Gender and age differences in the association between sleep characteristics and fasting glucose levels in Chinese adults

AIM

The present study examined the associations between night-time sleep duration, midday napping duration and bedtime, and fasting glucose levels, and whether or not such associations are dependent on gender and age.

METHODS

This study was a cross-sectional analysis of 172,901 adults aged≥40 years living in mainland China. Sleep duration was obtained by self-reports of bedtime at night, waking-up time the next morning and average napping duration at midday. Fasting plasma glucose (FPG)≥7.0mmol/L was defined as hyperglycaemia. Independent associations between night-time sleep duration, midday naptime duration and bedtime with hyperglycaemia were evaluated using regression models.

RESULTS

Compared with night-time sleep durations of 6-7.9h, both short (<6h) and long (≥8h) night-time sleep durations were significantly associated with an increased risk of hyperglycaemia in women [odds ratio (OR): 1.12, 95% confidence interval (CI): 1.01-1.29 and OR: 1.14, 95% CI: 1.08-1.21, respectively], and revealed a U-shaped distribution of risk in women and no significant association in men. Long midday nap durations (≥1h) were significantly but weakly associated with hyperglycaemia (OR: 1.04, 95% CI: 1.01-1.09) compared with no napping without interactions from gender or age, whereas the association between bedtime and fasting glucose levels did vary according to gender and age.

CONCLUSION

Night-time sleep duration, midday napping duration and bedtime were all independently associated with the risk of hyperglycaemia, and some of the associations between these sleep characteristics and hyperglycaemia were gender- and age-dependent.

[Feasibility of the determination of plasma vardenafil level in rat by performance liquid chromatography-tandem mass spectrometry]

Objective: To develope and validate a reliable and sensitive liquid chromatography-tandem mass spectrometry (LC-MS/MS) method for determination of vardenafil concentration in plasma of rat. Methods: Plasma samples of normal Sprague-Dawley rats were collected. A Phenomenex Synergi Polar-RP 80A column (2.0 mm×50 mm, 4 µm) was used. Column temperature was set at 30 ℃. Mobile phase A was 0.1% formic acid in water; mobile phase B was 0.1% formic acid in acetonitrile. The flow rate was 0.4 ml/minutes. Quantitative determination was performed by electrospray ionization, operating in positive ion multiple reaction monitoring (MRM) mode. Cisapride was used as the internal standard. The feasibility of the method was evaluated by examining its specificity, linearity and quantitative range, precision and accuracy, matrix effects, and stability. Results: Under the selected chromatographic and mass spectrometry conditions, the monitoring ions of vardenafil and internal standard were mass-to-charge ratio（m/z) 489.3/151.2 and 466.4/234.2, the retention times of vardenafil and internal standard were 2.62 and 2.80 minutes, respectively, and the peak shape was satisfactory. The method has good linearity in the concentration range of 0.2-200 ng/ml. The intra-batch precision (%CV) and accuracy (%DEV) of vardenafil were 1.5%-9.7% and -6.8%-6.6%, respectively. The inter-batch precision and accuracy of vardenafil were 3.1% -8.4% and -3.7%-4.6%, respectively. In this sample processing method, the extraction recovery rate of vardenafil was obtained at range of 88.2%-104.6%, which met the requirements for the investigation of extraction recovery rate. In this sample processing method, the normalized matrix factor of each quality control concentration of vardenafil was 1.04, 0.85, and 1.04, and the coefficient of variation (%CV) was in the range of 1.7%-10.7%, which met the requirements for the investigation of matrix effects. Variations of short-term stability, long-term stability, and stability of 4 freeze-thaw cycles of vardenafil was within ±15%, and the coefficient of variation were within 5%. Conclusion: The high performance liquid chromatography-tandem mass spectrometry method established in this study is feasible for the measurement of concentration of vardenafil in rat plasma and this method has good specificity and high accuracy, and can be used to detect the concentration of vardenafil in rat plasma.

AB0491 ELEVATED COMPLEMENT 3 INDICATES DISEASE ACTIVITY IN TAKAYASU ARTERITIS

Background:

The disease activity evaluation of Takayasu arteritis (TA) is a critical issue for disease monitoring and treatment. But the previous markers such as Kerr score or ITAS 2010 are not convenient enough.

Objectives:

We aim to explore novel biomarkers to assess TA disease activity.

