Desirable Strong and Tough Adhesive Inspired by Dragonfly Wings and Plant Cell Walls

The production of wood-based panels has a significant demand for mechanically strong and flexible biomass adhesives, serving as alternatives to nonrenewable and toxic formaldehyde-based adhesives. Nonetheless, plywood usually exhibits brittle fracture due to the inherent trade-off between rigidity and toughness, and it is susceptible to damage and deformation defects in production applications. Herein, inspired by the microstructure of dragonfly wings and the cross-linking structure of plant cell walls, a soybean meal (SM) adhesive with great strength and toughness was developed. The strategy was combined with a multiple assembly system based on the tannic acid (TA) stripping/modification of molybdenum disulfide (MoS2@TA) hybrids, phenylboronic acid/quaternary ammonium doubly functionalized chitosan (QCP), and SM. Motivated by the microstructure of dragonfly wings, MoS2@TA was tightly bonded with the SM framework through Schiff base and strong hydrogen bonding to dissipate stress energy through crack deflection, bridging, and immobilization. QCP imitated borate chemistry in plant cell walls to optimize interfacial interactions within the adhesive by borate ester bonds, boron-nitrogen coordination bonds, and electrostatic interactions and dissipate energy through sacrificial bonding. The shear strength and fracture toughness of the SM/QCP/MoS2@TA adhesive were 1.58 MPa and 0.87 J, respectively, which were 409.7% and 866.7% higher than those of the pure SM adhesive. In addition, MoS2@TA and QCP gave the adhesive good mildew resistance, durability, weatherability, and fire resistance. This bioinspired design strategy offers a viable and sustainable approach for creating multifunctional strong and tough biobased materials.

Urban airborne PM2.5 induces pulmonary fibrosis through triggering glycolysis and subsequent modification of histone lactylation in macrophages

Airborne fine particulate matter (PM2.5) can cause pulmonary inflammation and even fibrosis, however, the underlying molecular mechanisms of the pathogenesis of PM2.5 exposure have not been fully appreciated. In the present study, we explored the dynamics of glycolysis and modification of histone lactylation in macrophages induced by PM2.5-exposure in both in vivo and in vitro models. Male C57BL/6 J mice were anesthetized and administrated with PM2.5 by intratracheal instillation once every other day for 4 weeks. Mouse RAW264.7 macrophages and alveolar epithelial MLE-12 cells were treated with PM2.5 for 24 h. We found that PM2.5 significantly increased lactate dehydrogenase (LDH) activities and lactate contents, and up-regulated the mRNA expression of key glycolytic enzymes in the lungs and bronchoalveolar lavage fluids of mice. Moreover, PM2.5 increased the levels of histone lactylation in both PM2.5-exposed lungs and RAW264.7 cells. The pro-fibrotic cytokines secreted from PM2.5-treated RAW264.7 cells triggered epithelial-mesenchymal transition (EMT) in MLE-12 cells through activating transforming growth factor-β (TGF-β)/Smad2/3 and VEGFA/ERK pathways. In contrast, LDHA inhibitor (GNE-140) pretreatment effectively alleviated PM2.5-induced pulmonary inflammation and fibrosis via inhibiting glycolysis and subsequent modification of histone lactylation in mice. Thus, our findings suggest that PM2.5-induced glycolysis and subsequent modification of histone lactylation play critical role in the PM2.5-associated pulmonary fibrosis.

Polystyrene microplastic-induced oxidative stress triggers intestinal barrier dysfunction via the NF-κB/NLRP3/IL-1β/MCLK pathway

Emerging evidence has demonstrated the association between microplastics (MPs) with a diameter of <5 mm and the risk of intestinal diseases. However, the molecular mechanisms contributing to MP-induced intestinal barrier dysfunction have not been fully appreciated. In this study, C57BL/6 J mice were exposed to polystyrene microplastics (PS-MPs, 0.2, 1 or 5 μm) at 1 mg/kg body weight daily by oral gavage for 28 days. We found that PS-MPs exposure induced oxidative stress and inflammatory cell infiltration in mice colon, leading to an increased expression of pro-inflammatory cytokine. Moreover, there were an increase in intestinal permeability and decrease in mucus secretion, accompanied by downregulation of tight junction (TJ)-related zonula occluden-1 (ZO-1), occluding (OCLN) and claudin-1 (CLDN-1) in mice colon. Especially, 5 μm PS-MPs (PS5)-induced intestinal epithelial TJ barrier damage was more severe than 0.2 μm PS-MPs (PS0.2) and 1 μm PS-MPs (PS1). In vitro experiments indicated that PS5-induced oxidative stress upregulated the expression of nuclear factor kappa B (NF-κB), nucleotide-binding domain and leucine-rich repeat protein 3 (NLRP3) inflammasome, and myosin light chain kinase (MLCK). Meanwhile, pre-treatment with the antioxidant NAC, NLRP3 inhibitor MCC950 and MLCK inhibitor ML-7 considerably reduced PS5-triggered reactive oxygen species (ROS) production and inflammatory response, inhibited the activation of the NF-κB/NLRP3/MLCK pathway, and upregulated ZO-1, OCLN and CLDN-1 expression in Caco-2 cells. Taken together, our study demonstrated that PS-MPs cause intestinal barrier dysfunction through the ROS-dependent NF-κB/NLRP3/IL-1β/MLCK pathway.

