Impaired sensitivity to thyroid hormone correlates to osteoporosis and fractures in euthyroid individuals

BACKGROUND

There is growing evidence that thyroid function affects bone metabolism and even fractures risk. However, little is known about the relationship between thyroid sensitivity and osteoporosis and fractures. Therefore, we explored the relationship between thyroid sensitivity-related indices and bone mineral density (BMD) and fractures in euthyroid US adults.

METHODS

In this cross-sectional study, 20,686 subjects from National Health and Nutrition Examination Survey (NHANES) data were extracted and analyzed during 2007 to 2010. A total of 3403 men and postmenopausal women aged 50 years or older with available data on diagnosis of osteoporosis and/or fragility fractures, bone mineral density (BMD) and thyroid function, were eligible. TSH index (TSHI), thyrotrophin T4/T3 resistance index (TT4RI/TT3RI), Thyroid feedback quantile-based index (TFQI), Parametric TFQI (PTFQI), free triiodothyronine to free thyroxine ratio (FT3/FT4), the secretory capacity of the thyroid gland (SPINA-GT) and the sum activity of peripheral deiodinases (SPINA-GD) were calculated.

RESULTS

FT3/FT4, SPINA-GD, FT4, TSHI, TT4RI, TFQI and PTFQIFT4 were significantly correlated with BMD (P < 0.001). Multiple linear regression analysis showed that FT3/FT4 and SPINA-GD was significantly positively associated with BMD, while FT4, TSHI, TT4RI, TFQI and PTFQIFT4 were negatively associated with BMD (P < 0.05 or P < 0.001). In logistic regression analysis, the odds ratio (OR) for osteoporosis of TSHI, TFQI and PTFQIFT4 were 1.314(1.076, 1.605), 1.743(1.327, 2.288) and 1.827(1.359, 2.455) respectively, and were 0.746(0.620, 0.898) for FT3/FT4 (P < 0.05).

CONCLUSIONS

In elderly euthyroid individuals, impaired sensitivity to thyroid hormones correlates to osteoporosis and fractures, independent of other conventional risk factors.

Agricultural management strategies for balancing yield increase, carbon sequestration, and emission reduction after straw return for three major grain crops in China: A meta-analysis

Straw return can improve crop yield as well as soil organic carbon (SOC) but may raise the possibility of N₂O and CH₄ emissions. However, few studies have compared the effects of straw return on the yield, SOC, and N₂O emissions of various crops. Which management strategies are the best for balancing yield, SOC, and emission reduction for various crops needs to be clarified. A meta-analysis containing 2269 datasets collected from 369 studies was conducted to investigate the influence of agricultural management strategies on yield increase, soil carbon sequestration, and emission reduction in various crops after the straw return. Analytical results indicated that, on average, straw return increased the yield of rice, wheat, and maize by 5.04%, 8.09%, and 8.71%, respectively. Straw return increased maize N₂O emissions by 14.69% but did not significantly affect wheat N₂O emissions. Interestingly, straw return reduced the rice N₂O emissions by 11.43% but increased the CH₄ emissions by 72.01%. The recommended nitrogen application amounts for balancing yield, SOC, and emission reduction varied among the three crops, while the recommended straw return amounts were more than 9000 kg/ha. The optimal tillage and straw return strategies for rice, wheat, and maize were plow tillage combined with incorporation, rotary tillage combined with incorporation, and no-tillage combined with mulching, respectively. A straw return duration of 5-10 years for rice and maize and ≤5 years for wheat was recommended. These findings provide optimal agricultural management strategies after straw return to balance the crop yield, SOC, and emission reduction for China's three major grain crops.

[Surgical treatment strategy for difficult-reducible atlantoaxial dislocation]

Objective: To discuss the surgical strategy for difficult-reducible atlantoaxial dislocation. Methods: Clinical data of 82 patients with difficult-reducible atlantoaxial dislocation underwent surgical treatment in the Department of Neurosurgery, Xuanwu Hospital from January 2018 to February 2019 were retrospectively reviewed. Total of 32 men and 50 women were included, with a mean age of (41.8±12.9) years. Most cases (n=80) were treated with one-staged posterior atlantoaxial joint distraction and cage implantation, a few (n=2) underwent ventral decompression. All cases were followed up, postoperative improvement of clinical symptoms and radiology parameters were analyzed. Results: Of the patients, 80 cases (97.6%) received one-staged posterior atlantoaxial joint distraction and cage implantation; lateral facet joint bony fusion was found in 4 patients and was cut off with an osteotome. Transoral odontoidectomy was performed in 2 cases (2.4%) with fused atlanto-odontoid joint. All the patients were followed-up for (18.6±7.3) months. Postoperative CT showed complete reduction of ADI was achieved in 60 patients (75.0%). The ADI decreased significantly after the operation [(2.1±1.4) mm vs (5.0±1.5) mm, P<0.05]. The postoperative vertical distance between odontoid process and the Chamberlain line decreased significantly when compared with that before the operation [(3.9±3.8) mm vs (10.2±5.2) mm, P<0.05]. The mean JOA score at 6 months post operation improved significantly than that before the operation (13.7±1.5 vs 11.2±1.7, P<0.05). Seventy-five patients (93.8%) had atlantoaxial intra-articular bony fusion at 1 year follow-up. Conclusion: Most difficult-reducible atlantoaxial dislocations can be managed well by posterior one-staged atlantoaxial joint distraction and Cage implantation.

