TCMM: A unified database for traditional Chinese medicine modernization and therapeutic innovations.

Mining the potential of traditional Chinese medicine (TCM) in treating modern diseases requires a profound understanding of its action mechanism and a comprehensive knowledge system that seamlessly bridges modern medical insights with traditional theories. However, existing databases for modernizing TCM are plagued by varying degrees of information loss, which impede the multidimensional dissection of pharmacological effects. To address this challenge, we introduce traditional Chinese medicine modernization (TCMM), the currently largest modernized TCM database that integrates pioneering intelligent pipelines. By aligning high-quality TCM and modern medicine data, TCMM boasts the most extensive TCM modernization knowledge, including 20 types of modernized TCM concepts such as prescription, ingredient, target and 46 biological relations among them, totaling 3,447,023 records. We demonstrate the efficacy and reliability of TCMM with two features, prescription generation and knowledge discovery, the outcomes show consistency with biological experimental results. A publicly available web interface is at https://www.tcmm.net.cn/.

Impact of dehydroepiandrosterone sulfate and free androgen index on pregnancy and neonatal outcomes in PCOS patients.

BACKGROUND: Polycystic ovary syndrome (PCOS) is a prevalent endocrine disorder associated with infertility and pregnancy complications. The pathogenesis of PCOS and its impact on reproductive function may be influenced by the source of androgens, including testosterone, free androgen, dehydroepiandrosterone sulfate (DHEAS). However, the differential effects of these androgen on pregnancy and neonatal outcomes and the cut-off value of East Asian population with PCOS remain unclear. METHODS: A retrospective cohort study was conducted at the Reproductive Medicine Center of the First Affiliated Hospital of Sun Yat-sen University from January 2015 to November 2022, involving 636 cycles of in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI). Subgroup analyses were performed using cut-off values of 6.4 for free androgen index (FAI), 9.5 µmol/L for DHEAS. Pregnancy and neonatal outcomes were compared between groups. Restricted cubic spline (RCS) was used to identify significant cut-off values affecting pregnancy. RESULTS: Higher FAI levels (> 6.4) were associated with decrease in clinical pregnancy rate (PR) (50.61% vs. 41.66%, p = 0.024), live birth rate (LBR) (42.42% vs. 32.35%, p = 0.011). When DHEAS levels exceeded 9.5 µmol/L, there was a significant decrease in clinical PR (51.27% vs. 42.73%, P = 0.039), LBR (42.73% vs. 32.73%, P = 0.012). Negative correlations were also observed between DHEAS levels and cumulative pregnancy rate (70.57% vs 56.62% p = 0.002) and cumulative live birth rate (CLBR) (59.35% vs 43.37%, p = 0.0007). Both FAI and DHEAS elevated is associated with the lowest clinical pregnancy rate (37.84%). Conversely, when solely FAI is elevated, the pregnancy rate increases to 52.38%, while an elevation in DHEAS alone is associated with a pregnancy rate of, both of which are lower than when neither FAI nor DHEAS are elevated (60.68%). The live birth rates exhibit a similar trend (30.00% vs 40.00% vs 41.83% vs 44.48%). RCS revealed a significant decrease in CPR and CLBR when DHEA levels exceeded 7.69 umol/L, while the cut-off value of FAI was 6.36 for CPR and CLBR. CONCLUSION: In conclusion, PCOS patients with biochemical hyperandrogenism show unsatisfactory clinical PR and CLBR when undergoing assisted reproductive technology (ART). This may be attributed to the influence of both adrenal-derived DHEAS and ovarian-derived FAI on the unfavorable pregnancy outcomes.

Genome-wide analysis study of gestational diabetes mellitus and related pathogenic factors in a Chinese Han population.

BACKGROUND: Gestational diabetes mellitus (GDM) affects the metabolism of both the mother and fetus during and after pregnancy. Genetic factors are important in the pathogenesis of GDM, and associations vary by ethnicity. However, related studies about the relationship between the susceptibility genes and glucose traits remain limited in China. This study aimed to identify genes associated with GDM susceptibility in Chinese Han women and validate those findings using clinical data during pregnancy and postpartum period. METHODS: A genome-wide association study (GWAS) of 398 Chinese Han women (199 each with and without GDM) was conducted and associations between single nucleotide polymorphisms (SNPs) and glucose metabolism were identified by searching public databases. Relationships between filtered differential SNPs and glucose metabolism were verified using clinical data during pregnancy. The GDM group were followed up postpartum to evaluate the progression of glucose metabolism. RESULTS: We identified five novel SNPs with genome-wide significant associations with GDM: rs62069863 in TRPV3 gene and rs2232016 in PRMT6 gene were positive correlated with 1 h plasma glucose (1hPG) and 2 h plasma glucose (2hPG), rs1112718 in HHEX/EXOC6 gene and rs10460009 in LPIN2 gene were positive associated with fasting plasma glucose, 1hPG and 2hPG, rs927316 in GLIS3 gene was negative correlated with 2hPG. Of the 166 GDM women followed up postpartum, rs62069863 in TRPV3 gene was positively associated with fasting insulin, homoeostasis model assessment of insulin resistance. CONCLUSIONS: The variants of rs62069863 in TRPV3 gene, rs2232016 in PRMT6 gene, rs1112718 in HHEX/EXOC6 gene, rs927316 in GLIS3 gene, and rs10460009 in LPIN2 gene were newly-identified susceptibility loci for GDM in the Chinese Han population. TRPV3 was associated with worse insulin resistance postpartum. TRIAL REGISTRATION: This study was registered in the Chinese Clinical Trial Registry. TRIAL REGISTRATION NUMBER: ChiCTR2100043762. Date of first registration: 28/02/2021.