Methods:

This cross-sectional study was based on the East China TA (ECTA) cohort. Demographic characteristics, clinical features, laboratory and imaging results were collected. Complements and their combination with other biomarkers in identifying active disease (Kerr >= 2) group were analyzed. Internal and external validation were employed to confirm the accuracy and stability of the results.

Results:

519 patients were enrolled, among which 406 cases (72.2%) were identified as active disease. Higher ESR, CRP, platelet, globulin, IgG, IL-6, complement 3 (C3), complement 4 (C4) and median haemolytic complement (CH50) levels were observed in the active disease group. Logistic regression analysis demonstrated that C3 levels [odds ratio [OR] (95%CI): 10.710(1.825 – 62.835), P = 0.009] and CRP [OR (95%CI): 1.041(1.009 – 1.073), P = 0.011] were independently associated with active disease. The cut-off of C3 to identify active TA was 1.085 g/L, with 69.9% sensitivity, 66.7% specificity. Combining the CRP (cut-off, 10.65g/L; sensitivity, 50.7%; specificity, 82.4%) and C3, the sensitivity and specificity to identify the active disease were 85.1% and 55.0% (parallel test), and 35.4% and 94.1% (serial test), respectively. C3 could significantly improve the diagnostic ability of CRP [net reclassification index: OR (95%CI): 1.728 (1.556–1.990), P = 0.000; integrated discrimination index: OR (95%CI): 0.328 (0.224–0.431), P = 0.000]. The accuracy of the 10-fold cross validation of combining CRP with C3 was over 75%, and the accuracy of the external validation with 53 TA cases was 72.73%.

Conclusion:

C3 could reflect the disease activity of TA, and combining CRP with C3 could significantly improve the disease activity evaluation in TA.

References:

[1]Ma J, Luo X, Wu Q, Chen Z, Kou L, Wang H. Circulation levels of acute phase proteins in patients with Takayasu arteritis. J Vasc Surg. 2010;51(3):700-6.

Acknowledgments:

This work was supported by the National Natural Science Foundation of China [NSFC 81771730 and 81601398].

Disclosure of Interests: :

None declared

FRI0012 THERAPEUTIC VALUE OF CURCUMIN ON INITIATION AND DEVELOPMENT OF INFLAMMATION IN TAKAYASU’S ARTERITIS CAUSED BY HSP65-MEDIATED CCL2 OVEREXPRESSION

Background:

Takayasu’s arteritis (TA) is a chronic inflammatory disease characterized with macrophages infiltration. During active stage, aorta adventitial fibroblasts (AAFs) proliferate excessively and produce numerous pro-inflammatory factors in the adventitia, which is the main target of TA therapy. Monocyte chemokine CCL2 may contribute to the infiltration of macrophages in TA arteries[1]but whether with relationship with HSP65, an antigen of Mycobacterium tuberculosis (M. TB) which might involve in the pathogenesis of TA[2]and activate AAFs to produce inflammatory factors, has not been reported. The treatment of TA is full of difficulties and contradictions[3]. Curcumin is a traditional Chinese medicine with anti-inflammatory effect[4], whether it is effective on TA and the underlying mechanism remains unclear.

Objectives:

To explore the mechanism of TA inflammation triggered by M. TB associated antigen HSP65 activating AAFs, as well as the therapeutic value of curcumin in the initiation and development of TA.

Methods:

We first verified high HSP65 expression in aortic adventitia of TA patients by IHC. mRNA-seq was used to profile DEGs between AAFs stimulated by HSP65 with or without pretreated with curcumin, and AAFs without any treatment. Then the key chemokine CCL2 screened by mRNA-seq was detected in the adventitia of TA aorta, and its correlation with HSP65 expression was analyzed by double-labelled IF. Subsequently, we explored how HSP65 affected the production of inflammatory factors by AAFs at cellular level and its related signal pathway. Simultaneously, we explored whether curcumin could hinder this process. and verified the effect of curcumin on serum CCL2 level in patients with TA. Finally, serum CCL2 and other inflammation indicators of TA patients at baseline and after 3 months treatment by curcumin were determined.

