Measurement of the ^{18}O(α, γ)^{22}Ne Reaction Rate at JUNA and Its Impact on Probing the Origin of SiC Grains

The ^{18}O(α,γ)^{22}Ne reaction is critical for AGB star nucleosynthesis due to its connection to the abundances of several key isotopes, such as ^{21}Ne and ^{22}Ne. However, the ambiguous resonance energy and spin-parity of the dominant 470 keV resonance leads to substantial uncertainty in the ^{18}O(α,γ)^{22}Ne reaction rate for the temperature of interest. We have measured the resonance energies and strengths of the low-energy resonances in ^{18}O(α,γ)^{22}Ne at the Jinping Underground Nuclear Astrophysics experimental facility (JUNA) with improved precision. The key 470 keV resonance energy has been measured to be E_{α}=474.0±1.1  keV, with such high precision achieved for the first time. The spin-parity of this resonance state is determined to be 1^{-}, removing discrepancies in the resonance strengths in earlier studies. The results significantly improve the precision of the ^{18}O(α,γ)^{22}Ne reaction rates by up to about 10 times compared with the previous data at typical AGB temperatures of 0.1-0.3 GK. We demonstrate that such improvement leads to precise ^{21}Ne abundance predictions, with an impact on probing the origin of meteoritic stardust SiC grains from AGB stars.

Efficacy and safety of janagliflozin monotherapy in Chinese patients with type 2 diabetes mellitus inadequately controlled on diet and exercise: A multicentre, randomized, double-blind, placebo-controlled, Phase 3 trial

AIMS

To evaluate the efficacy and safety of janagliflozin, a selective renal sodium-glucose cotransporter-2 inhibitor, as monotherapy in drug-naive Chinese patients with type 2 diabetes mellitus (T2DM).

MATERIALS AND METHODS

This Phase 3 trial included a 24-week, multicentre, randomized, double-blind, placebo-controlled period, followed by a 28-week extension period. A total of 432 patients with glycated haemoglobin (HbA1c) levels ≥7.0% (53 mmol/mol) and ≤10.5% (91 mmol/mol) were randomized (1:1:1) to receive once-daily placebo, 25 mg or 50 mg janagliflozin. After 24 weeks, patients on placebo were switched and re-randomized (1:1) to 25 mg or 50 mg janagliflozin, whereas patients on janagliflozin maintained the initial therapy. The primary endpoint was change from baseline in HbA1c after 24 weeks.

RESULTS

At Week 24, the placebo-adjusted least squares mean changes in HbA1c were -0.80% (95% confidence interval [CI] -0.98% to -0.62%)/-8.7 mmol/mol (95% CI -10.7 mmol/mol to -6.8 mmol/mol) and -0.88% (95% CI -1.06% to -0.70%)/-9.6 mmol/mol (95% CI -11.6 mmol/mol to -7.7 mmol/mol), respectively (P < 0.001 for both). A higher proportion of patients achieved HbA1c <7.0% (53 mmol/mol) with janagliflozin 25 mg and janagliflozin 50 mg compared with placebo (47.2%, 49.3%, and 23.5%, respectively). Both janagliflozin doses significantly decreased fasting plasma glucose, 2-hour postprandial glucose, body weight and systolic blood pressure, as well as increased high-density lipoprotein (HDL) cholesterol and insulin sensitivity compared with placebo (P < 0.05 for all). The trends in improvement of these variables were sustained during the 28-week extension period. Overall incidences of adverse events were 67.8%, 71.5% and 60.7% with janagliflozin 25 mg, janagliflozin 50 mg and placebo, respectively. The incidence of urinary tract infections and genital fungal infections was low. No severe hypoglycaemia or ketoacidosis occurred.

CONCLUSIONS

Janagliflozin 25 mg and 50 mg monotherapy once-daily effectively improved glycaemic control, reduced body weight and blood pressure, improved HDL cholesterol and insulin sensitivity, and was generally well tolerated.

High iodine promotes autoimmune thyroid disease by activating hexokinase 3 and inducing polarization of macrophages towards M1

Autoimmune thyroid disease (AITD), the most common autoimmune disease, includes Graves’ disease (GD) and Hashimoto’s thyroiditis (HT). Currently, the pathogenesis of AITD is not fully understood. Our study aimed to examine the presence of macrophage polarization imbalance in AITD patients, to investigate whether high iodine can cause macrophage polarization imbalance, and to investigate the role of key genes of metabolic reprogramming in macrophage polarization imbalance caused by high iodine. We synergistically used various research strategies such as systems biology, clinical studies, cell culture and mouse disease models. Gene set enrichment analysis (GSEA) revealed that M1 macrophage hyperpolarization was involved in the pathogenesis of AITD. In vitro and in vivo experiments showed that high iodine can affect the polarization of M1 or M2 macrophages and their related cytokines. Robust rank aggregation (RRA) method revealed that hexokinase 3 (HK3) was the most aberrantly expressed metabolic gene in autoimmune diseases. In vitro and in vivo studies revealed HK3 could mediate macrophage polarization induced by high iodine. In summary, hyperpolarization of M1-type macrophages is closely related to the pathogenesis of AITD. High iodine can increase HK3 expression in macrophages and promote macrophage polarization towards M1. Targeting HK3 can inhibit M1 polarization induced by high iodine.