Spatial patterns and driving factor analysis of recommended nitrogen application rate for the trade-off between economy and environment for maize in China

Appropriate nitrogen (N) application increases crop yield, while its unreasonable application results in environmental problem. Determining the appropriate N application rate is the key to sustainable development. Here, the denitrification-decomposition (DNDC) model was used to analyze the effects of N fertilizer on maize yields, economic benefits, nitrate leaching, and nitrous oxide emissions in China. The N application rate for the trade-off between economy and environment at the county scale was further determined. The geodetector model was used to identify the main driving factors and their interactions of the recommended N rate in each agricultural zone. The results showed that the recommended N rate was generally high in the northwest but low in the south, consistent with the spatial patterns of yield potential. However, clay soils with clay ratios greater than 34% in southern China and sandy soils with bulk densities greater than 1.5 g cm^-3 on the Huanghuaihai Plain experienced high N levels and low yields, and thus soils need to be improved. Potential grain yield was the main driving factor in most zones, yet its effects gradually weakened from north to south. The influence of soil characteristics increased from north to south. It was found that the current average N application rate of farmers in China was 249 kg N/ha, and 86.55% of counties had excessive N applications. Compared to the regional optimal N rate at a regional scale, a differentiated N application strategy at the county scale determined in this study increased maize yield and economic benefit by 10.51% and 10.85%, respectively, and reduced N₂O emissions and NO₃^- leaching by 28.72% and 33.60%, respectively. The current research provides a scientific basis for China to formulate a win-win N management strategy for economy and environment and provides a method reference for other countries.

A recommended nitrogen application strategy for high crop yield and low environmental pollution at a basin scale

Mitigating environmental pollution and sustaining grain production have been foundational issues in sustainable development, however, ascertaining the optimal balance remains poorly investigated. This study used the Soil and Water Assessment Tool (SWAT) model to simulate crop growth and nitrogen loss, established the mapping relationship between nitrogen input to yield and water quality, and proposed a general method to determine a nitrogen application strategy for high yield and low pollution at a basin scale. Lake Xiaoxingkai basin, which is the primary maize producing area in China as well as an internationally important wetland distribution area, was used as a case study. First, we designed application scenarios for 10 base fertilizers (B1-B10) and 10 topdressing fertilizers (T1-T10) and evaluated their combined effects of maize growth to identify the critical nitrogen fertilizer rates determined under fixed and dynamic base/topdressing ratios. Then, the critical base and topdressing fertilizer rates were determined. Based on the mapping relationship between nitrogen fertilizer rate and nitrogen loss, we then revealed water quality at the basin outlet under the critical base and topdressing fertilizer rates. Finally, we proposed alternative nitrogen application strategies for high yield and low pollution while considering the different preferences of decision-makers for the economy, agriculture, and environment. We found that adjusting the ratio of base to topdressing fertilizer may create a win-win situation for agriculture and the environment, which will provide a scientific basis for sustainable development.

Comparing the Impacts of Sediment-Spiked Cadmium on Chironomidae Larvae in Laboratory Bioassays and Field Microcosms and the Implications for Field Validation of Site-Specific Threshold Concentrations

Information on the effects of pollutants in sediments at an ecosystem level to validate current and proposed risk-assessment procedures is scarce. The most frequent criticism of these procedures is that responses of surrogate species in the laboratory are not representative of responses of natural populations. A tiered approach using both laboratory and microcosm exposures (96-h and 21-d laboratory bioassays and a 3-mo field microcosm) was conducted to compare the impacts of sediment-spiked cadmium on the mortality, development, and abundance of Chironomidae larvae. The 96-h and 21-d lethal concentrations of sediment-spiked Cd to 50% of the species Chironomus riparius were estimated to be 201.07 and 172.66 mg/kg, respectively. In the 21-d laboratory bioassay, the endpoints, including the development rate and emergence ratio, were compared, and the lowest-observed-effect concentration (LOEC) values were 325.8 and 10.7 mg/kg, respectively. The abundance, richness, and biomass of field-collected larvae were compared among the different treatments in the field microcosm, and it was found that the order of sensitivities using different endpoints was biomass (2.6/5.2 mg/kg of no-observed-effect concentration/LOEC) > diversity (10.7/21.2 mg/kg) > abundance (41.2/82.7 mg/kg). The toxicity values based on lethal/sublethal changes in the laboratory bioassays might not fully protect field organisms against damage from chemicals, such as Cd, unless an assessment factor of 5 is used. These findings highlight the need to conduct field validation of criteria/guidelines before they are introduced to protect organisms/ecosystems in the field and provide a preliminary template for future field validation of criteria elsewhere. Environ Toxicol Chem 2021;40:2450-2462. © 2021 SETAC.