Results:

HSP65 was highly expressed in the adventitia of TA arteries. DEGs analysis showed a key role of CCL2. The expression of CCL2 in adventitia of TA arteries was significantly higher than healthy subjects, and was correlated with HSP65. HSP65 facilitated the production of CCL2, IL-6 and IL-1β by AAFs via activating TLR4-JAK2/AKT/STAT3 pathway, among which the change of CCL2 was the most remarkable. Curcumin reversed the upregulation of CCL2 induced by HSP65 in vitro, which was more obvious than that of MTX and tofacitinib. Finally, curcumin significantly downregulated the level of serum CCL2 of TA patients.

Conclusion:

HSP65 initiates and promotes inflammation of TA by upregulated CCL2 in AAFs through JAK/AKT/STAT3 pathway, while curcumin can reverse this process and slow down the initiation and development of TA.

References:

[1]L, A., J, H., A, M., G, G. & Z, A. Pathogenesis of Takayasu’s arteritis: a 2011 update.Autoimmunity reviews11, 61-67 (2011).

[2]Y, S., et al.Perforin-secreting killer cell infiltration and expression of a 65-kD heat-shock protein in aortic tissue of patients with Takayasu’s arteritis.The Journal of clinical investigation93, 750-758 (1994).

[3]L, B., G, Y. & C, P. Non-glucocorticoid drugs for the treatment of Takayasu’s arteritis: A systematic review and meta-analysis. Autoimmunity reviews 17, 683-693 (2018).

[4]T, E., et al.Curcumin--from molecule to biological function.Angewandte Chemie (International ed. In English)51, 5308-5332 (2012).

Figure A.

High expression of HSP65 and CCL2 in aortic adventitia of TA patients (n=8) than that of healthy controls (n=6).

Figure B.

HSP65 increased production of CCL2 in AAFs through TLR4/JAK2-STAT3 pathway.

Figure C.

Curcumin reversed inflammatory response initiated by HSP65 via inhibiting JAK2/AKT/STAT3 signal pathway in AAFs and significantly reduced serum CCL2 concentration of TA patients.

Acknowledgments:

We thank Ningli Li for her technical support in this study

Disclosure of Interests:

None declared

0797 Restless Legs Syndrome and Perceived Olfactory and Taste Dysfunction: A Community-Based Study

Introduction

Restless legs syndrome (RLS), an under-recognized sensorimotor condition worldwide, is thought to be a prodromal symptom of Parkinson’s disease as suggested by previous evidences. However, its association with prodromal chemosensory impairments, including olfactory or taste dysfunction, has remained largely unknown. Few studies of small sample sizes were conducted in predominantly Caucasian populations and results were inconsistent.

Methods

We performed a cross-sectional analysis including 90,337 Chinese adults free of neurodegenerative diseases in the Kailuan study in 2016. Presence of RLS was defined using revised RLS diagnostic criteria and further verified by Cambridge-Hopkins questionnaire for RLS. Perceived olfactory and taste dysfunction was collected via a questionnaire. The association between RLS and perceived olfactory and taste dysfunction was assessed using logistic regression model, adjusting for potential cofounders such as age, sex, smoking, alcohol consumption sleep conditions and medical history.

Results

RLS was associated with high odds of having perceived olfactory and/or taste dysfunction (adjusted odds ratio =5.92; 95% confidence interval, 3.11, 11.3). The significant association persisted when using Cambridge-Hopkins questionnaire for RLS (adjusted odds ratio =5.55; 95% confidence interval, 2.37-13.0) or when excluding participants with major chronic diseases.

Conclusion

RLS was associated with increased odds of perceived olfactory and taste dysfunction.

Support

This research was supported by start-up grant from the College of Health and Human Development and the Department of Nutritional Sciences, Pennsylvania State University, the Institute for CyberScience Seed Grant Program, Pennsylvania State University, and Natural Science Foundation of Hebei Province (H2018209318).

0214 The Relationship Between Work Stress and Sleep Quality in Shift Working Nurses: The Intermediate Effect of Circadian Rhythm Amplitude and Stability

Introduction

Research suggests that work stress may be an important factor in poor sleep in shift working nurses. However, evidence is limited about the underlying mechanism. Circadian rhythm might be effective. The purpose of this study was to explore the relationship between work stress and sleep quality in shift working nurses and the mediation effect of circadian rhythm amplitude and stability respectively.

Methods

A total of 529 nurses working in shifts from seven hospitals were selected by convenient sampling in Shanghai, China. Participants were assessed with the Circadian Type Inventory (CTI), Chinese Nursing Stressor Scale (CNSS), Pittsburgh Sleep Quality Index (PSQI). The Amos24.0 software was applied to construct structural equation models with circadian rhythm amplitude (LV) and circadian rhythm stability (FR) as intermediate variables respectively.

