Predictive value of ankle-brachial index and blood glucose on the outcomes of six-year all-cause mortality and cardiovascular mortality in a Chinese population of type 2 diabetes patients

AIM

The aim of this paper was to investigate the predictive value of ankle-brachial index (ABI) and blood glucose to estimate mortality in Chinese type 2 diabetes patients.

METHODS

Chinese type 2 diabetes patients (1706 subjects) were followed up for about 6 years,

RESULTS

One thousand four hundred fourteen were included in the final statistical analysis during a median follow-up of 69 months. Overall, 398 patients died during follow-up and 254 deaths were attributable to cardiovascular disease (CVD). Relative risks of all-cause and CVD mortality of patients with ABI≤0.4 were increased by 2.073-fold (95% CI: 1.236-3.478) and 3.086-fold (95% CI: 1.702-5.595), compared with those of patients with ABI>1.0 and ≤1.4. Mortality was significantly increased with increasing plasma glucose and decreasing ABI. All-cause and CVD mortality was the highest (55.6% and 44.4%) with ABI≤0.4 and plasma glucose >10 mmol/L simultaneously. Relative risks of all-cause and CVD mortality in these patients were increased by 3.905-fold (95% CI: 1.334-11.431) and 3.771-fold (95% CI: 1.079-13.171), compared with patients with ABI>1.0 and ≤1.4, and plasma glucose ≤6 mmol/L simultaneously. Models to evaluate additional predictive value of ABI for mortality of type 2 diabetes patients suggested that addition of ABI significantly improved the prediction of the death rate compared with the model including conventional risk factors only.

CONCLUSION

High plasma glucose and low ABI had synergistic effects on increasing mortality of type 2 diabetes patients. The addition of ABI can significantly improve the prediction of mortality compared to protocol using conventional risk factors only.

A model of isolated, vascular whole thymus transplantation in nude rats

BACKGROUND

We used a model of vascularized thymus lobes as a whole isolated organ transplantation in rats.

MATERIALS AND METHODS

Male Fisher rats (F344, RT11v1; n = 10) and male homozygous Rowett nude rats (rnu/rnu; n = 10) were used as donors and recipients, respectively. Both vascular lobes of the thymus as a whole isolated organ were heterotopically transplanted to the neck of recipients. The right common carotid artery of the donor thymus was anastomosed end-to-end to the homonymous artery of the recipient. The anterior vena cava and the left brachiocephalic vein of the donor thymus were anastomosed end-to-side to the right and left external jugular veins of the recipient, respectively. Histological examination was used to monitor graft viability; graft function was assessed using flow cytometry (FCM) and immunologic effects by skin grafts in vivo.

RESULTS

All recipients survived. Preparation of the donors and recipients took 35.6 ± 5.5 minutes and 60.3 ± 15.1 minutes, respectively. The blood supply to the thymus graft was patent. Histology of the thymus on postoperative days 14, 56, and 112 revealed viable grafts with preserved microarchitecture. FCM analysis showed 37.18 ± 11.1% CD3+ T cells at day 21 after transplantation. Skin grafts from F344 and Rowett rats survived 8-10 and more than 30 days, respectively, whereas all third-party Sprague Dawley grafts were rejected within 5 days.

CONCLUSION

We developed a novel model of isolated, direct vascularized whole thymus transplantation in nude rats, in which both lobes of the fully vascularized thymus were harvested en bloc for successful transplantation.

Morphology and volatile compounds of metathoracic scent gland in Tessaratoma papillosa (Drury) (Hemiptera: Tessaratomidae)

Tessaratoma papillosa (Drury) (Hemiptera: Tessaratomidae) is a serious insect pest of litchi and longan in South China. When disturbed, this insect could release large quantities of disagreeable odorous volatiles from its scent gland. Knowledge on the scent gland and its secretion is crucial for developing the semiochemical methods to manage this pest. Morphology and ultrastructure of the metathoracic scent glands (MTGs) were studied under stereo and scanning electron microscopy, and the volatile compounds of MTGs from both male and female T. papillosa were analyzed with coupled gas chromatography-mass spectrometry (GC-MS). The MTG complex is located between the metathorax and the first abdominal segment at the ventral surface of the insect, which has a well-developed single double valve cystic-shaped orange median reservoir, paired colorless lateral glands in both sides, and a long and wavy tubular accessory gland that inlays tightly into the ventral edge around the median reservoir. The MTG opens to the body surface through paired ostioles located between the meso- and metacoxae of the evaporatorium with mushroom bodies. The GC-MS analyses showed that female and male adults have nine major volatile components in common. Tridecane is the most abundant in both females and males, reaching up to 47.1% and 51.8% of relative amount, respectively. The minor component is benzophenone with only 0.28% and 0.14%. Furthermore, undecane, tetradecane, 3-methyl-tridecane, and cyclopentadecane were found only in males. The possible function of volatile compounds of MTG contents in T. papillosa is addressed.

