Transition of visceral adiposity index and risk of cardiovascular disease in middle-aged and older Chinese adults

OBJECTIVE

Visceral obesity and the lifetime risk of cardiovascular disease (CVD) have received increasing attention. However, the relationship between dynamic changes in visceral obesity and CVD has not been studied. We aimed to determine the association of visceral adiposity index (VAI) transition with CVD risk.

METHODS

A total of 5395 participants were recruited in 2011-2012 and followed up until 2018 from the China Health and Retirement Longitudinal Study. The cut-off value of the VAI was obtained by the receiver-operating characteristic curve. Participants were grouped based on VAI change patterns during the follow-up period (2011-2015): the low-low group, low-high group, high-low group, and high-high group. CVD was defined as a medical diagnosis of heart disease and/or stroke. A Cox proportional hazards model was used to evaluate the correlation between VAI transition and CVD.

RESULTS

Over a median follow-up period of 7 years, 969 participants (17.9 %) developed CVD. VAI change patterns were significantly associated with CVD risk after adjustment for demographic characteristics and risk factors. The high-high group (hazard ratio (HR): 1.65, 95 % confidence interval (CI): 1.39-1.97) and the low-high group (HR: 1.29, 95 % CI: 1.04-1.61) were associated with a higher risk of CVD after adjusting for demographic characteristics and traditional risk factors compared to the low-low group, while the effect in the high-low group was not significant.

CONCLUSIONS

VAI transition was significantly associated with the risk of CVD. Monitoring the dynamics of the VAI in public health practice would help prevent CVD.

The dynamic features and microbial mechanism of nitrogen transformation for hydrothermal aqueous phase as fertilizer in dryland soil

Hydrothermal aqueous phase (HAP) contains abundant organics and nutrients, which have potential to partially replace chemical fertilizers for enhancing plant growth and soil quality. However, the underlying reasons for low available nitrogen (N) and high N loss in dryland soil remain unclear. A cultivation experiment was conducted using HAP or urea to supply 160 mg N kg-1 in dryland soil. The dynamic changes of soil organic matters (SOMs), pH, N forms, and N cycling genes were investigated. Results showed that SOMs from HAP stimulated urease activity and ureC, which enhanced ammonification in turn. The high-molecular-weight SOMs relatively increased during 5-30 d and then biodegraded during 30-90 d, which SUV254 changed from 0.51 to 1.47 to 0.29 L-1 m-1. This affected ureC that changed from 5.58 to 5.34 to 5.75 lg copies g-1. Relative to urea, addition HAP enhanced ON mineralization by 8.40 times during 30-90 d due to higher ureC. It decreased NO3-N by 65.35%-77.32% but increased AOB and AOA by 0.25 and 0.90 lg copies g-1 at 5 d and 90 d, respectively. It little affected nirK and increased nosZ by 0.41 lg copies g-1 at 90 d. It increased N loss by 4.59 times. The soil pH for HAP was higher than that for urea after 11 d. The comprehensive effects of high SOMs and pH, including ammonification enhancement and nitrification activity inhibition, were the primary causes of high N loss. The core idea for developing high-efficiency HAP fertilizer is to moderately inhibit ammonification and promote nitrification.

Analysis of change process of NPP dominated by human activities in Northwest Hubei, China, from 2000 to 2020

Clarifying the spatial distribution of the impact of different human disturbance activities on the net primary productivity (NPP) in regions with single climatic conditions is of considerable importance to ecological protection. Time-series NPP from 2000 to 2020 was simulated in Northwest Hubei, China, and the effects of the climate and human activities on the NPP changes were separated. Research results showed that from 2000 to 2020, the NPP change with an area of 10,166.63 km2 in Northwest Hubei is influenced by climate and human activities. Among them, human activities account for as high as 84.53%. From 2000 to 2020, the NPP in Northwest Hubei showed a slight upward trend at a rate of 1.61 g C m-2 year-1. The significantly increased NPP accounted for 21.4% of the total, which was mainly distributed in north of Northwest Hubei. And the farming of cultivated land led to the increase of NPP in west as well as the reduced human distribution in cultivated land, which was scattered in forests. Only 6.67% of the total area demonstrated a significantly decreased NPP, which was distributed mainly in the central affected by the expansion of rural-urban land and change of broad-leaved forests to shrubs and in southeast regions of Northwest Hubei caused by the increase in potential evapotranspiration. This study refined the driving factors of spatial heterogeneity of NPP changes in Northwest Hubei, which is conducive to rational planning of terrestrial ecosystem protection measures.

Exploring spatial-temporal driving factors for changes in multiple ecosystem services and their relationships in West Liao River Basin, China

Ecosystem services (ES) are the direct and indirect benefits people obtain from ecosystems, serving as a bridge linking ecological systems and social-economic systems. The quantitative assessment of the dynamic changes in ES and their relationships and the identification of the driving forces behind them have recently become a research hotspot. However, several research gaps remain challenging, such as the lack of an analytical framework for selecting relevant driving factors and the need for an innovative approach that integrally estimates the impacts of driving factors on the changes in ES and the relationships between ES. In this study, we modify the social-ecological system framework as the analytical basis and suggest a series of principles for selecting relevant driving factors, we then adopt the path analysis model to simultaneously and consistently quantify the contributions of driving factors to ES changes and their relationships. Using the West Liao River Basin (WLRB) as a case study, the results show the spatial-temporal variations in three ES and six driving factors from 2000 to 2020, divided into four periods. The estimation of path analysis model confirm two hypotheses that different driving factors exerted differential effects on changes in multiple ES in four periods for the whole WLRB and in three sub-basins for the period 2015-2020. In addition, the path analysis exhibits the quantitative relationships between food production, water yield, and soil conservation, which vary temporally and spatially in different periods and different sub-basins. The identification of driving factors is helpful for supporting policy-making to construct a coupled self-adjusted social-ecological for the benefit of the public.

Association of eGFR slope with all-cause mortality, macrovascular and microvascular outcomes in people with type 2 diabetes and early-stage chronic kidney disease

AIMS

The association of estimated glomerular filtration rate (eGFR) slope with progression of complications in people with type 2 diabetes (T2D) and early-stage chronic kidney disease (CKD) is less clear.

METHODS

We identified 115,139 T2D participants without decreased eGFR (>60 mL/min/1.73 m2) between 2008 and 2015 from the electronic database of the Hong Kong Hospital Authority. eGFR slope calculated by linear-mixed effects model using 3-year eGFR measurements was categorized into quintiles. With Quintile 3 of eGFR slope as the reference group, we used Cox proportional or cause-specific models to investigate the association between eGFR slope and all-cause mortality, macrovascular and microvascular complications, as appropriate.

RESULTS

Over a median follow-up of 7.8 years, fastest eGFR declines (Quintile 1 with median eGFR slope: -4.32 mL/min/1.73 m2/year) were associated with increased risk of all adverse outcomes (adjusted hazard ratio [aHR] 1.36 to 2.97, all P < 0.0001), compared with less steep eGFR declines (Quintile 3: -1.08 mL/min/1.73 m2/year). Substantial eGFR increases (Quintile 5: 1.34 mL/min/1.73 m2/year) were associated with decreased risk of CKD and ≥ 40 % decline in eGFR (aHR [95 % CI] 0.65 [0.63, 0.67] and 0.85 [0.82, 0.89], respectively) and higher risk of death, CVD, DR and DN (aHR [95 % CI] 1.48 [1.40, 1.56], 1.19 [1.14, 1.25], 1.07 [1.004, 1.15] and 1.62 [1.37, 1.91], respectively).

CONCLUSIONS

In a cohort of T2D people without decreased eGFR, accelerated declines and increases in eGFR were associated with all-cause mortality, macrovascular and microvascular complications, supporting the potential prognostic utility of eGFR slope in T2D people with early-stage CKD.

Rethinking about acupuncture intervention opportunity based on dynamic perspective of inflammatory response

Acupuncture and moxibustion therapies are widely used in the field of anti-inflammation, but the dynamic characteristics of inflammatory response with time in the modern biological mechanism research has been ignored to some extent. Therefore, the body surface intervention system represented by acupuncture-moxibustion urgently needs to rebuild the research perspective oriented to the complex immune regulation model, and then to explore the opportunity of acupuncture-moxibustion anti-inflammatory intervention according to the dynamic change process of inflammatory response. Through comparative analysis on the ancient and modern acupuncture-moxibustion immune regulation, and starting from the construction of clinical body surface intervention system, we propose that grasping the appropriate "intervention opportunity" is an important entry point that cannot be ignored to effectively "pry" inflammatory response.

Changes in marker secondary metabolites revealed the medicinal parts, harvest time, and possible synthetic sites of Rubia cordifolia L

Rubia cordifolia L. is a significant medicinal plant. To investigate the changes of marker metabolites of R. cordifolia, the purpurin, mollugin, carbon, nitrogen contents, and the expression of genes involved in anthraquinones synthesis were examined. The findings indicated that the two secondary metabolites were only detected in stems and roots. Root purpurin content was 5-26 times higher than in stems, and root mollugin content was 92 times higher than in stems in June. These findings suggest that the potential of the roots as a medicinal part. The roots were found to have highest purpurin content in October (2.406 mg g-1), whereas the mollugin content was highest in August (6.193 mg g-1). However, the purpurin content in August was only 0.029 mg g-1 lower than that in October, making August a suitable harvest period for R. cordifolia. The expression 1-deoxy-D-xylulose 5-phosphate synthase (dxs) and 1-deoxy-D-xylulose-5-phosphate reductorisomerase (dxr) genes in roots showed an upward trend. However, the expression level of dxr gene was significantly higher than dxs with the range of 60-518 times higher, indicating the important role of dxr gene. Through correlation and redundancy analyses, it was found that mollugin showed positive correlation with carbon contents and carbon-nitrogen ratio of aerial parts. Additionally, purpurin showed a positive correlation with the expression of both genes. As a result, mollugin is likely to be synthesized in the aerial parts and then stored in the roots, whereas purpurin might be synthesized in the stems and roots. These findings could provide cultivation guidelines for R. cordifolia.