Feral dogs in Chitral gol national park, Pakistan: a potential threat to the future of threatened Kashmir Markhor (Capra falconeri cashmiriensis)

Feral dogs are well-organized hunters of ungulates in many parts of the world, causing great damage to wildlife populations and ultimately to the ecosystem. In Pakistan, the impacts of feral dogs on the wildlife have not been documented yet. In a period of fifteen years (2006-2020), feral dogs have killed hundreds of threatened markhor in Chitral gol national park (CGNP), Pakistan. Despite direct predation other impacts including disturbance and competition with other natural predators, could compromise conservation and management efforts. The population of feral dogs seems to have been increased with the increase of dumping sites by communities. Our findings suggest that there are pressing needs of controlling the feral dogs population and eradicating them from the core zone of CGNP and surrounding buffer communities. Conventional culling of dogs should be coupled with modern techniques like castration and sterilization. Communities should be educated regarding the clean environment, proper disposal of home wastes and, biodiversity conservation.

Source contribution analysis of nutrient pollution in a P-rich watershed: Implications for integrated water quality management

It is still a great challenge to address nutrient pollution issues caused by various point sources and non-point sources on the watershed scale. Source contribution analysis based on watershed modeling can help watershed managers identify major pollution sources, propose effective management plans and make smart decisions. This study demonstrated a technical procedure for addressing watershed-scale water pollution problems in an agriculture-dominated watershed, using the Dengsha River Watershed (DRW) in Dalian, China as an example. The SWAT model was improved by considering the constraints of soil nutrient concentration, i.e., nitrogen (N) and phosphorus (P), when modeling the nutrient uptake by a typical crop, corn. Then the modified SWAT model was used to quantify the contributions of all known pollution sources to the N and P pollution in the DRW. The results showed that crop production and trans-administrative wastewater discharge were the two dominant sources of nutrient pollution. This study further examined the responses of nutrient loss and crop yield to different fertilizer application schemes. The results showed that N fertilizer was the limiting factor for crop yield and that excessive levels of P were stored in the agricultural soils of the DRW. An N fertilizer application rate of approximately 40% of the current rate was suggested to balance water quality and environmental protection with crop production. The long-term impact of legacy P was investigated with a 100-year future simulation that showed the crop growth could maintain for 12 years even after P fertilization ceased. Our study highlights the need to consider source attribution, fertilizer application and legacy P impacts in agriculture-dominated watersheds. The analysis framework used in this study can provide a scientifically sound procedure for formulating adaptive and sustainable nutrient management strategies in other study areas.

CircRNA_100782 promotes roliferation and metastasis of gastric cancer by downregulating tumor suppressor gene Rb by adsorbing miR-574-3p in a sponge form

OBJECTIVE

The aim of this study is to investigate the expression levels of circRNA_100782 in gastric cancer tissues, and its function of regulating tumor suppressor gene Rb by absorbing miR-574-3p in a sponge form.

PATIENTS AND METHODS

qRT-PCR was performed to detect the expressions of circRNA_100782 at different stages during gastric cancer tissues. CCK-8 assay was performed to evaluate the osteoclast proliferation and differentiation. The correlation between miR-574-3p and circRNA_100782 was detected by statistical analysis. Bioinformatics and Luciferase assay were performed to explore the interaction and binding site of circRNA_100782 and miR-574-3p. The mice Rb 3'-UTR were cloned into the Luciferase reporter vector and miR-574-3p binding mutants were constructed to validate the inhibited regulation of miR-574-3p to the expression of Rb.

RESULTS

In the current study, compared with adjacent non-cancerous normal tissues, the expressions of circRNA_100782 and Rb were both downregulated in human gastric cancer cells. Through qRT-PCR and CCK-8 assay, we found that the expression of circRNA_100782 is related to the proliferation of gastric cancer cells. Besides, we also found that circRNA_100782 regulated the migration ability of gastric cancer cells through transwell assay. The bioinformatics prediction and luciferase assay demonstrated that circRNA_100782 can serve as a molecular sponge to further regulate the expression of Rb by sponging with miR-574-3p; moreover, circRNA_100782 can serve as a ceRNA for miR-574-3p to further regulate the expression of Rb.

CONCLUSIONS

In this research, we discovered that circRNA_100782 was downregulated in gastric cancer cells and is associated with cell proliferation and invasion by inhibiting tumor suppressor gene Rb by interacting with miR-574-3p.

Rhizoma Atractylodis macrocephalae: a review of photochemistry, pharmacokinetics and pharmacology

Rhizoma Atractylodis macrocephalae is commonly used in Traditional Chinese Medicine. Its traditional functions include treating hypofunction of the spleen with the loss of appetite, abdominal distension diarrhea, phlegm drink dizziness palpitation, edema, fetal movement restless. A literature search was conducted by systematic searching multiple electronic databases including Web of Science, PubMed, CNKI and Google Scholar. Chemical composition analysis of RAM showed that the main compositions were volatile oil, lactones, polysaccharides, amino acids, vitamins and resins. Pharmacological studies indicated that RAM possessed antitumor activities, neuroprotective effect, anti-hepatotoxicity, immune and anti-inflammatory activity, etc. This review gives a detailed description of the chemical constituents, pharmacology and pharmacokinetics of RAM and provides reliable basis for clinical development and application.

