Impact of structured self-monitoring of blood glucose on the quality of life of insulin-treated Chinese patients with type 2 diabetes mellitus: Results from the COMPASS study

AIMS

To evaluate the effect of structured self-monitoring of blood glucose (SMBG) regimen on quality of life (QoL) in poorly controlled insulin-treated patients with type 2 diabetes.

METHODS

Phase II of the COMPASS trial was a 6-month, multicenter, prospective, single-arm, interventional study. This study recruited 820 outpatients from 19 clinical sites in China who met the following inclusion criteria: type 2 diabetes, insulin treatment for ≥ 3 months, and age 18-65 years, an HbA1c >8.0% (64 mmol/mol), and willingness to perform SMBG. Subjects were advised to follow a structured SMBG regimen specific to their insulin regimen, and were trained to respond to SMBG readings via lifestyle changes and insulin dose self-adjustment. QoL assessments (SF-36) were performed at baseline and 6 months.

RESULTS

Patients with a mean age of 55.13 ± 9.77 years had an average diabetes duration of 9.83 ± 7.05 years and had been receiving insulin therapy for a mean of 45.4 ± 46.79 months. All QoL parameters were significantly improved following structured SMBG after 6 months, most notably the physical role functioning (p<0.0001) and emotional role functioning (p<0.0001) component scores. Overall, 40.6% of patients rated their overall QoL as 'a bit' or a lot better' after structured SMBG compared with 16.5% prior to the intervention (p<0.0001). SMBG also improved overall feelings of wellbeing, with 39.13% of patients believing that their health was deteriorating prior to SMBG compared with only 14.4% of patients after the intervention (p<0.0001).

CONCLUSIONS

The structured SMBG program in insulin-treated Chinese outpatients with type 2 diabetes significantly improved QoL outcomes. Physical and emotional role functioning are the 2 QoL scales that demonstrate the largest improvement with SMBG.

Newer antifungal agents micafungin and voriconazole for fungal infection prevention during hematopoietic cell transplantation: a meta-analysis

OBJECTIVE

The new antifungal agents provide further opportunities for effective prophylaxis for fungal infections during stem cell transplantation for patients with hematologic malignancies; however, the efficacy of these antifungal prophylactic drugs has not yet been established. This study was to compare the newer antifungal agents micafungin and voriconazole for prophylaxis effects on the clinical outcomes.

MATERIALS AND METHODS

We electronically searched the database of Cochrane Central Register of Controlled Trials, Pubmed, EMbase, and relevant database articles (1996.01-2013.12). Comparative studies were carried out on proved fungal infections, mortality, and adverse effects. Meta-analysis was performed by Review Manager 5.1.6 software and the funnel plot regression was adopted to assess the publication bias.

RESULTS

We found 1508 records and 13 studies totaling 3767 patients included in analyses. Pooled comparisons of studies found that antifungal prophylaxis with the new agents does reduce the incidence of invasive fungal infections than fluconazole or itraconazole. The reduction in invasive fungal infections was achieved by using micafungin, voriconazole for antifungal prophylaxis. Using voriconazole prophylaxis can decrease the transplant mortality compared with fluconazole or itraconazole prophylaxis. Voriconazole had higher rates of liver dysfunction, lower gastrointestinal side effects over fluconazole, and lower rates of nephrotoxic effects than amphotericin B. Both micafungin and voriconazole had a significant decrease in adverse events requiring drug discontinuation compared with itraconazole.

CONCLUSIONS

This analysis indicated the 2 agents appear to be well tolerated with manageable side effects and beneficial in the prophylaxis of IFI. Further work is needed with a large scale of random controlled trials on the effect of these drugs.

Effects of Dietary Supplementation of β-hydroxy-β-methylbutyrate on Sow Performance and mRNA Expression of Myogenic Markers in Skeletal Muscle of Neonatal Piglets

