Influencing factors on the psychosomatic health of medical staff since the normalized stage of COVID-19 in mainland China.

BACKGROUND: During the coronavirus disease 2019 (COVID-19) pandemic, there were under-recognized and unaddressed psychosomatic health problems among medical staff. The purpose of this study was to investigate their psychosomatic status. METHODS: An online questionnaire was performed to the medical staff of major hospitals in Jinan in January 2023. In total, 1244 valid questionnaires were collected, and their psychosomatic status was assessed by the Psychosomatic Symptom Scale (PSSS) and Perceived Stress Scale-10 (PSS-10). Finally, we analyzed the influencing factors for their psychosomatic status. RESULTS: The psychological health of the medical staff was poor, and the level of stress perception was intense, accompanied by obvious psychosomatic symptoms. Regression analysis indicated that age, gender, frontline involvement, work experience, marriage, presence of disease history and COVID-19 infection history were risk factors for psychosomatic symptoms, while education, frontline involvement and presence of disease history were risk factors for stress feeling. CONCLUSION: Medical staff often showed obvious psychosomatic symptoms and intense stress. Psychological health education and intervention should be given in order to improve their working quality.

Nano­selenium alleviates the pyroptosis of cardiovascular endothelial cells in chicken induced by decabromodiphenyl ether through ERS-TXNIP-NLRP3 pathway.

Decabromodiphenyl ether (BDE-209) is one of the most widely used flame retardants that can infect domestic and wildlife through contaminated feed. Nano­selenium (Nano-Se) has the advantage of enhancing the anti-oxidation of cells. Nonetheless, it remains uncertain whether Nano-Se can alleviate vascular Endothelial cells damage caused by BDE-209 exposure in chickens. Therefore, we established a model with 60 1-day-old chickens, and administered BDE-209 intragastric at a ratio of 400 mg/kg bw/d, and mixed Nano-Se intervention at a ratio of 1 mg/kg in the feed. The results showed that BDE-209 could induce histopathological and ultrastructural changes. Additionally, exposure to BDE-209 led to cardiovascular endoplasmic reticulum stress (ERS), oxidative stress and thioredoxin-interacting protein (TXNIP)-pyrin domain-containing protein 3 (NLRP3) pathway activation, ultimately resulting in pyroptosis. Using the ERS inhibitor 4-PBA in Chicken arterial endothelial cells (PAECs) can significantly reverse these changes. The addition of Nano-Se can enhance the body's antioxidant capacity, inhibit the activation of NLRP3 inflammasome, and reduce cellular pyroptosis. These results suggest that Nano-Se can alleviate the pyroptosis of cardiovascular endothelial cells induced by BDE-209 through ERS-TXNIP-NLRP3 pathway. This study provides new insights into the toxicity of BDE-209 in the cardiovascular system and the therapeutic effects of Nano-Se.

Astilbin antagonizes developmental cardiotoxicity after cadmium exposure in chicken embryos by inhibiting endoplasmic reticulum stress and maintaining calcium homeostasis.

Cadmium (Cd) is a dangerous heavy metal with high toxicity that is known to impair development. Astilbin (ASB) is a protective flavonoid compound. We aimed to explore whether ASB can antagonize the myocardial developmental toxicity of Cd exposure. Cd (2 µg) and/or ASB (0.002 µg) were injected into embryonized eggs that were 1 day old. Histological examinations revealed Cd-induced ventricular dilation, reduced wall thickness, and disrupted myocardial fiber connections, while co-administration of ASB mitigated these effects. Electron microscopy confirmed ASB's ability to counteract Cd-induced myocardial cell myofibril damage. Real-time quantitative PCR (QRT-PCR) and western blot (WB) molecular investigations revealed that Cd increased endoplasmic reticulum stress in myocardial tissue and primary cardiomyocytes, as shown by raised expression of stress-related genes (GRP78, XBP1, GRP94, ATF4, ATF6, IRE1, and CHOP). Moreover, Cd disrupted calcium homeostasis, affecting important genes linked to Ca2+ channels and causing an excess of Ca2+ in the cytoplasm. In addition, we detected genes related to development and differentiation-related genes in myocardial tissue and primary cardiomyocytes. The results showed that the downregulation of transcription factors in the IrxA cluster, Mefs, and Tbxs families after Cd exposure indicated that cardiac transcription was hindered and cardiac markers (TnnT2, TnnC1, Gata4, Gata6, and Nkx2-5) were abnormally expressed. ASB successfully mitigated these disturbances. During the cell cycle, primary cardiomyocytes undergo growth arrest in flow cytometry. These results suggest that the maturation and differentiation of cardiomyocytes are inhibited after Cd exposure, and ASB has an antagonistic effect on Cd. The present study indicated that Cd could trigger developmental cardiotoxicity in chicken embryos and primary cardiomyocytes by endoplasmic reticulum stress and Ca2+ overload, respectively, while ASB has an antagonistic effect.

