Association between sleep quality and cardiovascular damage in pre-dialysis patients with chronic kidney disease

Background

Poor sleep quality, a novel risk factor of cardiovascular diseases (CVD), is highly prevalent in patients with chronic kidney disease (CKD). The association between poor sleep quality and cardiovascular damage in patients with CKD is unclear. This study is aimed to assess the prevalence and related risk factors of sleep disturbance and determine the relationship between sleep quality and cardiovascular damage in Chinese patients with pre-dialysis CKD.

Methods

A total of 427 pre-dialysis CKD patients (mean age = 39 ± 15 years, 260 male/167 female) were recruited in this study. The demographics and clinical correlates were collected. The sleep quality was measured by the Pittsburgh Sleep Quality Index (PSQI), whereas the cardiovascular damage indicators (the Early/late diastolic peak flow velocity (E/A) ratio and left ventricular mass index (LVMI)) were determined by an echocardiographic examination.

Results

Of the CKD patients, 77.8% were poor sleepers as defined by a PSQI score > 5. Median estimated glomerular filtration rate (eGFR) was 69.4(15.8-110.9) ml/min/1.73 m². Logistic regression analysis revealed that left ventricular hypertrophy (LVH) was independently associated with the PSQI score (OR = 1.092, 95% CI = 1.011-1.179, p = 0.025), after adjustment for age, sex and clinical systolic blood pressure, diastolic blood pressure, Phosphate, Intact parathyroid hormone (iPTH), Hemoglobin and eGFR. The linear regression analysis showed that the E/A ratios were independently associated with the PSQI score (β = -0.115, P = 0.028) after adjustment for a series of potential confounding factors.

Conclusions

Poor sleep quality, which is commonly found in pre-dialysis CKD patients, is an independent factor associated with cardiovascular damage in CKD patients. Our finding implies that the association between poor sleep and CVD might be mediated by cardiac remodeling.

Role of HOTAIR long noncoding RNA in metastatic progression of lung cancer

OBJECTIVE

Lung cancer, the primary cause of cancer-related death worldwide, imperatively requires new therapeutic approaches that target the molecular regulatory machinery. Even though it has been reported that long noncoding RNAs are involved in different cancer types, limited data are available on the expression and function of long noncoding RNAs in lung cancer metastasis. The major objective of the current study was to profile expression and function of six long noncoding RNAs in five matched pairs of primary lung cancer and lymph node metastatic tissues.

MATERIALS AND METHODS

The study protocol was approved by the Institutional Review Board of the Chinese PLA General Hospital, China. All patients enrolled in the study provided signed informed consent.

RESULTS

Among the tested lncRNAs, HOTAIR and NEAT1 were most highly expressed in lymph node metastasis. However, only HOTAIR was subsequently found to be involved in lung cancer cell motility and invasion, as assessed by in vitro migration and invasion assay. Finally, our experiments suggest that HOTAIR promoted gelatinase activity in these cells.

CONCLUSIONS

Our data indicates that HOTAIR is overexpressed in metastatic lung cancer tissue, which is prospectively associated with the ability of HOTAIR to promote lung cancer cell motility and invasion.

Concurrent chemoradiotherapy followed by adjuvant chemotherapy compared with concurrent chemoradiotherapy alone for the treatment of locally advanced nasopharyngeal carcinoma: a retrospective controlled study

OBJECTIVE

We evaluated the survival benefit of providing concurrent chemoradiotherapy (ccrt) plus adjuvant chemotherapy compared with ccrt alone to patients with locally advanced nasopharyngeal carcinoma.

METHODS

This retrospective study included 130 patients with nasopharyngeal carcinoma treated with ccrt plus adjuvant chemotherapy from June 2005 to December 2010. Another 130 patients treated with ccrt alone during the same period were matched on age, sex, World Health Organization histology, T stage, N stage, and technology used for radiotherapy. The endpoints included overall survival, locoregional failure-free survival, distant metastasis failure-free survival, and failure-free survival.

RESULTS

At a mean follow-up of 42.1 months (range: 8-85 months), the observed hazard ratios for the group receiving ccrt plus adjuvant chemotherapy compared with the group receiving ccrt alone were: for overall survival, 0.77 [95% confidence interval (ci): 0.37 to 1.57]; for locoregional failure-free survival, 1.00 (95% ci: 0.37 to 2.71); for distant metastasis failure-free survival, 1.15 (95% ci: 0.56 to 2.37); and for failure-free survival, 1.26 (95% ci: 0.69 to 2.28). There were no significant differences in survival between the groups. After stratification by disease stage, ccrt plus adjuvant chemotherapy provided a borderline significant benefit for patients with N2-3 disease (hazard ratio: 0.35; 95% ci: 0.11 to 1.06; p = 0.052). Multivariate analyses indicated that only tumour stage was a prognostic factor for overall survival.