AI algorithms for accurate prediction of osteoporotic fractures in patients with diabetes: an up-to-date review.

Osteoporotic fractures impose a substantial burden on patients with diabetes due to their unique characteristics in bone metabolism, limiting the efficacy of conventional fracture prediction tools. Artificial intelligence (AI) algorithms have shown great promise in predicting osteoporotic fractures. This review aims to evaluate the application of traditional fracture prediction tools (FRAX, QFracture, and Garvan FRC) in patients with diabetes and osteoporosis, review AI-based fracture prediction achievements, and assess the potential efficiency of AI algorithms in this population. This comprehensive literature search was conducted in Pubmed and Web of Science. We found that conventional prediction tools exhibit limited accuracy in predicting fractures in patients with diabetes and osteoporosis due to their distinct bone metabolism characteristics. Conversely, AI algorithms show remarkable potential in enhancing predictive precision and improving patient outcomes. However, the utilization of AI algorithms for predicting osteoporotic fractures in diabetic patients is still in its nascent phase, further research is required to validate their efficacy and assess the potential advantages of their application in clinical practice.

Traditional Cantonese puerperal practices and postpartum cardiometabolism in gestational diabetes.

BACKGROUND AND OBJECTIVES: With gestational diabetes (GDM), women have a higher risk for future type 2 diabetes, and risk factors for diabetes for it are amplified. Whether this phenomenon is affected by traditional puerperal or postpartum practices among Chinese women who develop gestational diabetes is unclear. This has been explored in a Cantonese cultural setting to enable relevant risk management. METHODS AND STUDY DESIGN: Some 138 women were followed before, during and after pregnancy in accordance with Cantonese Puerperal Practices (CPP), and occurrence of GDM and exclusive breast-feeding. Body compositional and cardiometabolic information were collected. These included glucose tolerance and insulin resistance. RESULTS: During a median postpartum follow-up of 60.4 days, women with a typical CPP had a greater body weight and weight retention. With artificial feeding, women with a typical CPP had greater OGTT glycemic responses and more insulin resistance. With exclusive breast-feeding, however, no differences in postpartum cardiometabolic measurements were observed, except for a higher early-phase insulin response. CONCLUSIONS: Traditional CPP is associated with early postpartum cardiometabolic impairment in gestational diabetes, but this is avoided with breast-feeding.

Early postpartum abnormal glucose metabolism subtype differs according to mid-trimester lipid profile in women with gestational diabetes mellitus.

BACKGROUND: It is unknown whether early postpartum abnormal glucose metabolism (AGM) in women with previous gestational diabetes mellitus (GDM) is related to their mid-trimester lipid profile. The aim of this study was to characterize the mid-trimester lipid profile of women who experienced GDM and developed into different pathophysiologic subtypes of early postpartum AGM. METHODS: A retrospective cohort study of 498 women with history of GDM was conducted. A 75-g oral glucose tolerance test (OGTT) and plasma lipid measurements were performed at 24-28 weeks of gestation and 6-12 weeks of postpartum. Insulin secretion and sensitivity were estimated using early postpartum OGTT-based indices. RESULTS: Women in the mid-trimester dyslipidemia group had higher postpartum 30-min and 2-h plasma glucose, higher postpartum 2-h plasma insulin, higher postpartum triglyceride (TG), higher postpartum low density lipoprotein cholesterol (LDL-c) concentrations, lower postpartum 30-min insulinogenic index (IGI30), lower postpartum insulin sensitivity index (ISI), and lower postpartum disposition index than those in the normal lipid group (all P < 0.05). Abnormal mid-trimester TG and LDL-c concentrations were associated with postpartum AGM (adjusted odds ratio [OR] = 1.786, 95 % confidence interval [CI] = 1.142-2.425; and adjusted OR = 1.621, 95 % CI = 1.323-2.051, respectively; both P < 0.05). AGM women with low IGI30 and low ISI had higher mid-trimester total cholesterol and LDL-c concentrations, and AGM women with low ISI had higher mid-trimester TG concentrations than women with NGT or other subtypes of AGM (all P < 0.05). CONCLUSIONS: GDM women with abnormal mid-trimester TG and LDL-c were predisposed to early postpartum AGM. Postpartum AGM women who experienced GDM had heterogeneous mid-trimester lipid profile when classified according to their pathophysiologic subtype.

