Predictive value of systemic immune-inflammation index and NT-proBNP for contrast-induced acute kidney injury in elderly STEMI patients / 中华老年心脑血管病杂志

Objective To investigate the predictive value of systemic immune-inflammation index(SII)and N-terminal pro-brain natriuretic peptide(NT-proBNP)level in elderly patients with acute ST-segment elevation myocardial infarction(STEMI)developing contrast-induced acute kidney injury(CIAKI)after PCI.Methods A total of 1085 elderly STEMI patients undergoing emergency PCI in the Affiliated Hospital of Xuzhou Medical University from January 2018 to March 2023 were consecutively recruited as a training set,and another 287 elderly STEMI pa-tients receiving emergency PCI in the East Branch of the Affiliated Hospital from January 2021 to June 2023 were included as a verification set.According to the diagnostic criteria of CIAKI,they were divided into CIAKI group(n=95)and non-CIAKI group(n=990).Based on the results of restricted cubic spline(RCS)analysis,the patients from the training set were assigned into low-risk subgroup(n=292),moderate-risk group(n=515)and high-risk group(n=278).Multivari-ate logistic regression analysis was used to analyze the independent risk factors of CIAKI in elder-ly STEMI patients after PCI,and ROC curve was plotted to analyze the predictive value of combi-nation of SII and NT-proBNP.The risk of CIAKI was compared among the patients at different risk grades.Results Age,SII,baseline serum creatinine,NT-proBNP,fasting blood glucose and use of diuretics were independent risk factors for CIAKI after primary PCI in elderly STEMI patients(P＜0.05,P＜0.01).The AUC value of SII combined with NT-proBNP in predicting CIAKI was 0.801(95％CI:0.761-0.842,P＜0.01),with a sensitivity of 83.2％and a specificity of 67.5％,both superior to that of SII or NT-proBNP alone.RCS analysis revealed an increased risk of CIAKI at SII ≥1084.97 × 109/L and NT-proBNP ≥296.12 ng/L.The incidence of CIAKI was increased with the increase of risk grades(1.71％vs 6.41％vs 20.50％).Conclusion SII and NT-proBNP are independent risk factors for CIAKI after emergency PCI in elderly STEMI pa-tients.And their combination has better predictive value for CIAKI.

Euryale Small Auxin Up RNA62 promotes cell elongation and seed size by altering the distribution of indole-3-acetic acid under the light.

Euryale (Euryale ferox Salisb.) is an aquatic crop used as both food and drug in Asia, but its utilization is seriously limited due to low yield. Previously, we hypothesized that Euryale small auxin up RNAs (EuSAURs) regulate seed size, but the underlying biological functions and molecular mechanisms remain unclear. Here, we observed that the hybrid Euryale lines (HL) generate larger seeds with higher indole-3-acetic acid (IAA) concentrations than those in the North Gordon Euryale (WT). Histological analysis suggested that a larger ovary in HL is attributed to longer cells around. Overexpression of EuSAUR62 in rice (Oryza sativa L.) resulted in larger glumes and grains and increased the length of glume cells. Immunofluorescence and protein interaction assays revealed that EuSAUR62 modulates IAA accumulation around the rice ovary by interacting with the rice PIN-FORMED 9, an auxin efflux carrier protein. Euryale basic region/leucine zipper 55 (EubZIP55), which was highly expressed in HL, directly binds to the EuSAUR62 promoter and activated the expression of EuSAUR62. Constant light increased the expression of both EubZIP55 and EuSAUR62 with auxin-mediated hook curvature in HL seedlings. Overall, we proposed that EuSAUR62 is a molecular bridge between light and IAA and plays a crucial role in regulating the size of the Euryale seed.

[Expression profiling and functional verification of flavonoid 3'-hydroxylase gene from leaves of Euryale ferox].

Leaves of Euryale ferox are rich in anthocyanins. Anthocyanin synthesis is one of the important branches of the flavonoid synthesis pathway, in which flavonoid 3'-hydroxylase(F3'H) can participate in the formation of important intermediate products of anthocyanin synthesis. According to the data of E. ferox transcriptome, F3'H cDNA sequence was cloned in the leaves of E. ferox and named as EfF3'H. The correlation between EfF3'H gene expression and synthesis of flavonoids was analyzed by a series of bioinforma-tics tools and qRT-PCR. Moreover, the biological function of EfF3'H was verified by the heterologous expression in yeast. Our results showed that EfF3'H comprised a 1 566 bp open reading frame which encoded a hydrophilic transmembrane protein composed of 521 amino acid residues. It was predicted to be located in the plasma membrane. Combined with predictive analysis of conserved domains, this protein belongs to the cytochrome P450(CYP450) superfamily. The qRT-PCR results revealed that the expression level of EfF3'H was significantly different among different cultivars and was highly correlated with the content of related flavonoids in the leaves. Eukaryotic expression studies showed that EfF3'H protein had the biological activity of converting kaempferol to quercetin. In this study, EfF3'H cDNA was cloned from the leaves of E. ferox for the first time, and the biological function of the protein was verified. It provi-ded a scientific basis for further utilizing the leaves of E. ferox and laid a foundation for the further analysis of the biosynthesis pathway of flavonoids in medicinal plants.

