Association between sagittal abdominal diameter-to-height ratio and arteriosclerotic cardiovascular disease among the United States adults: A cross-sectional study

Objectives

Abdominal obesity is recognized as a significant determinant of Arteriosclerotic cardiovascular disease (ASCVD), with sagittal abdominal diameter (SAD) being considered a more precise indicator of visceral fat. Nevertheless, the association between SAD and ASCVD remains unexplored in large-scale general-population studies.

Methods

The study included 11,211 participants aged 20 to 80 from the National Health and Nutrition Examination Survey. Logistic regression models were utilized to evaluate the association between the SAD-to-height ratio (SADHtR) and ASCVD. Subgroup analyses based on age categories, sex, diabetes, and hypertension were conducted to assess result robustness.

Results

The median SADHtR value was 0.13 (0.12-0.15), and 1,006 cases (7.46 %) of ASCVD were recorded. Multivariable models showed that each standard deviation increase in SADHtR was positively associated with higher odds of ASCVD (OR 1.48, 95 % CI 1.36-1.62 in model 1; OR 1.41, 95 % CI 1.28-1.54 in model 2; OR 1.18, 95 % CI 1.08-1.30 in model 3). Comparing the first quartile of SADHtR to the second to fourth quartiles, positive associations with ASCVD were observed in models 1 and 2. However, in model 3, only the fourth quartile of SADHtR remained statistically significant (OR 1.58, 95 % CI 1.17-2.15), with all p-values for the trend being less than 0.05. No interactions were found in the subgroup analyses.

Conclusion

This study demonstrates a positive association between SADHtR and ASCVD in the general adult population of the United States. Our findings indicate that SADHtR, especially when ≥ 0.155, could be a valuable metric for assessing the risk of ASCVD.

Transition of the genital mollicutes from the second to the third trimester of pregnancy and its association with adverse pregnancy outcomes in GDM women: a prospective, single-center cohort study from China

BACKGROUND

The association of genital Mollicutes infection transition with adverse pregnancy outcomes was insignificant among general pregnant women, but there remains a paucity of evidence linking this relationship in gestational diabetes mellitus (GDM) women. The aim was to investigate the association between genital Mollicutes infection and transition and adverse pregnancy outcomes in GDM women, and to explore whether this association still exist when Mollicutes load varied.

METHODS

We involved pregnant women who attended antenatal care in Chongqing, China. After inclusion and exclusion criteria, we conducted a single-center cohort study of 432 GDM women with pregnancy outcomes from January 1, 2018 to December 31, 2021. The main outcome was adverse pregnancy outcomes, including premature rupture of membrane (PROM), fetal distress, macrosomia and others. The exposure was Mollicutes infection, including Ureaplasma urealyticum (Uu) and Mycoplasma hominis (Mh) collected in both the second and the third trimesters, and testing with polymerase chain reaction method. The logistic regression models were used to estimate the relationship between Mollicutes infection and adverse pregnancy outcomes.

RESULTS

Among 432 GDM women, 241 (55.79%) were infected with genital Mollicutes in either the second or third trimester of pregnancy. At the end of the pregnancy follow-up, 158 (36.57%) participants had adverse pregnancy outcomes, in which PROM, fetal distress and macrosomia were the most commonly observed adverse outcomes. Compared with the uninfected group, the Mollicutes (+/-) group showed no statistical significant increase in PROM (OR = 1.05, 95% CI:0.51 ∼ 2.08) and fetal distress (OR = 1.21, 95% CI: 0.31 ∼ 3.91). Among the 77 participants who were both Uu positive in the second and third trimesters, 38 participants presented a declined Uu load and 39 presented an increased Uu load. The Uu increased group had a 2.95 odds ratio (95% CI: 1.10~8.44) for adverse pregnancy outcomes.

CONCLUSION

Mollicutes infection and transition during trimesters were not statistically associated with adverse pregnancy outcomes in GDM women. However, among those consistent infections, women with increasing Uu loads showed increased risks of adverse pregnancy outcomes. For GDM women with certain Mollicutes infection and colonization status, quantitative screening for vaginal infection at different weeks of pregnancy was recommended to provide personalized fertility treatment.

[Long-term efficacy of balloon-assisted endplate augmentation combined with transforaminal pedicle screw fixation in the treatment of thoracolumbar burst fractures]

Objectives: To investigate the long-term efficacy of balloon assisted endplate reduction with vertebral augmentation combined with pedicle screw fixation in the treatment of thoracolumbar burst fractures, and to compare the clinical efficacy of calcium sulfate cement (CSC) and calcium phosphate cement(CPC). Methods: This study is a retrospective cohort study.The clinical data of 39 patients with thoracolumbar burst fractures admitted to Hefei Hospital Affiliated to Anhui Medical University from November 2013 to December 2017 were retrospectively analyzed.All patients were treated with pedicle screw reduction and fixation of the injured vertebra,balloon-assisted reduction of the collapsed endplate of the injured vertebra,and artificial bone vertebral body augmentation,and the follow-up time was >5 years.There were 24 males and 15 females,aged (42.9±13.3) years (range: 29 to 56 years).According to the Frankel spinal nerve dysfunction grading standard, there were 4 cases of grade C, 7 cases of grade D and 28 cases of grade E. There were 21 cases of CSC augmentation(CSC group) and 18 cases of CPC augmentation (CPC group). X-ray and CT were performed at 1 week, 1-, 2-, 5-year after surgery and at the last follow-up, and the imaging indicators were measured, including the injured vertebra anterior edge height ratio,the injured vertebra middle height ratio,the injured vertebra wedge angle,and the sagittal plane Cobb angle. The pain visual analogue scale (VAS) and the Oswestry disability index (ODI) was used for functional evaluation, nervous function was evaluated according to the Frankel spinal nerve dysfunction grading standard.Independent sample t test was used for inter-group comparison, and paired sample t test and repeated measure ANOVA were used for intra-group comparison. Results: All operative procedures were successfully completed, no spinal nerve function damage occurred. The postoperative imaging indexes of the patients were significantly improved compared with those before surgery (all P<0.01). The follow-up time of patients was (6.7±2.8)years (range: 5 to 9 years). Among the 11 patients with symptoms of neurological impairment before surgery, 9 patients completely recovered at the last follow-up, and 2 patients recovered from Frankel grade C to D. There were no significant differences in imaging indexes between the first week after surgery and the last follow-up in the CPC group (all P>0.05), while there were significant differences in imaging indexes between the CSC group and the last follow-up (all P<0.05). CPC group was superior to CSC group in frontal height ratio, middle height ratio, wedge angle variation and sagittal Cobb angle correction loss at 2 year, 5 year after surgery and the last follow-up, with statistical significance (all P<0.05). At the last follow-up, there were no differences in VAS and ODI between the two groups (all P>0.05). After absorption of CSC in the filling area, a hardened zone was formed around the area, and the central cavity remained without bone tissue filling. CPC absorption was very slow, and the CPC group was still filled satisfactorily at the last follow-up. Conclusions: Balloon assisted endplate reduction and vertebral augmentation combined with pedicle screw fixation through the injured vertebra have good long-term efficacy in the treatment of thoracolumbar burst fractures. Compared with CSC, CPC vertebral augmentation can better maintain the shape and spinal sequence of the injured vertebra in the long term, and can effectively reduce the collapse of the space above the injured vertebra.

Effects of different dietary vitamin D combinations during the grower phase and the feed restriction phase on growth performance and sternal morphology, mineralization, and related genes expression of bone metabolism in Pekin ducks

Our study aimed to investigate the effects of different dietary vitamin D (VD) combinations during the grower (1-32 d of age) and feed restriction (33-52 d of age) phases on growth performance. We also evaluated sternal morphology, mineralization, and related genes expression of bone metabolism as well as absorption of calcium and phosphorous in duodenal mucosa and kidney in Pekin ducks. During the grower phase, we used 2 VD regimes (Group A: 3,160 IU/kg VD3; Group B: 400 IU/kg VD3 + 69 μg/kg 25-OH-D3). Each dietary treatment had 50 replicate pens of 10 ducks per pen. During the feed restriction phase, 30 replicate pens selected from Group A and Group B, repetitively, were redivided into 5 different dietary VD regimes to form a 2 × 5 experimental design. Each group consisted of 6 replicates, each with 10 ducks. During the feed restriction phase, we evaluated 5 different dietary VD combinations were as follows: T1: 2,000 IU/kg VD3 ; T2: 5,000 IU/kg VD3; T3: 3,620 IU/kg VD3 + 34.5 μg/kg 25-OH-D3; T4: 2,240 IU/kg VD3 + 69 μg/kg 25-OH-D3; T5: 1,800 IU/kg VD3 + 80 μg/kg 25-OH-D3). Results showed that Group B combinations with T5 had a better growth performance and breast meat deposition (P < 0.1). Regardless of 5 dietary VD regimes during the feed restriction phase, Group B significantly increased (P < 0.05) 52 d sternal depth and tended to increase (P < 0.1) 52 d sternal defatted weight, ash content, and phosphate (P) content of ducks. A significant interactive effect (P < 0.05) was observed on the mRNA abundance of DMP1 and Sost1 as well as RANKL/OPG in sternum and of VDR in duodenal mucosa of ducks at 52 d of age between dietary VD combinations during 2 phases. These results indicated that dietary VD regimes during the grower phase could affect the effectiveness of dietary VD regimes during the feed restriction phases; Dietary VD combinations of both phases could affect the genes expression of bone formation and the absorption as well as reabsorption of calcium and phosphorus in duodenum and kidney.

