Association between nonalcoholic steatohepatitis and high serum ferritin levels in type 2 diabetes mellitus

SUMMARY OBJECTIVE: The aim of this study was to assess the role of elevated serum ferritin levels in the onset, pathological progression and prognosis of nonalcoholic fatty liver disease. Nonalcoholic fatty liver disease has been rapidly increasing worldwide. Despite extensive research on the pathogenesis of nonalcoholic fatty liver disease, a lack of sufficient clinical research on the relationship between nonalcoholic fatty liver disease and serum ferritin levels remains. METHODS: We analysed 968 patients with type 2 diabetes mellitus who underwent liver ultrasound examination and had their serum ferritin levels measured. The presence of nonalcoholic fatty liver disease and advanced liver fibrosis was determined through abdominal ultrasound examination and the nonalcoholic fatty liver disease fibrosis score. RESULTS: Compared to that in the non-nonalcoholic fatty liver disease group, the presence of hyperferritinemia was significantly more common in the nonalcoholic fatty liver disease group (83.3 vs. 56.3%, p=0.005). When patients with nonalcoholic fatty liver disease were stratified by the nonalcoholic fatty liver disease fibrosis score, those with advanced liver fibrosis exhibited a higher prevalence of hyperferritinemia (56.3, 78.9, and 88.9% for none, simple steatosis, and advanced fibrosis, respectively; p for trend=0.002). In multivariate logistic regression, liver fibrosis was independently associated with hyperferritinemia (odds ratio [OR] 1.45; 95% confidence interval [CI] 1.18-2.02; p=0.014), and this association remained significant in male patients after adjusting for other risk factors (OR 2.66; 95% CI 1.43-5.48; p=0.026). CONCLUSION: Identifying nonalcoholic fatty liver disease patients at a risk of developing nonalcoholic steatohepatitis and advanced fibrosis is crucial for implementing timely interventions and improving patient outcomes. This study highlights the potential utility of serum ferritin levels as a serum biomarker for identifying nonalcoholic steatohepatitis patients and those at a risk of late-stage fibrosis, particularly in male patients with nonalcoholic fatty liver disease.

Short-term exposure to ambient ozone associated with cardiac arrhythmias in healthy adults / 《全球健康杂志（英文）》

Objective:The exact biological mechanism whereby exposure to ambient ozone(O3)may contribute to clinical onset of cardiovascular events remains unclear.In this study,we aim to examine the impacts of O3 exposure on cardiac arrhythmias and potential pathways involved through autonomic dysfunction and myocardial injury.Methods:Seventy-three non-smoking healthy adults were followed with 4 repeated measurements of 24-hour ambulatory arrhythmias,heart rate variability,ST-segment deviation,and blood pressure(BP)in Beijing,China,2014-2016.Generalized additive mixed models coupled with distributed lag nonlinear models were constructed to evaluate the associations and potential interlinks between O3 exposure and outcome measurements.Results:During the study period,24-hour average concentrations of ambient O3 were 47.4 μg/m3(ranging from 1.0 to 165.9 μg/m3).Increased risks of premature ventricular contraction and ventricular tachycardia were associated with interquartile range increases in O3 exposure during the last 5 days before each participant's clinic visit,with relative risks of 2.14(95％confidence interval[CI]:1.95 to 2.32)and 5.47(95％CI:3.51 to 7.43),respectively.Mediation analyses further showed that sympathetic activation,parasympathetic inhibition,and elevated BP levels,as well as heightened risks of ST-segment depression could mediate up to 47.74％of the risks of arrhythmias attributable to O3 exposure.Conclusion:Our results suggest that short-term exposure to ambient O3 could prompt the genesis of arrhythmias partially through worsening autonomic function and myocardial burden.