Spatio-temporal dynamic change mechanism analysis of traffic conflict risk based on trajectory data

Analyzing risk dynamic change mechanism under spatio-temporal effects can provide a better understanding of traffic risk, which helps reinforce the safety improvement. Traditionally, spatio-temporal studies based on crash data were mostly conducted to explore crash risk evolution mechanism from a macroscopic perspective. Dynamic change mechanism of short-term risk within a small-scale area deserves exploration, which cannot be captured in macroscopic crash-based studies. It is practical to analyze traffic conflict risk as a surrogate safety measure, which can preferably overcome the limitations of crash-based studies. This study aims to explore the spatio-temporal dynamic change mechanism of conflict risk based on trajectory data. Both conflict frequency and severity are integrated and assessed by applying fuzzy logic theory to develop the whole risk indicator. Trajectories on U.S. Highway101 from NGSIM dataset are utilized and aggregated. A two-step framework is proposed to analyze the risk dynamic change mechanism. The spatial Markov model is firstly applied to explore the transition probability of risk level, and then the panel regression approach is employed to quantify the relationship between spatio-temporal risk and traffic characteristics. Modeling results show that (1) the dynamic change trend of safety states differs under different spatial lag conditions, and it can be well depicted by the spatial Markov model; (2) dynamic spatial panel data modeling method performs better than the model that only considers temporal or spatial dependency. The novel proposed framework promotes a systematic exploration of conflict risk from a mesoscopic perspective, which contributes to assess the real-time road safety more comprehensively.

Dynamic change of the systemic immune inflammation index is a risk factor for patients with oropharyngeal cancer: a case control study and an additional HPV-status subgroup analysis

BACKGROUND

The study aimed to analyze the relationship between the dynamic systemic immune inflammation index (SII), human papillomavirus (HPV) infection, and the prognosis of oropharyngeal cancer patients.

METHOD

We retrospectively obtained the data for 131 patients treated with curative treatments and calculated their SII values based on results acquired approximately 9 months after the first treatment. The entire cohort was divided into groups according to dynamic SII and HPV infection, and their prognoses were compared.

RESULTS

The high SII group, particularly the persistently high SII group, had a poor prognosis, and static SII levels cannot fully reflect the prognosis of patients with oropharyngeal cancer. In HPV- patients, unfavorable dynamic SII and the site of tumor locating at the tongue base were all significantly associated with decreased disease-free survival. In contrast, no characteristic was presented as a poor prognostic factor for disease-free or overall survival in HPV+ patients.

CONCLUSION

Dynamic SII values are more comprehensive prognostic indicators for oropharyngeal cancer patients, particularly HPV- patients. It could imply that an HPV- oropharyngeal cancer patient who experienced unfavorable dynamic changes in SII should receive more frequent tests or more advanced therapies.

Circulating tumor cell quantification during abiraterone plus prednisone therapy may estimate survival in metastatic castration-resistant prostate cancer patients

PURPOSE

Circulating tumor cells (CTCs) predict survival in response to different interventions in metastatic castration-resistant prostate cancer (mCRPC) patients. This study aimed to explore the dynamic change in CTCs during abiraterone plus prednisone therapy and its optimal threshold for prognostication in mCRPC patients.

METHODS

CTCs in blood samples from mCRPC patients (N = 98) at baseline and in the 2nd month after abiraterone plus prednisone treatment initiation (M2) were enumerated by using the CellSearch System.

RESULTS

CTCs were detected in 64.8% of mCRPC patients at baseline with a median value (interquartile range) of 2.0 (0.0-4.0). Elevated CTC count was related to visceral metastasis (P = 0.003), high alkaline phosphatase (P = 0.043), and high lactate dehydrogenase (P = 0.007). Baseline CTC ≥ 1 (vs. < 1) was only associated with shortened radiographic progression-free survival (rPFS) (P = 0.043); additionally, baseline CTC ≥ 5 (vs. < 5) was linked with unfavorable rPFS (P = 0.037) and overall survival (OS) (P = 0.021). Following the therapy, CTCs were reduced at M2 (P < 0.001). Notably, CTC ≥ 1 (vs. < 1) (P = 0.002) and CTC ≥ 5 (vs. < 5) (P < 0.001) at M2 were related to shortened rPFS according to the Kaplan‒Meier curves, and they could independently estimate deteriorative rPFS in the multivariate Cox regression (P = 0.043 and P = 0.027, respectively). Similarly, CTC ≥ 1 (vs. < 1) (P = 0.022) and CTC ≥ 5 (vs. < 5) (P = 0.002) at M2 were related to shortened OS, whereas only CTC ≥ 5 (vs. < 5) could independently predict unfavorable OS (P = 0.017).

CONCLUSION

CTC count ≥ 5 at M2 exhibits excellent prognostic value for abiraterone plus prednisone therapy in mCRPC patients.

Glucose metabolism continuous deteriorating in male patients with human immunodeficiency virus accepted antiretroviral therapy for 156 weeks

BACKGROUND

The dynamic characteristics of glucose metabolism and its risk factors in patients living with human immunodeficiency virus (PLWH) who accepted primary treatment with the efavirenz (EFV) plus lamivudine (3TC) plus tenofovir (TDF) (EFV + 3TC + TDF) regimen are unclear and warrant investigation.

AIM

To study the long-term dynamic characteristics of glucose metabolism and its contributing factors in male PLWH who accepted primary treatment with the EFV + 3TC + TDF regimen for 156 wk.

METHODS

This study was designed using a follow-up design. Sixty-one male treatment-naive PLWH, including 50 cases with normal glucose tolerance and 11 cases with prediabetes, were treated with the EFV + 3TC + TDF regimen for 156 wk. The glucose metabolism dynamic characteristics, the main risk factors and the differences among the three CD4+ count groups were analyzed.

RESULTS

In treatment-naive male PLWH, regardless of whether glucose metabolism disorder was present at baseline, who accepted treatment with the EFV + 3TC + TDF regimen for 156 wk, a continuous increase in the fasting plasma glucose (FPG) level, the rate of impaired fasting glucose (IFG) and the glycosylated hemoglobin (HbA1c) level were found. These changes were not due to insulin resistance but rather to significantly reduced islet β cell function, according to the homeostasis model assessment of β cell function (HOMA-β). Moreover, the lower the baseline CD4+ T-cell count was, the higher the FPG level and the lower the HOMA-β value. Furthermore, the main risk factors for the FPG levels were the CD3+CD8+ cell count and viral load (VL), and the factors contributing to the HOMA-β values were the alanine aminotransferase level, VL and CD3+CD8+ cell count.

CONCLUSION

These findings provide guidance to clinicians who are monitoring FPG levels closely and are concerned about IFG and decreased islet β cell function during antiretroviral therapy with the EFV + 3TC + TDF regimen for long-term application.

Insight into biofilm-forming patterns: biofilm-forming conditions and dynamic changes in extracellular polymer substances

The microbial biofilm adheres to the surface of the carrier, which protects the pollutant-degrading bacteria and resists harsh environments; thus, research on biofilm-forming patterns will help promote the application of biofilms in wastewater treatment. Herein, univariate analysis and response surface methodology (RSM) confirmed that glucose and mannose at 3-5 g/L promoted biofilm formation. Notably, the microplate method demonstrated that compared to trivalent cations, divalent cations could more greatly enhance the activity (especially magnesium) of the biofilm matrix, and the period of biofilm formation in the three strains was divided into the following stages: initial attachment (0-10 h), microcolony (10-24 h), maturation (24-48 h), and dispersion (36-72 h). During maturation, large amounts of extracellular polysaccharides (EPs) and extracellular DNA (eDNA) were distributed in the extracellular and intracellular spaces, respectively, as observed by super-resolution structured illumination microscopy (SR-SIM). This study enhances the understanding of the characteristics and patterns of biofilm formation and can facilitate the application of biofilms in wastewater treatment.

Dynamic change in the thickness of the masseter muscle between contraction and relaxation is associated with the masticatory function in older adults: a cross-sectional study

BACKGROUND

Decreased masticatory function contributes to malnutrition in the elderly. The purpose of our study was to explore whether the masseter muscle is involved in masticatory function in older adults and to help determine if the masticatory function of the elderly can be improved by exercising the masseter muscle.

METHODS

Random sampling was adopted in our research, and a total of 413 older adults from 9 nursing homes in China were recruited from March 10 to June 12, 2022. The thickness and echo intensity of their masseter muscles were assessed using ultrasound. Masticatory function was measured using a color-changing chewing gum, and the change of α* before and after chewing (Δα*) was defined as masticatory function. If Δα* <14.2 in males or <10.8 in females was masticatory dysfunction. Their number of molar occlusal supports (MOSN), comorbidity, oral diadochokinesis (ODK), maximum tongue pressure (MTP), and calf circumference (CC) were evaluated. Multiple linear regression analysis was performed to identify the factors independently associated with the masticatory function.

RESULTS

Of the 413 older adults, 179 (43.3%) had masticatory dysfunction. The average thickness of the masseter muscle between contraction and relaxation was 1.3 mm (range, 0.7-2.0 mm). The thickness of the masseter muscle and ODK decreased with age, while the echo intensity of the masseter muscle increased. The results of the multiple linear regression analysis showed that dynamic change in the thickness of the masseter muscle between contraction and relaxation (β=0.085; P=0.049), MTP (β=0.147; P=0.001) and MOSN (β=0.349; P<0.001), brushing teeth ≥2 times/day (β=-0.187; P<0.001), and CC (β=0.135; P=0.002) were independent factors affecting masticatory function.

CONCLUSIONS

We found that masticatory dysfunction was prevalent among older adults in nursing homes in Southwest China, and the dynamic change in the thickness of the masseter muscle between contraction and relaxation was positively correlated with masticatory function. This result suggests that we can improve the masticatory function of the elderly by increasing the thickness of the masseter muscle between contraction and relaxation (e.g., by exercising the masseter).

