[Lower urinary tract injury in transvaginal reconstructive pelvic surgery]

Objective: To explore the characteristics, prevention and treatment strategies of lower urinary tract injury in transvaginal reconstructive pelvic surgery (vRPS). Methods: A retrospective analysis was conducted on 24 patients who suffered lower urinary tract injuries occuring in vRPS from January 2005 to June 2021, among which 4 cases were referred to our hospital from other hospitals. Results: (1) In our hospital, 1 952 patients underwent vRPS for anterior and (or) middle pelvic organ prolapse during that study period, with a 1.0% (20/1 952) incidence of lower urinary tract injuries occurring in 20 cases. (2) Ureteral injuries were observed in 14 cases who underwent transvaginal high uterosacral ligament suspension (1.4%, 14/966). The symptoms were relieved after the removal of sutures. (3) Bladder injuries occurred in 6 cases in our hospital, with 4 cases (0.7%, 4/576) in anterior transvaginal mesh surgery (aTVM), one (0.4%, 1/260) in colpocleisis, and one (0.7%, 1/150) in apical suspension for fornix prolapse. An additional 4 cases of bladder injury were referred to our hospital after aTVM. Among the 8 cases of bladder injury during aTVM, 2 cases were intraoperative incidents. Cystoscopy confirmed that the superficial branch or puncture rod of anterior vaginal mesh had penetrated into the bladder. Re-puncturing and placement of the mesh were successfully performed. No abnormalities were observed during a follow-up period of 4-5 years. Postoperative bladder injuries were identified in 6 cases, characterized by mesh erosion into the bladder and formation of calculi. These injuries were confirmed between 6 months to 2 years after vRPS. The exposed mesh and calculi in the bladder were removed through laparotomy or cystoscopy, followed up for 2-12 years. One case experienced slight re-erosion of mesh to the bladder. Conclusions: Lower urinary tract injuries are difficult to avoid in vRPS, particularly in transvaginal high uterosacral ligament suspension and aTVM. However, the incidence is low. Lower urinary tract injuries during vRPS could be easily detected and managed intraoperatively because of the use of cystoscopy. As long-term postoperative complications, erosion of transvaginal mesh to lower urinary tract postoperatively could be treated correctly, seldom with severe sequelae.

FOXC1 Promotes Osteoblastic Differentiation of Bone Marrow Mesenchymal Stem Cells via the Dnmt3b/CXCL12 Axis

Bone defects have remained a clinical problem in current orthopedics. Bone marrow mesenchymal stem cells (BM-MSCs) with multi-directional differentiation ability have become a research hotspot for repairing bone defects. In vitro and in vivo models were constructed, respectively. Alkaline phosphatase (ALP) staining and alizarin red staining were performed to detect osteogenic differentiation ability. Western blotting (WB) was used to detect the expression of osteogenic differentiation-related proteins. Serum inflammatory cytokine levels were detected by ELISA. Fracture recovery was evaluated by HE staining. The binding relationship between FOXC1 and Dnmt3b was verified by dual-luciferase reporter assay. The relationship between Dnmt3b and CXCL12 was explored by MSP and ChIP assays. FOXC1 overexpression promoted calcium nodule formation, upregulated osteogenic differentiation-related protein expression, promoted osteogenic differentiation, and decreased inflammatory factor levels in BM-MSCs, and promoted callus formation, upregulated osteogenic differentiation-related protein expression, and downregulated CXCL12 expression in the mouse model. Furthermore, FOXC1 targeted Dnmt3b, with Dnmt3b knockdown decreasing calcium nodule formation and downregulating osteogenic differentiation-related protein expression. Additionally, inhibiting Dnmt3b expression upregulated CXCL12 protein expression and inhibited CXCL12 methylation. Dnmt3b could be binded to CXCL12. CXCL12 overexpression attenuated the effects of FOXC1 overexpression and inhibited BM-MSCs osteogenic differentiation. This study confirmed that the FOXC1-mediated regulation of the Dnmt3b/CXCL12 axis had positive effects on the osteogenic differentiation of BM-MSCs.

A new species of Nanhsiungchelys (Testudines: Cryptodira: Nanhsiungchelyidae) from the Upper Cretaceous of Nanxiong Basin, China

Nanhsiungchelyidae are a group of large turtles that lived in Asia and North America during the Cretaceous. Here we report a new species of nanhsiungchelyid, Nanhsiungchelys yangi sp. nov., from the Upper Cretaceous of Nanxiong Basin, China. The specimen consists of a well-preserved skull and lower jaw, as well as the anterior parts of the carapace and plastron. The diagnostic features of Nanhsiungchelys include a large entire carapace length (∼55.5 cm), a network of sculptures consisting of pits and ridges on the surface of the skull and shell, shallow cheek emargination and temporal emargination, deep nuchal emargination, and a pair of anterolateral processes on the carapace. However, Nanhsiungchelys yangi differs from the other species of Nanhsiungchelys mainly in having a triangular-shaped snout (in dorsal view) and wide anterolateral processes on the carapace. Additionally, some other characteristics (e.g., the premaxilla is higher than wide, the maxilla is unseen in dorsal views, a small portion of the maxilla extends posterior and ventral of the orbit, and the parietal is bigger than the frontal) are strong evidence to distinguish Nanhsiungchelys yangi from Nanhsiungchelys wuchingensis. A phylogenetic analysis of nanhsiungchelyids places Nanhsiungchelys yangi and Nanhsiungchelys wuchingensis as sister taxa. Nanhsiungchelys yangi and some other nanhsiungchelyids bear distinct anterolateral processes on the carapace, which have not been reported in any extant turtles and may have played a role in protecting the head. The Nanxiong Basin was extremely hot during the Late Cretaceous, and so we suggest that nanhsiungchelyids might have immersed themselves in mud or water to avoid the heat, similar to some extant tortoises. If they were capable of swimming, our computer simulations of fluid flow suggest the anterolateral processes could have reduced drag during locomotion.

Retracted: A new aquatic beetle (Adephaga: Coptoclavidae) from the Middle Jurassic Daohugou Biota

Tigrivia baii gen. et sp. nov. (Coleoptera: Adephaga: Coptoclavidae) is described and named based on a fossil specimen from the Middle Jurassic Daohugou Biota, Nincheng County, Inner Mongolia of China. The fossil is very similar in morphology with the adult Coptoclava longipoda Ping 1928 (Laiyang Formation of Nanligezhuang Village, Laiyang City, Shandong Province, China, Lower Cretaceous, 121 ~ 120 Ma), but differs from C. longipoda by the adjacencies of two procoxae and two mesocoxae. T. baii gen. et sp. nov. differs from Daohugounectes primitinus Wang et al. 2010 by the absence of striae on the elytra and the absence of ventral eyes under the head. The new beetle species shows developed aquatic adaptions, such as specialized raptorial forelegs, and swimming middle and hind legs. Furthermore, it is speculated to lead a similar lifestyle as extant Dytiscoidae, according to the two eyes on the side of head and the absence of spiracles on ventrites. This new fossil expanded our knowledge of the diversity of the Middle Jurassic Coptoclavid beetles in Daohugou Biota and improved our understanding of their paleoecological significance.

Giant Jurassic dragon lacewing larvae with lacustrine palaeoecology represent the oldest fossil record of larval neuropterans

Neuropterans seem to be less specious among holometabolans, while they are in fact the relicts of a diverse group from the Mesozoic era. Their early radiation resulted in great family level morphological heterogeneity of extant neuropterans, especially of their larvae. The earliest previously reported fossil larvae of this group were from the Early Cretaceous, where they already showed high taxonomic diversity and an extremely wide range of variations in morphotypes. In this work, the earliest record of the larva of the neuropteran Palaeoneurorthus baii gen. et sp. nov. from the Middle Jurassic Daohugou Beds of China is described. The larvae, which have large and elongated bodies, straight stylets with curved apices, an extremely elongated cervix and an extended anterior lobe of pronotum, are placed in Nevrorthidae. The elongated cervix is probably a specialized adaptation for hunting small organisms. The palaeoenvironment of these larvae indicates that larvae of Nevrorthidae have exhibited stable aquatic ecology since the Middle Jurassic, and underwent a possible shift from lakes to more lotic yet constricted modern mountain rivulet habitats over time.

