Prospective cohort study on association between peri-conceptional air pollution exposure and gestational diabetes mellitus / 中华预防医学杂志

Objective@#To explore the association between the exposure to major air pollutants in pre-pregnancy and early pregnancy (peri-conceptional period) and gestational diabetes mellitus (GDM).@*Methods@#From March 2015 to April 2018, 4 817 pregnancies were recruited at three prenatal check-ups hospital in Hefei (Hefei First People′s Hospital, Hefei. Maternal and Child Care Hospital and the First Affiliated Hospital of Anhui Medical University), China. Questionnaire was used to collect the demographic data, the health status and lifestyle of pregnant women. GDM was diagnosed according to the Chinese Guidelines for the Prevention and Treatment of Type 2 Diabetes (2017 Edition). Logistic regression was used to investigate the association of exposure to major air pollutants (PM2.5, PM10, SO2, CO and NO2) during different periods of pre-pregnancy (12 weeks before pregnancy) and first trimester (12 weeks after last menstruation) and duration of exposure to high levels of pollutants with GDM.@*Results@#The mean±SD of the age of subjects was (29.14±4.19) years old and the prevalence of GDM was 21.4% (n=1 030). The results of multivariate logistic regression analysis showed that after adjusting for confounding factors, the risk of GDM increased gradually with the prolonged exposure time of high-concentration pollutants compared with pregnant women who were not exposed to high pollution during the pre-pregnancy (χ2=61.28, Ptrend<0.001) with the OR (95%CI) values for exposure time of 1, 2, and 3 months about 1.42 (1.10-1.84), 1.73 (1.29-2.33), and 2.51 (1.75-3.59), respectively. In the pre-pregnancy period, in every 10 μg/m3 increase of PM2.5 and PM10, the OR (95%CI) values of GDM were 1.14 (1.08-1.20) and 1.13 (1.08-1.19), respectively; for each increase of 1 μg/m3 and 0.10 mg/m3 of SO2 and CO, the OR (95% CI) values of GDM were 1.03 (1.01-1.05) and 1.07 (1.01-1.13), respectively. For every 1 μg/m3 increase in the average concentration of SO2 in the first trimester, the OR (95%CI) value of GDM was 1.02 (1.01-1.05).@*Conclusion@#PM2.5, PM10, SO2 and CO exposure during the pre-pregnancy and SO2 exposure in first trimester were positively correlated with the risk of GDM.

Association of vitamin D and parathyroid hormone levels with glucose metabolism during pregnancy / 中华内分泌代谢杂志

Objective To explore the relationship between different statuses of vitamin D and parathyroid hormone (PTH) during pregnancy with glucose metabolism and the risk of gestational diabetes mellitus (GDM). Methods A total of 4138 pregnant women who had antenatal care in 3 hospitals of Hefei from March 2015 to December 2017 were recruited during 21-24 weeks. Baseline questionnaires were performed and serum 25-hydroxyvitamin D [25(OH) D] and PTH levels were measured in fasting venous blood. Glucose tolerance tests were performed during 24 to 28 weeks. Multivariate linear regression model and multivariate logistic regression model were applied to analyze the differences of glucose metabolism index and GDM risk among pregnant women at different statusesof25(OH)DandPTH.Results Theaveragelevelof25(OH)Dinthesecondtrimesterwas(39.8±16.6) nmol/L, with the median PTH 10.7 (6.9, 16.7) ng/L and the detection rate of GDM 20.4％. Covariance analysis showed no statistically significant association of vitamin D and PTH levels with glucose metabolism indexes. Pregnant women with high PTH and vitamin D deficiency had higher 1h postprandial plasma glucose ( 1hPG) , the area under the glucose curve ( AUCglu ) levels, and GDM risk compared with pregnant women with middle/lower PTH and vitamin D deficiency ( control group, all P<0.05) , and higher PTH accompanied with vitamin D non-deficiency ( Group 2, all P<0.05) . However, significant changes in glucose metabolism indicators and GDM risk were not observed in low-level PTH-pregnant women with vitamin D deficiency ( group 1) and group 2 pregnant women compared with control group. Conclusion There is an interaction between vitamin D/PTH levels and glucose metabolism during pregnancy. Vitamin D deficiency with elevated PTH level is associated with abnormal glucose metabolism.

