[Mid-to-long term outcomes and influence factors of postoperative concurrent chronic ankle instability and posterior ankle impingement]

OBJECTIVE

To investigate the mid-to-long-term efficacy of patients with chronic ankle instability combined with posterior impingement syndrome after 3-9 years of follow-up, and to analyze the influencing factors.

METHODS

From February 2010 to December 2015, 46 patients underwent concurrent lateral ankle ligament repair with posterior ankle arthroscopic surgery at the Institute of Sports Medicine, Peking University Third Hospital. The patient was first placed in a prone position and underwent arthroscopic debridement for the posterior impingement. After finishing the posterior arthroscopy, the surgeon and assistants first translated the patient to the affected side, then turned to the healthy side, and changed the position to the supine position. During the turning over, another assistant held the arthroscope and the instrument to ensure that it was sterile and could be used without replacement. The anterior ankle arthroscopy was operated if necessary and the lateral ankle ligament repair was anatomic repaired with anchors. The 42 patients were followed up, including 26 males and 16 females. The average age was (28.9±10.0) years. The patient's clinical symptoms, joint stability, mobility and motor function were compared by questionnaire and physical examination. The preoperative and postoperative visual analogue scale (VAS) scores, American Orthopaedic Foot and Ankle Society (AOFAS) scores, Tegner scores were compared, and the clinical scores and the patient age, gender, height and weight were compared. The correlations between body mass index (BMI), preoperative duration, surgery duration, and cartilage injury were analyzed.

RESULTS

The mean follow-up time was (71.8±22.8) months. The postoperative VAS scores (1.0 vs. 5.0, P<0.001), AOFAS scores (92 vs. 80, P<0.001), and Tegner scores (6.5 vs. 2, P<0.001) were significantly superior to the preoperative levels. The excellent and good rate was 97.6%. The postoperative VAS score (t=2.719, P=0.10), AOFAS score (t=-2.853, P=0.10), Tegner score (t=-3.443, P=0.001) and time to return exercise (t=2.814, P=0.008) were negatively correlated with the patient age, and the postoperative VAS score was negatively correlated with cartilage injury (Z=-2.195, P=0.028).

CONCLUSION

The mid-to-long-term clinical outcomes of the chronic ankle ligament instability combined with the posterior impingement were good. The age of the patients was negatively correlated with the clinical outcome. The combined cartilage injury could aggravate the postoperative pain.

[Retrospective analysis of modified Karlsson surgery for chronic calcaneofibular ligament injury]

Objective: To retrospectively evaluate the therapeutic effect and influencing factors of the modified Karlsson operation (anchor method) in treating chronic rupture of the calcaneofibular ligament (CFL). Methods: From August 2010 to May 2014, the data of 24 patients with calcaneofibular ligament rupture treated in Institute of Sports Medicine, Third Hospital of Peking University were retrospectively analyzed. All cases were repaired with modified Karlsson operation (anchor method). There were 14 males and 10 females, with an average age of (30±9) years, and the average body mass index (BMI) was (25±5) kg/m(2). Visual analogue pain score (VAS), American Foot and Ankle Surgery Association score (AOFAS), Tegner knee motion score, ankle stability and mobility were followed up and analyzed. The paired t test was used to compare the normal distribution data before and after the operation. Results: The average follow-up time was (41±13) months. Compared with pre-operation, VAS score decreased significantly at the last follow-up [0(0,7) vs 5(0,8), Z=4.13,P=0.000], AOFAS score increased significantly (94±10 vs 70±14, t=8.94, P<0.05), Tegner score increased significantly (4.7±1.5 vs 2.8±1.3, t=6.87, P<0.05), all improved significantly. AOFAS score was excellent in 19 cases, good in 4 cases and moderate in 1 case, the excellent and good rate was 95.8%. Among them, 20 cases (83.3%) were satisfied with the recovery effect after the operation. Postoperative sprain occurred in 5 cases (20.8%) and ankle mobility was limited in 3 cases (12.5%). Conclusions: The modified Karlsson operation (anchor method) can restore the stability of the ankle joint by treating the chronic rupture of CFL. It is an effective therapy for lateral ankle instability.

[Reconstruction of neglected Achilles tendon rupture: flexor hallucis longus transfer versus gastrocnemius turn-down flaps]

Objective: To compare the outcome of either flexor hallucis longus transfer or turn-down of proximal Achilles tendon tissue repair in treating chronic Achilles tendon rupture. Methods: The clinical data of 21 patients who underwent repair of Myerson type Ⅲ chronic Achilles tendon rupture at Peking University Sports Medicine Research Institute from May 2012 to March 2015 were retrospectively analyzed. Among them, 11 cases were treated with flexor hallucis longus (FHL) transfer, and 10 cases were treated with gastrocnemius turn-down flaps repair. The American Orthopedic Foot & Ankle Society (AOFOS) hindfoot score and Tegner motor function score before and after surgery were recorded and compared between the two groups. Data comparison between groups was performed with t test. Results: The patients in the both group were followed up for an average of (21±7) months. The postoperative AOFOS hindfoot score in the long flexor and gastrocnemius groups were both significantly higher than those before surgery, and the differences were statistically significant (97.7±2.6 vs 72.0±8.1 and 96.0±5.5 vs 78.5±6.4, t=10.70, 6.42, both P<0.05).The postoperative Tegner scores of the two groups were also significantly higher than those before surgery (4.2±1.4 vs 0.7±0.4 and 4.1±0.8 vs 0.6±0.5,t=7.29, 9.35, both P<0.05). There were no significant differences in postoperative AOFOS hindfoot scores and Tegner motor function scores between the two groups (both P>0.05). Conclusion: The flexor hallucis longus transfer and turn-down of proximal Achilles tendon tissue repair can both get satisfactory results in treating chronic Achilles tendon rupture.

