inhibiting the growth of hepatocellular carcinoma cells by inhibiting the laser kinase signaling pathway]

Objective: To investigate the effect of Na(+)/K(+)-ATPase inhibitor ouabain on the proliferation and division of liver cancer HepG2 cells, and to explore the anticancer mechanism. Methods: HepG2 cells were exposed with different concentrations of ouabain (0.1, 1, 10 μmol/L) for 24 h, the proliferation ability was appraised using CCK-8, and the HepG2 cells was as a control group. The status of chromosome separation was detected with cell immunofluorescence (ICC) coupled to confocal microscope. The expression levels of AURKA, mTOR, p-mTOR, ERK and p-ERK protein were analyzed using western blot. Results: After treating with 0.1, 1 and 10 μmol/L of ouabain for 24 h, the inhibitory rate of cells were (23.5±4.57)%, (49.80±5.32)%, and (72.10±5.62)%, respectively. Ouabain could significantly inhibit the proliferation of HepG2, and presented in a dose-dependent manner(F=32.8, P<0.05). The ICC results showed that the chromosome separation disorders occurred in HepG2 cells treated with 1 μmol/L for 24 h, and the spindle diameter of HepG2 cells with ouabain treatment was decreased significantly compared with the control group(t=9.58, P<0.05). The results of western blot showed that the expression levels of AURKA, p-mTOR and p-ERK expressions in HepG2 cells treated with 1 μmol/L of ouabain were significantly decreased compared with the control group(F=16.26, 8.32, 33.59, P<0.05). Ouabain inhibited the growth of hepatocellular carcinoma cells in nude mice(F=370.20, P<0.05). Conclusion: Ouabain can induce chromosome division disorder and inhibit the proliferation in liver cancer HepG2 cells by inhibiting AURKA signaling pathway.

The correlation between proinsulin, true insulin, proinsulin: True insulin ratio, 25(OH) D3, waist circumference and risk of prediabetes in Hainan Han adults

Purpose

Diabetes mellitus is a kind of highly prevalent chronic disease in the world. The intervention measures on the risk factors of prediabetes contribute to control and reduce the occurrence of diabetes. This study aimed to investigate the correlation between proinsulin (PI), true insulin (TI), PI/TI, 25(OH) D3, waist circumference (WC), and risk of prediabetes.

Methods

In this cross-sectional study, 1662 subjects including 615 prediabetes and 1047 non-prediabetes were recruited. Spearman’s correlation analysis was used to explore the association of PI, TI, PI/TI, 25(OH) D3, and waist circumference with prediabetes. Odds ratios (OR) and 95% confidence intervals (CI) were calculated by logistic regression. Receiver-Operator Characteristic (ROC) curve was used to evaluate the risk of prediabetes.

Results

Our study showed that FPI, 2hPI, FTI, 2hTI, FPI/FTI, and WC could enhance the risk of prediabetes (OR 1.034; OR 1.007; OR 1.005; OR 1.002; OR 3.577, OR 1.053, respectively; all p< 0.001). Stratified analyses indicated that FPI/FTI associated with an increased risk of prediabetes in men (OR 2.080, p = 0.042). FTI have a weak association with prediabetes risk in men and women (OR 0.987, p = 0.001; OR 0.994, p = 0.004, respectively). 2hPI could decrease prediabetes in women (OR 0.995, p = 0.037). Interesting, the sensitivity (86.0%) and AUC (0.942, p< 0.001) of combination (FPI+FTI+2hPI+2hTI+25(OH) D3+WC) were higher than the diagnostic value of these alone diagnoses. The optimal cutoff point of FPI, FTI, 2hPI, 2hTI, 25(OH) D3, and WC for indicating prediabetes were 15.5 mU/l, 66.5 mU/l, 71.5 mU/l, 460.5 mU/l, 35.5 ng/ml, and 80.5 cm, respectively. What’s more, the combination (FPI+FTI+2hPI+2hTI+25(OH) D3+WC) significantly improved the diagnostic value beyond the alone diagnoses of prediabetes in men and women (AUC 0.771; AUC 0.760, respectively).