Hadrosauroid eggs and embryos from the Upper Cretaceous (Maastrichtian) of Jiangxi Province, China

Background

Dinosaur eggs containing embryos are rare, limiting our understanding of dinosaur development. Recently, a clutch of subspherical dinosaur eggs was discovered while blasting for a construction project in the Upper Cretaceous red beds (Hekou Formation) of the Ganzhou Basin, Jiangxi Province, China. At least two of the eggs contain identifiable hadrosauroid embryos, described here for the first time.

Results

The eggs, attributable to Spheroolithidae indet., are thin-walled and small (~ 660 mL) compared to those of Lambeosaurinae. The shape of the embryonic squamosal is reminiscent of that seen in the Late Cretaceous hadrosauroids Levnesovia transoxiana, Tanius sinensis, and Nanningosaurus dashiensis, suggestive of possible affinities.

Conclusion

The small size of the eggs and embryos, similar to those of Hadrosaurinae, indicates that the larger eggs and hatchlings typical of Lambeosaurinae are evolutionarily derived.

Study on the Action Mechanism of Dkk-1, TGF-β1 and TNF-α Expression Levels in Dupuytren's Contracture

BACKGROUND

The biological mechanism of Dupuytren's contracture needs to be further studied in order to minimize postoperative recurrence and provide a pathological basis for the development of new therapeutic targets.

METHODS

HE staining, immunohistochemistry, PCR and western blotting were performed in pathological palmar aponeurosis specimens and normal palmar aponeurosis tissues for comparative study.

RESULTS

(1) TNF-α expression was up-regulated: TNF-α mRNA was more highly expressed in the pathological tissues of DD patients than in the CT group, P < 0.05, and the difference between the two groups was statistically significant; (2) Dkk-1 expression was down-regulated: Dkk-1 mRNA was lower expressed in the pathological tissues of DD patients than in the CT group, P < 0.05, and the difference between the two groups was statistically significant; (3) TGF-β1 expression was up-regulated: TGF-β1 mRNA was higher expressed in the pathological tissues of DD patients than in the CT group, P < 0.05, and the difference between the two groups was statistically significant; (4) Pearson correlation analysis suggested that TNF-α expression was positively correlated with TGF-β1 expression, TNF-α expression was negatively correlated with DKK-1 expression, and TGF-β1 expression was negatively correlated with DKK-1 expression.

CONCLUSION

TNF-α, DKK-1 and TGF-β1 may play a role in the pathogenesis of palmar aponeurosis contracture, and there is a relationship between them. The study of the relationship between the three and their related signaling pathways provides a therapeutic target and a basis for the prevention and early treatment of palmar aponeurotic contracture.

An exquisitely preserved in-ovo theropod dinosaur embryo sheds light on avian-like prehatching postures

Despite the discovery of many dinosaur eggs and nests over the past 100 years, articulated in-ovo embryos are remarkably rare. Here we report an exceptionally preserved, articulated oviraptorid embryo inside an elongatoolithid egg, from the Late Cretaceous Hekou Formation of southern China. The head lies ventral to the body, with the feet on either side, and the back curled along the blunt pole of the egg, in a posture previously unrecognized in a non-avian dinosaur, but reminiscent of a late-stage modern bird embryo. Comparison to other late-stage oviraptorid embryos suggests that prehatch oviraptorids developed avian-like postures late in incubation, which in modern birds are related to coordinated embryonic movements associated with tucking - a behavior controlled by the central nervous system, critical for hatching success. We propose that such pre-hatching behavior, previously considered unique to birds, may have originated among non-avian theropods, which can be further investigated with additional discoveries of embryo fossils.

MiR-199a-5p suppresses proliferation and invasion of human laryngeal cancer cells

OBJECTIVE

To explore the roles of micro ribonucleic acid (miR)-199a-5p in the proliferation, apoptosis, invasion and metastasis of laryngeal cancer cells, and its molecular mechanisms.

PATIENTS AND METHODS

The expression of miR-199a-5p in 25 cases of laryngeal cancer tissues and paracancerous tissues was detected via quantitative real-time polymerase chain reaction (qRT-PCR). Its expression in TU212, TU686 and human epithelial type 2 (HEp-2) laryngeal cancer cell lines and normal nasopharyngeal epithelial cell line NP69 was also detected via qRT-PCR. HEp-2 cells were transiently transfected with miR-199a-5p mimic or miR-199a-5p inhibitor, and the expression of miR-199a-5p was verified using RT-PCR after transfection. The regulatory effects of miR-199a-5p on the proliferation, apoptosis, invasion and migration abilities of HEp-2 cells were observed through methyl thiazolyl tetrazolium (MTT) assay, flow cytometry, wound healing assay and transwell assay, respectively. Then, the mechanisms of miR-199a-5p in regulating Caspase-3 activity and epithelial-mesenchymal transition (EMT)-related proteins were further explored.

RESULTS

The qRT-PCR results revealed that miR-199a-5p was significantly lowly expressed in the laryngeal cancer tissues and tumor cell lines, and overexpression of miR-199a-5p substantially inhibited the proliferation of HEp-2 cells. According to the results of flow cytometry, overexpression of miR-199a-5p promoted the apoptosis of HEp-2 cells, whereas down-regulating miR-199a-5p suppressed their apoptosis. It was found that the activity of Caspase-3 was notably enhanced after overexpression of miR-199a-5p, which was evidently weakened after down-regulating miR-199a-5p. Wound healing assay and transwell assay results manifested that overexpressing miR-199a-5p weakened the invasion and migration abilities of HEp-2 cells, which were facilitated by down-regulating miR-199a-5p. Based on Western blotting results, miR-199a-5p regulated the expressions of E-cadherin, N-cadherin and vimentin. Overexpression of miR-199a-5p could inhibit EMT process, whereas suppressing miR-199a-5p could accelerate the process.

CONCLUSIONS

The expression of miR-199a-5p in laryngeal cancer tissues is substantially lower than that in the paracancerous tissues. MiR-199a-5p suppresses proliferation, invasion and migration in laryngeal cancer cell proliferation, while triggers cell apoptosis.

Lower cretaceous avian-dominated, theropod, thyreophoran, pterosaur and turtle track assemblages from the Tugulu Group, Xinjiang, China: ichnotaxonomy and palaeoecology

Rich tetrapod ichnofaunas, known for more than a decade, from the Huangyangquan Reservoir (Wuerhe District, Karamay City, Xinjiang) have been an abundant source of some of the largest Lower Cretaceous track collections from China. They originate from inland lacustrine clastic exposures of the 581–877 m thick Tugulu Group, variously divided into four formations and subgroups in the northwestern margin of the Junggar Basin. The large Huangyangquan track assemblages occur in the Lower layer/Subgroup II. Similarly-composed track assemblages also occur at the smaller Asphaltite site in the Upper Layer/Subgroup III. The Huangyangquan assemblages have yielded more than 1,500 identified tracks including abundant tracks of avian and non-avian theropods, pterosaurs and turtles and less abundant tracks of stegosaurs. Previous avian track identifications have been reassessed to conclude that Moguiornipes robustus is a taphotaxon and Koreanaornis dodsoni might be better accommodated in the ichnogenus Aquatilavipes which appears to be the dominant avian ichnotaxon. The avian track Ignotornis is also recognized and represents the first occurrence of this ichnogenus in China. Although the Huangyangquan assemblages lack some of the larger components (e.g., sauropodan and ornithopodan tracks) known from other Lower Cretaceous localities, the association of abundant tracks of smaller tetrapods (avian and non-avian theropods, pterosaurs and turtles) appears to be representative of lacustrine basin faunas of this region, and are an excellent example of the shorebird ichnocoenosis/ichnofacies concept. This is the first comprehensive review and re-analysis of an important Lower Cretaceous ecosystem.