Findings from aetiological investigation of Auditory Neuropathy Spectrum Disorder in children referred to cochlear implant programs

OBJECTIVES

Auditory neuropathy spectrum disorder (ANSD) is an audiological diagnosis characterised by hearing dysfunction in the presence of intact outer hair cell function in the cochlea. ANSD is thought to account for 7-10% of all childhood permanent hearing impairment, and can result from a range of pathological processes. This paper describes the rationale, methods and findings from the aetiological investigation of ANSD.

METHODS

Retrospective audit of four cochlear implant programmes.

RESULTS

97 patients were identified. 79% of patients were identified before the age of one. Prematurity and jaundice were the most frequently identified aetiological factors. 33 patients had cochlear nerve deficiency on imaging. Genetic diagnoses identified included otoferlin, SX010 gene, connexin 26 and A1FM1 gene mutations. ANSD was seen in conjunction with syndromes including Kallman syndrome, CHARGE syndrome, X-linked deafness, SOTOS syndrome, Brown Vieletto Van Laere syndrome, and CAPOS syndrome.

DISCUSSION

We present a two-level system of aetiological investigation that is clinically practical. Patients with ANSD sufficiently severe to consider cochlear implantation are generally identified at an early age. Aetiological investigation is important to guide prognosis and identify comorbidity.

CONCLUSION

Prematurity and jaundice are the most commonly identified aetiological factors in ANSD. Imaging findings identify crucial factors in a significant minority. An important minority may have genetic and syndromic diagnoses that require further management.

A novel method for assessing proximal tibiofibular joint on MR images in patients with knee osteoarthritis

OBJECTIVES

To validate a method to measure the morphological parameters of the proximal tibiofibular joint (PTFJ) in patients with knee osteoarthritis (OA).

METHODS

408 participants were examined in this cross-sectional subject-based study. We calculated the fibular contacting area of PTFJ (S) and its projection areas onto the horizontal plane (load-bearing area, Sτ), the sagittal plane (lateral stress-bolstering area, Sφ) and the coronal plane (posterior stress-bolstering area, Sυ). Joint space narrowing (JSN) and osteophyte was measured using radiographs. Cartilage defects, bone marrow lesions (BMLs) and cartilage volume were evaluated using magnetic resonance imaging (MRI).

RESULTS

The average PTFJ fibular contacting area was 2.4 cm² (SD, ±0.7 cm²). Intra-observer and inter-observer reliabilities of measures of PTFJ morphological parameters were excellent (≥0.90). S, Sτ and Sφ were significantly associated with JSN in the medial tibiofemoral compartment (PR: 1.40, 95% CI 1.10-1.78; PR: 1.65, 95% CI 1.25-2.18 and PR: 0.53, 95% CI 0.29-0.97, respectively). There was a significantly positive association between S, Sτ and medial and/or femoral tibial cartilage defects. S, Sτ and Sυ were significantly and positively associated with medial and/or femoral tibial BMLs (PR: 1.36, 95% CI 1.12-1.64; PR: 1.47, 95% CI 1.17-1.83; and PR: 1.39, 95% CI 1.06-1.82, respectively) after adjustment. S and Sτ were significantly and negatively associated with medial tibial cartilage volume.

CONCLUSIONS

This novel method to assess the morphological parameters of PTFJ in MRI is reproducible. These parameters are associated with knee radiographic and MRI-based OA-related structural abnormalities, suggesting clinical construct validity. Its predictive validity needs to be examined in future longitudinal studies.

Edge toroidal charge exchange spectra analysis in the EAST

An edge toroidal charge exchange recombination spectroscopy (eCXRS) diagnostic has been deployed successfully on the Experimental Advanced Superconducting Tokamak (EAST) recently, providing edge plasma ion temperature and toroidal rotation. Edge CXRS on EAST typically monitors the carbon vi (529.059 nm, n = 8 → 7) spectral line. Spectral lines emitted from other different impurities that appeared in the wavelength ranges of 528 nm-530 nm illustrate the need to revise the edge change exchange spectra analysis in this region. Since the eCXRS sightlines end on the ion cyclotron range of frequencies (ICRF) stainless steel antenna, the passive Fe lines coming from the antenna could be recorded by eCXRS diagnostic when ICRF is used. A revised edge toroidal charge exchange spectra analysis including Fe spectral lines is presented. The accuracy of eCXRS measurement has been improved by the revised spectra analysis.