Angiotensin-Converting Enzyme Insertion/Deletion Polymorphism and the Risk of Leukoaraiosis in a South Chinese Han Population: A Case-Control Study.

Leukoaraiosis (LA) appears as white matter hyperintensities on T2-weighted brain magnetic resonance imaging scans. Age and hypertension are considered the primary risk factors for LA, but its pathogenesis remains uncertain. This study aims to investigate the correlation between the angiotensin-converting enzyme (ACE) insertion/deletion (I/D) polymorphism and LA. A total of 140 patients with LA and 136 neuroimaging alteration-free controls were recruited in a case-control study. ACE I/D polymorphism was determined using the polymerase chain reaction method. The allele and genotype distributions of the ACE I/D polymorphism were significantly different between subjects with and without LA. Significant difference was observed in the genotypic distribution between LA patients and controls for recessive and additive models. A statistically significant association remained apparent after adjusting for potential risk factors (D/D vs. I/D + I/I: adjusted OR 3.251, 95% CI 1.185-8.918; D/D vs. I/I: adjusted OR 3.277, 95% CI 1.187-9.047). Our results indicate that the D/D genotype and D allele are important risk factors for LA. Future studies with larger populations are needed to validate our results.

Selenium deficiency causes apoptosis through endoplasmic reticulum stress in swine small intestine.

Selenium (Se) plays a crucial role in intestinal health. However, the specific mechanism by which deficiency of Se causes intestinal damage remains unclear. This study was to explore whether Se deficiency can cause ER stress and induce apoptosis in swine small intestine. We established the Se deficiency swine model in vivo and the intestinal epithelial (IPEC-J2) cell Se deficiency model in vitro. The results of morphological observation showed that Se deficiency caused structural damage in intestinal villi and the decrease of goblet cell structure. The apoptotic characteristics such as nucleolar condensation, mitochondrial swelling, and apoptotic bodies were observed in the IPEC-J2 cells. The results of acridine orange/ethidium bromide and mitochondrial membrane potential fluorescence staining in vitro showed that there were more apoptotic cells in the Se-deficiency group than that in the control group. The protein and/or mRNA expression levels of Bax, Bcl-2, caspase 3, caspase 8, caspase 9, cytc, PERK, ATF6, IRE, XBP1, CHOP, GRP78, which are related to ER stress-apoptosis pathway, were significantly increased in the Se-deficient group which compared with the control group in vivo and in vitro were consistent. These results indicated that Se deficiency induced ER stress and increased the apoptosis in swine small intestine and IPEC-J2 cells and then caused the damage in swine small intestinal tissue. Besides, the results of gene expressions in our experiment proved that ER stress induced by Se deficiency promoted apoptosis. These results filled the blank in the mechanism of Se deficiency-induced intestinal injury in swine.

Associations between SNP83 of phosphodiesterase 4D gene and carotid atherosclerosis in a southern Chinese Han population: a case-control study.