What's sleep got to do with it? Longitudinal associations between insomnia, PTSD, and alcohol use among U.S. Veterans

U.S. veterans are at risk for insomnia, which often co-occurs with symptoms of posttraumatic stress disorder (PTSD) and alcohol use. Much of the research on veterans and these three constructs is cross-sectional and focused on unidirectional pathways. Recent theoretical and empirical evidence suggests a dynamic interplay between insomnia, PTSD, and alcohol use, yet few longitudinal studies exist. A clearer understanding of these pathways is needed to help inform integrated treatments. Using a sample of 1,230 post-9/11 veterans assessed over four time points across 12 months, we used a latent difference score modeling approach to examine proportional and dynamic change between insomnia, PTSD, and alcohol. Results revealed a complex interplay between all three constructs. Higher prior levels of both PTSD and alcohol use were associated with greater subsequent changes in insomnia symptoms (i.e., worse sleep). Moreover, although veterans drank less frequently as their insomnia symptoms worsened over time, greater changes in insomnia symptoms (i.e., worse symptoms) was a mechanism linking PTSD and more frequent drinking. As the research on interventions addressing insomnia, PTSD, and alcohol is limited, there are opportunities for researchers and clinicians to develop programs that effectively target all three in integrated treatments.

Dynamic change of soluble interleukin-2 receptor distinguished molecular heterogeneity and microenvironment alterations in diffuse large B-cell lymphoma

Diffuse large B-cell lymphoma (DLBCL) is an aggressive lymphoma with variable clinical outcomes and prediction of prognosis remains important for long-term remission. We performed serial serum soluble interleukin-2 receptor (sIL-2R) measurement pretreatment and before each cycle of the treatment in 599 patients with de novo DLBCL. Genomic and transcriptomic features were analyzed by 223 DNA- and 227 RNA-sequencing, respectively. Applying the cut-off value to sIL-2R pretreatment and cycle 2 (C2) level, patients were classified into FINE subtype (pretreatment low level) with good prognosis, RES subtype (pretreatment high level and C2 low level) with intermediate prognosis, and RET subtype (pretreatment high level and C2 high level) with poor prognosis, independent of International Prognostic Index. In “others” genetic subtype, dynamic change of sIL-2R showed prognostic significance and genetic features. Compared with FINE subtype, RES subtype had increased ARID1A and MYD88 mutations, and RET subtype had increased KMT2D, LYN and SOCS1 mutations. RES and RET subtypes showed significant enrichment in oncogenic pathways, such as ERK, NF-κB, JAK-STAT, and immune-associated pathways. As for tumor microenvironment, RES subtype exhibited increased recruiting activity of CD8 + T, T helper 1, and natural killer cells, and RET subtype with increased recruiting activity of CD4 + T and regulatory T cells in silico. There was a positive correlation between transcripts of IL-2R and immune checkpoint expressions including PD-1 and CTLA-4. Our findings identified that dynamic change of sIL-2R, with this simple and easy detection method in peripheral blood, had long-term prognostic effect and specific relation to microenvironment alterations in DLBCL.

Longitudinal white matter hyperintensity changes and cognitive decline in patients with minor stroke

Background and objective

As reported, both minor stroke and white matter hyperintensities (WMHs) are associated with an increased risk of cognitive impairment and dementia. The underlying factors for dynamic changes in WMH volume and cognitive performances in patients with minor stroke remain poorly understood. A 2-year longitudinal study was designed to investigate the factors associated with the changes in white matter hyperintensity (WMH) volume on brain MRI and cognitive decline in patients with minor stroke.

Methods

A group of eligible patients with minor ischemic stroke was recruited in a row. At the initial and 2-year follow-up visits, all the participants underwent routine examinations, multimodal MRI, and cognitive assessment. Using a lesion prediction algorithm tool, we were able to automate the measurement of the change in WMH volume. During the 2-year follow-up, cognitive function was evaluated using Telephone Interview for Cognitive Status-Modified (TICS-m). Participants’ demographic, clinical, and therapeutic data were collected and statistically analyzed. Regression analyses were used to test the relationships between risk factors and changes in WMH volume and cognitive decline.

Results

Finally, we followed up with 225/261 participants for 2 years, with a mean age of 65.67 ± 10.73 years (65.6% men). WMH volume was observed to be increased in 113 patients, decreased in 74 patients, and remained stable in 58 patients. Patients with WMH progression were more often had a history of hypertension (p = 0.006) and a higher CSVD burden both at baseline and follow-up visit (p < 0.05). Longitudinally, the proportion of patients taking antihypertension medications on a regular basis in the regression group was higher than in the stable group (p = 0.01). When compared to the stable group, the presence of lacunes (OR 9.931, 95% CI 1.597–61.77, p = 0.014) was a stronger predictor of progression in WMH volume. 87 subjects (38.6%) displayed incident cognitive impairment. The progression of WMH volume was a significant risk factor for cognitive decline (p < 0.001).

Conclusions

The longitudinal change of WMH is dynamic. The regressive WMH volume was associated with the use of antihypertensive medications on a regular basis. The presence of lacunes at the initial visit of the study was a stronger predictor of WMH progression. The progression of WMH volume could be useful in predicting cognitive decline in patients with minor stroke.

Dynamic changes in the systemic immune-inflammation index predict the prognosis of EGFR-mutant lung adenocarcinoma patients receiving brain metastasis radiotherapy

BACKGROUND

The systemic immune-inflammation index (SII) has recently emerged as a predictor of survival in non-small cell lung cancer patients. There is also tight correlation between radiotherapy and immune status, and brain metastases (BM) radiotherapy is an important treatment in patients with BM from lung adenocarcinoma harboring epidermal growth factor receptor (EGFR) mutations. Hence, this study aimed to present the prognostic value of SII and its dynamic changes during BM radiotherapy in EGFR-mutant lung adenocarcinoma patients with BM.

METHODS

Patients with EGFR-mutant lung adenocarcinoma who received BM radiotherapy between November 2011 and April 2021 were included in this retrospective study. The SII was calculated using data acquired within 1 week before the start of radiation treatment and 1 week before its completion. According to the cutoff value of SII before radiation treatment determined using receiver operating characteristic curve analyses, we divided the patients into a high group and a low group. Patients were further classified into high-high, high-low, low-low, and low-high groups based on dynamic changes in SII. Prognostic values of the SII and other factors were determined using the Kaplan-Meier method, as well as univariate and multivariate Cox analysis.

RESULTS

A total of 202 patients met the inclusion criteria, and the median overall survival (OS) of the entire cohort was 36 months. According to the SII cutoff of 859.79, an SII value below this cutoff was associated with longer OS (hazard ratio 0.6653, 95% confidence interval 0.4708-0.9402, P < 0.05). The patients in the low-low group, whose SII within 1 week before the start and end of BM radiotherapy were below the cutoff, had a median OS of 55.2 months, which was significantly longer than the OS in all other groups (P < 0.05). Univariate and multivariate analyses confirmed that dynamic SII change (P = 0.032), Lung-molGPA (P < 0.001), and thoracic radiation (P = 0.048) were independently correlated with OS.

CONCLUSIONS

The SII and its dynamic change may have a prognostic value in patients with EGFR-mutant lung adenocarcinoma treated with BM radiotherapy.

Gradual increasing dyslipidemia in treatment-naive male patients with human immunodeficiency virus and treated with tenofovir plus lamivudine plus efavirenz for 3 years

INTRODUCTION

Since the development of antiretroviral therapy (ART) with TDF plus 3TC plus EFV, this specific regimen has not been studied enough with long-term lipid and uric acid monitoring.

METHODS

A prospective follow-up cohort study was performed. Sixty-one treatment-naive male patients with human immunodeficiency virus (HIV) were divided into three groups based on their baseline CD4+ cell count (26, 12, and 23 patients in the < 200, 200 to 350, and > 350 groups, respectively). The lipid and purine metabolism parameters of the patients over 144 weeks were analyzed.

RESULT

Within 144 weeks, TG, LDL-c, TC and HDL-c gradually increased, especially TC and HDL-c (P = 0.001, 0.000, respectively). Moreover, the percentages of hyper-cholesterolemia, hyper LDL cholesterolemia, hyper-triglyceridemia and low HDL cholesterolemia also gradually increased, especially low HDL cholesterolemia significantly increased (P = 0.0007). The lower the baseline CD4+ cell counts were, the higher the TG levels and the lower the TC, LDL-c and HDL-c levels were. But there was significant difference of only baseline LDL-c levels between the three groups (P = 0.0457). No significant difference of the UA level and the percentages of hyperuricemia was found between the different follow-up time point groups or between the three CD4+ cell counts groups (all P > 0.05). The risk factors for dyslipidemia included age, anthropometric parameters and follow-up weeks, and for hyperuricemia was virus load.

CONCLUSIONS

Gradual increasing dyslipidemia was found in male patients with human immunodeficiency virus primarily treated with tenofovir plus lamivudine plus efavirenz for 3 years. There-fore lipid metabolism parameters should be closely monitored during long-term ART with the TDF plus 3TC plus EFV regimen.

Dynamic Changes in the Immune Response Correlate with Disease Severity and Outcomes During Infection with SARS-CoV-2

Introduction

The coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has rapidly spread throughout China and worldwide. Little is known about the dynamic changes in the patient immune responses to SARS-CoV-2 and how different responses are correlated with disease severity and outcomes.

Methods

Seventy-four patients with confirmed COVID-19 were enrolled in this prospective research. The demographic information, medical history, symptoms, signs and laboratory results were analyzed and compared between severe and non-severe patients. The leukocytes, lymphocyte subsets and inflammatory cytokines were longitudinally collected.

