[Associations of onset age, diabetes duration and glycated hemoglobin level with ischemic stroke risk in type 2 diabetes patients: a prospective cohort study].

Objective: To investigate the associations of onset age, diabetes duration, and glycated hemoglobin (HbA1c) levels with ischemic stroke risk in type 2 diabetes patients. Methods: The participants were from Comprehensive Research on the Prevention and Control of the Diabetes in Jiangsu Province. The study used data from baseline survey from December 2013 to January 2014 and follow-up until December 31, 2021. After excluding the participants who had been diagnosed with stroke at baseline survey and those with incomplete information on onset age, diabetes duration, and HbA1c level, a total of 17 576 type 2 diabetes patients were included. Cox proportional hazard model was used to calculate the hazard ratio (HR) and 95%CI of onset age, diabetes duration, and HbA1c level for ischemic stroke. Results: During the median follow-up time of 8.02 years, 2 622 ischemic stroke cases were registered. Multivariate Cox proportional risk regression model showed that a 5-year increase in type 2 diabetes onset age was significantly associated with a 5% decreased risk for ischemic stroke (HR=0.95, 95%CI: 0.92-0.99). A 5-year increase in diabetes duration was associated with a 5% increased risk for ischemic stroke (HR=1.05, 95%CI: 1.02-1.10). Higher HbA1c (per 1 standard deviation increase:HR=1.17, 95%CI: 1.13-1.21) was associated with an increased risk for ischemic stroke. Conclusion: The earlier onset age of diabetes, longer diabetes duration, and high levels of HbA1c are associated with an increased risk for ischemic stroke in type 2 diabetes patients.

[Progress in metabolomics epidemiology].

In recent years, with the rapid development of metabonomic technology and analytic methods, metabolomics epidemiology, as an important branch of systems epidemiology, attracts more attention. Metabolomics epidemiology can better describe the characteristics of exposure, reflect the interaction between environmental factors and genetics, uncover the "black box" of the mechanisms underlying exposure and disease, and identify new biomarkers. This article briefly introduces the definition, methods, and progress of metabolomics epidemiology.

[The research progress of circular RNAs in the development and progression of cervical cancer].

Cervical cancer is one of the most common gynecological malignancies, and its morbidity and mortality are among the highest. Persistent infection of high-risk types of HPV is the main reason for its onset, with types 16 and 18 being the most prevalent. Circular RNA (circRNA) is a single-stranded circular non-coding RNA formed by covalent end to end bonding of RNA precursors. It has functions such as miRNA sponge, binding RNA binding protein (RBP), and protein translation, and plays an important role in the occurrence and development of various diseases. At present, the research on circRNA in cervical cancer is still at an early stage. The latest progress of circRNA in high-risk HPV infection, occurrence and development of cervical cancer, and sensitivity to chemoradiotherapy is briefly reviewed.

[Application of polygenic risk scores in risk prediction and precision prevention of complex diseases: opportunities and challenges].

Along with the rapid progress in the field of human genomics, genome-wide association studies have successfully identified numerous risk loci for complex diseases. Polygenic risk scores can predict disease risk by integrating the effects of multiple susceptibility loci, and begin to show good performance for improving risk prediction, screening strategy and precision prevention. This paper briefly reviews the recent progress of polygenic risk scores in disease prevention, and summarizes the opportunities and challenges of its application.

MiR-26b regulates cartilage differentiation of bone marrow mesenchymal stem cells in rats through the Wnt/ß-catenin signaling pathway.

OBJECTIVE: To investigate the influence of micro-ribonucleic acid (miR)-26b on the cartilage differentiation of mesenchymal stem cells (MSCs) in rats and its mechanism. This study aims to provide references for the clinical treatment of orthopedic diseases, such as osteoarthritis. MATERIALS AND METHODS: MSCs were isolated from rat bone marrow, followed by identification of their immunological manifestation and multi-lineage differentiation potential. In addition, miR-26b small-interfering RNA (siRNA) was transfected into rat MSCs for evaluating its regulatory effect on MSCs differentiation. The predicted target gene Wnt was detected via Luciferase reporter gene assay and further verified via Reverse Transcription-Polymerase Chain Reaction (RT-PCR) and Western blotting. RESULTS: The expression level of miR-26b was significantly down-regulated during the in vitro cartilage differentiation of rat MSCs. Transfection of miR-26b siRNA enhanced in vitro cartilage differentiation of MSCs, and upregulated expressions of chondrogenesis-related marker molecules, including Collagen II and Aggrecan. Alcian blue staining further revealed that the differentiation of rat MSCs was promoted after transfection of miR-26b siRNA. According to further studies, the Wnt/ß-catenin signaling pathway was significantly activated during the differentiation of MSCs, and its expression was negatively regulated by miR-26b. The results of the Luciferase reporter gene assay showed that miR-26b could directly inhibit the 3'untranslated region (3'UTR) of Wnt in a targeted manner. CONCLUSIONS: MiR-26b plays an inhibitory role in the in vitro cartilage differentiation of rat MSCs by inhibiting Wnt expression.