Results

About 73.3% (388/529) of the nurses’ PSQI scores were above 5, indicating poor sleep quality. The correlations between work stress, circadian rhythm amplitude, circadian rhythm amplitude and sleep quality were all significant (all P&lt;0.01).Sleep quality total score was positively correlated with work stress(γ=0.348) and circadian rhythm amplitude (γ=0.330). Work stress was positively correlated with circadian rhythm amplitude (γ=0.297,P&lt;0.01). Sleep quality total score was negatively correlated circadian rhythm amplitude (γ=-0.204,P&lt;0.01);Work stress was negatively correlated with circadian rhythm amplitude (γ= -0.284,P&lt;0.01).Work stress showed significant indirect effects on sleep quality through the mediating effect of circadian rhythm amplitude (β=0.188,P&lt;0.01) and circadian rhythm amplitude (β= 0.082,P&lt;0.05).

Conclusion

It suggests that nurses working in shifts have poor sleep quality. Work stress and the amplitude and stability of circadian rhythm could affect sleep quality, and circadian rhythm amplitude and stability could mediate the relationship between work stress and sleep quality.

Support

The work was supported by Xinglin Young Talent Program of Shanghai University of Traditional Chinese Medicine(to Caiqin Wu) and The 12th Innovative activities of college students of Shanghai Traditional Chinese Medicine(2019SHUTCM094).

Using IL-2R/lymphocytes for predicting the clinical progression of patients with COVID-19

Effective laboratory markers for the estimation of disease severity and predicting the clinical progression of coronavirus disease-2019 (COVID-19) is urgently needed. Laboratory tests, including blood routine, cytokine profiles and infection markers, were collected from 389 confirmed COVID-19 patients. The included patients were classified into mild (n = 168), severe (n = 169) and critical groups (n = 52). The leukocytes, neutrophils, infection biomarkers [such as C-reactive protein (CRP), procalcitonin (PCT) and ferritin] and the concentrations of cytokines [interleukin (IL)-2R, IL-6, IL-8, IL-10 and tumor necrosis factor (TNF)-α] were significantly increased, while lymphocytes were significantly decreased with increased severity of illness. The amount of IL-2R was positively correlated with the other cytokines and negatively correlated with lymphocyte number. The ratio of IL-2R to lymphocytes was found to be remarkably increased in severe and critical patients. IL-2R/lymphocytes were superior compared with other markers for the identification of COVID-19 with critical illness, not only from mild but also from severe illness. Moreover, the cytokine profiles and IL-2R/lymphocytes were significantly decreased in recovered patients, but further increased in disease-deteriorated patients, which might be correlated with the outcome of COVID-19. Lymphopenia and increased levels of cytokines were closely associated with disease severity. The IL-2R/lymphocyte was a prominent biomarker for early identification of severe COVID-19 and predicting the clinical progression of the disease.

[Clinical experience of minimal invasive coronary surgery-coronary artery bypass grafting: a series of 244 cases]