Simultaneous measurement of C VI, Ne X, and Li III charge exchange lines on EAST

The core toroidal charge exchange recombination spectroscopy system on experimental advanced superconducting tokamak (EAST) has been enhanced recently to extend the spectral range. The C VI charge exchange line at 529.059 nm, Ne X line at 524.897 nm, and Li III line at 516.67 nm are observed successfully. The measurements were performed by injecting neon gas and dropping lithium powder simultaneously during the 2016 EAST experimental campaign. One channel connected to a neon lamp is used to perform the real-time wavelength calibration on a shot-to-shot basis. The preliminary results indicate that ion temperature profiles from the carbon and neon impurities are in excellent agreement and provide a consistency check of the measurement from different impurities. Toroidal velocity correction associated with the energy-dependent cross section has been performed. Toroidal rotation of neon impurity is obviously faster than C VI across the whole profile. A cumulative and saturated effect of core lithium ions was observed.

Advances in the Field of Bone Conduction Hearing Implants

The number of marketed bone-conduction hearing implants (BCHIs) has been steadily growing, with multiple percutaneous devices and transcutaneous devices now available. However, studies assessing efficacy often have small sample sizes and employ different assessment methodologies. Thus, there is a paucity of evidence to guide clinicians to the most appropriate device for each patient. This paper outlines audiological guidelines for the latest devices, as well as research from the most up-to-date clinical trials. We also outline the evidence base for some potentially contentious issues in the field of bone conduction, including bilateral fitting of BCHIs in those with bilateral conductive hearing loss as well as the use of BCHIs in single-sided deafness (SSD). Bilateral fitting of BCHIs have been found to significantly increase the hearing thresholds in quiet and improve sound localization, but to give limited benefits in background noise. Studies conducted via multiple assessment questionnaires have found strong evidence of subjective benefits for the use of BCHIs in SSD. However, there is little objective evidence of benefit for SSD patients from sound localization and speech in noise tests.

A standardised pathway for the surveillance of stable vestibular schwannoma

Introduction Conservative management of patients with a stable vestibular schwannoma (VS) places a significant burden on National Health Service (NHS) resources and yet patients' surveillance management is often inconsistent. Our unit has developed a standardised pathway to guide surveillance imaging of patients with stable VS. In this article, we provide the basis for our imaging protocol by reviewing the measurement, natural history and growth patterns of VS, and we present a cost analysis of implementing the pathway both regionally and nationally. Methods Patients with an extrameatal VS measuring ≤20mm in maximal diameter receive magnetic resonance imaging (MRI) six months after their index imaging, followed by three annual MRI scans, two two-year interval MRI scans, a single three-year interval MRI scan and then five-yearly MRI scans to be continued lifelong. Patients with purely intrameatal tumours follow the same protocol but the initial six-month imaging is omitted. A cost analysis of the new pathway was modelled on our unit's retrospective data for 2015 and extrapolated to reflect the cost of VS surveillance nationally. Results Based on an estimation that imaging surveillance would last approximately 25 years (+/- 10 years), the cost of implementing our regional surveillance programme would be £151,011 per year (for 99 new referrals per year) and it would cost the NHS £1,982,968 per year if implemented nationally. Conclusions A standardised surveillance pathway promotes safe practice in the conservative management of VS. The estimated cost of a national surveillance programme compares favourably with other tumour surveillance initiatives, and would enable the NHS to provide a safe and economical service to patients with VS.

Topical administration of Esculetin as a potential therapy for experimental dry eye syndrome

PurposeIn this study, we investigated the therapeutic effects of topical Esculetin for dry eye rabbits through the ocular tests, inflammatory factor levels and specific phosphorylated protein expressions of ERK1/2 singnal pathway.Patients and methodsThirty-two healthy adult male New Zealand white rabbits were chosen for the study. DES models were established after removing of the main lacrimal gland, Harderian gland and nictitating membrane in the left eyes and randomly divided into group DES control, group CsA, group Esculetin and group Esculetin combined with CsA (C&E), meanwhile the right eyes served as group Normal control. Schirmer's I tests, fluorescein scores, goblet cell densities, inflammatory cytokines IL-1α,IL-1β,TNF-αlevels were observed by slit-lamp microscope, conjunctival impression cytology and ELISA essay at week 0, 1, 2, 4, 8. Phosphorylated-ERK1/2 expressions were detected in Western blot analysis at week 8.ResultsAfter induction of DES, aqueous tear production and goblet cell density were decreased, FL score was much higher in group DES control throughout the study (P<0.05). Both topical Esculetin and Esculetin combing CsA increased the SIT values (10±1 mm, 14±3 mm, P<0.05) and goblet cell densities (77±12/HP, 92±12/HP, P<0.05), decreased FL scores (7.48±0.33, 5.09±0.24, P<0.05) at week 8. Alternations of IL-1α,IL-1β,TNF-αlevels had similar trend. In Western blot analysis, downregulations of p-ERK1/2 were observed in therapy groups when compared with group DES control and the most decreasing was found in group C&E (P<0.05).ConclusionTopical Esculetin improved DES symptoms, downregulated the inflammatory cytokine expressions, suppressed the ERK1/2 pathway and enhanced the therapeutic effect of CsA.

