Intracervical intracapsular myomectomy using loop ligation: a proposed technique

Performing laparoscopic myomectomy for an intracervical myoma, especially a single giant myoma, is challenging. Only skilled surgeons attempt this operation. Surgeons frequently encounter cases of massive intraoperative bleeding, difficulty suturing the cervical incision, risk of injuring the neighbouring tissues, haematoma formation and conversion to laparotomy or hysterectomy. We previously developed a the technique of loop ligation of the pseudocapsule and have been using it to treat sizeable intracervical myomas laparoscopically. Its advantages include less blood loss, lower risk of injuries to the neighbouring tissues, maintenance of the cervical canal and sparing of the pseudocapsule. This technique is safe and feasible, and facilitates fertility.

Properties of a New Group of Cosmic Nuclei: Results from the Alpha Magnetic Spectrometer on Sodium, Aluminum, and Nitrogen

We report the properties of sodium (Na) and aluminum (Al) cosmic rays in the rigidity range 2.15 GV to 3.0 TV based on 0.46 million sodium and 0.51 million aluminum nuclei collected by the Alpha Magnetic Spectrometer experiment on the International Space Station. We found that Na and Al, together with nitrogen (N), belong to a distinct cosmic ray group. In this group, we observe that, similar to the N flux, both the Na flux and Al flux are well described by the sums of a primary cosmic ray component (proportional to the silicon flux) and a secondary cosmic ray component (proportional to the fluorine flux). The fraction of the primary component increases with rigidity for the N, Na, and Al fluxes and becomes dominant at the highest rigidities. The Na/Si and Al/Si abundance ratios at the source, 0.036±0.003 for Na/Si and 0.103±0.004 for Al/Si, are determined independent of cosmic ray propagation.

Tri-domain proteins 27 reduce inflammation and apoptosis in HK-2 cells and protect against acute kidney injury in mice

OBJECTIVE

The kidney is one of the most commonly damaged organs in sepsis. Acute kidney injury (AKI) induced by sepsis is a clinically dangerous disease with a high mortality rate. Therefore, it is particularly important to find a way to prevent and treat sepsis-induced AKI.

MATERIALS AND METHODS

Human renal tubular epithelial cell line (HK-2) and 8-week-old C57BL/6 mice were used. Lipopolysaccharide (LPS) was used to induce HK-2 cell injury and mouse AKI. Lentiviruses overexpressing TRIM27 were constructed to increase TRIM27 expression in HK-2 cells. Then, the effects of TRIM27 on the inflammation and apoptosis of HK-2 cells were analyzed, and those of TRIM27 recombinant protein on AKI in mice was detected by immunohistochemical staining and Western blot.

RESULTS

It was found that TRIM27 overexpression reduced the expressions of inflammatory factors and signaling molecules in apoptosis-related pathways in HK-2 cells, but increased the ratio of Bcl-2 to Bax in HK-2 cells, indicating the anti-apoptotic effect of TRIM27. Toll-like receptor 4 (TLR4)/NF-κB signaling pathway is an important mechanism of LPS mediated renal injury, and TRIM27 overexpression in HK-2 cells significantly inhibited the activity of TLR4/NF-κB signaling pathway. In addition, AKI was significantly relieved in mice treated with TRIM27 recombinant.

CONCLUSIONS

TRIM27 exerts anti-inflammatory and anti-apoptotic effects by inhibiting the TLR4/NF-κB signaling pathway, which effectively alleviates LPS-induced HK-2 cell damage and mouse AKI.

