Risk of low-energy fracture in type 2 diabetes patients: a meta-analysis of observational studies

In this meta-analysis, evidence of an association between type 2 diabetes mellitus (T2DM) and low-energy fractures has been evaluated including 12 observational studies. The results suggested that T2DM patients had an enhanced risk of low-energy fractures.

INTRODUCTION

Type 1 diabetes mellitus (T1DM) patients have been shown to be at enhanced risk of fracture injury, but less is known about low-energy fractures among patients with T2DM.

METHODS

We performed a meta-analysis of 12 observational studies identified in Medline and EMBASE that included 938,742 participants, including 30,827 low-energy fracture cases. The incidence rate ratios (IRRs) of low-energy fractures were determined using a random-effects model.

RESULTS

The IRRs of low-energy fracture for men and women were 1.37 (95% confidence interval [CI], 0.94-2.00; p = 0.096) and 1.22 (95% CI, 1.09-1.35; p = 0.000), respectively, and the overall IRR was 1.23 (95% CI, 1.12-1.35; p = 0.000). The IRRs for hip and vertebral fractures were 1.08 (95% CI, 1.02-1.15; p = 0.007) and 1.21 (95% CI, 0.98-1.48; p = 0.073), respectively. The IRRs of low-energy fracture in case-control, prospective, retrospective, and cross-sectional studies were 1.18 (95% CI, 0.81-1.72; p = 0.380), 1.17 (95% CI, 1.05-1.32, p = 0.006), 1.15 (95% CI, 1.02-1.29; p = 0.020), and 1.60 (95% CI, 1.21-2.12; p = 0.001), respectively. The IRRs of low-energy fracture for less than 5 years, 5 to 10 years, and more than 10 years were 1.30 (95%, CI 1.13-1.50; p = 0.000), 1.05 (95% CI, 1.03-1.08; p = 0.000), and 1.19 (95% CI, 1.00-1.41; p = 0.049), respectively.

CONCLUSIONS

Patients with T2DM had a greater risk of low-energy fracture especially of the hip, compared with that in non-diabetic subjects. However, since according to our funnel plot a publication bias may be present and due to study heterogeneity as well as the limited number of publications, the finding needs to be interpreted with caution.

Genomewide differential expression profiling of long non-coding RNAs in androgenetic alopecia in a Chinese male population

BACKGROUND

Androgenetic alopecia (AGA), or male pattern baldness (MPB), is the most common form of hair loss in males. A combination of genetic and androgen causes have been suggested as factors that contribute to the development of AGA. However, the specific molecular mechanisms that underly AGA remain largely unknown. Long non-coding RNAs (lncRNAs), a new class of regulatory non-coding RNAs that are longer than 200 nucleotides, have been shown to play important roles in a number of cellular processes, including transcription, chromosome remodelling and post-transcriptional processing. The dysregulation of lncRNAs is associated with many forms of diseases, but it remains unknown whether lncRNAs are associated with AGA.

OBJECTIVE

The aim of this study was to identify AGA-associated lncRNAs and predict the potential roles of these lncRNAs in AGA.

METHODS

A genomewide microarray was used to identify lncRNAs that are differentially expressed between AGA and adjacent normal tissues. Real-time qRT-PCR was used to validate the microarray data.

RESULTS

A large number of lncRNAs were differentially expressed (fold change >2.4) between AGA and adjacent normal tissues. Of these, 770 were upregulated and 1373 were downregulated. Moreover, pathway analysis revealed that 53 functional pathways were associated with the upregulated transcripts, while 11 pathways were associated with the downregulated transcripts.

CONCLUSION

To our knowledge, this is the first study to investigate AGA-associated lncRNAs. lncRNA profiles are altered in AGA, and these lncRNAs and their target genes may serve as novel candidates for preventing and treating AGA.

Low-residue diet fed to rabbits induces histomorphological and biomechanical remodeling of small intestine

BACKGROUND

The composition of ingested food is important for the gut microbiome and intestinal homeostasis. We have previously demonstrated that the structure and mechanical properties in the small intestine remodel significantly during fasting. However, it is not clear to what extent the intestinal mechanical properties changes when the composition of food is changed. This study aimed to investigate the passive biomechanical properties and intestinal tissue remodeling in rabbits fed a low-residue diet.