Effect of vacuum-assisted closure on the circulating number of endothelia progenitor cell in diabetic patients with mild to moderate degrees of ischemic foot ulcer / 中华内分泌代谢杂志

Objective To investigate the effect of vacuum-assisted closure(VAC)on the circulating number of endothelia progenitor cell(EPCs)in diabetic patients with mild to moderate degrees of ischemic foot ulcer and their related factors. Methods A total of 84 diabetic patients with foot ulcer duration for at least 4 weeks and ankle brachial index(ABI)0.5~0.9 were selected and divided into and assigned to two groups according to 2: 1 randomization:vacuum-assisted closure(VAC)treatment group(n=56)and Non-VAC treatment group(n=28). The control group (NC) was composed of 18 patients who had normal glucose tolerance and lower extremity ulcer without arteriovenous disease. VAC was performed on the ulcer wound after debridement for 1 week in both VAC group and NC group,and the patients in Non-VAC group received conventional treatment process. The circulating number of EPCs was measured before and after various treatments and the influencing factors of their changes were analyzed. Results After VAC treatment,the circulating number of EPCs significantly increased in both VAC group and NC group[(85.3 ± 18.1)vs(34.1 ± 12.5)/106cells,(119.9 ± 14.4)vs(66.1 ± 10.6)/106cells,both P<0.05]. By contrast,the circulating number of EPCs had no significant change in Non-VAC group[(45.2 ± 19.4)vs(34.7 ± 16.8)/106cells, P>0.05]. In addition,the circulating levels of vascular endothelial growth factor(VEGF)and the protein expressions of VEGF and stromal cell-derived factor-1α(SDF-1α)in the granulation tissue also significantly increased after VAC treatment in both VAC group and NC group,but no significant change in Non-VAC group. Compared with Non-VAC group,the changes of VEGF and SDF-1α levels in the sera and granulation tissue were all significantly higher in both VAC group and NC group(P<0.05 or P<0.01). There were no significant differences in changes of the circulating number of EPCs, and VEGF and SDF-1α in the sera and granulation tissue between VAC group and NC group. Correlation analysis showed that the change of the circulating number of EPCs was correlated with the changes of VEGF and SDF-1α levels in the sera and granulation tissue of VAC group and NC group(P<0.05). Conclusion VAC treatment may increase the circulating number of EPCs in diabetic patients with mild to moderate ischemic foot ulcer as in non-diabetic controls,which may be attributed to the upregulation of systemic and local VEGF and SDF-1α levels.

MicroRNA expression profiling in male and female model mice after renal ischemia-reperfusion injury / 中国组织工程研究

BACKGROUND:Renal ischemia-reperfusion injury has been shown to exhibit gender difference, but its precise mechanisms deserve further investigations. OBJECTIVE:To investigate the differential expression of microRNAs in the kidney between female and male mice in order to study the effects and mechanisms of microRNA in pathogenesis of ischemia-reperfusion injury between different genders. METHODS:Male and female mice received kidney ischemia for 45 minutes and reperfusion injury for 24 hours. Simultaneously, male and female sham surgery groups served as controls. The microRNA gene chip technology was used to detect the differences of microRNA expression in the kidney of male and female mice at 45 minutes after ischemia and 24 hours of reperfusion as wel as after sham surgery. The threshold of difference in expression among samples was double. RESULTS AND CONCLUSION:Five microRNAs were up-regulated between female and male ischemia-reperfusion injury groups. Twenty-nine microRNAs differential y expressed in the female ischemia-reperfusion group and female sham surgery group, including 25 up-regulated microRNAs and 4 down-regulated microRNAs. Thirty-eight microRNAs differential y expressed in male ischemia-reperfusion injury group and male sham surgery group, including 9 up-regulated microRNAs and 29 down-regulated microRNAs. 102 microRNAs differential y expressed in the female sham surgery group and male sham surgery group, including 22 up-regulated microRNAs and 80 down-regulated microRNAs. Results suggested that there was differential expression in microRNAs in the kidney before and after renal ischemia-reperfusion in male and female mice. These differential y expressed microRNAs may be lead to different sensitivity and tolerance to the ischemia-reperfusion injury in the kidney of male and female mice.