Body shape trajectories and incidence of depression in the "Seguimiento Universidad de Navarra" (SUN) prospective cohort.

BACKGROUNDS AND AIM: The association between trajectories of body-shape from early childhood to early adulthood (first 40 years of life) and subsequent depression risk has not been explored before. We assessed this association in a prospective cohort of university graduates. METHODS: We used a group-based modeling approach to assess the body shape trajectories from age 5 to 40 years, among 3888 women and 4124 men of the "Seguimiento Universidad de Navarra" (SUN) cohort study. All participants were free of depression at the beginning of the follow-up, and the occurrence of a new medical diagnosis of depression was evaluated every two years. RESULTS: Four distinct trajectories for women and men were found ("lean-moderate increase", "medium-stable", "heavy-medium" and "heavy-marked increase" for women and "lean-marked increase", "medium-marked increase", "medium-stable" and "heavy-stable" for men). Among 78,475 person-years of follow-up a total of 351 incident cases of depression were identified. Among women, compared to those who maintained a medium body shape during life span ("medium-stable" trajectory), women who were heavy at childhood and had a marked increase in their body shape during early adult life ("heavy-marked increase" trajectory) showed significantly higher risk of a new-onset depression [HR = 1.92 (1.18-3.13)]. No association was observed in men between body-shape trajectories and subsequent risk of depression. CONCLUSIONS: Our results suggest that in a Mediterranean cohort, women who were heavy at early childhood and showed marked increases in body shape during early adulthood were at higher risk of developing depression later in life.

Body shape trajectories and the incidence of hypertension in a Mediterranean cohort: The sun study.

AIMS: Our aim was to assess the association between trajectories of body-shape across the first 40 years of life and subsequent development of hypertension in a Mediterranean cohort. METHODS AND RESULTS: We used a group-based modeling approach to assess body shape trajectories from age 5 to 40 years, among 7514 participants included in the SUN study (1999-2016), and assessed the subsequent incidence of hypertension. To create the trajectories, we used a censored normal model as a polynomial function of age. Cox models were used to estimates hazard ratios (HR) for hypertension according to body shape trajectories. Identified trajectories were "childhood lean -mid-life increase", "childhood medium-mid-life stable", " childhood heavy -mid-life decrease", and "childhood heavy -mid-life increase" for women; and "childhood lean-mid-life increase", "childhood medium-mid-life stable", "childhood medium -mid-life increase" and "childhood heavy-mid-life stable" for men. After a follow-up of 63,068 person-years, 865 incident cases of hypertension were found. Among women, compared to those in the "childhood medium-mid-life stable" trajectory, those, in the "childhood heavy -mid-life increase" trajectory showed higher risk to develop hypertension [HR = 1.72 (1.17-2.53)]. In men, compared with those in the "childhood medium-mid-life stable" trajectory, those in the "childhood lean and childhood medium -mid-life increase" and the "childhood heavy- mid-life stable" trajectories showed higher subsequent incidence of hypertension [HR = 1.43 (1.11-1.85), HR = 1.52 (1.17-1.97) and HR = 1.56 (1.14-2.14), respectively] after adjusting for potential confounders (including age, lifestyles, dietary intake, personality traits, physical activity and sedentary behaviors). CONCLUSIONS: Our results suggest that mid-life increases in body shape or maintaining a heavy body shape during early and middle life in men and childhood heavy-mid-life increase in women is associated with a higher subsequent risk of developing hypertension in this Mediterranean population.

[Progress of interruption of schistosomiasis transmission in Jiangsu Province].

Schistosomiasis was once heavily endemic in Jiangsu Province. Following the control efforts for several decades, schistosomiasis was almost eradicated in all endemic counties in Jiangsu Province in 1980, and transmission control was achieved in the province in 2011. According to the principle of "implementing the control measures with adaptation to local circumstances and guiding the control programs with classified interventions", an integrated strategy with emphasis on the management of both infectious sources and snails has been recently employed for schitsosomiasis control in Jiangsu Province. In addition, a sensitive and highly effective surveillance system has been built and the application of novel techniques and information construction has been intensified to effectively interrupt the transmission of schistosomiasis in the Province. Transmission interruption of schistosomiasis was achieved in all endemic counties in Jiangsu Province. The paper summarizes the endemic situation of schistosomiasis, progress of schistosomiasis control, and major schistosomiasis control measures implemented during the stage of transmission interruption in Jiangsu Province.