SU-E-T-06: A Mathematical Explanation to Tumor's Response to Perfusion and Hypoxic Fraction after Radiation

PURPOSE

To develop a dynamic model that explains oxygen dynamics between the microvascular perfusion and the hypoxic cell population inside a tumor.

METHODS

Bussink et al (Radiat Res 153(4), p.398 (2000)) observed fast oxygen dynamics, faster than cell-death. Based on a simplified three-compartment-model: the microvasculature, well-oxygenated, and hypoxic tumor cell populations. We applied a first-order differential model for the tumor's transient response as a function of oxygen content within the blood vessels. The sink terms in our model for each compartment are fast changing parameters because radiation rapidly changes the oxygen consumption of the tumor cell in a time scale which is much faster than the population changes of the tumor. Transportation balance condition is also applied for each compartment.

RESULTS

Our simulation results can explain the experimental data in Bussink et al's (Radiat Res 153(4), p.398 (2000)) paper. We provide an explanation for the relative complex behavior of the microvascular perfusion after radiation that emphasizes the role of dynamic metabolic changes in addition to population changes.

CONCLUSIONS

A newly developed dynamic model leads our understanding to the interrelationship between microvascular oxygen content within the blood vessels and the hypoxia state of the tumor to a deeper level, which has the potential to provide the theoretical foundation for the patient' specific adaptive radiotherapy.

SU-E-J-197: A Novel Optical Interstitial Fiber Spectroscopic System for Real-Time Tissue Micro-Vascular Hemodynamics Monitoring

PURPOSE

To demonstrate a novel interstitial optical fiber spectroscopic system, based on diffuse optical spectroscopies with spectral fitting, for the simultaneous monitoring of tumor blood volume and oxygen tension. The technique provides real-time, minimally-invasive and quantification of tissue micro-vascular hemodynamics.

METHODS

An optical fiber prototype probe characterizesthe optical transport in tissue between two large Numerical Aperture (NA) fibers of 200μm core diameter (BFH37-200, ThorLabs) spaced 3-mm apart. Two 21-Ga medical needles are used to protect fiber ends and to facilitate tissue penetration with minimum local blunt trauma in nude mice with xenografts. A 20W white light source (HL-2000-HP, Ocean Optics) is coupled to one fiber with SMA adapter. The other fiber is used to collect light, which is coupled into the spectrometer (QE65000 with Spectrasuite Operating software and OmniDriver, Ocean Optics). The wavelength response of the probe depends on the wavelength dependence of the light source, and of the light signal collection that includes considerable scatter, modeled with Monte-Carlo techniques (S. Jacques 2010 J. of Innov. Opt. Health Sci. 2 123-9). Measured spectra of tissue are normalized by a measured spectrum of a white standard, yielding the transmission spectrum. A head-and-neck xenograft on the flank of a live mouse is used for development.

RESULTS

The optical fiber probe delivers and collects light at an arbitrary depth in the tumor. By spectral fitting of the measured transmission spectrum, an analysis of blood volume and oxygen tension is obtained from the fitting parameters in real time.

CONCLUSIONS

A newly developed optical fiber spectroscopic system with an optical fiber probe takes spectroscopic techniques to a much deeper level in a tumor, which has potential applications for real-time monitoring hypoxic cell population dynamics for an eventual adaptive therapy metric of particular use in hypofractionated radiotherapy.

SU-E-J-196: In-Vivo Tumor Blood-Oxygen Content Measurement via Interstitial Optical Transmission Spectroscopy

PURPOSE

To demonstrate the application of in-vivo diffuse optical transmission spectroscopy in quantifying oxygen saturation in interstitial tissue, and to use this technique to examine reoxygenation dynamics in real-time as tumors responds to radiotherapy.

