Efficacy and safety of Rhizoma curcumea longae with respect to improving the glucose metabolism of patients at risk for cardiovascular disease: a meta-analysis of randomised controlled trials

BACKGROUND

Clinical evidence suggests that curcuminoids, as a natural polyphenol, can provide support for cardioprotection and glucose metabolism. This meta-analysis assessed the efficacy and safety of curcumin with respect to improving glucose metabolism in patients with cardiovascular risk factors.

METHODS

Four databases (PubMed, Cochrane Library, Web of Science and Embase) were searched up to June 2018. The inclusion criteria included (i) randomised controlled trials (RCT) and (ii) subjects with risk factors for cardiovascular disease supplemented with curcumin and curcuminoids. A random-effects model and a standardised mean difference with a 95% confidence interval were used to perform quantitative data synthesis. Sensitivity and subgroup analyses were conducted to assess the effects.

RESULTS

Fourteen eligible RCT with 1277 subjects were included. In the overall analyses, curcumin led to significant decreases in fasting blood glucose (FBG), glycated haemoglobin (HbA1c) and homeostatic model assessment of insulin resistance (HOMA-IR). The subgroup analyses suggested that curcumin or combined curcuminoids were more effective at reducing FBG and HbA1c in type 2 diabetes patients than in individuals with metabolic syndrome. Supplementation with curcuminoids at doses ≥300 mg day^-1 showed significant decreases in FBG, HbA1c and HOMA-IR. The effects of supplementation on FBG, HbA1c and HOMA-IR were more significant over long periods (≥12 weeks) than short periods. Curcumin and curcuminoids were well tolerated, with no serious adverse events.

CONCLUSIONS

Curcumin or combined curcuminoids could exert cardioprotective effects in patients at risk for cardiovascular disease by improving glucose metabolism. However, further high-quality studies and larger sample sizes are required to confirm these results.

[Progression of diagnosis and treatment of medullary thyroid carcinoma]

Objective: To review and summarize recent update on preoperative diagnostic criteria, treatment and postoperative follow-up for medullary thyroid carcinoma. Methods: The relevant literatures and guidelines about medullary thyroid carcinoma were analyzed and summarized. Results: In the early stages of the disease radical surgery still dominated. Ultrasound results suggested that prophylactic lateral neck dissection was required for patients with high risk factors or high levels of carcinoembryonic antigen and calcitonin need prophylactic. Early hereditary medullary carcinoma could receive prophylactic thyroidectomy based on RET gene test results. Advanced progressive medullary thyroid carcinoma could be treated with palliative surgery,molecular targeted drugs and chemotherapy. Conclusions: The prognosis of medullary thyroid carcinoma is poor and lymph node metastasis is easy to occur early. The extent of initial operation should be enough. Locally advanced or distant metastatic medullary thyroid carcinoma can be treated with palliative surgery,molecular targeted drugs and chemotherapy.

Crystallization-induced refractive index modulation on sapphire-derived fiber for ultrahigh temperature sensing

We have demonstrated crystallization-induced refractive index (RI) modulation on sapphire-derived fiber (SDF) showing superheat resistance and developed the SDF based Fabry-Perot interferometers (FPIs) for ultrahigh temperature sensing. The SDF is a special fiber with high concentration of alumina to silica in the fiber core region. Reheating and cooling the SDF by arc discharge generates mullite particles in the core region, which achieves RI modulation up to ~0.015. Such crystallized region in the SDF is explored as mirrors for FPI, showing a good linear response to temperature with sensitivity of ~13.2 pm/°C. Benefiting from superheat resistance of the crystallized SDF being mirrors, the developed SDF-FPI sensor is capable to withstand high temperature up to 1600°C, which is the highest working temperature for amorphous fiber. Moreover, the SDF-FPI sensor exhibits 6-hour stability at 1200°C. The crystallized SDF-FPIs with compactness, wide temperature working range, high sensitivity, and robustness show great potential application in harsh environment such as turbine engines, power plants, petrochemical, gas industry, etc.

Subcongenic analysis of a quantitative trait locus affecting body weight and glucose metabolism in zinc transporter 7 (znt7)-knockout mice

Background

A genome-wide mapping study using male F₂zinc transporter 7-knockout mice (znt7-KO) and their wild type littermates in a mixed 129P1/ReJ (129P1) and C57BL/6J (B6) background identified a quantitative trait locus (QTL) on chromosome 7, which had a synergistic effect on body weight gain and fat deposit with the znt7-null mutation.

Results

The genetic segment for body weight on mouse chromosome 7 was investigated by newly created subcongenic znt7-KO mouse strains carrying different lengths of genomic segments of chromosome 7 from the 129P1 donor strain in the B6 background. We mapped the sub-QTL for body weight in the proximal region of the previously mapped QTL, ranging from 47.4 to 64.4 megabases (Mb) on chromosome 7. The 129P1 donor allele conferred lower body weight gain and better glucose handling during intraperitoneal glucose challenge than the B6 allele control. We identified four candidate genes, including Htatip2, E030018B13Rik, Nipa1, and Atp10a, in this sub-QTL using quantitative RT-PCR and cSNP detection (single nucleotide polymorphisms in the protein coding region).