[Effectiveness of abdominal minimal incision sacrocolpopexy for advanced pelvic organ prolapse]

Objective: To evaluate the indications, surgical skills and clinic outcomes of abdominal minimal incision sacrocolpopexy (AMISC) for treatment of advanced pelvic organ prolapse (POP). Methods: The retrospective study analyzed 30 women with advanced POP who underwent AMISC between June 2016 and October 2019, including 9 cases of recurrent prolapse and 10 cases of vault prolapse. AMISC was especially applicable to: (1) patients with several medical complications who was unable to tolerate general anesthesia or laparoscopic surgery, but able to tolerate combined spinal-epidural anesthesia and open surgery; (2) other abdominal procedures were indicated to perform with AMISC simultaneously, such as myomectomy, subtotal hysterectomy etc, the specimens were easy to get out of the abdominal cavity and morcellation was avoided; (3) surgeons preferring open surgery to laparoscopic surgery or skilled in open surgery; (4) patients with prior pelvic operations, presenting severe abdominal and pelvic adhesions. Objective outcomes were assessed by pelvic organ prolapse quantification (POP-Q) system. Subjective outcome were assessed by pelvic floor distress inventory-short form 20 (PFDI-20), pelvic floor impact questionnaire-short form (PFIQ-7) and patient global impression of improvement (PGI-I). Results: All patients with 1-3 medical complications were successfully performed with AMISC without stopping procedure, enlarging the incision or changing to other procedure, the operation duration was (110±19) minutes. The mean time of follow-up was (33.5±12.4) months (range: 8-49 months). The postoperative points of Aa, Ba, C, Ap, Bp reduced significantly and point C improved from (2.33±2.50) cm to (-7.54±1.18) cm after AMISC (P<0.01). The objective cure rates were both 100% (30/30) in apex and posterior compartment, while 97% (29/30) in anterior compartment. Postoperative scores of PFDI-20 and PFIQ-7 were all significant decreased (all P<0.01). About PGI-I, 29 patients chose "significant improvement", subjective satisfaction was 97% (29/30). Anterior sacral plexus hemorrhage occurred in 2 cases (7%, 2/30). There was no intestinal obstruction or injury of bladder, bowel and ureter intra- and postoperation. Two cases (7%, 2/30) had mesh exposure. Conclusion: AMISC is a safety, convenient, minimal traumatic and durable procedure for apical prolapse with short learning curve in the most of cases.

Effects of lipids and surfactants on the fermentation production of echinocandin B by Aspergillus nidulans

AIMS

Echinocandin B (ECB) is a kind of lipopeptide antifungal antibiotic, as well as the key precursor of antifungal drug Anidulafungin. Its efficient bioproduction plays an important role in promoting the industrial production of Anidulafungin.

METHODS AND RESULTS

In this study, methyl oleate and Tween 80 were firstly used to enhance the ECB fermentation by Aspergillus nidulans, the results showed that the ECB titre was significantly enhanced with the addition of methyl oleate and Tween 80. Among the lipids, methyl oleate was found to play a pivotal role in increasing the ECB titre to 2123 mg l^-1 , which was more than five times higher than that of the control. The addition of Tween 80 in the medium resulted in ECB titre increased to 2584 mg l^-1 . The scanning electron microscope (SEM) and N-phenyl-1-naphthylamine (NPN) assay indicated that Tween 80 could influence the cell membrane permeability of A. nidulans, and enhance the intracellular and extracellular substance exchange, therefore lead to the increasing of ECB titre.

CONCLUSIONS

Methyl oleate and Tween 80 are optimal carbon sources and surfactants for efficient ECB biosynthesis respectively.

SIGNIFICANCE AND IMPACT OF THE STUDY

Surfactant was used in ECB fermentation for the first time, which provided feasible ideas for optimizing the fermentation process of other fungi.

A uniaxial force and stiffness model of the vagina during laparoscopic sacrocolpopexy

BACKGROUND

Laparoscopic sacrocolpopexy is the preferred procedure for restoring vaginal vault prolapse. An assistant uses a vaginal manipulator to position and tension the vault such that the surgeon can dissect the bladder, rectum and vault to eventually suture a synthetic mesh used to suspend the vagina to the longitudinal anterior vertebral ligament. Vaginal vault manipulation requires application of high forces for long periods of time.

METHODS

This work quantifies the task by measuring and analyzing the interaction forces and the workspace during vaginal vault manipulation. From the measurements we developed a uniaxial model, expressing the increase in interaction force and stiffness of the vagina. By adapting the model parameters, the difference in interaction force and stiffness between moderate and severe prolapse is predicted.

FINDINGS

For moderate prolapse the average interaction force and stiffness start at 2.56 N and 0.11 N mm^-1 in the tensionfree state, and go up to 20.14 N and 0.53 N mm^-1 after complete insertion of the instrument. For severe degrees of prolapse, tissue interaction is much lower starting at 1.68 N and 0.06 N mm^-1 while staying limited to 12.20 N and 0.30 N mm^-1 at full extension.

INTERPRETATION

Population data shows that the stage of prolapse and total vaginal length increase with age and parity. The interaction force and stiffness of the vagina are correlated with this degree of prolapse. By adapting the model parameters a good estimation of the tissue interaction is found for patients with mild and severe prolapse.

Enhanced O-succinyl-l-homoserine production by recombinant Escherichia coli ΔIJBB*TrcmetL/pTrc-metAfbr -Trc-thrAfbr -yjeH via multilevel fermentation optimization

AIMS

Constructing a strain with high yield of O-succinyl-l-homoserine (OSH) and improving the titre through multilevel fermentation optimization.

METHODS AND RESULTS

OSH high-yielding strain was first constructed by deleting the thrB gene to block the threonine biosynthesis. Single-factor experiment was carried out, where a Plackett-Burman design was used to screen out three factors (glucose, yeast and threonine) from the original 11 factors that affected the titre of OSH. The Box-Behnken response surface method was used to optimize the fermentation conditions. Through gene editing and medium optimization, the titre of OSH increased from 7·20 to 8·70 g l^-1 in 500 ml flask. Furthermore, the fermentation process and fed-batch fermentation conditions including pH, temperature, feeding strategy and feeding medium were investigated and optimized. Under the optimal conditions, the titre of OSH reached 102·5 g l^-1 , which is 5·6 times higher than before (15·6 g l^-1 ).

CONCLUSIONS

O-succinyl-l-homoserine fermentation process was established and the combination of response surface methodology and metabolic pathway analysis effectively improved the titre of OSH.

SIGNIFICANCE AND IMPACT OF THE STUDY

In this study, the titre of OSH reached the needs for industrial production and the metabolic pathway of OSH was demonstrated for further optimization.

An early Cambrian euarthropod with radiodont-like raptorial appendages

Resolving the early evolution of euarthropods is one of the most challenging problems in metazoan evolution^1,2. Exceptionally preserved fossils from the Cambrian period have contributed important palaeontological data to deciphering this evolutionary process^3,4. Phylogenetic studies have resolved Radiodonta (also known as anomalocaridids) as the closest group to all euarthropods that have frontalmost appendages on the second head segment (Deuteropoda)^5-9. However, the interrelationships among major Cambrian euarthropod groups remain disputed^1,2,4,7, which impedes our understanding of the evolutionary gap between Radiodonta and Deuteropoda. Here we describe Kylinxia zhangi gen. et. sp. nov., a euarthropod from the early Cambrian Chengjiang biota of China. Kylinxia possesses not only deuteropod characteristics such as a fused head shield, a fully arthrodized trunk and jointed endopodites, but also five eyes (as in Opabinia) as well as radiodont-like raptorial frontalmost appendages. Our phylogenetic reconstruction recovers Kylinxia as a transitional taxon that bridges Radiodonta and Deuteropoda. The most basal deuteropods are retrieved as a paraphyletic lineage that features plesiomorphic raptorial frontalmost appendages and includes Kylinxia, megacheirans, panchelicerates, 'great-appendage' bivalved euarthropods and isoxyids. This phylogenetic topology supports the idea that the radiodont and megacheiran frontalmost appendages are homologous, that the chelicerae of Chelicerata originated from megacheiran great appendages and that the sensorial antennae in Mandibulata derived from ancestral raptorial forms. Kylinxia thus provides important insights into the phylogenetic relationships among early euarthropods, the evolutionary transformations and disparity of frontalmost appendages, and the origin of crucial evolutionary innovations in this clade.

Validation of reference genes for the normalization of RT-qPCR expression studies on human laryngeal cancer and hypopharyngeal cancer

OBJECTIVE

Selecting stably expressed reference genes is crucial for evaluating real-time quantitative polymerase chain reaction (RT-qPCR) data via the relative quantification method. In the present-day study, our aim was to select optimal reference genes (RGs) for the investigation of target gene (TG) expression profiling in cancerous human laryngeal and hypopharyngeal tissues.

PATIENTS AND METHODS

12 cancerous laryngeal tissues and 10 cancerous hypopharyngeal tissues were investigated. The expression characteristics of 11 reference genes (18S rRNA, GAPDH, B2M, ACTB, TBP, ALAS1, RPL29, HMBS, HPRT1, GUSB, and PUM1), which were commonly used in RT-qPCR for the analysis of gene expression, were investigated using the geNorm, NormFinder, and BestKeeper algorithm programs.