Dorzagliatin add-on therapy to metformin in patients with type 2 diabetes: a randomized, double-blind, placebo-controlled phase 3 trial

Metformin, the first-line therapy for type 2 diabetes (T2D), decreases hepatic glucose production and reduces fasting plasma glucose levels. Dorzagliatin, a dual-acting orally bioavailable glucokinase activator targeting both the pancreas and liver glucokinase, decreases postprandial glucose in patients with T2D. In this randomized, double-blind, placebo-controlled phase 3 trial, the efficacy and safety of dorzagliatin as an add-on therapy to metformin were assessed in patients with T2D who had inadequate glycemic control using metformin alone. Eligible patients with T2D (n = 767) were randomly assigned to receive dorzagliatin or placebo (1:1 ratio) as an add-on to metformin (1,500 mg per day) for 24 weeks of double-blind treatment, followed by 28 weeks of open-label treatment with dorzagliatin for all patients. The primary efficacy endpoint was the change in glycated hemoglobin (HbA1c) levels from baseline to week 24, and safety was assessed throughout the trial. At week 24, the least-squares mean change from baseline in HbA1c (95% confidence interval (CI)) was -1.02% (-1.11, -0.93) in the dorzagliatin group and -0.36% (-0.45, -0.26) in the placebo group (estimated treatment difference, -0.66%; 95% CI: -0.79, -0.53; P < 0.0001). The incidence of adverse events was similar between groups. There were no severe hypoglycemia events or drug-related serious adverse events in the dorzagliatin and metformin combined therapy group. In patients with T2D who experienced inadequate glycemic control with metformin alone, dorzagliatin resulted in effective glycemic control with good tolerability and safety profile ( NCT03141073 ).

[Whole transcriptome analysis and critical gene regulatory network analysis during Schistosoma japonicum infection and praziquantel treatment in mice]

OBJECTIVE

To investigate long non-coding RNA (lncRNA)-microRNA (miRNA)-messenger RNA (mRNA) interactions and identify the critical gene regulatory network during Schistosoma japonicum infections and praziquantel treatment using whole transcriptome sequencing.

METHODS

A total of 110 male C57BL/6 mice were randomly divided into the control group, the infection group and the treatment group. Mice in the infection treatment and the control group were infected with S. japonicum cercariae via the abdomen, and liver specimens were sampled from 10 mice 3, 6, 8 weeks post-infection. Praziquantel treatment was given to mice in the treatment group 8 weeks post-infection, and liver specimens were sampled from 10 mice 2, 4, 6, 8, 10 weeks post-treatment. Total RNA was isolated from mouse liver specimens, and the transcriptome library was constructed for highthroughput whole transcriptome sequencing. The significant differentially expressed genes were subjected to functional annotations, Gene Ontology (GO) terms enrichment analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis. Correlation analysis of liver specimens was performed using R Corrplot and Himsc functions, and the lncRNAmiRNA-mRNA interaction network analysis was performed using R MixOmics and Himsc functions.

RESULTS

There were 1 176 differentially expressed miRNAs, 5 270 differentially expressed mRNAs, and 2 682 differentially expressed lncRNAs between the infection group and the control group, 1 289 differentially expressed miRNAs, 7 differentially expressed mRNAs, and 69 differentially expressed lncRNAs between the treatment group and the infection group, and 1 210 differentially expressed miRNAs, 4 456 differentially expressed mRNAs, and 2 016 differentially expressed lncRNAs between the treatment group and the control group. Correlation analysis showed a higher correlation of gene expression between the treatment group and the control group. Principal component analysis showed obvious separate clustering between the infection group and the treatment group. The differentially expressed genes with significant relevance were significantly enriched in 24 GO terms, including arachidonic acid metabolic process, xenobiotic catabolic process, unsaturated fatty acid metabolic process, xenobiotic metabolic process, long-chain fatty acid metabolic process, and 8 KEGG metabolic pathways, including cholesterol metabolism, tyrosine metabolism, linoleic acid metabolism, retinol metabolism, and steroid hormone biometabolism.

CONCLUSIONS

There were 23 mRNAs including Cyp2b9 and 14 lncRNAs including Rmrpr in the core position of the gene regulatory network, which may play a critical role in S. japonicum infections and praziquantel treatment, and 9 miRNAs including miR-8105 may serve as potential molecular markers for diagnosis of S. japonicum infections.

Candidate sex-associated gene identification in Trachinotus ovatus (Carangidae) using an integrated SLAF-seq and bulked segregant analysis approach

It is difficult to distinguish the sexes of Trachinotus ovatus based on appearance, and little data about sex-determining genes are available for this species. Here, we generated 200 F2 individuals using the parents R404 and R403. DNA samples were collected from 50 individuals of each sex and aggregated into sex-specific DNA pools. Specific-locus amplified fragment sequencing was integrated with bulked segregant analysis to detect candidate sex-associated genes. Approximately 3,153,153 high-quality single-nucleotide polymorphism (SNP) markers and 135,363 high-quality insertion-deletion (Indel) markers were generated. Six candidate regions within chromosome 14, encompassing 132 candidate genes, were identified as closely related to sex. Based on annotations, six genes (EVM0019817, EVM0004192, EVM0001445, EVM0005260, EVM0014734, and EVM0009626) were predicted to be closely associated with sex. These results present an efficient genetic mapping approach that lays a foundation for molecular sex discrimination in T. ovatus.

[A prospective cohort study on BMI levels and risk of acute pancreatitis]

Objective: To investigate the effects of body mass index (BMI) levels at different baseline on the risk of new-onset acute pancreatitis (AP). Methods: The subjects were from the Kailuan Study Cohort and divided into 3 groups according to baseline BMI levels: BMI<24 kg/m², normal weight; BMI 24-28 kg/m², overweight; BMI≥28 kg/m², obesity. The incidence of new-onset AP in these three groups was analyzed. The survival curve was plotted by Kaplan-Meier method, the cumulative incidence was calculated and tested by log-rank method. Multivariate Cox proportional hazards regression model was used to calculate HR of baseline BMI levels for AP. Results: A total of 123 841 subjects were included and followed up for (11.94±2.13) years, during which, 395 cases were found with AP. The incidence of AP was 2.67 per 10 000 person years in total population, and the incidences of AP were 2.20, 2.72 and 3.58 per 10 000 person-years in the normal, overweight and obesity groups, respectively. The cumulative incidences of AP was 0.32%, 0.40% and 0.49% in normal, overweight and obesity groups, respectively, which showed a significant inter-group difference by log-rank test (χ ²=13.17,P<0.01). The results of multivariable adjusted Cox proportional hazards regression model analysis indicated that obesity group (HR=1.45, 95%CI: 1.10-1.92) had a higher risk for AP compared with the normal BMI group. The subgroup analyses by age and sex showed that compared with the normal weight group,the HRs for AP in the obesity group was 1.58(95%CI:1.14-2.19) and 1.40(95%CI:1.03-1.90) among subjects younger than 60 years old and male subjects, respectively. After excluded onset AP within two years from baseline,with a control group from normal weight,the results of multivariate Cox proportional hazards regression model analysis indicated that the AP in the obesity group was 1.60 (95%CI: 1.18-2.15). Conclusion: Obesity may increase the risk of developing AP, particularly among young and middle-aged men.