Ruifuping pectin protects against intestinal mucosal injury in the rat exertional heat stroke model / 中华危重病急救医学

Objective:To evaluate the intestinal function in rats with exertional heat stroke (EHS) and explore the protective role of Ruifuping pectin (RFP) against heat related intestinal mucosal injury.Methods:One hundred and twenty healthy special pathogen free (SPF) male Sprague-Dawley (SD) rats were randomly divided into normothermic control group, EHS model group, hyperthermic plus drinking water group (H 2O+EHS group) and hyperthermic plus pectin group (RFP+EHS group) with 30 rats in each group. The rats in the H 2O+EHS group and RFP+EHS group were given water 20 mL/kg or RFP 20 mL/kg orally for 5 days during adaptive training period. After 1 week, the temperature control range was adjusted to (37±1)℃ using the temperature control treadmill, and the rat model of EHS was reproduced by one-time high temperature exhaustive exercise. No rehydration intervention was given during the training adaptation period in the EHS model group. The rats in the normothermic control group were maintained to room temperature (25±2)℃ and humidity (55±5)% without other treatment. Behavior tests including withdraw response, righting, and muscle strength were performed immediately after onset of EHS. Blood of inferior vena cava was collected, and the serum inflammatory cytokines [tumor necrosis factor-α (TNF-α) and interleukins (IL-6, IL-1β, IL-10)] and activity of diamine oxidase (DAO) were detected by enzyme linked immunosorbent assay (ELISA). The intestinal mucosa was collected, after hematoxylin-eosin (HE) staining, and Chiu score was performed to assess EHS induced pathological changes under light microscope. Results:The rats in the EHS model group had behavioral, inflammatory and pathological changes, such as delayed withdraw response and righting, decreased forelimb pulling, increased inflammatory index, and obvious intestinal mucosal injury, which indicated that the reproduction of the EHS model was successful. There was no significant difference in above parameters between the H 2O+EHS group and the EHS model group except that the inflammatory index in the RFP+EHS group was improved. Compared with the EHS model group, the withdraw reflex to pain and righting after RFP pretreatment in the RFP+EHS group were significantly improved (righting score: 1.4±0.2 vs. 0.3±0.2, withdraw reflex to pain score: 1.0±0.1 vs. 0.2±0.1, both P < 0.05), the muscle strength was significantly increased (N: 13.0±0.5 vs. 8.2±0.6, P < 0.01). The levels of pro-inflammatory factors in the RFP+EHS group were significantly lower than those in the EHS model group [TNF-α (ng/L): 67.5±9.2 vs. 194.3±13.7, IL-6 (ng/L): 360.0±54.1 vs. 981.2±84.4, IL-1β (ng/L): 33.7±9.0 vs. 88.7±6.1, all P < 0.01], while the level of anti-inflammatory factor IL-10 was higher than that in the EHS model group (ng/L: 208.7±10.5 vs. 103.7±7.0, P < 0.01). The degree of intestinal mucosal injury in the RFP+EHS group was less severe than that in the EHS model group, and the Chiu score and DAO were significantly lower than those in the EHS model group [Chiu score: 1.5±0.2 vs. 3.8±0.0, DAO (U/L): 83.7±6.7 vs. 128.7±10.5, both P < 0.05]. Conclusions:High temperature training can damage the intestinal barrier function, and induce endotoxemia and systemic inflammatory response syndrome (SIRS) in rats. Oral prophylactic RFP can protect the intestinal barrier function, alleviate SIRS, and promote the recovery of basic nerve reflex and muscle strength after the occurrence of EHS in rats.

Effect of Wenxin Prescription on G1/S Cell Cycle Transformation in Atherosclerosis Rats / 中国实验方剂学杂志