Effect of miR-181d on chemo-sensitivity in human small cell lung cancer / 中国肿瘤临床

Objective:To investigate the possible role of miR-181d in regulating the multidrug resistance (MDR) of small cell lung cancer (SCLC) and its clinical significance. Methods: Quantitative reverse transcriptase-polymerase chain reaction (QRT-PCR) and Western blot were used to investigate the differential expression of miR-181d and BCL2 from mRNA and protein levels in the chemo-sensitivity cell H69 and the chemo-resistance cell H69AR. The miR-181d expression in H69AR was then upregulated. More-over, CCK8 assay was employed to detect the sensitivities of the cells to chemotherapy drugs, such as ADM, DDP, and VP-16. Mean-while, the expression of miR-181d in the specimens of 87 cases with SCLC were detected using QRT-PCR. All patients received the chemotherapeutic regimen of EP (etoposide+cisplatin). Correlation of the miR-181d expression with clinicopathological features, prog-nosis, and survival time of the patients was studied. Results:miR-181d was downregulated in the SCLC multidrug-resistant cell line H69AR and chemo-resistant patients. Moreover, miR-181d was concurrent with the upregulation of BCL2 protein compared with the parental H69 cell line and chemo-sensitive patients (P<0.001). miR-181d expression in H69 cells resistant to chemotherapy drugs (ADM, DDP, and VP-16) was inhibited (P<0.01). Enforced miR-181d expression reduced the BCL2 protein level and sensitized H69AR cells to chemotherapy drugs (P<0.01). miR-181d expression was associated with tumor stage, sensitivity of chemotherapy, and survival time (all P<0.001). Patients with high miR-181d expression had longer overall survival and progress-free survival time com-pared with those with low miR-181d expression (P<0.001). Conclusion: miR-181d may play a role in the development of MDR in SCLC and may be a potential predictive factor for treatment efficacy.

Expression and clinical significance of CIP2A in small cell lung cancer patients / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To explore the expression of cancerous inhibitor of phosphatase 2A (CIP2A) protein in small cell lung cancer and their relationship with clinicpathological features and prognosis.</p><p><b>METHODS</b>A total of 112 cases of surgical specimens or bronchoscopic biopsies of small cell lung cancer were collected. There were specimens of 94 cases of SCLC tissues and 40 cases of paracancerous lung tissues. Quantitative RT-PCR and immunohistochemistry analysis were performed to determine the CIP2A expression in SCLC tissues. Kaplan-Meier curves were used to estimate the association between CIP2A expression and clinicopathological characteristics and prognosis of the patients.</p><p><b>RESULTS</b>The expression of CIP2A in SCLC tissue was 7.605 ± 1.893, significantly higher than that in the paracancerous tissues (1.041 ± 0.786) (P < 0.01). The positive rate of CIP2A expression in cancer tissues was 82.8%, significantly higher than that in the paracancerous tissues (13.3%) (P < 0.01). The median disease-free survival was 9.88 months in the CIP2A-high expressing patients, significantly shorter than the 20.92 months in CIP2A-low expressing patients (P < 0.001). CIP2A expression was significantly correlated with the tumor stage, chemotherapeutic sensitivity, and survival (P < 0.05 for all).</p><p><b>CONCLUSIONS</b>CIP2A expression is associated with the pathogenesis of SCLC, and may become a potential prognostic indicator of SCLC.</p>

Bone marrow mesenchymal stem cells protect against renal ischemia-reperfusion injury through immune regulatory mechanism / 中国组织工程研究