RESULTS

HMBS, ALAS1, and B2M were suggested as optimal RGs for studying human laryngeal and hypopharyngeal cancerous tissues together, laryngeal cancerous tissue by itself, and hypopharyngeal cancerous tissue by itself, respectively. If 2 or more reference genes are needed to achieve better standardization, 3 reference genes can optimally be used in combination to improve the accuracy of relative quantitation normalization. The recommended combinations for studying human laryngeal and hypopharyngeal cancerous tissues together, laryngeal cancerous tissue by itself, and hypopharyngeal cancerous tissue by itself were HMBS + HPRT1 + GUSB, ALAS1 + GUSB + HMBS, and B2M + HPRT1 + TBP, respectively.

CONCLUSIONS

The recommended reference genes could be used to improve the accuracy of gene expression studies on the molecular mechanisms of cancerous human laryngeal and hypopharyngeal tissues. The selected combination of reference genes can effectively improve the accuracy of the relative quantitative diagnosis of gene expression levels, such as messenger RNA, circular RNA, and long-noncoding RNA.

Excessive daytime sleepiness with snoring or witnessed apnea is associated with handgrip strength: a population-based study

BACKGROUND

Sarcopenia is emerging as an important public health problem, and evidences have determined that poor sleep is associated with muscle strength, but the potential effects of excessive daytime sleepiness (EDS), snoring and witnessed apnea on handgrip strength have not been evaluated.

AIM

We aimed to examine the association between EDS, snoring, witnessed apnea and muscle strength in an adult population.

DESIGN

Cross-sectional study.

METHODS

This cross-sectional study comprised 19 434 adults. Handgrip strength was measured using a handheld digital dynamometer. EDS was assessed by Epworth Sleepiness Scale, snoring and witnessed apnea during sleep were reported through simple yes/no questions. Analysis of covariance was carried out to determine the association between EDS with snoring or witnessed apnea and muscle strength.

RESULTS

The means (95% confidence interval) for average handgrip strength/body weight (kg/kg) across symptoms categories were 0.396 (0.333-0.472), 0.393 (0.330-0.467), 0.396 (0.333-0.471) and 0.386 (0.325-0.460) (P < 0.0001), respectively. Similar results were observed with maximal handgrip strength/body weight (kg/kg).

CONCLUSIONS

Self-reported EDS accompanied with snoring or apnea is associated with lowest handgrip strength, independently of confounding factors. Whether improvement of EDS, snoring and apnea, can ameliorate age-associated decline in muscle strength warrants further studies.

A mid-Cretaceous enantiornithine foot and tail feather preserved in Burmese amber

Since the first skeletal remains of avians preserved in amber were described in 2016, new avian remains trapped in Cretaceous-age Burmese amber continue to be uncovered, revealing a diversity of skeletal and feather morphologies observed nowhere else in the Mesozoic fossil record. Here we describe a foot with digital proportions unlike any previously described enantiornithine or Mesozoic bird. No bones are preserved in the new specimen but the outline of the foot is recorded in a detailed skin surface, which is surrounded by feather inclusions including a partial rachis-dominated feather. Pedal proportions and plumage support identification as an enantiornithine, but unlike previous discoveries the toes are stout with transversely elongated digital pads, and the outer toe appears strongly thickened relative to the inner two digits. The new specimen increases the known diversity and morphological disparity among the Enantiornithes, hinting at a wider range of habitats and behaviours. It also suggests that the Burmese amber avifauna was distinct from other Mesozoic assemblages, with amber entrapment including representatives from unusual small forms.

[A five-year analysis of effect on transvaginal high uterosacral ligament suspension with or without native-tissue repair for middle compartment defect]

Objective: To assess the five-year effect of the transvaginal high uterosacral ligament suspension (HUS) with or without additional concomitant native-tissue anterior and (or) posterior repair in women suffering from middle compartment defect. Methods: A retrospective review of records identified 79 women who underwent transvaginal HUS with or without additional concomitant native-tissue anterior and (or) posterior repair from January 2007 to January 2018 in Fourth Medical Center, General Hospital of People's Liberation Army. The middle compartment defects were predominant in these patients with point C no less than point Ba or Bp if accompanied with anterior or posterior vaginal wall prolapse. Follow-up visits were performed 2,6 and 12 months after surgery and then annually. Anatomic results of pelvic organ prolapse (POP) was established by pelvic examination using pelvic organ prolapse quantitation system (POP-Q) staging. Funtional results were obtained by patient global impression of improvement (PGI-I) scale in POP, pelvic floor distress inventory-short form 20 (PFDI-20) and pelvic floor impact questionnaire short form (PFIQ-7). Surgical success required the fulfillment of all 3 criteria: (1) anterior or posterior vaginal wall prolapsed leading edge of 0 cm or less and apex of 1/2 total vaginal length or less; (2) the absence of POP symptoms as reported on the PFDI-20 question No.3 ( "Do you usually have a bulge or something falling out that you can see or feel in your vaginal area?" ); and (3) no prolapse reoperations or pessary use during the study period. Results: Of 79 women, 51(65%, 51/79) women completed the five-year follow-up during the study period. The median follow-up time was 5.2 years (2.8-8.3 years). The overall surgery success rate was 86% (44/51) according to above all 3 criteria. Prolapse recurrence rates were isolated anterior 8% (4/51), isolated apical 0, isolated posterior 2% (1/51) and multiple compartments 4% (2/51). Seven women (14%,7/51) developed anterior or posterior prolapse beyond the hymen with the leading edge≤1 cm. No apical prolapsed occurred. None of recurrent women underwent retreatment,including either surgery or pessary usage at last follow-up. The subjective satisfaction rate was 90% (46/51). There was a 1% (1/79) rate of intraoperative ureteral kinking and 3% (2/79) rate of postoperative morbidity. Conclusions: The transvaginal HUS for middle compartment defect offers good long-term anatomical results with excellent vault suspension. With additional concomitant native-tissue anterior and (or) posterior repair, it will be a reconstructive surgery for the majority of moderate-to-severe POP. It is minimal traumatic and worthy of being popularized for clinical application.

Inter-amphibian predation in the Early Cretaceous of China

For most fossil taxa, dietary inference relies primarily on indirect evidence from jaw morphology and the dentition. In rare cases, however, preserved gut contents provide direct evidence of feeding strategy and species interaction. This is important in the reconstruction of food webs and energy flow through ancient ecosystems. The Early Cretaceous Chinese Jehol Biota has yielded several such examples, with lizards, birds, small dinosaurs, and mammals as both predator and prey. Here we describe an Early Cretaceous fossil frog specimen, genus Genibatrachus, that contains an adult salamander within its body cavity. The salamander is attributed to the hynobiid-like genus Nuominerpeton. The salamander skeleton is complete and articulated, suggesting it was caught and swallowed shortly before the frog itself died and was buried.

[Effectiveness of vaginal high uterosacral ligament suspension for treatment of recurrent pelvic organ prolapse]

Objective: To evaluate the indications and clinic outcomes of vaginal high uterosacral ligament suspension (HUS) for treatment of recurrent advanced pelvic organ prolapse (POP). Methods: This retrospective study analyzed 42 women with recurrent advanced POP who were referred to Fourth Medical Center of PLA General Hospital and underwent transvaginal HUS between November 2005 and January 2018. Primary surgeries included 30 vaginal colporrhaphy, 5 Manchester operation, 5 transvaginal mesh repair,2 sacrospinous ligament fixation.The median time for recurrence from primary pelvic floor repair surgery was 9 months, including 14 cases (33%, 14/42) ≤3 months (median time was 2 months) and 25 cases (67%, 28/42) longer than 3 months (median time was 18 months).The rate of recurrent prolapse in stage Ⅲ or Ⅳ was 79% (33 cases), 45% (19 cases) and 17%(7 cases) in anterior, apical and posterior compartment respectively. Results: Transvaginal high bilateral uterosacral ligaments were identified and used for successful vaginal vault suspension after vaginal hysterectomy and residual cervical resection in all 42 consecutive patients. The cases of transvaginal mesh used in anterior wall and posterior wall were 25 (60%, 25/42) and 3 (7%, 3/42) respectively. There was no major intra- and postoperative complications,such as ureter and other pelvic organ injury. The median time of follow-up was 5.3 years after transvaginal HUS. The points of pelvic organ prolapse quantification system reduced significantly and point C improved from +0.3 cm to -8.2 cm after reoperation (P<0.01). The objective cure rate were 100% (42/42) both in apex and posterior compartment,while 93% (39/42) in anterior compartment. None had reoperation or pessary usage for recurrence of prolapse. Conclusion: Transvaginal HUS with vaginal wall repair could be as a safety, cost-effective, minimal traumatic and durable procedure for recurrent POP in the most of cases.