Results

Of the 74 patients included, 17 suffered from severe disease. The severe patients tended be older (65.29 ± 12.33 years vs. 45.37 ± 18.66 years) and had a greater degree of underlying disease (41.18% vs. 24.56%), lower baseline lymphocyte counts [0.64 (0.46–0.95) × 10⁹ vs. 1.27 (0.95–1.70) × 10⁹], higher neutrophil–lymphocyte ratios [NLRs; 3.76 (3.15–5.51) vs. 2.07 (1.48–2.93)] and lower baseline eosinophil counts [0 (0–0.01) × 10⁹ vs. 0.03 (0.01–0.06) × 10⁹] than those in non-severe patients. The baseline helper T (Th) cells (335.47 vs. 666.46/μl), suppressor T(Ts) cells (158 vs. 334/μl), B cells (95 vs. 210/μl) and natural killer (NK) cells (52 vs. 122/μl) were significantly decreased in severe cases compared to that in non-severe cases. In addition, the baseline neutrophils were positively correlated with the severity of COVID-19, and the baseline lymphocytes were negatively correlated with the severity of COVID-19. The dynamic change of T cells, Th cells and IFN-γ in the severe cases were parallel to the amelioration of the disease.

Conclusions

Collectively, our study provides novel information on the kinetics of the immune responses in a cohort of COVID-19 patients with different disease severities. Furthermore, our study indicates that both innate and adaptive immune responses correlate with better clinical outcomes.

Using dynamic cell communication improves treatment strategies of breast cancer

Several insights from the clinical treatment of breast cancer patients have revealed that only a portion of patients achieve the expected curative effect after traditional targeted therapy, that surgical treatment may promote the development of cancer metastasis, and that the optimal combination of neoadjuvant chemotherapy and traditional treatment is not clear. Therefore, a more precise classification of breast cancer and selection of treatment methods should be undertaken to improve the efficacy of clinical treatment. In the clinical treatment of breast cancer, cell communication molecules are often selected as therapeutic targets. However, various cell communications are not static. Their dynamic changes are related to communicating cells, communicating molecules, and various intertwined internal and external environmental factors. Understanding the dynamic microenvironment can help us improve therapeutic efficacy and provide new ways to more accurately determine the cancer status. Therefore, this review describes multiple types of cellular communication in the breast cancer microenvironment and incorporates internal and external environmental factors as variable signaling factors in cell communication. Using dynamic and developmental concepts, we summarize the functional changes in signaling molecules and cells to aid in the diagnosis and treatment of breast cancer.

Dynamic changes in microbial community structure in farming pond water and their effect on the intestinal microbial community profile in juvenile common carp (Cyprinus carpio L.)

Water quality parameter dynamics, gut, sediment and water bacteria communities were studied to understand the environmental influence on the gut microbial community of a new strain of Huanghe common carp. A total of 3,384,078 raw tags and 5105 OTUs were obtained for the gut, water and sediment bacteria. The water quality had a stronger influence on the water bacteria community than gut and sediment bacteria communities. The ambient water quality parameters also significantly influenced the water and sediment bacteria communities. Comparing the gut, sediment, and water microbial communities, a relationship was found among them. However, gut bacteria were more closely related to sediment bacterial communities than to water bacteria communities. The results showed that the top three bacterial taxa were identical in gut and sediment samples in the early days of rearing. Interestingly, bacterial communities in the carp gut, water, and sediment had different adaptabilities to variations in environmental factors.

Dynamic Systolic Changes in Tricuspid Regurgitation Vena Contracta Size and Proximal Isovelocity Surface Area in Hypoplastic Left Heart Syndrome: A Three-Dimensional Color Doppler Echocardiographic Study

BACKGROUND

The aims of this study were to investigate the dynamic changes in the vena contracta (VC) and proximal isovelocity surface area (PISA) through systole in patients with hypoplastic left heart syndrome and tricuspid regurgitation and to identify the stage of systole (early, mid, or late) in which VC and PISA radius are optimal.

METHODS

Twenty-eight patients with hypoplastic left heart syndrome were prospectively studied using continuous two-dimensional (2D) and three-dimensional (3D) echocardiography. Two-dimensional VC width, 3D VC area, and PISA radii (2D and 3D) were measured frame by frame throughout systole. The maximal 2D VC width, 3D VC area, and PISA radii in the first, middle, and last thirds of systole were compared, and correlations were explored with 3D tricuspid annular areas, right atrial volumes, and right ventricular volumes.

RESULTS

In all, 35 data sets that met inclusion criteria were analyzed. On frame-by-frame analysis, maximal 2D VC width and 3D VC area were found in the first third of systole in 17% and 20% of studies, in the second third in 34% and 31%, and in the final third in 49% and 49%. Similarly, the maximal 2D and 3D PISA radii were found in the first third of systole in 26% and 17% of studies, in the second third in 28% and 34%, and in the final third in 46% and 49%.

CONCLUSIONS

In hypoplastic left heart syndrome, detailed temporal analysis of tricuspid regurgitation-associated VC and PISA by 2D and 3D echocardiography reveals no reliable pattern predicting when in systole these parameters peak. Frame-by-frame measurement is necessary for identification of maximal VC and PISA radius on 2D and 3D color Doppler echocardiography because the severity of tricuspid regurgitation could be underestimated because of temporal variability in VC and PISA.

Dynamic change of heart rate in the acute phase and clinical outcomes after intracerebral hemorrhage: a cohort study

BACKGROUND

Dynamic change of heart rate in the acute phase and clinical outcomes after intracerebral hemorrhage (ICH) remains unknown. We aimed to investigate the associations of heart rate trajectories and variability with functional outcome and mortality in patients with acute ICH.

METHODS

This prospective study was conducted among 332 patients with acute ICH. Latent mixture modeling was used to identify heart rate trajectories during the first 72 h of hospitalization after ICH onset. Mean and coefficient of variation of heart rate measurements were calculated. The study outcomes included unfavorable functional outcome, ordinal shift of modified Rankin Scale score, and all-cause mortality.

RESULTS

We identified 3 distinct heart rate trajectory patterns (persistent-high, moderate-stable, and low-stable). During 3-month follow-up, 103 (31.0%) patients had unfavorable functional outcome and 46 (13.9%) patients died. In multivariable-adjusted model, compared with patients in low-stable trajectory, patients in persistent-high trajectory had the highest odds of poor functional outcome (odds ratio 15.06, 95% CI 3.67-61.78). Higher mean and coefficient of variation of heart rate were also associated with increased risk of unfavorable functional outcome (P trend < 0.05), and the corresponding odds ratios (95% CI) comparing two extreme tertiles were 4.69 (2.04-10.75) and 2.43 (1.09-5.39), respectively. Likewise, similar prognostic effects of heart rate dynamic changes on high modified Rankin Scale score and all-cause mortality were observed.

CONCLUSIONS

Persistently high heart rate and higher variability in the acute phase were associated with increased risk of unfavorable functional outcome in patients with acute ICH.

Microbial catabolism of lindane in distinct layers of acidic paddy soils combinedly affected by different water managements and bioremediation strategies

The environmental fate of the recalcitrant organic chlorine insecticide lindane and its removal from contaminated soils are still of great concern. However, the key factors influencing microbial removal of lindane from paddy soils with intermittent flooding and draining remain largely unknown. Here, we conducted laboratory experiments to investigated lindane biodegradation in different layers of typical acidic paddy soils under different water managements and bioremediation strategies, together with the changes of functional bacterial consortium, key genes and metabolic pathways. It was found that under flooded conditions, lindane spiking significantly stimulated the growth of some bacterial genera with potential anaerobic catabolic functions in both top- (0-20 cm depth) and subsoil (20-40 cm depth), leading to the shortest half-life of lindane with 7.6-9.0 d in the topsoil. In contrary, lindane spiking dramatically stimulated the growth of bacterial members with aerobic catabolic functions under drained conditions, exhibiting half-lives of lindane with 85-131 d and 18-23 d in the top- and subsoil, respectively. Overall, biostimulation coupled with flooding management would be the better combination for increased lindane bioremediation. Functional genes involved in lindane degradation and retrieved from metagenomic data further supported the anaerobic and aerobic biodegradation of lindane under flooded and drained conditions, respectively. Moreover, the integrated network analysis suggested water management and organic matter were the primary factors shaped the assembly of functional bacteria in lindane degradation, among which Clostridium and Rhodanobacter were the key anaerobic and aerobic functional genera, respectively. Taken together, our study provides a comprehensive understanding of lindane biodegradation in distinct layers of acidic paddy soils that were combinedly affected by different water managements and bioremediation strategies.

Association of non-HDL-C/HDL-C ratio and its dynamic changes with incident type 2 diabetes mellitus: The Rural Chinese Cohort Study

BACKGROUND

We aimed to evaluate the association of the ratio of non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol (non-HDL-C/HDL-C) and its dynamic changes with incident type 2 diabetes mellitus (T2DM).

METHODS

A total of 11,487 nondiabetic participants ≥18 years old in rural China were recruited in 2007-2008 and followed up in 2013-2014. A Cox proportional-hazards model was used to assess the risk of incident T2DM by quartiles of baseline non-HDL-C/HDL-C ratio and dynamic absolute and relative changes in non-HDL-C/HDL-C ratio, estimating hazard ratios (HRs) and 95% confidence intervals (CIs).

RESULTS

Risk of incident T2DM was increased with quartiles 2, 3, and 4 versus quartile 1 of baseline non-HDL-C/HDL-C ratio (HR 1.46 [95% CI 1.08-1.98], 1.51 [1.12-2.03], and 2.16 [1.62-2.88], P_trend < 0.001). As compared with stable non-HDL-C/HDL-C ratio during follow-up, an absolute gain in non-HDL-C/HDL-C ratio was associated with increased risk of T2DM (HR 1.67 [95% CI 1.25-2.24] for quartile 3 and 2.00 [1.52-2.61] for quartile 4). A relative increase in non-HDL-C/HDL-C ratio was also associated with increased risk of T2DM (HR 1.56 [95% CI 1.19-2.04] for quartile 3 and 1.97 [1.49-2.60] for quartile 4). Subgroup analyses showed that the association of non-HDL-C/HDL-C ratio with T2DM risk remained consistent.

CONCLUSIONS

Increased non-HDL-C/HDL-C ratio is associated with increased risk of incident T2DM among rural Chinese adults, so the index may be an important indicator for identifying individuals at T2DM risk.