METHODS

Two 200 micron core fiber optics were threaded through two 21 gauge hypodermic needles: one coupled to an OceanOptics QE65000 spectrometer, and the other to an Ocean Optics HL-2000-HP 20W light source. These needles were fixed approximately 3 mm apart, and inserted into nude mice with human head- and-neck tumor xenografts. The oxygen saturation was then measured as a function of time after irradiation at intervals of 0.5, 1, 2, 6, 12, and 24, to measure the tumors' prompt oxygen saturation response to radiation.

RESULTS

Blood volume, deoxy and oxy-hemoglobin concentrations were measured through least-squares fitting of transmission spectra. Furthermore, various configurations of interstitial fiber optic probes were explored to optimize signal strength. Improvement of the optical coupling to the biological system and a concurrent increase in source intensity are the main two focuses for boosting signal strength.

CONCLUSIONS

This work has the potential to give an understanding of the time-scales of hypoxia and reoxygenation in vivo as tumors respond to radiation injury. This technique is of particular interest for hypofractionated therapies particularly treatments of only two or three treatments, where optimizing treatment timing can increase the tumorcidal effect of the remaining fractions.

Effect of interaction of vitamin C on macrophage immune response to infection with Mycobacterium bovis

Bovine tuberculosis is a chronic infectious disease caused by Mycobacterium bovis affecting humans and livestock. Like Mycobacterium tuberculosis (M.tb), M. bovis can persist in cattle without causing overt symptoms after entering a non-replicating persistent (NRP) state. Given that M.tb enters NRP under stress conditions, we sought to find the effects of vitamin C (VC) on M. bovis in vitro and in vivo (VC could mimic stresses like hypoxia by O2 scavenging and acidic conditions in phagosome). M. bovis was cultured in a medium with VC for 48 h. The differential expression of five genes (dosR, dosS, dosT, icl, and hspX of M. bovis) implicated in the M. bovis NRP state was measured with real-time quantitative PCR. Expression of all five genes was increased by VC. Relative to the control, VC-exposed bacteria appeared smaller and more rounded in shape with a much thicker inner envelope. A lower number of viable bacteria were found in comparison with those of the control. We infected macrophage cell line ANA-1 with M. bovis and cultured it in VC-added medium (MC group) for 24h and 48 h. Expression of il-10, il-6, tnf-α, and il-β was examined and compared with expression by cells infected by M. bovis only without VC treatment (MB group), uninfected cells in the medium treated with VC (VC group), and cells in the medium only without VC. Il-1β, tnf-α, and il-6 transcription were up-regulated significantly in MC group. IL-10 gene expression in MB and MC groups was less than in the control at 24h, but that of MC group increased more than the MB group at 48 h. The numbers of intracellular M. bovis in the MC group were lower than that in the other groups. Slower growth was found in VC-treated M. bovis, and macrophages were more bactericidal for intracellular VC-stimulated M. bovis than for M. bovis with no VC treatment.

Cardiac mass in Behçet's disease

Cardiac mass is a rare manifestation of Behçet's disease (BD). Intracardiac thrombosis, endomyocardiofibrosis, endocardial fibroelastosis, inflammatory mass and cystic change have been reported as different entities of cardiac mass in BD. Here we presented 6 cases of this rare manifestation of BD. The clinical and pathological features were reviewed.

Sox2 targets cyclinE, p27 and survivin to regulate androgen-independent human prostate cancer cell proliferation and apoptosis

OBJECTIVES

Sox2 is a major transcription factor and the transforming growth factor-α (TGF-α)/EGFR autocrine loop is a hallmark of prostate cancer progression. In this study, we have evaluated the effects and potential mechanisms of Sox2 on cell proliferation and apoptosis, and investigated effects of TGF-α on expression of Sox2 on androgen-independent human prostate cancer cells.

MATERIALS AND METHODS

Expression of Sox2 has been determined by RT-PCR, western blot analysis and immunocytochemistry, using RNAi and over-expression strategy to study functions of Sox2 in DU145 and PC-3 cells. Changes in level of proliferation, cell cycle and apoptosis profiles were measured by MTT, colony-forming, bromodeoxyuridine incorporation assays, cell cycle and annexin V analysis.

RESULTS

Sox2 was expressed in six human prostate cancer cell lines, and its inhibition reduced cell proliferation and induced apoptosis in DU145 cells. We have shown that knock-down of Sox2 inhibited G(1) to S phase transition concomitantly with down-regulation of cyclin E and up-regulation of p27 proteins. Conversely, over-expression of Sox2 led to the opposite effect in PC-3 cells but its inhibition induced apoptosis by down-regulation of survivin in DU145 cells. We also found that TGF-α up-regulated Sox2 and survivin protein expression via the EGFR/PI3K/AKT pathway.