Direct Measurement of the Astrophysical ^{19}F(p,αγ)^{16}O Reaction in the Deepest Operational Underground Laboratory

Fluorine is one of the most interesting elements in nuclear astrophysics, where the ^{19}F(p,α)^{16}O reaction is of crucial importance for Galactic ^{19}F abundances and CNO cycle loss in first generation Population III stars. As a day-one campaign at the Jinping Underground Nuclear Astrophysics experimental facility, we report direct measurements of the essential ^{19}F(p,αγ)^{16}O reaction channel. The γ-ray yields were measured over E_{c.m.}=72.4-344  keV, covering the Gamow window; our energy of 72.4 keV is unprecedentedly low, reported here for the first time. The experiment was performed under the extremely low cosmic-ray-induced background environment of the China JinPing Underground Laboratory, one of the deepest underground laboratories in the world. The present low-energy S factors deviate significantly from previous theoretical predictions, and the uncertainties are significantly reduced. The thermonuclear ^{19}F(p,αγ)^{16}O reaction rate has been determined directly at the relevant astrophysical energies.

Application and Effectiveness of Big Data and Artificial Intelligence in the Construction of Nursing Sensitivity Quality Indicators

In order to explore the quality management efficiency of applying big data and artificial intelligence in nursing quality index, a method of building a nursing management platform integrating nursing indicators and nursing events is proposed. Based on the investigation of the application demand of nursing information system, the method achieves timely data sharing and transmission through WLAN technology and realizes nursing management monitoring, nursing quality index enquiry, and automatic statistical analysis under the vertical management mode of nursing. The results showed that 77 people (73%) thought the time decreased, 19 people (18%) thought the time was the same, and 9 people (7%) thought the time increased. In terms of intelligent application and big data of nursing information management system, there is a significant difference in nursing management efficiency before and after using nursing management information system (P < 0.001). The nursing management control platform is designed and applied, and the nursing quality control method and actual management process are improved, which is very good for strengthening nursing quality management. The overall optimization of the quality control process is realized, which helps to mobilize the initiative and enthusiasm of nursing staff and continuously improve the effectiveness of nursing management and nursing efficiency.

MicroRNA-199-3p targets Sp1 transcription factor to regulate proliferation and epithelial to mesenchymal transition of human lung cancer cells

The present study was undertaken to study the function of miRNA-199-3p in the regulation of human lung cancer growth and metastasis. The results showed significant (P < 0.05) downregulation of miRNA-199-3p in lung cancer tissues and cell lines. Overexpression of miR-197 caused considerable inhibition of the viability and colony formation of the lung cancer cells. The inhibition of proliferation was found to be due to the arrest of the SK-LU-1 lung cancer cells. At the G2/M phase of the cell cycle. In silico analysis and subsequent the dual-luciferase assays showed that miR-199-3p targets Sp1 at molecular. The expression of Sp1 was significantly (P < 0.05) upregulated in lung cancer cells and tissues. Nonetheless, miR-199-3p overexpression could cause post-transcriptional suppression of Sp1. Silencing of Sp1suppress the proliferation of SK-LU-1 lung cancer cells. However, overexpression Sp1 transcription factor prevents the tumor-suppressive effects of miR-199-3p on lung cancer cells. Additionally, miR-199-3p was found to suppresses the migration, invasion and epithelial-to-mesenchymal transition of human lung cancer cells. Summing up, miRNA-199-3p/SP1 axis controls the growth and metastasis of SK-LU-1 lung cancer cells.

Clinical retrospective study on the expression of the PD-L1 molecule in sporadic colorectal cancer and its correlation with K-ras gene mutations in Chinese patients

OBJECTIVE

To detect the expression of PD-L1 and K-ras gene status in colorectal cancer tissues and analyze the relationship between PD-L1 expression and the clinicopathological features and K-ras gene status in colorectal cancer.

METHODS

Two hundred fifty colorectal cancer tissues were collected from the First Affiliated Hospital of Nanchang University. The normal intestinal mucosal tissues of 20 patients were randomly selected for inclusion in the control group. PD-L1 expression was detected by immunohistochemistry. K-ras gene mutation in colorectal cancer tissues was detected by sequencing. The clinical significance of PD-L1 expression and relationship between PD-L1 expression and K-ras gene mutation were analyzed.

RESULTS

The immunohistochemistry assay showed that PD-L1 was highly expressed in colorectal cancer. The positive expression of PD-L1 was increased with lymph node metastasis and high TNM stage. The 5-year survival rate of PD-L1-positive patients was significantly lower than that of PD-L1-negative patients. The K-ras gene mutation rate was 35.6%, and the main mutation site was in codon 12. The positive PD-L1 expression rate in patients with K-ras gene mutations was significantly higher than that in patients with wild-type K-ras gene mutations.

CONCLUSION

PD-L1 is highly expressed in colorectal cancer, and its expression is related to metastasis and tumor stage. PD-L1 expression is closely related to K-ras gene mutation, and the K-ras gene status may affect PD-L1 expression.

TRIAL REGISTRATION

retrospectively registered.

Challenges in diagnosis of spinal epidural abscess: A case report

RATIONALE

Spinal epidural abscess (SEA) is a rare condition that shows a high prevalence in immunocompromised patients. The clinical presentation of SEA includes the "classic triad" of pain, fever, and neurological dysfunction. However, these nonspecific features can lead to a high rate of misdiagnosis. SEA may lead to paralysis or even death; thus, prognosis of these patients remains unfavorable.

PATIENT CONCERNS

We report a case of a multilevel (T6-T12) SEA in a 22-year-old woman.

DIAGNOSIS

The patient was initially diagnosed with spinal tuberculosis at a local hospital based on a history of tuberculosis exposure, as well as radiography and computed tomography. Histopathological examination of the tissue resected during laminectomy confirmed the diagnosis of SEA in this patient.