METHODS

New Zealand rabbits (control group n=6, intervention group n=7) were studied. Segments from duodenum, jejunum and ileum were excised. The intestinal diameter and length were obtained from digitized images of the segments at preselected luminal pressure levels and at no-load and zero-stress states. Circumferential and longitudinal stresses (force per area) and strains (deformation) were computed from the length, diameter and pressure data referenced to the zero-stress state geometry. Histomorphometric data were also obtained.

KEY RESULTS

The wet weight-per-unit length, wall thickness and wall area decreased in the intervention group (P<.05, P<.01). Histological measurement confirmed that the wall thickness decreased in all three segments, which was primarily due to mucosal thinning (P<.05). The opening angle tended to increase in all segments in the intervention group. Significant difference between the two groups was found for the jejunum (P<.05). Feeding the low-residue diet shifted the circumferential stress-strain curves in the intervention group to the right, indicating intestinal wall softening.

CONCLUSIONS & INFERENCES

Low-residue diet in rabbits for 1 month induces location-dependent histomorphometric and biomechanical remodeling of the intestine.

Inhibition of miR-660-5p expression suppresses tumor development and metastasis in human breast cancer

Breast cancer, which derives from the epithelium of the mammary glands, is one of the most common cancers diagnosed in women globally. To date, the authors of many studies have reported that the deregulation of microRNAs (miRNAs) plays a crucial role in the occurrence, development, and metastasis of tumors. Here, we discovered that miR-660-5p was upregulated in the breast cancer cell lines MCF7 and MDA-MB-231 compared with that in the normal control cell line CCD-1095Sk. We then inhibited the expression of miR-660-5p to investigate its biological function in cancer development, progression, and metastasis. We determined the changes in the levels of expression of transcription factor CP2 (TFCP2) and CDKN1A to further clarify the specific mechanism involved. The results showed that downregulation of miR-660-5p significantly suppressed the proliferation, migration, and invasion of MCF7 breast cancer cell. Moreover, inhibition of miR-660-5p promoted cell cycle G1 arrest and reduced apoptosis in breast cancer cells. The specific mechanism studies confirmed that TFCP2 was a direct downstream target of miR-660-5p. Aberrant expression of miR-660-5p repressed TFCP2 expression, whereas inhibition of miR-660-5p decreased TFCP2 protein expression, which is a vital factor in the downstream signaling pathway. In conclusion, miR-660-5p can regulate the proliferation, migration, and invasion of human breast cancer cells, and is a novel potential therapeutic target for the clinical treatment of breast cancer.

[Clinical characteristics of bone disease in multiple myeloma and clinical significance of monitoring bone metabolic markers]

OBJECTIVE

To observe the clinical characteristics of bone disease in patients with multiple myeloma (MM) and the clinical significance of monitoring bone metabolic markers.

METHODS

The data of 178 MM cases newly diagnosed in Beijing Ji Shui Tan Hospital from January 2009 to June 2014 were reviewed to analysis the types and classification of bone disease and to observe the clinical characteristics of patients with different grades of bone disease. The levels of bone metabolic markers total procollagen type Ⅰ N-terminal peptide (tPINP) and β C-terminal telopeptide of type Ⅰ collagen (β-CTX) were monitored regularly in the two years following treatment in 66 cases.