BACKGROUND:Stem celltherapy for renal ischemia-reperfusion injury has been the hot topics for many scholars. Its mechanism is very complex, which could not be explained by simple mechanism of stem cells differentiation. It is the result involving a variety of mechanisms. OBJECTIVE:To investigate the influence on immune cells during the bone marrow mesenchymal stem celltherapy for renal ischemia-reperfusion injury, then to preliminary summarize the immune regulation mechanism of bone marrow mesenchymal stem celltherapy for renal ischemia-reperfusion injury. METHODS:First, we established a model of renal ischemia-reperfusion injury in rats and, cultured and purified rat bone marrow mesenchymal stem cells in vitro. Then, the bone marrow mesenchymal stem cells were transplanted into the rat models. Using flow cytometry detection technology, we analyzed the proportion of CD4+CD25+regulatory T cells of rat spleen cells, discussed the effects on immune cells during the bone marrow mesenchymal stem celltherapy for renal ischemia-reperfusion injury, and then transferred the rat’s spleen cells to the nude mice which were subjected to renal renal ischemia-reperfusion injury. Renal function and renal histological changes of nude mice were assessed. RESULTS AND CONCLUSION:The bone marrow mesenchymal stem celltransplantation could significantly inhibit the decrease of CD4+CD25+regulatory T cellof spleen cells in rats with renal ischemia-reperfusion injury. The transplantation of spleen cells from the above-mentioned rats to nude mice could obviously protect nude mice from renal ischemia-reperfusion injury, characterized by lower serum creatinine, blood urea nitrogen and renal tubule pathologic damage score. Therefore, bone marrow mesenchymal stem cells have protective effects on renal ischemia-reperfusion injury by regulating the immune system.

Serum nesfatin-1 levels in gestational diabetes mellitus in relation to insulin resistance and pancreatic β-cell function / 中华内分泌代谢杂志

The association of serum nesfatin-1 levels with insulin resistance and pancreatic β-cell function in gestational diabetes mellitus was investigated.Oral glucose tolerance test(OGTT) was performed in ninety pregnant women from 24,to 28 gestational weeks.They were divided into three groups according to OGTT:45 nomal controls,27 gestational diabetes mellitus with fasting plasma glucose (FPG) of 5.1 mmol/L to 7.0 mmol/L (GDM1),18 gestational diabetes mellitus with FPG more than 7.0 mmol/L (GDM2).Serum nesfatin-1 levels were significantly higher in patients with GDM1 and GDM2 than in controls (P＜0.01),and in GDM2 group it was also higher than GDM1 group(P＜0.05).Fasting serum nesfatin-1 was positively correlated with FPG,30 min plasma glucose,1 h plasma glucose,2 h plasma glucose,homeostasis model assessment for insulin resistance,and PGAUC,but negatively correlated with homeostasis model assessment for β-cell function.Furthermore,multiple stepwise regression analysis showed that FPG was the independent influencing factor of serum nesfatin-1 level.Nesfatin-1 was positively correlated with insulin resistance,while negatively correlated with pancreatic β-cell function.Nesfatin-1 may play a role in the pathogenesis of gestational diabetes mellitus.

Clinical follow-up observation for 34 type 2 diabetic patients with six-year intensive insulin therapy / 中华内分泌代谢杂志

The data collected from 34 type 2 diabetic patients receiving intensive insulin therapy for six years showed that the yearly mean HbA1C was less than 7.0％,and none of the patients showed severe hypoglycemia,occurrence or evident progression of retinopathy or nephropathy,and the islet β cell function gained improvement.The DQOL score,used to evaluate the quality of patients' life had no significant change during the observation ( P ＞0.05 ).It is satisfactory and safe to maintain long-term glycemic control with prolonged intensive insulin therapy in patients with type 2 diabetes,and that such therapy does not induce untoward influence on the quality of diabetic patients life.