Atherosclerosis was an important pathophysiological basis of atherothrombotic stroke, and phosphodiesterase 4D (PDE4D) polymorphism (SNP83/rs966221) was reported to be associated with the susceptibility to atherothrombotic stroke. Aim of the present study was to explore the potential association between SNP83 and carotid atherosclerosis (CAS). 204 southern Chinese Han participants were divided into two groups according to the carotid intima-media thickness (IMT) of the carotid artery: CAS group (carotid IMT ≥ 1.0 mm) and non-CAS group (carotid IMT < 1.0 mm). Carotid IMT was measured by color Doppler ultrasound. The PDE4D SNP83 polymorphism was determined by SNaPshot technique. Our study found that SNP83 was associated significantly with CAS susceptibility under the dominant, overdominant and codominant models. After adjusting for age, gender, low-density lipoprotein cholesterol, Hemoglobin A1c, cigarette smoking, hypertension history, and diabetes mellitus history, the association still remained significant (dominant model: crude OR = 2.373, 95% CI: 1.268-4.442, P = 0.007; adjusted OR = 3.129, 95% CI: 1.104-8.866, P = 0.032; overdominant model: crude OR = 1.968, 95% CI: 1.043-3.714, P = 0.037; adjusted OR = 2.854, 95% CI: 1.005-8.108, P = 0.049; codominant: crude OR = 2.102, 95% CI: 1.110-3.979, P = 0.023; adjusted OR = 2.984, 95% CI: 1.047-8.502, P = 0.041). Carotid IMT of carriers with CT + CC genotypes was higher than carriers with TT genotype (P = 0.016). Our results indicated that the SNP83/rs966221 located on PDE4D gene was significantly associated between CAS susceptibility and carotid IMT independently of conventional risk factors in a southern Chinese Han population.

NLRP3 inflammasome mediated pyroptosis is involved in cadmium exposure-induced neuroinflammation through the IL-1ß/IkB-α-NF-κB-NLRP3 feedback loop in swine.

Cadmium (Cd) chloride, as widely distributed toxic environmental pollutants by using in industry, severely imperils animal and human health. Pyroptosis is a Cas1-dependent pro-inflammatory programmed cell death and involves in various types of diseases. Nevertheless, the mechanism of pyroptosis and Cd-induced neurotoxicity remains obscure. To investigate the specific molecular mechanisms of Cd-induced neurotoxicity, 10 weaned piglets were randomly divided into 2 groups treated with 0 and 20 mg/kg CdCl2 in the diet for 40 days. The levels of pyroptosis, mitochondrial and inflammation-related genes were validated by qRT-PCR and WB in vivo. Our results revealed that Cd caused cerebral histopathology lesions, inducing cerebral pyroptosis and the mass generation of inflammatory cytokines, as indicated by the increased NLRP3 inflammasome activation (NLRP3, Cas1 and ASC) and the upregulation of inflammation factors IL-2, IL-6, IL-7 and inhibition of IL-10. Subsequently, further research indicated that Cd triggered pyroptosis via activating the TRAF6-IkB-α-NF-κB pathway, which interfered with the phosphorylation and ubiquitination of IkB-α. Furthermore, Cd caused mitochondrial dysfunction and fragmentation by inhibiting the AMPK-PGC-1α-NRF1/2 signaling pathway and reduced the expression of mitochondrial-related regulatory factors OPA1, TFAM and mtDNA, resulting in the increase of NLRP3 inflammasome. Besides, we found eight hub genes (IKK, IKB-α, NLRP3, TRAF6, NF-κB, AMPK, TNFα and PGC-1α), mainly related to the interaction between the NF-κB pathway and NLRP3 inflammasome. Overall, these results demonstrated that Cd could promote the IL-1ß/IkB-α-NF-κB-NLRP3 inflammasome activation positive feedback loop to result in neuroinflammation in swine, which provided new insights in understanding Cd-induced toxicity.

[Spectral Distribution and Pollution Characteristics of Polybrominated Diphenyl Ethers in the Air of an Office Building Clustered Area].

To evaluate the pollution level, congener distribution, and human exposure of polybrominated diphenyl ethers (PBDEs) in the atmosphere of Beijing's office buildings, outdoor air samples (particles+gas) were collected from a typical scientific area and PBDEs concentrations were quantified using GC-MS. The results showed that the mass concentrations of PBDEs in the gas phase, PM2.5, and PM10 were 2.3-78.6 pg·m-3, 14.4-335.3 pg·m-3, and 11.6-431.7 pg·m-3, respectively, and the annual average mass concentrations were 21.7 pg·m-3, 96.9 pg·m-3, and 149.3 pg·m-3, respectively. BDE-209 was the predominant congener in particulates, accounting for 50% of the total concentration. The mass concentration of PBDEs in the particles decreased in the following order:autumn > winter > summer > spring, with an obvious change in winter and stability in summer. Tri-BDEs mainly existed in the gas phase, and the proportion of PBDEs in the particle phase increased with bromine number. Source analysis indicated that BDE-209 degradation was an important source of other PBDEs in the air. Exposure risk analysis showed that the respiratory intake of children and adults was 18.6 pg·(kg·d)-1 and 7.1 pg·(kg·d)-1, respectively, which is far below the recommended lowest observed adverse effect level of 1 mg·(kg·d)-1. Similarly, the carcinogenic risk values of BDE-209 for children and adults were 2.3×10-9 and 3.7×10-9, respectively, which were much smaller than the carcinogenic risk limit of 10-6, indicating that there was no health hazard from PBDEs in the atmosphere.