An extended analysis of cardiovascular benefits of indoor air filtration intervention among elderly:a randomized crossover trial(Beijing indoor air purifier study,BIAPSY) / 《全球健康杂志（英文）》

Objective:Evidence on potential cardiovascular benefits of personal-level intervention among the elderly exposed to high levels of particulate matter(PM)remains limited.We aimed to assess improvements in surrogate markers of cardiovascular injury in vulnerable populations at risks by using indoor air filtration units.Methods:We conducted a randomized crossover trial for 2 separate 2-week air filtration interventions in 20 households of patients with stable chronic obstructive pulmonary disease and their partners in the winter of 2013,with concurrent measurements of indoor PM.The changes in biomarkers indicative of cardiac injury,atherosclerosis progression and systemic inflammation following intervention were evaluated using linear mixed-effect models.Results:In the analysis,average levels of indoor PM with aerodynamic diameters＜2.5 μm(PM2.5)decreased significantly by 59.2％(from 59.6 to 24.3 μg/m3,P＜0.001)during the active air filtration.The reduction was accompanied by improvements in levels of high-sensitivity cardiac troponin I by-84.6％(95％confidence interval[CI]:-90.7 to-78.6),growth differentiation factor-15 by-48.1％(95％CI:-31.2 to-25.6),osteoprotegerin by-65.4％(95％CI:-56.5 to-18.7),interleukin-4 by-46.6％(95％CI:-62.3 to-31.0)and myeloperoxidase by-60.3％(95％CI:-83.7 to-3.0),respectively.Conclusion:Indoor air filtration intervention may provide potential cardiovascular benefits in vulnerable popu-lations at risks.

Effects of atmospheric particulates exposure on Nrf2 signaling pathway and inflammatory factors in myocardium of rats fed with high-fat and high-glucose diet / 上海预防医学

Objective To study the effect of atmospheric particulate exposure on the expression of key molecules of Nrf2 signaling pathway involved in oxidative stress and inflammatory response factors in myocardium of rats fed with high-fat and high-glucose diet. Methods A total of 48 SD male rats were randomly divided into control group (CC group), high-fat and high-glucose diet group (HC group), atmospheric particulates group (CP group) and atmospheric particulates plus high-fat and high-glucose diet group (HP group), with 12 rats in each group.Rats were fed in individual ventilated cages (IVC).The CC and HC groups were placed in IVCs equipped with the atmospheric particulate filter, however, the CP and HP groups without the atmospheric particulate filter to make the air composition similar to the outdoor.A total of 24 rats were sacrificed for acquiring myocardial tissue after 3 and 6 months of exposure.The mRNA expression of Nrf2, HO-1, NQO1, VCAM-1 and MCP-1 were measured using RT-qPCR and the protein expression of VCAM-1, MCP-1 detected using western blot. Results The mRNA expression levels of Nrf2, HO-1, NQO1, VCAM-1 and MCP-1 and the protein expression levels of VCAM-1 and MCP-1 in HC, CP and HP groups were higher than CC group (P < 0.05).The mRNA expression levels of Nrf2, HO-1, NQO1, VCAM-1, MCP-1 and the protein expression levels of VCAM-1, MCP-1 in the HP group were higher than HC and CP groups (P < 0.05).The mRNA expression levels of Nrf2 in CP and HP groups after 6 months of exposure were lower than that at 3 months (P < 0.05). Conclusion The exposure of atmospheric particles, high-fat and high-glucose and their combination diets could cause myocardial tissue inflammatory responses, and activate Nrf2 signaling pathways to protect against myocardial damage.

Preoperative localization indication of clinical peripheral pulmonary ground-glass nodules by Da Vinci robot surgery / 中国胸心血管外科临床杂志