[Association of cadmium internal exposure with chronic kidney disease in Chinese adults]

Objective: To analyze the association of the cadmium internal exposure with chronic kidney disease (CKD) in Chinese adults aged 18 and older. Methods: A total of 9 821 adults aged 18-79 from the China National Human Biomonitoring (CNHBM) from 2017 to 2018 were included. Blood and urine cadmium exposure levels were measured by inductively coupled plasma mass spectrometry (ICP-MS), and urine cadmium levels were adjusted with urine creatinine; CKD were defined by estimated glomerular filtration (eGFR) using the chronic kidney disease epidemiology collaboration (CKD-EPI). Weights were considered due to complex sampling process for in statistical analysis. Logistic regression is used to analyze the association of blood cadmium, urine cadmium, and urine cadmium adjusted with creatinine exposure levels with CKD, and restricted cube spline (RCS) was used to assess the exposure-response curve of blood cadmium, urine cadmium and urine cadmium adjusted with creatinine with CKD. Results: The weighted age was 44.75 and males accounted for 61.1%. The prevalence rate of CKD was 12.7%. The geometric mean values of blood cadmium, urine cadmium, and urine cadmium adjusted with creatinine were 0.96 μg/L, 0.61 μg/L, and 0.58 μg/g. After adjusting for confounding factors, the weighted logistic regression showed that the lowest quintile (Q1) was compared with the odds ratio (OR) of the highest quintile (Q5) of blood cadmium, urine cadmium, and urine cadmium adjusted with creatinine and the 95% confidence interval (CI) was 1.80 (1.02-3.20), 1.77 (0.94-3.31) and 1.94 (1.11-3.37) respectively. In the restricted cubic spline regression model, non-linear association of blood cadmium, urine cadmium, and urine cadmium adjusted with creatinine with CKD were observed after adjusting for related confounding factors (P<0.001, 0.018, 0.031 respectively). The risk of CKD increased with the increment of cadmium exposure without risk threshold, and the exposure response curve was steeper at low cadmium exposure. Conclusions: Among Chinese adults aged 18 and older, cadmium exposure is positively associated with the risk of chronic kidney disease.

Application of Chrysomya rufifacies （Diptera, Calliphoridae） to Postmortem Interval Estimation in Southwest China: A Case Report

Insect samples found on human corpses can provide the information important to estimating the minimum postmortem interval （PMI_min）. A female cadaver, found in a deserted factory in Chongqing of China, was confirmed as a homicide case after the forensic investigation and autopsy. Determining the time of death was difficult due to the inconsistent degree of decomposition in different parts of the decedent. The insect specimens found on the cadaver were identified to be Chrysomya rufifacies （C. rufifacies, Macquart） by morphology and mitochondrial DNA sequence analysis. The PMI_min was estimated to be 452 h, based on the developmental rate of C. rufifacies. The PMI_min was estimated successfully to be almost precise, which provided an important entomological evidence for case investigation and suspect prosecution. In so doing, this highlights the usefulness of entomological evidence of specific species in the geographic area for PMI accurate estimation, especially in the case of advanced decomposed corpses.

[Analysis of gut microbiome in patients with lung adenocarcinoma and lung squamous cell carcinoma]