Conclusions

This study dissected the genetic determinates of body weight and glucose metabolism in znt7-KO mice. The study demonstrated that a 17-Mb long 129P1 genomic region on mouse chromosome 7 conferred weight reduction and improved glucose tolerance in znt7-KO male mice. Among the four candidate genes identified, Htatip2 is the most likely candidate gene involved in the control of body weight based on its function in regulation of lipid metabolism. The candidate genes discovered in this study lay a foundation for future studies of their roles in development of metabolic diseases, such as obesity and type 2 diabetes.

Electronic supplementary material

The online version of this article (10.1186/s12863-019-0715-2) contains supplementary material, which is available to authorized users.

Abstract P4-03-08: Analyzing the clinical actionability of germline CYP2D6 polymorphism in Chinese breast cancer population

Background:Tamoxifen is effective for endocrine-responsive breast cancer as adjuvant therapy. CYP2D6 enzyme metabolizes tamoxifen to clinically active metabolites, while CYP2D6 polymorphisms may adversely affect tamoxifen efficacy by some retrospective clinical evidence. This study was carried out to estimate genotype frequencies of common variants of CYP2D6 in Chinese population. The relationship between prescription of selective estrogen receptor modulators (SERMs) and CYP2D6 polymorphism was also analyzed.

Methods: This was a retrospective research of early-stage patients who underwent surgical treatment at Fudan University Shanghai Cancer Center with ER+ and/or PR+ breast cancer. Genomic DNA was extracted from peripheral blood, which was used for genotyping CYP2D6*10 (C100T) single-nucleotide polymorphisms by polymerase chain reaction-based methods.

Results: A total of 312 patients with primary breast cancer were identified. More than 90.0% patients were in premenopausal status. The allele frequence of CYP2D6*10 in the Chinese population was 54.3%. The genotype frequencies of CYP2D6*10 were 20.5%, 50.3%, 29.2%, for wild-type, heterozygous and homozygous type respectively. We also found this SNP had no significant correlation with clinical characteristics. 145 patients were continuing endocrine treatment in first 5 years. 34.5% patients received CYP2D6 polymorphism test before the prescription of SERMs. The results significantly effected the choice of SERMs. Only 6.2% homozygous type patients took tamoxifen, 45.5% heterozygous patients chose tamoxifen, while 75.0% for wild type. 65.5% patients received CYP2D6 polymorphism test during the treatment of tamoxifen. 63.9% homozygous type patients switched to Toremifene, while 18.9% heterozygous patients changed the endocrine treatment.

Conclusions: The results showed that the frequence of CYP2D6*10 allele was high and nearly 30% Chinese breast cancer population were intermediate metabolizer for tamoxifen. The cyp2d6 polymorphism would influence prescription of SERM in premenopausal breast cancer patients. Patients with homozygous types should take other endocrine treatment instead of tamoxifen, which need more evidence of prospective clinical trials.

Citation Format: Huang L, Cao A. Analyzing the clinical actionability of germline CYP2D6 polymorphism in Chinese breast cancer population [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P4-03-08.

Abstract P2-08-51: Residual Ki67 index and PRPTD mutational status after neoadjuvant chemotherapy containing platinum salts predicts the survival in triple negative breast cancer

Background: Platinum salts have demonstrated sufficient efficacy and safety to consider their use in a neoadjuvant setting for triple negative breast cancer (TNBC). In this study, we focused on the prognostic value of Ki-67 and PRPTD in TNBC patients who received neoadjuvant chemotherapy containing platinum salts.

Patients and Methods: We retrospectively analyzed 145 TNBC cases to compare the activity and tolerability of cisplatin and carboplatin. Two groups received weekly paclitaxel and platinum salts for 4 cycles. Immunohistochemistry assessment of EGFR, Ki67, CK5/6, CK14 was conducted in paraffin-embedded tumor samples after neoadjuvant treatment. Nonsense/missense mutations of PTPRD were also evaluated in these tumor samples determined by using next generation sequencing.

Results: In total, 87% of patients in the cisplatin group and 82% of patients in the carboplatin group experienced a clinical objective response after 4 cycles (P=0.570). Pathological complete response (pCR) occurred similarly in both groups (44% versus 42%, P=0.789). In survival analysis, there was no difference between two regimens. The pathological variables of univariate Cox analysis were obtained from EGRF, Ki67 index, CK5/6, CK14, PTPRD mutational status in residual tumor after NAC. Multivariate Cox analysis identified two significant prognostic factors, including Ki67 index and PRPTD mutational status. The most common grade 3/4 adverse events were neutropenia and leukopenia.