CONCLUSIONS

Patients with locally advanced nasopharyngeal carcinoma received no significant survival benefit from the addition of adjuvant chemotherapy to ccrt. However, patients with N2-3 disease might benefit from the addition of adjuvant chemotherapy to ccrt.

Mitigating voltage fade in cathode materials by improving the atomic level uniformity of elemental distribution

Lithium- and manganese-rich (LMR) layered-structure materials are very promising cathodes for high energy density lithium-ion batteries. However, their voltage fading mechanism and its relationships with fundamental structural changes are far from being well understood. Here we report for the first time the mitigation of voltage and energy fade of LMR cathodes by improving the atomic level spatial uniformity of the chemical species. The results reveal that LMR cathodes (Li[Li0.2Ni0.2M0.6]O2) prepared by coprecipitation and sol-gel methods, which are dominated by a LiMO2 type R3̅m structure, show significant nonuniform Ni distribution at particle surfaces. In contrast, the LMR cathode prepared by a hydrothermal assisted method is dominated by a Li2MO3 type C2/m structure with minimal Ni-rich surfaces. The samples with uniform atomic level spatial distribution demonstrate much better capacity retention and much smaller voltage fade as compared to those with significant nonuniform Ni distribution. The fundamental findings on the direct correlation between the atomic level spatial distribution of the chemical species and the functional stability of the materials may also guide the design of other energy storage materials with enhanced stabilities.

Erlotinib in African Americans with advanced non-small cell lung cancer: a prospective randomized study with genetic and pharmacokinetic analyses

Prospective studies on epidermal growth factor receptor (EGFR) inhibitors in African Americans with non-small cell lung cancer (NSCLC) have not previously been performed. In this phase II randomized study, 55 African Americans with NSCLC received 150 mg/day erlotinib or a body weight-adjusted dose with subsequent escalations to the maximum-allowable dose, 200 mg/day, to achieve rash. Erlotinib and OSI-420 exposures were lower than those observed in previous studies, consistent with CYP3A pharmacogenetics implying higher metabolic activity. Tumor genetics showed only two EGFR mutations, EGFR amplification in 17/47 samples, eight KRAS mutations, and five EML4-ALK translocations. Although absence of rash was associated with shorter time to progression (TTP), disease-control rate, TTP, and 1-year survival were not different between the two dose groups, indicating the dose-to-rash strategy failed to increase clinical benefit. Low incidence of toxicity and low erlotinib exposure suggest standardized and maximum-allowable dosing may be suboptimal in African Americans.

Proteomic Analysis of RBP4/Vitamin A in Children with Cleft Lip and/or Palate

Cleft of the lip and/or palate (CLP) is one of the most common congenital craniofacial defects. Non-syndromic CLP (NSCLP) is a multifactorial disease influenced by the interaction of genetic and environmental factors. However, there are few studies reporting on the developmental or metabolic status of babies with NSCLP after birth. In our study, we sought to identify and evaluate the differential expression of serum protein profiles in NSCLP children and unaffected babies. Thus, a 'shotgun proteomics' approach was first used to analyze the plasma proteome of 13 children with NSCLP and 10 control children, aged 2 to 3.5 years. In total, more than 300 proteins were identified in the serum sample. With gene ontology (GO) analysis, we detected many differentially expressed proteins that could be related to NSCLP, including those involved in lipoprotein metabolism, insulin-like growth-factor-related processes, and so on, especially the proteins involved in retinol transport. Retinol binding protein 4 (RBP4), one protein of the retinol transport category, was significantly decreased in the NSCLP group. Thus, serum vitamin A levels were further determined by high-performance liquid chromatography (HPLC). A significant difference (p < .01) was also found in vitamin A concentrations, consistent with the trend of RBP4. Our results indicated that reduced levels of RBP4 and vitamin A were related to newborns with NSCLP and should thus receive more attention. These results also suggest that vitamin A supplementation might be necessary at an early stage.

[Comparing different treatments for femoral neck fracture of displacement type in the elderly:a meta analysis]

OBJECTIVE

To compare the effects and security between internal fixation and total hip arthroplasty for the patients in elderly with femoral neck fracture of displacement type through a meta analysis.

METHODS

Studies on comparison between internal fixation and total hip arthroplasty for the patients in the elderly with femoral neck fracture of displacement type were identified from PubMed database,EMBase database, COCHRANE library, CMB database, CNKI database and MEDLINE database. Data analysis were performed using Revman 5.2.6(the Cochrane Collaboration).