Bounded perturbation resilience of extragradient-type methods and their applications

In this paper we study the bounded perturbation resilience of the extragradient and the subgradient extragradient methods for solving a variational inequality (VI) problem in real Hilbert spaces. This is an important property of algorithms which guarantees the convergence of the scheme under summable errors, meaning that an inexact version of the methods can also be considered. Moreover, once an algorithm is proved to be bounded perturbation resilience, superiorization can be used, and this allows flexibility in choosing the bounded perturbations in order to obtain a superior solution, as well explained in the paper. We also discuss some inertial extragradient methods. Under mild and standard assumptions of monotonicity and Lipschitz continuity of the VI's associated mapping, convergence of the perturbed extragradient and subgradient extragradient methods is proved. In addition we show that the perturbed algorithms converge at the rate of [Formula: see text]. Numerical illustrations are given to demonstrate the performances of the algorithms.

An integrative model of prostate cancer interaction with the bone microenvironment

Despite advanced efforts in early diagnosis, aggressive surgical treatment, and use of targeted chemotherapies, the prognosis for many cancers is still dismal. This emphasizes the necessity to develop new strategies for understanding tumor growth and metastasis. Here we use a systems approach that combines mathematical modeling and numerical simulation to develop a predictive computational model for prostate cancer and its subversion of the bone microenvironment. This model simulates metastatic prostate cancer evolution, progressing from normal bone and hormone levels to quantifiable diseased states. The simulations clearly demonstrate phenomena similar to those found clinically in prostate cancer patients. In addition, the major prediction of this model is the existence of low and high osteogenic states that are markedly different from one another. The existence and potential realization of these steady states appear to be mediated by the Wnt signaling pathway and by the effects of PSA on TGF-β, which encourages the bone microenvironment to evolve. The model is used to explore several potential therapeutic strategies, with some potential drug targets showing more promise than others: in particular, completely blocking Wnt and greatly increasing DKK-1 had significant positive effects, while blocking RANKL did not improve the outcome.

[A multicenter clinical study for the comparison of S-1 versus capecitabine in the treatment of advanced breast cancer]

Objective: To investigate the safety, efficacy and prognostic factors of S-1 versus capecitabine in patients with advanced breast cancer (ABC). Methods: From January 1, 2012 to December 31, 2014, 154 ABC patients with pathological diagnosis were separated into two groups: S-1 with or without the 3rd generation chemotherapy drug (group S-1) and capecitabine with or without the 3rd generation chemotherapy drug (Group capecitabine). The efficacy, side effects and prognostic factors were compared between the two groups. Results: There were 70 patients in group S-1 and 84 patients in group capecitabine. The objective response rates (ORR) were 31.4% (22/70) in group S-1 and 28.6% (24/84) in group capecitabine. The disease control rates (DCR) were 74.3% (52/70) and 83.3% (70/84), respectively. There were no significant differences in DCR and ORR between two groups (P>0.05). The DCR of patients treated with capecitabine monotherapy was significantly higher than that of S-1 monotherapy [94.4%(17/18) and 64.0%(16/25), P=0.028]. The median PFS was 7.5 and 8.9 months for the patients in the group S-1 and group capecitabine, with no statistically significant difference (P=0.423). The 1-year survival rates of group S-1 and group capecitabine were 81.4% and 66.7%, respectively, with no significant differences(P=0.020). Univariate analysis showed that ER and/or PR status (P=0.004), T stage (P=0.041), and molecular typing (P=0.046) were associated with PFS. Multivariate analysis showed ER and/or PR status (P=0.034) was an independent prognostic factor related with PFS. The incidence of hemoglobin reduction was 14.3% (10/70) and 36.9% (31/84) in the group S-1 and group capecitabine, and the differences were statistically significant (P=0.002). There was no significant difference in the incidence of leukopenia, neutropenia, thrombocytopenia and hand-foot syndrome between the two groups(P>0.05). Conclusions: S-1 and capecitabine are both effective for advanced breast cancer. Neither ORR nor DCR were significantly different between these two groups. The incidence of gastrointestinal reactions and thrombocytopenia of S-1 was slightly lower than that of capecitabine.

Dynamics of microbial community during ensiling direct-cut alfalfa with and without LAB inoculant and sugar

AIM

To gain deeper insights into the clostridial community dynamics and chemical transformations during the ensiling of alfalfa.

METHODS AND RESULTS

Direct-cut alfalfa silage (with the dry matter content of 240 g kg^-1 ) was prepared with or without the addition of a lactic acid bacterial inoculant and sucrose. Silages were sampled at 0, 3, 7, 14, 28 and 56 days after ensiling and their bacterial community was determined using high-throughput sequencing with a special focus on the clostridial community. A clostridial fermentation occurred in the control silage, with high contents of acetic acid, butyric acid and ammonia nitrogen and Clostridia counts; while the inoculated silage was well preserved, with low pH and high lactic acid content. Lactic acid bacteria dominated the bacterial community during the ensiling process. In the control silage, Weissella confusa, Lactobacillus brevis, Enterococcus mundtii and Pediococcus acidilactici were identified at the beginning of the fermentation. Thereafter, W. confusa, Lactobacillus helsingborgensis and Bifidobacterium asteroides appeared and quickly prevailed. In the inoculated silage, Lactobacillus plantarum dominated the whole ensiling process. The genus Clostridium dominated the clostridial community, and was depressed with the inoculated treatment. Clostridium perfringens, Garciella sp. and Clostridium baratii were the main initiators of the clostridial fermentation of the control silage, while Clostridium tyrobutyricum became the most abundant Clostridia with prolonged ensiling. Overall in the inoculated silage, little changes in the clostridial community were observed throughout the ensiling period. Treating alfalfa silage with a homolactic acid-based bacterial inoculant prevented a clostridial fermentation resulting in more efficient fermentation.