Objective:To observe the effects of Wenxin prescription on the key targets of gap 1/synthesis （G₁/S） cell cycle transformation in rats with atherosclerosis （AS）， and reveal the mechanism of Wenxin prescription in the treatment of AS. Method:Ninety SPF Wistar rats were randomly divided into a normal group （<italic>n</italic>=6） and a modeling group （<italic>n</italic>=84）. The rats in the modeling group were fed on a high-fat diet （4% cholesterol， 0.5% sodium cholate， 0.2% propyl thiouracil， 10% lard， 5% sugar， and 80.3% basal feed） for 60 days， and intraperitoneally injected with 400 000 U·kg^-1vitamin D₃， once a week for three weeks. The model rats were then randomly divided into a model group， high-dose （24 g·kg^-1）， medium-dose （12 g·kg^-1）， and low-dose （6 g·kg^-1） Wenxin prescription groups， and a rosuvastatin （1.8 mg·kg^-1） group. The groups with drug intervention were treated correspondingly by gavage for 30 days. The rats in the model group were administered with an equal volume of distilled water. The general condition of rats was observed after treatment. The levels of high-density lipoprotein cholesterol （HDL-C）， low-density lipoprotein cholesterol （LDL-C）， and total cholesterol （CHO） were detected by enzyme-linked immunosorbent assay （ELISA）， and the atherosclerosis index （AI） was calculated. The pathological morphology of the coronary artery and aorta was observed by hematoxylin-eosin （HE） staining. The protein and mRNA expression of E2F transcription factor 1 （E2F1）， phosphorylated retinoblastoma protein （p-Rb）， cell division cycle 25 （Cdc25）， CyclinE， and CyclinD₁ was detected by Western blot and real-time fluorescence-based quantitative polymerase chain reaction （Real-time-PCR）， respectively. Result:Compared with the normal group， the model group showed intima thickening， smooth muscle proliferation， and plaque formation in the coronary artery and aorta， decreased HDL-C （<italic>P</italic><0.01）， increased LDL-C， CHO， and AI （<italic>P</italic><0.01）， elevated protein and mRNA expression of E2F1， Cdc25， p-Rb， CyclinE and CyclinD₁ （<italic>P</italic><0.05）. Compared with the model group， the rosuvastatin group and the Wenxin prescription groups showed slight intimal hyperplasia and lumen narrowing of the coronary artery and aorta， decreased levels of LDL-C， CHO， and AI （<italic>P</italic><0.01）， and declining protein and mRNA expression of E2F1， Cdc25， p-Rb， CyclinE， and CyclinD₁ to varying degrees （<italic>P</italic><0.05）. Conclusion:Wenxin prescription can significantly inhibit the expression of key proteins and genes of the G₁/S cell cycle， regulate G₁/S cell cycle transformation， and reduce vascular smooth muscle and intimal hyperplasia in AS rats.

Effects of isotonic muscle exercise on body shape and neck-shoulder muscle activity of college students / 中国学校卫生

Objective@#The purpose of this study was to investigate effects two kinds of isotonic muscle contraction training on muscle body shape and neck-shoulder muscle activity among college students with physical inactivity and poor body posture, to provide appropriate exercise options for these college students.@*Methods@#Thirty subjects with typical sedentary behavior and upper-cross syndrome were randomly divided into no load isotonic training(IT),resistance isotonic training(RIT) and health education control(C) groups. Two training groups were trained for 12 weeks. All subjects were tested their heath-carter anthropometric somatotype,cervical spine angle,range of cervical spine extending and scapula adduction,surface electromyography data of neck and shoulder musle activity were measured before/after training.@*Results@#After training,three factors value in IT, RIT, C groups were[(3.68±1.01)(5.68±1.05)(3.17±0.54)，(2.84±0.84)(5.87±1.45)(1.34±0.10)，(3.82±0.18)(4.83±1.03)(3.30±0.22)] respectively. After training,cervical spine angles were(32.70±9.20)(20.78±2.24)(11.24±3.21)°; extending angles of cervical spine were(3.21±1.82)(2.24±0.60)(1.24±0.01)°; ranges of scapula adduction were(3.44±1.28)(3.08±1.35)(6.08±1.57)cm in IT, RIT, C groups respectively. Three parameters in two training groups significantly increased(F=8.43, 7.29, 8.04, P<0.05). Antagonistic muscle coactivation in neck and shoulder in three groups were(0.11±0.01) and(0.34±0.02)(0.31±0.01) and(0.56±0.03)(0.36±0.11) and(0.69±0.04) respectively,which significantly decreased in two training groups(F=27.39,5.45,P<0.05). There were more obviously changes of neck and shoulder musclebone system in IT group(P<0.05).@*Conclusion@#Musculoskeletal system improved while body fat reduced after resistance isotonic training. No load isotonic training was more superior in adjusting and correctingg upper-crossed syndrome posture than resistance isotonic training. College students with sedentary behavior and upper-cross syndrome can choose no load isotonic training preliminarily for muscle strength and concordance increasing before adding load.

The correlation and dose-response relationship of pulse pressure and pulse pressure index with metabolic syndrome in the elderly / 中华老年医学杂志

Objective:To investigate the correlation and dose-response relationship of pulse pressure and pulse pressure index with metabolic syndrome in the elderly population.Methods:This was a cross-sectional study.A total of 114 212 subjects aged 65 years and over in Wujin District receiving health examination in 2019 were enrolled, including 40 388(35.4%)patients with metabolic syndrome.The survey contents included a questionnaire, physical examination and laboratory tests.Logistic regression and restricted cubic splines were used to analyze the correlation and dose-response relationship of pulse pressure and pulse pressure index with metabolic syndrome.Results:With increases in pulse pressure levels and pulse pressure index, the prevalence of metabolic syndrome and its components increased accordingly( P<0.01). After adjusting for confounding factors, the ORvalue of metabolic syndrome gradually increased along with increases in pulse pressure and pulse pressure index.Compared with the first quartile, pulse pressure and pulse pressure index in the second, third and fourth quartiles were correlated with metabolic syndrome(pulse pressure: OR=1.52, 95% CI: 1.47~1.58, OR=1.89, 95% CI: 1.82~1.96 and OR=2.15, 95% CI: 2.07~2.23, respectively; pulse pressure index: OR=1.22, 95% CI: 1.18~1.26, OR=1.36, 95% CI: 1.31~1.41 and OR=1.47, 95% CI: 1.42~1.53, respectively). Restricted cubic spline analysis showed that pulse pressure and pulse pressure index had non-linear dose-response relationships with metabolic syndrome( χ2=309.23 and 57.14, P<0.01). Conclusions:Pulse pressure and pulse pressure index are correlated and show non-linear dose-response relationships with metabolic syndrome and its components in the elderly.