CONCLUSIONS

Sox2 expression is necessary for cell proliferation and evasion of apoptosis in prostate cancer cells and TGF-α could regulate Sox2 and survivin expression by activating the EGFR/PI3K/AKT pathway.

Anthropogenic atmospheric nickel emissions and its distribution characteristics in China

Nickel and its compounds are considered as potential human carcinogens, and atmospheric nickel is one of the major routes for human exposure. By applying the best available fuel-based or product-based emission factors and annual activity levels, a multiple-year comprehensive inventory of anthropogenic atmospheric nickel emissions in China is presented with temporal trend and spatial resolutions for the period of 1980-2009 from both fuels combustion sources and industrial producing processes. We estimate that the total atmospheric nickel emissions from all the sources have increased from 1096.07 t in 1980 to 3933.71 t in 2009, at an average annual growth rate of 4.5%. Therein, coal combustion is the leading source, attributing 63.4% of the national total nickel emissions in 2009; liquid fuels consumption ranks the second, contributing 12.4% of the totals; biofuels burning accounts for 8.4% and the remaining sources together contribute 15.8% of the totals. Significant spatial variations are demonstrated among provincial emissions and the most concentrated regions are the highly industrialized and densely populated areas like the Yangtze River Delta, the Pearl River Delta and the Beijing-Tianjin-Hebei region. Moreover, the overall uncertainties are estimated at -32.6%-37.7% by using Monte Carlo simulation, most of which come from non-ferrous metals smelting category, implying the urgent need for further investigation and field tests. This article may help to combat the increasing stress on air heavy metals pollution in China and provide useful information to calculate global mass balance models for hazardous trace elements.

An integrated urban drainage system model for assessing renovation scheme

Due to sustained economic growth in China over the last three decades, urbanization has been on a rapidly expanding track. In recent years, regional industrial relocations were also accelerated across the country from the east coast to the west inland. These changes have led to a large-scale redesign of urban infrastructures, including the drainage system. To help the reconstructed infrastructures towards a better sustainability, a tool is required for assessing the efficiency and environmental performance of different renovation schemes. This paper developed an integrated dynamic modeling tool, which consisted of three models for describing the sewer, the wastewater treatment plant (WWTP) and the receiving water body respectively. Three auxiliary modules were also incorporated to conceptualize the model, calibrate the simulations, and analyze the results. The developed integrated modeling tool was applied to a case study in Shenzhen City, which is one of the most dynamic cities and facing considerable challenges for environmental degradation. The renovation scheme proposed to improve the environmental performance of Shenzhen City's urban drainage system was modeled and evaluated. The simulation results supplied some suggestions for the further improvement of the renovation scheme.

Spatial-temporal expression of pum1 and pum2 in medaka Oryzias latipes

Two pumilios, pum1 and pum2, were identified in medaka Oryzias latipes. Oryzias latipes pum1 and pum2 are ubiquitous in the adult tissues but with specific expression in the germ cells of gonads, ovary and testis. Pum1 is expressed in the spermatogonia to spermatocytes whilst pum2 presents in spermatocytes of testis only. Oryzias latipes pum1 and pum2 are maternally supplied RNA with ubiquitous expression in the early stages, and embryonic expression of pum1 and pum2 may begin from early gastrula. Both pum1 and pum2 are expressed in the tissues including brain, eye and trunk, and both are expressed in the gonads after hatching. Taken together, Pum1 and Pum2 may play important roles in embryonic and germ cell development of O. latipes.

A U-shaped relationship between ankle-brachial index and carotid intima-media thickness in a Chinese population of Inner Mongolia

AIM

The study was designed to investigate the relationship between ankle-brachial index (ABI) and carotid intima-media thickness (IMT), and provide scientific basis for primary and secondary prevention of atherosclerotic diseases.

METHODS

Participants were recruited for this investigation from Inner Mongolia in China through cluster multistage and random sampling. ABI and carotid-IMT were measured for each subject. Periphery arterial disease (PAD) was defined as an ABI≤0.9 in either leg. ABI values were divided into eight groups at every 0.05, and three carotid-IMT measures were compared among groups separately using analysis of variance (ANOVA) and multivariate linear regression analyses.