INTERVENTIONS

The patient underwent multilevel laminectomy combined with long-term antibiotic therapy.

OUTCOMES

Physical examination performed 16 months postoperatively revealed that superficial and deep sensation was restored to normal levels in the lower extremities with improvement in the patient's motor function (muscle strength 2/5).

LESSONS

This case report indicates that whole spine magnetic resonance imaging is warranted in patients with SEA and that prompt surgical intervention is important at symptom onset. Long-term antibiotic therapy is also essential postoperatively.

Ulcerative colitis followed by the development of typical intestinal Behçet disease: A case report

RATIONALE

Intestinal Behçet disease (intestinal BD) and inflammatory bowel disease (IBD) share a lot of characteristics, including genetic background, clinical manifestations, and therapeutic strategies, especially the extraintestinal manifestations, such as oral ulcers, arthralgia, eye lesions, skin lesions, etc, but the coexistence of these 2 diseases are uncommon. Behçet disease with gastrointestinal involvement in ulcerative colitis (UC) patient has been reported in just 1 previous case report, but, which can not be diagnosed as definite intestinal BD based on Korean novel diagnositic criteria due to lacking the typical ileocecal ulcer.

PATIENT CONCERNS

We present a 23-year-old woman with ulcerative disease who developed typical intestinal BD, which is the first case report of patient with coexisting UC and typical intestinal BD.

DIAGNOSES

This patient was diagnosed as coexistence of intestinal BD and UC base on the clinical manifestations, extra intestinal manifestations and typical colonoscopic findings.

INTERVENTIONS

Steroid and methotrexate were administered.

OUTCOMES

This patient achieved clinical remission and mucosal healing.

LESSONS

Coexistence of intestinal BD and UC is uncommon, and the combination with steroid, methotrexate, and 5-aminosalicylic acids is an effective therapy.

Plasma soluble CD36, carotid intima-media thickness and cognitive function in patients with type 2 diabetes

INTRODUCTION

Diabetes and atherosclerosis are both risk factors of cognitive deficits. Scavenger receptor CD36 is associated with increasing risk of diabetes and atherosclerosis, and may play a role in cognitive deficits. The aim of this study is to determine the correlations of plasma soluble CD36 concentrations with carotid intima-media thickness (IMT) and cognitive function in patients with type 2 diabetes.

MATERIAL AND METHODS

We determined the levels of soluble CD36 (sCD36), blood lipids, fasting blood glucose, glycosylated hemoglobin, carotid atherosclerosis as IMT, cognitive function by the Montreal Cognitive Assessment (MoCA) scoring system, and other clinical characteristics in 357 patients with type 2 diabetes.

RESULTS

Diabetic patients with the lowest quartile of IMT (Q1) had lower sCD36 concentrations (ANOVA, p_trend < 0.05) and higher MoCA scores than upper ones (Q2-Q4) (p_trend < 0.05), and those with the highest quartile of sCD36(Q4) had higher FBG, LDL-C and carotid IMT than lower ones (Q1-Q3) (p_trend < 0.05 for all). Plasma log₁₀(sCD36) was significantly correlated with carotid IMT (r = 0.202, p < 0.001) after adjustment for age, gender, and education level. Carotid IMT was significantly associated with MoCA scores (r = 0.284, p < 0.001) after adjustment for, age, gender, education level, duration of DM and hypertension. There were no correlations between sCD36 and MoCA scores (r = -0.038, p = 0.470).

CONCLUSIONS

Our study shows that sCD36 is associated with carotid IMT, and carotid IMT is inversely correlated with cognitive function in type 2 diabetic patients. Nevertheless, no cross-sectional association between sCD36 and MoCA scores was detected in this study.

HtrA1 Down-regulation Induces Cisplatin Resistance in Colon Cancer by Increasing XIAP and Activating PI3K/Akt Pathway

The high temperature requirement factor A1 (HtrA1), a member of serine protease family, has been reported to be down-regulated in various cancer types and correlate with chemoresistance. However, the function of HtrA1 in colon cancer remains unclear. This study investigated the role of HtrA1 in cisplatin (CDDP) resistance of colon cancer. We found that HtrA1 was up-regulated in colon cancer cell line SW480 incubated with CDDP. By treating SW480 cells to a continuous exposure to CDDP, we developed CDDP-resistant SW480/CDDP cells and found that the mRNA and protein levels of HtrA1 were reduced. Besides, the stable knock-down of HtrA1 in SW480 transfected with HtrA1 shRNA could also induce chemoresistance against CDDP. To the contrary, ectopic expression of HtrA1 in SW480/CDDP cells abrogated CDDP resistance. The mechanism underlying HtrA-1 down-regulation induced chemoresisance was also investigated. In SW480/CDDP cells and SW480 cells with HtrA1 knock-down, X-linked inhibitor of apoptosis protein (XIAP) was increased, while the interfering of XIAP impeded CDDP resistance in SW480/CDDP cells. We also found that Akt was activated in SW480/CDDP cells and SW480 cells with HtrA1 knock-down. The inhibition of Akt activation reversed CDDP resistance. In conclusion, our results indicate that HtrA1 down-regulation induces CDDP resistance in colon cancer by increasing XIAP and activating PI3K/Akt pathway. This study provides evidence that HtrA1 might be a therapeutic target for overcoming CDDP resistance in colon cancer.

Polyphasic taxonomy of Aspergillus section Cervini

Species belonging to Aspergillus section Cervini are characterised by radiate or short columnar, fawn coloured, uniseriate conidial heads. The morphology of the taxa in this section is very similar and isolates assigned to these species are frequently misidentified. In this study, a polyphasic approach was applied using morphological characters, extrolite data, temperature profiles and partial BenA, CaM and RPB2 sequences to examine the relationships within this section. Based on this taxonomic approach the section Cervini is resolved in ten species including six new species: A. acidohumus, A. christenseniae, A. novoguineensis, A. subnutans, A. transcarpathicus and A. wisconsinensis. A dichotomous key for the identification is provided.