RESULTS

(1) Among the 178 newly diagnosed MM cases, 167 cases complained of pain in bones on first visit, 35 cases combined with hypercalcemia, 83 cases combined with osteoporosis, 154 cases combined with osteolytic bone destruction, and 73 cases combined with pathologic fracture. The most common osteolytic location was the spine. The most common fracture sites was the spine. (2) According to bone disease grading, the 178 cases were divided into group A (bone grade 0-2, n=51) and group B(bone grade 3-4, n=127). There were no significant differences between group A and group B in gender, median age, therapeutic effect/ineffec, median overall survival, median progress-free survival, mean serum lactic dehydrogenase, mean albumin, urine light chains and serum creatinine(all P>0.05). Compared with group A, group B had lower hemoglobin level[(99.78±29.93)vs (108.84±29.30) g/L], and higher blood calcium level[(2.47±0.40)vs (2.30±0.29) mmol/L], serum β2-microglobuin level[(6.04±4.84)vs (4.12±3.97)mg/L], and bone marrow plasma cells percentage(33.30%±24.87% vs 23.51%±22.67%)(all P<0.05). (3) Before treatment, the levels of β-CTX and tPINP in patients of group B(n=47) were higher than those in group A(n=19)(median 0.78 vs 0.42 μg/L, 60.95 vs 43.47 μg/L, both P<0.05). The ratio of β-CTX /tPINP in group B was higher than that in group A (median 0.017 vs 0.012, P<0.05). After chemotherapy for 3 months, there were no differences in the level of tPINP compared with that before treatment in both group A and group B (both P>0.05), the level of β-CTX decreased significantly compared with that before treatment in both groups(median 0.16 vs 0.42 μg/L, 0.26 vs 0.78 μg/L, both P<0.05); the ratio of β-CTX /tPINP decreased significantly compared with that before treatment in both group A and in group B(median 0.008 vs 0.012, 0.011 vs 0.017, both P<0.05). There were no differences in the level of β-CTX, tPINP and β-CTX/tPINP ratio after treatment for 6 months, 1 year and 2 years compared with that after 3 months in both group A and group B (all P>0.05). (4)All patients were divided into two groups according to the therapeutic effect: effective group included patients who reach the effect of partial remission or better remission(n=48), while ineffective group included patients who did not reach the effect of partial remission(n=18). Before treatment there were no differences in the level of β-CTX, tPINP and β-CTX/tPINP ratio between the effective groupand the ineffective group (all P>0.05). After chemotherapy for 3 months, there were no differences in the level of tPINP compared with that before treatment in both effective group and ineffective group (all P>0.05), but the level of β-CTX decreased significantly compared with that before treatment both in effective group and ineffective group (median 0.24 vs 0.60 μg/L, 0.44 vs 0.95 μg/L, both P<0.05). The ratio of β-CTX /tPINP decreased significantly compared with that before treatment both in effective group and ineffective group (median 0.005 vs 0.012, 0.005 vs 0.011, both P<0.05). There were no differences in the level of β-CTX, tPINP and β-CTX/tPINP ratio after treatment for 6 months, 1 year and 2 years compared with that for 3 months both in effective group and ineffective group (all P>0.05).

CONCLUSIONS

Pain in bones, osteolysis and pathological fracture are the most common clinical manifestations in myeloma-related bone disease. The severity of bone disease can reflect the tumor load, but may not affect the therapeutic effect and the overall survival. The bone metabolic markers tPINP and β-CTX can be used to evaluate the severity of myeloma-related bone disease at diagnosis and to monitor the effect of treatment for bone disease.

[The prognostic significance of proportion of blasts in bone marrow on day 14 during induction chemotherapy in patients with adult Ph-negative acute lymphoblastic leukemia]

OBJECTIVE

To investigate the prognostic significance of proportion of the blasts in bone marrow on day 14 (D14) during induction chemotherapy in patients with adult Ph-negative acute lymphoblastic leukemia (Ph (-) ALL).

METHODS

Newly diagnosed Ph (-) ALL patients with bone marrow morphology analysis on day 14 during induction chemotherapy were analyzed retrospectively. The proportion of the D14 blasts which had an impact on achieving a CR by the first induction chemotherapy and outcomes were determined by ROC curve.

RESULTS

166 ALL patients including 94 male and 72 female were analyzed. The median age was 32 years (range, 18-64 years). The CR rate by the first induction chemotherapy was 74.7% with a total CR rate as 93.3%. By ROC analysis, 7.5% of the D14 blasts had the best sensitivity and specificity. The patients with D14 blasts ≥7.5% had lower CR rates after the first and overall induction chemotherapy compared with those with D14 blasts <7.5% (42.7% vs 85.9%, P<0.001 and 75.9% vs 95.6%, P=0.001 respectively). The probabilities of 5-year disease free survival (DFS) and 5-year overall survival (OS) were higher in the patients with D14 blasts<7.5% than those with D14 blasts ≥7.5% (49.8% vs 29.6%, P=0.006 and 52.4% vs 32.6%, P=0.010 respectively). Multivariate analysis showed that higher WBC or central nervous system leukemia at diagnosis, D14 blasts ≥7.5%, no CR after the first induction chemotherapy and receiving consolidation and maintenance chemotherapy rather than transplant were associated with poor outcomes.