Dynamic changes in longitudinal stretching of the spinal cord in thoracic spine: Focus on the spinal cord occupation rate of dural sac

OBJECTIVES

This study aimed to evaluate the anteroposterior diameters and cross-sectional areas of the dural sac and spinal cord in the thoracic spine, to elucidate the spinal cord occupation rate of the dural sac in these dynamic changes for each level using multidetector-row computed tomography (MDCT).

PATIENTS AND METHODS

Fifty patients with cervical or lumbar spinal disease were prospectively enrolled. After preoperative myelography, MDCT was performed at maximum passive flexion and extension. The anteroposterior diameter and cross-sectional area of the dural sac and spinal cord in the axial plane and the thoracic spinal cord length in the sagittal plane were measured. The spinal cord occupation rate in the dural sac was calculated.

RESULTS

The spinal cord occupation rate of the dural sac in anteroposterior diameter was lower on flexion than on extension, with significant differences from the T1/T2 to T11/T12 levels (p < 0.0001). The spinal cord occupation rate of the dural sac in cross-sectional area was lower on flexion than on extension, with significant differences except from T3/T4 to T6/T7 levels (p < 0.01). There was a bimodal increase in the occupation rate with elevations at the cervicothoracic junction and thoracolumbar junction. The thoracic spinal cord length on flexion was significantly longer than that on extension (p < 0.0001).

CONCLUSIONS

The spinal cord occupation rate of the dural sac was lower on flexion than on extension, despite thoracic spine being considered a rigid region. The dynamic changes in longitudinal stretching and shrinkage of the spinal cord affected the occupation rate.

Lymphocyte subsets with the lowest decline at baseline and the slow lowest rise during recovery in COVID-19 critical illness patients with diabetes mellitus

BACKGROUND

Host dysregulation of immune response was highly involved in the pathological process of Coronavirus disease 2019 (COVID-19), especially COVID-19 severe cases with DM.

AIM

In this study we aimed at the dynamic change of peripheral lymphocyte and subsets during COVID-19 covery.

METHODS

The peripheral lymphocyte and subsets of 95 confirmed cases with COVID-19 from baseline to four weeks were compared between critical illness and non-critical illness cases with or without DM.

RESULTS

The dynamic characteristics of lymphocyte and subsets in COVID-19 patients was that it reduced significantly at one week, rapidly elevated to the peak at two weeks after onset, then gradually declined during recovery. The COVID-19 critical illness patients with DM had the lowest decline at one week and the slow lowest rise at two weeks after onset, while COVID-19 non-critical illness patients with DM had the rapid highest rise at two weeks after onset, both of them had similar lymphocyte and subsets at five weeks after onset and lower than those patients without DM.

CONCLUSIONS

These findings provide a reference for clinicians that for COVID-19 patients with DM and the lowest decline of lymphocyte and subsets, immunomodulatory therapy as soon as possible might avoid or slow down disease progression; moreover for COVID-19 critical illness patients with or without DM and non-critical illness patients with DM, continuous immunomodulatory therapy in later stages of disease might speed up virus clearance, shorten hospital stay, improve disease prognosis in COVID-19 critical illness patients with DM.

Dynamic changes in clinical and CT characteristics of COVID-19 cases with different exposure histories: a retrospective study

BACKGROUND

To assess the dynamic changes in clinical and CT characteristics of COVID-19 patients with different epidemiology histories.

METHODS

Fifty-three discharged COVID-19 patients were enrolled at Beijing YouAn Hospital, Capital Medical University, between January 21 and March 10, 2020. Spearman correlation analysis was performed between CT scores and laboratory indicators. Patients were divided into the Wuhan group (lived in or with travel to Wuhan, numbering 30 cases) and non-Wuhan group (close contacts or unknown exposure, totaling 23 cases). The CT and laboratory findings were compared between and within groups during the clinical process.

RESULTS

Fever (88.7%), cough (64.2%), fatigue (34%), and abnormal laboratory indicators, including lymphopenia, reduced albumin, albumin/globulin (A/G), and elevated C-reactive protein (CRP), were mainly observed. Subpleural ground-glass opacities (86.8%) were usually detected at admission. The CT scores were highly correlated with lymphocytes, CRP, albumin, and A/G at initial and follow-ups (all p < 0.05). Four days after admission, most patients (66.7% Wuhan, 47.8% non-Wuhan) showed progression, and the CT scores of Wuhan significantly increased (p = 0.015). Eight days after admission, the vast majority of patients (69.2% Wuhan, 100% non-Wuhan, p = 0.006) presented improvement, and the CT scores of non-Wuhan were significantly lower than Wuhan (p = 0.006). Pneumonia was completely absorbed in most patients 2-4 weeks after discharge.

CONCLUSIONS

CT plays a crucial role in the early diagnosis and monitoring of changes in COVID-19. Lymphocytes, CRP, albumin, and A/G are expected to predict disease severity and prognosis. Viral pathogenicity in non-endemic areas may be weaker than core-infected areas. In most patients, lung lesions can disappear around 4 weeks after discharge.

Pattern of liver injury in adult patients with COVID-19: a retrospective analysis of 105 patients

BACKGROUND

Recent studies reported that patients with coronavirus disease-2019 (COVID-19) might have liver injury. However, few data on the combined analysis and change patterns of alanine aminotransferase (ALT), aspartate aminotransferase (AST) and total bilirubin (TBil) have been shown.

METHODS

This is a single-center retrospective study. A total of 105 adult patients hospitalized for confirmed COVID-19 in Beijing Ditan Hospital between January 12, and March 17, 2020 were included, and divided into mild group (n = 79) and severe group(n = 26). We compared liver functional test results between the two groups. Category of ALT change during the disease course was also examined.

RESULTS

56.2% (59/105) of the patients had unnormal ALT, AST, or total TBil throughout the course of the disease, but in 91.4% (96/105) cases the level of ALT, AST or TBil ≤3 fold of the upper limit of normal reference range (ULN). The overall distribution of ALT, AST, and TBil were all significantly difference between mild and severe group (P <  0.05). The percentage of the patients with elevated both ALT and AST was 12.7% (10/79) in mild cases vs. 46.2% (12/26) in severe cases (P = 0.001). 34.6% (9/26) severe group patients started to have abnormal ALT after admission, and 73.3% (77/105) of all patients had normal ALT before discharge.

CONCLUSIONS

Elevated liver function index is very common in patients with COVID-19 infection, and the level were less than 3 × ULN, but most are reversible. The abnormality of 2 or more indexes is low in the patients with COVID-19, but it is more likely to occur in the severe group.

Comparison of microbial communities and amino acid metabolites in different traditional fermentation starters used during the fermentation of Hong Qu glutinous rice wine

Hong Qu glutinous rice wine (HQGRW) is produced from glutinous rice with the addition of the traditional fermentation starter Hong Qu (mainly Gutian Hong Qu and Wuyi Hong Qu) has been added. It is unpalatable and rejected by consumers because the bitter and umami tastes are too high. The objective of this study was to compare the dynamics of the microbial communities and amino acids especially those in the different traditional fermentation starters used during HQGRW fermentation, and elucidate the key microbes responsible for amino acids. Three widely-used types of Hong Qu starters were used which can make different bitterness and umami in our previous studies, namely, black Wuyi Hong Qu (WB), red Wuyi Hong Qu (WR), and Gutian Hong Qu (GT). The living dynamics of fungal and bacterial communities during the fermentation were determined by high-throughput sequencing and rRNA gene sequencing technology for the first time. The content of amino acids in the HQGRW were determined by reverse-phase high-performance liquid chromatography analysis. The results showed that there were differences between fungal communities during the fermentation process in Wuyi Hong Qu and Gutian Hong Qu starters and between bacterial communities during the fermentation process in the three types of starters. The amino acid content of the samples showed an increasing trend in each group. The total amino acids, as well as the bitter, sweet, umami, astringent amino acids, in the GT Hong Qu group increased more slowly during fermentation, as comparerd to those in WB and WR groups. Furthermore, Meyerozyma, Saccharomyces, Bacillus, Rhizopus, Pediococcus, Monascus, and Halomonas were strongly positively correlated with the content of bitter and umami amino acids (|r| > 0.6 with FDR adjusted P < 0.05) by Spearman's correlation analysis. To conclude, these findings may contribute to a better understanding of the bitter and umami amino acid production mechanism during traditional fermentation and helpful in improving the taste of HQGRW.

Monitoring of the invasion of Spartina alterniflora from 1985 to 2015 in Zhejiang Province, China

Background

Spartina alterniflora is an invasive plant on the coast of China that replaces native vegetation and has a serious negative impact on local ecosystems. Monitoring the spatial distribution of S. alterniflora and its changes over time can reveal its expansion mechanism, which is crucial for the management of coastal ecosystems. The purpose of this study was to map the distribution of S. alterniflora in Zhejiang Province from 1985 to 2015 using a time series of Landsat TM/OLI images and analyze the temporal and spatial patterns of expansion of this species.

Results

After analyzing the distribution of coastal vegetation, the vegetation index was calculated based on Landsat images for 4 years (1985, 1995, 2005 and 2015). According to a threshold determined based on expert knowledge, the distribution of S. alterniflora in Zhejiang Province was extracted, and the temporal and spatial changes in the distribution of S. alterniflora were analyzed. The classification accuracy was 90.3%. S. alterniflora has expanded rapidly in recent decades after being introduced into southern Zhejiang. Between 1985 and 2015, S. alterniflora increased its area of distribution by 10,000 hm², and it replaced native vegetation to become the most abundant halophyte in tidal flats. Overall, S. alterniflora expanded from south to north over the decades of the study, and the fastest expansion rate was 463.64 hm²/year, which occurred between 1995 and 2005. S. alterniflora was widely distributed in the tidal flats of bays and estuaries and expanded outward as sediment accumulated.

Conclusions

This study reveals the changes over time in S. alterniflora cover in Zhejiang and can contribute to the control and management of this invasive plant.