Effects of body mass index or dosage on gastrointestinal disorders associated with extended-release metformin in type 2 diabetes: Sub-analysis of a Phase IV open-label trial in Chinese patients

AIM

To determine whether gastrointestinal (GI) tolerability of metformin monotherapy varies according to baseline BMI or at doses >1500mg/day in patients newly diagnosed with type 2 diabetes.

METHODS

We performed a sub-analysis of the safety population from a prospective, multicenter, Phase IV open-label study in which 371 Chinese patients with type 2 diabetes received extended-release metformin monotherapy for 16 weeks. The incidence, severity and duration of GI adverse events (AEs) were compared between normal-weight (BMI<25kg/m(2), n=155) and overweight/obese (BMI≥25kg/m(2), n=216) patients. The primary objective was to determine whether baseline BMI affect the incidence, severity and duration of GI AEs, using Fisher's exact test and Student's t-test. Secondary objectives were to compare these factors according to final metformin dose (≤1500mg/day versus 2000mg/day).

RESULTS

The proportion of patients who reported ≥1 GI AE did not differ significantly between BMI groups (25.2% of the normal-weight group versus 21.3% of the overweight/obese group; p=0.3840). Patients who reported GI AEs in the two BMI groups experienced similar GI AE severity (p=0.5410), mean duration (p=0.3572) and duration distribution (p=0.1347). There was no significant difference in GI AE severity and duration between metformin dosage groups (≤1500mg/day versus 2000mg/day).

CONCLUSIONS

Newly-diagnosed Chinese type 2 diabetes patients of normal weight are no more likely than overweight/obese patients to suffer from increased incidence rates, severity or duration of GI AEs when treated with first-line extended-release metformin monotherapy. Doses of 2000mg/day did not increase the severity or duration of GI AEs.

Correlations between serum levels of 25-hydroxyvitamin D and carotid atherosclerosis in patients with type 2 diabetes in Shanghai

OBJECTIVE

To explore the potential association between the serum levels of 25-hydroxyvitamin D [25(OH)D] and carotid atherosclerosis in patients with type 2 diabetes.

MATERIAL AND METHODS

Three hundred and fifty patients with type 2 diabetes were enrolled in this study in Shanghai, China. B-mode ultrasound was used to detect carotid plaques as indicators of atherosclerosis and measure carotid artery intima-media wall thickness (C-IMT) at two sites of carotid artery. Subjects were divided into group A (patients with carotid plaques) and group B (patients without carotid plaques) and be assessed clinically. Serum levels of 25(OH)D and other clinical parameters were measured. Multivariate logistic regression was performed to find predictors of carotid atherosclerosis in the entire group.

RESULTS

The levels of serum 25(OH)D were lower in group A than in group B[19.60 (13.30-25.73) vs 23.19 (18.10-30.06)ng/ml, P<0.001]. The C-IMT levels [(1.00±0.17 vs 0.88±0.20)mm, Ptrend<0.001] and proportion of people with carotid plaques(44/88 vs 20/87, Ptrend<0.001) in the lowest quartile of 25(OH)D were higher than in the highest quartile. Vitamin D concentrations were inversely associated with HbA1c in women(r=-0.194, P=0.006), and C-IMT in men(r=-0.409, P<0.001). Logistic regression analysis showed age, male sex, current smoke, history of hypertension, SBP, LDL-C and lg[25(OH)D] (OR: 0.924, 95%CI: 0.893-0.955, P<0.001) were independently associated with the presence of carotid plaques in T2DM.

CONCLUSIONS

Serum vitamin D level is significantly and independently associated with carotid atherosclerosis in patients with T2DM in Shanghai, China.

Serum levels of 25-hydroxyvitamin D are associated with cognitive impairment in type 2 diabetic adults

Hypovitaminosis D is highly prevalent in type 2 diabetes. The aim of this study is to determine the serum levels of 25-hydroxyvitamin D [25(OH)D] in type 2 diabetic patients with and without mild cognitive impairment (MCI), and examine the relationship of 25(OH)D and MCI with other clinical factors. One hundred and sixty-five diabetic patients were enrolled in this study. Among whom, 95 patients were considered as MCI [Montreal Cognitive Assessment score (MoCA) < 26] and the other 70 as no MCI (MoCA ≥ 26). Subjects were assessed clinically. Diabetic patients with MCI had a longer duration of DM, fewer years of education, elevated fasting blood glucose (FBG), resistant index (RI) of carotid, and lower levels of 25(OH)D {[17.35 (13.02-25.92) vs 28.00 (19.67-34.30)] ng/ml, P < 0.001}. The MoCA score was positively correlated with log10[25(OH)D], education year, and inversely correlated with duration of DM, history of hypertension, intima-media thickness (IMT), FBG, max-RI, and min-RI. Log10[25(OH)D] was positively correlated with MoCA score, and inversely correlated with IMT, in multivariate regression analysis adjusted for age, sex, and education year, 25(OH)D (β = 0.210, P = 0.003), history of hypertension (β = -0.191, P = 0.007), IMT (β = -0.194, P = 0.007), and FBG (β = -0.157, P = 0.026) independently predicted MoCA score. In conclusion, our results suggest that levels of serum 25(OH)D are inversely associated with the cognitive impairment in diabetic patients. Vitamin D may be a potential protective factor for cognitive impairment in patients with type 2 diabetes.

The applicability of Ki-67 marker for renal epithelioid angiomyolipoma: experience of ten cases from a single center

In order to present our experience with 10 cases of renal epithelioid angiomyolipoma (EAML) and validate the applicability of Ki-67 (proliferation marker) for EAML, we reviewed medical records of 10 consecutive cases diagnosed EAML from January 2005 to February 2012 at our department. Clinical data were collected and analyzed and pathology slides were reviewed. The immunohistochemical reactions for Ki-67 were performed and tumors showed positive expression were estimated. Active follow-up was performed to investigate the association between Ki-67 expression and the prognosis. The mean age and tumor size of the patients was 43.6 years (range 32-56) and 8.2 cm (range 2-15 cm), respectively. Seven were females while three were males. Radical nephrectomy was performed in 6 patients, partial nephrectomy in 3, and renal artery ligation in 1. The immunohistochemical reactions for HMB-45 (Human Melanoma Black), SMA (Smooth Muscle Actin) were positive but for S-100 were negative. The number of patients showing positive/negative Ki-67 expression was 5/5. The survival rate of the positive group was 20% (1/5) while 100% (5/5) of the negative group during the median follow-up time of 26.75 months (range 1-53). Recurrence, metastasis and death due to disease occurred in 1 (10%), 3 (30%) and 4 (40%) patients, respectively. Higher expression (positive) of Ki-67 indicates the presence of EAML and poor prognosis of patients. Surgical excision including radical and partial nephrectomy is a considerable approach to the treatment for its malignant potential.