CONCLUSION

Distinct changes in the bacterial community with a special focus on the clostridial community were associated with the development of the clostridial fermentation during the ensiling of alfalfa.

SIGNIFICANCE AND IMPACT OF THE STUDY

High-throughput sequencing based on a novel Clostridia-specific primer set proved a potentially useful tool to study the clostridial community dynamics, and could aid to elucidate the mechanism by which the clostridial fermentation develops during the ensiling of alfalfa.

Sofosbuvir plus ribavirin in treatment-naïve patients with chronic hepatitis C virus genotype 1 or 3 infection in India

Until 2014, pegylated interferon plus ribavirin was the recommended standard of care for the treatment of chronic hepatitis C virus (HCV) infection in India. This open-label phase 3b study, conducted across 14 sites in India between 31 March 2014 and 30 November 2015, evaluated the efficacy and safety of sofosbuvir plus ribavirin therapy among treatment-naïve patients with chronic genotype 1 or 3 HCV infection. A total of 117 patients with genotype 1 or 3 HCV infection were randomized 1:1 to receive sofosbuvir 400 mg and weight-based ribavirin (1000 or 1200 mg) daily for 16 or 24 weeks. Among those with genotype 1 infection, the primary efficacy endpoint of sustained virologic response at 12 weeks post-treatment (SVR12) was reported in 90% (95% confidence intervals [CI], 73-98) and 96% (95% CI, 82-100) of patients following 16 and 24 weeks of treatment, respectively. For patients with genotype 3 infection, SVR12 rates were 100% (95% CI, 88-100) and 93% (95% CI, 78-99) after 16 and 24 weeks of therapy, respectively. Adverse events, most of which were mild or moderate in severity, occurred in 69% and 57% of patients receiving 16 and 24 weeks of treatment, respectively. The most common treatment-emergent adverse events were asthenia, headache and cough. Only one patient in the 24-week group discontinued treatment with sofosbuvir during this study. Overall, sofosbuvir plus ribavirin therapy achieved SVR12 rates ≥90% and was well tolerated among treatment-naïve patients with chronic genotype 1 or 3 HCV infection in India.

Association between glycaemic control and common infections in people with Type 2 diabetes: a cohort study

AIM

To investigate the impact of glycaemic control on infection incidence in people with Type 2 diabetes.

METHODS

We compared infection rates during 2014 in people with Type 2 diabetes and people without diabetes in a large primary care cohort in the UK (the Royal College of General Practitioners Research and Surveillance Centre database). We performed multilevel logistic regression to investigate the impact of Type 2 diabetes on presentation with infection, and the effect of glycaemic control on presentation with upper respiratory tract infections, bronchitis, influenza-like illness, pneumonia, intestinal infectious diseases, herpes simplex, skin and soft tissue infections, urinary tract infections, and genital and perineal infections. People with Type 2 diabetes were stratified by good [HbA_1c < 53 mmol/mol (< 7%)], moderate [HbA_1c 53-69 mmol/mol (7-8.5%)] and poor [HbA_1c > 69 mmol/mol (> 8.5%)] glycaemic control using their most recent HbA_1c concentration. Infection incidence was adjusted for important sociodemographic factors and patient comorbidities.

RESULTS

We identified 34 278 people with Type 2 diabetes and 613 052 people without diabetes for comparison. The incidence of infections was higher in people with Type 2 diabetes for all infections except herpes simplex. Worsening glycaemic control was associated with increased incidence of bronchitis, pneumonia, skin and soft tissue infections, urinary tract infections, and genital and perineal infections, but not with upper respiratory tract infections, influenza-like illness, intestinal infectious diseases or herpes simplex.

CONCLUSIONS

Almost all infections analysed were more common in people with Type 2 diabetes. Infections that are most commonly of bacterial, fungal or yeast origin were more frequent in people with worse glycaemic control.

Bone marrow sFRP5 level is negatively associated with bone formation markers

Secreted frizzled-related protein 5 (sFRP5) level in bone marrow environment is inversely correlated with bone formation markers, suggesting that it decreases bone mass by inhibiting bone formation. Besides, it functions in a local fashion when regulating bone metabolism. sFRP5 may be a target when developing anti-osteoporotic agents.

INTRODUCTION

The purpose of the study is to investigate the relationship between bone marrow sFRP5 level and bone turnover state.

METHODS

Eighty-three total knee arthroplasty patients were enrolled in this study. Data were collected prospectively and reviewed retrospectively. Lumbar spine and femoral neck bone mineral density (BMD), marrow adipose tissue (MAT) sFRP5 messenger RNA (mRNA) expression level, sFRP5 concentrations in marrow fluid and serum, concentrations of bone formation and resorption markers were measured for each participant.