The association between the maternal pre-pregnancy platelet count and fecundability in mainland China: a population-based cohort study

BACKGROUND

Currently, awareness about platelet count (PC) and its consequences for perinatal outcome have increased, but there is little reliable evidence on fecundability.

METHODS

Based on the National Free Pre-conception Check-up Projects supported by the Chinese government, 5,524,886 couples met the inclusion criteria were included in this cohort study. Cox regression models were adopted to estimate fecundability ratios (FRs) and their 95% confidence intervals for pre-pregnancy PC quintiles. Restricted cubic splines were used to flexibly model and visualize the relationship of PC with FRs. Microsoft SQL server and R software were used for data management and analysis.

RESULTS

The median of pre-pregnancy PC among women was 221.00×109/L. The first (<177.00 ×109/L) and second quintile (177.00-207.99 ×109/L) of PC showed slightly increased fecundability (Q1: adjusted FR 1.05, 95% CI 1.04-1.06; Q2: adjusted FR 1.04, 95% CI 1.03-1.05), while higher quintals (Q4: 236.00-271.99 ×109/L; Q5: ≥272.00 ×109/L) were related to reduction of fecundability, when compared with the third quintile of PC (208.00-235.99 ×109/L) (Q4: adjusted FR 0.96, 95% CI 0.95-0.97; Q5: adjusted FR 0.88, 95% CI 0.87-0.89). In the first quintiles (<177.00×109/L), only 20.93% women had PC below 129.94×109/L. An inverse-U shape association was consistently observed among women such that the lower PC of normal range (<118.03×109/L) and higher PC (>223.06×109/L) were associated with the risk of reduced female fecundability (P for non-linearity < 0.01).

CONCLUSION

PC is associated with female fecundability. Further classification of PC levels may deepen our understanding of the early warnings and significance of female fecundability.

Protective effects of tanshinone IIA on Porphyromonas gingivalis-induced atherosclerosis via the downregulation of the NOX2/NOX4-ROS mediation of NF-κB signaling pathway

Tanshinone IIA (TSA), an active component isolated from Danshen, possess high medicinal values against atherosclerosis by reducing vascular oxidative stress, inhibiting platelet aggregation, and protecting the endothelium from damage. The periodontal pathogen Porphyromonas gingivalis (P. gingivalis) has been proven to accelerate the development of atherosclerosis. We aim to determine the effects of TSA on P. gingivalis-induced atherosclerosis in ApoE-knockout (ApoE-/-) mice. After feeding with a high-lipid diet and infected with P. gingivalis three times per week for four weeks, TSA-treated (60 mg/kg/d) mice greatly inhibited atherosclerotic lesions both morphologically and biochemically and exhibited significantly reduction ROS, 8-OHdG, and ox-LDL levels in serum compared with P. gingivalis-infected mice. Additionally, TSA-treated mice were observed a marked reduction of ROS, 8-OHdG and ox-LDL in the serum, mRNA levels of COX-2, LOX-1, NOX2 and NOX4 in the aorta, as well as the levels of NOX2, NOX4, and NF-κB. These results suggest that TSA attenuates oxidative stress by decreasing NOX2 and NOX4 and downregulating NF-κB signaling pathway, which might be contributed to the amelioration of atherosclerosis.

The Resistance and Virulence Characteristics of Salmonella Enteritidis Strain Isolated from Patients with Food Poisoning Based on the Whole-Genome Sequencing and Quantitative Proteomic Analysis

Objective

This paper explores the drug resistance, genome and proteome expression characteristics of Salmonella from a food poisoning event.

Methods

A multidrug-resistant Salmonella Enteritidis strain, labeled as 27A, was isolated and identified from a food poisoning patient. Antimicrobial susceptibility testing determined the resistance of 27A strain to 14 antibiotics. Then, WGS analysis and comparative genomics analysis were performed on 27A, and the functional annotation of resistance genes, virulence genes were performed based on VFDB, ARDB, COG, CARD, GO, KEGG, and CAZY databases. Meanwhile, based on iTRAQ technology, quantitative proteomic analysis was conducted on 27A to analyze the functions and interactions of differentially expressed proteins related to bacterial resistance and pathogenicity.

Results

Strain 27A belonged to ST11 S. Enteritidis and was resistant to levofloxacin, ciprofloxacin, ampicillin, piperacillin, and ampicillin/sulbactam. There were 33 drug resistance genes, 384 virulence genes and 2 plasmid replicon, IncFIB(S) and IncFII(S), annotated by WGS. Proteomic analysis revealed significant changes in virulence and drug proteins, which were mainly involved in bacterial pathogenicity and metabolic processes. PPI prediction showed the relationship between virulence proteins and T3SS proteins, and PagN cooperated with proteins related to T3SS to jointly mediate the invasion of 27A strain on the human body. Phylogenetic analysis indicated that S. Enteritidis has potential transmission in humans, food, and animals.

Conclusion

This study comprehensively analyzed the drug resistance and virulence phenotypes of S. Enteritidis 27A using genomic and proteomic approaches. These helps reveal the drug resistance and virulence mechanisms of S. Enteritidis, and provides important information for the source tracing and the prevention of related diseases, which lays a foundation for research on food safety, public health monitoring, and the drug resistance and pathogenicity of S. Enteritidis.

Regorafenib alone or in combination with high/low-dose radiotherapy plus toripalimab as third-line treatment in patients with metastatic colorectal cancer: protocol for a prospective, randomized, controlled phase II clinical trial (SLOT)

Combination strategies to improve immunotherapy response in microsatellite stable metastatic colorectal cancer (MSS mCRC) remain an unmet need. Several single-arm clinical trials have shown promising synergistic effects between regorafenib and ICIs; however, some contradictory results have also been reported. Randomized controlled trials are needed to further validate the combination of regorafenib with ICIs. In addition, low-dose radiotherapy has been demonstrated to induce local immune responses by reprogramming the tumor microenvironment when combined with high-dose radiotherapy and ICIs. In this study, we designed a prospective, randomized, controlled phase II trial to investigate the efficacy and safety of regorafenib in combination with high/low-dose radiotherapy plus toripalimab in MSS mCRC compared to regorafenib alone. Patients with MSS metastatic adenocarcinoma of the colon or rectum will be enrolled and randomly assigned into two arms: a control arm and an experimental arm. Patients in the control arm will receive regorafenib monotherapy (120 mg once daily on days 1-21 of each 28 days cycle). Patients in the experimental arm will first receive one cycle of regorafenib (80 mg once daily on days 1-21 of each 28 days cycle) and toripalimab (240mg, q3w), followed by high-dose (4-8 fractions of 8-12Gy) and low-dose (1-10Gy at 0.5-2Gy/fraction) radiotherapy, and then continue regorafenib and toripalimab treatment. The primary endpoint is the objective response rate, and the secondary endpoints are disease control rate, duration of remission, median progress-free survival, median overall survival, and adverse events. Recruitment started in August 2023 and is ongoing.

Clinical Trial Registration

https://clinicaltrials.gov/study/NCT05963490?cond=NCT05963490&rank=1, identifier NCT05963490.

Long-Term Anorectal Function in Rectal Cancer Patients Managed by a Watch-and-Wait Strategy after Neoadjuvant Therapy: A Cross-Sectional Study

PURPOSE/OBJECTIVE(S)

Rectal cancer patients reaching complete clinical response (cCR) after neoadjuvant chemoradiotherapy can be offered a nonoperative watch-and-wait (W&W) strategy. As evidence of good oncological outcomes accumulates, the functional outcomes remain less explored. The aim of this study is to comprehensively assess the long-term rectal toxicity and anorectal function in patients managed by a W&W strategy and to investigate the clinical risk factors for anorectal dysfunction.

MATERIALS/METHODS

Seventy W&W patients who were disease-free at the moment of recruitment were included. A minimum 2-year follow-up was considered. We graded late rectal toxicity according to the Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer (RTOG/EORTC) scale and the Late Effects of Normal Tissue/Subjective Objective Management Analytic (LENT/SOMA) system. Long-term anorectal function was assessed with the Wexner score, the Low Anterior Resection Syndrome score (LARS score), and the Memorial Sloan Kettering Bowel Function Instrument (MSK BFI).

RESULTS

All patients received standard chemoradiotherapy consisting of a total dose of 5000 cGy in 25 fractions. The median tumor distance from the anal verge was 3 (IQR 2-4) cm. After a median follow-up of 43 (IQR 28-66) months, less than half of patients developed Grade 1 (40.0%) or Grade 2 (1.4%) late rectal toxicity, and no patients complained of higher grades. LENT/SOMA criteria also identified more patients with mild symptoms. The most frequent symptoms were sphincter control problems, mainly manifested as fecal urgency, reported by 60.0% of patients. For long-term anorectal function, the median LARS score was 16 (IQR 4-25). 17.1% of patients reported minor LARS and 15.7% reported major LARS. The median Wexner score was 2 (IQR 0-3). The median MSK BFI total score was 82 (IQR 77-86). Smoking history was an independent risk factor for anorectal dysfunction in multivariate analyses (OR = 6.491, 95% CI 1.536-27.432).