Pharmaceutical and Personal Care Products in Surface Waters from the Inner City of Beijing, China: Influence of Hospitals and Reclaimed Water Irrigation.

Surface waters from five districts in the inner city of Beijing were collected for analysis of 43 target compounds of pharmaceuticals and personal care products (PPCPs) to understand the spatial distribution patterns of different groups of PPCPs in the central urban area of a metropolitan city characterized by many hospitals and public parks. The total concentrations of PPCPs showed large spatial variability, ranging from 71.1 to 2400 ng/L. The x-ray contrast medium iopromide was the compound with the highest concentrations. Pharmaceuticals showed similar spatial distributional patterns with large hospitals. Positive correlations between iopromide and pharmaceuticals were observed. In contrast, in general there is no correlation between iopromide and personal care products. The concentrations of PPCPs in the landscape waters were not high but were characterized by high proportions of acidic, nonsteroidal anti-inflammatory drugs with low or even negative removal efficiencies in the WWTP in Beijing, suggesting that the reclaimed water irrigation can be another source of PPCPs in surface waters in the inner city of Beijing.

Nobiletin reduces LPL-mediated lipid accumulation and pro-inflammatory cytokine secretion through upregulation of miR-590 expression.

Nobiletin has protective effects on cardiovascular diseases, but the mechanism is not clear. In this study, we examined whether nobiletin affects the expression of miR-590/LPL and its relative effects on lipid accumulation and pro-inflammatory cytokine secretion in human THP-1 macrophages. RT-qPCR analysis showed that nobiletin increased the expression of miR-590. Western blot analysis showed that nobiletin-suppressed LPL expression was enhanced by miR-590 mimic and abrogated by miR-590 inhibitor. Oil Red O staining and high-performance liquid chromatography assays showed that nobiletin attenuated lipid accumulation in macrophages. Treatment with nobiletin and miR-590 mimic decreased cellular lipid accumulation, whereas treatment with miR-590 inhibitor increased cellular lipid accumulation. ELISA illustrated that nobiletin alleviated pro-inflammatory cytokine secretion in macrophages as measured by, which was reduced by miR-590 mimic and increased by miR-590 inhibitor. In conclusion, nobiletin may alleviate lipid accumulation and secretion of pro-inflammatory cytokines by enhancing the inhibitory effect of miR-590 on LPL expression, suggesting a promising strategy for potential drug development for atherosclerosis.

Exploration of dominant diseases and clinical application characteristics of wrist-ankle acupuncture therapy based on data mining technology / 中国针灸

OBJECTIVE@#To analyze the literature regarding wrist-ankle acupuncture therapy by data mining technology, and the dominant diseases of wrist-ankle acupuncture therapy were summarized to provide reference for evaluation of specificity effect of wrist-ankle acupuncture therapy.@*METHODS@#The journal articles regarding wrist-ankle acupuncture therapy from the CNKI, WANFANG, and VIP since January 1, 1975 to December 31, 2017, and the medical cases regarding wrist-ankle acupuncture therapy in - and were retrieved. Based on the disease types of wrist-ankle acupuncture therapy in the journal articles and medical cases, the association rules method of data mining technology was applied to calculate frequent itemsets. The self-developed database platform for wrist-ankle acupuncture therapy was used to extract and summarize the information to explore the rules of clinical application.@*RESULTS@#The scope of disease involved a total of 7 disease entities in the literature regarding wrist-ankle acupuncture therapy. In the journal articles, there were 83 disease types and the most common surgical diseases were soft tissue injury and periarthritis of shoulder, the frequency were 34 and 24 times respectively. The total effective rates of wrist-ankle acupuncture therapy were 92.74% in internal medicine, 91.39% in surgery, 91.51% in gynecology, 90.88% in dermatology, 96.20% in pediatric, 89.05% in ophthalmology and otorhinolaryngology and 88.78% in psychiatry. In the medical cases of wrist-ankle acupuncture therapy, there were 118 disease types and the most common diseases were pain and syndrome, herpes zoster was also a common disease. Psychiatric diseases used more wrist-ankle acupuncture therapy, and the common diseases were anxiety and mania.@*CONCLUSION@#Wrist-ankle acupuncture therapy is widely used in treatment of clinical diseases and has significant therapeutic effects. It is mostly used in the treatment of surgery, internal medicine (neurology particularly), dermatology (herpes zoster particularly). Besides, the wrist-ankle acupuncture therapy is also applicable in the treatment of diseases of ophthalmology and otorhinolaryngology, gynecology, pediatric and psychiatry.