[Establishment and operation of schistosomiasis diagnostic reference laboratory in Jiangsu Province].

OBJECTIVE: To construct the schistosomiasis diagnostic reference laboratory in Jiangsu Province, and to examine the role and diagnostic efficiency of the reference laboratory. METHODS: A schistosomiasis diagnostic reference laboratory was built in Jiangsu Province according to the requirements of the construction of the national schistosomiasis diagnostic reference laboratory in China. Inter-laboratory comparisons were conducted and the diagnostic capability of grassroots laboratories was evaluated in Jiangsu Province. RESULTS: The organization structure, environmental conditions, administration and quality systems of the schistosomiasis diagnostic reference laboratory in Jiangsu Province all met the requirements for construction of the national schistosomiasis diagnostic reference laboratory in China, and the schistosomiasis diagnostic reference laboratory in Jiangsu Province was issued a certificate of a province-level schistosomiasis diagnostic reference laboratory. During the 6 inter-laboratory comparisons performed by national schistosomiasis diagnostic reference centers of China, the qualitative and quantitative results of each detection item were all in agreement with the reference samples (Kappa = 1), and the diagnostic capability was identified excellent. The results of indirect hemagglutination assay of 426 serum samples from 4 grassroots laboratories were re-examined, and the mean coincidence rate was 94.13% (range, 92.08% to 96.25%) with the grassroots laboratories, with a mean Kappa value of 0.85 (range, 0.83 to 0.86) and a mean missing rate of 10.19% (range, 0 to 17.65%). CONCLUSIONS: The schistosomiasis diagnostic reference laboratory has been successfully established and effectively operated in Jiangsu Province, which plays an active role in improving the capability of schistosomiasis diagnostic equality in the province.

[Association between genetic variants in microRNA biosynthesis genes and the risk of head and neck squamous cell carcinoma].

OBJECTIVE: To investigate the association between genetic variants in microRNA biosynthesis genes and the risk of head and neck squamous cell carcinoma (HNSCC). METHODS: A case-control study was conducted with 576 HNSCC patients and 1 552 healthy controls matched by factors as age-(±5 years) and sex. Eight potentially functional single nucleotide polymorphism loci in microRNA biosynthesis genes (DICER1, GEMIN3, and PIWIL1) were genotyped using the Illumina Infinium BeadChip platform. Univariate and multivariate logistic regression models were performed to assess the association between genotypes and HNSCC risk. RESULTS: The allele frequencies of rs1106042 (G> A) in PIWIL1 were significantly different between the cases and controls (P=0.011). After controlling for factors as age, sex, smoking and alcohol intake, the A allele of rs1106042 showed a decreased risk of HNSCC (additive model: adjusted OR=0.73, 95% CI: 0.57-0.93, P=0.011). RESULTS from the stratification analysis by age, sex, smoking, alcohol intake and tumor sites showed that the effect of rs1106042 A allele on HNSCC risk was significant in older age groups (≥60), females, nonsmokers, non-alcohol drinkers, and subjects with oral cavity cancer (P<0.05). CONCLUSION: Potentially, functional single nucleotide polymorphism in PIWIL1 might modify the risk of HNSCC in China.

Prognostic value of the stem cell markers CD133 and ABCG2 expression in esophageal squamous cell carcinoma.

