Associations of early pregnancy serum uric acid levels with risk of gestational diabetes and birth outcomes: a retrospective cohort study

BACKGROUND

Previous evidence suggests that higher blood uric acid (UA) levels are associated with adverse cardiovascular outcomes during pregnancy and subsequent birth outcomes. However, it has been relatively unclear whether these associations persist in normotensive pregnant women.

METHODS

The study was based on a retrospective analysis of 18,250 mother-infant pairs in a large obstetric center in China. Serum UA concentrations in early pregnancy (median: 17.6, IQR: 16.3, 18.6 gestational weeks) were assessed. Hyperuricemia was defined as ≥ one standard deviation (SD) of the reference value for the corresponding gestational age. Outcomes of gestational diabetes mellitus (GDM), preterm birth (PB), low birth weight (LBW), macrosomia, small for gestational age (SGA) and large for gestational age (LGA) were extracted from the medical records.

RESULTS

The mean maternal UA level was 0.22 ± 0.05 mmol/L, and 2,896 (15.9%) subjects had hyperuricemia. After adjustment for several covariates, UA was associated with several adverse outcomes. The ORs (95%CI) per one SD increase in serum UA concentration were 1.250 (1.136, 1.277) for GDM, 1.137 (1.060, 1.221) for PB, 1.134 (1.051, 1.223) for LBW, and 1.077 (1.020, 1.137) for SGA, respectively. Similar adverse associations were found between hyperuricemia and GDM, PB (ORs: 1.394 and 1.385, P < 0.001), but not for LBW, macrosomia, SGA, and LGA. Adverse associations tended to be more pronounced in subjects with higher BMI for outcomes including PB, LBW, and SGA (P interaction = 0.001-0.028).

CONCLUSION

Higher UA levels in early pregnancy were associated with higher risk of GDM, PB, LBW, and SGA in normotensive Chinese women.

[Establishment and preliminary application of organoids in ovarian cancer]

Objective: To explore the establishment and application of ovarian cancer organoids. Methods: Fresh ovarian tumor tissues, obtaining from patients underwent surgery in the First Affiliated Hospital of Nanjing Medical University between October 2021 and March 2022, were collected, enzymatic degraded, digested, and embedded into matrigel to establish organoids. A total of 32 ovarian cancer samples were collected. Hematoxylin eosin (HE) staining and immunofluorescence (IF) procedure were used to verify the morphological structure of organoids and their expression of molecular markers. 3D cyto-live or dead assay was used to detecte the live or dead cells in organoids. Carboplatin with a concentration ranging from 5 to 80 μmol/L (5, 10, 20, 40, 80 μmol/L) was added to organoids to calculate the 50% inhibitory concentration (IC₅₀) in different organoids. Results: (1) Organoids from a total of 32 patients were established, of which 18 cases could be passaged stably in the long term in vitro, while 14 could be passaged in the short time. The average amplification time of long-term passage in vitro was over 3 months, and the longest reached 9 months. (2) In HE staining, significant nuclei atypia and local micropapillary structures were observed in organoids. IF staining revealed that ovarian cancer organoids expressed molecular markers similar to primary tumor tissues, such as Pan cytokeratin (Pan-CK), p53, paired box gene 8 (PAX8), and Wilms tumor gene 1 (WT1). (3) In 3D cyto-live or dead assay, a large number of apoptotic cells were observed inside and around the organoids after added carboplatin. The sensitivity to carboplatin varied in 18 organoids could amplify in the long term, with an average IC₅₀ of (29.5±15.8) μmol/L. Moreover, IC₅₀ values of 4 organoids derived from patients received neoadjuvant chemotherapy were much higher than the 14 organoids which did not received neoadjuvant chemotherapy [(48.7±11.3) μmol/L vs (24.0±12.1) μmol/L; t=3.429, P=0.022]. Conclusions: Organoids recapitulate ovarian cancers in vitro and could be stably passaged. Organoids derived from patients received neoadjuvant chemotherapy have higher resistance to carboplatin.

MicroRNA-155 enhances the activation of Wnt/β-catenin signaling in colorectal carcinoma by suppressing HMG-box transcription factor 1

Colorectal carcinoma (CRC) is a malignant solid tumor arising from the large intestine and is associated with an increasing incidence and poor prognosis. Further understanding of the molecular mechanisms underlying CRC may contribute to the development of novel effective therapeutic strategies. MicroRNAs (miRs), including miR‑155, have been reported to be associated with the etiology and biology of CRC; however, the molecular mechanisms by which miR‑155 affect CRC remain to be fully elucidated. The present study used a multidisciplinary approach, involving reverse transcription‑quantitative polymerase chain reaction, northern blotting, MTT assay, cell cycle progression analysis, immunoblotting, and animal experiments, to determine the possible targets of miR‑155 in CRC cells. miR‑155 was found to be overexpressed in CRC tissue samples, compared with paired normal colon tissue samples. In addition, the inhibition of miR‑155 induced a deceleration in CRC cell proliferation and inactivation of the Wnt/β‑catenin signaling pathway. miR‑155 suppression also reduced the growth of CRC xenografts in an animal model. HMG‑box transcription factor 1 (HBP1) was identified as a novel target of miR‑155, which mediated its effect on CRC via the Wnt/β‑catenin pathway. Furthermore, patients with CRC exhibiting higher serum levels of miR‑155 exhibited reduced survival rates. In conclusion, the present study demonstrated that miR‑155 may contribute to the progression and growth of CRC by enhancing the Wnt/β‑catenin pathway in an HBP1‑associated mechanism. Therefore, miR‑155 may be considered a promising therapeutic target for the treatment of CRC.