The effects of dietary β-hydroxy-β-methylbutyrate (HMB) supplementation during gestation on reproductive performance of sows and the mRNA expression of myogenic markers in skeletal muscle of neonatal pigs were determined. At day 35 of gestation, a total of 20 sows (Landrace × Yorkshire, at third parity) were randomly assigned to two groups, with each group receiving either a basal diet or the same diet supplemented with 4 g/day β-hydroxy-β-methylbutyrate calcium (HMB-Ca) until parturition. At parturition, the total and live litter size were not markedly different between treatments, however, the sows fed HMB diet had a decreased rate of stillborn piglets compared with the sows fed the control (CON) diets (p < 0.05). In addition, piglets from the sows fed HMB diet tended to have an increased birth weight (p = 0.08), and a reduced rate of low birth weight piglets (p = 0.05) compared with piglets from the CON sows. Nevertheless, lower feed intake during lactation was observed in the sows fed the HMB diet compared with those on the CON diet (p < 0.01). The relative weights of the longissimus dorsi (LD) and semitendinosus (ST) muscle were higher (p < 0.05) in neonatal pigs from the HMB than the CON sows. Furthermore, maternal HMB treatment increased the mRNA levels of the myogenic genes, including muscle regulatory factor-4 (MRF4, p < 0.05), myogenic differentiation factor (MyoD) and insulin-like growth factor-1 (IGF-1, p < 0.01). In conclusion, dietary HMB supplementation to sows at 4 g/day from day 35 of gestation to term significantly improves pregnancy outcomes and increases the expression of myogenic genes in skeletal muscle of neonatal piglets, but reduces feed intake of sows during lactation.

Particle emissions from microalgae biodiesel combustion and their relative oxidative potential

Microalgae are considered to be one of the most viable biodiesel feedstocks for the future due to their potential for providing economical, sustainable and cleaner alternatives to petroleum diesel. This study investigated the particle emissions from a commercially cultured microalgae and higher plant biodiesels at different blending ratios. With a high amount of long carbon chain lengths fatty acid methyl esters (C20 to C22), the microalgal biodiesel used had a vastly different average carbon chain length and level of unsaturation to conventional biodiesel, which significantly influenced particle emissions. Smaller blend percentages showed a larger reduction in particle emission than blend percentages of over 20%. This was due to the formation of a significant nucleation mode for the higher blends. In addition measurements of reactive oxygen species (ROS), showed that the oxidative potential of particles emitted from the microalgal biodiesel combustion were lower than that of regular diesel. Biodiesel oxygen content was less effective in suppressing particle emissions for biodiesels containing a high amount of polyunsaturated C20-C22 fatty acid methyl esters and generated significantly increased nucleation mode particle emissions. The observed increase in nucleation mode particle emission is postulated to be caused by very low volatility, high boiling point and high density, viscosity and surface tension of the microalgal biodiesel tested here. Therefore, in order to achieve similar PM (particulate matter) emission benefits for microalgal biodiesel likewise to conventional biodiesel, fatty acid methyl esters (FAMEs) with high amounts of polyunsaturated long-chain fatty acids (≥C20) may not be desirable in microalgal biodiesel composition.

Delocalized Surface State in Epitaxial Si(111) Film with Spontaneous √3 × √3 Superstructure

The “multilayer silicene” films were grown on Ag(111), with increasing thickness above 30 monolayers (ML). Scanning tunneling microscopy (STM) observations suggest that the “multilayer silicene” is indeed a bulk-like Si(111) film with a (√3 × √3)R30° honeycomb superstructure on surface. The possibility for formation of Si(111)(√3 × √3)R30°-Ag reconstruction on the surface can be distinctively ruled out by peeling off the surface layer with the STM tip. On this surface, delocalized surface state as well as linear energy-momentum dispersion was observed from quasiparticle interference patterns. Our results indicate that a bulklike silicon film with diamondlike structure can also host delocalized surface state, which is even more attractive for potential applications, such as new generation of nanodevices based on Si.

[Research progress on site-oriented and three-dimensional immobilization of proteins]

In today's post-genome era, the goals of research are geared toward understanding the meaning of information in sequenced DNA, namely, understanding the functional characteristics of proteins encoded by genomes of living beings. Protein array technologies, particularly miniaturized high-throughput platforms such as micro- or nano-fluidic chips that allow the parallel detection of thousands of proteins simultaneously, are playing increasing important roles as discovery tools in proteomics. These technologies are based on principles of molecular recognition and consist of a support surface, such as a glass slide, bead, or microtiter plate, to which an array of captured proteins is bound. However, immobilized proteins often lose their immunoactivity and suffer from low surface density, which results in inefficient signal response. In this review, we mainly provide an introduction about the research progress on site-oriented adsorption of protein at solid-liquid interfaces, especially the three-dimensional immobilization of protein, whose objective is to retain immobilized proteins in an active state at great density.

A case of bone marrow infection by Staphylococcus saccharolyticus

We report a case of fatal bone marrow infection caused by Staphylococcus saccharolyticus in a 26 year old female. The causative organism was isolated by anaerobic culture on blood agar, and was identified by PCR amplification of the gap gene and genotyping of the resultant sequence.