RESULTS

Marrow fluid sFRP5 concentration was positively correlated with both MAT sFRP5 expression (p = 0.040) and serum sFRP5 concentration (p = 0.043). Significantly positive correlation existed between MAT sFRP5 expression level and BMD (p < 0.05). Marrow fluid sFRP5 concentration had a moderate but not significant positive association with BMD. MAT sFRP5 was negatively related to serum bone formation markers including N-terminal propeptide of type 1 procollagen (P1NP) (p = 0.011), osteocalcin (OC), and alkaline phosphatase (ALP). Marrow fluid and serum sFRP5 concentrations also had mild negative correlations with bone formation markers but reached no significance. There was no significant correlation between bone resorption marker β-crosslaps (β-CTX) and sFRP5. The mRNA expression level of MAT sFRP5 was positively related with those of MAT leptin, peroxisome proliferator-activated receptor-γ (PPARγ), and adiponectin, and its correlation with leptin was statistically significant (p = 0.026).

CONCLUSIONS

Bone marrow sFRP5 level is closely correlated with BMD and bone formation markers. sFRP5 may be a potential negative regulator of bone mass by inhibiting bone formation. It may exert its effects on bone metabolism in a paracrine, rather than endocrine manner.

Effect of epigallocatechin-3-gallate on acrylamide-induced oxidative stress and apoptosis in PC12 cells

Acrylamide (ACR) is a chemical intermediate utilized in industry. ACR is also formed during heating of foods containing carbohydrates and amino acids. Therefore, humans are widely exposed to ACR, and ACR neurotoxicity in humans is a significant public health issue attracting wide attention. In this study, we investigated the potential neuroprotective effects of epigallocatechin-3-gallate (EGCG), the most abundant polyphenolic compound in green tea, in PC12 cells treated with ACR. ACR-treated PC12 cells pretreated with various concentrations of EGCG (2.5, 5 and 10 μM) for 24 h had increased viability and acetylcholinesterase activity and reduced apoptosis and necrosis compared to cells exposed to ACR alone. EGCG reduced the expression of bax mRNA, decreased cytochrome c release, reduced intracellular calcium levels, inactivated caspase 3 and increased mitochondrial membrane potential, suggesting that EGCG prevents ACR-induced apoptosis through a mitochondrial-mediated pathway. In addition, EGCG inhibited the formation of reactive oxygen species and lipid peroxidation while enhancing superoxide dismutase activity and glutathione levels, thereby reducing oxidative stress. Our results indicate that pretreatment of PC12 cells with EGCG attenuates ACR-induced apoptosis by reducing oxidative stress. Therefore, drinking green tea may reduce nerve injury induced by ACR.

Activation of chrysocolla flotation by organic chelating agents

Activation of chrysocolla by organic Cu-chelating agents was studied using a series of test and analysis methods, revealing that the performance of these agents was related to their chemical activity and chrysocolla dissolution properties.

Trajectories of Nutritional Risk: The Manitoba Follow-Up Study

OBJECTIVES

To identify patterns of nutritional risk among older men over a four-year period and to project their survival rates over the next two and a half years.

DESIGN

A prospective longitudinal study.

SETTING

Canada.

PARTICIPANTS

Three hundred and thirty-six male survivors of the Manitoba Follow-up Study (MFUS) cohort with an average age of 90 years in 2011.

MEASUREMENTS

Four years of nutritional risk SCREEN II scores (five waves) from the male survivors of the MFUS cohort. The semi-parametric group-based trajectory approach and survival analysis were used to investigate the trajectories of nutritional risk.

RESULTS

Of the participants, 30% lived alone. Five distinct developmental trajectory groups for nutritional risk score were identified. Significant statistical differences were found among the five trajectory groups for SF-36 mental health (p=.02), SF-36 physical health (p=<.001), perception of aging successfully (p=.04) and living alone (p=<.001). Among the five groups, the most pairwise differences were found in appetite, intake of meat and alternatives, and vegetables and fruit, weight change, skipping meals and eating with others. Men in the poorest nutritional risk trajectory group were two times more likely to die within a 2 1/2 year period compared to men in the best nutritional risk trajectory group (hazard rate = 2.33, p=.07).

CONCLUSION

Distinct nutritional risk trajectories were found for older men over a four year period. Poor nutritional risk trajectories are associated with higher risk of mortality for very old men over a short period of time. Timely nutritional assessments by health professionals are needed to identify older men at nutritional risk. Subsequent nutrition education and follow-up may be important in preventing further decline.