Assessment of choriocapillaris and choroidal vascular changes in posterior uveitis using swept-source wide-field optical coherence tomography angiography

PURPOSE

To evaluate choriocapillaris (CC) and choroidal vascular changes in patients with posterior uveitis using swept-source (SS) wide-field optical coherence tomography angiography (OCTA).

METHOD

Consecutive patients with posterior uveitis were evaluated using 3×3 mm and 12×12 mm OCTA scan patterns and montage images of 5×12×12 mm or 2×15×9 mm, covering approximately 70°-90° of the retina. The images were quantitatively and qualitatively analysed and compared with healthy controls.

RESULTS

Eighty-six eyes of 56 patients with posterior uveitis (mean age 45.2±19.9 years; 58.9% female), and 38 eyes of 19 age-matched healthy controls (57.9% female) were included. The mean perfusion density (PD) in 3×3 mm and 12×12 mm CC scans was significantly lower in eyes with posterior uveitis compared with those of healthy controls. However, no significant difference in the mean PD of choroidal scans was found comparing eyes with posterior uveitis and healthy controls. The mean PD in eyes with active disease was significantly higher compared with the inactive eyes on 12×12 mm choroidal scans (55.61% vs 51.25%, p=0.02), while no difference was found in the CC slabs.

CONCLUSION

CC and choroidal assessment using OCTA provides useful information in patients with posterior uveitis. SS-OCTA metrics of the CC and choroidal slabs are promising tools in uveitis patients in the future.

TRIAL REGISTRATION NUMBER

NCT02811536.

[Associations of blood pressure change with change in foods' intake among adults with mild to moderate hypertension]

Objective: To explore the association between the intake and changes in various types of food and the changes in blood pressure in patients with mild to moderate hypertension. Methods: Mild to moderate hypertension participants with complete baseline and outcome data were included from DECIDE-Diet study, a multicenter, randomized controlled trial. Dietary records and blood pressure measurements at both 7-day run-in (baseline) and 28-day intervention phases were collected for enrolled participants. Blood pressure change was defined as the difference between blood pressure at the end of trial and the baseline blood pressure. Baseline intake of food was the average daily intake during the run-in period, and the intake increment was defined as the difference between the average intake during the trial period and the average intake during the run-in period. After adjusting for age, sex, study center, intervention groups, baseline body mass index (kg/m2), antihypertension medication use, and baseline total calorie intake, a linear regression model was used to analyze the associations of the before-after-intervention change in blood pressure with baseline intake and intake increment of foods. Results: A total of 258 patients with mild to moderate hypertension were included, including 133 males, aged (56.5±9.9) years. (1) After adjusting for confounding factors, there was no significant association between baseline intake of food and baseline blood pressure (all P>0.05). The blood pressure change was negatively associated with baseline intakes of tubers, vegetables, and vegetable oils but positively with baseline intake of meats; and was negatively associated with intake increment of whole grains and fish (all P<0.05). (2) The multiple linear regression analysis showed that baseline intake of vegetables (β=-0.021, P=0.004), vegetable oils (β=-0.260, P=0.002), and increment in intake of fish (β=-0.128, P=0.026) were all significantly associated with changes in systolic blood pressure; baseline intake of vegetables (β=-0.017, P=0.002), vegetable oils (β=-0.182, P=0.001), dairy products (β=0.021, P=0.022), and increment in intake of fish (β=-0.092, P=0.010) were all significantly associated with changes in diastolic blood pressure. Conclusion: Increasing the intake of whole grains, vegetables, vegetable oils, and fish and decreasing the intake of meat may be beneficial for blood pressure control in patients with mild to moderate hypertension.

A tough bio-adhesive inspired by pearl layer and arthropod cuticle structure with desirable water resistance, flame-retardancy, and antibacterial property

Petroleum-derived formaldehyde resin adhesives are serious hazards to human health and depend on limited resources. Abundant, cheap and renewable biomass materials are expected to replace them. However, the contradictory mechanisms of high mechanical strength and fracture toughness affect the use of bioadhesives. Herein, a biomimetic soybean meal (SM) adhesive inspired by the structure of insect cuticles and shell pearl layer was proposed. Specifically, chitosan (CS@DA) modified 3,4-dihydroxybenzoic acid (DA, rich in catechol moiety) was anchored on molybdenum disulfide nanosheets (MoS2) to construct a biomimetic structure with copper hydroxide and SM substrate (SM-MoS2/CS@DA-Cu). Schiff base, ionic, and hydrogen bonding strengthened the cohesion of the adhesive. The ordered alternating stacking "brick-mortar" structure stimulated the lamellar sliding and crack deflection of MoS2, synergistically reinforcing the toughness. Compared to SM adhesive (0.57 MPa and 0.148 J), the wet shear strength and adhesion work of the SM-MoS2/CS@DA-Cu were 1.68 MPa and 0.867 J, with 194.7 % and 485.8 % increases, respectively. The multiple antimicrobial effects of CS@DA, Schiff base, and Cu2+ increased the applicability period of the adhesive to 40 days. The adhesive also displayed favorable water resistance and flame retardancy. Therefore, this peculiar and efficient biomimetic structural design inspired the development of multi-functional composites.