CONCLUSIONS

Higher proportion of D14 blasts in bone marrow during the first induction therapy indicated poor prognosis in adult Ph(-) ALL.

[Comparison of efficacy and prognostic factors in elderly acute myelogenous patients with MA or CAG induction chemotherapy regimen]

OBJECTIVE

To analyze the difference of efficacy and prognostic factors between MA and CAG induction chemotherapy in elderly acute myelogenous leukemia (AML) patients.

METHODS

From April 2009 to September 2015, 103 consecutive hospitalized 60-plus-year-old AML patients were retrospectively analyzed. NPM1 positive FLT3-ITD negative accounted for 17 cases (16.7%). Sixty-five patients received MA regimen and thirty-eight patients received CAG regimen. MA group had higher WBC and FLT3-ITD positive mutations at diagnosis compared with CAG group (P=0.001, P=0.005; respectively). The median follow-up was 13 months for all patients and 17 months for the survivors.

RESULTS

Six patient (5.8%) died in early phase. Complete remission (CR) rate after the first cycle of induction chemotherapy was 51.5% (50/97). Overall CR rate was 70.1% (68/97). CR rate after the first cycle of induction chemotherapy and overall CR rate were indiscriminate between MA and CAG regimen. The time to neutrophil count recovery, the time to platelet count recovery and the number of platelet transfusions were indiscriminate between MA and CAG regimen. Among 68 CR patients, 23 patients relapsed at median 9 months, and cumulative incidence of relapse (CIR) at 3 years was (52.5±10.1)%. Median overall survival (OS) was 20 months. OS rate at 3 years was 32.2%. Median disease-free survival (DFS) was 28 months. DFS rate at 3 years was 43.7%. CIR, DFS and OS at 3 years were indiscriminate between MA and CAG regimen. Multivariate analysis showed that less than 70 years of age (P=0.001), achieved CR (P<0.001), and NPM1 (+) FLT3-ITD(-) mutation (P=0.044) were the independent factors for increasing OS. NPM1(+) FLT3-ITD(-) mutation was the independent factor for increasing DFS (P=0.042). Patients were classified by three prognosis factors: <70 ages, CR, and NPM1(+)FLT3-ITD(-) mutation. Patients with no poor prognosis factors were classified as low risk (n=13), with one factor as medium risk (n=52) and with two and more factors as high risk (n=31). There were significant differences in OS rate and DFS rate at 3 years for 3 groups patients (60.5% vs 48.1% vs 0, P<0.001; 60.2% vs 39.4% vs 0, P=0.045; respectively). OS and DFS at 3 years for 3 groups' patients were indiscriminate between MA and CAG regimen.

CONCLUSIONS

There was indiscrimination of efficacy among MA and CAG induction chemotherapy in old AML patients. Less than 70 years of age, CR and NPM1(+)FLT3-ITD(-) mutation were the independent factors for better survival.

High-density interspecific genetic linkage mapping provides insights into genomic incompatibility between channel catfish and blue catfish

Catfish is the leading aquaculture species in the United States. The interspecific hybrid catfish produced by mating female channel catfish with male blue catfish outperform both of their parent species in a number of traits. However, mass production of the hybrids has been difficult because of reproductive isolation. Investigations of genome structure and organization of the hybrids provide insights into the genetic basis for maintenance of species divergence in the face of gene flow, thereby helping develop strategies for introgression and efficient production of the hybrids for aquaculture. In this study, we constructed a high-density genetic linkage map using the hybrid catfish system with the catfish 250K SNP array. A total of 26,238 SNPs were mapped to 29 linkage groups, with 12,776 unique marker positions. The linkage map spans approximately 3240 cM with an average intermarker distance of 0.25 cM. A fraction of markers (986 of 12,776) exhibited significant deviation from the expected Mendelian ratio of segregation, and they were clustered in major genomic blocks across 15 LGs, most notably LG9 and LG15. The distorted markers exhibited significant bias for maternal alleles among the backcross progenies, suggesting strong selection against the blue catfish alleles. The clustering of distorted markers within genomic blocks should lend insights into speciation as marked by incompatibilities between the two species. Such findings should also have profound implications for understanding the genomic evolution of closely related species as well as the introgression of hybrid production programs in aquaculture.