Improved spatial calibration for the CXRS system on EAST

A Charge eXchange Recombination Spectroscopy (CXRS) diagnostic system has been developed to measure profiles of ion temperature and rotation since 2014 on EAST. Several techniques have been developed to improve the spatial calibration of the CXRS diagnostic. The sightline location was obtained by measuring the coordinates of three points on each sightline using an articulated flexible coordinate measuring arm when the vessel was accessible. After vacuum pumping, the effect of pressure change in the vacuum vessel was evaluated by observing the movement of the light spot from back-illuminated sightlines on the first wall using the newly developed articulated inspection arm. In addition, the rotation of the periscope after vacuum pumping was derived by using the Doppler shift of neutral beam emission spectra without magnetic field. Combining these techniques, improved spatial calibration was implemented to provide a complete and accurate description of the EAST CXRS system. Due to the effects of the change of air pressure, a ∼0.4° periscope rotation, yielding a ∼20 mm movement of the major radius of observation positions to the lower field side, was derived. Results of Zeeman splitting of neutral beam emission spectra with magnetic field also showed good agreement with the calibration results.

First measurement of the edge charge exchange recombination spectroscopy on EAST tokamak

An edge toroidal charge exchange recombination spectroscopy (eCXRS) diagnostic, based on a heating neutral beam injection (NBI), has been deployed recently on the Experimental Advanced Superconducting Tokamak (EAST). The eCXRS, which aims to measure the plasma ion temperature and toroidal rotation velocity in the edge region simultaneously, is a complement to the exiting core CXRS (cCXRS). Two rows with 32 fiber channels each cover a radial range from ∼2.15 m to ∼2.32 m with a high spatial resolution of ∼5-7 mm. Charge exchange emission of Carbon VI CVI at 529.059 nm induced by the NBI is routinely observed, but can be tuned to any interested wavelength in the spectral range from 400 to 700 nm. Double-slit fiber bundles increase the number of channels, the fibers viewing the same radial position are binned on the CCD detector to improve the signal-to-noise ratio, enabling shorter exposure time down to 5 ms. One channel is connected to a neon lamp, which provides the real-time wavelength calibration on a shot-to-shot basis. In this paper, an overview of the eCXRS diagnostic on EAST is presented and the first results from the 2015 experimental campaign will be shown. Good agreements in ion temperature and toroidal rotation are obtained between the eCXRS and cCXRS systems.

DREADD in parvalbumin interneurons of the dentate gyrus modulates anxiety, social interaction and memory extinction

Parvalbumin (PV)-positive interneurons in the hippocampus play a critical role in animal memory, such as spatial working memory. However, how PV-positive interneurons in the subregions of the hippocampus affect animal behaviors remains poorly defined. Here, we achieved specific and reversible activation of PV-positive interneurons using designer receptors exclusively activated by designer drugs (DREADD) technology. Inducible DREADD expression was demonstrated in vitro in cultured neurons, in which co-transfection of the hM3D-Gq-mCherry vector with a Cre plasmid resulted in a cellular response to hM3Dq ligand clozapine-N-oxide (CNO) stimulation. In addition, the dentate gyrus (DG) of PV-Cre mice received bilateral injection of control lentivirus or lentivirus expressing double floxed hM3D-Gq-mCherry. Selective activation of PV-positive interneurons in the DG did not affect locomotor activity or depression-related behavior in mice. Interestingly, stimulation of PV-positive interneurons induced an anxiolytic effect. Activation of PVpositive interneurons appears to impair social interaction to novelty, but has no effect on social motivation. However, this defect is likely due to the anxiolytic effect as the exploratory behavior of mice expressing hM3DGq is significantly increased. Mice expressing hM3D-Gq did not affect novel object recognition. Activation of PV-positive interneurons in the DG maintains intact cued and contextual fear memory but facilitates fear extinction. Collectively, our results demonstrated that proper control of PV interneurons activity in the DG is critical for regulation of the anxiety, social interaction and fear extinction. These results improve our fundamental understanding of the physiological role of PV-positive interneurons in the hippocampus.

Tollip SNP rs5743899 modulates human airway epithelial responses to rhinovirus infection

BACKGROUND

Rhinovirus (RV) infection in asthma induces varying degrees of airway inflammation (e.g. neutrophils), but the underlying mechanisms remain unclear.

OBJECTIVE

The major goal was to determine the role of genetic variation [e.g. single nucleotide polymorphisms (SNPs)] of Toll-interacting protein (Tollip) in airway epithelial responses to RV in a type 2 cytokine milieu.

METHODS

DNA from blood of asthmatic and normal subjects was genotyped for Tollip SNP rs5743899 AA, AG and GG genotypes. Human tracheobronchial epithelial (HTBE) cells from donors without lung disease were cultured to determine pro-inflammatory and antiviral responses to IL-13 and RV16. Tollip knockout and wild-type mice were challenged with house dust mite (HDM) and infected with RV1B to determine lung inflammation and antiviral response.

RESULTS

Asthmatic subjects carrying the AG or GG genotype (AG/GG) compared with the AA genotype demonstrated greater airflow limitation. HTBE cells with AG/GG expressed less Tollip. Upon IL-13 and RV16 treatment, cells with AG/GG (vs. AA) produced more IL-8 and expressed less antiviral genes, which was coupled with increased NF-κB activity and decreased expression of LC3, a hallmark of the autophagic pathway. Tollip co-localized and interacted with LC3. Inhibition of autophagy decreased antiviral genes in IL-13- and RV16-treated cells. Upon HDM and RV1B, Tollip knockout (vs. wild-type) mice demonstrated higher levels of lung neutrophilic inflammation and viral load, but lower levels of antiviral gene expression.

