Insulin-like growth factor I reduces the occurrence of necrotizing enterocolitis by reducing inflammatory response and protecting intestinal mucosal barrier in neonatal rats model

OBJECTIVE

To observe the effect of enteral supplement of insulin-like growth factor I (IGF-1) on dynamic changes of TLR4, NF-κB, IL-6, SIgA and MUC2 in intestinal tissues of neonatal rats, and to investigate the protective effects and possible mechanisms of IGF-1 on necrotizing enterocolitis (NEC).

MATERIALS AND METHODS

Specific pathogen free (SPF) neonatal Sprague Dawley (SD) rats aged 3 days old were randomly divided into 3 groups, namely, normal control group, NEC model group and IGF-1 intervention group. In NEC group, the neonatal NEC rat models were established using artificial feeding, hypoxia and cold stimulation. In IGF-1 intervention group, the models were established by means of artificial feeding plus hypoxia and cold stimulation, and IGF-1 (22 ug/L) at a physiological concentration similar to the breast milk was added to milk replacer for intervention. The rats in the three groups were killed after the blood was collected from the heart at 24, 48 and 72 h, respectively, following the establishment of models; then, 3 cm of the terminal ilea were dissected and used for histopathological examination, RT-PCR and ELISA studies after hematoxylin and eosin (HE) staining.

RESULTS

Symptoms in IGF-1 intervention group were significantly relieved, and the incidence rate of NEC was lowered remarkably. In NEC model group, the peak expression of TLR4 mRNA occurred later than that of NF-κB mRNA and IL-6, and the expressions of TLR4 mRNA, NF-κB mRNA and IL-6 were decreased at 72 h after IGF-1 intervention. In NEC model group, the expression of MUC2 showed a transient decrease, the expression of SIgA was on the decline, but the expressions of MUC2 and SIgA were increased after IGF-1 intervention.

CONCLUSIONS

The enteral administration of IGF-1 at a physiological concentration can ameliorate the clinical symptoms in neonatal NEC rat models and decrease the occurrence rate. The possible mechanism is that IGF-1 down-regulates the TLR4 mRNA expression to inhibit the production of inflammatory mediators, and it up-regulates the expressions of MUC2 and SIgA to protect the mechanical and immuno-barrier functions of the intestinal mucous.

Influences of RFA combined with TACE on the HIF-1α and EGR level of patients with primary hepatic carcinoma

OBJECTIVE

To discuss the influences of radiofrequency ablation (RFA) combined with hepatic arterial chemoembolization on the expression level of immunity and hypoxia-inducible factor (HIF-1a) and early growth response protein2 (EGR2) of patients with hepatocarcinoma.

PATIENTS AND METHODS

Patients with primary hepatic carcinoma treated in our hospital from 2011 to 2014 were divided into research group (RFA+TACE) and control group (TACE) according to different therapy methods, with 72 patients in each group. Then, the immunity functions were detected before treatment and 3 months after treatment, the expression level of HIF-1a, EGR-2, the alpha fetal protein (AFP), the therapeutic effect, and incidence of adverse reaction in near and specific future were compared between two groups.

RESULTS

After treatment, the ratio of CD3+ and CD4+T cells, specific vale of CD4/CD8, and NK cell population in research group were more than those in control group, while the ratio of CD8+T cells was less than that in control group with statistical significance. Meanwhile, the expression levels of HIF-1a (F between-group*time point = 5.353, p = 0.043), EGR-2 (F between-group*time point = 4.385, p = 0.044), and AFP (F between-group*time point = 4.205, p = 0.045) had difference with statistical significance. Moreover, the recent therapy response rate in research group was 76.4%, which was higher than that in control group (50.0%), with significant difference (χ2 = 10.784, p = 0.029), while the difference of long-term therapeutic effect between two groups has statistical significance (χ2 = 7.439, p = 0.005).

CONCLUSIONS

The treatment of primary hepatic carcinoma by TACE combined with RAF therapeutic schedule was helpful in improving organic immunity, decreasing tumor angiogenesis and reducing tumor cell proliferation speed to improve the short- and long-term therapeutic effects.