Objective: To examine the safety and efficacy of minimally invasive coronary surgery-coronary artery bypass grafting (MICS-CABG). Methods: From the first case in November 2015 to November 2019, a total of 244 cases of MICS-CABG were performed in Department of Cardiovascular Surgery, Peking University Third Hospital. There were 197 males and 47 females, aging (62.3±8.7)years (range: 36 to 88 years). The operations were performed via the 5(th) intercostal space of left thoracic lateral incision (length: 4 to 5 cm extended for 8 to 10 cm), and were performed under off-pump, with the help of the chest wall suspension device and cardiac fixator. The proximal anastomosis on ascending aorta and the distal anastomosis of left anterior descending branch, circumflex branch and right coronary system were completed according to procedure. In all 244 cases, the proportion of 2 grafts was 53.7% (131 cases), 3 grafts was 36.1% (88 cases), 4 grafts was 9.8% (24 cases) and 5 grafts was 0.4% (1 case). The average of grafts was 2.6±0.7 (range: 2 to 5). The proportion of hybrid was 14.3% (35 cases), sequential bypass procedure was 43.0% (105 cases) and multiple artery grafts was 25.4% (62 cases). The perioperative complications of the patients were collected, the patency rate of the grafts was evaluated by coronary angiography or CT within 7 days after the operation, and main adverse cardiovascular and cerebrovascular events (MACCE) were followed up. The survival curve was drawn by Kaplan-Meier method, and the 1-year MACCE rate was calculated by survival analysis. Results: All cases had no transition to thoracotomy and cardiopulmonary bypass procedure, and no cases needed intra aortic balloon pumping and extracorporeal membrane oxygenation during the operation.There were 2 cases of poor incision healing, and reoperation was performed in 10 cases (6 cases of postoperative bleeding, 2 cases of incision debridement, and 2 cases of grafts problems). The rate of MACCE in 30 days was 2.6% (10 cases), which contained 3 cases of death (2 cases of grafts occlusion, 1 case of serious hemorrhage after thoracic puncture drainage), 3 cases of stroke and 5 cases of non-fatal myocardial infarction. By the re-examination of angiography in 7 days after operation, the overall patency of the grafts was 96.1%, and the patency of the left anterior descending was 98.6%. Kaplan-Meier survival analysis was conducted for 235 patients (96.3%) with 1 to 36 months follow-up results, and the 1-year MACCE rate was 5.6% (95%CI: 4.2% to 7.0%) . There was no significant difference among the incidences of MACCE at each stage of learning curve. Surgeon could reduce the operation time and complete more anastomosis with the accumulation of experience after the early 30 cases. Conclusions: MICS-CABG can safely achieve completed revascularization, which has good operative effects in short and medium-long term. There is no significant risk in the early cases of learning curve.

The dietary combination of essential oils and organic acids reduces Salmonella enteritidis in challenged chicks

This study was conducted to determine the effects of essential oils and organic acids (EOA) on Salmonella Enteritidis (S. Enteritidis) challenged chickens. One-day-old specific pathogen-free (SPF) chicks (250) were randomly assigned to 5 groups, with 50 birds in each group. The treatment groups were as follows: 1) basal diet, negative control group (NC); 2) basal diet + S. Enteritidis, positive control group (PC); 3) PC + 4,000 g/t of enrofloxacin (5%), antibiotic group (ENR); 4) PC + 800 g/t of EOA1, thymol-benzoic acid group (TBA); and 5) PC + 800 g/t of EOA2, cinnamylaldehyde-caproic acid group (CCA). At 7 D of age, each bird, except those in NC, was orally gavaged with 0.4 mL of a suspension of 4.4 × 10⁹ cfu S. Enteritidis/mL. Results revealed that ENR reduced bacterial counts in the liver and spleen on days 3, 5, and 7 post-challenge more (P < 0.05) than any other treatments. However, bacterial counts in cecal contents among ENR, TBA, and CCA were similar at 5 and 7 D post-challenge but lower than those of PC. Additionally, the bacterial counts in liver, spleen, and cecum contents in TBA were lower (P < 0.05) than in PC at 3, 5, and 7 D post-challenge; the bacterial counts in spleen contents in TBA were lower (P < 0.05) than in CCA at 7 D post-challenge. Tumor necrosis factor-α contents in TBA and CCA were lower (P < 0.05) than those in PC. Also, the ratio of villus height to crypt depth in the ileum of CCA was higher (P < 0.05) than that of PC and ENR; however, there was no difference in the secretory IgA content of the jejunum among the groups. In conclusion, EOA had a bacteriostatic effect on S. Enteritidis, and the effect of the thymol-benzoic acid complex surpassed that of the cinnamaldehyde-caproic acid complex. Therefore, EOA may act as an effective antibiotic substitute for animals in the prevention and treatment of Salmonella.

Supplementing glycine, serine, and threonine in low protein diets for meat type chickens