CONCLUSION

Rectal cancer patients managed by a watch-and-wait strategy after neoadjuvant chemoradiotherapy have retained satisfactory anorectal function. However, fecal urgency might be a common problem. Smoking history was an independent risk factor for long-term anorectal dysfunction. Prospective studies with emphasis on bowel function outcomes containing a larger number of patients are needed.

The determinants of neonatal asphyxia in the tropical province of China: A case-control study

As the major public health problem among under-5 children in the world, neonatal asphyxia (NA) contributes to 24% of the main causes of neonatal death. The effects of NA is not only limited to death but also has a long-term brain injury with lifelong adverse effects. Therefore, the goal of this study was to identify determinants of NA among newborns in the tropical province of China to guide early interventions and improve the survival and quality of life of these infants. A case control study was conducted at Hainan Women and Children's Medical Center from January 1 to December 31, 2021. A total of 255 newborns (85 cases and 170 controls, 1:2 case to control ratio) were enrolled in the study. A systematic random sampling approach was adopted based on hospital delivery registration. Structured questionnaires were used to collected data. The data was entered into statistical software SPSS version 20.0 for analysis. In the bivariable analysis, variables with P values less than .1 were entered into multivariable logistic regression analysis. At a P value of .05, a statistically significant level was reported. Amniotic fluid stained by meconium/blood (AOR = 3.19, 95% confidence interval [CI]: 1.47-6.95), primiparity, fetal presentation of malpresentation (AOR = 3.89, 95% CI: 1.25-12.09), and low birth weight (AOR = 10.51, 95% CI: 3.02-36.55) were to be significantly associated with NA. This study identified that amniotic fluid stained by meconium/blood, primiparity, low birth weight were determinants of NA. Thus, preventive solutions such as close monitoring of fetus presentation, meliorating the obstetric care setup during antenatal care consultations should be stressed in China.

Assessment of Prior Infection With Hepatitis B Virus and Fecundability in Couples Planning Pregnancy

IMPORTANCE

The association of hepatitis B virus (HBV) infection with reduced fecundability among reproductive-aged couples lacks large-population, in-depth study evidence.

OBJECTIVE

To investigate the association of HBV infection with time to pregnancy in couples planning pregnancy, and to explore whether this association varied by gravidity, health statuses, or lifestyles.

DESIGN, SETTING, AND PARTICIPANTS

This is a population-based cohort study of Chinese couples participating in the National Free Preconception Check-up Projects during 2015 to 2017. They were planning pregnancy and were followed-up every 3 months until getting pregnant, as confirmed by gynecologic ultrasonography, or were followed-up for 1 year. Data were analyzed between March 1, 2022, and September 30, 2022.

MAIN OUTCOMES AND MEASURES

The main outcome was time to pregnancy, assessed using fecundability hazard ratios (HRs). The Cox proportional hazards regression models were used to estimate the association of HBV infection with fecundability.

RESULTS

Among 2 419 848 couples (mean [SD] age, 27.87 [5.20] years for women and 29.58 [5.50] years for men), 126 728 women (5.24%) and 156 572 men (6.47%) were infected with HBV. Compared with the HBV-negative group, the fecundability of both women and men in the HBV-positive group decreased by 5% (HR, 0.95; 95% CI, 0.94-0.95). Compared with couples in which both partners were HBV negative, the fecundability of those in which both partners were HBV positive declined by 6% (HR, 0.94; 95% CI, 0.93-0.96) among all couples, by 3% (HR, 0.97; 95% CI, 0.95-0.99) among nulligravidas couples, and by 7% (HR, 0.93; 95% CI, 0.91-0.95) among multigravidas couples. Both the female-male and couple models suggested that the association of HBV infection with decreased fecundability was more pronounced in couples with multigravidas. The negative association was greater in people with overweight and obesity and was inconsistent in certain subgroups; in particular, it was more pronounced in women with reproductive tract infections, normal fasting plasma glucose, and no alcohol intake and in men with normal blood pressure.

CONCLUSIONS AND RELEVANCE

In this population-based cohort study, HBV infection was associated with decreased fecundability in a general reproductive-aged population, especially in couples with multigravidas. For women and men with certain health statuses and lifestyles, a comprehensive consideration of this association is recommended to provide personalized fertility guidance.

Poor sleep quality in early pregnancy increases the risk of developing gestational diabetes mellitus: a propensity score matching analysis

PURPOSE

This study aimed to demonstrate the relationship between poor sleep quality in early pregnancy and the risk of developing gestational diabetes mellitus (GDM).

METHODS

We conducted a nested case-control study and performed a 1:3 propensity score (PS) matching to match pregnant women with GDM to women without GDM. After PS matching, logistic regressions were carried out to describe the association between sleep quality (assessed by Pittsburgh Sleep Quality Index [PSQI]) and the risk of GDM. We also performed a second analysis to explore the association in groups divided according to maternal age.

RESULTS

A total of 535 women were enrolled in this study. Of 456 women with complete data, the incidence of GDM was 12.1% (55/456). After PS matching, we found poor sleep quality (PSQI > 5) in early pregnancy was a statistically significant risk factor for GDM (OR 2.03; 95% CI 1.02-4.01; p-value = 0.043). The association of poor sleep quality (PSQI > 5) with GDM was significant among women less than 35 years old (OR 2.72; 95% CI 1.22-6.43; p-value = 0.018) but not among women more than or equal to 35 years old after adjusting for all covariates.

CONCLUSION

Poor sleep quality in early pregnancy is associated with higher risk of developing GDM, especially for women under 35 years old. Screening expectant mothers with sleep problems in the first trimester is suggested.

Association between obstructive sleep apnea symptoms and gout in US population, a cross-sectional study

The results of association between Obstructive Sleep Apnea (OSA) and gout are not consistent. Participants aged 20 years or older in the National Health and Nutrition Examination Survey (NHANES) 2007-2008 and 2015-2018 were included. Weighted univariable and multivariable logistic regressions were used to evaluate the association between OSA symptoms and gout. The subgroup and sensitivity analyses were also performed. Among the 15,947 participants in this study, the mean age was 47.8 years old, 48.87% of whom were male, 4891 had OSA symptoms, and 842 had gout. In multivariable logistic regression analyses, OSA symptoms were positively associated with gout in all models. The odds ratio (OR) was 1.315 and 95% confidence interval (CI) was 1.070-1.616 in fully adjusted model 4. In the subgroup analyses, we found a considerable interaction between OSA symptoms and gender with gout (P for interaction = 0.003). In the sensitivity analyses, the association between OSA symptoms and gout remained stable after adjustment for congestive heart failure and diuretics using. OSA symptoms were associated with an increased likelihood of gout. This association could especially be found in female participants.

Single-Cell RNA-Seq Analysis Reveals Ferroptosis in the Tumor Microenvironment of Clear Cell Renal Cell Carcinoma

In this study, we investigated the role of ferroptosis in the tumor microenvironment (TME) of clear cell renal cell carcinoma (ccRCC), the leading cause of renal cancer-related death. We analyzed single-cell data from seven ccRCC cases to determine cell types most correlated with ferroptosis and performed pseudotime analysis on three myeloid subtypes. We identified 16 immune-related ferroptosis genes (IRFGs) by analyzing differentially expressed genes between cell subgroups and between high and low immune infiltration groups in the TCGA-KIRC dataset and the FerrDb V2 database. Using univariate and multivariate Cox regression, we identified two independent prognostic genes, AMN and PDK4, and constructed an IRFG score model immune-related ferroptosis genes risk score (IRFGRs) to evaluate its prognostic value in ccRCC. The IRFGRs demonstrated excellent and stable performance for predicting ccRCC patient survival in both the TCGA training set and the ArrayExpress validation set, with an AUC range of 0.690-0.754, outperforming other commonly used clinicopathological indicators. Our findings enhance the understanding of TME infiltration with ferroptosis and identify immune-mediated ferroptosis genes associated with prognosis in ccRCC.

Calibration of Acousto-Optic Interaction Geometry Based on the Analysis of AOTF Angular Performance

Acousto-optic interaction geometry determines the spectral and spatial response of an acousto-optic tunable filter (AOTF). The precise calibration of the acousto-optic interaction geometry of the device is a necessary process before designing and optimizing optical systems. In this paper, we develop a novel calibration method based on the polar angular performance of an AOTF. A commercial AOTF device with unknown geometry parameters was experimentally calibrated. The experimental results show high precision, in some cases falling within 0.01°. In addition, we analyzed the parameter sensitivity and Monte Carlo tolerance of the calibration method. The results of the parameter sensitivity analysis show that the principal refractive index has a large influence on the calibration results, while other factors have little influence. The results of the Monte Carlo tolerance analysis show that the probability of the results falling 0.1° using this method is greater than 99.7%. This work provides an accurate and easy-to-perform method for AOTF crystal calibration and can contribute to the characteristic analysis of AOTFs and the optical design of spectral imaging systems.