Chronological records of sediment organic carbon at an entrance of Dongting Lake: Response to historical meteorological events.

Lake sediments are the products of soil erosion and are strongly influenced by climate variability, particularly extreme meteorological events. Sediment organic carbon (SOC) can reflect environmental changes that affect sediment transport. However, the response of SOC chronological records to major meteorological events is relatively unknown. This study explored the chronological regularity of SOC and verified its variations using major historical meteorological events. Based on three sediment profiles with a depth of 230 cm at the Yuan River entrance to the West Dongting Lake (Hanshou entrance), the SOC chronology was reconstructed by employing the sedimentation rates calculated by 137Cs and 210Pb. The sedimentary environment then was interpreted via comparisons and quantitative analysis. The grain distribution and the S-shaped distribution of SOC reflected the general deposition regularity of organic carbon in lake sediments, which gradually stabilized with depth. The average sedimentation rates based on 137Cs and 210Pb were 1.310 and 1.319 cm a-1, respectively. Accordingly, SOC records covered the past 76 years via dating (0-100 cm), during which the SOC content first increased and subsequently stabilized. By comparing the data with the occurrence of 11 major historical meteorological events, we found that SOC generally increased after these events. Moreover, the frequent occurrence of meteorological events stabilized the SOC content. Severe floods had a greater impact on SOC content than severe droughts, causing SOC to change by up to 20.24% and 8.77%, respectively. Our findings suggest that major historical meteorological events can verify SOC chronological records, thereby highlighting their significant impacts on organic carbon variations in sediments.

Early postpartum dyslipidemia and its potential predictors during pregnancy in women with a history of gestational diabetes mellitus.

BACKGROUND: This study aimed to analyze the incidence of early postpartum dyslipidemia and its potential predictors in women with a history of gestational diabetes mellitus (GDM). METHODS: This was a retrospective study. Five hundred eighty-nine women diagnosed with GDM were enrolled and followed up at 6-12 weeks after delivery. A 75 g oral glucose tolerance test (OGTT) and lipid levels were performed during mid-trimester and the early postpartum period. Participants were divided into the normal lipid group and dyslipidemia group according to postpartum lipid levels. Demographic and metabolic parameters were analyzed. Multiple logistic regression was performed to analyze the potential predictors for early postpartum dyslipidemia. A receiver operating characteristic curve (ROC) was calculated to determine the cut-off values. RESULTS: A total of 38.5% of the 589 women developed dyslipidemia in early postpartum and 60% of them had normal glucose metabolism. Delivery age, systolic blood pressure (SBP), glycated hemoglobin (HbA1c) and low-density lipoprotein cholesterol (LDL-C) were independent predictors of early postpartum dyslipidemia in women with a history of GDM. The cut-offs of maternal age, SBP, HbA1c values, and LDL-C levels were 35 years, 123 mmHg, 5.1%, and 3.56 mmol/L, respectively. LDL-C achieved a balanced mix of high sensitivity (63.9%) and specificity (69.2%), with the highest area under the receiver operating characteristic curve (AUC) (0.696). When LDL-C was combined with age, SBP, and HbA1c, the AUC reached to 0.733. CONCLUSIONS: A lipid metabolism evaluation should be recommended in women with a history of GDM after delivery, particularly those with a maternal age > 35 years, SBP > 123 mmHg before labor, HbA1c value > 5.1%, or LDL-C levels > 3.56 mmol/L in the second trimester of pregnancy.

Identification and characteristics of a novel testis-specific gene, Tsc21, in mice and human.

Testis-specific genes are essential for spermatogenesis in mammalian male reproduction. We have identified a novel gene, Tsc21, exclusively expressed in mice and human testes from the results of the Affymetrix Genechip analysis in the six developmental stages of testis of postnatal Balb/C mice. The full cDNA length of Tsc21 was 810 bp, with a 543 bp open reading frame encoding a 180 amino acids protein with a predicted molecular weight of 21.040 kDa. A Blast search in the mouse genome database localized the Tsc21 gene to mice chromosome 6C3. Multiple amino acid sequence alignment of human, mouse, and rat homologous genes showed that mice Tsc21 protein was highly homologous with the human Tsc21 gene (70%) and rat Tsc21 gene (86%). The results of reverse transcriptase-polymerase chain reaction analysis showed that the mice Tsc21 is exclusively expressed in the testis and epididymis of mice, and its expression is only detected after the mice is 35 days old. Human Tsc21 is also exclusively expressed in testis of human. Considering the expression profile Tsc21 in mice and human, we propose that Tsc21 may play a role during mammalian male spermatogenesis. Our study should be a basis for function characterization of the Tsc21 gene, leading to the elucidation of the molecular events underlying mammalian male reproduction.