Dynamic Change of T-Helper Cell Cytokines in Nasal Secretions and Serum after Endoscopic Sinus Surgery in Chronic Rhinosinusitis with Nasal Polyps

BACKGROUND/AIMS

This study aimed to determine the dynamic change of postoperative T-helper cell cytokines in nasal secretions and serum in chronic rhinosinusitis with nasal polyps (CRSwNP).

METHODS

Nasal secretions and serum samples of 30 CRSwNP patients and 10 healthy subjects were collected. Among CRSwNP patients, samples of 30 patients were collected 1 day before endoscopic sinus surgery (ESS) and that of 18 patients (12 asthmatic and 6 non-asthmatic) were collected 4, 8, and 12 weeks after ESS. Concentrations of interleukin (IL)-2, IL-4, IL-5, IL-17, and interferon gamma (IFN-γ) were determined by Cytometric Beads Array. The Sino-Nasal Outcomes Test 22 and Lund-Kennedy endoscopic scoring (LKES) system were collected for all patients.

RESULTS

The levels of IL-2 and IL-5 in secretions of CRSwNP were significantly higher than that of healthy control at the baseline. At the 4th and 8th week after ESS, the IL-4 levels in nasal secretions of the asthmatic group were significantly higher than their baseline controls (preoperatively). From the 4th to 12th week after ESS, the IL-2, IFN-γ, IL-4, and IL-17 levels in nasal secretions of the non-asthmatic group were significantly increased as compared to their baseline controls. Postoperative IL-5 levels in serum of the asthmatic group decreased significantly as compared to their baseline controls. There was no significant association between LKES and levels of cytokines in postoperative secretions and serum.

CONCLUSIONS

Our results indicate that postoperative endoscopic findings may not directly reflect the underlying mucosal inflammation, and surgery could not change the systemic immunity status. Despite endoscopic resolution of mucosal abnormalities, it may not avert the need for subsequent postoperative medical intervention to treat the underlying mucosal inflammation.

Dynamic Change of Lumbar Structure and Associated Factors: A Retrospective Study

Objective

To determine whether lumbar anatomy parameters are in dynamic change and related factors.

Methods

This is a retrospective study. Participants who did lumbar computed tomography (CT) scanning in Shandong University Qilu Hospital from October 2017 to March 2019 were selected. The 476 participants were randomly selected as male or female, with the age ranging from 17 to 87 years (mean, 55.19; standard deviation, 14.28 years). All the measurements were taken based on the CT scanning image and the measurement of lumbar morphology was conducted using picture archiving and communication systems (PACS). The angle between the horizontal alignment and pedicle center on median sagittal view, the angle between upper endplate and lower endplate on median sagittal view as well as transverse section angle (TSA) using Magerl point in the axial view was determined by reconstructive CT analysis.

Results

In the overall participants, the angle between the horizontal alignment and pedicle center on median sagittal view of lumbar one to three was significantly decreased with aging, from 3.90° ± 2.81° to −4.18° ± 6.86° (P = 0.002), 5.60° ± 2.89° to −4.14° ± 5.90° (P = 0.030), and 4.75° ± 2.95° to −2.87° ± 4.68° (P < 0.001), respectively. Additionally, the angle between the horizontal alignment and pedicle center on median sagittal view in male participants of lumbar two was dramatically decreased, from 4.83° ± 2.79° to −4.45° ± 5.97° (P = 0.30). And that of lumbar three in female participants was significantly decreased, from 4.56° ± 2.52° to −2.88° ± 5.03° (P = 0.029). Furthermore, of the overall participants, the angle between upper endplate and lower endplate on median sagittal view of lumbar one to four was associated with aging (P < 0.001, P < 0.001, P = 0.015, P < 0.001, respectively). The angle of lumbar one, two and four in male participants and lumbar one to four in female participants were all significantly related to aging (all P < 0.05). Moreover, in the participants overall, the TSA of lumbar one to three was significantly associated with aging (P = 0.015, P = 0.006 and P = 0.007, respectively). In addition, this angle in lumbar one to lumbar four in male participants were all negatively associated with aging (P = 0.017, P = 0.001, P = 0.005 and P = 0.036, respectively).

Conclusion

Lumbar anatomy parameters are in dynamic change in an age and gender dependent manner. During spine surgery in elderly patients, more attention should be paid to these anatomic changes.

LCN2-interacting proteins and their expression patterns in brain tumors

Lipocalin 2 (LCN2) is a member of the lipocalin family. Elevated expression of LCN2 has been observed in many human tumors, suggesting it might be a potential biomarker and/or therapeutic target in malignancies. In this study, we aimed to explore LCN2 interacting proteins through bioinformatics, as well as their biological functions. Protein-protein interaction networks (PPIN) were constructed using LCN2 and its interacting proteins as the core node. These PPINs were scale free biological networks in which LCN2 and its interacting proteins could connect or cross-talk with at least one partner protein. Both functional and KEGG pathway enrichment analyses identified the known and potential biological functions of the PPIN, such as cell migration and cancer-related pathways. Expression levels of the PPIN proteins, as well as their expression correlations, in five types of brain tumor, were analyzed and integrated into the PPIN to illustrate a dynamic change. A significant correlation was found between the survival time of glioblastoma patients and the expression level of 10 genes (LCN2, MMP9, MMP2, PDE4DIP, L2HGDH, HNRNPA1, DDX31, LOXL2, FAM60A and RNF25). Taken together, our results suggest that LCN2 and its interacting proteins are mostly differentially expressed and have a distinguishing co-expression pattern. They might promote proliferation and migration via cell migration signaling and cancer-related pathways. LCN2 and its interacting proteins might be potential biomarkers in glioblastoma.

Comparison of dynamic changes in aortic diameter during the cardiac cycle measured by computed tomography angiography and transthoracic echocardiography

OBJECTIVE

This study aimed to examine the relationship between dynamic changes in aortic diameter and corresponding measurement methods.

METHODS

Consecutive adult (nonaneurysmal) patients being surgically treated for heart disease (mean age, 51 ± 11 years; range, 29-76 years; N = 25) were included in this study. All patients underwent transthoracic echocardiography (TTE), computed tomography angiography (CTA), and intraoperative ultrasound (IOUS). Anteroposterior diameters were measured at 1 cm above the junction of the aortic sinus, the proximal 1 cm of the innominate artery, and the midpoint of the two.

RESULTS

The average diameter of the proximal ascending aorta in systole/diastole measured by IOUS was 32.07 ± 2.03/30.27 ± 2.05 mm (paired t-test: difference, 1.80 ± 0.46 mm; P < .001). The average diameters of the proximal ascending aorta measured by nonelectrocardiography-gated CTA and TTE were 31.45 ± 1.97 mm and 29.7 ± 1.84 mm, respectively. The average diameter of the mid and distal ascending aorta in systole/diastole measured by IOUS was 32.35 ± 1.95/30.57 ± 1.94 mm (paired t-test: difference, 1.78 ± 0.44 mm; P < .001) and 32.32 ± 1.92/30.67 ± 1.90 mm (paired t-test: difference, 1.65 ± 0.42 mm; P < .001), respectively. The average diameter of the mid and distal ascending aorta measured by CTA was 31.74 ± 1.92 mm and 31.59 ± 1.96 mm, respectively. At each location, the difference in the aortic diameter between systole and diastole was statistically significant (all P values <.001; paired t-test). The minimum and maximum changes in the diameter between systole and diastole were 0.90 mm and 2.70 mm. In all, 96% (24/25) of the average diameters derived from IOUS and CTA at the three locations were within the concordance limit in systole, and 92% to 100% (23/25 to 25/25) were within the concordance limit in diastole. The average diameters derived from IOUS and TTE images of the proximal ascending aorta were within the bounds of the concordance limit 92% (23/25) of the time in systole and 100% (25/25) of the time in diastole. The average diameters derived from CTA and TTE images of the proximal ascending aorta were within the bounds of the concordance limit 88% (22/25) of the time. Pearson correlation coefficients between these groups ranged from 0.905 to 0.982 (all P values <.01).

CONCLUSIONS

The ascending aorta diameters measured by nonelectrocardiography-gated CTA and TTE were consistent with the IOUS measurements.

Fluctuation in time-resolved PM2.5 from rural households with solid fuel-associated internal emission sources

Indoor air contributes significantly to overall exposure, particularly for rural Chinese who often use solid fuels for cooking and/or heating. Unfortunately, overlooked rural indoor air leads to a critical knowledge gap. Simultaneous measurements in the kitchen, living room, and immediately outside of houses using six-channel particle counters were carried out in 18 biomass-burning rural and 3 non-biomass-burning urban households (as a comparison) in winter to characterize dynamic change patterns indoor air pollution and indoor-outdoor relationship. The rural households mainly used wood or crop residues for cooking and heating, while the urban households used pipelined natural gas for cooking and air conditioners for heating. In rural households with significant solid-fuel burning internal sources, the highest concentration was found in the kitchen (101 ± 56 μg/m³), with comparable levels in the living room (99 ± 46 μg/m³) and low levels in outdoor air (91 ± 39 μg/m³). A generally opposite direction of indoor-outdoor exchange was found between the rural and urban households. PM in kitchen air is smaller than that in living rooms and outdoors because solid fuel burning (mainly in rural households) and cooking oil heating (in rural and urban households). Indoor and outdoor PM concentration changed synchronously, with a slight delay in indoor air in urban households but a slight delay in outdoor air in rural households. Cooking, heating, and smoking elevated indoor PM significantly, but different from the cooking activity that produced peaks lasting for about 30 min, emissions from heating created a series of peaks due to frequent disturbance and fuel-feeding and had more significant impacts on the daily average concentration. Distinct indoor-outdoor relationships and dynamic change patterns between the two household categories w/o strong internal biomass burning sources imply that totally different model schemes are needed to quantitatively address indoor air pollution and inhalation exposure.