Comparative assessment of gut microbial composition and function in patients with Graves' disease and Graves' orbitopathy

BACKGROUND

A previous study indicated that gut microbiota changed notably in Graves' orbitopathy (GO) patients as compared to controls. However, the characteristics of intestinal bacteria in Graves' disease (GD) and GO are unclear.

OBJECTIVE

The present study aimed to identify specific intestinal bacteria of GD and GO, respectively.

METHODS

The gut microbial communities of the fecal samples of 30 GD patients without GO, 33 GO subjects, and 32 healthy subjects were analyzed and compared by 16S rRNA gene sequencing.

RESULTS

At the phylum level, the proportion of Deinococcus-Thermus and Chloroflexi was decreased significantly in GO patients as compared to GD. At the genus level, the proportion of Subdoligranulum and Bilophila was increased while that of Blautia, Anaerostipes, Dorea, Butyricicoccus, Romboutsia, Fusicatenibacter, unidentified_ Lachnospiraceae, unidentified_Clostridiales, Collineslla, Intestinibacter, and Phascolarctobacterium was decreased in the GO group as compared to the GD group. Random forest analysis was used for the identification of specific intestinal microbiota, and Deinococcus-Thermus, Cyanobacteria and Chloroflexi were ranked in the top ten according to their contributions to sample classification. Moreover, compared to the control, there were multiple gut bacterial enrichment metabolic pathways in GO and GD patients, including nucleotide metabolism, enzyme family, and energy metabolism. Compared to GO, the only enrichment metabolic pathway found in GD was the viral protein family.

CONCLUSIONS

This study highlighted the significant differences in the intestinal microbiota and predictive functions of GD with GO, thereby providing new insights into the role of the gut bacteria that might contribute to the development of GO in GD patients.

OP0001 BARICITINIB, TOFACITINIB, UPADACITINIB, FILGOTINIB, AND CYTOKINE SIGNALING IN HUMAN LEUKOCYTE SUBPOPULATIONS: AN UPDATED EX-VIVO COMPARISON

Background:

everal JAKi are now used for the treatment of RA; approved doses include baricitinib (bari) 2- and/or 4-mg QD, tofacitinib (tofa) 5-mg BID, upadacitinib (upa) 15-mg QD. The JAK selectivity these agents is proposed to vary across the class.

Objectives:

In vitro cellular pharmacology of bari to tofa, upa, and filgotinib (filgo) were compared.

Methods:

PBMCs from 6 healthy donors were incubated with the JAKis over a 7- to 8-point concentration range. Following cytokine stimulation, levels of pSTAT were measured and IC50 calculated in gated leukocyte subpopulations. Therapeutic dose relevance was assessed using calculated mean concentration-time (CT) profiles over 24 hours for bari 2- and 4-mg QD; tofa 5- and 10-mg BID; upa 15- and 30-mg QD; filgo 100- and 200-mg QD. Average daily % inhibition of pSTAT (%SI) was calculated for each JAKi, cytokine, and cell type; filgo %SI integrated parent drug + metabolite.

Results:

The cytokines did not signal in all cell types (Figure 1). When signaling was detected, IC50 and %SI for a particular JAKi were generally similar across cell types, with dose-dependent inhibition (Figures 1 & 2). Based on IC50s, upa was most and filgo/metabolite least potent across JAK2/2 or JAK2/TYK2-dependent (IL-3, GM-CSF, G-CSF), JAK1/3-dependent (IL-2, 4, 15, 21), and JAK1/2/TYK2 dependent (IL-6 & 10, IFN-α & γ) signaling pathways.

Figure 1.

IC50 values (nM) for baricitinib, tofacitinib, upadacitinib, filgotinib (parent and metabolite) in cytokine-stimulated human PBMC preparations. *p<0.01, **p<0.001, ***p<0.0001 vs. bari.

Incorporating CT profiles, no agent potently or continuously inhibited an individual cytokine signaling pathway throughout the dosing interval. Comparing bari 4-mg to tofa 5-mg BID, upa 15-mg QD, and filgo 100-mg QD, %SI of JAK2/2 or JAK2/TYK2-dependent cytokines was highest with bari 4-mg and upa. Inhibition of JAK1/2/TYK2 cytokines was highest with bari 4-mg. Inhibition of JAK2/2 or JAK2/TYK2, and of JAK1/3-dependent cytokines was lowest for filgo 100-mg QD. For bari 2-mg QD vs. these other JAKi doses, %SI of JAK2/2 or JAK2/TYK2 was highest with upa followed by bari 2-mg. The highest inhibitors of the JAK1/2/TYK2-dependent cytokines varied by cytokine / cell type though consistently included upa. Inhibition of JAK1/3 was highest for upa and tofa. Across comparisons, filgo 100-mg QD showed the least %SI of JAK2/2 or JAK2/TYK2-dependent, and of JAK1/3-dependent cytokines. Filgo reached the highest levels of %SI among agents only for 200-mg QD vs. lower doses of the other JAKi (for selected JAK1/2/TYK2-dependent cytokines).