A clinical study on docetaxel combined with nedaplatin or cisplantin in the treatment of advanced head and neck carcinoma / 中国基层医药

Objective To evaluate the efficacy and toxicity of the docetaxel combined with nedaplatin or cisplatin in the treatment of patients with advanced head and neck carcinoma.Methods 58 patients with advanced head and neck carcinoma were enrolled into the study.These patients were divided into nedaplatin group (27 patients:docetaxel 75mg/m2 on day 1 and nedaplatin 80mg/m2 on day 1 of the 21-day cycle) and cisplantin group( 31 patients:docetaxel 75mg/m2 on day 1 and cisplatin 25mg/m2 on day 1-3 day of 21-day cycle).Each patient should complete two cycle.Results The response rate in nedaplatin group was 59.2％ and in cisplantin group was 54.8％,the difference was statistically significant between the two groups( P ＞ 0.05 ).The rate of white blood cell and plate let reduction in nedaplatin group was 55.5％,40.7％,respectively,and those in cisplantin group was 51.6％,35.4％,respectively,the difference was statistically significant between the two groups ( call P ＜ 0.05 ).The rate of vomit in nedaplatin group was 29.6％,which was lower than that of cisplantin group (64.5％) ( x2 =4.02,P ＜ 0.05 ).Conclusion In the treatment of advanced head and neck carcinoma,the combination of docetaxel and nedaplatin had the same efficacy as the combination of docetaxel and cisplatin,and they appeared to be more-tolerated.

Interferon-beta gene engineered human mesenchymal stem cells in the treatment of human prostate cancer xenograft in mouse model / 中华泌尿外科杂志

Objective To investigate the effect of human interferon-beta (IFN-β) gene engineered human mesenchymal stem cells (hMSC) in the treatment of human prostate cancer xenograft in nude mice.Methods An adenovirus vector containing human IFN-β gene was constructed and transfected into hMSC in vitro.IFN-β-expressing mesenchymal stem cells (IFN-β-hMSC) were labeled with 4,6-diamidino-2-phenylindole (DAPI).The human prostate cancer cell line PC-3 were injected into the flank or axillary of severe combined immunodeficiency (SCID) mice subcutaneously to establish human prostate cancer xenograft models.IFN-β-hMSC were injected into the tail vein of mice bearing human prostate cancer xenografts.The tumors,livers,lungs,spleens and kidneys were harvested.Frozen sections and paraffin sections were used to observe the distribution of IFN-β-hMSC in vivo by fluorescence microscope.Mice were divided into seven groups of six animals randomly,IFN-β-hMSC (2 × 106,2 × 105 ) as treatment group,Ad-hMSC,unmodified hMSC,Ad-IFN-β,Recombinant IFN-β,and NS as control group.The weight of the tumor and the survival time of mice were observed to evaluate the experimental efficacies of IFN-β-hMSC in the treatment of prostate cancer. Results IFN-β-hMSC with blue nuclei were distributed extensively in the tumors,but no blue nucleus was seen in the livers,lungs,spleens and kidneys.After treating,the weights of the tumour masses from mice were (1.35 ±0.28) g,(1.43±0.41) g,(3.49 ±0.25)g,(3.58±0.30)g,(3.30 ±0.24) g,(3.32 ±0.25) g,(3.32 ±0.47) g in the IFN-β-hMSC (2 ×106),IFN-β-hMSC (2 ×105),Ad-hMSC,unmodified hMSC,Ad-IFN-β,Recombinant IFN-β,and NS group,the median survival time from mice were 91 d,87 d,57 d,59 d,62 d,61 d,61 d in the IFN-β-hMSC (2 × 106),IFN-β-hMSC (2 × 105),Ad-hMSC,unmodified hMSCs,Ad-IFN-β,Recombinant IFN-β,and NS group,respectively.Injection of IFN-β-MSC can significantly reduce tumor weight and increase animal survival compared with controls ( P ＜ 0.05 ). Conclusion IFN-β-hMSC can migrate to prostate cancer microenviroment in vivo,and injection of IFN-β-MSC can significantly reduce tumor weight and increase animal survival.