Structurally Diverse Highly Oxygenated Triterpenoids from the Roots of Ailanthus altissima and Their Cytotoxicity.

Ten new triterpenoids, ailanaltiolides A-J (1-10), and three known analogues (11-13) were isolated from the roots of Ailanthus altissima. Compounds 1-7 are apotirucallane-type, compounds 8 and 9 are tirucallane-type, and compound 10 is a trinordammarane-type triterpenoid. This is the first study indicating the genus Ailanthus as a potential source for apotirucallane derivatives, which contain an α,ß-unsaturated-ε-lactone A-ring and diversely modified C-17 side chains. Spectroscopic data interpretation, electronic circular dichroism analysis, and X-ray crystallographic data defined the structures and absolute configurations of these triterpenoids. Compounds 2, 7, and 8 showed cytotoxicity against four tumor cell lines (HeLa, 786-O, HepG2, and A549). In particular, compound 2 exhibited the highest activity against 786-O cells with an IC50 value of 8.2 µM in vitro.

High serum uric acid levels are a protective factor against unfavourable neurological functional outcome in patients with ischaemic stroke.

Objective We aimed to evaluate the association between serum uric acid levels at the onset and prognostic outcome in patients with acute ischaemic stroke. Methods We retrospectively analysed the outcomes of 1166 patients with ischaemic stroke who were hospitalized in our centre during August 2008 to November 2012. Correlations of serum uric acid levels and prognostic outcomes were analysed. Results Men had higher serum uric acid levels and better neurological functional outcomes compared with women. There was a strong negative correlation between serum uric acid levels and unfavourable neurological functional outcomes. Generalized estimated equation analysis showed that a higher serum uric acid level (>237 µmol/L) was a protective factor for neurological functional outcome in male, but not female, patients. Among five trial of ORG 10172 in acute stroke treatment classification subtypes, only patients with the large-artery atherosclerosis subtype had a significant protective effect of serum uric acid levels on neurological outcome. Conclusions Our study shows that high serum uric acid levels are a significant protective factor in men and in the large-artery atherosclerosis subtype in patients with ischaemic stroke. This is helpful for determining the prognostic value of serum uric acid levels for neurological outcome of acute ischaemic stroke.

The Extent of the Impact of a Fluorochemical Industrial Park in Eastern China on Adjacent Rural Areas.

High levels of perfluoroalkyl substances (PFASs) were observed in rural areas near a fluorochemical industrial park (FCIP) in the Yangtze River Delta region. The concentrations of total PFAS (∑PFASs) in soil, surface water, groundwater, and rainwater were in the range of 0.6-64.6 ng/g dry weight, 15.6-480.9, 4.8-614.6, and 13.4-542.2 ng/L, respectively. PFASs in rainwater and groundwater were higher than in surface water. The influence of the FCIP on rural soils extended to a distance of approximately 4 km based on the changes in PFAS compositions. The impact on surface water is mainly through direct river flow connected with contaminated sources, which may extend farther than 7 km in the case of unrestricted flow but much shorter distance for unconnected rivers. The penetration of PFASs in groundwater aquifers can extend as far as ca. 6 km, while direct water flow is the main transport route for PFASs. The influence radius of the FCIP can be as far as 60 km due to atmospheric precipitation.

Perfluoroalkyl acids in surface waters and tapwater in the Qiantang River watershed-Influences from paper, textile, and leather industries.