Conclusion

The FPI, 2hPI, FTI, 2hTI, FPI/FTI, and WC significantly associated with an increased risk of prediabetes. The combination of FPI, FTI, 2hPI, 2hTI, 25(OH) D3, and WC might be used as diagnostic indicators for prediabetes.

[Comparison on efficacy and safety of different bridging anticoagulation therapies in patients undergoing mechanical heart valve replacement surgery]

Objective: To evaluate the efficacy and safety of different bridging anticoagulant therapies in patients undergoing mechanical heart valve replacement (MHVR) surgery. Methods: Consecutive patients undergoing MHVR surgery from January 2018 to December 2018 in First Hospital of Lanzhou University were prospectively enrolled in this study. Patients were divided into unfractionated heparin (UFH) group and low molecular weight heparin (LMWH) group according to the postoperative bridging anticoagulation methods. Preoperative clinical data and postoperative related time and cost parameters, including drainage time, duration of stay in intensive care unit (ICU), postoperative time (interval from end of operation to discharge) and INR stabilization time (interval from start of bridge anticoagulation to INR value reaching the standard for 2 consecutive days) of all enrolled patients were collected, and all patients were followed up for 4 weeks and thromboembolic or bleeding events were analyzed. Multivariate logistic regression was used to determine the independent prognostic factors of thromboembolic or bleeding events after MHVR receiving various bridging anticoagulant therapies. Results: A total of 217 patients were included in the study, including 120 patients in the UFH group and 97 patients in the LMWH group. Stroke occurred in two patients in the UFH group, while no stroke event occurred in the LMWH group. The incidence of bleeding events was significantly higher (9.28%(9/97) vs. 1.67%(2/120), P=0.02), while the drainage time, duration of stay in ICU, postoperative time, INR stabilization time were all significantly shorter in LMWH group than in UFH group (all P<0.05). Multivariate logistic regression analysis showed that bridging anticoagulation therapies (OR=0.18, 95%CI 0.04-0.86, P=0.03), fibrinogen level (OR=1.99, 95%CI 1.16-3.41, P=0.01) and creatinine level (OR=1.05, 95%CI 1.01-1.08, P=0.04) were independent prognostic factors for bleeding events. Conclusion: LMWH use is associated with increased risk of bleeding events, but can significantly reduce the drainage time, duration of stay in ICU, postoperative time, INR stabilization time in patients post MHVR surgery.

ABCC8-Related Maturity-Onset Diabetes of the Young (MODY12): A Report of a Chinese Family

Maturity-onset diabetes mellitus of the young (MODY) is a monogenic diabetes characterized by autosomal dominant inheritance. Its atypical clinical features make diagnosis difficult and it can be misdiagnosed as type 1 or type 2 diabetes. Fourteen subtypes of MODY have been diagnosed so far, of which MODY12 is caused by mutation of the ABCC8 (ATP Binding Cassette Subfamily C Member 8) gene, which is rarely reported in China. This paper reports a Chinese family of MODY12 caused by a rare missense mutation on the ABCC8 gene, which has not been reported to be associated with MODY in China or in other countries, with the aim of increasing clinicians' awareness and attention to the disease.

Type A insulin resistance syndrome misdiagnosed as polycystic ovary syndrome: a case report

Background

Type A insulin resistance syndrome, one type of the hereditary insulin resistance syndromes, is a rare disorder. Patients with type A insulin resistance syndrome are nonobese and demonstrate severe hyperinsulinemia, hyperandrogenism, and acanthosis nigricans. The clinical features are more severe in affected females than in males, and they mostly become apparent at the age of puberty. In many cases, when severe insulin resistance is covered up by other signs or symptoms of type A insulin resistance syndrome, patients are often easily misdiagnosed with other diseases, such as polycystic ovary syndrome.