Study on the Performance and Solidification Mechanism of Multi-Source Solid-Waste-Based Soft Soil Solidification Materials

In this paper, ground granulated blast furnace slag, steel slag, red mud, waste ceramic powder, and desulfurization gypsum were used as raw materials to develop a kind of multi-source solid-waste-based soft soil solidification material. Three ratios and the strength activity index were used to determine the fractions of different solid wastes. The mineralogical and microstructural characterization was analyzed by X-ray diffraction (XRD), scanning electron microscope (SEM), and thermogravimetric analysis-differential scanning calorimetry (TG&DSC) tests. The results showed that the unconfined compressive strength of the three types of soft soil increases with an increase in the content of the solidifying agent. The failure strain of the stabilized soil decreases from 1.0-1.3% to 0.75-1.0%, and the failure mode gradually changes from plastic failure to brittle failure. The optimum content of the solidifying agent was determined to be 17% (the lime saturation factor (KH), silica modulus (SM), and alumina modulus (IM) of the solidifying agent were set to 0.68, 1.74, and 1.70, respectively), and the unconfined compressive strength (28 d) of the solidified soil (sandy soil, silty clay, and organic clay) was 3.16 MPa, 2.05 MPa, 1.04 MPa, respectively. Both measurements can satisfy the technical requirements for a cement-soil mixing pile, suggesting the possibility of using various types of solid waste as a substitute for cement.

A Self-Supervised Learning Based Framework for Eyelid Malignant Melanoma Diagnosis in Whole Slide Images

Eyelid malignant melanoma (MM) is a rare disease with high mortality. Accurate diagnosis of such disease is important but challenging. In clinical practice, the diagnosis of MM is currently performed manually by pathologists, which is subjective and biased. Since the heavy manual annotation workload, most pathological whole slide image (WSI) datasets are only partially labeled (without region annotations), which cannot be directly used in supervised deep learning. For these reasons, it is of great practical significance to design a laborsaving and high data utilization diagnosis method. In this paper, a self-supervised learning (SSL) based framework for automatically detecting eyelid MM is proposed. The framework consists of a self-supervised model for detecting MM areas at the patch-level and a second model for classifying lesion types at the slide level. A squeeze-excitation (SE) attention structure and a feature-projection (FP) structure are integrated to boost learning on details of pathological images and improve model performance. In addition, this framework also provides visual heatmaps with high quality and reliability to highlight the likely areas of the lesion to assist the evaluation and diagnosis of the eyelid MM. Extensive experimental results on different datasets show that our proposed method outperforms other state-of-the-art SSL and fully supervised methods at both patch and slide levels when only a subset of WSIs are annotated. It should be noted that our method is even comparable to supervised methods when all WSIs are fully annotated. To the best of our knowledge, our work is the first SSL method for automatic diagnosis of MM at the eyelid and has a great potential impact on reducing the workload of human annotations in clinical practice.

Automated quantification of cartilage quality for hip treatment decision support

Purpose

Preservation surgery can halt the progress of joint degradation, preserving the life of the hip; however, outcome depends on the existing cartilage quality. Biochemical analysis of the hip cartilage utilizing MRI sequences such as delayed gadolinium-enhanced MRI of cartilage (dGEMRIC), in addition to morphological analysis, can be used to detect early signs of cartilage degradation. However, a complete, accurate 3D analysis of the cartilage regions and layers is currently not possible due to a lack of diagnostic tools.

Methods

A system for the efficient automatic parametrization of the 3D hip cartilage was developed. 2D U-nets were trained on manually annotated dual-flip angle (DFA) dGEMRIC for femoral head localization and cartilage segmentation. A fully automated cartilage sectioning pipeline for analysis of central and peripheral regions, femoral-acetabular layers, and a variable number of section slices, was developed along with functionality for the automatic calculation of dGEMRIC index, thickness, surface area, and volume.

Results

The trained networks locate the femoral head and segment the cartilage with a Dice similarity coefficient of 88 ± 3 and 83 ± 4% on DFA and magnetization-prepared 2 rapid gradient-echo (MP2RAGE) dGEMRIC, respectively. A completely automatic cartilage analysis was performed in 18s, and no significant difference for average dGEMRIC index, volume, surface area, and thickness calculated on manual and automatic segmentation was observed.

Conclusion

An application for the 3D analysis of hip cartilage was developed for the automated detection of subtle morphological and biochemical signs of cartilage degradation in prognostic studies and clinical diagnosis. The segmentation network achieved a 4-time increase in processing speed without loss of segmentation accuracy on both normal and deformed anatomy, enabling accurate parametrization. Retraining of the networks with the promising MP2RAGE protocol would enable analysis without the need for B1 inhomogeneity correction in the future.

Evaluation of prognostic risk models for postoperative pulmonary complications in adult patients undergoing major abdominal surgery: a systematic review and international external validation cohort study

BACKGROUND

Stratifying risk of postoperative pulmonary complications after major abdominal surgery allows clinicians to modify risk through targeted interventions and enhanced monitoring. In this study, we aimed to identify and validate prognostic models against a new consensus definition of postoperative pulmonary complications.

METHODS

We did a systematic review and international external validation cohort study. The systematic review was done in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched MEDLINE and Embase on March 1, 2020, for articles published in English that reported on risk prediction models for postoperative pulmonary complications following abdominal surgery. External validation of existing models was done within a prospective international cohort study of adult patients (≥18 years) undergoing major abdominal surgery. Data were collected between Jan 1, 2019, and April 30, 2019, in the UK, Ireland, and Australia. Discriminative ability and prognostic accuracy summary statistics were compared between models for the 30-day postoperative pulmonary complication rate as defined by the Standardised Endpoints in Perioperative Medicine Core Outcome Measures in Perioperative and Anaesthetic Care (StEP-COMPAC). Model performance was compared using the area under the receiver operating characteristic curve (AUROCC).