Association between nonalcoholic fatty liver disease and peripheral neuropathy in US population, a cross-sectional study

Nonalcoholic fatty liver disease (NAFLD) has become an important risk of type 2 diabetes mellitus (T2DM). Peripheral neuropathy (PN) is regarded as one of the main microvascular complications of diabetes. But the association of NAFLD with PN is still unclear. We aimed to investigate the association between NAFLD and PN in US population by conducting a cross-sectional study. We enrolled 3029 participants aged 40-85 years from National Health and Nutrition Examination Survey (NHANES) 1999-2004. NAFLD was defined as a US Fatty Liver Index (FLI) score ≥ 30, and PN was defined as having one or more insensate areas on either foot. Participants were divided into two groups (with or without PN). We performed multivariate logistic regression models to evaluate the association between NAFLD and PN. Subgroup analyses were used to find out whether the association was stable in different stratified groups. Sensitivity analyses were conducted to assess the robustness of the results. All the analyses were weighted. Among the individuals, 524 (17.3%) had PN and 1250 (41.27%) had NAFLD. In the multivariate logistic regression models, NAFLD was associated with an increased risk of PN (OR 1.44 [1.03 ~ 2.02]) after fully adjusting for covariates. In the subgroup analyses, NAFLD was significantly associated with PN in the age group (40-64 years), compared with those in the age group (65-85 years), (P for interaction: 0.004). The results of association of NAFLD with PN were stable in sensitivity analyses. In this cross-sectional study among US adults aged 40-85 years old, NAFLD was associated with an increased likelihood of prevalent PN.

Effects of supplemented mode of emulsifier on growth performance, serum biochemical index, quality of meat and skin fat, and nutrient utilization in Pekin ducks

In our previous experiment, we found that fats with pre-emulsification (PreE), a new supplemented mode of emulsifier, had an improved bioavailability for Pekin ducks than fats without PreE based on dietary EE utilization. Therefore, this study was conducted to investigate the effects of the supplemented mode of emulsifier (PreE vs. emulsifier direct supplementation) on the growth performance, serum biochemical index, quality of meat and skin fat, and nutrient utilization in Pekin ducks. A total of 640 healthy 10-day-old Pekin male ducks (408.65 ± 12.00 g) were randomly allocated into 4 treatments with 16 replicates of 10 birds each. The 4 dietary treatments were as follows: the positive control group (PC; the oil supplemented amount of 6%), the negative control group (NC; the oil supplemented amount of 5.4%), the emulsifier group (E; NC diet with an emulsifier added directly), and the oil pre-emulsification group (PreE; NC diet with oil PreE). The results showed reducing the amount of fat in the diet (NC vs. PC) significantly decreased growth performance and quality of skin fat, and affected serum lipid metabolism (P < 0.05). Interestingly, the body weight (BW), body weight gain (BWG), and the shear force of skin fat were increased, but the feed to gain ratio (F/G) was markedly decreased in the PreE group (P < 0.05) compared to those in the NC group, and these levels were similar to those in the PC group (P > 0.05). Additionally, the utilization of dietary dry matter (DM), ether extract (EE), and total phosphorous (TP) were increased, but the activity of aspartate aminotransferase (AST) in serum was decreased in the PreE group compared to those in the NC group (P < 0.05). Furthermore, compared to the E group, the F/G was decreased (P < 0.05), and the utilization of dietary EE, the shear force of skin fat and content of collagen in skin fat were markedly increased (P < 0.05) in the PreE group. However, no differences were observed (P > 0.05) in growth performance between the group administered a direct supplementation of emulsifier and the control groups (PC and NC). These results indicate that the negative effect of reducing the oil supplementation amount (-0.6%) in the diet can be restored by supplementation with emulsifier, especially by oil with PreE.

Association Between Uric Acid to HDL Cholesterol Ratio and Diabetic Complications in Men and Postmenopausal Women

AIM

Previous studies have implicated the uric acid to high-density lipoprotein cholesterol (HDL-C) ratio (UHR) was associated with type 2 diabetes. However, the association between UHR and diabetes-related vascular damages is still unclear.

METHODS

The total of 4551 patients with type 2 diabetes from the cross-sectional Environmental Pollutant Exposure and Metabolic Diseases in Shanghai study (METAL study) were enrolled. UHR was calculated as uric acid to HDL-C ratio. Cardiovascular disease (CVD) was defined as previously diagnosed with stroke, coronary heart disease, or peripheral arterial disease. Chronic kidney disease (CKD) was defined as estimated glomerular filtration rate ≤60 mL/min/1.73 m² and/or urinary albumin to creatinine ratio ≥30 mg/g. Fundus image was examined by trained individuals and degree of diabetic retinopathy (DR) was evaluated.

RESULTS

UHR was positively correlated with CVD (OR = 1.28, 95% CI: 1.02-1.61) and CKD (OR = 1.78, 95% CI: 1.39-2.27) after adjusting for all confounders. No association was found between UHR and DR. In stratified analyses, UHR was predominantly correlated with CVD in diabetic patients with age older than 65 (OR = 1.41, 95% CI: 1.08-1.85), female (OR = 1.43, 95% CI: 1.06-1.94) and BMI≥24kg/m² (OR = 1.57, 95% CI: 1.17-2.11). A 1-SD increment of UHR was also positively associated with CVD (OR 1.26, 95% CI 1.03, 1.15) and CKD (OR 1.28, 95% CI 1.20,1.39). UHR was positively associated with CKD in all subgroups analysis. No significant interaction effect was observed between UHR and all subgroup variables in CVD and CKD risk.

CONCLUSION

Our study reported a positive association between the UHR and diabetic-related vascular complications in men and postmenopausal women. The relationship between the UHR and DR seems to be uncertain and requires further investigation. And no significant interaction effect was observed between the UHR and all subgroup variables in CVD and CKD risk.

Effects of a high-fat diet on the growth performance, lipid metabolism, and the fatty acids composition of liver and skin fat in Pekin ducks aged from 10 to 40 days

This study aimed to investigate the effect of a high-fat diet on the growth performance, serum, liver, and skin lipid metabolism as well as the fatty acids composition of liver and skin fat in Pekin ducks from 10 to 40 d of age based on a pair-fed group. Two hundred forty healthy male ducks (10 d old, 470.53 ± 0.57 g) were randomly divided into 3 groups (8 replicates per cage of 10 ducks): a normal diet (ND, 3% fat), a high-fat diet (HFD, 9% fat), and a pair-fed diet (PFD, given the ND in an amount equal to that consumed of the HFD to eliminate the effects of feed intake). The results were as follows: compared to ND feeding, HFD feeding significantly decreased (P < 0.05) the feed intake and feed:gain ratio (F:G), along with serum triglyceride and nonesterified fatty acid contents. When compared with the ND and PFD, the HFD significantly decreased (P < 0.05) the liver weight and inhibited hepatic de novo lipogenesis (glucose-6-phosphate dehydrogenase and malate dehydrogenase activities), β-oxidation (carnitine palmitoyltransferase-1 content), and decreased saturated fatty acids and monounsaturated fatty acids deposition. Moreover, the HFD significantly increased (P < 0.05) the total fat content, lipid droplet area, and polyunsaturated fatty acids (PUFAs) content in the liver, as well as the abdominal fat weight, subcutaneous fat weight, the total fat and PUFAs content in skin fat. These results suggested that the HFD improved feed efficiency, which was related to HFD feeding inhibiting hepatic de novo lipogenesis and β-oxidation and promoting the deposition of fat in skin as well as altering the fatty acids composition of the liver and skin fat in Pekin ducks.

1Progress, applications, challenges and prospects of protein purification technology

Protein is one of the most important biological macromolecules in life, which plays a vital role in cell growth, development, movement, heredity, reproduction and other life activities. High quality isolation and purification is an essential step in the study of the structure and function of target proteins. Therefore, the development of protein purification technologies has great theoretical and practical significance in exploring the laws of life activities and guiding production practice. Up to now, there is no forthcoming method to extract any proteins from a complex system, and the field of protein purification still faces significant opportunities and challenges. Conventional protein purification generally includes three steps: pretreatment, rough fractionation, and fine fractionation. Each of the steps will significantly affect the purity, yield and the activity of target proteins. The present review focuses on the principle and process of protein purification, recent advances, and the applications of these technologies in the life and health industry as well as their far-reaching impact, so as to promote the research of protein structure and function, drug development and precision medicine, and bring new insights to researchers in related fields.

The Impact of County Medical Community Reform on the Medical Service Efficiency of County-Level Public General Hospitals in China: A Case Study of Shanxi Province

China introduced the county medical community (CMC) reform, aimed to provide high-quality medical resources to rural citizens, in 2017. This study examines the impact of the reform on the medical service efficiency of county-level public general hospitals in Shanxi Province, China. In total, 92 county-level public general hospitals from Shanxi Province were taken as the research objective, and the super-efficiency SBM-DEA model was applied to measure medical service efficiency. Further, a two-way fixed-effect model was used to evaluate the impact of CMC reform on the medical service efficiency of county-level public general hospitals by using health statistics data from 2014 to 2018. The study reveals that the CMC reform improved the medical service efficiency of county-level public general hospitals by 15.6%. Moreover, the CMC reform had regional heterogeneity in its impact on the medical service efficiency of county-level public general hospitals. The CMC reform improved the medical service efficiency of hospitals in the southern region more than in the northern region of the province. The medical service efficiency of hospitals in the central region was also improved by CMC reform, but the causal relationship was not found significant. Further, hospital-level factors (e.g., fixed assets, hospital stay, and regional health center) and environmental factors (e.g., GDP, population, urbanization rate, and government subsidies) affected the medical service efficiency of county-level public hospitals during the process of promoting the CMC reform.

Association of hypertriglyceridemic waist phenotype with non-alcoholic fatty liver disease: a cross-sectional study in a Chinese population

BACKGROUND

The aim of this study was to determine the association between hypertriglyceridemic waist (HTGW) phenotype and non-alcoholic fatty liver disease (NAFLD) in a middle- to older-aged Chinese population.