Case presentation

Our patient was a 27-year-old Han Chinese woman who sought treatment because of a menstrual disorder and hirsutism. Tests showed that her levels of insulin and testosterone were elevated, and gynecological color Doppler ultrasound suggested multiple cystic changes in the bilateral ovaries. After a diagnosis of polycystic ovary syndrome was made, pulsatile gonadotropin-releasing hormone therapy and metformin were administered, but the patient’s symptoms did not improve in 1 year of follow-up. Considering that the previous diagnosis might have been incorrect, venous blood samples were collected from the patient and her relatives for genetic analysis. Subsequently, using Illumina sequencing, it was found that the proband, her father, and two brothers all had the c.3601C>T heterozygous missense mutation in exon 20 of the insulin receptor gene. The diagnosis was corrected to type A insulin resistance syndrome, and the patient’s treatment was modified.

Conclusion

We report a case of a young woman with type A insulin resistance syndrome that was misdiagnosed as polycystic ovary syndrome. We discuss the causes, clinical features, diagnosis, and treatment of type A insulin resistance syndrome to improve the recognition of the disease and reduce its misdiagnosis. Female patients with high androgen levels and severe hyperinsulinemia should be considered for the possibility of hereditary insulin resistance syndromes (such as type A insulin resistance syndrome). Gene sequencing helps in making an early diagnosis and developing a targeted treatment strategy.

VDJ Gene Usage of B Cell Receptors in Peripheral Blood of ABO-incompatible Kidney Transplantation Patients

INTRODUCTION

B cell subtypes and immunoglobulin variable (V), diversity (D), joining (J) gene segment usage of B cell receptors in ABO-incompatible (ABOi) kidney transplantation (KT) in comparison to ABO-compatible KT have not been studied. The aims of this study were to analyze the VDJ gene segment usages of B cell receptors in peripheral blood of ABOi KT recipients.

METHODS

Eighteen ABOi KT patients with accommodation (ABOiA), 10 ABO-compatible stable KT patients (ABOcS), and 10 ABOi KT patients with biopsy-proven acute antibody-mediated rejection (ABOiR) at day 10 after transplantation were selected. Complete transcriptomes of their peripheral blood samples were sequenced and analyzed through RNA sequencing.

RESULTS

By family, immunoglobulin heavy chain variable 3 (IGHV3), immunoglobulin light kappa chain variable 1 (IGKV1), immunoglobulin light lambda chain variable 2 (IGLV2), and immunoglobulin light lambda chain joining 3 (IGLJ3) gene segments were most frequently used in all groups, and their usage was not statistically different among the three groups except for IGHV3 and IGKV1. IGKV1 was more frequently used in the ABOiA group than in the ABOcS group. According to individual gene segments, IGHV3-7, IGHV3-15, IGHV4-59, IGKV3-11, IGLV1-44, IGLV2-14, IGLV4-69, and IGLV7-46 were more frequently used in the ABOcS group than other groups, and IGKV3-7 was more frequently used in the ABOiR group than other groups. IGLV5-52 and IGLV7-43 were more frequently used in the ABOiA group than in ABOcS group.

CONCLUSIONS

Our findings suggest that RNA sequencing transcriptomic analyses of peripheral blood can provide information on the VDJ gene usage of B cell receptors and the mechanisms of accommodation and immune reaction in ABOi KT.

[Effect of different parts of skull thickness on stereotactic electroencephalogram in children]

Objective: To investigate the thickness of cranial bone in different parts of children skull during stereotactic electroencephalogram (SEEG) and its effect on electrode fixation. Methods: From October 2016 to March 2017, 13 children with SEEG by robot of surgery assistant (ROSA) were selected. The basic case information and electrode design scheme were collected. The skull thickness of each electrode channel was measured on post-operation CT, and the loosening of the fixed screws were recorded. The thickness of skull in frontal bone, temporal bone, parietal bone and occipital bone was statistically processed by SPSS statistical software. Results: There were total 113 electrodes in 13 children with epilepsy. There were 45 electrodes at frontal bone, of which the thickness was (5.7±2.8)mm. There were 34 electrodes at temporal bone, of which the thickness was (3.5±1.3)mm.There were 16 electrodes at parietal bone, of which the thickness was (6.0±2.5)mm.There were 18 electrodes at occipital bone, of which the thickness was (6.9±0.5)mm. Statistics showed that there was significant difference between differnt bone (F=15.340, P<0.01). There were 4 electrodes loosening, 1 at frontal bone and 3 at temporal bone, when the screws were removed. There was no adverse event related to the implantation of electrodes. Conclusions: The children's skull thickness is thinner than adults. The screw loosening is exist in some cases, but it has no effect on SEEG recording. No SEEG related adverse events are found in this group. Therefore, ROSA guided SEEG is safe and reliable in children with epilepsy.