Sex differences in the impact of nonalcoholic fatty liver disease on cardiovascular risk factors

BACKGROUND AND AIMS

Information on sex differences in the association of nonalcoholic fatty liver disease (NAFLD) with cardiovascular disease (CVD) risk factors is scarce. We examined whether men exhibit greater differences in established CVD risk factors between NAFLD and non-NAFLD than women.

METHODS AND RESULTS

We conducted a cross-sectional analysis using a cohort of 10761 apparently healthy Chinese adults who underwent comprehensive health checkups including abdominal ultrasonography. In the setting of NAFLD and non-NAFLD, although men had significantly higher levels of atherogenic lipids as indicated by higher levels of triglyceride, triglyceride/HDL-cholesterol, and lower levels of HDL-cholesterol and worsen renal function as indicated by higher levels of creatinine and lower levels of estimated glomerular filtration rate (eGFR) than female counterparts, men with NAFLD showed greater relative differences in atherogenic lipids and deteriorated renal function than women with NAFLD when compared with their non-NAFLD counterparts. The interactions between sex and NAFLD on triglyceride, HDL-cholesterol, triglyceride/HDL-cholesterol, creatinine, and eGFR were statistically significant (P < 0.05). In the multivariate Logistic regression analyses, we observed a stronger association of TG with NAFLD and comparable associations of eGFR or HDL-C with NAFLD in men compared with women.

CONCLUSION

There was greater adverse influence of NAFLD per se on triglyceride, and triglyceride/HDL-cholesterol in men compared with women. The greater adverse influence of NAFLD per se on HDL-C and eGFR in men compared with women probably related to the gender differences in TG levels.

Ten-year follow-up analysis of chronic hepatitis C patients after getting sustained virological response to pegylated interferon-α and ribavirin therapy

There is little data on the long-term follow-up outcomes of chronic hepatitis C patients achieving sustained virological response (SVR) after treatment with peglylated interferon-α plus ribavirin. We prospectively investigated the overall clinical, biochemical, virological and histological outcomes in a ten-year cohort study of 325 patients with chronic hepatitis C achieving SVR to pegylated interferon-α and ribavirin therapy. Patients underwent consistent clinical, biochemical and virological evaluation every six months, and patients with pretherapy Ishak fibrosis score ≥2 were invited to accept a second liver biopsy at the last follow-up. Liver biopsy specimens were evaluated using Ishak's scoring system. At the end of follow-up, five patients developed decompensated liver cirrhosis. One patient (0.3%) with pretherapy cirrhosis was diagnosed with hepatocellular carcinoma (HCC). A total of 305 patients (94%) had normal serum ALT and AST levels during the entire period of follow-up. Twenty-seven patients (8%) had conclusive evidence of virological relapse. Among the 117 patients with paired pretherapy and long-term follow-up biopsies, 96 (82%) had a decreased fibrosis score. Ninety-nine (79%) had a decrease in combined inflammation score. Thirty-seven (32%) had normal or nearly normal livers on long-term follow-up biopsy. SVR achieved with PEG-IFN-α and RBV combination therapy is durable, while late virological relapse may still occur in some patients. Clinical outcomes for patients who obtain SVR are excellent, although the patients with cirrhosis are still at a low risk of hepatocellular carcinoma.

Measuring perceived rehabilitation needs of people with schizophrenia in mainland China

This paper reports the development and validation of the Wuxi version of the Rehabilitation Needs Questionnaire for People with Schizophrenia (PRNQ-S-WX) based on the original Hong Kong version. PRNQ-S-WX was validated by exploratory factor analysis (EFA) using a convenience sample of 250 people with schizophrenia. EFA yielded a 17-factor solution accounting for 81.3 % of the total variance which resulted in a 75-item PRNQ-S-WX. The questionnaire has sound internal consistencies. Its factor structure is similar to the Hong Kong version. Some suggestions for policy, service and research development in mental health in mainland China are made.