To investigate the diversity and composition of gut microbiota in patients with lung adenocarcinoma and lung squamous cell carcinoma. A single-center and case-control study was conducted to consecutively enroll a total of 27 lung cancer patients, including 15 males and 12 females, who were seen at the Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine between September 2018 to October 2020. A total of 20 cases of healthy healthy physical examiners, including 9 males and 11 females were recruited as healthy control group (HC) during the same period. Clinical data and stool samples were collected from each participants, and lung cancer patients were divided into lung adenocarcinoma group (AC, 19 patients, 8 males and 11 females) and lung squamous cell carcinoma group (SCC, 8 patients, 7 males and 1 females) according to the pathology type. Genomic DNA were extracted to amplify 16S rDNA V3-V4 region, then the Illumina MiSeq high-throughput sequencing platform and QIIME software were used for sequencing and analyzing the structure of the gut microbiota, respectively. Analysis of variance, χ² test, K-W test were used to analyze the differences in age, gender,α diversity, and relative abundance of microbiota among the three groups. AC, SCC, and HC were aged (58.74±9.27), (63.38±6.12), and (55.65±7.79) years old, respectively. There were no difference in gender and age among the three groups (gender and age are respectively:χ²=5.155, P=0.076;F=2.598,P=0.086). And no significant difference in alpha diversity were found among the three groups (Chao and Shannon index were respectively: F=0.616, P=0.545; F=2.484, P=0.095), while β-diversity analysis indicated significant differences in the structure of intestinal flora among AC, SCC and HC (P=0.001). LEfSe analysis showed that AC and SCC both have dominant bacterials. Megasphaera (H=7.855,P=0.020) and Erysipelatoclostridium (H=7.426,P=0.024) were enriched in patients with AC, while Enterococcus (H=8.400, P=0.015), Veillonella (H=9.957,P=0.007), and Eubacterium_eligens_group (H=10.514,P=0.005) were enriched in patients with SCC. Lung cancer patients have gut microbiota imbalance, while lung adenocarcinoma and lung squamous cell carcinoma patients have no significant difference in gut microbiota diversity, but lung adenocarcinoma and lung squamous cell carcinoma have their own unique microbiota. This imbalance of the intestinal microenvironment is of great significance for studying the occurrence and development of different pathological types of lung cancer.

Effects of Cryopreservation on Acrosin Activity and DNA Damage of Russian Sturgeon (Acipenser gueldenstaedtii) Semen

BACKGROUND

Cryopreservation of sturgeon sperm can be successful, but there can be a decrease in sperm viability and the reasons are not clear.

OBJECTIVE

To investigate variations in the acrosin activity and the DNA integrity of Acipenser gueldenstaedtii semen during cryopreservation at -196ºC.

MATERIALS AND METHODS

Fish semen samples were randomly divided into three groups: [1] fresh control; [2] native semen diluted 1:1 with 23.4 mM sucrose + 0.25 mM KCl + 30 mM Tris (pH 8.0) and the addition of 10% methanol as cryoprotectant; and [3] semen without any diluents or cryoprotectants. Acrosin activity and DNA damage (COMET assay) were assessed.

RESULTS

The average acrosin activity fell to 61% and 27% of the control for cryoprotected and non-cryoprotected semen after cryopreservation. The differences among the three groups were significant (P<0.05). We also observed that various indexes of DNA damage (L-tail; tail DNA, tail momentum, olive tail momentum) were higher in semen that had been frozen.

CONCLUSION

Although cryopreservation of semen induces decreased acrosin activity and increased DNA damage, cryoprotectants can protect the semen during cryopreservation.

[A cohort study on plasma uric acid levels and the risk of type 2 diabetes mellitus among the oldest old in longevity areas of China]

Objective: To investigate the effect of plasma uric acid level on the incident risk of type 2 diabetes mellitus (T2DM) among the oldest old (those aged ≥80 years). Methods: Participants were recruited from the Healthy Aging and Biomarkers Cohort Study (HABCS), which conducted a baseline survey in 2008-2009 and follow-up of 3 times in 2011-2012, 2014, and 2017-2018, respectively. A total of 2 213 oldest old were enrolled in this study. The general demographic, socioeconomic, lifestyle and disease data of the oldest old were collected, and physical measurements were made for the oldest old. Fasting venous blood was collected for uric acid and blood glucose detection. Information on the incident and death of T2DM were collected through the follow-up. Cox proportional hazard regression model was used to explore the association of hyperuricemia and plasma uric acid level with the incidence of T2DM. Restricted cubic spline (RCS) function was used to explore the dose-response relationship of plasma uric acid levels with the risk of T2DM. Results: The age of participants was (93.2±7.6) years old, and 66.7% of the participants (1 475) were female. The plasma uric acid level at baseline was (289.1±88.0)μmol/L, and the prevalence of hyperuricemia was 13.3% (294 cases). During 9 years of cumulative follow-up of 7 471 person-years (average of 3.38 years for each), 122 new cases of T2DM occurred and the incidence density was 1 632.98/10⁵ person year. Cox proportional hazards regression analysis showed that per 10μmol/L increase in plasma uric acid level, the risk of T2DM increased by 1.1% [HR (95%CI): 1.011 (1.004, 1.017)]. Compared with the participants with the lowest quintile of plasma uric acid (Q₁), the risk of diabetes increased by 20.7 % among the oldest old with uric acid in the highest quintile (Q₅) [HR (95%CI):1.207 (1.029, 1.416)]. The risk of T2DM was 19.2% higher in the hyperuricemia group than that in the oldest old with normal plasma uric acid [HR (95%CI): 1.192 (1.033, 1.377)]. RCS function showed that the risk of T2DM increased with the increase in plasma uric acid levels in a nonlinear dose-response relationship (P=0.016). Conclusion: The incident risk of T2DM increases with the elevates of plasma uric acid levels in the oldest old.