Relationships between Islet-Specific Autoantibody Titers and the Clinical Characteristics of Patients with Diabetes Mellitus

BackgroundDysimmunity plays a key role in diabetes, especially type 1 diabetes mellitus. Islet-specific autoantibodies (ISAs) have been used as diagnostic markers for different phenotypic classifications of diabetes. This study was aimed to explore the relationships between ISA titers and the clinical characteristics of diabetic patients.MethodsA total of 509 diabetic patients admitted to Department of Endocrinology and Metabolism at the Affiliated Hospital of Nantong University were recruited. Anthropometric parameters, serum biochemical index, glycosylated hemoglobin, urinary microalbumin/creatinine ratio, ISAs, fat mass, and islet β-cell function were measured. Multiple linear regression analysis was performed to identify relationships between ISA titers and clinical characteristics.ResultsCompared with autoantibody negative group, blood pressure, weight, total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), visceral fat mass, fasting C-peptide (FCP), 120 minutes C-peptide (120minCP) and area under C-peptide curve (AUCCP) of patients in either autoantibody positive or glutamate decarboxylase antibody (GADA) positive group were lower. Body mass index (BMI), waist circumference, triglycerides (TGs), body fat mass of patients in either autoantibody positive group were lower than autoantibody negative group. GADA titer negatively correlated with TC, LDL-C, FCP, 120minCP, and AUCCP. The islet cell antibody and insulin autoantibody titers both negatively correlated with body weight, BMI, TC, TG, and LDL-C. After adjusting confounders, multiple linear regression analysis showed that LDL-C and FCP negatively correlated with GADA titer.ConclusionDiabetic patients with a high ISA titer, especially GADA titer, have worse islet β-cell function, but less abdominal obesity and fewer features of the metabolic syndrome.

Relationships between Islet-Specific Autoantibody Titers and the Clinical Characteristics of Patients with Diabetes Mellitus

BackgroundDysimmunity plays a key role in diabetes, especially type 1 diabetes mellitus. Islet-specific autoantibodies (ISAs) have been used as diagnostic markers for different phenotypic classifications of diabetes. This study was aimed to explore the relationships between ISA titers and the clinical characteristics of diabetic patients.MethodsA total of 509 diabetic patients admitted to Department of Endocrinology and Metabolism at the Affiliated Hospital of Nantong University were recruited. Anthropometric parameters, serum biochemical index, glycosylated hemoglobin, urinary microalbumin/creatinine ratio, ISAs, fat mass, and islet β-cell function were measured. Multiple linear regression analysis was performed to identify relationships between ISA titers and clinical characteristics.ResultsCompared with autoantibody negative group, blood pressure, weight, total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), visceral fat mass, fasting C-peptide (FCP), 120 minutes C-peptide (120minCP) and area under C-peptide curve (AUCCP) of patients in either autoantibody positive or glutamate decarboxylase antibody (GADA) positive group were lower. Body mass index (BMI), waist circumference, triglycerides (TGs), body fat mass of patients in either autoantibody positive group were lower than autoantibody negative group. GADA titer negatively correlated with TC, LDL-C, FCP, 120minCP, and AUCCP. The islet cell antibody and insulin autoantibody titers both negatively correlated with body weight, BMI, TC, TG, and LDL-C. After adjusting confounders, multiple linear regression analysis showed that LDL-C and FCP negatively correlated with GADA titer.ConclusionDiabetic patients with a high ISA titer, especially GADA titer, have worse islet β-cell function, but less abdominal obesity and fewer features of the metabolic syndrome.