Clinical Effect of Skeletal Metastases Treated by Chemotherapy Combined with Ibandronate / 药物流行病学杂志

Objective:To observe the therapeutic effect of the treatment with intravenous(Ⅳ)ibandronate com- bined with chemotherapy on patients with skeletal metastases.Method:138 patients with skeletal metastases were randomly divided into ibandronate group combined with chemotherapy(68 cases)and simple chemotherapy group(70 cases).The controlled group took a standard chemotherapy project but combined the treatment group took a chemotherapy project plus ibandronate.In a week after the chemotherapy,68 cases of the treatment group were treated with ibandronate 4mg in NS 500ml by intravenous infusion once 4 weeks for 3 months.The effect was evaluated when the three cycles finished.Result: There was a statistical difference(P

Role of insulin pump in controlling of hyperglycemia of patients with type 2 diabetes mellitus / 中国医师进修杂志

Objective To compare the effect of treating hyperglycemia on insulin pump therapy in newly diagnosed type 2 diabetes mellitus(T2DM) and the patients with failure to oral antidiabetic therapy. Methods Selecting 32 patients with newly diagnosed T2DM(NDM group)and 64 T2DM patients with failure to oral antidiabetic therapy(ODM group),which were treated by insulin pump,having no significant difference of the level of blood glucose,body mass index(BMI),age,proportion of sex between NDM group and ODM group. Results (1)The mean time and the maximal dosage of insulin for blood glucose to be targeted in NDM group were all lower than those in ODM group(P all

Irirotecan Combined with Fluoropyrimidine in the Treatment of 46 Cases with Metastatic Colorectal Carcinoma / 药物流行病学杂志

Objective:To evaluate the efficacy and toxicity of Irirotecan(CPT-11) combined with 5-FU/CF in the treatment of metastatic colorectal cancer, in which FOLFOX4 or LV5FU2 had failed to cure it. Method: 46 cases of metastatic colorectal cancer patients were treated by CPT-11 combined with 5-FU/CF for one cycle every two weeks; namely, CPT-11 was given by 180mg/m2 iv d1, CF by 200mg/m2 iv d1-2, 5-FU by 400mg iv bolus d1, and 5-FU by 600mg/m2 iv 22h d1-2. Two weeks was a cycle. The study term was 3-6 months. Result:CR was 0, PR was 39. 13% (18/46) , SD was 43.47% (20/46) , PD was 17.39% (8/46) and CBR was 82.69% (38/46). The clinical reaction evaluation efficiency was 78. 86% (36/46). Their life quality was notably improved. Conclusion:CPT-11 combined 5-Fu/CF can be used as second-line treatment for metastatic colotedal cancer.

The clinical analysis of chest wall recurrence of breast cancer after mastectomy / 中国癌症杂志

Background and Purpose:The recurrent rate of breast cancer after mastectomy was 5%~20%,high risk factors were included it could achieve 34%~40%,Chest wall recurrence was the most common.This paper explores the reason for chest wall recurrence of breast cancer after mastectomy,hoping to find an efficient way to prevent and reduce chest wall recurrence after mastectomy.Methods:For 39 patients with local recurrence on the chest wall after mastectomy clinical data was reviewed retrospectively.Results:This group of patients was 5.1% of all breast cancer patients in the same period.Most of recurrences(59.0%)occured within two years affer operation.The recurrent rate of T_1～T_4 was 1.6%、1.9%、9.7% and 37.2% respectively.Rate of chest wall recurrence in patients with negative axillary nodes and positive axillary nodes was 1.3%、7.6%,but if the amount of positive axillary nodes≥4,it was 13.4%.Conclusions:In the patients who had more positive axillary nodes,larger primary tumor and no proper adjuvant therapy,recurrence on the chest wall was seen more often.Adjuvant chemotherapy and postoperative radiotherapy are efficient ways to prevent recurrence on the chest wall.

The relationships of serum levels of leptin,tumor necrosis factor-alpha,free fatty acid and resistin with insulin resistance in type 2 diabetes / 中国糖尿病杂志

Objective To explore the relationships of serum levels of leptin,TNF-?,FFA and resistin with IR and between themselves. Methods 48 T2DM patients and 47 non-diabetic controls were selected.Levels of leptin,TNF-?,FFA and resistin were measured.FPG,insulin,blood lipid,blood pressure,BMI and WHR were measured.Results The levels of leptin,TNF-?,FFA and resistin were correlated positively with HOMA-IR(P