Endoscope-controlled maxillary sinus floor elevation: a review of the literature

A systematic review of the literature was conducted to assess the safety and efficacy of endoscope-assisted maxillary sinus elevation. PubMed, Embase, Web of Science, and the Cochrane database were searched for articles in English. Published studies involving patients who had undergone endoscope-assisted maxillary sinus floor augmentation were selected. The validity of the included articles was evaluated. After going through full texts, a total of 12 studies met the eligibility criteria and were included. It was concluded that endoscope-controlled maxillary sinus floor elevation was a viable and beneficial method, providing direct visualisation of the integrity of the mucosa and placing of bone graft material. The endoscope could be inserted into the maxillary sinus lumen, subantral space below the Schneiderian membrane, or through the alveolar crest. With the endoscope, perforations can be detected and managed precisely. However, high-quality clinical trials are still needed to validate the predictability and advantages of this surgical procedure.

[Effects of chronic stress during pregnancy on composition and diversity of intestinal microbiota in female rats and offspring]

Objective: To investigate the effect of chronic stress of pregnant rats on the gut microbiota of female rats and offspring, and explore the role of intestinal microbiota in chronic stress during pregnancy. Methods: In November 2019, SPF-grade healthy adult SD rats were selected. 16 female rats were randomly divided into control group and model group, with 8 in each group; 12 male rats were randomly divided into model mating group (8) and control mating group (4) . A model of chronic unpredictable mild stress (CUMS) during pregnancy was established. Blood samples were collected from the iliac vein of the female rats 1 day before and 1, 7, and 14 days after the CUMS protocol, and measured for plasma corticosterone content by radioimmunoassay. After the stress was completed, fresh feces of the female rats were collected for testing. The offspring's fresh stool samples were collected on postnatal day 20 (PND20) , and they were divided into control offspring group and model offspring group samples. The sequence of 16S rRNAV3-V4 regions of microorganisms in the feces of offspring was determined by Illumina MiSeq technique; and the interaction between microbial community structure and diversity were analyzed. Results: The content of plasma corticosterone in the model group was higher than that in the control group on the 7th and 14th day of stress (P<0.05) . Compared with the control group, the Sobs index, Chao index, ACE index and Shannon index of the model group were decreased (P<0.05) . The number of unique species abundance (OTU) in the control group was 130, and 91 in the model group. The relative abundance of female Firmicutes in the control group (64.87%) was higher than that in the model group, and the relative abundance of Bacteroides (31.72%) was lower than that of the model group (46.35%) . The Sobs index, Chao index, ACE index, Simpson index and Shannon index of the control offspring group were higher than those of the model offspring group (P<0.05) . The number of unique OTUs in the model offspring group was 75, and 93 in the control offspring group. The relative abundance of Firmicutes (60.24%) in the control offspring group was higher than that of the model offspring group (52.95%) . Conclusion: Chronic stress during pregnancy can not only lead to the disorder of intestinal flora in female rats, but also lead to the change of intrauterine environment, thus affecting the diversity of intestinal flora in offspring.