Evidence for hydrophobic catalysis of DNA strand exchange

DNA strand exchange is catalysed by a hydrophobic environment which destabilises base stacking and promotes DNA breathing.

Ginkgo biloba extract for essential hypertension: a systemic review

BACKGROUND

Ginkgo biloba extract (GBE), a traditional natural herbal product, is often used in the treatment of essential hypertension (EH) as complementary therapy in China and European countries.

AIM

To critically assess the current clinical evidence of efficacy and safety of GBE for EH.

METHODS

7 electronic databases (Cochrane Library, PubMed, EMBASE, VIP, CBM, Wanfang data, and CNKI) were searched to identify randomized controlled trials (RCTs) of GBE for EH. Methodological quality was assessed independently using the Cochrane Handbook for Systematic Reviews of Interventions.

RESULTS

A total of 9 RCTs with 1012 hypertensive patients were identified and reviewed. Most RCTs were of high risk of bias with flawed study design and poor methodological quality. 6 trials demonstrated potential positive effect of GBE as complementary therapy on BP reduction when compared with antihypertensive drug therapy; however, it was not associated with a statistically significant effect on both SBP and DBP reduction in 3 other trials. Despite the positive findings, there were so many methodological limitations and significant clinical heterogeneity. Most of the trials did not report adverse effects, and the safety of GBE is still uncertain.

CONCLUSION

No confirmative conclusions on the efficacy and safety of GBE for EH could be drawn. More rigorous trials are warranted to support their clinical use.

Abnormalities in whole-brain functional connectivity observed in treatment-naive post-traumatic stress disorder patients following an earthquake

BACKGROUND

Convergent studies have highlighted the dysfunction of the amygdala, prefrontal cortex and hippocampus in post-traumatic stress disorder (PTSD). However, only a few studies have investigated the functional connectivity between brain regions in PTSD patients during the resting state, which may improve our understanding of the neuropathophysiology of PTSD. The aim of this study was to investigate patterns of whole-brain functional connectivity in treatment-naive PTSD patients without co-morbid conditions who experienced the 8.0-magnitude earthquake in the Sichuan province of China.

METHOD

A total of 72 PTSD patients and 86 trauma-exposed non-PTSD controls participated in the resting-state functional magnetic resonance imaging study. All these subjects were recruited from the disaster zone of the 2008 Sichuan earthquake. Functional connectivities between 90 paired brain regions in PTSD patients were compared with those in trauma-exposed non-PTSD controls. Furthermore, Pearson correlation analysis was performed between significantly abnormal connectivities in PTSD patients and their clinician-administered PTSD scale (CAPS) scores.

RESULTS

Compared with non-PTSD controls, PTSD patients showed weaker positive connectivities between the middle prefrontal cortex (mPFC) and the amygdala, hippocampus, parahippocampal gyrus and rectus, as well as between the inferior orbitofrontal cortex and the hippocampus. In addition, PTSD patients showed stronger negative connectivity between the posterior cingulate cortex (PCC) and the insula. The CAPS scores in PTSD patients correlated negatively with the connectivity between the amygdala and the mPFC.

CONCLUSIONS

PTSD patients showed abnormalities in whole-brain functional connectivity, primarily affecting the connectivities between the mPFC and limbic system, and connectivity between the PCC and insula.

Observation of Dirac cone warping and chirality effects in silicene

We performed low temperature scanning tunneling microscopy (STM) and spectroscopy (STS) studies on the electronic properties of (√3 × √3)R30° phase of silicene on Ag(111) surface. We found the existence of Dirac Fermion chirality through the observation of -1.5 and -1.0 power law decay of quasiparticle interference (QPI) patterns. Moreover, in contrast to the trigonal warping of Dirac cone in graphene, we found that the Dirac cone of silicene is hexagonally warped, which is further confirmed by density functional calculations and explained by the unique superstructure of silicene. Our results demonstrate that the (√3 × √3)R30° phase is an ideal system to investigate the unique Dirac Fermion properties of silicene.

Guided bone regeneration using acellular bovine pericardium in a rabbit mandibular model: in-vitro and in-vivo studies

BACKGROUND AND OBJECTIVE

To investigate the feasibility of acellular bovine pericardium (BP) for guided bone regeneration (GBR) in vitro and in vivo. The success of GBR relies on the fact that various cellular components possess different migration rates into the defect site and that a barrier membrane plays a significant role in these processes.