Clinical and pathological evaluationCategoryCisplatin groupCarboplatin groupOR [95% CI]P valueypT0/is,ypN0--0.911 (0.459-1.806)0.789No29 (56%)54 (58%)--Yes23 (44%)39 (42%)--ypT0/is,ypN0/+--1.031 (0.523-2.034)0.930No25 (48%)44 (47%)--Yes27 (52%)49 (53%)--MP grade for breast--NA0.448MP 527 (52%)49 (53%)--MP 48 (15%)8 (9%)--MP 314 (27%)24 (26%)--MP 23 (6%)9 (10%)--MP 10 (0%)3 (3%)--Clinical response after 2 cycles--NA0.352CR3 (6%)2 (2%)--PR43 (82%)84 (90%)--Overall (CR or PR)46 (88%)86 (92%)--SD or PD6 (12%)7 (8%)--Clinical response after 4 cycles--NA0.570CR8 (15%)11 (12%)--PR37 (72%)65 (70%)--Overall (CR or PR)45 (87%)76 (82%)--SD or PD2 (4%)7 (8%)--

Prognostic value of pathological variables in predicting disease free survival using univariate and multivariate Cox modelCategoryUnivariate Cox Analysis Odds ratio (95% CI)P-valueMultivariate Cox Analysis Odds ratio (95% CI)P-valueEGFR negative vs. positive1.353 (0.548-3.342)0.512--Ki67 ≤20% vs. >20%3.951 (1.291-12.094)0.0166.239 (1.614-24.114)0.008CK5/6 negative vs. positive0.822 (0.324-2.085)0.680--CK 14 negative vs. positive1.396 (0.541-3.604)0.490--PTPRD wide type vs. mutation type3.219 (1.117-9.277)0.0307.362 (2.305-23.513)0.001Abbreviation: EGFR. epidermal growth factor receptor; PTPRD. protein tyrosine phosphatase receptor type delta

Conclusion: There was no significant difference between the groups in adverse events. Both types of platinum salts and weekly paclitaxel are feasible therapies that achieved high pCR rates and tolerability in TNBC patients. Ki67 index and PRPTD mutational status in residual tumor should be suggested as promising biomarkers to predict the prognosis.

Citation Format: Huang L. Residual Ki67 index and PRPTD mutational status after neoadjuvant chemotherapy containing platinum salts predicts the survival in triple negative breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P2-08-51.

Abstract P5-13-02: Not presented

This abstract was not presented at the conference.

Citation Format: Rositch AF, Ginsburg OM, Huang L, Chao CA, Visvanathan K, Masalu N. Not presented [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P5-13-02.

Stable isotopic characterization of a coastal floodplain forest community: a case study for isotopic reconstruction of Mesozoic vertebrate assemblages

Stable isotopes are powerful tools for elucidating ecological trends in extant vertebrate communities, though their application to Mesozoic ecosystems is complicated by a lack of extant isotope data from comparable environments/ecosystems (e.g. coastal floodplain forest environments, lacking significant C4 plant components). We sampled 20 taxa across a broad phylogenetic, body size, and physiological scope from the Atchafalaya River Basin of Louisiana as an environmental analogue to the Late Cretaceous coastal floodplains of North America. Samples were analysed for stable carbon, oxygen and nitrogen isotope compositions from bioapatite and keratin tissues to test the degree of ecological resolution that can be determined in a system with similar environmental conditions, and using similar constraints, as those in many Mesozoic assemblages. Isotopic results suggest a broad overlap in resource use among taxa and considerable terrestrial-aquatic interchange, highlighting the challenges of ecological interpretation in C3 systems, particularly when lacking observational data for comparison. We also propose a modified oxygen isotope-temperature equation that uses mean endotherm and mean ectotherm isotope data to more precisely predict temperature when compared with measured Atchafalaya River water data. These results provide a critical isotopic baseline for coastal floodplain forests, and act as a framework for future studies of Mesozoic palaeoecology.

In situ metrology for adaptive x-ray optics with an absolute distance measuring sensor array

Adaptive x-ray mirrors are emerging as one of the primary solutions for meeting the performance needs of the next generation of x-ray light sources. Currently, these mirrors operate open loop with intermittent feedback from invasive sensors that measure the beam quality. This paper outlines a novel design for real-time in situ metrology of the shape of these mirrors using an array of interferometric sensors that does not interrupt the x-ray beam. We describe a proof-of-principle demonstration which shows sub-nm agreement over a range of mirror deflection magnitudes and shapes as compared to simultaneous measurements by using a large-aperture Fizeau interferometer.

Source apportionment of circum-Arctic atmospheric black carbon from isotopes and modeling

Black carbon (BC) contributes to Arctic climate warming, yet source attributions are inaccurate due to lacking observational constraints and uncertainties in emission inventories. Year-round, isotope-constrained observations reveal strong seasonal variations in BC sources with a consistent and synchronous pattern at all Arctic sites. These sources were dominated by emissions from fossil fuel combustion in the winter and by biomass burning in the summer. The annual mean source of BC to the circum-Arctic was 39 ± 10% from biomass burning. Comparison of transport-model predictions with the observations showed good agreement for BC concentrations, with larger discrepancies for (fossil/biomass burning) sources. The accuracy of simulated BC concentration, but not of origin, points to misallocations of emissions in the emission inventories. The consistency in seasonal source contributions of BC throughout the Arctic provides strong justification for targeted emission reductions to limit the impact of BC on climate warming in the Arctic and beyond.