Conclusion:

JAKis display different in vitro pharmacologic profiles which, coupled to their in vivo pharmacokinetics, suggest they modulate distinct cytokine pathways to differing degrees and durations over 24 hours. Ex vivo whole cell assays seem distinct from cell free kinase inhibition assays in determining the overall cytokine modulatory potential of members of the JAKi class.

References:

[1]McInnes IB, et al. Arthritis Res Ther. 2019 Aug 2;21(1):183

Figure 2.

Baricitinib, tofacitinib, upadacitinib, filgotinib: calculated average percent daily STAT inhibition for selected cytokines. -p<0.01, --p<0.001, ---p<0.0001 significantly lower compared to bari (vs. 2-mg if left of vertical line “|”, vs. 4-mg if right of vertical line “|”). +p<0.01, ++p<0.001, +++p<0.0001 significantly higher compared to bari (vs. 2-mg if left of vertical line “|”, vs. 4-mg if right of vertical line “|”).

Disclosure of Interests:

Iain McInnes Grant/research support from: Bristol-Myers Squibb, Celgene, Eli Lilly and Company, Janssen, and UCB, Consultant of: AbbVie, Bristol-Myers Squibb, Celgene, Eli Lilly and Company, Gilead, Janssen, Novartis, Pfizer, and UCB, Guilherme Rocha Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company, Richard E Higgs Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company, Daniel Dairaghi Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company, Thomas Wehrman Shareholder of: An insignificant amount in AbbVie as part of a larger portfolio, Consultant of: Primity Bio Inc. works with many pharmaceutical and biotech companies and provides CRO services., Evan Wang Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company, Zhang Xin Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company, Jorge Ross Terres Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company, Terence Rooney Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company, Peter C. Taylor Grant/research support from: Celgene, Eli Lilly and Company, Galapagos, and Gilead, Consultant of: AbbVie, Biogen, Eli Lilly and Company, Fresenius, Galapagos, Gilead, GlaxoSmithKline, Janssen, Nordic Pharma, Pfizer Roche, and UCB

Clinical and genetic analysis of idiopathic normophosphatemic tumoral calcinosis in 19 patients

PURPOSE

Tumoral calcinosis is a rare clinicopathological entity characterized by ectopic soft-tissue calcification, typically periarticular. Normophosphatemic tumoral calcinosis is seldom reported in East Asian populations, and the preoperative diagnosis is often elusive. This study was performed to characterize the clinical profile of normophosphatemic tumoral calcinosis and investigate the presence of the SAMD9 gene mutation.

METHODS

The clinical features, pathological examination findings, and outcomes of 19 subjects were retrospectively reviewed. All patients were analyzed for SAMD9 gene mutation using paraffin-embedded tumoral calcinosis specimens.

RESULTS

Nineteen subjects were analyzed (7 males, 12 females). Their mean age at surgery, mean age at symptom onset, and median disease duration was 51.9 ± 17.3 (range 7-75) years, 49.1 ± 17.2 (range 7-74) years, and 1.3 (interquartile range 0.5-3.0) years, respectively. Lesions were located in the hand in 8 (42.1%) subjects; wrist in 5 (26.3%); shoulder in 2 (10.5%); and hip, knee, buttock, and scrotum in 1 (5.3%) subject each. The lesions in 17 (89.5%) subjects were located around the joints [small joints (hand and wrist) in 13 (68.4%) and large joints (shoulder, hip, and knee) in 4 (21.1%)]. Lesions occurred in the upper limbs in 15 (78.9%) subjects and in the lower limbs in 2 (10.5%). Multiple-lesion involvement (distal right index finger and middle finger) occurred in one (5.3%) subject. Symptoms included pain in 15 (78.9%) subjects, impaired mobility in 5 (26.3%), swelling in 5 (26.3%), numbness in 2 (10.5%), and an asymptomatic mass in 2 (10.5%). The serum inorganic phosphorus concentration was normal in all 19 subjects (mean 1.17 ± 0.15 mmol/L). The serum calcium concentration was normal in 18 subjects and low in 1. The serum alkaline phosphatase concentration was normal in all 19 subjects. Pathological examination indicated multiple nodules of calcified materials that manifested an amorphous or granular blue-purple crystal and were surrounded by proliferation of mononuclear or multinuclear macrophages, osteoclastic-like giant cells, fibroblasts, and chronic inflammatory cells. Notably, different phases of pathological manifestations were observed in the same microscopic field. During follow-up (0.5-65.0 months), no recurrence of tumoral calcinosis was observed in 18 (94.7%) subjects, but 1 subject developed in situ recurrence of an asymptomatic subcutaneous mass after 6 months postoperatively. Genetic analysis in all 19 subjects revealed no SAMD9 gene mutations.

CONCLUSIONS

Most subjects were females and developed calcinosis in adulthood. Small joints (hand and wrist) and the upper limbs were frequently involved. The presence of different phases of pathological features in the same subject suggests that about half of the study participants had been misdiagnosed with another condition (such as gout, osteoarthritis, etc.). Complete surgical excision led to cure without recurrence during follow-up in majority of the study participants.

Alterations in the intestinal microbiota of patients with severe and active Graves' orbitopathy: a cross-sectional study

BACKGROUND

The intestinal microbiota was linked to autoimmune diseases. Graves' orbitopathy (GO) is an autoimmune disease that is usually associated with Graves' disease. However, information on the microbiome of GO patients is yet lacking.