METHODS

In this cross-sectional study, a total of 9015 participants (age 40-79 years) were recruited and grouped into four phenotypes, as follows: NWNT: normal waist-normal triglyceride; NWET: normal waist-elevated triglycerides; EWNT: elevated waist-normal triglycerides; and hypertriglyceridemic waist (HTGW). Logistic regression analysis was carried out to assess the associations between HTGW phenotype and NAFLD. Receiver-operating characteristic (ROC) curves were drawn to evaluate the utility of waist circumference-triglyceride index (WTI) as a reference factor for screening for NAFLD.

RESULTS

HTGW phenotype had a higher prevalence of NAFLD (53.3%), diabetes (19.6%), and hypertension (79.8%) than the other three subgroups. After adjusting for age, sex, and BMI, HTGW phenotype was associated with NAFLD (odds ratio (OR) 6.12; 95% confidence interval (CI) 5.11-7.32). Further adjusted for potential confounders, the HTGW phenotype was still significantly associated with NAFLD (adjusted OR 5.18; 95% CI 4.30-6.23) regardless of gender. The subgroup analyses generally revealed similar associations across all subgroups. ROC curve analysis showed that when the maximum area under the curve was 0.748, the WTI was 90.1, and the corresponding sensitivity and specificity were 90.6 and 59.5%, respectively.

CONCLUSIONS

HTGW phenotype is strongly associated with NAFLD and can be used as a reference factor for NAFLD screening.

[Analysis on perioperative safety and feasibility of pure single-port laparoscopic distal gastrectomy for gastric cancer]

Objective: To investigate the safety and feasibility of pure single-port laparoscopic distal gastrectomy (SDG) in the radical treatment of gastric cancer. Methods: A retrospective cohort study with propensity score matching (PSM) was conducted. Subjects were included in the study who were diagnosed by imaging examination and pathology as early distal gastric cancer, no distant metastasis, no serious cardiovascular and cerebrovascular diseases and underwent radical gastrectomy. Patients with incomplete clinical data, unplanned second operation and complicated with other tumors were excluded. A retrospective analysis was performed on 15 patients who underwent pure SDG radical gastrectomy for gastric cancer from September 2020 to March 2022, namely the SDG group. Fifty-eight patients undergoing conventional five-port laparoscopic radical gastrectomy for gastric cancer were included as the control group, namely the LDG group. As it was found that there was a statistically significant difference in baseline body mass index (BMI) between the two groups [(20.8±0.8) kg/m² vs. (22.9±0.4) kg/m², t=2.456, P=0.017], one-to-one PSM was conducted between the two groups. Then the basic conditions of the two groups of patients in perioperative period were analyzed and compared. Results: There were 14 patients after PSM in the SDG group and the LDG group respectively. There were no significant differences in intraoperative bleeding, number of lymph nodes dissected, time to the first postoperative feeding and postoperative complications between the SDG group and the LDG group (all P>0.05). Compared with LDG group, the operative time in the SDG group was longer [(163.6±6.3) minutes vs. (133.9±4.4) minutes, t=3.866, P=0.001]. However, in the SDG group, time to the first flatus [(2.6±0.2) days vs. (3.3±0.1) days, t=3.053,P=0.005], time to drainage tube removal [(4.5±0.8) days vs. (6.9±0.2) days, t=2.914, P=0.007)] and postoperative hospital stay [(6.7±0.1) days vs. (9.2±1.0) days, t=2.534,P=0.018)] were significantly shorter, and pain score at the first postoperative day evaluated by NRS (1.86±0.29 vs. 2.86±0.35, t=2.205, P=0.037) was significantly lower as compared to the LDG group. Four patients in SDG group did not receive peritoneal drainage tube placement after surgery, and they all recovered safely. Conclusion: The pure single-port laparoscopic radical gastrectomy for gastric cancer is safe and feasible, and has an advantage over the LDG in postoperative recovery.

Corn distiller's dried grains with solubles as an alternative ingredient to corn and soybean meal in Pekin duck diets based on its predicted AME and the evaluated standardized ileal digestibility of amino acids

The study aimed to investigate the effects of dietary distillers dried grains with solubles (DDGS) levels on growth performance, carcass characteristic, serum biochemical indexes, meat physical and chemical quality, nutrient utilization, and standardized ileal digestibility of amino acids (SIDAA) in Pekin ducks aged 11 to 42 d based on the evaluation of its SIDAA. A total of 560 eleven-day-old Cherry Valley ducks were randomly allotted to 5 treatments with 7 replicate pens per treatment and 16 ducks per pen based on the average body weight. Six isonitrogenous and isocaloric experimental diets were formulated on a digestible amino acid basis to produce diets containing 0, 5, 10, 15, and 20% DDGS, respectively. With increasing of dietary DDGS levels, a linear and quadratic reduction (P < 0.05) was observed in the body weight (BW) at d 42, average day gain (ADG) and average day feed intake (ADFI) from d 11 to 42, breast meat yield, the moisture and protein content in the breast meat, and dietary DM and EE utilization. Moreover, a linear and quadratic increase (P < 0.05) was observed in the b* value of the breast meat and serum total cholesterol and triglyceride concentrations. Compared with the control group, the group with 10% inclusion of DDGS exhibited no adverse effect on growth performance, carcass characteristics, serum biochemical indexes, meat physical and chemical quality, nutrient utilization, and the SIDAA of the diets (P > 0.05). These results suggested that 10% of corn DDGS can function as an alternative ingredient to corn and soybean meal, and the optimal levels of DDGS in the diets of ducks aged from 11 to 42 d depends more on its quality.

The Effects of Information Continuity and Interpersonal Continuity on Physician Services Online: Cross-sectional Study

BACKGROUND

Web-based medical services have become an effective supplement to traditional services in hospitals and an essential part of medical services. Studies have shown that web-based medical services are useful for shortening the delayed admission time and for enhancing the treatment effect from the service continuity perspective. However, the specific measures that patients and physicians should take to improve service continuity remain unknown.

OBJECTIVE

Based on the information richness theory and continuity of care, this study investigates the dynamic effects of information continuity and interpersonal continuity on physician services online.

METHODS

Data of 7200 patients with 360 physicians covering complete interaction records were collected from a professional web-based platform in China. Content analysis was performed to recognize matching patients and physicians, and least square regression analysis was performed to obtain all empirical results.

RESULTS

Empirical results showed that in the short term, information continuity (including offline experience, medical records, and detailed information) influences physicians' web-based services, and their influences show heterogeneity. Moreover, if a patient's online physician is the same physician who he/she has visited offline, we find that interpersonal continuity is important for service. In the long term, information continuity and interpersonal continuity positively improve service continuity by facilitating repeat purchases.

CONCLUSIONS

Overall, our findings not only shed new light on patient behavior online and cross-channel behavior but also provide practical insights into improving the continuity of care in online health communities.

A study protocol of a randomized phase II trial of perioperative chemoimmunotherapy verses perioperative chemoimmunotherapy plus preoperative chemoradiation for locally advanced gastric (G) or gastroesophageal junction (GEJ) adenocarcinoma: the NeoRacing study

Background

Perioperative chemotherapy (ChT) and preoperative chemoradiation (CRT) are both the standard treatments for locally advanced gastric cancer (LAGC). CRT can achieve a higher pathological complete regression (pCR) rate, but whether this higher pCR rate can be transformed into a long-term survival benefit remains inconclusive. Therefore, relevant studies are in progress. On the other hand, immunotherapy has been established for the first-line treatment of advanced gastric cancer (AGC) and has been widely explored in the perioperative setting. The combination of chemotherapy/radiotherapy and immunotherapy may have a synergistic effect, which will lead to a better antitumor effect. The preliminary reports of ongoing studies show promising results, including a further improved pCR rate. However, the preferred treatment combination for LAGC is still not established. To solve this problem, we are carrying out this randomized phase II trial, which aims to evaluate the efficacy and safety of perioperative chemotherapy plus the use of PD-1 antibody with or without preoperative chemoradiation for LAGC.

Methods

Eligible patients with LAGC or gastroesophageal junction (GEJ) adenocarcinoma were randomized to receive perioperative ChT, PD-1 antibody, surgery with (Arm A) or without preoperative CRT (Arm B), and PD-1 antibody maintenance until one year after surgery. The primary endpoint of this study is that the pCR rate of Arm A will be significantly higher than that of Arm B. The secondary endpoints include the pathological partial regression (pPR) rate, R0 resection rate, objective response rate (ORR), event-free survival (EFS), overall survival (OS), safety and surgical complications. Moreover, several explorative endpoints will be evaluated to find and validate the predictive biomarkers of immunotherapy.

Discussion

The results of the NeoRacing study will provide important information concerning the application of PD-1 antibody in LAGC patients during the perioperative setting. Meanwhile, the two treatment protocols will be compared in terms of efficacy and safety.

Trial registration

ClinicalTrials.gov, NCT05161572. Registered 17 December 2021 - Retrospectively registered.