CRISPR/Cas9-mediated disruption of the immediate early-0 and 2 as a therapeutic approach to Bombyx mori nucleopolyhedrovirus in transgenic silkworm

The CRISPR/Cas9 system is a powerful tool for the treatment of infectious diseases. In our previous study, we knocked out the Bombyx mori nucleopolyhedrovirus (BmNPV) key genes and BmNPV-dependent host factor to generate transgenic antiviral strains. To further expand the range of target genes for BmNPV and more effectively prevent and control pathogenic infections, we performed gene editing and antiviral analysis by constructing a target-directed baculovirus early transcriptional activator immediate early-0 (ie-0) and 2 (ie-2) transgenic silkworm line. We hybridized it with Cas9 transgenic line to produce a double-positive transgenic Cas9(+)/sgIE0-sgIE2(+) line that could activate the CRISPR gene editing system. We first demonstrated that the system is capable of efficiently editing target genes and resulting in fragment deletions in the BmNPV genome. Survival rate of the transgenic Cas9(+)/sgIE0-sgIE2(+) line reached 65% after inoculation with 1 × 10⁶ occlusion bodies/larva. Molecular analysis showed that BmNPV DNA replication and viral gene expression level in the transgenic Cas9(+)/sgIE0-sgIE2(+) line were significantly inhibited compared with the control Cas9(-)/sgIE0-sgIE2(-) line. These results indicated that IE-0 and IE-2, as baculovirus early transcriptional activators, can be used as target sites for gene therapy and that multigene editing could expand the range of target sites for research to create silkworm resistance breeds.

Alterations in Brain Metabolites in Patients with Epilepsy with Impaired Consciousness: A Case-Control Study of Interictal Multivoxel 1H-MRS Findings

BACKGROUND AND PURPOSE

Previous studies have shown perfusion abnormalities in the thalamus and upper brain stem in patients with epilepsy with impaired consciousness. We hypothesized that these areas associated with consciousness will also show metabolic abnormalities. However, metabolic abnormalities in those areas correlated with consciousness has not been characterized with multiple-voxel ¹H-MRS. In this study, we investigated the metabolic alterations in these brain regions and assessed the correlation between seizure features and metabolic alterations.

MATERIALS AND METHODS

Fifty-seven patients with epilepsy and 24 control subjects underwent routine MR imaging and 3D multiple-voxel ¹H-MRS. Patients were divided into 3 subgroups: focal impaired awareness seizures (n = 18), primary generalized tonic-clonic seizures (n = 19), and secondary generalized tonic-clonic seizures (n = 20). The measured metabolite alterations in NAA/Cr, NAA/(Cr + Cho), and Cho/Cr ratios in brain regions associated with the consciousness network were compared between the patient and control groups. ROIs were placed in the bilateral inferior frontal gyrus, supramarginal gyrus, cingulate gyrus, precuneus, thalamus, and upper brain stem. Correlations between clinical parameters (epilepsy duration and seizure frequency) and metabolite alterations were analyzed.

RESULTS

Significantly lower NAA/Cr and NAA/(Cho + Cr) ratios (P < .05 and < .01, respectively) were observed in the bilateral thalamus and upper brain stem in all experimental groups, and significantly high Cho/Cr ratios (P < .05) were observed in the right thalamus in the focal impaired awareness seizures group. There were no significant differences in metabolite ratios among the 3 patient groups (P > .05). The secondary generalized tonic-clonic seizures group showed a negative correlation between the duration of epilepsy and the NAA/(Cr + Cho) ratio in the bilateral thalamus (P < .05).

CONCLUSIONS

Metabolic alterations were observed in the brain stem and thalamus in patients with epilepsy with impaired consciousness.

Spin-orbit torque switching in a T-type magnetic configuration with current orthogonal to easy axes

Different symmetry breaking ways determine various magnetization switching modes driven by spin–orbit torques (SOT). For instance, an applied or effective field parallel to applied current is indispensable to switch magnetization with perpendicular anisotropy by SOT. Besides of this mode, here we experimentally demonstrate a distinct field-free switching mode in a T-type magnetic system with structure of MgO/CoFeB/Ta/CoFeB/MgO where a perpendicular layer with tilted easy axis was coupled to an in-plane layer with a uniaxial easy axis. Current was applied orthogonal to both easy axes and thus also normal to an in-plane effective field experienced by the perpendicular layer. Dynamic calculation shows perpendicular layer could be switched at the same time as the in-plane layer is switched. These field-free switching modes realized in the same T-type magnetic system might expedite the birth of multi-state spin memories or spin logic devices which could be operated by all electric manners.

Spin-orbit torque (SOT) induced magnetization switching facilitates all electric multi-state spin memories and spin logic devices. Here the authors show a new SOT field-free switching mode where the perpendicular layer with tilted easy axis is coupled to an in-plane layer with a uniaxial easy axis.