Mechanoresponsive Properties of the Periodontal Ligament

The periodontal ligament (PDL) functions as an enthesis, a connective tissue attachment that dissipates strains created by mechanical loading. Entheses are mechanoresponsive structures that rapidly adapt to changes in their mechanical loading; here we asked which features of the PDL are sensitive to such in vivo loading. We evaluated the PDL in 4 physiologically relevant mechanical environments, focusing on mitotic activity, cell density, collagen content, osteogenic protein expression, and organization of the tissue. In addition to examining PDLs that supported teeth under masticatory loading and eruptive forces, 2 additional mechanical conditions were created and analyzed: hypoloading and experimental tooth movement. Collectively, these data revealed that the adult PDL is a remarkably quiescent tissue and that only when it is subjected to increased loads—such as those associated with mastication, eruption, and orthodontic tooth movement—does the tissue increase its rate of cell proliferation and collagen production. These data have relevance in clinical scenarios where PDL acclimatization can be exploited to optimize tooth movement.

A survey of outcomes and management of patients post fragility fractures in China

We found that the fragility hip and vertebral fractures caused excess mortality rates in this Chinese female population, which was unexpectedly lower than those in western countries and other Asian countries. This was the first nationwide survey relating to post-fracture outcomes conducted among Chinese population in Mainland China.

INTRODUCTION

This study aimed to investigate the mortality, self-care ability, diagnosis, and medication treatment of osteoporosis following fragility hip and vertebral fractures through a nationwide survey among female patients aged over 50 in Mainland China.

METHODS

This was a multicenter, retrospective cohort study based on medical chart review and patient questionnaire. Female patients aged 50 or older admitted for low-trauma hip or vertebral fractures and discharged from Jan 1, 2008 to Dec 31, 2012 were followed.

RESULTS

Total of 1151 subjects of hip fracture and 842 subjects of vertebral fracture were included. The mean age was 73.4 ± 10.0, and the median of duration from index fracture to interview was 2.6 years. The overall 1-year, 2-year, 3-year, 4-year, and 5-year cumulative mortality rates were 3.5, 7.0, 11.2, 13.1, and 16.9 %, respectively. The first year mortality rates in hip (3.8 %, 95% CI 3.3-4.4 %) and vertebral fracture (3.1 %, 95% CI 2.5-3.7 %) were significantly higher than that in the general population (1.6 %). Impaired self-care ability was observed in 33.2, 40.6, and 23.8 % of overall, hip fracture, and vertebral fracture group, respectively. The overall diagnosis rate of osteoporosis was 56.8 %, and bone mineral density (BMD) measurement had never been conducted in 42.0 % among these women. After the index fracture, 69.6 % of them received supplements and/or anti-osteoporotic medications, among which 39.6 % only received calcium with/without vitamin D supplementation.

CONCLUSIONS

The osteoporotic hip and vertebral fractures caused excess mortality rates in this population of Mainland China. The current diagnosis and medical treatment following the fragility fractures is still insufficient in Mainland China.

Towards next generation adenosine A(2A) receptor antagonists

The Adenosine A2A receptor is a member of the G-protein coupled receptor superfamily. It plays a key role in numerous physiological processes through the central nervous system and in peripheral tissues. Functional interactions between the A2A and dopamine D2 receptor has spurred interest in the use of antagonists as anti-Parkinson drugs. Additionally, oncology drugs are now being designed based on the potential for A2A antagonists to function as immunotherapeutics. From early studies based on classical xanthine type A2A antagonists through second generation agents, this mini review will cover aspects of the discovery, development, chemical synthesis and medicinal evaluation of this important class of drugs.