Properties of Heavy Secondary Fluorine Cosmic Rays: Results from the Alpha Magnetic Spectrometer

Precise knowledge of the charge and rigidity dependence of the secondary cosmic ray fluxes and the secondary-to-primary flux ratios is essential in the understanding of cosmic ray propagation. We report the properties of heavy secondary cosmic ray fluorine F in the rigidity R range 2.15 GV to 2.9 TV based on 0.29 million events collected by the Alpha Magnetic Spectrometer experiment on the International Space Station. The fluorine spectrum deviates from a single power law above 200 GV. The heavier secondary-to-primary F/Si flux ratio rigidity dependence is distinctly different from the lighter B/O (or B/C) rigidity dependence. In particular, above 10 GV, the F/Si/B/O ratio can be described by a power law R^{δ} with δ=0.052±0.007. This shows that the propagation properties of heavy cosmic rays, from F to Si, are different from those of light cosmic rays, from He to O, and that the secondary cosmic rays have two classes.

Evaluation of pulmonary ventilation in COVID-19 patients using oxygen-enhanced three-dimensional ultrashort echo time MRI: a preliminary study

AIM

To evaluate the lung function of coronavirus disease 2019 (COVID-19) patients using oxygen-enhanced (OE) ultrashort echo time (UTE) MRI.

MATERIALS AND METHODS

Forty-nine patients with COVID-19 were included in the study. The OE-MRI was based on a respiratory-gated three-dimensional (3D) radial UTE sequence. For each patient, the percent signal enhancement (PSE) map was calculated using the expression PSE = (S_100% – S_21%)/S_21%, where S_21% and S_100% are signals acquired during room air and 100% oxygen inhalation, respectively. Agreement of lesion detectability between UTE-MRI and computed tomography (CT) was performed using the kappa test. The Mann–Whitney U-test was used to evaluate the difference in the mean PSE between mild-type COVID-19 and common-type COVID-19. Spearman's test was used to assess the relationship between lesion mean PSE and lesion size. Furthermore, the Mann–Whitney U-test was used to evaluate the difference in region of interest (ROI) mean PSE between normal pulmonary parenchyma and lesions. The Kruskal–Wallis test was applied to test the difference in the mean PSE between different lesion types.

RESULTS

CT and UTE-MRI reached good agreement in lesion detectability. Ventilation measures in mild-type patients (5.3 ± 5.5%) were significantly different from those in common-type patients (3 ± 3.9%). Besides, there was no significant correlation between lesion mean PSE and lesion size. The mean PSE of COVID-19 lesions (3.2 ± 4.9%) was significantly lower than that of the pulmonary parenchyma (5.4 ± 3.9%). No significant difference was found among different lesion types.

CONCLUSION

OE-UTE-MRI could serve as a promising method for the assessment of lung function or treatment management of COVID-19 patients.

Optimal operation strategy of LWR based on the PCI online prognosis model

The pellet-cladding interaction (PCI) is one of the major issues in fuel rod during the power change operation in light water reactors (LWR). The frequent power transient will lead to the PCI failure, which results in the radioactive leakage. Unfortunately, the failure cannot be detected on time during operation. For solving this problem, the PCI results is calculated and predicted before the power transient, and the results is used for optimizing the operation strategy. As everyone knows, the calculation of the fuel is a cumbersome work, which is not fit for online evaluation. At first, we present a PCI online prognosis model in this paper by the method of radial basis function neural network (RBFNN). Based on this online model, an optimal operation strategy is present then. The PCI evaluation results is treated as the feedback of the strategy, which will go to the power control system to decide to carry out the power plan or to modify it. The presented operation strategy used the fast online prognosis model to predict the PCI status, which is used as a feedback signal to the power control system. The optimal operation strategy is tested by the experimental data from the references, and the results demonstrate its effectiveness.