Effects of rapeseed meal on laying performance and egg quality in laying ducks

This study was conducted to investigate the effect of different varieties of rapeseed meal (RSM) with different concentrations of glucosinolates (Gls) and erucic acid (EA) on performance and egg quality of laying ducks. A total of 576 twenty eight-wk-old laying ducks were randomly allocated to 4 treatments. Each treatment had 8 replicates of 18 laying ducks raised in 6 adjacent cages with 3 laying ducks per cage. The control diet was corn soybean meal based without RSM. Three varieties of RSM varying in Gls concentrations were supplemented to the base diet at 10% by substituting soybean meal to formulate the three RSM diets. The experiment lasted 12 wk. Diets with 10% RSM decreased average egg weight (P < 0.01) and feed intake (P = 0.07) compared with the control diet, but there was no significant difference in laying performance among the 3 RSM diets. RSM increased color value (P < 0.05) and crude protein (CP) content (P < 0.05) of yolk compared with the control diet, but had no significant effects on the other egg quality indexes including eggshell strength, albumen height, Haugh unit, and the composition ratio of eggshell, albumen and yolk. RSM decreased total monounsaturated fatty acids (MUFA) (P < 0.01) and increased total polyunsaturated fatty acids (PUFA) (P < 0.01) of yolk, but total saturated fatty acids (SFA) proportions and UFA/SFA ratio of egg yolk were not significantly affected by RSM. RSM increased deposition of trimethylamine (TMA) and 5-vinyl-1,3-oxazolidine-2-thione (5-VOT) in yolk (P < 0.01); moreover, the high Gls RSM increased deposition of TMA (P < 0.01) and 5-VOT in yolk (P < 0.01) compared with the RSM varieties low in Gls. These results suggested that dietary inclusion of 10% RSM decreased egg weight of laying ducks, and affected yolk quality especially yolk color, fatty acid profile, CP, TMA, and 5-VOT content of yolk. Moreover, RSM with higher Gls concentration resulted in higher deposition of TMA and 5-VOT in egg yolk.

Short-term effects of lifestyle intervention in the reversion to normoglycemia in people with prediabetes

AIMS

To evaluate the short-term effect of lifestyle intervention in people with prediabetes.

METHODS

A stratified multistage sampling method was used in the recruitment of residents of the Jiangsu Province, China in 2017, who had no previous diagnosis of diabetes. Physical examination and laboratory tests were performed, and questionnaires were completed. Those with a prediabetes diagnosis at baseline were included in the cohort and participants were randomized to the intervention group or the control group. The intervention group received a lifestyle intervention strategy, which included exercise, diet and peer educations. The control group received general health education. Participants were followed up in 2018.

RESULTS

A total of 2005 individuals were included in the analysis. At follow-up, there were 516 (36.7%) individuals in the intervention group and 207 (34.5%) individuals in the control group with normal blood glucose levels. The decline in waist circumference and fasting plasma glucose levels was significantly higher in the intervention group than in the control group. This was still observed after adjusting for variables (odds ratio 1.32, P = 0.02). Females or younger individuals who had lower body mass index and plasma glucose levels at baseline were more likely to reverse to normoglycemia at follow-up.

CONCLUSIONS

Compared with a strategy of general health education, a lifestyle intervention strategy could reverse glucose levels to normoglycemia in individuals with prediabetes.

Effects of Dietary Corn Germ Meal Levels on Growth Performance, Serum Biochemical Parameters, Meat Quality, and Standardized Ileal Digestibility of Amino Acids in Pekin Ducks

The study aimed to investigate the effects of dietary corn germ meal (CGM) levels on growth performance, carcass characteristic, serum biochemical indexes, meat physical and chemical quality, and standardized ileal digestibility of amino acids (SIDAA) in Pekin ducks from 10 to 42 d of age. A total of 420 ten-day-old Cherry Valley ducks were randomly allotted to 5 treatments with 6 replicate cages per treatment and 14 ducks per cages based on mean body weight. Five isonitrogenous and isocaloric experimental diets were formulated on a digestible amino acid basis to produce diets containing 0, 3, 6, 9, or 12% CGM. Results showed: 1) Compared with other groups, ducks fed 12% CGM significantly increased (P < 0.05) the feed to gain ratio. 2) Dietary CGM levels had no effect (P > 0.05) on the carcass traits and breast meat physical quality; but the content of crude protein presented a linear decrease (P < 0.05) in breast meat with increasing dietary CGM levels. 3) Serum biochemical indices (e.g., alanine aminotransferase, aspartate aminotransferase, glucose, high density lipoprotein cholesterol, total cholesterol, triglyceride, total protein, and urea) showed no significant differences among all groups (P > 0.05). 4) The levels of CGM had no significant effect on SIDAA of diets (P > 0.05), except for cysteine which showed a quadratic increase (P < 0.05). These results suggested that the optimal levels of CGM in diets for meat duck aged from 10 to 42 d should be below 9% based on feed to gain ratio and the content of crude protein in breast meat.

The association of hypertriglyceridemic waist phenotype with hypertension: A cross-sectional study in a Chinese middle aged-old population

The present study aimed to evaluate the relationship between the hypertriglyceridemic waist (HTGW) phenotype and hypertension. We undertook a cross‐sectional study with a sample of 9015 adults from China. The HTGW phenotype was defined as elevated waist circumference (WC) and elevated triglyceride (TG) concentration. Logistic regression analysis was used to evaluate the association between the HTGW phenotype and hypertension. The prevalence of hypertension was significantly higher in individuals with the HTGW phenotype, than in those with the normal waist normal triglyceride (NWNT) phenotype (89.9% vs 75.3%, respectively, P < .001). After adjusting for age, sex, BMI, current smoker, and current alcohol consumption, the HTGW phenotype was associated with hypertension (Odds Ratio (OR)1.53; 95% CI 1.25–1.87). After further adjustment for potential confounders, the HTGW phenotype was still significantly associated with hypertension (adjusted OR1.28; 95% CI 1.04‐1.58) regardless of sex. The subgroup analyses generally revealed similar associations across all subgroups. This study indicated that the HTGW phenotype was strongly associated with hypertension, and blood pressure should be clinically monitored in individuals with the HTGW phenotype. We suggested a combined use of hypertriglyceridemia waist phenotype in identifying participants who are at high risk of hypertension.

The Association Between Hypertriglyceridemic-Waist Phenotype and Chronic Kidney Disease in Patients with Type 2 Diabetes: A Cross-Sectional METAL Study

BACKGROUND

The aim of this study was measuring the association between the hypertriglyceridemic-waist (HTGW) phenotype and chronic kidney disease in a large type 2 diabetes population.

METHODS

A total of 4254 diabetic patients from the cross-sectional Environmental Pollutant Exposure and Metabolic Diseases in Shanghai (METAL) study were enrolled. The hypertriglyceridemic-waist (HTGW) phenotype was defined as the presence of an elevated waist circumference (WC) and elevated triglyceride (TG) concentration. Chronic kidney disease (CKD) was defined as an estimated glomerular filtration rate (eGFR) less than 60 mL/min/1.73 m² or urinary albumin creatinine ratio (uACR) more than 30 mg/g. Linear and multiple logistic regression models were used for measuring the association between HTGW phenotype and chronic kidney disease.

RESULTS

The prevalence of CKD was 29% and 35.8% in total participants and participants with HTGW phenotype, respectively. Subjects in the HTGW phenotype group were more likely to have CKD (OR 1.47, 95% CI: 1.11, 1.95) compared with subjects in the normal waist circumference and normal triglycerides (NTNW) group. HTGW phenotype was both associated with the increasing risk of decreased eGFR (OR 1.31, 95% CI: 1.02, 1.75) and elevated uACR (OR 1.57, 95% CI: 1.18, 2.11). Furthermore, the stratified analysis showed that the strongest positive association between HTGW phenotype and CKD presence was found in the subgroup of presence of hypertension. The associations were all fully adjusted for age, sex, BMI, current smoking, current drinking and other confounding factors.

CONCLUSION

Our study suggested a positive association between the HTGW phenotype and CKD in Chinese type 2 diabetes patients. Further prospective studies are needed to confirm our findings and to investigate the underlying biological mechanisms.

Chiral Nematic Coatings Based on Cellulose Nanocrystals as a Multiplexing Platform for Humidity Sensing and Dual Anticounterfeiting

The need for a precise regulation of the properties of chiral nematic structures in response to external stimuli is addressed. Self-assembled iridescent coatings are produced under the effect of electrostatic interactions between cellulose nanocrystals and poly(acrylic acid), endowing a high anisotropic dissymmetry (>0.3) and sensitivity to environmental humidity (13.1 nm/1% at 68-75% relative humidity, RH). The phenomena associated with shifts in selective light reflection (green to orange) and polarization, facilitate tunable transmitted colors (blue to orange) at given rotation angles (RA). Such properties are conveniently integrated into a "RH-RA-color" ternary code that is introduced as an anticounterfeiting technology, taking advantage of multicolor patterns that conveniently track with changes in RH and RA. The proposed charge-driven assembly opens new opportunities for chiral nematic materials that enable precise optical sensing and information encryption.

Bioconversion of steviol glycosides into steviol by Microbacterium barkeri

The strain which degraded steviol glycosides to steviol (STE) was screened and isolated from soil samples. A phylogenetic tree was constructed and used to determine the taxonomic status of the strain. 16S rDNA sequence was ultimately used to identify the strain as Microbacterium barkeri XJ. The transformation product was detected and identified as STE by HPLC/LC-MS/IR analysis. The bioconversion rate of 1% (v/v) steviol glycosides (stevioside, rebaudioside A, rebaudioside C) into STE in basic medium were 100% within 24 h, 84 h and 144 h, respectively. The results indicated XJ was more effective than mixed flora in the bioconversion of steviol glycosides to STE.