Reducing dietary protein has been of interest to the global poultry industry to improve bird health, welfare, and industry sustainability. Low protein (LP) diets are typically glycine (Gly) deficient and produce poor performance. Supplementing the diet with Gly or precursors of Gly can overcome this deficiency. A feeding experiment was conducted with 330 Ross 308 off-sex males across 5 treatments in a randomized design using 11 birds per pen replicated 6 times. Grower and finisher treatments were fed from day 7 to 21 and day 21 to 35, respectively. The objective was to test the efficacy of supplementation with Gly and Gly equivalents (Glyequiv), serine (Ser) and threonine (Thr), in plant-based LP diets on bird performance against a standard protein (SP) diet containing meat and bone meal. Glycine, Ser, or Thr were supplemented on Glyequiv basis to an approximately 3% lower CP diet to achieve the same digestible Gly and Ser level as the SP diet. Nitrogen efficiency, serum uric acid, blood plasma amino acids (AA) and AA digestibility were also investigated to monitor potential metabolic effects. Birds fed the LP diet were only 3.3% lower in final body weight than the SP treatment (2,556 vs. 2,641 g) while the supplementation of Gly or Ser had no effect. Supplementation of Thr reduced final body weight by 9.5% (P < 0.05). Reducing CP increased N efficiency by 9.6% (P < 0.05) and decreased blood serum uric acid by 26.9% (P < 0.001) in the finisher treatments. Glycine and Ser supplementation in LP diets had no effect on these parameters. The LP diet reduced AA digestibility and blood plasma AA while the supplementation with either Gly, Ser, or Thr increased overall AA digestibility (P < 0.05) but had no overall effect on blood plasma AA. Further research is required into Gly metabolism; however, Thr supplementation depressed growth and therefore is not feasible to cover Gly deficiency in LP diets on a Glyequiv basis.

Phenotypical and potential functional characteristics of different immune cells expressing CD28H/B7-H5 and their relationship with cancer prognosis

CD28H and B7-H5 have been identified as receptor-ligand pairs in the B7/CD28 family, and have co-stimulatory activity in immune cells. Here, we have systematically reviewed the research reports concerning the CD28H/B7-H5 pathway. It was found that CD28H is mainly expressed in T cells and natural killer (NK) cells with naive and poorly differentiated properties, and repeated antigen stimulation leads to permanent loss of CD28H. In tumors, CD28H is mainly expressed in tissue-resident memory (T_RM ) lymphocyte T cells, which is associated with improved tumor prognosis. B7-H5 is a ligand for CD28H and is widely expressed in tumor cells. B7-H5 expression is closely related to the prognosis of the tumor. Studies have shown that high expression of B7-H5 in tumor is related to a worse prognosis for lung cancer, osteosarcoma, oral squamous cell carcinoma (OSCC), breast carcinoma, human clear cell renal cell carcinoma (ccRCC), intrahepatic cholangiocarcinoma (ICC), bladder urothelial carcinoma (BUC) and colorectal cancer (CRC), but is associated with a better prognosis for pancreatic ductal adenocarcinoma (PDAC) and glioma. Controversial views exist in studies on gastric cancer prognosis.

[Application of Chen's pancreaticojejunostomy technique in laparoscopic pancreaticoduodenectomy (116 cases report)]

Objective: To investigate the safety and feasibility of longitudinal transpancreatic U-sutures invaginated pancreatojejunostomy (Chen's pancreaticojejunostomy technique) in laparoscopic pancreaticoduodenectomy (LPD). Methods: Clinical data of 116 consecutive patients who underwent LPD using Chen's pancreaticojejunostomy technique in Hunan Provincial People's Hospital from May 2017 to December 2018 were retrospectively analyzed. Among these patients, 66 were males and 50 were females. The median age was 58 years old (32-84 yeas old). All 116 patients underwent pure laparoscopic whipple procedure with Child reconstruction method, using Chen's pancreaticojejunostomy technique. The intraoperative and postoperative data of patients were analyzed. Results: All 116 patients underwent LPD successfully. The mean operative time was (260.3±33.5) minutes (200-620 minutes). The mean time of pancreaticojejunostomy was (18.2±7.6) minutes (14-35 minutes). The mean time of hepaticojejunostomy was (14.6±6.3) minutes (10-25 minutes). The mean time of gastrojejunostomy was (12.0±5.5) minutes (8-20 minutes). The mean estimated blood loss was (106.0±87.6) ml (20-800 ml). Postoperative complications were: 11.2%(13/116) of cases had postoperative pancreatic fistula (POPF), including 10.3% (12/116) of biochemical fistula and 0.9%(1/116) of grade B POPF, no grade C POPF occurred; 10.3%(12/116) had gastrojejunal anastomotic bleeding; 3.4%(4/116) had hepaticojejunal anastomotic fistula; 3.4%(4/116) had delayed gastric emptying; 4.3% (5/116) had localized abdominal infection; 12.1%(14/116) had pulmonary infection; postoperative mortality were 0(0/116) and 1.7%(2/116) within 30 days and 90 days, respectively. One patient died of massive abdominal bleeding secondary to Gastroduodenal artery pseudoaneurysm rupture, the other patient died of extensive tumor recurrence and metastasis after surgery. Conclusions: Chen's pancreaticojejunostomy technique is safe and feasible for LPD.It is an option especially for surgeons who have not completed the learning curve of LPD.