RESULTS

Six published randomized controlled trials including 627 patients were suitable for the review, 286 cases in internal fixation group and 341 cases in total hip arthroplasty group. The results of meta analysis indicated that statistically significant difference were observed between the two groups in the quality of life which was reflected by the Harris scale (RR = 0.82, 95%CI:0.72-0.93, P < 0.05) , the reoperation rate (RR = 5.81, 95%CI:3.09-10.95, P < 0.05) and the major complications rate (RR = 3.60, 95%CI:2.29-5.67, P < 0.05) postoperatively. There were no difference in the mortality at 1 year and 5 years postoperatively(P > 0.05).

CONCLUSIONS

For the patients with femoral neck fracture of displacement type in the elderly, there is no statistical difference between two groups in the mortality postoperatively. The quality of life and the security of operation in internal fixation group is worse than the total hip arthroplasty group.

Protonated primary amines induced thymine quintets studied by electrospray ionization mass spectrometry and density functional theory calculations

As the novel magic number clusters of nucleobases, the thymine quintets induced by ammonium ion (NH4(+)), and particularly by its derivatives such as protonated alkyl amines and protonated aryl amines, have been studied by electrospray ionization mass spectrometry (ESI-MS) and density functional theory (DFT) calculations. The DFT-optimized geometry of NH4(+) induced thymine quintet ([T5 + NH4](+)) reveals some new features including three additional hydrogen bonds between NH4(+) and its surrounding thymine molecules when compared with that of the alkali metal ions induced thymine quintets. In addition, the fourth hydrogen atom of NH4(+) is sticking out the assembly, and, thus, it might be replaced by an organic group R to form the protonated primary amine induced thymine quintet ([T5 + R - NH3](+)), a hypothesis that has been confirmed by both DFT calculations and ESI-MS experiments. Furthermore, the relative abilities of the different protonated primary amines for inducing the thymine quintets are investigated by ESI-MS competition experiments, and the results have shown a clear trend of stronger ability as the alkyl chain gets longer or as the aryl ring gets larger for the alkyl amines or the aryl amines. Two basic influence factors are consequently identified: one is the ability of the alkyl amine to accept proton, another is the π-π stacking interaction between the aryl ring and the π-surface of the thymine molecule(s), whose explanations are strongly supported by multiple types of thermochemical data, various control experiments and DFT calculations.

Refractive error and risk of early or late age-related macular degeneration: a systematic review and meta-analysis

OBJECTIVE

To summarize relevant evidence investigating the associations between refractive error and age-related macular degeneration (AMD).

DESIGN

Systematic review and meta-analysis.

METHODS

We searched Medline, Web of Science, and Cochrane databases as well as the reference lists of retrieved articles to identify studies that met the inclusion criteria. Extracted data were combined using a random-effects meta-analysis. Studies that were pertinent to our topic but did not meet the criteria for quantitative analysis were reported in a systematic review instead.

MAIN OUTCOME MEASURES

Pooled odds ratios (ORs) and 95% confidence intervals (CIs) for the associations between refractive error (hyperopia, myopia, per-diopter increase in spherical equivalent [SE] toward hyperopia, per-millimeter increase in axial length [AL]) and AMD (early and late, prevalent and incident).

RESULTS

Fourteen studies comprising over 5800 patients were eligible. Significant associations were found between hyperopia, myopia, per-diopter increase in SE, per-millimeter increase in AL, and prevalent early AMD. The pooled ORs and 95% CIs were 1.13 (1.06-1.20), 0.75 (0.56-0.94), 1.10 (1.07-1.14), and 0.79 (0.73-0.85), respectively. The per-diopter increase in SE was also significantly associated with early AMD incidence (OR, 1.06; 95% CI, 1.02-1.10). However, no significant association was found between hyperopia or myopia and early AMD incidence. Furthermore, neither prevalent nor incident late AMD was associated with refractive error. Considerable heterogeneity was found among studies investigating the association between myopia and prevalent early AMD (P = 0.001, I2 = 72.2%). Geographic location might play a role; the heterogeneity became non-significant after stratifying these studies into Asian and non-Asian subgroups.

CONCLUSION

Refractive error is associated with early AMD but not with late AMD. More large-scale longitudinal studies are needed to further investigate such associations.