A crossover study of the combination therapy of metformin and exenatide or biphasic insulin aspart 30 in overweight or obese patients newly diagnosed with type 2 diabetes mellitus

The aim of the present study was to explore the effects of various combinations of exenatide, metformin (MET) and biphasic insulin aspart 30 (BIA30) on type 2 diabetes mellitus (T2DM). Two hundred overweight or obese patients newly diagnosed with T2DM were evenly randomized into two groups: A (twice daily for all: Phase I, 5 µg exenatide + 0.5 g MET for 4 weeks, then 10 µg exenatide + 0.5 g MET for 8 weeks; Phase II, 0.5 g MET for 12 weeks; Phase III, 0.3-0.4 U/kg/day BIA30 + 0.5 g MET for 12 weeks) and B (Phases I, II, III matched the phases III, II and I in group A). In groups A and B a significant decrease and increase, respectively, in glycated hemoglobin (HbAlc) and body mass index (BMI) was noted during Phase I. A 3.2±0.4-kg decrease in body weight in group A and a 2.6±0.3-kg increase in group B was observed. In Phase II, HbAlc was significantly increased in both groups (P<0.05). In Phase III, the BMI was increased in group A and reduced in group B (P<0.05). There was a 3.8±0.4-kg weight decrease in group B and 4.2±0.5-kg increase in group A (P<0.05). The combination of exenatide and MET promoted weight loss, glycemic control, β-cell function index, C peptide and adiponectin levels. These results suggested that the combination of exenatide and MET is better than the combination of BIA and MET for the therapy of overweight or obese patients newly diagnosed with T2DM.

[Diagnosis and treatment for one case of elderly diabetes complicated with Still's disease]

Adult onset Still's disease (AOSD) is a clinical syndrome with multiple organ failure. The patients normally show intermittent high fever for a long time, a transient rash, arthritis or joint pain as the main performance, accompanied by an increase in granulocytes and enlargement in liver, spleen and lymph node. A 71-years-old female patient with type 2 diabetes admitted hospital because of high fever, skin rash, joint pain and increased granulocyte. After review of the iron protein, she was diagnosed as AOSD. We found that clinicians need to improve the understanding for this disease in order to make the early diagnosis, especially in elderly patients with diabetes mellitus. In such patients, ferritin may not be high at early time. However, when the symptoms and signs are consistent with clinical manifestations, and anti-infection treatment effect is poor, we should pay attention to the disease, and repeated review of ferritin is necessary to assist the early diagnosis.

LXW7 ameliorates focal cerebral ischemia injury and attenuates inflammatory responses in activated microglia in rats

Inflammation plays a pivotal role in ischemic stroke, when activated microglia release excessive pro-inflammatory mediators. The inhibition of integrin αvβ3 improves outcomes in rat focal cerebral ischemia models. However, the mechanisms by which microglia are neuroprotective remain unclear. This study evaluated whether post-ischemic treatment with another integrin αvβ3 inhibitor, the cyclic arginine-glycine-aspartic acid (RGD) peptide-cGRGDdvc (LXW7), alleviates cerebral ischemic injury. The anti-inflammatory effect of LXW7 in activated microglia within rat focal cerebral ischemia models was examined. A total of 108 Sprague-Dawley rats (250–280 g) were subjected to middle cerebral artery occlusion (MCAO). After 2 h, the rats were given an intravenous injection of LXW7 (100 μg/kg) or phosphate-buffered saline (PBS). Neurological scores, infarct volumes, brain water content (BWC) and histology alterations were determined. The expressions of pro-inflammatory cytokines [tumor necrosis factor-alpha (TNF-α) and interleukin-1 beta (IL-1β)], and Iba1-positive activated microglia, within peri-ischemic brain tissue, were assessed with ELISA, western blot and immunofluorescence staining. Infarct volumes and BWC were significantly lower in LXW7-treated rats compared to those in the MCAO + PBS (control) group. The LXW7 treatment lowered the expression of pro-inflammatory cytokines. There was a reduction of Iba1-positive activated microglia, and the TNF-α and IL-1β expressions were attenuated. However, there was no difference in the Zea Longa scores between the ischemia and LXW7 groups. The results suggest that LXW7 protected against focal cerebral ischemia and attenuated inflammation in activated microglia. LXW7 may be neuroprotective during acute MCAO-induced brain damage and microglia-related neurodegenerative diseases.