@#Objective    To investigate the preoperative localization of pulmonary glabrous nodules. Methods    A total of 192 patients admitted to General Hospital of  Northern Theater Command from April 2012 to September 2019 were selected for the study. There were 95 males and 97 females at an age of 56.47±11.79 years. All patients completed preoperative examination, and were divided into a positioning group (n=97) and a non-positioning group (n=95) according to whether the preoperative positioning was performed. And the surgical indicators between the two groups were compared. According to the substance of ground-glass opacity, they were divided into a pure ground-glass nodules group (n=23) and a mixed ground-glass nodules group (n=74) in the positioning group and a pure ground-glass nodules group (n=14) and a mixed ground-glass nodules group (n=81) in the non-positioning group . According to the size and distance of the nodules from the pleura and whether the nodules could be detected, the corresponding linear function was obtained. Results    The operative time of methylene blue localization group was shorter than that of the no localization group. In the scatter plot, the corresponding diameter and depth of the nodules and the corresponding coordinate points which can be explored were described. And linear regression was performed on all the coordinate points to obtain the linear function: depth=0.648×diameter–1.446 (mm). It can be used as an indication for the preoperative localization of pure ground-glass nodules in Da Vinci robotic surgery. Linear function: depth=0.559 5×diameter+0.56 (mm). It can be used as an indication of preoperative localization of mixed ground-glass nodules in Da Vinci robotic surgery. Conclusion    This equation can be used as a preoperative indication for clinical peripheral pulmonary ground-glass nodules.

Surgical treatment of mediastinal tumors combined with myasthenia gravis: comparison of Da Vinci robot-assisted, video-assisted thoracoscopic surgery and median sternotomy / 中国胸心血管外科临床杂志

@#Objective To compare three surgical treatments for mediastinal mass with myasthenia gravis. Methods Retrospective analysis was performed on the clinical data of 53 patients who underwent extended thymectomy between January 2010 and December 2017 in our hospital. There were 29 males and 24 females, aged 17-73 years. Patients were divided into three groups according to the surgical methods: a group A (video-assisted thoracoscopic surgery with the da Vinci robotic system, n=22), a group B (video-assisted thoracoscopic surgery, n=12) and a group C (median sternotomy, n=19). The gender distribution, age, intraoperative blood loss, operation time, postoperative extubation time, postoperative hospital stay, Osserman classification of myasthenia gravis, postoperative myasthenic remission rate, etc were compared in three groups. Results No perioperative death was observed in 53 patients. One patient in the group C suffered from postoperative myasthenic crisis and improved after active treatment. One patient with video-assisted thoracoscopic surgery was converted to median sternotomy due to the intraoperative injury of the left brachiocephalic vein. Compared with the group B and group C, the group A had shorter operation time, less intraoperative blood loss and drainage on the first postoperative day and fewer days of extubation. Postoperative hospital stay was less in the group A than that in the group C (P<0.05). The postoperative myasthenic remission rate was higher in the group A than that in the other two groups, but there was no statistical difference. Conclusion Because of the robot’s unique minimally invasive advantage, in this study, the outcome of patients with myasthenia gravis treated with Da Vinci robots and thymectomy is better than that of the remaining two groups in terms of perioperative outcomes and myasthenic remission rate. But long-term results and a large of number matching experiments are needed to confirm. However, it is undeniable that robotic surgery must be the future of the minimally invasive surgery.

Risk factors of lower limb DVT and thrombosis risk assessment after breast cancer surgery / 中国肿瘤临床

Objective:To investigate the risk factors of breast cancer complicated with deep venous thrombosis (DVT) in lower limb and to explore the predictive significance of the thrombus risk assessment model for patients with breast cancer. Methods:A total of 703 patients with breast cancer in Tianjin Medical University Cancer Institute and Hospital who suffered from DVT after operation dur-ing January 2013 to June 2016 were retrospectively selected as the thrombosis group. A total of 706 cases for the control group were selected by systematic sampling. The risk factors of lower limb DVT after surgery were investigated. The predictive values of the Khora-na and Caprini thrombosis risk assessment models for these patients were also presented in this research. Results:Age, BMI≥30 kg/m2, diagnosis by excisional biopsy, neoadjuvant chemotherapy, operation time>2 h, lipoprotein a (Lpa)>475.5 mg/L, protein C (PC)<102.5%, blood coagulation factor-Ⅷ(F-Ⅷ)>129.8%, and D-Dimer (D-D)>289.99 ng/mL had statistical differences between in the two groups (P<0.05). Significant difference between the groups was found in the Caprini scores (P<0.001) but not in the Khorana thrombo-sis risk assessment model (P=0.207). Conclusion:Age, BMI≥30 kg/m2, diagnosis by excisional biopsy, neoadjuvant chemotherapy, op-eration time>2 h, Lpa>475.5 mg/L, PC<102.5%, F-Ⅷ>129.8%, and D-D>289.99 ng/mL are the independent risk factors of thrombo-sis. The Caprini thrombosis risk assessment model may require complicated evaluation. Hence, a new model that is suitable for pa-tients with breast cancer must be developed.