CONCLUSIONS AND CLINICAL RELEVANCE

Our data suggest that Tollip SNP rs5743899 may predict varying airway response to RV infection in asthma.

Diabetes mellitus and the skin

Diabetes is a debilitating, life-threatening disease accounting in 2015 for the death of 5 million people worldwide. According to new estimations, 415 million adults currently suffer from the disease, and this number is expected to rise to 642 million by 2040. High glucose blood levels also affect the skin among systemic organs, and skin disorders can often predict the onset of this metabolic disorder. In this review, we address the pathomechanistic effects of diabetes on the skin and give an overview on the most common skin diseases associated with diabetes.

Effects of dietary conjugated linoleic acid on cytotoxicity of peripheral blood lymphocytes in piglets

The aim of this study was to investigate the effects of dietary conjugated linoleic acid (CLA) on the cytotoxicity of peripheral blood lymphocytes in piglets. A total of forty 21-d-old Duroc × Large White × Landrace weaned piglets were randomly allocated into two treatment groups and fed with control diet or 2% CLA diet for 6 weeks. Dietary CLA significantly increased the number of peripheral blood CD8+ T lymphocytes (P < 0.05). Compared with the control group, cytotoxicity, perforin, and granzyme B mRNA expression of peripheral blood lymphocytes in piglets from the CLA-supplementation group increased by 29.98% (P < 0.01), 32.87% (P < 0.01), and 43.36% (P < 0.05), respectively. The piglets on the CLA diet had higher mRNA expression of Lck and Fyn in peripheral blood lymphocytes (P < 0.05). The content of C16:0 significantly increased in piglets from the dietary CLA-supplementation group (P < 0.05), whereas the content of C18:1 significantly decreased (P < 0.05). The CLA content of peripheral blood lymphocytes in piglets in the CLA diet group ranged up to 0.24% (P < 0.01). These results suggest that dietary CLA enhanced cytotoxicity of peripheral blood lymphocytes perhaps through changing its fatty acid composition.

[Determination of trace cobalt and tungsten in human urine by inductively coupled plasma mass spectrometry]

OBJECTIVE

To establish a method to determine cobalt and tungsten in human urine by ICP-MS.

METHODS

Both Co and W were linear within 0.05~10.00 ng/ml with r>0.999. Spike experiment showed that both Co and W received good recovery rate, which were 90%~97%. Intra-assay precisions were 3.2%~5.1% for Co and 2.2%~4.1% for W, inter-assay precisions were 4.4%~5.2% for Co and 3.7%~4.5% for W.

CONCLUSION

The method by using ICP-MS to determine urine Co and W was fast, accurate and with low matrix effect. It could meet the requirement in GBZ/T 210.5-2008.

[Determination of trace cobalt in human urine by graphite furnace atomic absorption spectrometr]

OBJECTIVE

To establish a method to determine cobalt in human urine by graphite furnace atomic absorption spectrometry.

METHODS

Urine with 2% nitric acid diluted two-fold, to quantify the curve, graphite furnace atomic absorption spectrometric detection.

RESULTS

Co was linear within 2.5~40.0 ng/ml with r>0.999. Spike experiment showed that Co received good recovery rate, which was 90.8%~94.8%. Intra-assay precisions were 3.2%~5.1% for Co, inter-assay precisions were 4.4%~5.2% for Co.

CONCLUSION

The method by using graphite furnace atomic absorption spectrometr to determine urine Co was fast, accurate and with low matrix effect. It could meet the requirement in GBZ/T 210.5-2008.

Factors affecting finger and hand pain in workers with HAVS

BACKGROUND

Pain and its management are important aspects of hand-arm vibration syndrome (HAVS).

AIMS

To determine the factors associated with finger and hand pain in workers with HAVS and, specifically, to assess the impact of several neurological variables as well as the vascular component of HAVS, grip strength and age.

METHODS

We assessed men with HAVS at a hospital occupational medicine clinic over 2 years. Subjects scored finger and hand pain separately using the Borg Scale (0-10). The possible predictors we evaluated included the Stockholm Neurological Scale (SNS) and Stockholm Vascular Scale (SVS) stages, current perception threshold (CPT), carpal tunnel syndrome (CTS), ulnar neuropathy, grip strength and age. We carried out nerve conduction testing to confirm the presence of CTS and ulnar neuropathy and measured CPT in the fingers at 2000 Hz, 250 Hz and 5 Hz corresponding to A-beta (large myelinated), A-delta (small myelinated) and C (unmyelinated) fibres, respectively. We calculated Spearman rank correlations to examine the relation between finger and hand pain and possible predictor variables.

RESULTS

Among the 134 subjects, the median (25th-75th percentile) pain scores were 6 (4-8) for the fingers and 5 (1-7) for the hands. We found statistically significant correlations with finger pain for the SVS stage (r = 0.239; P < 0.01) and CTS (r = 0.184; P < 0.05). The only statistically significant correlation identified for hand pain was a negative correlation with grip strength (r = -0.185; P < 0.05).

CONCLUSIONS

Management of finger and hand pain in HAVS should focus on the correlates we have identified.