The effectiveness and safety of cervus and cucumis polypeptide injection in promoting fracture healing after bone fracture surgeries: Protocol for a systematic review and meta-analysis

BACKGROUND

Bone fractures are a common occurrence, and, according to clinical investigations, approximately 5% to 10% of patients with fractures will suffer from delayed healing or even non-healing. The high efficacy of traditional Chinese medicine in promoting fracture healing has been fully verified over a long history of diagnosis and treatment. Traditional Chinese medicine has a long history of applying Chinese herbs to treat fractures. Cervus and cucumis polypeptide injection has been widely used to promote fracture healing after fracture surgery in clinic, but its efficacy and safety are controversial. For the above reasons, the purpose of this study is to systematically evaluate the efficacy and safety of cervus and cucumis polypeptide injection in promoting fracture healing after bone fracture surgeries and to provide a theoretical basis for the selection of appropriate treatment measures for delayed healing of patients with fractures.

METHODS

A total of 8 databases were searched, including the non-Chinese-language databases PubMed, The Cochrane Library, Web of Science, and Embase and the Chinese databases Chongqing VIP Chinese Journal Service Platform (VIP), Wanfang Data Knowledge Service Platform (Wanfang Data), SinoMed and Chinese National Knowledge Infrastructure (CNKI). The databases were queried for publicly released randomized controlled trials of the effectiveness and safety of Cervus and Cucumis polypeptide injection for fracture healing after surgical treatment, and no language restrictions were imposed. The software Review Manager 5.3 was used to evaluate the quality of the selected documents, and Stata 12.0 software was used for statistical analysis.

RESULTS

This review will be to assess the efficacy and safety of cervus and cucumis polypeptide injection in promoting fracture healing after bone fracture surgeries.

CONCLUSION

Our study will use systematic evaluation to objectively evaluate the efficacy and safety of cervus and cucumis polypeptide injection in promoting fracture healing after fracture surgery. It will provide theoretical basis for guiding clinical practice and benefit more patients.

ETHICS AND DISSEMINATION

This study is a systematic review that does not require ethical approval and meets the requirements of protocol for a systematic review and meta-analysis. At the same time, this study does not involve the recruitment of patients. All data are from published academic papers.

PROTOCOL AND REGISTRATION

A protocol had been registered for this systematic review and meta-analysis in PROSPERO. (registration number: CRD42019120965).

[Clinical management of 110 cases of polypropylene mesh and sling exposure after reconstructive pelvic floor surgery]

Objective: To explore the clinical management and outcomes of polypropylene mesh and sling exposure after reconstructive pelvic surgery (RPS) . Methods: A total of 110 cases of mesh and sling exposure after RPS were analyzed, who admitted between Jan. 2002 and Oct. 2017 in First Affiliated Hospital of PLA General Hospital, in which 3 cases were referred from other hospitals. Mesh and sling exposures were identified in the outpatient clinic and categorized and managed according to International Continence Society and International Urogynecology Association (ICS-IUGA) classification about category, time and site (CTS) of mesh complication. Outpatient management included observation, topical estrogen use and mesh removal. Management in hospital included surgical removal of exposed mesh and repair of the resulting defects under the anesthesia. Seventy-four cases were managed in the outpatient setting, and 36 cases required inpatient management. Follow-up was consecutively performed from 1 month to 10 years. Objective outcome included the surgeon's assessment of the healing state of the vaginal mucosa. Subjective outcome was evaluated with patient global impression of improvement questionnaire (PGI-I) . Results: One hundred and ten patients with mesh exposure were classified according to the different RPS underwent. There were 95 cases from transvaginal mesh surgery, 5 cases from anti-stress urinary incontinence sling surgery, and 10 cases from sacrocolpopxy. The outpatient group healed at an average of (3.0±1.8) months. Of the 36 patients who required inpatient management, 21 cases healed completely at an average of 7 days after one surgery. The remaining 8 cases required either two or three times surgeries or conservative management. In the outpatient group, the PGI-I scale very much better was found in 65 cases (87.8%) and much better in 9 cases (12.2%) . In the inpatient surgery group, the scale was very much better in 30 cases (83.3%) , and much better in 6 cases (16.7%) . Conclusions: Among patients with mesh exposure after mesh-augmented RPS, 2/3 of patients with a CTS classification 1-3 could be managed in the office, and remaining 1/3 with CTS classification 4-6 need operation under anesthesia in hospital. If the mesh and sling exposure could be scientifically classified, according to the size, site and accompany symptoms, as well as pain, most of the mesh complications after explosure could be resolved. Using the pelvic floor repair and polypropylene mesh sling, the majority of the patients could get a better outcome, without affecting the effect of the original operation.

[Long-term effectiveness of transvaginal high uterosacral ligament suspension]

Objective: To assess the long-term effectiveness of the transvaginal high uterosacral ligament suspension (HUS) in women suffering from advanced pelvic organ prolapse (POP). Methods: A retrospective review of records identified 118 women who underwent transvaginal HUS with or without additional concomitant anterior and (or) posterior repairs from June 2003 to August 2009 in the First Affiliated Hospital, General Hospital of People's Liberation Army. Of 118 women, 104 women completed the follow-up during study period; these 104 women were analysed. Follow-up visits were performed 2, 6 and 12 months after surgery and then annually. Anatomic results of POP was established by pelvic examination using pelvic organ prolapse quantitation system (POP-Q) staging. Funtional results were obtained by patient global impression of improvement (PGI-I), pelvic floor distress inventory-short form 20 (PFDI-20) and pelvic floor impact questionnaire short form (PFIQ-7). Surgical success required the fulfillment of all 3 criteria: (1) prolapse leading edge of 0 cm or less and apex of 1/2 total vaginal length or less; (2) the absence of pelvic organ prolapse symptoms as reported on the PFDI-20 question No. 3 ( "Do you usually have a bulge or something falling out that you can see or feel in your vaginal area?" ); and (3) no prolapse reoperations or pessary use during the study period. Results: The mean follow-up time was (9.1±1.5) years. The overall surgery success rate was 91.3% (95/104) according to above all 3 criteria. Prolapse recurrence rates were isolated anterior 6.7% (7/104), isolated apical 0, isolated posterior 2.9% (3/104) and multiple compartments 1.0% (1/104). Five women (4.8%, 5/104) developed bothersome vaginal bulge symptoms. None of recurrent women underwent retreatment, including either surgery or use of a pessary at last follow-up. The subjective satisfaction rate was 90.4% (94/104). PFDI-20 and PFIQ-7 scores showed a statistically significant improvement from preoperative 72 and 65 points to postoperative 17 and 9 points respectively (all P<0.01). There was a 2.9% (3/104) rate of intraoperative ureteral kinking and 3.8% (4/104) rate of postoperative morbidity. Conclusions: The transvaginal HUS for vault prolapse offers good long-term anatomical results with excellent vault suspension. With additional concomitant anterior and (or) posterior repairs, it will be a reconstructive surgery for the majority of advanced POP. It is minimal traumatic and appropriate for different type of POP, especially for the eldly patients. It is worthy of being popularized for clinical application.

Evaluation of Collaterals and Clot Burden Using Time-Resolved C-Arm Conebeam CT Angiography in the Angiography Suite: A Feasibility Study

BACKGROUND AND PURPOSE

The assessment of collaterals and clot burden in patients with acute ischemic stroke provides important information about treatment options and clinical outcome. Time-resolved C-arm conebeam CT angiography has the potential to provide accurate and reliable evaluations of collaterals and clot burden in the angiographic suite. Experience with this technique is extremely limited, and feasibility studies are needed to validate this technique. Our purpose was to present such a feasibility study.