FINDINGS

In total, we identified 2903 records from our literature search; of which, 2514 (86·6%) unique records were screened, 121 (4·8%) of 2514 full texts were assessed for eligibility, and 29 unique prognostic models were identified. Nine (31·0%) of 29 models had score development reported only, 19 (65·5%) had undergone internal validation, and only four (13·8%) had been externally validated. Data to validate six eligible models were collected in the international external validation cohort study. Data from 11 591 patients were available, with an overall postoperative pulmonary complication rate of 7·8% (n=903). None of the six models showed good discrimination (defined as AUROCC ≥0·70) for identifying postoperative pulmonary complications, with the Assess Respiratory Risk in Surgical Patients in Catalonia score showing the best discrimination (AUROCC 0·700 [95% CI 0·683-0·717]).

INTERPRETATION

In the pre-COVID-19 pandemic data, variability in the risk of pulmonary complications (StEP-COMPAC definition) following major abdominal surgery was poorly described by existing prognostication tools. To improve surgical safety during the COVID-19 pandemic recovery and beyond, novel risk stratification tools are required.

FUNDING

British Journal of Surgery Society.

Vanadium(IV)-Chlorodipicolinate Protects against Hepatic Steatosis by Ameliorating Lipid Peroxidation, Endoplasmic Reticulum Stress, and Inflammation

Non-alcoholic fatty liver disease (NAFLD) is increasingly prevalent and represents a growing challenge in terms of prevention and treatment. The aim of this study is to investigate the protective effects and the underlying mechanisms of vanadium(IV)-chlorodipicolinate ([VIVO(dipic-Cl)(H2O)2, VOdipic-Cl]) in a mouse model of NAFLD induced by a high-fat diet (HFD). VOdipic-Cl (10 mg/kg/day body weight) treatment for 4 weeks significantly controlled body weight gain, and effectively reduced the increase in serum and hepatic triglyceride (TG) and total cholesterol (TC) levels, mitigated pathological injury, decreased malondialdehyde (MDA) level, and inhibited endoplasmic reticulum (ER) stress and inflammatory response in the livers of C57BL/6 obese mice. Moreover, RNA-sequencing analysis revealed distinct transcriptional profiles with differentially expressed genes (DEGs) in livers. We found that VOdipic-Cl effectively down-regulated genes related to lipid synthesis and up-regulated genes related to fatty acid transport and lipolysis, and down-regulated the expression of genes related to ER stress and immune response in the livers of obese mice. In conclusion, VOdipic-Cl effectively prevented hepatic steatosis by controlling body weight, mitigating oxidative stress, and regulating the expression of genes related to lipid metabolism, ER stress and immune response, which provides new insights into the molecular mechanism of the protective effect of VOdipic-Cl against hepatic steatosis.

Comparison of Indocyanine Green Angiography and Swept-Source Wide-Field Optical Coherence Tomography Angiography in Posterior Uveitis

Purpose

To compare indocyanine green angiography (ICGA) and swept-source wide-field optical coherence tomography angiography (SS-OCTA) for the assessment of patients with posterior uveitis.

Method

SS-OCTA montage images of 5 x 12 x 12 mm or 2 x 15 x 9 mm, covering ~70–90 degree of the retina of consecutive patients with posterior uveitis were acquired. The choriocapillaries and choroidal slabs were compared to findings on ICGA.

Results

Sixty-eight eyes of 41 patients were included (mean age 47.2 ± 20.4 years; 58.5% female). In 23 (34%) lesions were visible on OCTA, but not discernable on ICGA. In turn, out of the 45 eyes with clearly discernable lesions on ICGA, 22 (49%) and 21 (47%) eyes showed no corresponding areas of flow deficit on OCTA in the CC and choroidal slab, respectively. Lesion size strongly correlated among ICGA and OCTA choriocapillaries- (CC) (r = 0.99, p ≤ 0.0001) and choroidal slabs (r = 0.99, p ≤ 0.0001), respectively. The mean lesion size on the late frames of ICGA (8.45 ± 5.47 mm²) was larger compared to the lesion size on OCTA CC scan (7.98 ± 5.47 mm², p ≤ 0.0001) and choroidal scan (7.69 ± 5.10 mm², p = 0.002), respectively. The lesion size on OCTA CC scan was significantly larger than on the OCTA choroidal scan (p ≤ 0.0001).

Conclusion

SS-wide field OCTA may be a promising tool to assess posterior uveitis patients and may replace ICGA to a certain extent in the future.

Three-Dimensional Magnetic Resonance Imaging Bone Models of the Hip Joint Using Deep Learning: Dynamic Simulation of Hip Impingement for Diagnosis of Intra- and Extra-articular Hip Impingement

Background:

Dynamic 3-dimensional (3D) simulation of hip impingement enables better understanding of complex hip deformities in young adult patients with femoroacetabular impingement (FAI). Deep learning algorithms may improve magnetic resonance imaging (MRI) segmentation.

Purpose:

(1) To evaluate the accuracy of 3D models created using convolutional neural networks (CNNs) for fully automatic MRI bone segmentation of the hip joint, (2) to correlate hip range of motion (ROM) between manual and automatic segmentation, and (3) to compare location of hip impingement in 3D models created using automatic bone segmentation in patients with FAI.