A multi-center study on the prophylactic application of antibiotics in aseptic operations

To understand the application of antibacterial agents in aseptic operations and to provide evidence for their rational use and management, the antibiotic use statuses of six types of aseptic operations (306 cases from 4 tertiary hospitals) were retrospectively analyzed. Of 312 patients, 306 (65.08%) were treated with antibacterial agents in the perioperative period. Four categories of antibiotics including cephalosporins, penicillins, nitroimidazoles, and fluoroquinolones were administered (descending sequence). Administration time: preoperative >2 h, 15 cases; preoperative 0.5-2 h, 20 cases; postoperative: 265 cases. Drug withdrawal time: postoperative 1-3 days: 33 cases; 3-7 days: 255 cases; 7-15 days: 12 cases. The prophylactic use of antibacterial agents in aseptic operations suffers from non-strict mastered medication indication, improper drug selection, aimless drug combinations, inappropriate administration timing, and over long medication duration.

Severe influenza A(H1N1)pdm09 infection induces thymic atrophy through activating innate CD8(+)CD44(hi) T cells by upregulating IFN-γ

Thymic atrophy has been described as a consequence of infection by several pathogens including highly pathogenic avian influenza virus and is induced through diverse mechanisms. However, whether influenza A(H1N1)pdm09 infection induces thymic atrophy and the mechanisms underlying this process have not been completely elucidated. Our results show that severe infection of influenza A(H1N1)pdm09 led to progressive thymic atrophy and CD4⁺CD8⁺ double-positive (DP) T-cells depletion due to apoptosis. The viruses were present in thymus, where they activated thymic innate CD8⁺CD44^hi single-positive (SP) thymocytes to secrete a large amount of IFN-γ. Milder thymic atrophy was observed in innate CD8⁺ T-cell-deficient mice (C57BL/6J). Neutralization of IFN-γ could significantly rescue the atrophy, but peramivir treatment did not significantly alleviate thymic atrophy. In this study, we demonstrated that thymic innate CD8⁺CD44^hi SP T-cells have critical roles in influenza A(H1N1)pdm09 infection-induced thymic atrophy through secreting IFN-γ. This exceptional mechanism might serve as a target for the prevention and treatment of thymic atrophy induced by influenza A(H1N1)pdm09.

Opioid receptor trafficking and interaction in nociceptors

Opiate analgesics such as morphine are often used for pain therapy. However, antinociceptive tolerance and dependence may develop with long-term use of these drugs. It was found that μ-opioid receptors can interact with δ-opioid receptors, and morphine antinociceptive tolerance can be reduced by blocking δ-opioid receptors. Recent studies have shown that μ- and δ-opioid receptors are co-expressed in a considerable number of small neurons in the dorsal root ganglion. The interaction of μ-opioid receptors with δ-opioid receptors in the nociceptive afferents is facilitated by the stimulus-induced cell-surface expression of δ-opioid receptors, and contributes to morphine tolerance. Further analysis of the molecular, cellular and neural circuit mechanisms that regulate the trafficking and interaction of opioid receptors and related signalling molecules in the pain pathway would help to elucidate the mechanism of opiate analgesia and improve pain therapy.

LINKED ARTICLES

This article is part of a themed section on Opioids: New Pathways to Functional Selectivity. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2015.172.issue-2.

Meta-analysis of the association of dermatomyositis and polymyositis with cancer

BACKGROUND

Although some features of dermatomyositis (DM) and polymyositis (PM) have been reported as possible prognostic indicators for cancer development, previous studies were small in size and were unable to establish a definitive relationship between neoplasms and DM and PM.

OBJECTIVES

To evaluate risk factors for developing malignancies in patients with DM and PM.