Effects of NFAT5 inhibition on proliferation, invasion, migration and apoptosis of lung adenocarcinoma cells / 国际肿瘤学杂志

Objective:To investigate the expressions of nuclear factor of activated T cell 5 (NFAT5) in lung adenocarcinoma tissues and cells, and the effects of NFAT5 on the proliferation, invasion, migration and apoptosis of lung adenocarcinoma cells.Methods:The clinical pathological specimens and paracancerous tissues of 61 patients with lung adenocarcinoma diagnosed and treated in 904th Hospital of Joint Logistic Support Force of People′s Liberation Army from June 2017 to June 2019 were collected. The expression levels of NFAT5 in lung adenocarcinoma tissues and paracancerous tissues were detected by quantitative real-time PCR (qRT-PCR), and the relationships between the expression of NFAT5 and clinicopathological features of patients were analyzed. H1975 cells were divided into control group (no treatment), NC group (transfecting siRNA-NC) and si-NFAT5 group (transfecting siRNA-NFAT5) . qRT-PCR was used to detect the expression level of NFAT5 in cell line. MTT and clone formation assay were used to detect cell proliferation. Transwell and scratch test were used to detect cell invasion and migration ability. Flow cytometry was used to detect cell apoptosis. The expressions of mitogen-activated protein kinase (MAPK) signaling pathway related proteins were detected by Western blotting.Results:The expression level of NFAT5 mRNA in lung adenocarcinoma (3.22±0.20) was significantly higher than that in paracancerous tissues (1.00±0.12), and there was a statistically significant difference ( t=75.662, P<0.001). The expression level of NFAT5 in lung adenocarcinoma tissue was associated with TNM stage ( χ2=10.357, P=0.001) and lymph node metastasis ( χ2=18.268, P<0.001). The expression levels of NFAT5 in the control group, NC group and si-NFAT5 group were 1.00±0.06, 1.01±0.05 and 0.31±0.06, and there was a statistically significant difference ( F=140.498, P<0.001). The absorbance ( A) values in the control group, NC group and si-NFAT5 group were 0.70±0.01, 0.55±0.01 and 0.35±0.01 at 24 h after transfection, 0.92±0.03, 0.87±0.06 and 0.57±0.06 at 48 h after transfection, 1.05±0.01, 0.90±0.01 and 0.66±0.01 at 72 h after transfection, and there were statistically significant differences ( F=9.815, P=0.013; F=45.977, P<0.001; F=129.494, P<0.001). Further pairwise comparison showed that the proliferation abilities of the si-NFAT5 group at 24, 48 and 72 h were significantly lower than those of the control group and NC group (all P<0.001). The cell clone numbers in the three groups were 452.33±31.50, 421.00±17.35 and 129.00±17.35 respectively, with a statistically significant difference ( F=128.200, P<0.001). The cell clone number in the si-NFAT5 group was significantly lower than that in the control group and NC group (both P<0.001). The invasion numbers of cells in the three groups were 262.67±28.02, 278.00±27.50 and 46.00±12.00 respectively, and there was a statistically significant difference ( F=89.896, P<0.001). The cell invasive ability in the si-NFAT5 group was significantly lower than that in the control group and NC group (both P<0.001). The relative scratch widths in the three groups were 0.28±0.04, 0.32±0.04 and 0.54±0.04 respectively, and there was a statistically significant difference ( F=42.889, P<0.001). The relative scratch width in the si-NFAT5 group was significantly increased than that in the control group and NC group (both P<0.001). The apoptosis rates in the three groups were (3.38±0.56)%, (3.14±0.62)% and (13.82±0.75)% respectively, and there was a statistically significant difference ( F=264.705, P<0.001). The apoptosis rate in the si-NFAT5 group was significantly higher than that in the control group and NC group (both P<0.001). The differences of protein expressions of NFAT5, p-P38/P38, p-ERK1/2/ERK1/2, p-JNK/JNK among the three groups were statistically significant ( F=91.245, P<0.001; F=132.896, P<0.001; F=243.332, P<0.001; F=118.358, P<0.001). The protein expressions of NFAT5, p-P38/P38, p-ERK1/2/ERK1/2, p-JNK/JNK in the si-NFAT5 group were all significantly lower than those in the control group and NC group, and there were statistically significant differences (all P<0.001). Conclusion:The expression of NFAT5 is increased in lung adenocarcinoma tissues and cells. Inhibition of NFAT5 can inhibit proliferation, invasion and migration of lung adenocarcinoma H1975 cells, and promote apoptosis of H1975 cells. The mechanism may be related to the inhibition of MAPK signal pathway by NFAT5.

Effect and cost-benefit of influenza vaccination for patients with chronic diseases / 公共卫生与预防医学

Objective To evaluate the effect and cost-benefit of influenza vaccination for patients with chronic diseases in Wujin district of Changzhou City. Methods An epidemiological quasi-experiment was employed in this study. A total of 441 patients with chronic diseases were recruited as the vaccine group and inoculated with trivalent influenza virus vaccine, while 467 patients with chronic diseases matched with the age, gender and health status of the vaccine group were selected as the control group for both baseline and follow-up investigations. Results A total of 431 subjects in the vaccine group and 460 subjects in the control group completed baseline and 1-year follow-up investigations. The incidence of influenza-like illness was 7.42% (32/431) and 14.13% (65/460) in the vaccine group and the control group, respectively, with a statistically significant difference (χ2=9.634, P=0.002). The protective rate was 47.46%, and the effect index was 1.90. The incidence of common cold was 16.94% (73/431) and 25.43% (117/460), respectively, and the difference was statistically significant (χ2=9.077, P=0.003), with a protective rate of 33.41%, and an effect index of 1.50. The incidence of chronic disease was 5.57% (24/431) and 9.35% (43/460), respectively. The difference was statistically significant (χ2=4.043, P=0.044), with a protective rate of 40.43% and an effect index of 1.68. The per capita benefit of inoculation was 675.86 yuan, and the benefit-cost ratio was 10.09:1. Conclusion Influenza vaccination for patients with chronic diseases effectively prevented the occurrence of influenza-like illness and reduced the incidence of related chronic diseases.