Selenium (Se) uptake and dynamic changes of Se content in soil-plant systems

In this study, we collected crop plants and associated soil samples and determined these for selenium (Se) content to analyze the uptake, enrichment, and translocation of Se in the different soil-plant systems of an agricultural production area, elucidate the dynamic mechanisms relating to Se content in plants and soil during different growth periods, and screen plants for high Se enrichment ability. Bioconcentration factor determinations indicated that the grains of rice have the strongest Se enrichment ability, followed by soybean and corn. Translocation factor analysis indicated that the grains of rice and corn have similar low translocation abilities for Se compared with soybean. Within the study area, the Se content in plants was closely related to the soil available Se content and varied considerably among different growth periods and plant organs. This study provides a theoretical basis for the development and utilization of local agricultural products.

Dynamic succession of substrate-associated bacterial composition and function during Ganoderma lucidum growth

Background

Ganoderma lucidum, a valuable medicinal fungus, is widely distributed in China. It grows alongside with a complex microbial ecosystem in the substrate. As sequencing technology advances, it is possible to reveal the composition and functions of substrate-associated bacterial communities.

Methods

We analyzed the bacterial community dynamics in the substrate during the four typical growth stages of G. lucidum using next-generation sequencing.

Results

The physicochemical properties of the substrate (e.g. acidity, moisture, total nitrogen, total phosphorus and total potassium) changed between different growth stages. A total of 598,771 sequences from 12 samples were obtained and assigned to 22 bacterial phyla. Proteobacteria and Firmicutes were the dominant phyla. Bacterial community composition and diversity significantly differed between the elongation stage and the other three growth stages. LEfSe analysis revealed a large number of bacterial taxa (e.g. Bacteroidetes, Acidobacteria and Nitrospirae) with significantly higher abundance at the elongation stage. Functional pathway prediction uncovered significant abundance changes of a number of bacterial functional pathways between the elongation stage and other growth stages. At the elongation stage, the abundance of the environmental information processing pathway (mainly membrane transport) decreased, whereas that of the metabolism-related pathways increased.

Discussion

The changes in bacterial community composition, diversity and predicted functions were most likely related to the changes in the moisture and nutrient conditions in the substrate with the growth of G. lucidum, particularly at the elongation stage. Our findings shed light on the G. lucidum-bacteria-substrate relationships, which should facilitate the industrial cultivation of G. lucidum.

Characterization of molecular signature of the roots of Paeonia lactiflora during growth

The roots of Paeoniae lactiflora Pall. are widely consumed as crude drugs in Asian countries due to their remarkable beneficial health effects. The present research was undertaken to illuminate the dynamic changes in metabolites and enzymes and facilitate selection of the harvesting time when the herb can provide optimum health benefits. P. lactiflora roots were analyzed at 12 stages of growth for monoterpenoid glycosides, phenols, nucleosides, nucleobases, amino acids, and polysaccharides by high-performance liquid chromatography with photodiode array detector, ultra-high pressure liquid chromatography coupled with tandem mass spectrometry, and UV spectrophotometry. The enzyme activities of plant β-glucosidases and esterases were determined by UV methods. The total content of monoterpenoid glycosides and phenols peaked in December. For nucleosides and nucleobases, the highest content appeared in April. The maximum phasic accumulation of the total amino acids took place in March, and the content of total polysaccharides reached a peak value in September. December, April, and March were selected as the appropriate harvesting times for producing natural medicinal or health food products. Plant β-glucosidases and esterases showed the highest activity in December and May, respectively. When the activity of β-glucosidase increased, esterase activity decreased, while the contents of oxypaeoniflora and paeoniflorin increased. When esterase activity increased, the contents of benzoylpaeoniflorin, paeoniflorin, and gallic acid decreased. In conclusion, the results from the present study would be useful in determination of the suitable time for harvesting P. lactiflora roots for medicinal purposes.

Correlation analysis on serum inflammatory cytokine level and neurogenic pulmonary edema for children with severe hand-foot-mouth disease

Objective

This study aims to discuss the correlation between serum inflammatory cytokines and neurogenic pulmonary edema (NPE) in children with severe hand–foot–mouth disease (HFMD).

Methods

A total of 89 patients with severe HFMD were enrolled into this study. These patients were divided into two groups, according to the presence of NPE: central nervous system disease (CNSD) group and NPE group. Serum IL-4, IL-10, IL-6, IL-17, tumor necrosis factor-α (TNF-α), and interferon-γ (IFN-γ) levels were measured in patients by enzyme-linked immunosorbent assay at 1, 3, and 5 days after admission. Furthermore, risk factors for NPE were screened using multivariable logistic regression analysis.

Results

IL-6, TNF-α, IL-10, and interferon-γ (IFN-γ) levels in the NPE group were higher than in the CNSD group. TNF-α, IL-10, and IFN-γ levels reached a peak on the 3rd day of admission. Age, continuous fever, blood sugar, white blood cell count, and IL-10 were risk factors for the occurrence of NPE in severe HFMD.

Conclusion

The dynamic unbalance of inflammatory cytokines is related to the occurrence and progress of NPE.

Predictive value of dynamic change of haemoglobin levels during therapy on treatment outcomes in patients with Enneking stage IIB extremity osteosarcoma

Background

We aimed to investigate the roles of hemoglobin (Hb) concentrations and dynamic change during treatment on outcomes of patients with extremity osteosarcoma.

Methods

We retrospectively analysed 133 patients with Enneking stage IIB extremity osteosarcoma who underwent standard treatments, including univariate and multivariate analyses of patient charateritics, Hb concentrations and changes during pretreatment, neoadjuvant, adjuvant chemotherapy, and decreased Hb levels (ΔHb) to assess their prognostic value in 5-year overall survival (OS) and lung metastasis-free survival (LMFS).

Results

Five-year OS or LMFS were similar between patients who were anaemic and non-anaemic during pretreatment, neoadjuvant or adjuvant chemotherapy. Patients with continuously decreasing Hb had lower 5-year OS (52.3%) than those without continuous Hb decrease (68.5%, P = 0.04). Patients with ΔHb > 7.6 g/L had lower 5-year OS (57.5%) than those with ΔHb ≤7.6 g/L (75.8%, P = 0.04). However, continuous Hb decrease had no prognostic effect on 5-year LMFS. Subgroup analyses showed that patients who were anaemic during pretreatment, neoadjuvant, or adjuvant chemotherapy with ΔHb ≤7.6 g/L had better outcomes than those with ΔHb > 7.6 g/L (P < 0.05, for both).

Conclusion

Dynamic Hb decrease and ΔHb > 7.6 predicted poor5-year OS in patients with Enneking stage IIB extremity osteosarcoma. Attempts to correct anaemia and their effects on outcomes for osteosarcoma patients should be investigated in future trials.

The properties and dynamic changes of DOM subfractions during food waste and sugarcane leaves co-composting

The purpose of this research was to evaluate the properties and dynamic changes of humic acids (HA), fulvic acids (FA), hydrophobic neutrals (HoN), and hydrophilic (Hi) fractions of dissolved organic matter (DOM) during food waste and sugarcane leaves co-composting process. The pools of HA, FA, HoN, and Hi were separated from DOM by fractionation method, and characterized using spectroscopic (UV-vis, FTIR) and pyrolysis-GC/MS analyses. The least peaks in the HA pool were found in FTIR spectra with the simple structure in HA. The highest value of SUV₂₅₄ was observed in HA, indicating that the HA pool played a dominant role in aromaticity of DOM. Hydrophobic compounds (HA, FA, HoN) had higher percentages of alkanes and cyclo-alkanes at the end of composting, while lower contents in the Hi pool. Both DOM and its subfractions increased the Chinese flowering cabbage (Brassica campestris L.) seed germination rate (SGR), whereas HA had a significant effect on promoting the root growth.

[Dynamic change of population structure of Oncomelania hupensis]

Objective To understand the successive dynamic change of population structure of Oncomelania hupensis during a one-year period, so as to provide the evidence for snail control. Methods A river beach and a ditch infested with O. hupensis snails were selected and longitudinally investigated in the midmonth during one year. The snail survey indices included the survival status, gender, number of whorls, length and width of shell, and gonad development status (measured by the color depth of gonad and the length ratio of gonad to liver), and the monthly snail eggs in the soil were collected and counted simultaneously. In addition, the temperature and humidity of the soil and the daily data of air temperature and precipitation were measured or collected during the study period (every month). Results Both survival rate of snails and live snail density at the two environments were positively correlated with the temperatures of air and soil. With a slight bimodal distribution, the snail survival rate peaked from May to June, and in September. The living snail densities got the highest level in July and September in the river beach, and from April to May in the ditch. The regression equations of snail length (L) and width (W) were L_beach = 2.355 + 1.678W (F = 2 989.43, P < 0.01) and L_ditch = 0.478 + 2.091W (F = 2.989.43, P < 0.01), respectively. The snails were the ones with 4.07-11.81 mm in the length (8.98 ± 0.92) mm in the river beach, and the snails were the ones with 3.63-9.92 mm in the length (7.03 ± 0.82) mm in the ditch. The main snails were the ones with five to eight whorls of shell in the river beach and four to seven whorls of shell in the ditch. The proportions of snails with less than or equal to five whorls (in the river beach) and four (in the ditch) were the highest in May and September, about 20%. The ratios of male and female snails were 1.66 in the river beach and 1.22 in the ditch, respectively. The gonad development status of male and female snails was basically synchronous and had a bimodal abundance period - from April to May and September to October. The numbers of snail eggs in the soil among months were significantly different, reaching the highest in June in the river beach (100.8/0.1 m²), and May in the ditch (82.5/ 0.1 m²). Conclusion The principal periods of breeding and alternation of generations of snails are April-May and SeptemberOctober every year, which should also be the optimal time for mollusciciding in schistosomiasis susceptible zones.

Changes in the spatial and temporal pattern of natural forest cover on Hainan Island from the 1950s to the 2010s: implications for natural forest conservation and management

The study of the past, present, and future state and dynamics of the tropical natural forest cover (NFC) might help to better understand the pattern of deforestation and fragmentation as well as the influence of social and natural processes. The obtained information will support the development of effective conservation policies and strategies. In the present study, we used historical data of the road network, topography, and climatic productivity to reconstruct NFC maps of Hainan Island, China, from the 1950s to the 2010s, using the random forest algorithm. We investigated the spatial and temporal patterns of NFC change from the 1950s to the 2010s and found that it was highly dynamic in both space and time. Our data showed that grid cells with low NFC were more vulnerable to NFC decrease, suggesting that conservation actions regarding natural forests need to focus on regions with low NFC and high ecological value. We also identified the hot spots of NFC change, which provides insights into the dynamic changes of natural forests over time.