Comparison of a paraspinal approach with a percutaneous approach in the treatment of thoracolumbar burst fractures with posterior ligamentous complex injury: a prospective randomized controlled trial

OBJECTIVE

This prospective randomized controlled study compared the efficacy and safety of two paraspinal muscle-sparing surgical approaches for the management of neurologically intact patients with thoracolumbar burst fractures and posterior ligamentous complex injuries.

METHODS

Patients were randomized to undergo either percutaneous (n=31) or paraspinal (n=30) fluoroscopically-guided pedicle screw-rod fixation, and were followed for ≥3 years. Preoperative postural reduction was attempted in all patients.

RESULTS

The percutaneous approach was associated with significantly less intraoperative blood loss and shorter duration of surgery and hospitalization, as well as less pain and better functional recovery at 3 months after surgery compared with the paraspinal approach. Paraspinal surgery resulted in significantly better correction of kyphosis and restoration of vertebral height compared with percutaneous surgery. There were no differences in long-term clinical outcomes between the two groups.

CONCLUSIONS

The minimally invasive percutaneous approach appears to be better in cases of successful postural reduction. The paraspinal approach results in better surgical correction and is, therefore, recommended for patients without successful postural reduction.

[The effects of Nrf2 gene expression induced by RU486 at different doses on A549 cell damage induced by paraquat]

OBJECTIVE

To observe the effects of Nrf2 gene expression induced by RU486 at different doses on A549 cell damage induced by paraquat (PQ).

METHODS

After A549 cells transfected with Ad-RUNrf2 were treated by RU486 at the doses of 10(-10), 10(-9), 10(-8) and 10(-7) mol/L for 6 h, A549 cell cultures were exposed to 10(-3) mol/L of PQ for 48 h. Then qRT-PCR and EMSA assays were used to detect the expression of Nrf2 gene, and qRT-PCR and ELISA assays were utilized to measure the effects of Nrf2 gene on the expression of the inflammatory cytokines IL-6, IL-10 and TNF-α, apoptotic factors Caspase-3, Caspase-9 and Cytochrome C. The oxidation factors (CAT and MDA protein contents) were observed by Chemical Colorimetric Analysis.

RESULTS

Nrf2 gene relative expression and protein contents increased with RU486 concentrations, and the above expression was the highest when the concentration of RU486 was 10(-7) mol/L, which was significantly higher than those in control and PQ exposure groups (P < 0.01 or P < 0.05). The relative gene expression and protein expression of IL-6 and TNF-α enhanced with the reduced concentrations of RU486, which were the lowest when RU486 concentration was 10(-7) mol/L, as compared with control and PQ exposure groups (P < 0.01 or P < 0.05), while the change of IL-10 content was the opposite. The relative expression of Caspase3, Caspase9 and Cytochrome C genes also increased with the reduced concentrations of RU486, which were the lowest when RU486 concentration was 10(-7) mol/L, as compared with control and PQ exposure groups (P < 0.01 or P < 0.05). The content of CAT enhanced with RU486 concentration, which was the highest when RU486 concentration was 10(-7) mol/L, as compared with control and PQ exposure groups (P < 0.05). But the change of MDA content was the contrary.

CONCLUSION

Nrf2 expression induced by RU486 can promote the balance of oxidation-antioxidation system in A549 cells and inhibit the inflammation and apoptosis factors, which has a protective effect on A549 cell injury induced by PQ.

Anti-IgM-induced down-regulation of nuclear Thy28 protein expression in Ramos B lymphoma cells

We recently cloned mouse Thy28 cDNA (mThy28), which is highly conserved among vertebrates and plants. The mThy28 mRNA is highly expressed in testis, liver, kidney, brain, with moderate expression in thymus, spleen, and heart. In the present study, characteristics of mouse Thy28 protein expression were examined using rabbit anti-mThy28 polyclonal antibody (Ab). Levels of mThy28 protein expression were highest in testis, with moderate expression in liver, spleen, and thymus. The Thy28 protein was mainly located in the nucleus, which was revealed by immunofluorescence microscopy and Western blotting using anti-mThy28 Ab, and transient expression of the mThy28/EGFP fusion gene. Engagement of membrane immunoglobulin with anti-IgM induced down-regulation of human Thy28 expression at both mRNA and protein levels, accompanied by induction of apoptosis in Ramos B lymphoma cells. Expression of protein and mRNA and induction of apoptosis were evaluated by flow cytometry/Western blotting, reverse transcription-polymerase chain reaction, and propidium iodide staining, respectively. Anti-IgM also down-regulated the promoter activity of the mThy28 gene, as demonstrated by luciferase assay. Thus, the anti-IgM-induced down-regulation of the nuclear Thy28 expression appears to correlate with the induction of apoptosis in Ramos B lymphoma cells.

[Observation of plasma levels of beta-endorphin in patients with trigeminal neuralgia]

OBJECTIVE

To observe the relationship between plasma levels of beta-endorphin and trigeminal neuralgia.

METHODS

During the attacks of trigeminal neuralgia, beta-endorphin levels of plasma from external jugular, cubital fossa vein blood ipsilateral to the pain and contralateral external jugular vein blood were assessed by sensitive radioimmunoassay in 12 cases, after operations the venous blood from the ipsilateral external jugular vein was sampled again, the external jugular vein blood of 12 normal volunteers was collected as control.

RESULTS

The plasma levels of beta-endorphin in patients with trigeminal neuralgia were significantly lower than that in normal volunteers (P<0.05).