Properties of Iron Primary Cosmic Rays: Results from the Alpha Magnetic Spectrometer

We report the observation of new properties of primary iron (Fe) cosmic rays in the rigidity range 2.65 GV to 3.0 TV with 0.62×10^{6} iron nuclei collected by the Alpha Magnetic Spectrometer experiment on the International Space Station. Above 80.5 GV the rigidity dependence of the cosmic ray Fe flux is identical to the rigidity dependence of the primary cosmic ray He, C, and O fluxes, with the Fe/O flux ratio being constant at 0.155±0.006. This shows that unexpectedly Fe and He, C, and O belong to the same class of primary cosmic rays which is different from the primary cosmic rays Ne, Mg, and Si class.

[Folic acid supplementation before and during pregnancy and the risk of preeclampsia]

Objective: To investigate the relationship between folic acid supplementation and the risk of preeclampsia (PE). Methods: A total of 9 048 pregnant women were selected from the First Hospital of Shanxi Medical University in Taiyuan from March 2012 to September 2016. Among them, 882 pregnant women with PE were divided into case group, and 8 166 pregnant women without PE were divided into control group. Information on demographic characteristics, folic acid supplementation, maternal complications, and other factors were collected by face-to-face interviews after child birth in the hospital. Unconditional logistic regression analyses were used to investigate the relationship between folic acid supplementation and the risk of PE and the effects of pre-pregnancy BMI on the relationship of folic acid supplementation with the risk of PE. Results: Compared with nonusers, folic acid supplement users had reduced risk of PE (OR=0.79, 95%CI: 0.64-0.96). Folic acid supplementation before and during pregnancy were negatively related with the risk of PE (OR=0.63, 95%CI: 0.49-0.81). Pregnant women who used folic acid tablets only or used both folic acid tablets and multivitamin containing folic acid had reduced risk of PE (OR=0.81, 95%CI: 0.66-0.99; OR=0.64, 95%CI: 0.49-0.85). No significant relationship was observed in the multivitamin group. Supplemental folic acid doses of <400, 400, and >400 μg/d were related with reduced risk of PE (OR=0.62, 95%CI: 0.42-0.91; OR=0.81, 95%CI: 0.66-0.99; OR=0.68, 95%CI: 0.49-0.94). After stratified by pre-pregnancy BMI, pregnant women who used folic acid supplementation, those with pre-pregnancy BMI<24.0 kg/m(2) had reduced risk of PE (OR=0.75, 95%CI: 0.59-0.96). However, no significant relationship was observed in women with pre-pregnancy BMI≥24.0 kg/m(2). Conclusions: Folic acid supplementation before and during pregnancy were related with reduced risk of PE. Pre-pregnancy BMI might affect the relationship between folic acid supplementation and the risk of PE. Appropriate folic acid supplementation should be recommend for women with different pre-pregnancy BMI.

[Association of sleep duration with cognitive impairment among older adults aged 65 years and older in China]

Objective: The study is to examine association of sleep duration and cognitive impairment in the older adults aged 65 years and older in China. Methods: We analyzed data from 2017-2018 wave of Chinese Longitudinal Healthy Longevity Survey (CLHLS). A total of 14 966 participants were included in the analysis. Data with respect to socioeconomic status, community involvement, behavior pattern, diet, life style, family structure, disease condition, mental health and cognitive function were collected. Cognitive function was measured with Mini-mental State Examination (MMSE). We conducted generalized linear mixed models to examine associations of sleep duration with cognitive impairment, and subgroup analyses of sex and age were conducted. Results: Among 14 966 participants, the percentage of participants aged 65 to 79 years, 80 to 89 years, 90 to 99 years and 100 years and older was 5 148 (4.40%), 3 777 (25.24%), 3 322 (22.20%) and 2 719 (18.16%), respectively. A total of 2 704 participants reported sleep duration of 5 h and less, and 3 883 reported 9 h and more, accounting for 18.94% and 27.19%, respectively. In total, 3 748 were defined with cognitive impairment, accounting for 25.04%. The results of generalized linear mixed models showed that both short (≤5 h) and long (≥ 9 h) sleep duration were associated with cognitive impairment compared with sleep duration of 7 h, with OR(95%CI) of 1.35(1.09-1.68) and 1.70(1.39-2.07), respectively. The association of sleep duration with cognitive impairment was more obvious in males and individuals aged 65 to 79 years old. Conclusion: Short or long sleep duration was responsible for increased risk of cognitive impairment in older Chinese.