Study Design:

Cohort study (diagnosis); Level of evidence, 3.

Methods:

The authors retrospectively reviewed 31 hip MRI scans from 26 symptomatic patients (mean age, 27 years) with hip pain due to FAI. All patients had matched computed tomography (CT) and MRI scans of the pelvis and the knee. CT- and MRI-based osseous 3D models of the hip joint of the same patients were compared (MRI: T1 volumetric interpolated breath-hold examination high-resolution sequence; 0.8 mm³ isovoxel). CNNs were used to develop fully automatic bone segmentation of the hip joint, and the 3D models created using this method were compared with manual segmentation of CT- and MRI-based 3D models. Impingement-free ROM and location of hip impingement were calculated using previously validated collision detection software.

Results:

The difference between the CT- and MRI-based 3D models was <1 mm, and the difference between fully automatic and manual segmentation of MRI-based 3D models was <1 mm. The correlation of automatic and manual MRI-based 3D models was excellent and significant for impingement-free ROM (r = 0.995; P < .001), flexion (r = 0.953; P < .001), and internal rotation at 90° of flexion (r = 0.982; P < .001). The correlation for impingement-free flexion between automatic MRI-based 3D models and CT-based 3D models was 0.953 (P < .001). The location of impingement was not significantly different between manual and automatic segmentation of MRI-based 3D models, and the location of extra-articular hip impingement was not different between CT- and MRI-based 3D models.

Conclusion:

CNN can potentially be used in clinical practice to provide rapid and accurate 3D MRI hip joint models for young patients. The created models can be used for simulation of impingement during diagnosis of intra- and extra-articular hip impingement to enable radiation-free and patient-specific surgical planning for hip arthroscopy and open hip preservation surgery.

AGMB-Transformer: Anatomy-Guided Multi-Branch Transformer Network for Automated Evaluation of Root Canal Therapy

Accurate evaluation of the treatment result on X-ray images is a significant and challenging step in root canal therapy since the incorrect interpretation of the therapy results will hamper timely follow-up which is crucial to the patients' treatment outcome. Nowadays, the evaluation is performed in a manual manner, which is time-consuming, subjective, and error-prone. In this paper, we aim to automate this process by leveraging the advances in computer vision and artificial intelligence, to provide an objective and accurate method for root canal therapy result assessment. A novel anatomy-guided multi-branch Transformer (AGMB-Transformer) network is proposed, which first extracts a set of anatomy features and then uses them to guide a multi-branch Transformer network for evaluation. Specifically, we design a polynomial curve fitting segmentation strategy with the help of landmark detection to extract the anatomy features. Moreover, a branch fusion module and a multi-branch structure including our progressive Transformer and Group Multi-Head Self-Attention (GMHSA) are designed to focus on both global and local features for an accurate diagnosis. To facilitate the research, we have collected a large-scale root canal therapy evaluation dataset with 245 root canal therapy X-ray images, and the experiment results show that our AGMB-Transformer can improve the diagnosis accuracy from 57.96% to 90.20% compared with the baseline network. The proposed AGMB-Transformer can achieve a highly accurate evaluation of root canal therapy. To our best knowledge, our work is the first to perform automatic root canal therapy evaluation and has important clinical value to reduce the workload of endodontists.

[Association between dietary vitamin A intake and gestational diabetes mellitus in the first trimester]

Objective: To investigate the relationship between dietary vitamin A intake and its sources in the first trimester and gestational diabetes mellitus (GDM). Methods: A prospective study was conducted to select women at 6-14 weeks of gestation in an obstetric clinic of a maternal and child health care medical institution in Chengdu in 2017. The types and quantities of food during the first trimester were collected by 3-day 24-hour dietary recalls. Dietary vitamin A intake was calculated based on the Chinese Food Composition Table (2018), and it was divided into animal and plant vitamin A intakes according to its food sources. An oral glucose tolerance test was performed at 24-28 weeks of gestation to diagnose GDM according to the Chinese guidelines for diagnosis and treatment of gestational diabetes mellitus (2014). According to the estimated average requirement (EAR) and recommended nutrient intake (RNI), dietary vitamin A intake was divided into low-level group (<EAR), medium-level group (EAR-RNI) and high-level group (>RNI). Animal and plant vitamin A intakes were divided into four groups (Q1-Q4) according to the quartile method, respectively. The association between dietary vitamin A intake, its different sources of vitamin A intake and GDM in the first trimester was analyzed by log-binomial regression models. Results: A total of 1 298 valid samples were finally included. The average dietary vitamin A intake, animal and plant vitamin A intakes in the first trimester were 341.1 (227.8-501.0) μgRAE/d, 139.3 (69.6-195.3) μgRAE/d and 184.2 (99.4-301.1) μgRAE/d, respectively. After adjusting for confounding factors, log-binomial regression analysis showed that the risk of GDM in high-level group of dietary vitamin A intake was lower than that in low-level group [RR (95%CI):0.53 (0.36-0.80)]. Pregnant women in the highest quartile of animal vitamin A intake had a lower risk of GDM than those in the lowest quartile [RR (95%CI):0.66 (0.47-0.95)]. No relationship between plant vitamin A intake and GDM was found. Conclusion: Dietary vitamin A intake in the first trimester is associated with the occurrence of GDM, and higher intake than RNI may reduce the risk of GDM. Higher vitamin A intake from animal-derived food is associated with decreased risk of GDM.