Gender-related different effects of a combined therapy of Exenatide and Metformin on overweight or obesity patients with type 2 diabetes mellitus

BACKGROUND

Although men and women have similar diabetes prevalence, the same medicine will cause different therapeutic results in different genders. To understand the molecular mechanism, we explored the effects of a combined therapy of Exenatide and Metformin on obesity and overweight female and male patients with newly diagnosed type 2 diabetes mellitus (T2DM).

METHODS

One hundred and five overweight and obesity patients with newly diagnosed T2DM (n=54 female in a female group and n=51 males in a male group) received the therapy: 5 μg Exenatide+0.5 g MET twice daily for 4 weeks, then 10 μg Exenatide+0.5 g MET twice daily for 24 weeks.

RESULTS

There was an average of 8.2 ± 2.4 kg and 4.6 ± 2.3 kg weight loss in female and male patients, respectively. The combined therapy showed better effects on female than male patients for improving insulin sensitivity and serum lipid profile, reducing insulin resistance, increasing adiponectin levels, and decreasing the levels of HbA1c, BMI, resistin, TNF-alpha and C-reactive protein (P<0.05).

CONCLUSIONS

The combined therapy of Exenatide and MET shows better therapeutic results in female patients than in male patients. Therefore, the dual therapy is more suitable for female patients.

[Efficiency of integrin αvβ3 inhibitor Cilengitide in acute cerebral ischemia in rats]

OBJECTIVE

To explore the effect of the integrin αvβ3 inhibitor Cilengitide on the blood brain barrier (BBB) permeability, brain edema, neuronal cell apoptosis and the relation with the vascular endothelial growth factor (VEGF)expression in acute cerebral ischemia rats.

METHODS

A rat focal cerebral ischemia/reperfusion model was established by middle cerebral artery occlusion. Rats with middle cerebral artery occlusion, in accordance with the random number table, were divided into four groups: (1) the rats in Cilengitide group A (n=30) were treated with Cilengitide at a dose of 100 μg/kg; (2) the rats in Cilengitide group B (n=28) were treated with Cilengitide at a dose of 200 μg/kg; (3) the rats in sham group (n=31), without inserting thread into middle cerebral artery, were treated with normal saline; (4) the rats in control group (n=27) were treated with normal saline.All rats were treated with Cilengitide or saline 1 hour after infarction, given reperfusion 2 hours after infarction and were sacrificed 22 hours after reperfusion.The brain-water content was measured by dry/wet weight method. The permeability of BBB was measured by quantifying Evans Blue. The infarction volume was measured by 2, 3, 5-tripheyl tetrazolium Chloride (TTC) staining. Expression level of VEGF, P-Flk, Cleaved-Caspase-3 was measured by immunohistochemistry and Western blot, respectively.The neuronal cell apoptosis was evaluated by terminal deoxynucleotidyl transferased UTP nick end labeling (TUNEL).