CONCLUSION

The lowered plasma beta-endorphin levels may be an important factor for the development of pain in patients with trigeminal neuralgia, which may result in pain and neurogenic inflammation that can not be controlled in central nervous system and peripheral nerve terminals.

Long-term results of wide-field brachytherapy as the sole method of radiation therapy after segmental mastectomy for T(is,1,2) breast cancer

BACKGROUND

We hypothesized that wide-field brachytherapy (BRT) after margin negative excision would result in complication rates, local recurrence rates, and cosmesis scores equivalent to external beam radiotherapy (ERT).

METHODS

Patients with T(is,1,2) tumors less than or equal to 4 cm, 0 to 3 positive axillary nodes, and negative inked surgical margins were entered prospectively into BRT phase I/II trial. Patients who met the eligibility criteria for BRT but were treated with ERT during the same time period were retrospectively identified as controls. A blinded panel of healthcare professionals graded cosmetic outcome.

RESULTS

Fifty patients with 51 breast cancers received BRT from January 1992 to October 1993. We identified 94 patients eligible for BRT but concurrently treated with ERT. At a median follow-up of 75 months, the two groups were similar for grade III treatment toxicities, local/regional recurrence rates, and cosmesis scores.

CONCLUSIONS

For selected breast cancer patients undergoing breast-conserving therapy, BRT is an attractive alternative to ERT.

The effects of 2-bromopropane on viability and testosterone production ability of rat Leydig cells in primary culture

Epidemiological surveys and animal experiments have shown that 2-bromopropane induces oligozoospermia in exposed workers and inhibits spermatogensis in laboratory animals. However, the mechanism by which 2-bromopropane exerts its effects is unknown. To this end, we examined the formation of testosterone by the Leydig cells and their survival of these cells in the presence of different concentrations of 2-bromopropane in vitro. Leydig cells were isolated following vascular perfusion, enzymatic dissociation and Percoll gradient centrifugation techniques. The cells were cultured in culture dishes. After 8 h, different cultures were exposed to 2-bromopropane at concentrations of 0.01 mmol/L, 0.10 mmol/L and 1.00 mmol/L. In order to stimulate Leydig cells to secrete testosterone, human chorionic gonadotropin (hCG) was also added. Cell viability was determined using the trypan blue dye exclusion test and cell numbers were counted by hemocytometer. Testosterone secretion was detected by radioimmunoassay. The cell viability decreased after exposure to 2-bromopropane in a dose-dependent way, but no morphological change was observed. The cell number decreased in the 2-bromopropane-treated cultures. The secretion of testosterone did not manifest defectable changes in the culture treated with 0.10 mmol/L and 0.01 mmol/L of 2-bromopropane; however, it decreased significantly (P < 0.02) in the presence of 1.00 mmol/L. Therefore, our results strongly suggest that 2-bromopropane may exert its cytotoxic effects on Leydig cells in vitro. We speculate that the decrease in the numbers of Leydig cells caused by 2-bromopropane was mediated by a feedback mechanism resulting from a lower testosterone concentration.

[Clinical application study of intraoral high-level mandibular neurotomy: Reported of 19 cases]

Trigeminal neuralgia is a common disease in clinical practice. The recurrence rate after avulsion is relatively high. In order to reduce the recurrence rate, the author developed a new method and operated on 19 cases with intraoral high level trigeminal neurotomy based on 21 cases of adult human skull anatomy. The method is simple, safe and in good condition. The author emphasized that the proper management of the buccal branch during operation may have a close relation with the post-operative recurrence rate.

The distribution of HgCl2 in rat body and its effects on fetus

Both female and male Wistar rats were dividend into 3 groups according to their body weights. The two test groups were given 75 micrograms/ml and 7.5 micrograms/ml HgCl, respectively, via drinking water, while the control group was given distilled water. Animals were mated after the male rats were treated for 12 weeks and female rats for 2 weeks. Blood samples from rats were taken on the 18th day of the pregnancy and the results showed that the HgCl2 was absorbed and stored in the blood in the form of inorganic mercury. The greatest amount of HgCl2 was found in the kidney. The placenta and the tests also had high mercury deposits. Fetuses showed low levels of HgCl2, thus, the placenta appears to serve as a barrier against HgCl2. No pathological changes were observed in the placenta, ovary, liver, and kidney in the female rats, but the epithelial cells of the rental proximal convoluted tubules were cloudy and swelling. The renal corpuscle showed no changes in the male rats. Pathological examination showed that a portion of the seminiferous epithelia were falling off, and the number of sperm released by the male was reduced. Examination by electron microscopy revealed that particulate fat was increased in sperm cells, which suggests that spermatozoa had been degenerated and were possibly one of the causes for the decreased rates of pregnancy in the exposed groups. No malformation of organs and bones in the rat fetuses were observed.

[Three-dimensional computed tomography in the diagnosis of diseases of jaw bone(report of 22 cases).]

3DCT reconstruction,as a new roentnogenographic technique,has not been yet used so much in Oral Maxillofacial Surgery in our country.Scine early 1993,22 cases of 3DCT reconstruction have been performed on a Siemens Plus-s CT scanner for the diagnosis and surgical planning of jaw bone disease and injuries.It demonstrated that 3DCT reconstruction is a useful technique for the diagnosis and surgical planning of jaw bone disease.

Studies on the toxicity and maximum allowable concentration of chloroform

Chloroform has obvious hepato-, nephro-toxicity and carcinogenicity. In order to get necessary data for recommendation of maximum allowable concentration of chloroform in workplace, a series of studies were carried out. The results showed that exposed workers mainly distributed in the industries of perspex processing, production of refrigerants, drugs and pesticides. The exposure level ranged 4.27-147.91 mg/m3 in 119 air samples collected from 3 representative worksites, with 45.4% air samples below 20 mg/m3. The workers exposed to chloroform at 29.51 mg/m3 had slight liver damage indicated by the higher rates of abnormal serum prealbumin and transferrin levels than those of control workers. The neurobehavioral functions of these workers were also obviously affected, manifested as increases in scores of passive mood states and dose-related negative changes in neurobehavioral testing. The observed effect threshold concentration of subacute inhalation in rats was 592 mg/m3 according to the observation on the biochemical changes in liver tissue and abnormal activities of serum enzymes. Mainly based on the above results, we recommended 20 mg/m3 as the Maximum Allowable Concentration in workplace in China at present.