Relationship between high-temperature working classification and hypertension among iron and steel production workers / 中国职业医学

OBJECTIVE: To analyze the relationship between the high-temperature working classification and prevalence of hypertension in iron and steel production workers. METHODS: By a convenience sampling method,2 798 workers in an iron and steel production enterprise were selected as study subjects. They were divided into high-temperature working group( 1 070 cases) and non-high-temperature working( control) group( 1 728 cases). The occupational health status was investigated by questionnaire survey and the blood pressure was measured. The wet bulb globe temperature in workplace of high temperature working group was measured,and the high-temperature classification was made based on the time of exposure to high temperature. RESULTS: The prevalence rate of hypertension of 2 798 iron and steel production workers was32. 8%. The prevalence rate of hypertension of high-temperature working group was higher than that of the control group( 41. 3% vs 27. 5%,P < 0. 01). The prevalence rate of hypertension in high temperature working group presented an increasing tendency with the increase of high-temperature working level( P < 0. 01). The multiple logistic regression analysis results showed that excluding the confounding factors of age,body mass index,family history of hypertension,educational background,smoking,alcohol drinking,salt intake and mental stress,it showed that high-temperature working classification was positively correlated with increasing prevalence of hypertension in high-temperature working group( P <0. 01); and the initial exposure age to high-temperature was negatively correlated with the prevalence of hypertension in iron and steel production workers( P < 0. 01). CONCLUSION: High-temperature is an important influence factor to the prevalence of hypertension in iron and steel production workers. Strengthening the management of high-temperature classification is helpful for the prevention and treatment control of hypertension in the iron and steel production workers

Relationship between cumulative noise exposure and hypertension among iron and steel production workers / 中国职业医学

OBJECTIVE: To analyze the relationship between the cumulative noise exposure( CNE) and prevalence of hypertension in iron and steel production workers. METHODS: By convenience sampling method,2 253 workers,whose workplace in an iron and steel enterprise with wet bulb globe temperature index less than 25. 0 ℃,were selected as study subjects. The blood pressure and workplace noise exposure level were measured. According to the equal energy principle,the normalized continuous A-weighted sound pressure level equivalent to an 8 h-working-day and workers' length of service were used to calculate the CNE level. The workers with CNE≥75 d B( A) ·year were regarded as the exposure group,and those with CNE < 75 d B( A) ·year were deemed as the control group. RESULTS: The prevalence rate of hypertension in the exposure group was higher than that of the control group( 32. 3% vs 21. 5%,P < 0. 01). With the increased CNE level,the prevalence rate of hypertension increased( P < 0. 01). The multiple logistic regression analysis results showed that the prevalence risk of hypertension disputed an upward trend of the dose-response relationship following the increasing CNE among the iron and steel production workers( P < 0. 01) after controlling the confounding factors of age,body mass index,educational background,family history of hypertension,smoking,alcohol drinking,salt intake,fried barbecue food intake and so on. CONCLUSION: CNE is a vital factor which influences hypertension prevalence in iron and steel production workers. Strengthen the noise protection is helpful for the prevention and treatment of hypertension in the steel workers.

Effect of Cypermethrin and Deltamethrin on DNA Damage in Lymphocytes in Male Mice / 环境与健康杂志

0.05).After the contamination,the mice body weight of high dose group of cypermethrin and dehamethrin were lower than the negative control group (P