[The diagnostic value of neuron-specific enolase, central nervous system specific protein and interleukin-6 in sepsis-associated encephalopathy]

Objective: To investigate the diagnostic value of neuron-specific enolase(NSE), central nervous system specific protein(S100β), interleukin-6(IL-6) in sepsis-associated encephalopathy(SAE). Methods: Clinical data of patients admitted to ICU and diagnosed with sepsis were collected from January 2015 to June 2016 in Xiangya Hospital, Central South University. SAE was defined as cerebral dysfunction in the presence of sepsis that also fulfilled the exclusion criteria. The acute physiology and chronic health score (APACHE Ⅱ), sequential organ failure assessment (SOFA), NSE, S100β, IL-6, ICU stay time and 28-day mortality were compared between the two groups. NSE, S100β and IL-6 were measured on the 1st and 3rd day in ICU to determine the optimal cut-off value of SAE. Results: Among 59 enrolled patients, 36 were assigned to SAE group while 23 were non-SAE group. The SAE group had a significantly higher APACHE Ⅱ and SOFA scores, as well as the length of ICU stay (P<0.01). The levels of NSE, S100β and IL-6 in the two groups both increased on the 1st day, and decreased on the 3rd day. The level of NSE on the 1st day[19.28(13.00, 30.52) μg/L vs 16.61(7.58, 22.01 μg/L)] and the 3rd day[16.03(9.40, 21.29) μg/L vs 11.39(8.49, 15.00) μg/L, P=0.029], IL-6 on the 1st day[676.25(81.34, 5 000.00) mg/L vs [209.10(42.27, 648.20) mg/L, P=0.005] and the 3rd day[157.10(72.85, 687.63) mg/L vs 55.92(31.62, 177.00) mg/L, P=0.026] of SAE group was significantly higher than those of non-SAE group. However S100β between groups on the 1st day [0.33(0.15, 0.54) μg/L vs 0.23(0.16, 0.53) μg/L] and the 3rd day[0.19(0.10, 0.29) μg/L vs 0.10(0.05, 0.17) μg/L] was neither significant (P>0.05). The diagnostic values for SAE of NSE, S100β and IL-6 were 14.36 μg/L, 0.14 μg/L and 91.305 mg/L with sensitivity 61.1%, 61.1%, 72.2% and specificity 73.9%, 69.6%, 69.6%, respectively. The diagnostic AUC of NSE and IL-6 combination was 0.774, 95%CI 0.651-0.896. Conclusion: All sepsis patients have different degrees of brain injury. NSE combined with IL-6 on the 3rd day in ICU demonstrates the diagnostic significance of SAE.

The effect of neonatal maternal separation on short-chain fatty acids and airway inflammation in adult asthma mice

BACKGROUND

To investigate neonatal maternal separation (NMS) effects on airway inflammation of asthma and potential mechanism using a mouse model.

METHODS

80 Balb/c neonatal male mice were randomly assigned to NMS and non-NMS groups. Feces were collected on PND21, 28, 35 and 42 to analyze microbiota and short-chain fatty acids (SCFAs). Non-NMS group were then divided into control (group A) and asthma groups (group B), while NMS group was assigned to NMS+asthma (group C) and NMS+SCFAs+asthma groups (group D). Inflammatory cells and eosinophils (EOS) in bronchoalveolar lavage fluid (BALF) were assessed. Pathological changes and cytokines in lung tissue were observed. Protein expression of Occludin and E-cadherin in airway epithelial was examined.

RESULTS

The number of S', diversity index H' and dominance index D', as well as content butyric acid in NMS group C were significantly lower than non-NMS group B (p<0.05). Mice in group C had a higher level of inflammatory cells and EOS compared with group A, B and D. EOS moderate infiltration was found in mice of group B, C and D. Mice in group C had significantly higher levels of cytokines and showed slightly increased bronchial epithelium goblet cells and a small amount of visceral secretions. Occludin and E-cadherin expression in lung in B, C and D groups was depressed, and protein level in group C was significantly lower than group B and D.

CONCLUSIONS

NMS is associated with exacerbated inflammation of adult asthma by changing intestinal microflora resulting in butanoic acid decline and airway epithelial barrier damage.