Search for patterns by combining cosmic-ray energy and arrival directions at the Pierre Auger Observatory

Energy-dependent patterns in the arrival directions of cosmic rays are searched for using data of the Pierre Auger Observatory. We investigate local regions around the highest-energy cosmic rays with [Formula: see text] eV by analyzing cosmic rays with energies above [Formula: see text] eV arriving within an angular separation of approximately 15[Formula: see text]. We characterize the energy distributions inside these regions by two independent methods, one searching for angular dependence of energy-energy correlations and one searching for collimation of energy along the local system of principal axes of the energy distribution. No significant patterns are found with this analysis. The comparison of these measurements with astrophysical scenarios can therefore be used to obtain constraints on related model parameters such as strength of cosmic-ray deflection and density of point sources.

Isomer-specific comparisons of the hydrolysis of synthetic pyrethroids and their fluorogenic analogues by esterases from the cotton bollworm Helicoverpa armigera

The low aqueous solubility and chiral complexity of synthetic pyrethroids, together with large differences between isomers in their insecticidal potency, have hindered the development of meaningful assays of their metabolism and metabolic resistance to them. To overcome these problems, Shan and Hammock (2001) [7] therefore developed fluorogenic and more water-soluble analogues of all the individual isomers of the commonly used Type 2 pyrethroids, cypermethrin and fenvalerate. The analogues have now been used in several studies of esterase-based metabolism and metabolic resistance. Here we test the validity of these analogues by quantitatively comparing their hydrolysis by a battery of 22 heterologously expressed insect esterases with the hydrolysis of the corresponding pyrethroid isomers by these esterases in an HPLC assay recently developed by Teese et al. (2013) [14]. We find a strong, albeit not complete, correlation (r = 0.7) between rates for the two sets of substrates. The three most potent isomers tested were all relatively slowly degraded in both sets of data but three esterases previously associated with pyrethroid resistance in Helicoverpa armigera did not show higher activities for these isomers than did allelic enzymes derived from susceptible H. armigera. Given their amenability to continuous assays at low substrate concentrations in microplate format, and ready detection of product, we endorse the ongoing utility of the analogues in many metabolic studies of pyrethroids.

Nontraditional risk factors for cardiovascular disease and visceral adiposity index among different body size phenotypes

BACKGROUND AND AIMS

Increased cardiovascular disease and mortality risk in metabolically healthy obese (MHO) individuals remain highly controversial. Several studies suggested risk while others do not. The traditional cardiovascular risk factors may be insufficient to demonstrate the complete range of metabolic abnormalities in MHO individuals. Hence, we aimed to compare the prevalence of elevated lipoprotein (a), apolipoprotein B, and uric acid (UA) levels, apolipoprotein B/apolipoprotein A1 ratio, and visceral adiposity index (VAI) scores, and low apolipoprotein A1 levels among 6 body size phenotypes (normal weight with and without metabolic abnormalities, overweight with and without metabolic abnormalities, and obese with or without metabolic abnormalities).

METHODS AND RESULTS

We conducted a cross-sectional analysis of 7765 Chinese adults using data from the nationwide China Health and Nutrition Survey 2009. MHO persons had intermediate prevalence of elevated apolipoprotein B and UA levels, apolipoprotein B/apolipoprotein A1 ratio and VAI scores, and low apolipoprotein A1 levels between metabolically healthy normal-weight (MHNW) and metabolically abnormal obese individuals (P < 0.001 for all comparisons). Elevated apolipoprotein B and UA concentrations, apolipoprotein B/apolipoprotein A1 ratio, and VAI scores were all strongly associated with the MHO phenotype (all P < 0.01).

CONCLUSIONS

Prevalence of elevated apolipoprotein B and UA levels, apolipoprotein B/apolipoprotein A1 ratio and VAI scores, and low levels of apolipoprotein A1 was higher among MHO persons than among MHNW individuals. The elevated levels of the nontraditional risk factors and VAI scores in MHO persons could contribute to the increased cardiovascular disease risk observed in long-term studies.