[Effects of oxygen saturation on all-cause mortality among the elderly over 65 years old in 9 longevity areas of China]

Objective: To investigate the association between oxygen saturation (SpO₂) and risk of 3-year all-cause mortality among Chinese older adults aged 65 or over. Methods: The participants were enrolled from Healthy Aging and Biomarkers Cohort Study in year of 2012 to 2014 in 9 longevity areas in China. In this prospective cohort study, 2 287 participants aged 65 or over were enrolled. Data on SpO₂ and body measurements were collected at baseline in 2012, and data on survival outcome and time of mortality were collected at the follow-up in 2014. Participants were divided into two groups according to whether SpO₂ was abnormal (SpO₂<94% was defined as abnormal). Results: The 2 287 participants were (86.5±12.2) years old, 1 006 were males (44.0%), and 315 (13.8%) were abnormal in SpO₂. During follow-up in 2014, 452 were died, 1 434 were survived, and 401 were lost to follow-up. The all-cause mortality rate was 19.8%, and the follow-up rate was 82.5%. The mortality rate of SpO₂ in normal group was 21.1%, and that of abnormal group was 41.6% (P<0.001). After adjusting for confounding factors, compared to participants with normal SpO₂, participants with abnormal SpO₂ had increased risk of all-cause mortality with HR (95%CI) of 1.62 (1.31-2.02); HR (95 % CI) was 1.49 (0.98-2.26) for males and 1.71 (1.30-2.26) for females in abnormal SpO₂ group, respectively; HR (95%CI) was 2.70 (0.98-7.44) for aged 65-79 years old, 1.22 (0.63-2.38) for aged 80-89 years old, and 1.72 (1.35-2.19) for aged over 90 years old in abnormal SpO₂ group, respectively. Conclusion: Abnormal SpO₂ was responsible for increased risk of 3-year all-cause mortality among Chinese elderly adults.

[Association of blood lead level with cognition impairment among elderly aged 65 years and older in 9 longevity areas of China]

Objective: To investigate the association between blood lead concentrations and cognition impairment among Chinese older adults aged 65 or over. Method: Data was collected in 9 longevity areas from Heathy Aging and Biomarkers Cohort Study between 2017 and 2018. This study included 1 684 elderly aged 65 years and older. Information about demographic characteristics, socioeconomic factors, health status and cognitive function score of respondents were collected by questionnaire survey and physical examination. Venous blood of the subjects was collected to detect the blood lead concentration. Subjects were stratified into four groups (Q₁-Q₄) by quartile of blood lead concentration. Multivariate logistic regression model was used to analyze the association between blood lead concentration and cognitive impairment. The linear or non-linear association between blood lead concentration and cognitive impairment were described by restrictive cubic splines (RCS). Results: Among the 1 684 respondents, 843 (50.1%) were female and 191 (11.3%) suffered from cognition impairment. After adjusting for confounding factors, the OR value and 95%CI of cognition impairment was 1.05 (1.01-1.10) for every 10 μg/L increase in blood lead concentration in elderly; Compared with the elderly in Q₁, the elderly with higher blood lead concentration had an increased risk of cognitive impairment. The OR value and 95%CI of Q₂, Q₃ and Q₄ groups were 1.19 (0.69-2.05), 1.45 (0.84-2.51) and 1.92 (1.13-3.27), respectively. Conclusion: Higher blood lead concentration is associated with cognitive impairment among the elderly aged 65 years and older in 9 longevity areas in China.