[Efficacy and safety of catheter-directed interventional therapy in patients with acute pulmonary embolism]

Objective: To evaluate the efficacy and safety of catheter-directed interventional therapy in patients with acute pulmonary embolism(PE). Methods: PE was diagnosed by CT pulmonary angiography(CTPA). After risk stratification, a total of 79 PE patients (age (58.9±14.9) years old)were treated with catheter-directed interventional therapy via pulmonary vessels. The changes of pulmonary hemodynamics were compared before and after treatment. The risk of complications and side effects were observed. Results: The pulmonary artery pressure was changed followed by interventional therapy. The interventional therapy significantly decreased mean pulmonary arterial pressure (mPAP) from (35.3±11.2)mmHg (1 mmHg=0.133 kPa) to (30.0±10.6)mmHg (t=8.803,P<0.05) and the echocardiographic derived right ventricular dimension to left ventricular dimension (RV/LV) ratio from 0.93±0.16 to 0.83±0.15 (t=6.868,P<0.05). The arterial partial pressure of oxygen was increased from (69.0±8.6)mmHg to (75.1±9.9)mmHg (t=8.561,P<0.05) . The oxygen saturation was also increased from (93.9±2.9)% to (95.1±1.9)% at 24 h after the treatment (t=2.621,P<0.05) . Patients were further grouped as high-risk group (n=28) and intermediate risk group (n=51). mPAP and RV/LV ratio were significantly reduced in the two subgroups (all P<0.05) and the range of reduction was more significant in the high-risk group. Five patients experienced minor bleeding complication, 3 patients suffered worsened dispone post procedure and were treated with mechanical ventilation, 1 patient died, and 1 patient developed recurrent PE. Conclusion: The catheter-directed interventional therapy improves pulmonary hemodynamics and reduces load of right ventricle both in high-risk or intermediate risk PE patients, this therapy strategy is safe and effective for patients with PE.

[Measurement of rifampicin concentrations in tuberculous pleural effusion before and after combination treatment with oral and local rifampicin]

Objective: To investigate the changes of rifampin concentrations in pleural effusion before and after combination treatment with oral and pleural administration of rifampicin by electro-phonophoresis(EP). Methods: A self-control study was performed in 32 cases of tuberculous pleurisy treated in the Second Department of Respiratory Medicine of Affiliated Hospital of Zunyi Medical College between September 2016 and January 2018. Based on the weight of each patient, an oral administration of isoniazid (0.3-0.4 g/d), rifampicin (0.45-0.60 g/d),ethambutol(0.75 g/d),and pyrazinamide (1.0-1.5 g/d) were given. After a 5-day traditional anti-tuberculosis treatment, an additional EP treatment was applied by penetrating chest wall to deliver 3 ml of rifampicin. The concentration of rifampicin in 5 ml pleural effusion was measured at 0, 0.5, 1, 2, 4 and 8h after applying EP treatment using high performance liquid chromatography. The measurement data were analyzed by using statistic software SPSS 20.0. The results were expressed by x±s and t test was conducted, with a statistical significance of P<0.05. Results: The average concentration of rifampicin in pleural effusion was (2.2±1.1) μg/ml by oral rifampicin alone. The concentration of rifampicin was (2.7±1.1) μg/ml, (3.0±1.4) μg/ml, (3.2±1.2) μg/ml, (2.8±1.2) μg/ml and (1.3±1.1) μg/ml, respectively, at 0.5 h, 1, 2, 4, 8 h after combining local EP treatment. The results indicated that combining local EP treatment significantly increased the drug concentration in pleural effusion, which lasted for about 5 hours. Conclusions: By applying rifampicin into pleural cavity through EP treatment with penetration of the chest wall, the concentration of rifampicin in pleural effusion of patients with tuberculous pleurisy could be increased. Combined with oral administration of rifampicin, this treatment could prolong the effective drug concentration in pleural effusion, which was beneficial to the bactericidal effects of rifampicin.

[Effects of Personality and Psychological Acceptance on Medical Workers' Occupational Stress]

Objective: To assess psychological acceptance and occupational stress of medical staff, analyze the relationship among personality, psychological acceptance and occupational stress and discuss the direct or indirect effects of personality to occupational stress. Methods: Eysenck Personality Questionnaire (EPQ-RSC) , Acceptance and Action Questionnaire-II (AAQ-Ⅱ) and Revised Occupational Stress Inventory (OSI-R) were administered to 749 medical staff. Results: The level of occupational stress of medical staff was high, the score of PSY was 26.8±7.13 and the score of PHS was 24.3±6.50. Personality and psychological acceptance can predict occupational stress. Psychological acceptance was a protective factor of occupational stress. Medical staff with personality of introversion, neuroticism and psychoticism suffered higher occupational stress. Personality have both direct and indirect effects on occupational stress. Neuroticism have the strongest effect on occupational stress with effect size of 0.496 (psychological stress) and 0.431 (physical strain) . Conclusion: Medical staff have heavier occupational stress. There is a significant correlation between personality and occupational stress. Measures depending on personality should be taken to deal with this situation.

Expressions of HBV X gene regulated by different promoters and their effects on cell apoptosis

OBJECTIVE

To investigate the difference in expression level of hepatitis B virus (HBV) X gene, and to further study the difference of HBV X protein (HBx) at varied expression levels in apoptosis regulation of hepatocellular carcinoma cells. The recombinant plasmid rPX with HBV enhancer 1 (Enh1), X gene promoter, X gene and polyA tail were constructed, respectively.