MATERIALS AND METHODS

Ten C-arm conebeam CT perfusion datasets from 10 subjects with acute ischemic stroke acquired before endovascular treatment were retrospectively processed to generate time-resolved conebeam CTA. From time-resolved conebeam CTA, 2 experienced readers evaluated the clot burden and collateral flow in consensus by using previously reported scoring systems and assessed the clinical value of this novel imaging technique independently. Interobserver agreement was analyzed by using the intraclass correlation analysis method.

RESULTS

Clot burden and collateral flow can be assessed by using the commonly accepted scoring systems for all eligible cases. Additional clinical information (eg, the quantitative dynamic information of collateral flow) can be obtained from this new imaging technique. Two readers agreed that time-revolved C-arm conebeam CTA is the preferred method for evaluating the clot burden and collateral flow compared with other conventional imaging methods.

CONCLUSIONS

Comprehensive evaluations of clot burden and collateral flow are feasible by using time-resolved C-arm conebeam CTA data acquired in the angiography suite. This technique further enriches the imaging tools in the angiography suite to enable a "one-stop- shop" imaging workflow for patients with acute ischemic stroke.

The consumption of fish cooked by different methods was related to the risk of hyperuricemia in Japanese adults: A 3-year follow-up study

BACKGROUND AND AIMS

Fish consumption is a recognized risk factor for elevated serum uric acid (UA) levels, hyperuricemia, and gout. However, the relationship between the consumption of fish cooked by different methods and the risk of hyperuricemia is unclear. Therefore, we aimed to investigate the relationship between the consumption of fish cooked by different methods and the risk of hyperuricemia in Japanese adults.

METHODS AND RESULTS

A 3-year follow-up study was conducted with 424 Japanese adults aged 29-74 years. Fish consumption was assessed using a validated self-administered dietary history questionnaire, and hyperuricemia was defined as serum UA ≥7 mg/dL in men and ≥6 mg/dL in women or the use of any anti-gout treatment. During the 3-year follow-up period, we documented 30 newly diagnosed cases of hyperuricemia. After adjusting for potential confounders, multivariate logistic regressions analysis revealed a significant positive relationship between the risk of hyperuricemia and raw (sashimi and sushi) or roasted fish consumption, but not boiled or fried fish consumption. The odds ratios (95% CI) for hyperuricemia with increasing raw fish consumption were 1.00 (reference), 2.51 (0.85, 7.39), and 3.46 (1.07, 11.14) (P for trend: 0.036). Similarly, the odds ratios (95% CI) with increasing roasted fish consumption were 1.00 (reference), 3.00 (0.75, 11.89), and 5.17 (1.30, 20.62) (P for trend: 0.018).

CONCLUSION

This 3-year follow-up study showed that the consumption of raw or roasted fish, but not boiled or fried fish, was related with a higher risk of hyperuricemia in Japanese adults.

C-Arm Conebeam CT Perfusion Imaging in the Angiographic Suite: A Comparison with Multidetector CT Perfusion Imaging

BACKGROUND AND PURPOSE

Perfusion imaging in the angiography suite may provide a way to reduce time from stroke onset to endovascular revascularization of patients with large-vessel occlusion. Our purpose was to compare conebeam CT perfusion with multidetector CT perfusion.

MATERIALS AND METHODS

Data from 7 subjects with both multidetector CT perfusion and conebeam CT perfusion were retrospectively processed and analyzed. Two algorithms were used to enhance temporal resolution and temporal sampling density and reduce the noise of conebeam CT data before generating perfusion maps. Two readers performed qualitative image-quality evaluation on maps by using a 5-point scale. ROIs indicating CBF/CBV abnormalities were drawn. Quantitative analyses were performed by using the Sørensen-Dice coefficients to quantify the similarity of abnormalities. A noninferiority hypothesis was tested to compare conebeam CT perfusion against multidetector CT perfusion.

RESULTS

Average image-quality scores for multidetector CT perfusion and conebeam CT perfusion images were 2.4 and 2.3, respectively. The average confidence score in diagnosis was 1.4 for both multidetector CT and conebeam CT; the average confidence scores for the presence of a CBV/CBF mismatch were 1.7 (κ = 0.50) and 1.5 (κ = 0.64). For multidetector CT perfusion and conebeam CT perfusion maps, the average scores of confidence in making treatment decisions were 1.4 (κ = 0.79) and 1.3 (κ = 0.90). The area under the visual grading characteristic for the above 4 qualitative quality scores showed an average area under visual grading characteristic of 0.50, with 95% confidence level cover centered at the mean for both readers. The Sørensen-Dice coefficient for CBF maps was 0.81, and for CBV maps, 0.55.

CONCLUSIONS

After postprocessing methods were applied to enhance image quality for conebeam CT perfusion maps, the conebeam CT perfusion maps were not inferior to those generated from multidetector CT perfusion.

Incidence, Risk Factors, and the Protective Effect of High Body Mass Index against Sarcopenia in Suburb-Dwelling Elderly Chinese Populations

BACKGROUND

Few studies have explored the risk factors of sarcopenia in certain cohorts. The objective of this study was to examine the incidence of sarcopenia and associated factors over a 1-year period in an elderly Chinese suburban population.

METHODS

This study was conducted on 356 Chinese suburb-dwelling participants aged ≥60 years, for whom detailed information regarding sociodemographics, behavioral characteristics, and medical conditions had been documented. Sarcopenia was defined according to the Asian Working Group for Sarcopenia (AWGS) criteria. Sarcopenia incidence was documented after one year of follow-up, and correlated with several possible factors.

RESULTS

At baseline, 64 (9.7%) of the initial 657 participants had sarcopenia. The prevalence of sarcopenia was 10.4% after one year. Between baseline and 1-year follow-up, 13 of the participants without sarcopenia at baseline had developed sarcopenia. After multivariate adjustments, it was found that the incidence of sarcopenia increased with age and high body mass index (BMI) is associated with less incidence of sarcopenia. Incidence was also higher among women.

CONCLUSIONS

We found sarcopenia incidence increased with age, and women were more likely to have sarcopenia. A higher BMI is also associated with a lower incidence of sarcopenia. Maintaining a healthy weight could be beneficial in the prevention of sarcopenia.

Consumption of Chilies, but not Sweet Peppers, Is Positively Related to Handgrip Strength in an Adult Population

BACKGROUND

Chili consumption may have a beneficial effect on muscle strength in the general population. The aim of this study was to investigate the relationship between frequency of chili consumption and handgrip strength in adults.

DESIGN

Population-based cross-sectional study.

SETTING

This study used baseline data from the Tianjin Chronic Low-grade Systemic Inflammation and Health Cohort Study.

PARTICIPANTS

A total of 3 717 subjects were recruited to the study. Frequency of chili consumption during the previous month was assessed using a valid self-administered food frequency questionnaire. Analysis of covariance was used to examine the relationship between muscle strength and frequency of chili consumption. Handgrip strength was measured using a handheld digital dynamometer.

RESULTS

After adjustment for potential confounding factors, significant relationships were observed between different categories of chili consumption and handgrip strength in males, the means (95% confidence interval) for handgrip strength across chili consumption categories were 44.7 (42.1, 47.2) for < one time/week; 45.5 (42.9, 48.1) for one time/week; and 45.8 (43.3, 48.4) for ≥ 2-3 times/week (P for trend < 0.01). Similar results were not observed with sweet pepper consumption.

CONCLUSIONS

This study reveals a positive correlation between frequency of chili consumption and muscle strength in adult males. Further studies are necessary in order to determine whether there is a causal relationship between chili consumption frequency and muscle strength.

Dietary patterns are associated with prevalence of fatty liver disease in adults

BACKGROUND/OBJECTIVES

Previous studies have indicated that higher levels of food consumption are associated with fatty liver disease (FLD), but few studies have investigated the relationship between this disease and different dietary patterns. The aim of this cross-sectional study was to examine the association between dietary patterns and FLD in adults.

SUBJECTS/METHODS

Dietary intakes of participants in the Tianjin were assessed via questionnaire. Factor analysis was used to identify dietary patterns, and FLD was defined as having a FLD diagnosis using liver ultrasonography. Relationships between dietary patterns and FLD were assessed using multiple logistic regression analysis.