[The diagnosis and the treatment on lingual thyroid]

Lingual thyroid is a rare example of ectopic thyroid.This paper reported three cases of lingual thyroid(all female,aged between 16 and 61 years) were discussed with diagnosis and treatment.A transoral excision using the median total glossotomy and precervical excision was performed through a transsuprahyoid approach.Postoperative complications is not developed.The approach above mention is better than that of median labiomandibular glossotomy.

More precise localization of nasal tumors associated with chronic exposure of F-344 rats to formaldehyde gas

Considerable interest and research have resulted from the finding that squamous cell carcinomas, polypoid adenomas, and a small number of other nasal neoplasms occurred in F-344 rats following chronic inhalation exposure to formaldehyde. These tumors were reported to originate in the anterior portion of the nasal cavity but their precise location in the nose was not determined. Histologic sections from the nasal passages of these rats have been reexamined and the location of each tumor has been recorded. The majority of squamous cell carcinomas occurred on the anterior portion of the lateral aspect of the nasoturbinate and adjacent lateral wall (57%) or the midventral nasal septum (26%). Polypoid adenomas were confined to a small region of the anterior nasal cavity and were restricted to the free margins of the naso-and maxilloturbinates and lateral wall adjacent to these margins. One neoplasm, considered to be the malignant counterpart of the polypoid adenoma, originated on the dorsal margin of the maxilloturbinate in the same region of the nose. Remaining neoplasms were generally too large or too poorly preserved for assessment of their site of origin. Mechanistic studies directed toward a better understanding of the nasal carcinogenicity of formaldehyde, or other nasal carcinogens. should take into account the anatomic sites of origin of the neoplasms whenever this can be determined.

The nasal mucociliary apparatus. Correlation of structure and function in the rat

Rats are used extensively in inhalation toxicologic studies, but little information is available on the rat nasal mucociliary apparatus. The function of the rat nasal mucociliary apparatus was studied in vitro by video analysis, and its structure was examined by light and electron microscopy. Video analysis permitted determination of mucus flow rate and ciliary beat frequency without disrupting mucociliary function. In different regions of the nose, there was a characteristic mucus flow rate, flow pattern, and ciliary beat frequency, with minimal interanimal variation. Analysis of data pairs revealed no evidence of a correlation between mucus flow rate and ciliary beat frequency, ciliary length, density of the ciliated cell population, or the products of these factors. Mucus was seen to flow over certain nonciliated areas, and it is proposed that the mucus is pulled over these areas. Mucus flow characteristics indicated that the hypophase was less viscous than, and moved in the same direction as, the epiphase. The nasal mucus was present as a continuous layer over the respiratory epithelium, and had an osmiophilic surface film, which was found to be made up of 2 separate membranous components. On the basis of these studies, it was concluded that the rat nasal mucociliary apparatus represents a useful and readily accessible model for in vitro studies of nasal mucociliary function.

Respiratory tract lesions induced by sensory irritants at the RD50 concentration

Exposure of mice to airborne sensory irritants causes a concentration-dependent depression of respiratory rate. The RD50 concentration (that concentration which elicits a respiratory rate decrease of 50%) has been predicted to be an unacceptable occupational exposure concentration due to intolerable sensory irritation and possible respiratory tract injury in humans. The purpose of this study was (1) to determine whether lesions occur in the respiratory tract of Swiss-Webster mice after exposure to the RD50 concentrations of ten sensory irritants and (2) to compare these changes with respect to type and severity. The RD50 values (ppm) of the chemicals studied are as follows: 2,4-toluene diisocyanate (0.4), acrolein (1.7), formaldehyde (3.1), chloropicrin (8.0), chlorine (9.3), sulfur dioxide (117), ammonia (303), hydrogen chloride (309), dimethylamine (511), and epichlorohydrin (687). After exposure of mice for 6 hr/day for 5 days, the respiratory tract was examined for histopathologic changes. All irritants produced lesions in the nasal cavity with a distinct anterior-posterior severity gradient. There was considerable variation in the extent, and nature of the lesions. The lesions ranged from slight epithelial hypertrophy or hyperplasia to epithelial erosion, ulceration, and necrosis with variable inflammation of the subepithelial tissues. Only chlorine, chloropicrin, and epichlorohydrin induced lesions in the lower respiratory tract. These findings give additional support to the potential value of the RD50 model for setting occupational exposure guidelines and predicting the risk of injury to the respiratory tract from exposure to airborne sensory irritants.

Pathology of toxic responses to the RD50 concentration of chlorine gas in the nasal passages of rats and mice

Male Swiss-Webster mice and Fischer-344 rats were exposed to chlorine gas at their respective RD50 concentrations (ca. 9 to 11 ppm). The RD50 concentration is that concentration which reduces respiratory rate by 50%. The exposures were carried out for 6 hr per day for 1, 3, or 5 days, and the animals were killed immediately at the end of the last exposure. The nasal passages were examined by light and scanning electron microscopy. Lesions were observed in all exposed groups and were of similar severity and character in rats and mice. The most severe changes were found in the olfactory mucosa of the anterior portion of the dorsal meatus and consisted of partial to complete degeneration of olfactory sensory cells, with olfactory sustentacular cells being more resistant to chlorine exposure. Lesions in the respiratory epithelium were located primarily on the free margins of the naso- and maxilloturbinates and adjacent nasal septum. Scanning electron microscopy, using large size specimens, demonstrated loss of olfactory cilia in areas of the olfactory epithelium which appeared unaffected by light microscopy. Scanning electron microscopy was also helpful in locating areas of respiratory epithelium exhibiting loss of cilia and cellular exfoliation, which occurred primarily on naso- and maxilloturbinates. Therefore, chlorine-induced severe lesions in specific locations in both the olfactory and respiratory epithelia of the nasal passages with more widespread loss of respiratory and olfactory cilia.