PATIENTS AND METHODS

HepG2 cells were transiently transfected with the recombinant plasmids and control vector pGEM®-7Zf (+) by virtue of Fugene®HD; reverse transcription PCR (RT-PCR) and Western blotting were applied to analyze the transcription and expression of HBV X gene as well as the difference in the expression level in multiple groups. The activity of the transfected cells in each group was detected by using the methyl thiazolyl tetrazolium (MTT) method for 6 consecutive days after transfection. A flow cytometer was utilized to measure the cell apoptosis rate.

RESULTS

The RT-PCR results showed that messenger RNA expression of HBV X gene was detected in all HepG2 cells transfected by different recombinant plasmids, of which the relationships of the expression levels were rCX>rEX1 and rEX2> rPX (p<0.05). Only HepG2/rCX cells in each group of transfected cells showed HBx expression by Western blot. MTT method revealed that there were notable differences between HepG2/rCX, HepG2/rEX1, HepG2/rPX and HepG2/pGEM®-7Zf (+) (p<0.05). The apoptosis rates of HepG2/rCX, HepG2/rEX1 and HepG2/rPX were significantly higher than that of HepG2/pGEM®-7Zf (+) (p<0.05).

CONCLUSIONS

HBx can promote cell apoptosis. Results of this research also indicate that there is a significant difference in the pro-apoptotic role of HBx when its expression is regulated by different promoters, and such a difference may be a part of the complex pathogenic mechanisms of HBV and hepatocellular carcinoma.

A Upf3b-mutant mouse model with behavioral and neurogenesis defects

Nonsense-mediated RNA decay (NMD) is a highly conserved and selective RNA degradation pathway that acts on RNAs terminating their reading frames in specific contexts. NMD is regulated in a tissue-specific and developmentally controlled manner, raising the possibility that it influences developmental events. Indeed, loss or depletion of NMD factors have been shown to disrupt developmental events in organisms spanning the phylogenetic scale. In humans, mutations in the NMD factor gene, UPF3B, cause intellectual disability (ID) and are strongly associated with autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD) and schizophrenia (SCZ). Here, we report the generation and characterization of mice harboring a null Upf3b allele. These Upf3b-null mice exhibit deficits in fear-conditioned learning, but not spatial learning. Upf3b-null mice also have a profound defect in prepulse inhibition (PPI), a measure of sensorimotor gating commonly deficient in individuals with SCZ and other brain disorders. Consistent with both their PPI and learning defects, cortical pyramidal neurons from Upf3b-null mice display deficient dendritic spine maturation in vivo. In addition, neural stem cells from Upf3b-null mice have impaired ability to undergo differentiation and require prolonged culture to give rise to functional neurons with electrical activity. RNA sequencing (RNAseq) analysis of the frontal cortex identified UPF3B-regulated RNAs, including direct NMD target transcripts encoding proteins with known functions in neural differentiation, maturation and disease. We suggest Upf3b-null mice serve as a novel model system to decipher cellular and molecular defects underlying ID and neurodevelopmental disorders.

[Assessment on Application of 24 Y-STR Loci in Forensic Science]

OBJECTIVES

To select a Y-STR marker system with strong haplotype identification ability, appropriate mutation rate and high compatibility and to assess its forensic application.

METHODS

The 24 Y-STR loci were tested by self-built fluorescent multiplex system, and the forensic assessment was conducted by 139 pairs of father-son samples collected in Jinan, Shandong province.

RESULTS

Totally 176 alleles were identified among the 24 Y-STR loci in the sample of 139 unrelated individuals labeled with father, and the gene diversity （GD） distributed between 0.083 7 （DYS645）-0.966 9 （DYS385a/b）. According to the 24 Y-STR loci, 139 different haplotypes were detected from 139 unrelated male individuals labeled with father in Han population of Shandong province and with no shared haplotype observed. The overall haplotype diversity （HD） was 1 and the discrimination capacity （DC） was 1. A total of 5 one-step mutations events were observed among the 24 Y-STR loci in 139 pairs of father-son. The average mutation rate was 0.001 5 [95% CI （0.000 5, 0.003 5）].

CONCLUSIONS

The system of 24 Y-STR loci shows a strong individual recognition ability and low mutation rate in the population in Jinan, Shandong province, and it has good application value in forensic science.

[Effect of neuroglobin on oxygen-glucose deprivation and reoxygenation induced autophagy in a human neuroblastoma cell line]

Objective: To investigate the effect of neuroglobin on oxygen-glucose deprivation and reoxygenation (OGD/R) induced autophagy in a human neuroblastoma cell line (SH-SY5Y). Methods: SH-SY5Y cells were transfected with plasmids (or vector) to establish a stable cell line of NGB overexpression (OE). After treated with OGD/R, cells were collected for the analyses of mRNA (Atg5, Atg7, BECN1 and FUNDC1) and protein levels of LC3. Furthermore, mitochondrial and cytosolic fractions were isolated for protein levels of PINK1 and Parkin. Results: Treatment of OGD/R significantly increased the levels of mRNA of Atg5, Atg7, BECN1 and FUNDC1 (peak levels were 4.90±0.71, 6.72±0.75, 2.71±0.39 and 3.96±0.78 fold, all P<0.05). The protein level of Parkin increased in mitochondria and decreased in cytoplasm after the treatment. Compared with the vector group, Ngb OE group showed a significant higher level of FUNDC1 mRNA (3.96±0.78 versus 6.86±0.63 fold, P<0.05), while Atg5, Atg7 and BECN1 mRNA levels showed no significant difference. Moreover, the mitochondrial or cytosolic protein levels of PINK1 or Parkin showed no significant difference between Ngb OE and vector group. Conclusions: Overexpression of Ngb can not affect autophagy or mitohpagy in OGD/R treated SH-SY5Y cells. Overexpression of Ngb can increase the mRNA level of FUNDC1 and the mechanism needs further study.