RESULTS

Female participants in the highest quartile of high-carbohydrate/sweet pattern scores had a 2.19-fold greater risk (95% confidence interval (CI), 1.40-3.46) of developing non-alcoholic FLD (NAFLD) than those in the lowest quartile after adjusting for confounding factors. No significant differences were found between any dietary pattern and NAFLD in males. In males, a significantly increasing trend of alcoholic FLD (AFLD) prevalence was associated with increasing high-protein/cholesterol pattern scores (P for trend = 0.03; odds ratio (OR), 2.08; 95% CI, 1.15-3.81) while an increased high-carbohydrate/sweet pattern score appeared protective against AFLD (P for trend = 0.02; OR, 0.55; 95% CI, 0.29-1.00).

CONCLUSIONS

Our study demonstrates that high-protein/cholesterol pattern scores are associated with higher prevalence of AFLD in males. We also show high-carbohydrate/sweet pattern scores are associated with higher prevalence of NAFLD in females; but, interestingly, this pattern shows a favorable effect on AFLD in males.

Breakfast consumption frequency is associated with grip strength in a population of healthy Japanese adults

BACKGROUND AND AIMS

Several studies have reported that regular consumption of breakfast is associated with health benefits. However, only a few studies have examined the association between frequency of breakfast consumption and muscular function. Therefore, this study aims to investigate the association between frequency of breakfast consumption and muscle strength among apparently healthy Japanese adults.

METHODS AND RESULTS

A cross-sectional study design was used. Between 2008 and 2011 in Sendai, Japan, 1415 Japanese adult employees (1069 men and 346 women) aged between 19 and 83 years participated in the study. Grip strength, as measured by a handheld digital dynamometer, was used as an indicator of muscle strength. Frequency of breakfast consumption during the previous month was assessed using a brief self-administered dietary history questionnaire, and the results were divided into three categories for analysis: low (≤2 days week⁻¹), middle (3-5 days week⁻¹) and high (≥6 days week⁻¹). Multivariate analysis was performed using analysis of covariance, with covariates mainly including socio-demographic, lifestyle-related and health-related factors. After adjusting for several potential confounders, grip strength was shown to be positively associated with breakfast consumption frequency (geometric means, 95% confidence interval (CI): low frequency, 36.2 (35.7-36.8) kg; middle frequency, 36.7 (36.0-37.5) kg; high frequency, 37.0 (36.6-37.5) kg; P for trend = 0.03). Grip strength per kilogramme body weight (kg kg⁻¹) was also positively associated with frequency of breakfast consumption (P for trend = 0.01).

CONCLUSIONS

This cross-sectional study reveals a positive association between breakfast consumption frequency and muscle strength in apparently healthy adults.

Inverse association between circulating adiponectin levels and skeletal muscle strength in Japanese men and women

BACKGROUND AND AIMS

Increased levels of circulating adiponectin in the elderly cause a negative impact on physical function and health status, which suggests that circulating adiponectin may be related to skeletal muscle function. However, data on the relationship between circulating adiponectin levels and skeletal muscle function is limited. Our objective was to investigate the association between serum adiponectin levels and muscle strength in adults.

METHODS AND RESULTS

This cross-sectional study is a part of the Oroshisho Study of adult employees in Japan from 2008 to 2011. In our study, we used data gathered in 2008-2010 that had included serum adiponectin measurements (n = 1378; age, 19-83 years). From this population, 1259 subjects were evaluated for grip strength (949 men, 310 women), and 965 subjects were evaluated for leg extension power (716 men, 249 women). Multivariate linear regression analyses showed that adiponectin was associated significantly and negatively with both grip strength (β and standard error [SE]: men, -0.09 [0.01], p = 0.010; women, -0.20 [0.03], kg, p = 0.002) and leg extension power (men, -0.09 [0.02], p = 0.014; women, -0.14 [0.07], W, p = 0.032) after adjusting for age, physical activity, nutrient intake, depressive symptoms, metabolic syndrome, C-reactive protein, body mass index, and other lifestyle-related potential confounders.

CONCLUSION

This population-based cross-sectional study indicates an inverse association between serum adiponectin levels and muscle strength in adults. Further studies are necessary to confirm this association and to clarify causality.

De novo symptoms and their impact on life quality in patients following transvaginal reconstructive pelvic surgery with polypropylene mesh

OBJECTIVE

To study the de novo symptoms and their impact on life quality in patients that underwent transvaginal reconstructive pelvic surgery (RPS) with polypropylene mesh.

MATERIALS AND METHODS

From May 2004 to March 2011, 114 severe pelvic organ prolapse (POP) patients with Stage III-IV by POP-Q system underwent RPS with polypropylene mesh. Patients completed pelvic floor distress inventory short form (PFDI-20) and pelvic floor impact questionnaire short form (PFIQ-7) preoperatively and repeated them at two and six months, and one year postoperatively.

RESULTS

Ninety-six (84%, 96/114), 85 (75%, 85/114), and 77 (68%, 77/114) patients, respectively, completed the questionnaires at two months, six months, and one year postoperatively. All patients had POP-Q staging scoring < or = I at one year after surgery. Nineteen (19.8%, 19/96) patients had mesh exposure at two and six months (7.8%, 6/77) at one year follow-up. Most vaginal and pelvic symptoms, urinary and obstructive defecation bothersome symptoms improved significantly at two months postoperatively and this improvement was maintained at the one year follow-up. Mean score of PFDI-20 and PFIQ-7 all improved significantly postoperatively at two and six months and at one year follow-up (p < 0.01). Fifty percent (48/96) of patients had postoperative de novo symptoms at the two months follow-up predominantly presented with bothersome vaginal discharge (35.4%, 34/96) and pelvic muscle symptoms (20.8%, 20/96). Patients with de novo symptoms had higher postoperative mean POPDI-6 and POPIQ-7 scores (p < 0.05) than those without at the two month follow-up, but no significant difference was seen at the six month and at one year follow-ups. Patients with bothersome vaginal discharge had higher vaginal mesh exposure rate (41.2%, 14/34) than patients without (8.1%, 5/62) (p = 0.0003). One year after operation, 77 (68%) patients completed the non-validated satisfaction questionnaire. Seventy-four (96%, 74/77) patients said that they were either 'very satisfied' or 'satisfied' with the outcome of their surgery, while three (4%, 3/77) reported unsatisfactory results.

CONCLUSIONS

De novo symptoms were common after transvaginal RPS with polypropylene mesh, but most of them were moderate and resolved within six months postoperatively and seldomly had a long-term negative impact on their quality of life. The impact of dyspareunia on patients' sexual function requires further research.

Skin advanced glycation end-product accumulation is negatively associated with calcaneal osteo-sono assessment index among non-diabetic adult Japanese men

This study aims to determine the relationship between advanced glycation end-product (AGE) accumulation in skin tissue and bone strength, assessed by quantitative ultrasound, among healthy adult Japanese men. The results of the study suggest that men with higher AGE accumulation in skin tissue have a lower osteo-sono assessment index.

INTRODUCTION

AGE accumulate in bone collagen with age and diabetes and decrease the mechanical properties of bone. Although increased AGE levels are associated with fractures among diabetic patients and elderly women, it is unclear whether a relationship between increased AGE levels and bone strength is present in apparently healthy adult males. The aim of this study was to determine the relationship between AGE accumulation in tissue and the mechanical properties of bone among adult Japanese men, using quantitative ultrasound as a surrogate measure of the latter.

METHODS

Skin autofluorescence (AF), which is a noninvasive method for measuring tissue AGEs, and osteo-sono assessment index (OSI), which is determined by quantitative ultrasound, were measured in 193 adult Japanese men (median age 43 years; interquartile range 37.0-55.0 years).

RESULTS

Adjusted for age, BMI, calcium intake, physical activity, smoking status, and education level, log-transformed skin AF had a negative association with log-transformed OSI (β = -0.218, P < 0.01). Adjusted geometric means (95% CI) for OSI across the tertiles of skin AF were 2.81 (2.75-2.87) for the lowest tertile, 2.81 (2.74-2.87) for the middle tertile, and 2.66 (2.61-2.73) for the highest tertile; thus, OSI for the highest skin AF appeared to be 5.0% lower than that for the lowest and middle skin AF tertiles (P < 0.01).

CONCLUSION

Among apparently healthy adult Japanese men, those with higher skin AF had a lower OSI, indicating a relationship between AGE accumulation and bone strength. A long-term prospective study is required to clarify the causality.