Relationships between Islet-Specific Autoantibody Titers and the Clinical Characteristics of Patients with Diabetes Mellitus

Background@#Dysimmunity plays a key role in diabetes, especially type 1 diabetes mellitus. Islet-specific autoantibodies (ISAs) have been used as diagnostic markers for different phenotypic classifications of diabetes. This study was aimed to explore the relationships between ISA titers and the clinical characteristics of diabetic patients. @*Methods@#A total of 509 diabetic patients admitted to Department of Endocrinology and Metabolism at the Affiliated Hospital of Nantong University were recruited. Anthropometric parameters, serum biochemical index, glycosylated hemoglobin, urinary microalbumin/creatinine ratio, ISAs, fat mass, and islet β-cell function were measured. Multiple linear regression analysis was performed to identify relationships between ISA titers and clinical characteristics. @*Results@#Compared with autoantibody negative group, blood pressure, weight, total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), visceral fat mass, fasting C-peptide (FCP), 120 minutes C-peptide (120minCP) and area under C-peptide curve (AUCCP) of patients in either autoantibody positive or glutamate decarboxylase antibody (GADA) positive group were lower.Body mass index (BMI), waist circumference, triglycerides (TGs), body fat mass of patients in either autoantibody positive group were lower than autoantibody negative group. GADA titer negatively correlated with TC, LDL-C, FCP, 120minCP, and AUCCP.The islet cell antibody and insulin autoantibody titers both negatively correlated with body weight, BMI, TC, TG, and LDL-C. After adjusting confounders, multiple linear regression analysis showed that LDL-C and FCP negatively correlated with GADA titer. @*Conclusion@#Diabetic patients with a high ISA titer, especially GADA titer, have worse islet β-cell function, but less abdominal obesity and fewer features of the metabolic syndrome.

Magnetic Resonance Diffusion Kurtosis Imaging for Evaluating Stage of Liver Fibrosis in a Rabbit Model.

RATIONALE AND OBJECTIVES: As an extension of the conventional diffusion weighted imaging, diffusion kurtosis imaging (DKI) is based on the non-Gaussian diffusion model that can inherently account for restricted water diffusion within the complex microstructure of most tissues. This study aimed to investigate association of liver DKI derived parameter with stage of liver fibrosis. MATERIALS AND METHODS: Fifty-six healthy New Zealand white rabbits were enrolled into this study, among which 48 rabbits were randomly given carbon tetrachloride to model liver fibrosis, and 8 rabbits treated with normal saline served as control subjects. All rabbits underwent liver DKI followed by biopsy to stage fibrosis (stages F0-F4) on 6th, 8th, 10th, and 12th weekends after initiation of modeling fibrosis. Mean kurtosis (MK), fractional anisotropy (FA), and mean diffusion (MD) were derived from DKI data. Statistical analysis was to evaluate association of DKI derived parameter with stage of fibrosis. RESULTS: FA (r = 0.512) and MK (r = 0.567) increased, and MD (r = -0.574) decreased with increasing stage of fibrosis from F0 to F4 (all p values < 0.05). Significant differences were found in all parameters between F0 and F3 or F4, F1 and F4, F0 and F1-4, and F0-1 and F2-4 (all p values < 0.05). FA and MD could distinguish between F0 from F2, MD, and MK could distinguish F1 from F3, F0-2 from F3-4, and F1-2 from F3-4, and MK and FA could distinguish F2 from F4, and F0-3 from F4 (all p values < 0.05). According to receiver operating characteristic analysis, MK could best predict stage ≥F1, ≥F2, ≥F3, and F4, and discriminate F1-2 from F3-4 with areas under receiver operating characteristic curve of 0.766-0.930. CONCLUSION: DKI derived parameters can help stage fibrosis.

Practice of ADRB2, GLCCIl, FCER2 Gene Detection in Individualized Medication of 2 Children with Refractory Asthma / 中国药房

OBJECTIVE: To study the value of ADRB2, GLCCI1, FCER2 gene detection in individualized medication of children with refractory asthma.METHODS: Clinical pharmacists participated in therapy for 2 cases of refractory asthma, and comprehensively analyzed risk factors as its pathogenic factors (allergens and pathogens of respiratory infections), lung function indexes and family history. It was suggested to conduct anti-asthmatic drugs gene [p2-adrenergic receptor (ADRB2), glucocorticoid induced transcriptional 1 gene (GLCCI1), low affinity IgE receptor (FCER2)] testing. According to detection results, the suggestions were put forward such as increasing the dose of Glucocorticoid for inhalation, stopping β2 receptor agonist, additionally using anticholinergic drug. RESULTS: The clinical physicians adopted the suggestions of clinical pharmacists. After optimizing refractory asthma therapy plan according to the results of gene testing and clinical factors, 2 patients were stable and the number of seizures decreased significanthy. CONCLUSIONS: Gene test can provide evidence for the formulation of individualized therapy in asthma children.