OBJECTIVES

To investigate whether GO patients differ from healthy controls in the fecal microbiota.

DESIGN

A cross-sectional study.

SETTING

33 patients with severe and active GO and 32 healthy controls of Han nationality were enrolled between March 2017 and March 2018.

METHODS

The Gut microbial communities of the fecal samples of GO patients and healthy controls were analyzed and compared by 16S rRNA gene sequencing.

RESULTS

Community diversity (Simpson and Shannon) was significantly reduced in fecal samples from patients with GO as compared to controls (p < 0.05). The similarity observed while assessing the community diversity (PCoA) proposed that the microbiota of patients with GO differ significantly from those of controls (p < 0.05). At the phyla levels, the proportion of Bacteroidetes increased significantly in patients with GO (p < 0.05), while at the genus and species levels, significant differences were observed in the bacterial profiles between the two groups (p < 0.05).

LIMITATIONS

Single-centered study design and limited fecal samples.

CONCLUSIONS

The present study indicated distinctive features of the gut microbiota in GO patients. The study provided evidence for further exploration in the field of intestinal microbiota with respect to the diagnosis and treatment of GO patients by modifying the microbiota profile.

Depth of field extension and objective space depth measurement based on wavefront imaging

When all the parts of the wavefront imaging system are kept static after wavefront measuring, the target's images are blurry, because the depth of field (DOF) of the system affects the imaging quality. In this paper, the method for extending the DOF of the wavefront imaging system through an integrated architecture of a liquid-crystal microlens array (LCMLA) powered by electricity and a common photosensitive array, is presented. The DOF can be extended remarkably only by stitching together several sub-images of the LCMLA. The problem that the wavefronts and imaging results are insensitive to the objective depth is also solved. Optimal driving voltage signals are found out according to Sobel mean gradient to efficiently calibrate the depth of objective space in order to quantitatively measure the depth. The approach indicates a viable way to effectively extend the DOF of imaging micro-systems and to measure the geometrical depth of targets at the same time.

Bisphosphonates for the preservation of periprosthetic bone mineral density after total joint arthroplasty: a meta-analysis of 25 randomized controlled trials

The present meta-analysis aimed to evaluate the long-term efficacy of bisphosphonates (BPs) on preservation of periprosthetic bone mineral density (BMD) after joint arthroplasty. It confirmed the protective effect of BPs in a long-term follow-up, and found the influence factors on this effect.

INTRODUCTION

Periprosthetic bone loss is believed to cause aseptic loosening and failed prosthetic fixation in joint arthroplasty. This meta-analysis which included high-quality randomized controlled trials aimed to analyze the effect of bisphosphonates on maintaining periprosthetic bone mineral density after total joint arthroplasty.

METHODS

Twenty-five RCTs were included and the total number of participants was 1163 by computerized searches of bibliographic databases. The weighted mean differences with 95% confidence interval were calculated to evaluate the efficacy of BPs on total periprosthetic BMD and the BMD of different Gruen zones. Subgroup analyses identified the potentially influencing factors such as surgical site, cement fixation, and generation of BPs. A descriptive review was conducted for BP-related adverse effects.

RESULTS

The BPs group presented significantly higher total periprosthetic BMD in the BPs group than that in the control group at 3, 6, 12 months, 2-4 years, and 5-10 years after arthroplasty (P < 0.05). The BPs group presented significantly higher periprosthetic BMD in femoral Gruen Zone 1 and 7 than that in the control group at 3, 6, 12 months, 2-4 years, and 5-10 years (P < 0.05). The heterogeneity was minimized by dividing THA and TKA into two subgroups. Subgroup analyses revealed that the effect of BPs on preservation of BMD was significantly greater in arthroplasty with cemented component than in that with uncemented component at 12 months and 5-10 years (P < 0.05), and the administration of the second and third generation BPs was significantly more effective than the first-generation BPs at 6 and 12 months (P < 0.05). None of the included studies described severe or fatal adverse effects related to BPs.

CONCLUSIONS

BPs have significantly long-term efficacy on the preservation of periprosthetic BMD after joint arthroplasty. To obtain a better efficacy, the cemented components and the second and third generation BPs are recommended.

A genome-wide DNA methylation analysis in peripheral blood from patients identifies risk loci associated with Graves' orbitopathy

OBJECTIVE

Graves' orbitopathy (GO) is an inflammatory orbital disease of autoimmune origin with the potential to cause severe functional and psychosocial effects. The pathogenesis has not been fully elucidated. We investigated whether DNA methylation was associated with GO incidence in Chinese patients.

MATERIALS AND METHODS

Six GO patients and six age-matched controls were recruited, and genome-wide DNA methylation patterns were analyzed in their peripheral blood. t tests were performed to determine differential methylated sites in genomic regions and the univariable logistic regression analyses was performed to evaluate their risk with GO incidence. Cluster analysis and principal component analysis (PCA) were performed to determine the effects of the extracted differentially methylated sites.