Effects of enzyme-treated soy protein on performance, digestive enzyme activity and mRNA expression of nutrient transporters of laying hens fed different nutrient density diets

It has been shown that enzyme-treated plant protein can increase performance and promote intestinal health, and save dietary protein. However, our understanding of the effects of enzyme-treated soy protein on performance and intestine function in laying hens, and its rational use, remains limited. The experiment was conducted to study the effect of enzyme-treated soy protein (ETSP) in different nutrient density diets on performance, egg quality, digestive enzyme activity and mRNA expression of amino acid transporters of laying hens. A total of 1 200 Lohmann laying hens (52 wk of age) was randomly divided into a 3 × 2 factorial design that included three nutrient levels: [positive control (PC), metabolisable energy (ME): 2 680 kcal/kg, CP: 15.5%; negative control 1 (NC1), ME: 2 630 kcal/kg, CP: 15%; negative control 2 (NC2), ME:2 580 kcal/kg, CP: 14.5%] and 2 ETSP levels (0 and 0.5%) for 12 weeks. Each treatment had 10 replicates with 20 birds. With the decrease of dietary nutrition density, egg production rate (P = 0.07) and feed conversion ratio (FCR) (P = 0.06) were reduced. Yolk colour was decreased, and yolk index was increased. Supplemented ETSP improved FCR (P = 0.05) and qualified egg rate (P < 0.05). The mass loss rate of egg was decreased after storage for 30 days (P < 0.05). An interaction between nutrient density and ETSP was observed on albumen height and Haugh unit (P < 0.05), and the effects were most noticeable in hens fed 0.5% ETSP in NC2 group. An increase in the activity of trypsin in duodenum (P < 0.05) and the relative expressions of jejunum peptide transporter 1 (PepT1) (P < 0.05) and B⁰ system neutral amino acid transport carrier (B⁰AT) mRNA (P < 0.01) was observed during ETSP supplementation. The nutrient density and ETSP supplementation had no significant effect on microbiota in the cecal contents. Overall, the results in this study indicated that the ME decreased 100 kcal/kg and CP decreased 1% in diet of laying hens had a decreasing trend on production performance, no effects on enzyme activity, amino acid transporter mRNA, and gut microbiota, whereas 0.5% ETSP can increase activity of trypsin, PepT1 and B⁰AT mRNA relative expressions, and improve FCR, qualified egg rate.

Author Correction: LncRNA HOTAIRM1 inhibits the progression of hepatocellular carcinoma by inhibiting the Wnt signaling pathway

Correction to: European Review for Medical and Pharmacological Sciences 2018; 22 (15): 4861-4868-DOI: 10.26355/eurrev_201808_15622-PMID: 30070317, published online 15 August 2018. After publication, the authors found some mistakes in the article. There are amendments to this paper. The Publisher apologizes for any inconvenience this may cause. https://www.europeanreview.org/article/15622.

Wireless and Flexible Skin Moisture and Temperature Sensor Sheets toward the Study of Thermoregulator Center

A disorder in the thermoregulator center in a human body leads to some potential diseases such as fever and hyperthyroidism. To predict these diseases early, monitoring the health condition of the human body due to the influence of thermoregulation disorders is important. Although extensive works are performed on sweat-rate detection by constructing microfluidic channels, skin-moisture evaporation before sweating remains unknown. This work proposes a wireless and flexible sensor sheet to investigate the thermoregulatory responses of different people under cold stimulation and exercise by measuring the temperature and moisture variations on the finger skin. An integrated flexible sensor system consists of a ZnIn₂ S₄ nanosheet-based humidity sensor and carbon nanotube/SnO₂ temperature sensor. The results exhibit distinct thermoregulation abilities of five volunteers. Interestingly, the sudden increase in finger moisture that results from the excitation by the sympathetic nerve is observed during the cold-stimulus test. Although further studies are required to predict the potential diseases resulted from thermoregulation disorders in human body, this study provides a possibility of continuous and real-time monitoring of thermoregulatory activities via skin moisture and temperature detection using a flexible sensor sheet.

Plasma miR-146a and miR-365 expression and inflammatory factors in patients with osteoarthritis

OBJECTIVE

To investigate the expression levels of micro-ribonucleic acid (miR)-146a and miR-365 in the plasma of osteoarthritis (OA) patients, to study their expression with the inflammatory factors and the severity of disease in patients and to analyse their diagnostic significance.

MATERIALS AND METHODS

A total of 42 OA patients diagnosed with OA and treated in our hospital from January 2017 to January 2018 were selected as the subjects, and 28 healthy people were enrolled as controls. The expressions of interleukin-1 beta (IL-1β) and IL-6 in the plasma of OA patients were detected via immunohistochemical staining. Moreover, the knee joint function of OA patients was evaluated by Lysholm score, Western Ontario and McMaster Universities (WOMAC) score and Visual Analogue Scale (VAS) score. The expression levels of plasma miR-146a and miR-365 in OA patients were measured through RT-PCR. Besides, the significance of the expression levels of miR-146a and miR-365 for the diagnosis of OA was analysed by ROC curves.

RESULTS

As compared with healthy people, OA patients had elevated expression levels of plasma IL-1β and IL-6, decreased Lysholm score, increased WOMAC and VAS scores as well as significantly up-regulated levels of plasma miR-146a and miR-365, which were of important significance for diagnosis.

CONCLUSION

The expression levels of plasma miR-146a, miR-365 and inflammatory factors are notably higher, the disease is more severe, and the function of knee joint movement is weaker in OA patients than those in healthy controls. It can be concluded that the levels of both miR-146a and miR-365 can serve as biomarkers of OA diagnosis.

The association between the vaginal microenvironment and fecundability: a register-based cohort study among Chinese women

OBJECTIVE

To evaluate the association between the vaginal microenvironment and fecundability among women.

DESIGN

Register-based nationwide cohort study.

SETTING

Chinese National Free Pre-conception Check-up Project from 2015 to 2018.

POPULATION

Our study included a total of 3 388 554 eligible women who were attempting to become pregnant.

METHOD

We assessed the vaginal microenvironment at baseline by considering four indices: vaginal pH, clue cell examination, whiff test and vaginal cleanliness grading. If any of these indicators was abnormal, the vaginal microenvironment was defined as poor. Propensity score matching was used to control for potential confounders and reduce bias. Logistic models were used to estimate the fecundability odds ratios (FORs) after adjustment for covariates.

MAIN OUTCOME MEASURES

Achievement of a pregnancy within 1 year.

RESULTS

Of the total study population, 379 718 women (11.2%) had a poor vaginal microenvironment and their pregnancy rate after 1 year was significantly lower than the group with a normal microenvironment (71.8% versus 76.1%, P < 0.001). After adjusting for potential confounders, the women with a poor vaginal microenvironment were associated with a 9% reduction in fecundability compared with the normal microenvironment group (FOR 0.91, 95% CI 0.90-0.92). The adverse effects of a poor vaginal microenvironment were stronger among multipara (FOR 0.89, 95% CI 0.87-0.90) or women with irregular menstruation (FOR 0.86, 95% CI 0.84-0.89).

CONCLUSION

There was a negative association between a poor vaginal microenvironment and the fecundability of women. These findings highlight the significance of assessing the vaginal microenvironment during pre-pregnancy health examinations.

TWEETABLE ABSTRACT

Women with a poor vaginal microenvironment were associated with a reduction in fecundability.

The impacts of egg storage time and maternal dietary vitamin E on the growth performance and antioxidant capacity of progeny chicks

Two trials were designed to investigate the impacts of egg storage time and maternal dietary vitamin E (VE) supplementation on the growth performance and antioxidant capacity of progeny chicks. In total 512 Ross 308 broiler breeder hens (71-wk-old) were assigned to 2 dietary VE treatments (6 and 100 mg/kg) for 14 wk. Progeny chicks used in trials 1 and 2 were originated from eggs laid at week 10 (stored 0 d) and week 8 (stored 14 d), and week 14 (stored 0 d) and week 12 (stored 14 d), respectively. The 4 groups in trial 1 consisted of 2 levels of maternal VE (6 and 100 mg/kg) and 2 egg storage time (0 and 14 d). The 8 groups in trial 2 consisted of 2 levels of maternal VE (6 and 100 mg/kg), 2 egg storage time (0 and 14 d) and progeny sex (male and female). In trial 1, egg storage decreased the body weight, the liver total superoxide dismutase and total antioxidant capacity of 21-day-old offspring (P < 0.05), and the body weight gain and feed intake from 8 to 21 d and 1 to 21 d (P < 0.05); and increased the serum and liver malonaldehyde (MDA) of 7-day-old offspring and the ratio of feed: gain (F/G) from 1 to 7 d (P < 0.05). Maternal VE (100 vs. 6 mg/kg) decreased the F/G from 1 to 7 d and increased the serum total superoxide dismutase of 21-day-old offspring (P < 0.05). In trial 2, egg storage decreased the body weight of 42-day-old offspring, and the body weight gain and feed intake from 22 to 42 d and 1 to 42 d (P < 0.05); and increased the serum and liver MDA of 21- and 42-day-old offspring (P < 0.05). Maternal VE (100 vs. 6 mg/kg) reduced the serum MDA of 7-day-old offspring (P < 0.05). Interactively, maternal VE (100 vs. 6 mg/kg) reduced the serum MDA of offspring originated from stored eggs (P < 0.05), but not for that of offspring originated from unstored eggs in the two trials. It can be concluded that egg storage (14 vs. 0 d) decreased the growth performance and antioxidant capacity of offspring, while maternal dietary VE (100 vs. 6 mg/kg) supplementation could partly alleviate the reduction of antioxidant capacity (except for growth performance) of offspring induced by egg storage for the early phase post-hatch.