The predictive value of integrated inflammation scores in the survival of patients with resected hepatocellular carcinoma: A Retrospective Cohort Study

BACKGROUND

Evidence supports the predictive potential of inflammatory marker-derived scores (inflammation scores) and hepatitis B virus (HBV) infection on prognosis of patients with hepatocellular carcinoma (HCC). However, no study has longitudinally assessed the predictive values of inflammation scores combined with hepatitis B virus status on survival of these patients. Therefore, a study was designed to evaluate the prognostic capacity of preoperative, dynamic changes in integrated scores, through a combination of general inflammation scores and HBV infection status, on HCC patients undergoing tumor resection.

METHODS

The clinicopathological data of 247 patients with primary HCC who underwent liver resection were collected. Inflammation-related laboratory examinations were performed 1 week before operation, and 1 week, 1 month, 3months, and 6months after operation. The prognostic values of preoperative and dynamic changes in integrated inflammation scores were studied using the Cox regression models.

RESULTS

Elevated preoperative integrated inflammation scores, including co-Glasgow prognostic score (coGPS), co-modified Glasgow prognostic score (comGPS), co-C reactive protein to albumin ratio (coCRP/ALB), co-prognostic index (coPI), co-neutrophil to lymphocyte ratio (coNLR), co-lymphocyte to monocyte ratio (coLMR), coNLR-PLR and coCRP/ALB-PLR, were associated with decreased overall survival (OS). Dynamic changes in coGPS, comGPS, coCRP/ALB, coPI, coPLR, coNLR, coSII, coNLR-PLR, and coCRP/ALB-PLR were independent prognostic factors of OS. coCRP/ALB-PLR was significantly associated with disease free survival.

CONCLUSIONS

Preoperative and dynamic changes in integrated inflammation scores, particularly for coCRP/ALB-PLR were important and stable prognostic markers in HCC.

Characterization of white tea metabolome: Comparison against green and black tea by a nontargeted metabolomics approach

White tea is considered the least processed form of tea and is reported to have a series of potent bioactivities, such as antioxidant, anti-inflammatory, anti-mutagenic, and anti-cancer activities. However, the chemical composition of white tea and the dynamic changes of the metabolites during the manufacturing process are far from clear. In this study, we applied a nontargeted metabolomics approach based on ultra-high performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry (UHPLC-QTOF/MS) to comprehensively profile the characteristic metabolites of white tea. There were significant differences in the content of amino acids, catechins, dimeric catechins, flavonol and flavone glycosides, and aroma precursors in white tea compared with green and black teas that were manufactured from the same fresh tea leaves. Furthermore, the dynamic changes of the metabolites in the tea samples with various withering durations of 0, 4, 8, 12, 16, 20, 24, 28, and 36 h were also profiled. This study offers a comprehensive characterization of the metabolites and their changes in white tea.

Dynamic changes of flavonoids in Actinidia valvata leaves at different growing stages measured by HPLC-MS/MS

Flavonoids are a large group of phenolic secondary metabolites havinga wide range of biochemical and pharmacological effects. Quantitative analysis of flavonoid profiles in the genus Actinidia, which has not been intensively conducted, is useful to a better understanding of the pattern and distribution of flavonoids. In the present work, a liquid chromatography-electrospray ionization-tandem mass spectrometry (LC-ESI-MS/MS) method was developed to profile the flavonoids, which was then used to determine the dynamic change of 17 biologically active flavonoids in the leaves of Actinidia valvata at the main growing stages, including glucuronides and acylated di- and triglycosides of flavonoids. The contents of flavonoid triglycosides were significantly higher than other flavonoids. The highest concentrations of kaemperol glycosides were observed in June, while other flavonoids showed highest concentrations in October. On the other hand, the contents of four isorhamnetin glycosides were increased sharply in September to October. The flavonoid profiles seem to be related to temperature, UV-B, and water deficit. Further studies are required to examine the functions of flavonoids in the Actinidia valvata and the underlying molecular mechanisms of actions.

Association of Serum Magnesium Level with Odds of Prediabetes and Diabetes in a Southern Chinese Population: a Prospective Nested Case-Control Study

Although emerging clinical evidence supports that magnesium deficiency is a risk factor for the development of type 2 diabetes, there are sparse studies concerning the dynamic change of serum magnesium with the risk of diabetes and its early stages. In this nested case-control study, we performed a 75-g oral glucose tolerance test or a standardized steamed bread meal test in 178 subjects with incident glucose metabolism impairment (33 with type 2 diabetes and 145 with prediabetes) and 178 matched controls at baseline and at 3-year follow-up and determined the associations between baseline serum magnesium levels as well as changes in serum magnesium levels at follow-up and odds of prediabetes and diabetes. After adjusting for potential confounders, the odds ratios of risk for prediabetes and type 2 diabetes in the highest quartile of serum magnesium levels were 0.22 (95 % confidence intervals [CI] 0.10-0.49; p for trend <0.001) and 0.02 (95 % CI 0.00-0.29; p for trend = 0.009), respectively, as compared with the lowest quartile. In addition, a significant decline in the serum magnesium level was detected in type 2 diabetes cases (p = 0.015) at 3 years as compared with at baseline. These results suggest that a low magnesium level is an independent risk factor for prediabetes and type 2 diabetes, and that the reduction of serum magnesium is associated with type 2 diabetes in a southern Chinese population.

The role of vascular endothelial growth factor and vascular endothelial growth inhibitor in clinical outcome of traumatic brain injury

OBJECTIVES

Tumor necrosis factor superfamily-15 (TNFSF15) also known as vascular endothelial growth inhibitor (VEGI) is a cytokine that modulates anti-angiogenesis and inflammation. Vascular endothelial growth factor (VEGF) promotes angiogenesis and vascular permeability following traumatic brain injury (TBI). The balance of VEGF and VEGI may play a key role in the maintenance of vascular and immune system homeostasis in the brain. However, the dynamic changes of circulating VEGF and VEGI after traumatic brain injury (TBI) and the correlation between plasma VEGF and plasma VEGI remains obscure. In this study, we were to investigate whether circulating VEGF and VEGI can be used as prognostic markers for patients with TBI.

PATIENTS AND METHODS

A prospective clinical study was conducted in two neurosurgical intensive care units of Tianjin Medical University General Hospital and Tianjin Huanhu Hospital (Tianjin, China). 40 patients and 30 healthy controls were recruited. The recruited subjects were aged over 18 with randomized gender and GCS. 1mL of blood was withdrawn on 1, 4, 7, 14, and 21days after TBI. Blood samples were centrifuged at 3000rpm and the supernatants were used to measure VEGF and VEGI by ELISA kit.

RESULTS

1) Circulating VEGF in TBI patients was decreased on the 1st day after TBI, then climbed up on the 4th day, reaching a maximum level on the14th day after TBI, as compared to normal controls. VEGF level returned to normal level on 21th day after TBI. 2) Circulating VEGI in TBI patients was decreased on the 1st and 4th day after TBI, then climbed up on the 7th day after TBI, reaching a maximum level on 14th day after TBI, as compared to normal controls. VEGI levels declined to normal level on 21th day after TBI. 3) There was a significant positive correlation between circulating VEGF and VEGI. 4) However, TBI patients whose conditions had improved exhibited lower VEGF levels 7days after TBI when compared to TBI patients whose condition had deteriorated. Survivors exhibited higher VEGI levels 7days after TBI when compared to non-survivors. 5)TBI patients whose condition had improved exhibited higher VEGI levels when compared to TBI patients whose condition had deteriorated 21days after TBI. Patients with mild TBI exhibited higher VEGI levels than those with moderate and severe TBI 21days after TBI. 6) A lower rate of recovery and higher hospital mortality were found in patients with VEGF/VEGI ratio≥2.366 as compared to those with VEGF/VEGI ratio<2.366 7days after TBI.

CONCLUSIONS

1) VEGF level positively correlates with VEGI after TBI. 2) The elevation of VEGF exhibits an adverse effect from 4 to 14days after TBI while it has an advantageous effect from 14 to 21days after TBI. Increasing VEGI levels are beneficial in recovery after TBI. Controlling the ratio of VEGF/VEGI may benefit the clinical outcome following TBI.

Dynamic changes in the cross-sectional area of the dural sac and spinal cord in the thoracic spine

PURPOSE

The thoracic spine is considered a rigid region because it is restricted by the rib cage. Previously, we reported functional alignments and range of motion (ROM) at all segmental levels. The purpose of this study was to investigate dynamic changes of the dural sac and spinal cord in the thoracic spine using a multidetector-row computed tomography (MDCT).

METHODS

Fifty patients with cervical or lumbar spinal disease were prospectively enrolled. After preoperative myelography, MDCT was performed at maximum passive flexion and extension. The anteroposterior diameter and cross-sectional area of the dural sac and spinal cord in the axial plane were measured using Scion imaging software. We also evaluated the correlation between the change ratio of the cross-sectional area and segmental kyphotic angle and ROM.

RESULTS

In flexion, the anteroposterior diameter of the dural sac was larger than in extension. The cross-sectional area in the upper and middle regions was smaller, but was larger in the lower region. The anteroposterior diameter and cross-sectional area of the spinal cord in the upper and middle regions were smaller than in extension, but these values were nearly the same in both flexion and extension in the lower region. Change ratios of the cross-sectional area were correlated with segmental kyphotic angle rather than ROM.

CONCLUSIONS

The thoracic spine showed some dynamic changes of the dural sac and spinal cord in the axial plane within functional motion. Segmental kyphotic angle, rather than segmental ROM, was the more important factor affecting dimensions of the dural sac and spinal cord.