Perfluoroalkyl acids (PFAAs) are widely used as multi-purpose surfactants or water/oil repellents. In order to understand the contamination level and compositional profiles of PFAAs in aqueous environment in textile, leather, and paper making industrial areas, surface waters and tap waters were collected along the watershed of the Qiantang River where China's largest textile, leather, and paper making industrial bases are located. For comparison, surface water and tapwater samples were also collected in Hangzhou and its adjacent areas. 17 PFAAs were analyzed by solid phase extraction-high performance liquid chromatography-tandem mass spectrometry. The results show that the total concentrations of PFAAs (ΣPFAAs) in the Qiantang River waters ranged from 106.1 to 322.9 ng/L, averaging 164.2 ng/L. The contamination levels have been found to be extremely high, comparable to the levels of the most serious PFAA contamination in surface waters of China. The PFAA composition profiles were characterized by the dominant PFOA (average 58.1% of the total PFAAs), and PFHxA (average 18.8%). The ΣPFAAs in tap water ranged from 9.5 to 174.8 ng/L, showing PFAA compositional pattern similar to the surface waters. Good correlations between PFAA composition profiles in tap waters and the surface waters were observed.

Up-Regulation of HMGB1 Exacerbates Renal Ischemia-Reperfusion Injury by Stimulating Inflammatory and Immune Responses through the TLR4 Signaling Pathway in Mice.

BACKGROUND/AIMS: The aim of this study was to elucidate how high-mobility group box 1 (HMGB1) exacerbates renal ischemic-reperfusion injury (IRI) by inflammatory and immune responses through the toll-like receptor 4 (TLR4) signaling pathway. METHODS: A total of 30 wild-type (WT) mice and 30 TLR4 knockout (TLR4-/-) mice were selected and then randomly assigned to the Sham, I/R or HMGB1 groups. The serum and kidney tissues of all mice were collected 24 h after the perfusion. The fully automatic biochemical detector and ELISA were applied to determine the blood urea nitrogen (BUN) and serum creatinine (Scr) levels, and TNF-α, IL-1ß, IL-6, IFN-γ and IL-10 levels, respectively. HE staining was used to evaluate kidney tissue damage, immunofluorescence and immunohistochemical staining were performed to observe CD68 and MPO cell infiltration, and flow cytometry was applied to detect immune cells. qRT-PCR and Western blotting were used to detect the expressions of TLR signaling pathway-related genes and proteins, respectively. RESULTS: Compared with the Sham group, the levels of BUN, Scr, TNF-α, IL-1ß, IL-6, IFN-γ and IL-10, kidney tissue damage score, CD68 and MPO cell infiltration, the numbers of immune cells, and the expressions of TLR signaling pathway-related genes and proteins in the I/R and HMGB1 groups were significantly up-regulated. In the I/R and HMGB1 groups, the levels of BUN and Scr, TNF-α, IL-1ß, IL-6 and IFN-γ, kidney tissue damage score, CD68 and MPO cell infiltration, immune cell numbers, and TLR signaling pathway-related gene and protein expressions in the WT mice were all higher than those in the TLR4-/- mice, but IL-10 level was significantly lower. Similarly, all aforementioned indexes but IL-10 level in the WT and TLR4-/- mice were higher in the HMGB1 group than in the I/R group. CONCLUSION: Our study indicated that the up-regulation of HMGB1 could exacerbate renal IRI by stimulating inflammatory and immune responses through the TLR4 signaling pathway.c.

Current Contamination Status of Perfluoroalkyl Substances in Tapwater from 17 Cities in the Eastern China and Their Correlations with Surface Waters.

The contamination status of perfluoroalkyl substances (PFASs) were investigated in 64 tapwater samples collected from 17 cities and 45 surface water samples from adjacent areas in the eastern China. The total PFAS concentrations in tapwater ranged from 1.4 to 175 ng/L; relatively higher PFAS levels were observed in samples collected from the Yangtze River Delta region, which was similar to the geographical distribution pattern of PFAS levels observed in rivers and lakes. The highest total PFASs in tapwater was found in Changshu, where several fluorine-related industries are located, whereas the lowest was observed in Beijing. Significant positive correlations between PFAS compositions in tap water sample and their source waters were noted. Several industries such as paper, textile, and leather industries may contribute to the contamination of PFASs in tapwater.