Carbohydrate Metabolism Regulated by Antisense vicR RNA in Cariogenicity

Streptococcus mutans is a major cariogenic pathogen that resides in multispecies oral microbial biofilms. The VicRK 2-component system is crucial for bacterial adaptation, virulence, and biofilm organization and contains a global and vital response regulator, VicR. Notably, we identified an antisense vicR RNA (AS vicR) associated with an adjacent RNase III–encoding ( rnc) gene that was relevant to microRNA-size small RNAs (msRNAs). Here, we report that ASvicR overexpression significantly impeded bacterial growth, biofilm exopolysaccharide synthesis, and cariogenicity in vivo. Transcriptome analysis revealed that the AS vicR RNA mainly regulated carbohydrate metabolism. In particular, overproducing AS vicR demonstrated a reduction in galactose and glucose metabolism by monosaccharide composition analysis. The results of high-performance gel permeation chromatography revealed that the water-insoluble glucans isolated from AS vicR presented much lower molecular weights. Furthermore, direct evidence showed that total RNAs were disrupted by rnc-encoded RNase III. With the coexpression of T4 RNA ligase, putative msRNA1657, which is an rnc-related messenger RNA, was verified to bind to the 5′-UTR regions of the vicR gene. Furthermore, AS vicR regulation revealed a sponge regulatory-mediated network for msRNA associated with adjacent RNase III–encoding genes. There was an increase in AS vicR transcript levels in clinical S. mutans strains from caries-free children, while the expression of AS vicR was decreased in early childhood caries patients; this outcome may be explored as a potential strategy contributing to the management of dental caries. Taken together, our findings suggest an important role of AS vicR-mediated sponge regulation in S. mutans, indicating the characterization of lactose metabolism by a vital response regulator in cariogenicity. These findings have a number of implications and have reshaped our understanding of bacterial gene regulation from its transcriptional conception to the key roles of regulatory RNAs.

Weyl-like points from band inversions of spin-polarised surface states in NbGeSb

Band inversions are key to stabilising a variety of novel electronic states in solids, from topological surface states to the formation of symmetry-protected three-dimensional Dirac and Weyl points and nodal-line semimetals. Here, we create a band inversion not of bulk states, but rather between manifolds of surface states. We realise this by aliovalent substitution of Nb for Zr and Sb for S in the ZrSiS family of nonsymmorphic semimetals. Using angle-resolved photoemission and density-functional theory, we show how two pairs of surface states, known from ZrSiS, are driven to intersect each other near the Fermi level in NbGeSb, and to develop pronounced spin splittings. We demonstrate how mirror symmetry leads to protected crossing points in the resulting spin-orbital entangled surface band structure, thereby stabilising surface state analogues of three-dimensional Weyl points. More generally, our observations suggest new opportunities for engineering topologically and symmetry-protected states via band inversions of surface states.

Prospective study of perceived dietary salt intake and the risk of non-alcoholic fatty liver disease

BACKGROUND

A high sodium intake is associated with obesity and metabolic syndrome. However, little is known regarding whether greater salt intake is a potential risk factor for non-alcoholic fatty liver disease (NAFLD). We thus prospectively investigated whether individuals with higher perceived dietary salt intake had a higher risk of developing NAFLD.

METHODS

The present study included 35 023 participants (22 629 men and 12 394 women) from the Kailuan study who were free of NAFLD at baseline (2006) and who did not drink alcohol at baseline and during follow-up (2006-2014; follow-rate 95.2%). NAFLD was defined as a participant who had been diagnosed with fatty liver at least twice by ultrasound tests conducted every 2 years during follow-up. Dietary salt intake was determined by a self-report question and was classified into three categories: low (<6 g day^-1 ), medium (6-9 g day^-1 ) or high (≥10 g day^-1 ). Cox proportional models were used to estimate the risk of NAFLD, adjusting for potential confounders, such as age, sex, education, physical activity, smoking, income, occupation, marriage, body mass index, waist circumference and blood pressure, as well as serum concentrations of glutamic-pyruvic transaminase, glucose, total cholesterol and triglyceride.