In the light of increasing evidence supporting cancer stem cells (CSCs) theory, the expression of two stem cell markers, CD133 and adenosine triphosphate-binding cassette superfamily G member 2 (ABCG2), in esophageal squamous cell carcinoma (ESCC) was investigated, and their prognostic values were evaluated. Paraffin-embedded tissue sections of 110 ESCC patients were investigated using Immunohistochemistry. The association of CD133 and ABCG2 expression with clinicopathologic characteristics was analyzed by χ(2) test. Survival analysis was carried out using Kaplan-Meier method and Cox proportional hazards model. CD133 and ABCG2 expression were detected in 27.3% and 15.5% of ESCC patients, respectively. The presence of CD133-positive cancer cells was associated with tumor cell differentiation (P= 0.008) but not significantly related to the survival of ESCC patients (P= 0.085). ABCG2 expression was not associated with clinicopathologic characteristics but was a significant prognostic factor for adverse overall survival of ESCC patients (P= 0.005). The median overall survival time for ESCC patients with and without ABCG2 expression were 21.8 and >49.3 months, respectively. A combined analysis of CD133 and ABCG2 expression did not show that ESCC patients with coexpression of these two markers had a worse prognosis than those with only ABCG2 expression (P= 0.934). Moreover, ABCG2 expression was revealed to be an independent prognostic factor along with tumor node metastasis stage in multivariate analysis (hazard ratio of ABCG2, 3.38; 95% confidence interval, 1.61∼7.09; P= 0.001). By survival analysis based on tumor node metastasis stage of ESCC, the association between ABCG2 expression and the patients' prognosis was found significant in the group of relatively early stage (P= 0.005) and marginally significant in the group of relatively late stage (P= 0.058). This is the first time to report the presence of CD133-positive cancer cells in ESCC but not supporting its prognostic value and validity as a CSC marker for ESCC. ABCG2 expression was found to correlate with the survival of ESCC patients, especially those at relatively early stage, suggesting that ABCG2-positive cancer cells may represent a pool of CSCs in ESCC, and relatively early-stage patients with ABCG2 expression may deserve more intensive or targeted therapy.

Progressive brain damage and alterations in dendritic arborization after collagenase-induced intracerebral hemorrhage in rats.

Intracerebral hemorrhage (ICH) was widely believed to be a monophasic event whereby cell death occurs from the initial space-occupying effects of the hematoma. However, we now know that secondary degenerative events contribute to delayed cell death, functional impairment and clinical deterioration. In three experiments, we further characterized the long-term maturation of injury in the collagenase model of striatal ICH in rat. First, we quantified the volume of tissue lost from 7 to 60 days showing that tissue loss more than doubled over this time. As the volume of tissue lost does not distinguish gray from white matter damage, gold chloride staining was used in a second experiment in ICH rats that survived 7 or 60 days. The mid-sagittal area of the corpus callosum significantly declined (22%) over this period, whereas the hippocampal and anterior commissures were not affected. A third experiment used the Golgi-Cox stain to examine dendritic arborization of peri-hematoma and contralateral medium spiny neurons of the striatum. We found an early and sustained increase in dendritic arborization in the non-lesioned hemisphere, whereas there was initial atrophy of peri-hematoma striatal neurons that eventually recovered to normal. These findings show that tissue loss, including white matter atrophy, continues over extended periods after ICH making it a potential target for cytoprotective agents. Finally, the dendritic alterations in both ipsi- and contralateral striatal neurons likely influence spontaneous recovery and are potential targets to further improve it.

Gauging recovery after hemorrhagic stroke in rats: implications for cytoprotection studies.

Successful clinical translation of prospective cytoprotectants will likely occur only with treatments that improve functional recovery in preclinical (rodent) studies. Despite this assumption, many rely solely on histopathologic end points or the use of one or two simple behavioral tests. Presently, we used a battery of tests to gauge recovery after a unilateral intracerebral hemorrhagic stroke (ICH) targeting the striatum. In total, 60 rats (N=15 per group) were stereotaxically infused with 0 (SHAM), 0.06 (MILD lesion), 0.12 (MODERATE lesion), or 0.18 U (SEVERE lesion) of bacterial collagenase. This created a range of injury akin to moderate (from SEVERE to MODERATE or MODERATE to MILD lesion size approximately 30% reduction) and substantial cytoprotection (SEVERE to MILD lesion size--51% reduction). Post-ICH functional testing occurred over 30 days. Tests included the horizontal ladder and elevated beam tests, swimming, limb-use asymmetry (cylinder) test, a Neurologic Deficit Scale, an adhesive tape removal test of sensory neglect, and the staircase and single pellet tests of skilled reaching. Most tests detected significant impairments (versus SHAM), but only a few (e.g., staircase) frequently distinguished among ICH groups and none consistently differentiated among all ICH groups. However, by using a battery of tests we could behaviorally distinguish groups. Thus, preclinical testing would benefit from using a battery of behavioral tests as anything less may miss treatment effects. Such testing must be based on factors including the type of lesion, the postoperative delay and the time required to complete testing.

Repair of full thickness rotator cuff tears. Gender, age, and other factors affecting outcome.