RESULTS

Compared with Control group, treatment groups with cilengitide at the dose of 100 μg/kg and 200 μg/kg reduced brain-water content [(80.8±1.1)% vs (84.8±1.4)%, (81.0±1.4)% vs (84.8±1.4)%, P<0.05], reduced exudation of Evans blue[(9.2±1.1) μg/g vs (12.2±0.8) μg/g, (8.6±0.6) μg/g vs (12.2±0.8) g/g, P<0.05], reduced infarction volume[(31.9±4.9) mm(3) vs(43.0±2.2) mm(3), (29.2±3.5) mm(3) vs(43.0±2.2) mm(3), P<0.05] , reduced neuronal cell apoptosis [(36±4)vs(69±6)、(35±3)vs (69±6), P<0.05]. Compared with sham group, Cilengitide group A and Cilengitide group B had lower brain-water content, permeability of BBB, infarction volume, expression level of VEGF, P-Flk, Cleaved-Caspase-3 and neuronal cell apoptosis (P<0.05). When Cilengitide group A was compared with Cilengitide group B, there were no significant differences in brain-water content, permeability of BBB, infarction volume, expression level of VEGF, P-Flk, Cleaved-Caspase-3 and neuronal cell apoptosis (P>0.05).

CONCLUSION

The integrin αvβ3 inhibitor Cilengitide improves outcomes in the MCAO model by preserving the blood-brain barrier, attenuating brain edema and inhibiting neuronal cell apoptosis, which may occur in a VEGF-and VEGF-receptor-dependent manner, with the same efficacy between Cilengitide 100 μg/kg and 200 μg/kg after 23 hours treatment.

Effects of humic acid and ionic strength on TiO₂ nanoparticles sublethal toxicity to zebrafish

The stability and bioavailability of titanium dioxide nanoparticles (TiO2 NPs) suspension could be modified by the physicochemical properties of solution. In the present study, the effect of humic acid (HA) and ionic strength (by adding NaCl) on aggregation and sedimentation of TiO2 NPs suspension were investigated. Accordingly, the sublethal toxicity of TiO2 NPs suspensions with different HA and NaCl concentrations toward zebrafish (Danio rerio) was evaluated by monitoring the changes of superoxide dismutase, catalase, malonaldehyde and glutathione in gill, liver and intestine. The results showed that the aggregations formation and hydrodynamic diameter of TiO2 NPs in suspensions are not essential characteristics to decide toxicity. The varied oxidative stress responses detected in gill, liver and intestine derived from different toxicity mechanisms of TiO2 NPs. Nevertheless, the oxidative stress could be suppressed by the adding of HA and/or the increase of ionic strength, which can decrease the bioavailability of TiO2 NPs in water. The study suggests that the environmental factors, such as HA and ionic strength, are important for the fate (aggregation and sedimentation) and toxicity of nanomaterials in aquatic environment.

Exenatide enhances INS-1 rat pancreatic β‑cell mass by increasing the protein levels of adiponectin and reducing the levels of C-reactive protein

Type 2 diabetes mellitus (T2DM) is a complex and heterogeneous disorder affecting >220 million individuals worldwide; this is projected to reach 366 million by 2030. Exenatide, a long‑acting glucagon‑like peptide 1 receptor agonist, exhibits potential in the treatment of T2MD due to its ability to increase β‑cell mass. However, the molecular mechanism by which exenatide increases β‑cell mass is yet to be elucidated. Exenatide function was explored in the INS‑1 rat pancreatic β‑cell line. Exenatide was found to increase adiponectin protein levels by 20% (P<0.05 versus the control group) and reduce the level of C‑reactive protein (CRP) by 50% (P<0.01 versus the control group) in INS‑1 cells, resulting in an increase in the INS‑1 rat pancreatic β‑cell mass by 20% (P<0.01 versus the control group). These findings suggest that exenatide may ameliorate T2DM by increasing adiponectin protein levels and reducing the level of CRP.

Liquid immiscibility in an Fe-Cu alloy by molecular dynamics simulation

Liquid-liquid phase segregation in an Fe-Cu melt is investigated by molecular dynamics (MD) simulation based upon a newly developed embedded atom method due to Bonny. The partial pair correlation functions (PPCF) of liquid Fe(50)Cu(50) at a temperature of 1873 K show stronger interaction of homogeneous atom pairs. The coordination number (CN) of Cu-Cu and Fe-Fe in Fe(50)Cu(50) melt is about 11, much higher than that of Fe-Cu. Liquid-liquid phase segregation has also been observed clearly by the atom snapshot method. The calculated enthalpy of mixing is positive in the whole concentration range and the Bhatia-Thornton (BT) structure factor S(CC)(q) increases sharply at lower q, which are all typical features of dense fluid that exhibits a phase segregation tendency. Our present work provides an understanding of atomic-scale phase segregation in liquid Fe-Cu alloy.