RESULTS

One hundred and forty-eight differentially methylated sites were identified, including CD14 (fold change = 4.31, p = 0.005), IL17RE (fold change = 2.128, p = 0.005), and DRD4 (fold change = 0.25, p = 0.004), and were supported by cluster and PCA analyses. Univariable logistic regression analyses showed that the methylation patterns at 12 loci were associated with GO incidence. The relative risk per 1% decrease in methylation at ZCCHC6 and GLI3 was 0.15 (95% CI 0.03-0.91; p = 0.039) and 0.65 (95% CI 0.42-0.98; p = 0.042), respectively. Pearson correlation analyses demonstrated that methylation levels at IL17RE were positively associated with Clinical Activity Score (CAS) (r = 0.967, p < 0.05).

CONCLUSIONS

Our results demonstrate that differential methylation levels at analyzed sites (genes) may be risk markers of GO. DNA methylation analysis could provide new insights into understanding the disease and provide new treatment strategies for GO in Chinese patients.

Targeted gene therapy and in vivo bioluminescent imaging for monitoring postsurgical recurrence and metastasis in mouse models of liver cancer

We investigated the effects of combined targeted gene therapy on recurrence and metastasis after liver cancer resection in nude mice. Twenty BALB/C mice were randomly divided into control and treatment groups with 10 mice in each group and a male/female ratio of 1:1. Luciferase gene-labeled human primary hepatic carcinoma cell line MHCC97-H was then used to prepare a carcinoma model. An optical in vivo imaging technique (OIIT) was used 10 days later to detect the distribution of tumor cells, followed by partial liver resection and gene therapy. In the treatment group, 100 mL phosphate-buffered saline (PBS) containing 1 x 1012 rAAV/AFP/IL-24 gene viral vectors was injected into liver sections and peritumoral posterior peritoneal tissues; in the control group, the same amount of PBS containing 1 x 1012 empty viral vectors was injected at the same sites. OIIT was then used to detect the in vivo tumor metastasis 21 days later. Luciferase gene-labeled human primary hepatic carcinoma cell line MHCC97-H successfully infected 20 nude mice, and OIIT showed that the two groups exhibited metastasis after local tumor resection, but there were more tumor cells in the control group (P < 0.05). rAAV/AFP/IL-24 gene therapy can inhibit recurrence after liver cancer resection.

Effect of daily sildenafil on patients with absent nocturnal erections due to pelvic fracture urethral disruption: a single-centre experience

Erectile dysfunction (ED) is a common sequel of pelvic fracture urethral disruption. Those patients with nocturnal erections may respond favourably to sildenafil; however, little is known about the response to sildenafil in patients with absent nocturnal erections. The aim was to evaluate the response to the treatment of sildenafil 50 mg taken once daily in the patients with absent nocturnal erections. From January 2008 to December 2011, a total of 28 patients with absent nocturnal erections were evaluated. We recorded nocturnal penile tumescence and rigidity with an erectometer. If nocturnal erections were absent for three nights, patients were administrated sildenafil 100 mg at bedtime and tested again at the fourth night. Penile duplex ultrasound with intracavernous injection was performed to define the cause of ED. All patients received a daily dose of sildenafil 50 mg for 12 weeks. Response to sildenafil treatment was defined as sustained erections allowing vaginal penetration and intercourse. Twenty-three (78%) patients completed the daily sildenafil treatment, and follow-up was available. The nocturnal erections at the fourth night in 13 patients (46.4%) were improved. About 61.5% (8/13) reported effective response to daily sildenafil. The improvement of nocturnal erections induced by sildenafil taken at bedtime might predict the response to sildenafil taken daily.

A smart core-sheath nanofiber that captures and releases red blood cells from the blood

A smart core-sheath nanofiber for non-adherent cell capture and release is demonstrated. The nanofibers are fabricated by single-spinneret electrospinning of poly(N-isopropylacrylamide) (PNIPAAm), polycaprolactone (PCL) and nattokinase (NK) solution blends. The self-assembly of PNIPAAm and PCL blends during the electrospinning generates the core-sheath PCL/PNIPAAm nanofibers with PNIPAAm as the sheath. The PNIPAAm-based core-sheath nanofibers are switchable between hydrophobicity and hydrophilicity with temperature change and enhance stability in the blood. When the nanofibers come in contact with blood, the NK is released from the nanofibers to resist platelet adhesion on the nanofiber surface, facilitating the direct capture and isolation of red blood cells (RBCs) from the blood above phase-transition temperature of PNIPAAm. Meanwhile, the captured RBCs are readily released from the nanofibers with temperature stimuli in an undamaged manner. The release efficiency of up to 100% is obtained while maintaining cellular integrity and function. This work presents promising nanofibers to effectively capture non-adherent cells and release for subsequent molecular analysis and diagnosis of single cells.

Treatment of different-aged children under bispectral index monitoring with intravenous anesthesia with propofol and remifentanil

OBJECTIVE

To investigate the changes in bispectral index (BIS) to determine the controllability and safety of intravenous anesthesia with propofol and remifentanil in different-aged children.