Gender difference in clinical features and outcomes of elderly patients with coronary true bifurcation lesions after percutaneous coronary intervention / 中国介入心脏病学杂志

Objective To explore the gender difference in clinical features and outcomes of elderly patients with coronary true bifurcation lesions after percutaneous coronary intervention (PCI).Methods A total of 169 consecutive patients were included in the study, who were diagnosed coronary true bifurcation lesions by coronary angiography (CAG)and received PCI in our hospital from December 2013 to December 2015.All patients were divided into 2 groups according to their gender (71 femals and 98 males).Angiographic characteristics of the coronary lesions and clinical data were analyzed in both groups.Clinical outcomes during follow up were recorded and studied.Results The levels of total cholesterol (TC), triglyceride (TG),high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C) in the female group were significantly higher than in the male group (all P0.05).The median follow-up time was 17 months and the incidence rate of overall adverse events in women was higher than that of men (25.4% vs.11.2%, P<0.05).Conclusions The clinical outcomes of elderly patients with coronary true bifurcation lesions after PCI had gender differences.The rates of adverse events in female patients was found significantly higher than male patients.

The angle of pancreaticobiliary junction correlates with acute pancreatitis: a magnetic resonance cholangiopancreatography study.

OBJECTIVE: To study the correlation between the angle of the pancreaticobiliary junction (APJ) and the prevalence of acute pancreatitis using magnetic resonance cholangiopancreatography (MRCP). MATERIALS AND METHODS: From February 2014 to October 2014, thirty two subjects with normal pancreas (group A) and 40 patients with acute pancreatitis (group B) who underwent MRCP were enrolled into our study. The type of biliary duct and main pancreatic duct joining the duodenal wall was reviewed and divided into V, B-P and P-B type. The V type is the pancreatic duct and biliary duct joining the duodenal wall without a common channel; the B-P type is the biliary duct draining into the pancreatic duct and forming a common channel; and the P-B type is the pancreatic duct draining into the biliary duct and forming a common channel. APJ was measured on MRCP. The correlation between the APJ and the prevalence of acute pancreatitis was analyzed. RESULTS: The APJ in group A was smaller than in group B (51.45°±13.51° vs. 65.76°±15.61°, P<0.05). According to the type of biliary duct and main pancreatic duct joining the duodenal wall, the prevalence of acute pancreatitis in the V type and in the B-P type was higher than in the P-B type (12/17 vs. 10/29, or 18/26 vs. 10/29, respectively, all P<0.05), whereas there were no significant difference for the prevalence of acute pancreatitis between the V type and B-P type (P>0.05). The APJ were 59.32°±20.04°, 60.22°±11.06°, 57.13°±17.27°, respectively in V type, B-P type and P-B type joining of main pancreatic duct (P>0.05). CONCLUSIONS: A larger APJ is related to a higher prevalence of acute pancreatitis.

Patterns of portosystemic collaterals and diameters of portal venous system in cirrhotic patients with hepatitis B on magnetic resonance imaging: Association with Child-Pugh classifications.

BACKGROUND AND OBJECTIVE: To determine associations of patterns of portosystemic collaterals and diameters of portal venous system in cirrhotic patients with hepatitis B on magnetic resonance (MR) imaging with Child-Pugh classification. MATERIALS AND METHODS: Eighty-eight consecutive patients with cirrhosis resulting from chronic hepatitis B graded by Child-Pugh classifications were recruited and undergone MR portography. Patterns of the collaterals (presented as no collateral, isolated esophageal varices, and esophageal varices combined with other shunts), and diameters of portal venous system including portal vein (PV), left portal vein (LPV), right portal vein (RPV), splenic vein (SV) and superior mesenteric vein (SMV) were assessed statistically to determine associations of patterns of collaterals and diameters of the portal veins with Child-Pugh classification. RESULTS: From no collateral, to isolated esophageal varices, and to the varices combined with other shunts, the Child-Pugh classifications tended to increase (r=0.516, P<0.001). Diameters of PV, LPV, RPV, SV and SMV tended to increase from Child-Pugh A to B but decrease from B to C. Differences in diameter of LPV and SV were significant between Child-Pugh A-B and C (all P<0.05) while no differences in diameters of other portal veins were found (all P>0.05). For discriminating Child-Pugh A-B from C, either a cut-off LPV diameter of 8.98mm or SV diameter of 9.10mm achieved a sensitivity of 67%-70%, specificity of 51%-53%. CONCLUSION: Patterns of portosystemic collaterals and diameters of LPV and SV tend to be associated with Child-Pugh classifications of cirrhosis.