The effect of strength-endurance training on serum and urine metabolic profiles of female adolescent volleyball athletes

Aim

Limited investigations on metabolic responses to exercise training in female adolescent volleyball athletes exist. The aim of this study was to obtain serum and urine metabolite markers in female adolescent volleyball athletes within 2-week strength-endurance training using a metabolomics approach coupled with biochemical analysis, which would be potential biomarkers for evaluating the physiological state of athletes.

Methods

Twelve female adolescent volleyball athletes were recruited for 2-week strength-endurance training. Differential serum and urine metabolic profiles between the pre- and post-training group were obtained on gas chromatography coupled to mass spectrometry (GC-MS) and data subsequently underwent orthogonal partial least-squares analysis (OPLS).

Results

Strength-endurance training exerted a significant influence on the athletes' serum and urine metabolic profiles. The changed metabolites were primarily involved in energy metabolism, lipid metabolism and amino acids metabolism. Results support the hypothesis that female athletes displayed an increased propensity to oxidize lipids as the major energy source. Exposure to strength-endurance training also led to a significant increase in cortisol, but a decrease in testosterone, indicating disordered hormone adjustment. Exercise-induced oxidative stress occurred, as was evidenced by the decrease in reduced glutathione, and increases in blood malondialdehyde and oxidized glutathione. Since the muscle damage markers creatine kinase and lactate dehydrogenase did not show significant changes, the training might not cause cell membrane damage and the athletes did not cross the adaptive injury level.

Conclusion

By measurement of endogenous metabolites, the metabolomics study has the potential to reveal the global physiological changes in response to exercise training.

Posterior Extra-articular Ischiofemoral Impingement Can Be Caused by the Lesser and Greater Trochanter in Patients With Increased Femoral Version: Dynamic 3D CT-Based Hip Impingement Simulation of a Modified FABER Test

Background:

Posterior extra-articular hip impingement has been described for valgus hips with increased femoral version (FV). These patients can present clinically with lack of external rotation (ER) and extension and with a positive posterior impingement test. But we do not know the effect of the combination of deformities, and the impingement location in early flexion is unknown.

Purpose:

To evaluate patient-specific 3-dimensional computed tomography (3D CT) scans of hips with increased FV and control hips for differences in range of motion, location and prevalence of osseous posterior intra- and extra-articular hip impingement.

Study Design:

Case series; Level of evidence, 4.

Methods:

Osseous 3D models based on segmentation of 3D CT scans were analyzed for 52 hips (38 symptomatic patients) with positive posterior impingement test and increased FV (>35°). There were 26 hips with an increased McKibbin instability index >70 (unstable hips). Patients were mainly female (96%), with an age range of 18 to 45 years. Of them, 21 hips had isolated increased FV (>35°); 22 hips had increased FV and increased acetabular version (AV; >25°); and 9 valgus hips (caput-collum-diaphyseal angle >139°) had increased FV and increased AV. The control group consisted of 20 hips with normal FV, normal AV, and no valgus (caput-collum-diaphyseal angle <139°). Validated 3D CT–based collision detection software for impingement simulation was used to calculate impingement-free range of motion and location of hip impingement. Surgical treatment was performed after the 3D CT–based impingement simulation in 27 hips (52%).

Results:

Hips with increased FV had significantly (P < .001) decreased extension and ER at 90° of flexion as compared with the control group. Posterior impingement was extra-articular (92%) in hips with increased FV. Valgus hips with increased FV and AV had combined intra- and extra-articular impingement. Posterior hip impingement occurred between the ischium and the lesser trochanter at 20° of extension and 20° of ER. Impingement was located between the ischium and the greater trochanter or intertrochanteric area at 20° of flexion and 40° of ER, with a modification of the flexion-abduction-ER (FABER) test.

Conclusion:

Posterior extra-articular ischiofemoral hip impingement can be caused by the lesser and greater trochanter or the intertrochanteric region. We recommend performing the modified FABER test during clinical examination in addition to the posterior impingement test for female patients with high FV. In addition, 3D CT can help for surgical planning, such as femoral derotation osteotomy and/or hip arthroscopy or resection of the lesser trochanter.

Senolytic agent Quercetin ameliorates intervertebral disc degeneration via the Nrf2/NF-κB axis

OBJECTIVE

Intervertebral disc degeneration (IDD) represents major cause of low back pain. Quercetin (QUE) is one of the approved senolytic agents. In this study, we evaluated the protective effects of QUE on IDD development and its underlying mechanism.

METHODS

Effects of senolytic agent QUE on the viability of nucleus pulposus cells (NPCs) were measured by CCK-8 assays and EdU staining. The senescence associated secreted phenotype (SASP) factors expressions were measured by qPCR, western blot, and ELISA; and NF-κB pathway was detected by immunofluorescence and western blot. Molecular docking was applied to predict the interacting protein of QUE; while Nrf2 was knocked down by siRNAs to confirm its role in QUE regulated senescence phenotype. X-ray, MRI, Hematoxylin-Eosin and Safranin O-Fast green staining were performed to evaluate the therapeutic effects of QUE on IDD in the puncture-induced rat model.

RESULTS

In in vitro experiments, QUE inhibited SASP factors expression and senescence phenotype in IL-1β-treated NPCs. Mechanistically, QUE suppressed IL-1β induced activation of the NF-κB pathway cascades; it was also demonstrated in molecular docking and knock down studies that QUE might bind to Keap1-Nrf2 complex to suppress NF-κB pathway. In vivo, QUE ameliorated the IDD process in the puncture-induced rat model.