Association of Japanese dietary pattern with serum adiponectin concentration in Japanese adult men

BACKGROUND AND AIMS

Although previous studies suggest that the traditional Japanese dietary pattern is independently associated with a low cardiovascular disease mortality risk, the mechanisms mediating or linking this association are not well understood. Adiponectin has emerged as a valuable biomarker for cardiovascular diseases. The aim of present study was to evaluate whether dietary patterns are associated with serum adiponectin concentration in Japanese adult men.

METHODS AND RESULTS

We designed a cross-sectional study of 702 men (median [interquartile range] age, 44.5 [37.8-54.2] years) living in Japan. Dietary consumption was assessed via a 75-item food frequency questionnaire. We used principal-components analysis to derive 3 major dietary patterns-"Japanese", "sweets-fruits" and, "Izakaya (Japanese Pub)"- from 39 food groups. Serum adiponectin concentration was measured by using a specific sandwich enzyme-linked immunosorbent assay. After adjustment for potential confounders, the geometric mean (95% confidence interval) for log-transformed adiponectin concentration associated with "Japanese" dietary pattern factor score tertiles were 5.24 (4.84-5.69) for the lowest tertile, 5.82 (5.39-6.29) for the middle tertile, and 5.95 (5.47-6.46) for the highest tertile (P for trend <0.01). In contrast, a significant inverse association was found between the "Izakaya" pattern factor score tertiles and adiponectin concentration (P for trend = 0.03).

CONCLUSIONS

Greater adherence to the "Japanese" dietary pattern was independently associated to a higher serum adiponectin concentration in Japanese adult men. This finding supports the hypothesis that the traditional Japanese diet may have a potentially beneficial effect on adiponectin concentrations. A long-term prospective study or randomized trials are required to clarify this causality.

Oral health behavior and metabolic syndrome and its components in adults

Inflammation has been strongly related to metabolic syndrome (MetS). Periodontal disease is the most common chronic infection in adults. We investigated a cross-sectional (n = 925) and 3-year longitudinal (n = 685) relationship between the daily frequency of toothbrushing and MetS. In the cross-sectional analysis, the prevalence of MetS was 15.7%. After adjustment for potential confounding factors (including all lifestyle factors), the odds ratios (95% confidence interval [CI]) of having MetS in those who brushed 2 times/day and ≥ 3 times/day were 0.71 (0.48-1.05) and 0.47 (0.24-0.92), respectively, as compared with ratios in those with a toothbrushing frequency of ≤ 1 time/day. Increasing toothbrushing frequency tended to relate inversely to hypertriglyceridemia and high-sensitivity C-reactive protein. In the longitudinal analysis, 99 participants were newly diagnosed with MetS. The adjusted odds ratios (95% CI) of the MetS in participants who brushed 2 times/day and ≥ 3 times/day as compared with participants who brushed ≤ 1 time/day were 0.80 (0.49-1.31) and 0.43 (0.19-0.97), respectively. The frequency of toothbrushing was related inversely only to hypertriglyceridemia, consistent with the cross-sectional analysis. This study found that more frequent toothbrushing is related to a lower prevalence and incidence of MetS. These results suggest that more frequent toothbrushing may contribute to the prevention of MetS due to the inflammation/triglyceride pathway.

Sex differences in the contribution of ATP-sensitive K+ channels in trigeminal ganglia under an acute muscle pain condition

In this study, we examined whether functional subunits of the ATP-dependent K+ channel (KATP) are expressed in trigeminal ganglia (TG), which contains sensory neurons that innervate oral and facial structures. We also investigated whether direct activation of the KATP effectively attenuates mechanical hypersensitivity in the context of an acute orofacial muscle pain condition. The KATP expression in TG and behavioral studies were conducted in age matched male and female Sprague-Dawley rats. RT-PCR experiments showed that the mRNAs for the inwardly rectifying pore-forming subunits, Kir6.1 and Kir6.2, as well as the regulatory sulfonylurea subunits, SUR1 and SUR2, were reliably detected in TG. Subsequent western blot analysis confirmed that proteins for all four subunits are expressed in TG, and showed that Kir6.2 is expressed at a significantly higher level in male TG compared to that of female rats. This observation was confirmed by the immunohistochemical demonstration of higher percentages of Kir6 positive masseter afferents in female rats. Masseteric injection of capsaicin evokes a time dependent increase in masseter sensitivity to noxious mechanical stimulation. A specific KATP agonist, pinacidil, dose-dependently attenuated the capsaicin-induced mechanical hypersensitivity in male rats. The dose of pinacidil (20 μg) that completely blocked the capsaicin responses in male rats was ineffective in female rats regardless of their estrus phases. Only at the highest dose (300 μg) we used, pinacidil was partially effective in female rats. Similarly, another KATP agonist, diazoxide which targets different KATP subunits also showed sex specific responses in attenuating capsaicin-induced masseter hypersensitivity. These data suggested that sex differences in functional KATP expression in TG may underlie sex specific responses to KATP agonists. The present study provided novel information on sex differences in KATP expression in TG and its contribution under an orofacial muscle pain condition.

Identification of B-cell growth factors (interleukin-14; high molecular weight-B-cell growth factors) in effusion fluids from patients with aggressive B-cell lymphomas

The molecular basis of neoplastic B-cell growth is complex and poorly understood. Cytokines have been postulated to contribute to neoplastic cell growth, and many in vitro studies have confirmed this prediction, but little is known about the in vivo role of these growth factors. We have examined the production of interleukin-14 (IL-14) (high molecular weight [HMW], B-cell growth factor [BCGF]) by aggressive intermediate (diffuse large cell) lymphomas of the B-cell type non-Hodgkin's lymphoma (NHL-B) in four patients with lymphomatous effusions. In these studies, IL-14 was detected in the effusion fluids by Western blots and IL-14 mRNA was constitutively expressed in the freshly isolated lymphoma cells that also expressed the receptor for IL-14 (IL14R). Lymphoma B cells placed at low serum and cell density proliferated in vitro to either purified IL-14 or IL-14 derived from effusion fluids. Antibodies to IL-14 removed the growth-stimulating cytokine(s) from the effusions. Cell lines developed from these patients produced IL-14 in vitro and antisense oligos to IL-14 blocked their growth in vitro. Thus, autocrine or paracrine production of IL-14 may play a significant role in the rapid proliferation of aggressive NHL-B. Interrupting this pathway could be a useful goal of therapy for patients resistant to conventional chemotherapy.

The Yantai model of community care for rural psychiatric patients

The main characteristics of the Yantai model are (a) a three-tier (county, township, village) management structure; (b) the vertical integration of community mental health workers, including a professional advisory group of psychiatrists from the central psychiatric hospital, groups of community psychiatrists at small county psychiatric hospitals, non-psychiatric physicians who run psychiatric out-patient clinics at township general hospitals, and village paramedics ('village doctors') who supervise patients in the community; (c) ongoing training of all community mental health workers; (d) registration and yearly follow-up of all patients with mental illnesses in the community; (e) provision of home-care services to a proportion of acutely ill patients; and (f) most of the cost of the service is borne by the state. The network of services provided by this model makes it convenient for patients to obtain treatment and, if necessary, go into hospital; it reduces the economic burden on the family and the community; it combines treatment, prevention, rehabilitation, and supervision under one administrative network; and it decreases the overall level of psychopathology and psychosocial dysfunction in the community.

Liver injury model in mice for immunopharmacological study

Experimental liver injury was produced in mice by the immunological technique. The utility of these models as an immunopharmacological method was investigated. The first model was produced by the injection of anti-basic liver protein (BLP) rabbit antibody into DBA/2 mice that had been previously immunized with rabbit IgG. The second liver injury was caused by injection of anti-liver specific protein (LSP) rabbit antibody into DBA/2 mice. The third model was produced by the injection of bacterial lipopolysaccharide (LPS) into Corynebacterium parvum pretreated ddY mice. In all injury models, extensive liver parenchymal cell damage was estimated by elevation of glutamate transaminase (GOT and GPT) activity. These were confirmed by histopathological studies of the liver. Typical histopathological changes in the liver from injured mice were submassive hepatocellular necrosis and infiltration of granulocytes and lymphocytes into the portal tract and sinusoid in the necrotic lesion. Administration of prednisolone and cyclophosphamide for 10 days prior to injection of eliciting antibodies or LPS suppressed the elevation of serum transaminase levels in all experimental liver injury models. Cianidanol and sylibin inhibited the elevation of GOT and GPT in anti-BLP induced liver injured mice. These evidences suggest that the above models are suitable for investigating the remedy for liver diseases.