MR imaging of acute pancreatitis: correlation of abdominal wall edema with severity scores.

OBJECTIVE: To study MRI findings of abdominal wall edema (AWE) in acute pancreatitis as well as correlations between AWE and the severity of acute pancreatitis according to the MR severity index (MRSI) and the Acute Physiology And Chronic Healthy Evaluation III (APACHE III) scoring system. MATERIALS AND METHODS: A total of 160 patients with AP admitted to our institution between December 2009 and March 2011 were included in this study. MRI was performed within 48 h after admission. MRI findings of acute pancreatitis were noted, including AWE on the MRI. The abdominal wall area was divided into quarters, and each area involved was recorded as 1 point to score the severity of AWE. The severity of acute pancreatitis was studied using both the MRSI and the APACHE III scoring system. Spearman correlation of AWE with the MRSI and the APACHE III scoring system was analyzed. RESULTS: In 160 patients with acute pancreatitis, 53.8% had AWE on MRI. The average AWE score was 1.2±1.4 points. The prevalence of AWE was 30.5%, 64.5% and 100% in mild, moderate and severe AP, respectively, according to MRSI. AWE on MRI was correlated with MRSI scores (r=0.441, p=0.000). According to APACHE III scores, the averages were 2.0±1.1 and 2.6±1.1 points in mild AP and severe AP, respectively (P=0.016). AWE was slightly correlated with the APACHE III scores (r=0.222, p=0.005). CONCLUSION: AWE on MRI in acute pancreatitis is common, which may be a supplementary indicator in determining the severity of AP.

Renal and perirenal space involvement in acute pancreatitis: An MRI study.

OBJECTIVES: To study the prevalence and characteristics of renal and perirenal space involvement and its relation to the severity of acute pancreatitis (AP) using MRI. METHODS: 115 patients with AP who underwent MRI with the clinical kidney function test were retrospectively analyzed in this study. MRI sequences included conventional and diffusion weighted imaging (DWI) sequences. The renal and perirenal space involvement in AP was noted on MRI. The renal apparent diffusion coefficient (ADC) on DWI was measured for each kidney. The severity of AP on MRI was graded using MR severity index (MRSI). The relationships among the renal and perirenal space involvement on MRI, the renal ADC, MRSI and the results of the kidney function test were analyzed. RESULTS: In the 115 patients with AP, the renal and perirenal space abnormalities detected included renal parenchymal abnormalities (0.8%), abnormalities of the renal collecting system (2.6%), renal vascular abnormalities (1.7%), thickened renal fascia (99%), perirenal stranding (62%) and perirenal fluid collection (40%). The prevalence of perirenal space abnormalities was correlated with the severity of AP based on MRSI (P<0.05). The renal ADC values were lower in patients with abnormal kidney function than in those without kidney injury (P<0.05). The prevalence of kidney function abnormalities was 9.4%, 32% and 100% in mild, moderate, and severe AP cases, respectively (P=0.00). CONCLUSION: Perirenal space involvement is much more than renal parenchymal involvement in AP. The prevalence of perirenal space involvement in AP on MRI has a positive correlation with the severity of AP according to MRSI.

Gallbladder patterns in acute pancreatitis: an MRI study.

RATIONALE AND OBJECTIVES: The aim of this study was to assess the gallbladder patterns on magnetic resonance imaging (MRI) associated with acute pancreatitis (AP). MATERIALS AND METHODS: There were 197 patients with AP, all of whom had undergone abdominal MRI. AP was categorized as either edematous or necrotizing according to its findings on MRI and graded as mild (0-3 points), moderate (4-6 points), or severe (7-10 points) according to the magnetic resonance severity index. The changes to the walls and dimensions of the gallbladder and common bile duct, in addition to the presence of biliary stones and pericholecystic fluid, were noted and compared with the severity of AP on the basis of the magnetic resonance severity index. RESULTS: Of the 197 patients with AP, 81% were classified as edematous and 19% as necrotizing on MRI. There were 35%, 59%, and 6% of patients with mild, moderate, and severe AP according to the magnetic resonance severity index, respectively. Seventy-six percent of patients had at least one gallbladder abnormality on MRI, including a thickened gallbladder wall (42%), pericholecystic fluid (38%), gallbladder stones (35%), an enlarged gallbladder (24%), dilatation of the common bile duct (16%), and subserosal edema (15%). Eighty-nine percent of patients (34 of 38) with necrotizing AP had gallbladder abnormalities, which was significantly higher than the 72% of patients (115 of 159) with edematous AP (P < .05). The prevalence of gallbladder abnormalities was 64% in patients with mild AP, 81% in those with moderate AP, and 91% in those with severe AP (P < .05 among the three groups). CONCLUSIONS: Most patients with AP have gallbladder abnormalities on MRI, including a thickened gallbladder wall and pericholecystic fluid. The prevalence of gallbladder abnormalities has a positive correlation with the severity of AP on MRI.