High efficiency chlorine removal from polyvinyl chloride (PVC) pyrolysis with a gas-liquid fluidized bed reactor

In this research a gas-liquid fluidized bed reactor was developed for removing chlorine (Cl) from polyvinyl chloride (PVC) to favor its pyrolysis treatment. In order to efficiently remove Cl within a limited time before extensive generation of hydrocarbon products, the gas-liquid fluidized bed reactor was running at 280-320 °C, where hot N2 was used as fluidizing gas to fluidize the molten polymer, letting the molten polymer contact well with N2 to release Cl in form of HCl. Experimental results showed that dechlorination efficiency is mainly temperature dependent and 300 °C is a proper reaction temperature for efficient dechlorination within a limited time duration and for prevention of extensive pyrolysis; under this temperature 99.5% of Cl removal efficiency can be obtained within reaction time around 1 min after melting is completed as the flow rate of N2 gas was set around 0.47-0.85 Nm(3) kg(-1) for the molten PVC. Larger N2 flow rate and additives in PVC would enhance HCl release but did not change the final dechlorination efficiency; and excessive N2 flow rate should be avoided for prevention of polymer entrainment. HCl is emitted from PVC granules or scraps at the mean time they started to melt and the melting stage should be taken into consideration when design the gas-liquid fluidized bed reactor for dechlorination.

Synergistic sporicidal effect of ethanol on a combination of orthophthalaldehyde and didecyldimethylammonium chloride

The objective of this study was to evaluate the potential synergistic effect of ethanol on a combination of orthophthalaldehyde (OPA) and didecyldimethylammonium chloride (DDAC) against the spores of Bacillus subtilis var. Niger. The quantitative carrier test for sporicidal testing of high-level disinfectants according to the guideline of China (Technical Standard for Disinfection 2002) was used as method. Considerable synergistic effect was observed after a 30-min treatment at 20°C. There was an augment in mean log reduction as the concentration of DDAC was increased ranging from 0·2 to 3 g l(-1) in combination with 6 g l(-1) OPA. Ten and 20% ethanol in combination with 6 g l(-1) OPA and 2 g l(-1) DDAC caused more than a 3-log reduction while either 6 g l(-1) OPA, 2 g l(-1) DDAC and 20% ethanol alone or a combination of two of the three agents produced less than a 1-log reduction. Further, 40-min exposure time of combination of OPA, DDAC and 20% ethanol led to greater than a 5-log reduction in spores, and no spore growth was observed following 60- and 90-min exposures.

SIGNIFICANCE AND IMPACT OF THE STUDY

Orthophthalaldehyde (OPA) is very effective at concentrations far lower than its recommended in-use concentration of 0·5% (w/v) and is equally effective against both the gram-negative and gram-positive bacteria. However, it shows lower activity against spores. The synergistic sporicidal effect exhibited by ethanol on a combination of OPA and DDAC can be considered to enhance sporicidal activity for using in situations of sterilization, to reduce in-use concentration of OPA used alone, which may minimize its side effect. OPA may be a more satisfactory and the first-choice agent to replace glutaraldehyde (GTA) as a high-level disinfectant for medical devices.

A simple and sensitive gas chromatography method for determination of isosorbide dinitrate and its metabolites in human plasma: application to pharmacokinetics study on oral spray

A sensitive method for the simultaneous determination of isosorbide dinitrate (ISDN) and its mononitrate metabolites, isosorbide 2-mononitrate and isosorbide 5-mononitrate (IS-2-MN and IS-5-MN), in human plasma was developed using capillary gas chromatography with electron-capture detection, whereas 1,2,4-butanetriol trinitrate was used as internal standard. The analytes were extracted with a simple liquid-liquid extraction from plasma and separated on a DB-1 column. The results of method validation demonstrated that the calibration curves were linear in range of 2-60 ng/mL for ISDN and IS-5-MN, 1-20 ng/mL for IS-2-MN, respectively. The precision (RSD%) was less than 15%, and the lower limit of quantitation was identifiable and reproducible at 2 ng/mL for ISDN and IS-5-MN, 1 ng/mL for IS-2-MN. The analytes in plasma were stable after being stored for more than 30 days and after 2 freeze-thaw cycles (-20 to 25°C). And then this method was successfully applied to a pharmacokinetic investigation on isosorbide dinitrate oral spray in healthy volunteers.