A simplified multivisceral transplantation procedure for patients with combined end-stage liver disease and type 2 diabetes mellitus.

In liver transplant patients with type 2 diabetes mellitus (DM), the disease worsens after transplantation because of longterm use of diabetogenic immunosuppressive drugs, making management of those patients a great challenge. The objective of our study was to evaluate the safety and efficacy of a simplified multivisceral transplantation (SMT) procedure for the treatment of patients with end-stage liver disease and concurrent type 2 DM. Forty-four patients who had pretransplant type 2 DM were included. A total of 23 patients received SMT, and 21 patients received orthotopic liver transplantation (OLT). Patient and graft survivals, complications, diabetic control, and quality of life (QOL) were retrospectively analyzed in both groups. The 1-, 3-, and 5-year cumulative patient and graft survival rates were 91.5%, 75.4%, and 75.4% in the SMT group and were 94.4%, 64.4%, and 64.4% in the OLT group, respectively (P = 0.70). Interestingly, 95.7% (22/23) of patients achieved complete remission from DM after SMT compared with 16.7% (3/18) of patients after OLT. The occurrence of biliary complication was significantly higher in the OLT group than that in the SMT group (23.8% versus 0.0%; P = 0.01). Moreover, better QOL was observed in the SMT group than that in the OLT group. In conclusion, the SMT procedure we described here is a safe and viable option for patients with end-stage live disease and concurrent type 2 DM. This SMT procedure offers excellent transplant outcomes and QOL. Liver Transplantation 23 1161-1170 2017 AASLD.

The association between the ring finger protein 213 (RNF213) polymorphisms and moyamoya disease susceptibility: a meta-analysis based on case-control studies.

A number of studies assessed the association of ring finger protein 213 (RNF213) gene polymorphisms with moyamoya disease (MMD), but the results were not entirely consistent. This meta-analysis was performed to explore the relationship between RNF213 polymorphisms and moyamoya disease in Asian population. A systematic search from the PubMed, MEDLINE, EMBASE, ISI web of science, CNKI, China CBM and WANFANG DATA databases was conducted to retrieve published studies until March 2015. Statistical analyses were performed using the STATA12.0 software. Fixed or random effects model, subgroup analysis, sensitivity analysis, and publication bias were used to improve the comprehensive analysis. Eight papers including 904 MMD patients and 2258 controls were recruited in the meta-analysis. rs112735431 was closely associated with the risk of MMD among Asian population in all genetic models (dominant model: OR 103.39, 95 % CI 52.25-204.55, P = 1.69e-40; recessive model: OR 16.45, 95 % CI 6.00-45.10, P = 5.33e-08; additive model: OR 61.49, 95 % CI 22.07-171.33, P = 3.32e-15), especially in the Japanese population. Subgroup analysis revealed highly statistically significant higher risk in the patients with family histories. Although another polymorphism rs148731719 showed no significant association with the MMD, rs138130613 was found to be related to the higher risk in Chinese population (dominant model: OR 8.34, 95 % CI 1.72-40.47, P = 0.008). Our meta-analysis strengthens RNF213 rs112735431 is closely associated with the increased risk of MMD in Japanese, and the screening combined with rs112735431 and rs138130613may improve the detection rate for MMD in China.

Perfluorinated compounds in soil, surface water, and groundwater from rural areas in eastern China.

Little research on perfluorinated compounds (PFCs) has been conducted in rural areas, although rural PFC sources are less complicated than in urban and industrial areas. To determine the levels and geographical distribution of 17 PFC compounds, samples of soil, surface water, and groundwater were collected from eight rural areas in eastern China. The total PFC concentrations (∑PFCs) in soils ranged from 0.34 to 65.8 ng/g ∑PFCs in surface waters ranged from 7.0 to 489 ng/L and ∑PFCs in groundwater ranged from 5.3 to 615 ng/L. Ratios of perfluorononanoic acid/perfluorooctanoic acid (PFNA/PFOA), perfluoro-n-butyric acid/perfluorooctanoic acid (PFBA/PFOA), and perfluoroheptanoic acid/perfluorooctanoic acid (PFHpA/PFOA) in rainwater increased due to the fluorine chemical plants in the surrounding rural and urban areas, suggesting that atmospheric precipitation may carry PFCs and their precursors from the fluorochemical industrial area to the adjacent rural areas.