First Detection of a Cluster Novel HIV-1 Second-Generation Recombinant (CRF01_AE/CRF07_BC) among Men Who Have Sex with Men in Nanjing, Eastern China

INTRODUCTION

A large number of unique recombinant forms have been found in China in recent years. This study aimed to report on a cluster of novel HIV-1 recombinants.

METHODS

We constructed phylogenetic trees using the maximum likelihood (ML) method with 1,000 bootstrap replicates in IQ-TREE 1.6.8 software and determined recombination break points using SimPlot 3.5.1.

RESULTS

Overall, 9 near-full-length genome (NFLG) sequences were reported in this study, including 1 circulation recombinant form (CRF)01_AE NFLG sequence and 8 highly similar novel HIV-1 second-generation recombinants composed of CRF01_AE and CRF07_BC (CRF105_0107) isolated from a cluster HIV-positive male subjects infected among men who have sex with men (MSM) in Nanjing, eastern China. The phylogenetic analysis of NFLG showed 1 sequence named "nj16" to have at least 11 breakpoints inner virus and 7 other sequences to have at least 10 breakpoints inner virus. Our findings further showed as follows: first, this is the first time that a cluster of novel CRF105_0107 HIV-1 strains were identified among MSM in Nanjing, Jiangsu. Second, the Chinese "4a" cluster of CRF01_AE which mainly circulating in northern China has spread in Jiangsu for more than 15 years. Third, HIV-1 recombination events were active in Nanjing city, and novel recombinants could spread rapidly through some small-scale transmission networks.

CONCLUSION

The continued emergence of novel recombinant HIV-1 strains in Nanjing suggests dynamics and complexity in the HIV epidemic among MSM in Jiangsu province. Further investigations and molecular epidemiological research should be taken to monitor and understand transmission networks among MSM.

Dietary resistant potato starch improves growth performance and feather development in Pekin ducks fed a low phosphorus diet

This study investigated whether dietary resistant potato starch (RPS) inclusion could ameliorate the negative impact of a low nonphytate phosphorus (nPP) diet on growth performance, feather growth, feather follicles (FF) development, and carcass traits by improving nutrient utilization and cecal microbiome fermentation capacity in Pekin ducks. The experiment was performed with a 2 × 2 randomized block design with 2 levels of RPS (0 or 12%) and 2 levels of nPP (low or normal, low: 0.22% at 1–14 d and 0.18% at 15–35 d of age; normal: 0.40% at 1–14 d and 0.35% at 15–35 d of age) for a total of 4 treatments, each with 8 replicate pens per treatment of 12 birds per pen. As regards growth performance and carcass traits, RPS inclusion markedly increased (P < 0.05) BW of 14 and 35 d, BWG and FI of 1–14 d, 15–35 d, and 1–35 d as well as abdominal fat and breast meat percentage of 35 d in ducks fed low nPP diets; moreover, RSP inclusion significantly reduced (P < 0.05) mortality in ducks fed low nPP diets. As regards feather growth and follicles development of 35 d, RPS inclusion significantly increased (P < 0.05) the fourth primary feather length, absolute feather weight, and the density of primary FF in the back skin in ducks fed low nPP diets. In regard to nutrition utilization, RPS supplementation significantly increased (P < 0.05) the availability of DM, CP, and energy, as well as dietary AME at 35 d of age in ducks fed low nPP diets. However, RPS supplementation had no effect (P > 0.05) on the concentration of cecal short-chain fatty acids and the activities of cecal phytase and cellulase in ducks fed low nPP diets. These results indicate that RPS can improve nutrient availability to ameliorate the negative effects on performance and feather development caused by a low nPP diet in Pekin ducks.

Adsorption mechanism of rhein-coated Fe3O4 as magnetic adsorbent based on low-field NMR

In the present study, a magnetic adsorbent, rhein-coated magnetic Fe₃O₄ nanoparticle (RMNP), for Pb²⁺ and Mg²⁺ had been developed, and adsorption mechanism was studied via low-field NMR. RMNP was characterized by TEM, FTIR, and XRD. RMNP could adsorb and remove Pb²⁺ and Mg²⁺ from water and was successfully applied to remove Pb²⁺ and Mg²⁺ from wastewater, with satisfactory recovery rates and high adsorption capacities. The calculated maximum adsorption capacity for Mg²⁺ and Pb²⁺ was approximately 69.3 and 64.9 mg g^-1 of RMNP, respectively, which was better than some results reported. Low-field NMR results showed that Pb²⁺ or Mg²⁺ enhanced the T₂ relaxation time of RMNP, which suggested that RMNP selectively coordinated with Pb²⁺ or Mg²⁺ and led to the aggregation of RMNP, furthermore removal of Pb²⁺ or Mg²⁺ from water. The standard curves for △T₂-cation concentration exhibited good line correlation. The linear ranges were from 4.2 × 10^-6 to 2.0 × 10^-4 mol L^-1 for Pb²⁺ and from 5.0 × 10^-6 mol L^-1 to 1.0 × 10^-4 mol L^-1 for Mg²⁺, respectively. The limits of detection were 1.4 × 10^-6 mol L^-1 for Pb²⁺ and 2.1 × 10^-6 mol L^-1 for Mg²⁺, respectively. In short, low-field NMR could clearly display the interaction between RMNP and Pb²⁺ or Mg²⁺, even be used to detect Pb²⁺ or Mg²⁺ in suitable condition. Besides, this method could be expanded to study the interaction between other magnetic adsorbents and analytes.

Effect of metabolic syndrome components on the risk of malignancy in patients with gallbladder lesions

Background: Gallbladder lesions have become more common nowadays. But there is limited evidence-based guidance on surveillance of these patients for malignancy. Predicting malignancy could help clinicians better manage this condition and improve the prognosis. We evaluated the independent and joint effects of metabolic syndrome components on the risk of malignancy among patients with gallbladder lesions.

Methods: Using a multicenter database, consecutive patients with pathologically confirmed gallbladder lesions between 2012 and 2019 were identified. Univariate and multivariate logistic regression analyses were used to evaluate the effects of metabolic syndrome components (diabetes, hypertension, dyslipidemia and obesity) as additive or combined indicators for the risk of malignancy. Unadjusted and adjusted odds ratios were calculated.

Results: Of the 625 patients, 567 patients were identified with benign gallbladder lesions and 58 patients with gallbladder cancer (GBC). GBC group had less obesity but more dyslipidemia. Among all metabolic syndrome components, only dyslipidemia was significantly associated with GBC (odds ratio 2.674, 95% confidence interval 1.173-6.094). Dyslipidemia was an independent risk factor for malignancy (adjusted odds ratio 2.164, 95% confidence interval 1.165-4.021), regardless of whether the other risk factors and metabolic syndrome components were combined. Patients with decreased high-density lipoprotein had 3.035-fold higher risk of malignancy (adjusted odds ratio 3.035, 95% confidence interval 1.645-5.600).

Conclusions: Dyslipidemia is associated with a 2.674-fold increase in the risk of malignancy in patients with gallbladder lesions. Dyslipidemia is an independent risk factor for malignancy, regardless of the presence of the other risk factors and metabolic syndrome components.

Clinical Manifestations of Polycystic Ovary Syndrome and Associations With the Vaginal Microbiome: A Cross-Sectional Based Exploratory Study

BACKGROUND

Previous studies suggest that the vaginal microbiome is associated with polycystic ovary syndrome (PCOS). However, the clinical manifestations of PCOS are heterogeneous. Whether the vaginal microbiome is related with different clinical symptoms was unknown.

MATERIALS AND METHODS

In this cross-sectional study, 89 female patients with PCOS admitted to Zhongda Hospital (Nanjing, China) were included. Basic demographic information, health-related behaviors, clinical manifestations and sex hormone levels were comprehensively recorded for all patients. Vaginal swabs were acquired for microbiota sequencing of the V3-V4 region of the 16S rRNA gene.

RESULTS

The prevalence of bacterial vaginitis and vulvovaginal candidiasis was 15.7% and 13.5%, respectively, within the PCOS patients, which were the most important factors affecting the vaginal microbiome (permutational multivariate analysis of variance test, R² = 0.108, P = 0.001). The vaginal microbiome was associated with specific clinical manifestations of PCOS, including acanthosis nigricans, intermenstrual bleeding, pregnancy history, testosterone level and anti-müllerian hormone level, with P values < 0.05. The abundance of Lactobacillus crispatus was higher (P = 0.010) while that of Lactobacillus iners was lower (P = 0.036) among PCOS patients with elevated testosterone levels. Other potential bacterial biomarkers were not statistically significant after adjusting for confounding factors. No evidence of associations of other common manifestations of PCOS, such as obesity and acne, with the vaginal microbiome was obtained.

CONCLUSION

Vaginal bacterial species among PCOS patients with variable clinical manifestations, especially differences in testosterone levels, are distinct. Further studies are essential to investigate the microbiota and molecular mechanisms underpinning this disease.