CONCLUSIONS

Together the present work suggests that QUE inhibits SASP factors expression and senescence phenotype in NPCs and ameliorates the progression of IDD via the Nrf2/NF-κB axis, which supports senolytic agent QUE as a potential therapeutic agent for the treatment of IDD.

Effect of dehydration pathway on the surface properties of molecular crystals

Atomic force microscopy was used to determine roughness, elastic modulus and work function after thermally-induced and solvent-induced dehydration. These properties correlated with electric charging to provide insight into behaviour of bulk powders.

MRI-based 3D models of the hip joint enables radiation-free computer-assisted planning of periacetabular osteotomy for treatment of hip dysplasia using deep learning for automatic segmentation

Introduction

Both Hip Dysplasia(DDH) and Femoro-acetabular-Impingement(FAI) are complex three-dimensional hip pathologies causing hip pain and osteoarthritis in young patients. 3D-MRI-based models were used for radiation-free computer-assisted surgical planning. Automatic segmentation of MRI-based 3D-models are preferred because manual segmentation is time-consuming.To investigate(1) the difference and(2) the correlation for femoral head coverage(FHC) between automatic MR-based and manual CT-based 3D-models and (3) feasibility of preoperative planning in symptomatic patients with hip diseases.

Methods

We performed an IRB-approved comparative, retrospective study of 31 hips(26 symptomatic patients with hip dysplasia or FAI). 3D MRI sequences and CT scans of the hip were acquired. Preoperative MRI included axial-oblique T1 VIBE sequence(0.8 mm³ isovoxel) of the hip joint. Manual segmentation of MRI and CT scans were performed. Automatic segmentation of MRI-based 3D-models was performed using deep learning.

Results

(1)The difference between automatic and manual segmentation of MRI-based 3D hip joint models was below 1 mm(proximal femur 0.2 ± 0.1 mm and acetabulum 0.3 ± 0.5 mm). Dice coefficients of the proximal femur and the acetabulum were 98 % and 97 %, respectively. (2)The correlation for total FHC was excellent and significant(r = 0.975, p < 0.001) between automatic MRI-based and manual CT-based 3D-models. Correlation for total FHC (r = 0.979, p < 0.001) between automatic and manual MR-based 3D models was excellent.(3)Preoperative planning and simulation of periacetabular osteotomy was feasible in all patients(100 %) with hip dysplasia or acetabular retroversion.

Conclusions

Automatic segmentation of MRI-based 3D-models using deep learning is as accurate as CT-based 3D-models for patients with hip diseases of childbearing age. This allows radiation-free and patient-specific preoperative simulation and surgical planning of periacetabular osteotomy for patients with DDH.

Surface modification of black phosphorus-based nanomaterials in biomedical applications: Strategies and recent advances

Black phosphorus-based nanomaterials (BPNMs), an emerging member of two-dimensional (2D) nanomaterials, possess excellent physicochemical properties and hold great potential for application in advanced nanomedicines. However, the bare BPNMs easily decrease their biomedical activities due to their degradability and in vivo interactions with biological macromolecules such as plasma proteins, largely restricting their biomedical application. A variety of surface modifications, via chemical, physical or biological approaches, have been developed for BPNMs to avoid these limitations and achieve stable, long-lasting and safe therapeutic effects, thus enlighten the development of the multifunctional BPNMs for more practical application in the field of biomedicine. The present review summarizes the recent advances in the surface modification of BPNMs and the resultant expansion of their biomedical applications. Focus is put on the strategy and method of modification while the effects incurred on the behavior and potential toxicity of BPNMs are also included. The future and challenge of the surface modification of the therapeutic BPNMs are finally discussed.

[Association between dietary glycemic load during first trimester and the risk of gestational diabetes mellitus: a prospective study]

Objective: To explore the effects of dietary glycemic load (GL) during first trimester on the risk of gestational diabetes mellitus (GDM). Methods: A prospective study was conducted among healthy women with singleton pregnancy at 8-14 weeks of gestation in a maternity out-patient clinic of maternal-and-child health care institution in Chengdu, Sichuan province. Information on dietary intake during the first trimester was collected through a 3-day 24-hour dietary recall. Glycemic index (GI) values were obtained from China Food Composition Tables (Standard Edition) and International Tables of Glycemic Index and Glycemic Load Values (2008). Dietary GL and GLs of staple foods were calculated based on GI values and the amount of carbohydrate consumed per day. Diagnostic criteria of GDM was followed the Guidelines for Diagnosis and Treatment of Pregnancy Diabetes in China (2014), and used on participants who underwent an oral glucose tolerant test during 24-28 weeks of gestation. Log-binomial regression models were used to explore the associations between both quartiles of dietary GL, GLs of staple foods and the risks of GDM,respectively. Results: The medians of dietary GL and GL of staple foods were 145.70 (113.23-180.85) and 121.05 (89.08-155.70), respectively. The median GL of both rice and tubers were 73.14 (43.89-107.50) and 3.43 (0.00-9.84), respectively. After adjusting for the age at pregnancy, pre-pregnancy body mass index and other confounding factors, results of log-binomial regressions analysis showed that when compared with the lowest quartile of dietary GL group, the third and highest quartiles of dietary GL groups increased the risk of GDM (RR=1.47, 95%CI: 1.20-1.80; RR=1.31, 95%CI: 1.04-1.64), respectively. Compared with the lowest quartile of GL of staple foods, the third and highest quartiles of GL of staple foods groups also increased the risk of GDM (RR=1.28, 95%CI: 1.04-1.58; RR=1.27, 95%CI: 1.02-1.60), respectively. The third and highest quartiles of GL of rice groups increased the risk of GDM (RR=1.30, 95%CI: 1.06-1.59; RR=1.28, 95%CI: 1.03-1.59), respectively, than the lowest quartile of GL of rice group. When compared with the lowest quartile of GL of tubers group, the highest quartile of GL of tubers group increased the risk of GDM (RR=1.30, 95%CI: 1.09-1.54). However, we did not notice the effects of wheat GL and coarse grain GL on the risk of GDM. Conclusions: A positive association was found between dietary glycemic load and the risk of GDM. Higher dietary glycemic load, especially in rice and tubers during first trimester, seemed to have increased the risk of GDM.