RESULTS

During 8 years of follow-up, we identified 5102 incident NAFLD cases. After adjusting for potential confounders, the hazard ratio (95% conference interval) for NAFLD was 1.12 (1.00, 1.26) for medium salt intake and 1.19 (1.02,1.39) for high salt consumption (P trend = 0.03) relative to the low salt consumption group.

CONCLUSIONS

A perceived high salt intake was associated with a higher future risk of NAFLD.

Dietary hydrolysed yeast cell wall extract is comparable to antibiotics in the control of subclinical necrotic enteritis in broiler chickens

1. The aim of this study was to examine the effect of yeast cell wall (YCW) on performance and physiological responses of broiler chickens under subclinical necrotic enteritis challenge.2. Six treatments in a 2 × 3 factorial arrangement (non-challenged or challenged plus no supplement, YCW or antibiotics (AB)) was used. Each treatment was replicated eight times with 12 birds per replicate. The treatments included: (1) Positive control (PC; no additive, not challenged); (2) Negative control (NC; no additive, with challenge); (3) YCWN = yeast cell wall (2.0 g/kg diet, not challenged; (4) YCWC = yeast cell wall (2.0 g/kg diet, challenged); (5) ABN = zinc bacitracin 50 ppm + Salinomycin 60 ppm, not challenged); (6) ABC = zinc bacitracin 50 ppm + Salinomycin 60 ppm, challenged).3. Eimeria challenge at 9 d of age did not affect feed intake (FI), body weight gain (BWG), FCR or liveability at 10 d. The BWG and FCR at 10 d were greater (P < 0.05) in birds fed YCW or AB (AB) diets relative to the PC or NC groups. On 24 and 35 d, FI, BWG, FCR and flock uniformity (28 d) were greater (P < 0.05) in the challenged groups fed YCW or AB diets compared to NC group.4. Supplementation with YCW ameliorated the negative effects of NE on liver, spleen and bursa weight of birds.5. Necrotic enteritis challenge decreased (P < 0.05) caecal Lactobacillus and Bifidobacterium spp. counts, and increased ileum lesion score and caecal Clostridium perfirngens counts. This was reversed by the addition of either YCW or AB.6. Supplementation with YCW and AB resulted to a greater (P < 0.05) dressing percentage and meat yield (35 d).7. The results indicated that YCW plays a vital role in improving the physiological response and performance of broiler chickens under subclinical necrotic enteritis challenge.

Metabolic syndrome and renal cell cancer risk in Chinese males: a population-based prospective study

Background

Metabolic syndrome (MetS) is now a common public health problem. Few researches have reported the relationship between MetS and the risk of renal cell cancer (RCC). To investigate the association of metabolic syndrome and its components with the risk of RCC in Chinese males, the study was performed in the Kailuan male cohort, a large prospective cohort study.

Methods

A total of 104,333 eligible males enrolled in the every 2-year health checkup were involved in the Kailuan male cohort study (2006-2015). Information on demographic and socioeconomic characteristics, lifestyle, medical history and laboratory tests at baseline entry was obtained. Univariable and multivariable Cox proportional hazards regression models were used to estimate the association between MetS and the RCC risk.

Results

During a median follow-up of 8.9 years, 131 RCC cases were verified over a total of 824,211.96 person-years. Among the 5 single MetS components, hypertension (Systolic/diastolic blood pressure≥130/85 mm Hg or antihypertensive drug treatment of previously hypertension) (HR = 2.35, 95%CI:1.48-3.72) and elevated triglyceride (TG) (≥1.7mmol/L) (HR = 1.78, 95%CI:1.23-2.56) showed significant risk for RCC. Multivariate analysis showed that compared to those who did not meet MetS diagnostic criteria (number of abnormal MetS components&lt;3), HR of RCC risk for participants with MetS was 1.95 (95% CI 1.35-2.83). The number of abnormal MetS components was linearly associated with an increased risk of RCC (P trend&lt;0.001), and the HRs of RCC risk for males with 1, 2 and ≥3 MetS components were 1.27 (0.56-2.90), 2.42 (1.12-5.20) and 3.32 (1.56-7.07), respectively, compared with subjects without MetS components.

Conclusions

MetS was inversely associated with of RCC risk in males.

Key messages

MetS might be one of the scientific and important predictors of RCC. Controlling metabolic syndrome may potentially have key scientific and clinical significance for RCC prevention.