PATIENTS AND METHODS

Forty cases of ASA levels I or II were divided into four groups (A group, ≤ three months old; B group, three months to two years old; C group, two years to six years old; and D group, six years to 12 years old) with 10 cases in each group. Propofol and remifentanil were used in anesthesia induction and maintenance. Hemodynamic changes, BIS values, and sedation scores during T1, T2, T3, T4, T5, T6, and T7, as well as spontaneous breathing recovery and extubation times, were recorded.

RESULTS

Compared with that at T1, the BIS values at T2, T3, T4, T5, and T6 decreased (p < 0.01). SBP, DBP, and HR also decreased (p < 0.01). Compared with the other groups, the extubation time of A group increased (p < 0.01). At T2, T3, T4, T5, T6, and T7, the BIS values of A group were all less than those of C group (p < 0.01).

CONCLUSIONS

Anesthesia is stable and safe when the same unit doses of propofol and remifentanil are administered to different-aged children. In infants under three months, the BIS values were lower, with prolonged palinesthesia time.

Characterization, tissue distribution and regulation of neuropeptideY in Schizothorax prenanti

In this study, the full-length neuropeptide Y (npy) complementary (c)DNA was cloned in ya fish Schizothorax prenanti. npy cDNA was composed of 789 nucleotides with a 288 nucleotide open reading frame encoding a protein of 96 amino acids. The deduced amino acid sequences contained a 28 amino acids signal peptide followed by a 36 amino acids mature neuropeptide Y (NPY). The npy mRNA was expressed mainly in the brain and eye as detected by real-time quantitative polymerase chain reaction RT-PCR (rt-qPCR). The S. prenanti NPY was detectable from blastulation to hatch, suggesting that npy might be involved in the late embryonic development of S. prenanti. An experiment was conducted to determine the expression profile of npy during feeding of a single meal and during long-term fasting. The expression level of npy in fed fish was significantly decreased at 0.5, 1.5, 3 and 9 h post-feeding (hpf) than in fasting fish. Fasting for 14 days induced an increase in npy messenger (m)RNA expression in the brain. Overall, the results suggest that NPY is a conserved peptide that might be involved in the regulation of feeding and other physiological function in S. prenanti.

Characterization of Schizothorax prenanti cgnrhII gene: fasting affects cgnrhII expression

In this study, the role of chicken gonadotropin-releasing hormone II (cgnrhII) in feeding regulation was investigated in Schizothorax prenanti. First, the full-length S. prenanti cgnrhII cDNA consisted of 693 bp with an open reading frame of 261 bp encoding a protein of 86 amino acids. Next, cgnrhII was widely expressed in the central and peripheral tissues. Last, there were significant changes in cgnrhII mRNA expression in the fasted group compared to the fed group in the S. prenanti hypothalamus during 24 h fasting (P < 0.05). Furthermore, the cgnrhII gene expression presented a significant decrease in the fasted group compared with the fed group (P < 0.05) on days 3, 5 and 7, after re-feeding, there was no significant changes in cgnrhII mRNA expression level between refed and fed group on day 9 (P > 0.05). Thus, the results suggest that cGnRH II expression is influenced by fasting and the gene may be involved in feeding regulation in S. prenanti.

Outcome of nerve transfers for traumatic complete brachial plexus avulsion: results of 28 patients by DASH and NRS questionnaires

The objective of this study was to evaluate outcomes of patients who suffered complete brachial plexus avulsion before and after nerve transfers by assessing upper extremity function and pain using the DASH and NRS questionnaires. Patients who underwent nerve transfers improved their DASH and NRS scores compared with before surgery. Although individually there was no correlation with improved scores, the triple combination of rehabilitation exercises, electrical stimulation therapy and neurotrophic drugs postoperatively correlated positively with improved functional outcomes. This study suggested a positive effect of the passage of time and nerve transfers in total brachial plexus avulsions from patients' self assessments.

Different biological properties of circulating and bone marrow endothelial progenitor cells in acute myocardial infarction rats

BACKGROUND

Many studies have shown that endothelial progenitor cell (EPC) can enhance the neovascularization of the ischemic myocardium. Peripheral blood and bone marrow are the most convenient resources for EPC.

OBJECTIVE

The aim of the study was to investigate, in vitro and in vivo, the different biological properties between circulating EPC (CEPC) and bone marrow EPC (BM-EPC) of AMI rats.

METHODS

The proliferative, migrative, adherent and angiogenic properties were investigated in vitro. 1 x 10 (6) CEPCs, 1 x 10 (6) BM-EPCs and medium (EBM-2) were injected in the myocardium of AMI rats. Echocardiography, regional myocardial blood flow (RMBF), capillary density and Y chromosome fluorescence in situ hybridization (FISH) were performed at 4 weeks after transplantation.

RESULTS

The CEPCs had higher proliferative, migrative, adherent capabilities and lower senescent ratio, could adhere more quickly to fibronectin than BM-EPCs. CEPCs could form capillary-like structures whereas BM-EPCs did not show similar structures on Matrigel. in vivo, transplanted CEPCs and BM-EPCs were found in cardiac tissue by FISH. CEPCs treatment led to a better cardiac function, RMBF and capillary density than BM-EPCs.

CONCLUSION

Different biological properties were observed between CEPCs and BM-EPCs. Autologous CEPCs are more suitable for the AMI rat.