Effects of Molecular Rigidity on Electric Field Induced Alignment and Orientational Stability of Dipolar Chromophore Composites

The relationship between the supramolecular conformational structure of assembled chromophores and their susceptibility to electric field poling is of interest for maximizing the bulk alignment achievable in an electro-optic material. We have employed solution phase dielectric constant measurements to investigate possible enhancements in dipolar susceptibility as a function of connectivity and state of aggregation in rationally synthesized chromophore assemblies, including conformationally defined head-to-tail oligomers. On the other hand, conformationally unrestricted, highly dipolar azo dyes behave as relatively isolated molecules even when present in supersaturated solutions and in close proximity on polymer chains.

Abstract P3-15-05: Muscle and Joint Symptoms in Breast Cancer Patients Receiving Taxane-Based Chemotherapy

Background: Docetaxel, paclitaxel, and (nab)-paclitaxel are taxanes used in treating breast cancer at various stages. While fairly well tolerated, they can cause distressing side effects. Both the prevalence and severity of muscle and joint symptoms (M&JS) in patients receiving taxane-based chemotherapies are poorly documented. We prospectively investigated the prevalence and severity of M&JS in women receiving taxane chemotherapy for breast cancer.

Methods: A total of 275 taxane-naive patients were enrolled in the study. This analysis presents data for 95 patients. For three consecutive treatmentcycles patients completed a baseline questionnaire as well as a diary, days 1 through 7 and on days 14 and 21 following treatment. Patient interviews were done by telephone days 2 to 3, and days 5 to 7 following treatment. They were then contacted at approximately three month intervals for one year. Data collection and data entry are ongoing; long term follow-up will conclude in August 2010.

Results: The average age of patients was 53 years. Disease status was classified as early for 50%, locally advanced for 35.34 %, and metastatic for 15.51% of patients. Overall 41.4% and 39.6% of patients reported muscle and joint pain, respectively, in their diaries on days 1 to 7. Muscle pain was most commonly reported in the legs, back, and arms and joint pain in the knees, ankles, and hips. The pain was most often described as aching, tiring, nagging, exhausting, and tender. The following scores are derived from a 10 cm visual analog scale. Of those who experienced pain in the seven days after treatment, the mean rating for pain at its worst was 5.15 and 5.02 for muscle and joint pain, respectively. Pain at its least had an average rating of 3.42 and 3.41 for muscle and joint pain, respectively. With respect to interference, patients who experienced pain had a mean score of 5.39, 4.86, 5.5, 4.12, 5.36, and 5.44 for interference with basic activities in daily life, mood, working or housework, relationships, sleeping and enjoyment of life, respectively. One, 3, 6, 9 and 12 months after taxane treatment ended, 27.2% (22/81), 31% (13/42), 45.5% (20/44), 37.2% (16/43), and 26.9% (7/26) reported muscle pain, respectively. Joint pain was reported by 26% (21/81), 38.1% (16/42), 43.2% (19/44), 48.8% (21/43) and 34.6% (9/26) of patients 1, 3, 6, 9 and 12 months following treatment, respectively. Data entry and analysis is ongoing and the final analysis will report on pain in relation to the taxane used, steroid tapering, role of anti-hormonal therapy, and effect of menopause on incidence of M&JS.

Discussion: Our preliminary data analysis indicates incidence rates of M&JS higher than previously reported during taxane treatment, and persistence of symptoms in a large proportion of patients up to a year following therapy completion. High pain scores and considerable interference with many aspects of life were reported. This study confirms the significant burden of M&JS during taxane chemotherapy. Conclusions: M&JS during taxane treatment is a common occurrence, and is significantly debilitating to the women who experience it. More research should be done regarding preventative measures and treatment options.

Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P3-15-05.