MATERIAL AND METHODS

BP membrane was isolated and decellularized using an enzymatic method. The microarchitecture, mechanical properties, cytotoxicity and cell chemotaxis properties of the acellular BP were evaluated in vitro, and the in-vivo efficacy of the acellular BP was also investigated in a rabbit mandibular model.

RESULTS

The acellular BP membrane possessed an interconnected fibrous structure. Glutaraldehyde (GA) treatment was efficient for enhancement of the mechanical properties of the acellular BP bur and resulted in negligible cytotoxicity. After 16 wk, standardized osseous defects created in the rabbit mandible, and covered with acellular BP, were associated with an enhanced deposition of mineralized tissue when compared with defects left to spontaneous healing.

CONCLUSION

GA-treated acellular BP is promising as a barrier membrane for GBR for further in-vivo and clinical studies.

Transporter studies in drug development: experience to date and follow-up on decision trees from the International Transporter Consortium

The International Transporter Consortium (ITC) organized a second workshop in March 2012 to expand on the themes developed during the inaugural ITC workshop held in 2008. The final session of the workshop provided perspectives from regulatory and industry-based scientists, with input from academic scientists, and focused primarily on the decision trees published from the first workshop. These decision trees have become a central part of subsequent regulatory drug-drug interaction (DDI) guidances issued over the past few years.

Multiple statistical methods for assessing differential gene expression in microarray data of diabetic model rats to predict the molecular mechanism of atorvastatin on anti-atherogenesis

BACKGROUND

Many evidences indicate that statins have pleiotropic effects that are lipid-lowering independent. These effects could suggest attenuation of many of the stages critical to atherosclerosis. However, the specific molecular mechanisms of statins on atherogenesis are still unknown. The goal is to detect and analyze the altered gene expression of the artery after atorvastatin treatment in streptozocin (STZ)-induced diabetic rats, and to predict the possible cholesterol-independent effects of atorvastatin on anti-atherogenesis.

METHODS

A total of 33 Sprague Dawley (SD) rats were randomly divided into 3 groups: control group, diabetic group, and diabetic group with atorvastatin treatment (receiving 50 mg/kg qd atorvastatin). Rats were sacrificed at the end of 4 weeks, and the aortas were obtained. The pathological changes were observed by Hematoxylin and eosin (HE) staining. A cDNA microarray analysis was carried out, and the results were analyzed by the random variance model (RVM) t-test, Stc analysis, Stc-Gene Ontology (GO) analysis, Stc-pathway analysis, and GeneFunNet analysis. Then reverse transcription polymerase chain reaction (RT-PCR) was used to evaluate the mRNA expression of Cathepsin S (Cat S),Which was one of the significant genes obtained by statistical analysis, in the aortas of rats in control group (Wistar rats), DM group (Goto Kakisaki rats) and atorvastatin treated DM group (Goto Kakisaki rats with 50 mg/kg qd atorvastatin) for 12 weeks.

RESULTS

A total of 1 073 differential expression genes were found in the 3 groups. 2 tendency profiles of gene expression, which represented the medicine effect, were picked out by Stc analysis of gene expression. The main functions of genes and the significant pathways in the 2 profiles were figured out by Stc-go analysis and Stc-pathway analysis. The core regulatory factors in the co-expression network were shown by GeneFunNet analysis. Among these significant genes, Cat S was chosen to be further evaluated as a target gene. Expression of Cat S was upregulated in the aortas of the diabetic rats and downregulated with statistical significance by atorvastatin treatment.

CONCLUSIONS

Atorvastatin can influence the expression of many genes and signal pathways, some may be significant and produce their marked effects on all of the processes of atherogenesis. Cat S is one of them. These data thus predict the possible molecular mechanism of pleiotropic effects of atorvastatin, which is useful for further experimental design.

Spontaneous symmetry breaking and dynamic phase transition in monolayer silicene

The (sqrt[3]×sqrt[3])R30° honeycomb of silicene monolayer on Ag(111) was found to undergo a phase transition to two types of mirror-symmetric boundary-separated rhombic phases at temperatures below 40 K by scanning tunneling microscopy. The first-principles calculations reveal that weak interactions between silicene and Ag(111) drive the spontaneous unusual buckling in the monolayer silicene, forming two energy-degenerate and mirror-symmetric (sqrt[3]×sqrt[3])R30° rhombic phases, in which the linear band dispersion near the Dirac point and a significant gap opening (150 meV) at the Dirac point were induced. The low transition barrier between these two phases enables them to be interchangeable through dynamic flip-flop motion, resulting in the (sqrt[3]×sqrt[3])R30° honeycomb structure observed at high temperature.