Seventy-two full thickness rotator cuff tears (72 patients) were treated with an open rotator cuff repair between 1986 and 1993. The average postoperative followup was 54 months (range, 24-102 months; standard deviation, 22 months). Fifty-three (74%) patients had no pain, 16 (22%) patients had slight pain without restriction of activities, and three (4%) patients had moderate pain with activity compromise. Women with an associated biceps tendon rupture tended to have worse results. Women had a negative, statistically significant relationship between age and shoulder scoring scales, but age at the time of surgery was not related to any outcome variables for men. A rotator cuff tear greater than or equal to 5 cm2 as determined at the time of surgery was associated with a poorer outcome. The average University of California at Los Angeles score was 32 points (range, 7-35 points; standard deviation, 5 points). The average Constant-Murley score was 78 of 100 points (range, 12-95 points; standard deviation, 15 points). A yes response was given for an average of 10 of 12 questions on the Simple Shoulder Test (range, 0-12 questions; standard deviation, 3 questions). More than 4 years after open rotator cuff repair, patients had a 94% patient satisfaction rate with lasting relief of pain and improved function.

Characterization of petroleum-degrading bacteria from oil-contaminated sites in Vietnam.

Four petroleum-degrading bacterial strains, 2TN-NB, 6TBX-CL, MVK2-5, and XCK, were isolated from various oil-contaminated sites in Vietnam. Determination of the nucleotide sequence of the gene encoding 16S rRNA allowed 2TN-NB to be identified as Acinetobacter sp. and the other three stains as Pseudomonas sp. Among the four isolates, 2TN-NB was most effective in degrading crude oil: in 1 d, it degraded 95% of the crude oil in the culture medium (5%, v/v). The isolated strains could also degrade a sulfur-containing aromatic hydrocarbon, dibenzothiophene (DBT), with low efficiency. Except for MVK2-5, which degraded crude oil least efficiently, the isolates produced biosurfactants in amounts sufficient for structural analysis. FT-IR measurement suggested that strains 6TBX-CL and XCK produced glycolipid-type biosurfactants while that produced by 2TN-NB was of the polysaccharide type.

MRI and morphology of the insertion of the patellar tendon after graft harvesting.

We performed MRI on 16 patients who had had reconstruction of the anterior cruciate ligament (ACL) with a mid-third bone-patellar-tendon-bone autograft. Our aim was to assess the tendon and the site of its insertion at an average of seven years after the original operation. In four of these patients biopsies were taken from the donor site when they had revision of their original operation. MRI showed reconstitution of the tendon into the patellar defect with no evidence of bone formation. Six patients had a persistent defect in the patellar tendon itself. Histological examination of the biopsies of the donor site showed an indirect pattern of insertion with absence of the normal fibrocartilage zone. These morphological changes may adversely affect the biomechanical properties of the healed donor site and we suggest that another graft taken from this site may not be suitable for use in a further operation for reconstruction of the ACL.

Repair of chronic distal biceps brachii tendon rupture using free autogenous semitendinosus tendon.

Distal biceps brachii tendon ruptures occur much less frequently than do their proximal counterparts. Distal tendon ruptures usually are associated with considerable function deficits and may require surgical treatment. Repair of chronic distal biceps brachii ruptures are extremely unusual. A free autogenous semitendinosus tendon graft was used to reconstruct the distal biceps tendon by reattaching the graft to the radial tuberosity via a 2-incision technique in a patient with symptoms and a chronic injury.

Noise levels of orthopedic instruments and their potential health risks.

Exposure to intense levels of noise has been identified as a potential workplace risk for the development of hearing impairment for health care workers. With this knowledge a noise level survey was performed on selected orthopedic equipment. Several instruments produced threshold levels of 95 dBA to 106 dBA. Often these levels remained as high as 90 dBA at 4 ft from the source. Based on the results of this survey, audiometric tests were conducted on five cast technicians to determine the prevalence of noise-induced hearing loss (NIHL). Audiometric measurements of the cast technicians indicated that, in the absence of other risk factors for hearing loss, there was an association between the presence of NIHL and the years of exposure. NIHL was most evident on the side of the dominant hand used for holding the cast cutter. These findings suggest there may be a risk of NIHL from the occupational exposure to various orthopedic instruments. Further, this level of risk may warrant the use of an individual hearing protection device or the development of quieter instruments.

Distal biceps rupture in a snowboarder.

As in this case study of a snowboarder, the typical history for distal biceps brachii rupture involves a single traumatic event, an audible popping sound, and intense pain. The physical exam will reveal ecchymosis in the antecubital area and weakness with both supination and elbow flexion; the distal biceps brachii tendon will not be palpable. Though distal biceps rupture is far less common than its proximal counterpart, primary care physicians should be aware of the diagnostic criteria. Referral for surgical treatment is necessary to preserve elbow flexion and supination strength.