First Report of Phytophthora tentaculata Causing Stem and Root Rot on Celery in China

Celery (Apium graveolens) is an important vegetable in China. In August 2012, about 20 to 70% declining plants with root and basal stem rot were observed in Bengbu, Anhui Province, China. Typical symptoms included large dark brown to black water-soaked lesions near the soil line of stems. As the disease progressed, lesions girdled the stem, and plants became brown, wilted, and eventually died. A Phytophthora-like organism was consistently isolated from symptomatic tissues on a selective medium, P₅ARP. Resultant isolates were identified as Phytophthora tentaculata based on their morphological features and rDNA sequence. Sporangia, chlamydospores, hyphal swellings, and oospores were produced on V8 agar. Sporangia were ovoid to pyriform, 28.5 to 52.5 × 21.5 to 40.6 μm, average 35.3 × 29.8 μm, with one or occasionally two papillae. Chlamydospores were spherical, 21.3 to 30.2 μm in diameter, average 25.7 μm. The isolates were homothallic, and one or occasionally two paragynous antheridia were attached to the global oogonia (24 to 39 μm in diameter, average 29.5 μm). The internal transcribed spacer region of rDNA was amplified with primer pair ITS1/ITS4 for one isolate (1), and the sequence (GenBank Accession No. KF501392) showed >99% similarity with those P. tentaculata isolates deposited in GenBank (AJ854302.1). Pathogenicity was confirmed by inoculating Shijihuangqin, a local cultivar of celery, with isolate PT12081. The isolate was cultivated on V8 agar at 25°C for 5 to 7 days to produce sporangia. Five 2-month-old, disease-free celery were drench-inoculated with 10 ml of a suspension of 2 × 10⁴ zoospores/ml, and five control plants per pot were treated with sterile water. There were four pots for each of the inoculated and non-inoculated treatments, and the experiment was repeated twice. All plants were maintained at 25°C for 10 days. Symptoms similar to those observed in the field developed 7 days after inoculation. Ten days later, five plants wilted and two or three died in each pot inoculated with PT12081, but the control plants remained symptomless. P. tentaculata was consistently re-isolated from the symptomatic plants. P. tentaculata has been reported to infect Chrysanthemum spp., Delphinium ajacis, Verbena spp., and Origanum vulgare (2,3). To our knowledge, this is the first report of Phytophthora blight caused by P. tentaculata on celery in China. References: (1) H. Guo et al. Plant Dis. 96:1072, 2012. (2) P. Martini et al. Plant Dis. 93:843, 2009. (3) J. Meng and Y. C. Wang. Plant Dis. 92:1365, 2008.

Pleural resection and pleural infusion chemotherapy for therapy of malignant pleural mesothelioma

The aim of this study was to evaluate effective treatment methods of malignant pleural mesothelioma (MPM). Twenty-three patients with MPM were cured by pleural infusion chemotherapy after surgery. Median survival time and the 1-, 2-, and 3-year survival rates were analyzed on the basis of follow-up. Median survival time of all patients was 15 months (range: 3 to 89 months); the 1-, 2-, and 3-year survival rates were 69.6, 43.5, and 13.0%, respectively. The 1-year survival rates of patients in stages I, II, and III were 83.3, 62.5, and 33.3%, respectively, the 2-year survival rates were 50, 37.5, and 33.3%, respectively, and the 3-year survival rates were 34, 23, and 0%, respectively. Surgery-oriented comprehensive treatment was adopted for MPM, which could improve the prognosis and life quality of patients to some extent.

A chitosan-Au-hyperbranched polyester nanoparticles-based antifouling immunosensor for sensitive detection of carcinoembryonic antigen

An electrochemical immunosensor was developed for the detection of carcinoembryonic antigen in whole blood, based on the antibiofouling properties of carboxylic acid group functionalized hyperbranched polyester nanoparticles.

Assessments of jaw bone density at implant sites using 3D cone-beam computed tomography

OBJECTIVE

To assess the bone density of dental implant sites using CBCT and Simplant software, and establish a quantitative ranges for each bone quality classification according to the classification of bone quality proposed by Lekholm and Zarb.

PATIENTS AND METHODS

128 patients' jaw bone were scanned by CBCT, the images were reconstructed by the Simplant software. The bone density of 236 potential implant sites was measured and the results were recorded using Hounsfield units (HU)．The data was analyzed with SPSS 19.0 software package for Mann-Whitney U test.

RESULTS

The anterior mandible mean bone density was (679.6 ± 141.67) HU > anterior maxilla, (460.25 ± 136.42) HU and posterior mandible, (394.4 ± 128.37) HU > posterior maxilla, (229.62 ± 144.48) HU. Quantitative parameters ranged of the bone density according to CBCT as follows: Lekholm and Zarb classification Type D4 was less than 200 HU, Type D2 and Type D3 were more than 200HU and less than 600 HU, and Type D1 was more than 600 HU.

CONCLUSIONS

Anterior mandible has the highest mean bone density and posterior maxilla has the lowest mean bone density．It is, therefore, proposed that an objective classification which confirms the importance of a site-specific bone tissue evaluation prior to implant installation.