A long-acting pegylated recombinant human growth hormone (Jintrolong® ) in healthy adult subjects: Two single-dose trials evaluating safety, tolerability and pharmacokinetics

WHAT IS KNOWN AND OBJECTIVE

Jintrolong^® is a pegylated recombinant human growth hormone (rhGH) (PEG-rhGH) developed for weekly subcutaneous (sc) injection. The current human tolerability trial and pharmacokinetics (PK) trial evaluated the safety, tolerability and PK of single-dose Jintrolong^® injection in healthy adult subjects.

METHODS

Both trials were single-centre, randomized, open-label and single-dose studies. In the human tolerability trial, 34 healthy subjects were randomized to receive single-dose Jintrolong^® sc injection (0.01, 0.06, 0.2, 0.5 or 0.8 mg/kg) or placebo. In the PK study, 30 healthy male subjects were evenly randomized into 3 groups to receive single-dose Jintrolong^® sc injection (0.1, 0.2 or 0.4 mg/kg), and the subjects receiving 0.4 mg/kg Jintrolong^® were given a single sc injection of conventional rhGH (0.067 mg/kg) after a 14-day washout period. Safety and PK profiles of Jintrolong^® were evaluated.

RESULTS AND DISCUSSION

Jintrolong^® was well tolerated with no serious adverse events or local injection responses. The PK trial showed that the plasma growth hormone concentration elevated quickly and stayed at peak level between 12 and 48 hours post-Jintrolong^® injection, then decreased gradually back to baseline within 168 hours. Compared to single-dose conventional rhGH, Jintrolong^® at all doses demonstrated significantly longer half time and time to maximum plasma concentration, lower clearance and higher systemic drug exposure, indicating prolonged presence of GH in the subjects' circulation. Additionally, systemic exposure to Jintrolong^® increased in a dose-dependent manner.

WHAT IS NEW AND CONCLUSION

Single-dose Jintrolong^® injection was well tolerated in healthy adult subjects, and the maximum tolerable dose was no lower than 0.8 mg/kg. Jintrolong^® was long-acting with the potential for weekly administration.

[Clinical features of post-splenectomy pulmonary hypertension and effects of its target therapy]

Objective: To analyze the clinical features of post-splenectomy pulmonary hypertension and effects of its target therapy, and improve the diagnosis and treatment of the disease. Methods: Clinical data of 18 patients with post-splenectomy pulmonary hypertension admitted to Fuwai Hospital from October 2006 to March 2017 were systematically reviewed and analyzed. Results: Among the 18 patients with a mean age of (41±11) years old, 11 were women and 7 were men. The interval between splenectomy and the diagnosis of pulmonary hypertension was (11±6) years. Shortness of breath (14/18) and chest distress (12/18) were the most common clinical manifestations. Nine patients were in World Health Organization functional class (WHO-FC) Ⅲ-Ⅳ, and two patients were combined with pulmonary embolism. According to the cause of splenectomy, the pulmonary hypertension patients were divided into hepatocirrhosis portal hypertension group (10/18) and non-hepatocirrhosis portal hypertension group (8/18). In hepatocirrhosis portal hypertension group, patients were combined with chronic liver abnormalities presentation, and no pulmonary embolism was found in these patients. Cardiac output and cardiac index were significantly higher (P=0.007 and 0.011, respectively) and pulmonary vascular resistance was significantly lower (P=0.013) in hepatocirrhosis portal hypertension group as compared with non-hepatocirrhosis portal hypertension group. There was no difference in WHO-FC and mean pulmonary arterial pressure between two groups (P=0.448 and 0.379, respectively). After 3 months of target treatment in 8 patients, WHO-FC of 3 patients improved, systolic pulmonary artery measured by ultrasonic cardiogram was significantly decreased[(84±10) vs (71±12) mmHg(1 mmHg=0.133 kPa), P=0.005]and right ventricular end diastolic diameter/left ventricular end diastolic diameter was significantly reduced[(0.78±0.17) vs (0.62±0.16), P=0.010]compared to the baseline. The level of NT-proBNP also tended to be decreased, although not to a significant extent. Conclusions: Post splenectomy pulmonary hypertension has various clinical features. Post splenectomy pulmonary hypertension resulted from hepatocirrhosis portal hypertension has better hemodynamics. Target treatment is effective for the patients with post splenectomy pulmonary hypertension.