RESULTS

The results indicated that the prevalence of PAD among 1236 participants was 1.9%. The average common carotid IMT was 0.70±0.21 mm, internal carotid IMT 0.77±0.24 mm, and carotid artery bifurcation IMT 0.78±0.25 mm. A U-shaped relationship was observed that the values of common carotid, carotid artery bifurcation, and internal carotid arteries IMT were decreased at first then increased as ABI values increased. The U-shaped relationship between ABI and three carotid-IMT measures were remained after adjusting for covariates.

CONCLUSION

The data suggests that carotid IMT values are correlated with ABI values in a U-shaped curve. Increased carotid IMT is correlated with the high prevalence of PAD in population of Inner Mongolia in China.

Involvement of the NF-κB pathway in multidrug resistance induced by HBx in a hepatoma cell line

It is widely believed that hepatocellular cancer (HCC), especially HBV associated HCC, is highly resistant to chemotherapy. To investigate the molecular influence of HBx protein on multidrug resistance (MDR) in HCC and the potential role of the NF-κB pathway in this process. We established HBx-expressing cells by liposome-mediated transfection of the HBx into the HepG2 cell line. We found that HBx expression in HCC cells induces drug resistance against multiple drugs, a significantly lower apoptosis ratio in HepG2-HBx and HepG2.2.15 cells, compared with HepG2 and HepG2-3.1 cells (P < 0.05) after treating with 5-FU or adriamycin. And compared with the control group, the HBx-transfected cells showed a higher expression of MDR-associated and anti-apoptotic genes. Furthermore, we found that the NF-κB activity was remarkably high in the HBx-expressing cells as measured by p65 nuclear localization. In addition, the upregulated anti-apoptotic genes, Gadd45b and Survivin, in HBx-expressing HCC cells were downregulated by IMD-0354 treatment, which is the NF-κB pathway inhibitor. Taken together, these results suggest that HBx protein might be one of the causes for the occurrence of MDR in HCC, and the NF-κB pathway might be involved in this change.

Elevated circulating CD4+ ICOS+ Foxp3+ T cells contribute to overproduction of IL-10 and are correlated with disease severity in patients with systemic lupus erythematosus

In this work, we aimed to investigate the frequency, possible categories and clinical significance of circulating CD4+ ICOS+ FoxP3+ T cells in patients with systemic lupus erythematosus (SLE). The frequency of circulating CD4+ ICOS+ FoxP3+ T cells was analysed by flow-cytometric analysis in 32 SLE patients, 10 rheumatoid arthritis patients and 32 healthy controls. Production of IL-10 and mTGF-β by different CD4+ T-cell populations was determined by intracellular cytokine staining. Plasma levels of IL-10 and TGF-β were determined by enzyme-linked immunosorbent assay (ELISA). The frequency of circulating CD4+ ICOS+ FoxP3+ T cells was significantly increased in SLE patients as compared with control groups. The elevated frequency of CD4+ ICOS+ FoxP3+ T cells had a positive correlation with SLE Disease Activity Index (SLEDAI) scores and serum anti-dsDNA but a negative correlation with serum C3. Additionally, the CD4+ ICOS+ Foxp3+ T cells contained significantly higher percentages of IL-10-producing cells than CD4+ ICOS- Foxp3+ T cells. A significant positive correlation was also observed between the frequency of CD4+ ICOS+ Foxp3+ T cells and the plasma level of IL-10 in SLE patients. In conclusion, an increased frequency of circulating CD4+ ICOS+ Foxp3+ T cells was observed in patients with SLE, suggesting its potential importance in the immunopathogenesis of SLE. Analysis of the CD4+ ICOS+ FoxP3+ T-cell population may be useful for the evaluation of lupus disease severity.

Temporal and spatial distribution of atmospheric antimony emission inventories from coal combustion in China

A multiple-year inventory of atmospheric antimony (Sb) emissions from coal combustion in China for the period of 1980-2007 has been calculated for the first time. Specifically, the emission inventories of Sb from 30 provinces and 4 economic sectors (thermal power, industry, residential use, and others) are evaluated and analyzed in detail. It shows that the total Sb emissions released from coal combustion in China have increased from 133.19 t in 1980 to 546.67 t in 2007, at an annually average growth rate of 5.4%. The antimony emissions are largely emitted by industrial sector and thermal power generation sector, contributing 53.6% and 26.9% of the totals, respectively. At provincial level, the distribution of Sb emissions shows significant variation. Between 2005 and 2007, provinces always rank at the top five largest Sb emissions are: Guizhou, Hunan, Hebei, Shandong, and Anhui.