EFFECT OF PREGNANE XENOBIOTIC RECEPTOR ACTIVATION ON INFLAMMATORY BOWEL DISEASE TREATED WITH RIFAXIMIN

The causes and pathogenesis of Inflammatory Bowel Disease (IBD) are still not clearly understood. This study aims to prove the important role of rifaximin played in inflammatory reaction caused by abnormity of the intestinal mucosal immune system. Intestinal microflora can greatly promote and maintain the inflammatory reaction of IBD, therefore, antibiotics can be used to treat IBD. Rifaximin is a medicine usually used for local intestinal infection. Many clinical and basic studies have shown that both a single application of rifaximin and the joint application with other medicines could achieve a good efficacy. This paper studied the activation of Pregnane Xenobiotic Receptor (PXR) in treating IBD with rifaximin and analyzed its efficacy in IBD when PXR was involved in the transport of medicine and metabolism. The results prove that rifaximin can not only serve as an anti-microbial drug, but can activate PXR and actually weaken the reaction of IBD. Thus it is safe to say that rifaximin has great potential in treating IBD.

Correlation between the cystathionine-γ-lyase (CES) and the severity of peptic ulcer disease

BACKGROUND

The infection of Helicobacter pylori (H. pylori) is one of the most important causes of gastric ulcer disease. The role of hydrogen sulfide (H2S) production in H. pylori-induced gastric ulcer disease.

AIM

The expression of cystathionine-γ-lyase (CSE) was determined, and correlated with the severity of gastric ulcer disease.

METHODS

One hundred and eight patients were selected based on the determination of gastric ulcer and the infection of Helicobacter pylori (H. pylori), including 36 normal control, 36 patients with H. Pylori-negative gastric ulcer, and 36 patients with H. Pylori-positive gastric ulcer. RT-PCR determination was performed to determine the expression of CSE, NF-κB and IL-8.

RESULTS

The expression of CSE, NF-κB and IL-8 was higher in the gastric ulcer group than control group (p<0.05). Compared with the H. pylori-negative gastric ulcer, the expression of CSE, NF-κB and IL-8 was higher than H. pylori-positive gastric ulcer group (p<0.05). For H. pylori-negative gastric ulcer group, the expression of CSE positively correlated with the expression of NF-κB (r=0.98, p<0.05) and IL-8 (r=0.95, p<0.05). For H. pylori-positive gastric ulcer group, the expression of CSE also positively correlated with the expression of NF-κB (r=0.99, p<0.05) and IL-8 (r=0.85, p<0.05).

CONCLUSION

The expression of CSE was positively correlated with the severity of gastric ulcer.

Achievement of equity and universal access in China's health service: a commentary on the historical reform perspective from the UK National Health Service

This paper aims to examine the UK National Health Service (NHS) in the historical context of its background reforms and to investigate future developmental strategies for China's health system. We focus on the central issues facing China's future healthcare development: equity and access. China and the UK have approached healthcare reform from opposite perspectives, the NHS has maintained the core principle of providing universal health coverage throughout the decades. However, due to increasing demand, reforms to improve and sustain efficiency have meant increasing government funding while introducing elements of a market system. Conversely, China has moved from a centrally planned system to a fee-for-service system, but serious problems of inequity and access call for new methods of organisation and financing. With the future of both systems under constant debate, international experience will play a vital role in formulating health system reform strategies.

Expression of B-type endothelin receptor gene during neural development

Mutations of the B-type endothelin receptor (ETRB) gene have been found to cause defects in the development of enteric neurons, which resulted in aganglionic megacolon in rodents and humans. To determine the distribution of ETRB mRNA during neural development, mainly in the CNS, in situ hybridization was applied at various developmental stages of rat. ETRB gene was abundantly expressed prenatally in the ventricular and subventricular zones, as well as postnatally in the ependymal and subependymal cells. ETRB mRNA was also strongly detected prenatally in the dorsal root ganglia, as well as postnatally in the cerebellar Bergmann glial cells and epithelial cells of choroid plexus. Our data suggest that ETRB acts as a regulator in the differentiation, proliferation, or migration of neural cells during development.

A comparative study of first and third year student nurses' knowledge and attitudes on the elderly and ageing

A comparative study was carried out to assess Year I and Year III student nurses' attitudes and knowledge of the elderly. Significantly more Year I students disagreed that the elderly had a capacity to learn (chi 2 = 11.08, p = 0.0006). Year III students were significantly more likely to obtain information about the elderly from the mass media, agencies, and relatives but not from health personnel. Nearly all respondents (96.25%) in the study wanted to know more about the elderly. Only 3 of the 14 questions on ageing revealed significant differences in knowledge between the two groups. The basic course in gerontology should be expanded and revised to dispel erroneous attitudes, allow better understanding of the ageing process, and ensure entry-level competence in caring for older people.

Absence of 4,977-bp deletion of blood cell mitochondrial DNA in patients with young-onset Parkinson's disease

Decreased mitochondrial Complex I activities and a 4,977-bp deletion in mitochondrial DNA (mtDNA) have been reported in patients with Parkinson's disease. Based on the assumption of possible links between this 4,977-bp deletion and the etiology of Parkinson's disease, we analyzed mtDNA of blood cells from 15 patients with young-onset Parkinson's disease after the DNA was amplified by polymerase chain reaction. We could not detect the 4,977-bp mtDNA deletion in any of these patients. This result suggests that Parkinson's disease is not a mitochondrial disease due to the 4,977-bp mtDNA deletion. The 4,977-bp deletion in mtDNA appears to be an age-related phenomenon.