[Association of blood oxidative stress level with hypertriglyceridemia in the elderly aged 65 years and older in 9 longevity areas of China]

Objective: To investigate the association of blood oxidative stress level with hypertriglyceridemia in the elderly aged 65 years and older in China. Methods: A total of 2 393 participants aged 65 years and older were recruited in 9 longevity areas from Heathy Aging and Biomarkers Cohort Study, during 2017 to 2018. Information on demographics characteristic, life style and health status were collected by questionnaire and physical examination, and venous blood was collected to detect the levels of blood oxidative stress and hypertriglyceridemia. The linear or non-linear association between oxidative stress and hypertriglyceridemia was described by restrictive cubic splines (RCS) fitting multiple linear regression model. The generalized linear mixed effect model was conducted to assess the association between oxidative stress and hypertriglyceridemia. Results: A total of 2 393 participants, mean age was 84.6 years, the youngest was 65 and the oldest was 112, the male was 47.9%(1 145/2 393), the triglyceride level was (1.4±0.8) mmol/L. The hypertriglyceridemia detection rate was 9.99%(239/2 393). The results of multiple linear regression model with restrictive cubic spline fitting showed that MDA level was linear association with triglyceride level; SOD level was nonlinear association with triglyceride level. MDA level had significantly association with hypertriglyceridemia, and the corresponding OR value was 1.063 (95%CI: 1.046,1.081) with 1 nmol/ml increment of blood MDA; SOD level had significantly association with hypertriglyceridemia, and the corresponding OR value was 0.986(95%CI: 0.983,0.989) with 1 U/ml increment of blood SOD. Conclusion: Among the elderly aged 65 and older in 9 longevity areas in China, MDA and SOD levels were associated with the risk of hypertriglyceridemia.

Gut Microbiota Participates in Antithyroid Drug Induced Liver Injury Through the Lipopolysaccharide Related Signaling Pathway

Background: Drugs can alter the gut microbiota structure, and gut microbiota dysbiosis in turn is correlated with drug side effects through the intestinal endotoxemia hypothesis. Whether antithyroid drugs (including methimazole and propylthiouracil) cause gut microbiota dysbiosis and whether the gut microbiota is correlated with antithyroid drugs induced liver injury is unknown.

Methods: Initial Graves’ disease patients were randomly divided into the methimazole group (n = 20) and the propylthiouracil group (n = 20) and were followed up every 2 weeks; 50 healthy controls were also included. The structure and function of gut microbiota were compared from the cross sectional and longitudinal levels. The correlation between the gut microbiota and clinical parameters was also determined. In addition, Sprague-Dawley rats were randomly allotted into six groups, including four drug groups, which received daily doses of methimazole (1.5 mg/kg/day; 2.5 mg/kg/day) or propylthiouracil (7.5 mg/kg/day; 12.5 mg/kg/day) by oral gavage, and two control groups received the vehicle. In addition to the indexes mentioned above, intestinal barrier-related indexes were also performed.

Results: Cross sectional and longitudinal comparison results from both clinical trials and animal studies indicate that antithyroid drugs altered gut microbiota structure; and the liver function related indexes all increased which correlated with gut microbiota. In addition, lipopolysaccharide-related pathways and the lipopolysaccharide concentration in feces and serum all increased after antithyroid drugs administration. These results consistent with the destroyed intestinal barrier in animal study after antithyroid drugs administration.

Conclusion: We verified that antithyroid drugs altered gut microbiota structure and that the gut microbiota may in turn be correlated with antithyroid drugs-induced liver injury through the intestinal endotoxemia hypothesis.