METHODS

Meta-analysis of the studies reported in the literature was performed to unveil risk factors for developing cancer among patients with DM and PM. The included studies were either cohort or retrospective case-control studies with information on cancer status. Risk for malignancy was determined as the odds ratio (OR) or weighted mean difference (WMD) with a 95% confidence interval (CI), determined by fixed and random effects models. Stata 10.0 software was used to identify possible publication bias.

RESULTS

Twenty studies with 380 patients and 1575 controls were included in the analysis. The factors that may increase the risk of cancer in patients with DM and PM were older age (WMD 11·41, 95% CI 9·84-12·98), male sex (OR 1·92, 95% CI 1·49-2·48), cutaneous necrosis (OR 5·52, 95% CI 3·49-8·74) and dysphagia (OR 2·41, 95% CI 1·50-3·86), whereas those that may provide protection against cancer included arthritis (OR 0·38, 95% CI 0·24-0·61) and interstitial lung disease (OR 0·32, 95% CI 0·20-0·51).

CONCLUSIONS

Our data suggest that age, sex, cutaneous necrosis, dysphagia, arthritis and lung complications may influence susceptibility to cancer in patients with DM and PM.

Immunolocalization of NGF and its receptors in ovarian surface epithelium of the wild ground squirrel during the breeding and nonbreeding seasons

The ovarian surface epithelium (OSE) plays an important role in normal ovarian physiology. During each reproductive cycle, the OSE takes part in the cyclical ovulatory ruptures and repair. The aim of this study was to investigate the immunolocalization of nerve growth factor (NGF) and its receptors, tyrosine kinase A (TrkA) and p75, in the OSE cells of the wild ground squirrels during the breeding and nonbreeding seasons. There were marked variations in ovarian weight and size between the breeding and the nonbreeding seasons. Histologically, cuboidal cells and squamous cells were identified in the OSE of both seasons. Yet, stronger immunostaining of NGF, TrkA and p75 were observed in cuboidal cells and squamous cells in the breeding season as compared to the nonbreeding season. In addition, plasma gonadotropin concentrations were higher in the breeding season than in the nonbreeding season, suggesting that the expression patterns of NGF, TrkA and p75 in the OSE were correlated with changes in plasma gonadotropins. These findings suggested that NGF and its receptor TrkA and p75 may be involved in the regulation of seasonal changes in the OSE of wild ground squirrel.

Mycobacterium tuberculosis MPT64 stimulates the activation of murine macrophage modulated by IFN-γ

BACKGROUND AND AIMS

MPT64, a major target of cell-mediated immunity in tuberculosis, is proposed to be a promising candidate for novel vaccines and diagnostic tests; it also involves in virulence mechanism of Mycobacterium tuberculosis. In this study, we investigated the effect of MPT64 on activation of RAW264.7 macrophage, and explored the possible mechanism.

MATERIALS AND METHODS

MPT64 protein was prepared by cloning, expression and purification from Escherichia (E.) coli. Cytokines (IL-1β, IL-6, IL-10 and TNF-α) expression in RAW264.7 macrophage induced by MPT64 was evaluated by xMAP technology. Cell counting kit (CCK8) assay was employed to detect the viability of MPT64-treated macrophage; moreover, flow cytometric analysis and Western Blot analysis were used to measure the effect of MPT64 on apoptosis in macrophage and cleaved caspase-3 expression respectively.

RESULTS

MPT64 significantly promoted the levels of IL-1β, IL-6, IL-10 and TNF-α; pretreatment of MPT64 followed by IFN-γ stimulation further up-regulated IL-6 production (p < 0.01, compared with MPT64-treated group). In CCK8 assay, significantly increased absorbance of MPT64-treated macrophage suggested that cell viability might be enhanced. Additionally, MPT64 modulated the apoptosis of RAW264.7 macrophage partly through caspase-3 pathway.

CONCLUSIONS

MPT64 activated RAW264.7 macrophage to secrete IL-1β, IL-6, IL-10 and TNF-α; it might down-regulate apoptosis of macrophage partially via caspase-3 pathway. Furthermore, the effect of MPT64 on RAW264.7 macrophage could be modulated by IFN-γ, and co-stimulation of MPT64 with IFN-γ was conducive to the host immune, which might be applied for vaccine design and provide a reference for the treatment of tuberculosis.