Pharmacokinetic and bioequivalence studies of ibuprofen suspension after a single-dose administration in healthy Chinese volunteers

OBJECTIVE

The aim of this study was to assessed the pharmacokinetic and bioequivalence of 2 formulations of ibuprofen suspension.

METHOD

20 healthy volunteers were enrolled into this random, single-dose, 2-way crossover, open-label, single-centre, pharmacokinetic study. After overnight fasting, 2 formulations (test and reference) of ibuprofen (400 mg ibuprofen/20 mL suspension) were administered as a single dose on 2 treatment days separated by a 7-day washout period. After dosing, blood samples were drawn for a period of 12 h. The plasma samples were analyzed for the presence of ibuprofen by HPLC with ultraviolet detection. Pharmacokinetic parameters were determined from plasma concentrations for both formulations.

RESULTS

The main pharmacokinetics parameters of test and reference were as follows: t1/2 was (1.94±0.38) h and (1.95±0.28) h; Cmax was (33.41±7.83) μg · mL- 1 and (31.08±9.30) μg · mL- 1; AUC0-12 was (91.44±19.26) μg · mL-1 · h and (84.75±24.45) μg · mL-1 · h; AUC0-∞ was (92.82±19.94) μg · mL-1 · h and (85.97±24.99) μg · mL-1 · h; median Tmax was 0.5 h (range, 0.25, 2) and 0.5 h (range, 0.25, 1.5). The 90% confidence intervals of the test/reference treatment ratios for Cmax, AUC0-12 and AUC0-∞ were observed to be within the predetermined acceptable interval of 80-125%.

CONCLUSION

This single-dose study in healthy Chinese fasted volunteers was shown that the ibuprofen test and reference met the requirement of the State Food and Drug Administration, and the test and reference were bioequivalent.

A more rapid, sensitive, and specific HPLC-MS/MS method for nifedipine analysis in human plasma and application to a pharmacokinetic study

A more rapid, sensitive and specific high-performance liquid chromatography coupled to -tandem mass spectrometry (HPLC-MS/MS) was developed and validated for the quantification of nifedipine in human plasma, and applied to the pharmacokinetic study of nifedipine in Chinese healthy volunteers. Nifedipine and internal standard (IS) acetaminophen in plasma were extracted with ethyl acetate, separated on a C18 (150 mm×4.6 mm, 5 µm) reversed-phase column, eluted with acetonitrile mixed with 5 mM ammonium acetate solution (pH=6.62) (60:40, v/v), ionized by negative ion pneumatically assisted electrospray and detected in the multi-reaction monitoring mode using precursor→product ions of m/z 354.1→222.2 for nifedipine and 150.1→107.1 for the IS. A single oral dose of 20 mg nifedipine sustained release tablets and blood samples (4 mL) was collected before and 1, 2, 2.5, 3, 3.5, 4, 4.5, 5, 6, 8, 12, 24, and 36 h after administration. The main pharmacokinetic parameters of nifedipine, as Tmax, t1/2α, t1/2β, t1/2z, Cmax, AUC0~36, AUC0~∞ were 2.80±0.50 h, 6.78±2.52 h, 6.82±2.53 h, 6.69±2.22 h, 76.69±19.51 (ng/mL), 546.49±162.28 (ng · h/mL) and 564.05±176.74 (ng · h/mL), respectively. The calibration curve was linear over the concentration range of 0.17-102 ng/mL (r2>0.99, n=5) with a lower limit of quantification (LLOQ) of 0.17 ng/mL. The intra- and inter-day precision was less than 15% for all quality control samples at concentrations of 0.42, 6.53 and 81.60 ng/mL and the accuracy (relative error, RE) was - 3.92% to 7.31% at 3 quality control levels. The specificity, matrix effect, recovery, sensitivity, linearity, accuracy, precision and stabilities were validated, and can fulfill the requirement of pharmacokinetic study of nifedipine sustained release tablets in Chinese volunteers.