Porphyromonas gingivalis Promotes Oral Squamous Cell Carcinoma Progression in an Immune Microenvironment

Increasing evidence has revealed a significant association between microorganisms and oral squamous cell carcinoma (OSCC). Porphyromonas gingivalis, the keystone pathogen in chronic periodontitis, is considered an important potential etiologic agent of OSCC, but the underlying immune mechanisms through which P. gingivalis mediates tumor progression of the oral cancer remain poorly understood. Our cohort study showed that the localization of P. gingivalis in tumor tissues was related to poor survival of patients with OSCC. Moreover, P. gingivalis infection increased oral lesion multiplicity and size and promoted tumor progression in a 4-nitroquinoline-1 oxide (4NQO)–induced carcinogenesis mouse model by invading the oral lesions. In addition, CD11b+ myeloid cells and myeloid-derived suppressor cells (MDSCs) showed increased infiltration of oral lesions. Furthermore, in vitro observations showed that MDSCs accumulated when human-derived dysplastic oral keratinocytes (DOKs) were exposed to P. gingivalis, and CXCL2, CCL2, interleukin (IL)–6, and IL-8 may be potential candidate genes that facilitate the recruitment of MDSCs. Taken together, our findings suggest that P. gingivalis promotes tumor progression by generating a cancer-promoting microenvironment, indicating a close relationship among P. gingivalis, tumor progression of the oral cancer, and immune responses.

Evaluation of algorithms for Multi-Modality Whole Heart Segmentation: An open-access grand challenge

Knowledge of whole heart anatomy is a prerequisite for many clinical applications. Whole heart segmentation (WHS), which delineates substructures of the heart, can be very valuable for modeling and analysis of the anatomy and functions of the heart. However, automating this segmentation can be challenging due to the large variation of the heart shape, and different image qualities of the clinical data. To achieve this goal, an initial set of training data is generally needed for constructing priors or for training. Furthermore, it is difficult to perform comparisons between different methods, largely due to differences in the datasets and evaluation metrics used. This manuscript presents the methodologies and evaluation results for the WHS algorithms selected from the submissions to the Multi-Modality Whole Heart Segmentation (MM-WHS) challenge, in conjunction with MICCAI 2017. The challenge provided 120 three-dimensional cardiac images covering the whole heart, including 60 CT and 60 MRI volumes, all acquired in clinical environments with manual delineation. Ten algorithms for CT data and eleven algorithms for MRI data, submitted from twelve groups, have been evaluated. The results showed that the performance of CT WHS was generally better than that of MRI WHS. The segmentation of the substructures for different categories of patients could present different levels of challenge due to the difference in imaging and variations of heart shapes. The deep learning (DL)-based methods demonstrated great potential, though several of them reported poor results in the blinded evaluation. Their performance could vary greatly across different network structures and training strategies. The conventional algorithms, mainly based on multi-atlas segmentation, demonstrated good performance, though the accuracy and computational efficiency could be limited. The challenge, including provision of the annotated training data and the blinded evaluation for submitted algorithms on the test data, continues as an ongoing benchmarking resource via its homepage (www.sdspeople.fudan.edu.cn/zhuangxiahai/0/mmwhs/).

Standardized Assessment of Automatic Segmentation of White Matter Hyperintensities and Results of the WMH Segmentation Challenge

Quantification of cerebral white matter hyperintensities (WMH) of presumed vascular origin is of key importance in many neurological research studies. Currently, measurements are often still obtained from manual segmentations on brain MR images, which is a laborious procedure. The automatic WMH segmentation methods exist, but a standardized comparison of the performance of such methods is lacking. We organized a scientific challenge, in which developers could evaluate their methods on a standardized multi-center/-scanner image dataset, giving an objective comparison: the WMH Segmentation Challenge. Sixty T1 + FLAIR images from three MR scanners were released with the manual WMH segmentations for training. A test set of 110 images from five MR scanners was used for evaluation. The segmentation methods had to be containerized and submitted to the challenge organizers. Five evaluation metrics were used to rank the methods: 1) Dice similarity coefficient; 2) modified Hausdorff distance (95th percentile); 3) absolute log-transformed volume difference; 4) sensitivity for detecting individual lesions; and 5) F1-score for individual lesions. In addition, the methods were ranked on their inter-scanner robustness; 20 participants submitted their methods for evaluation. This paper provides a detailed analysis of the results. In brief, there is a cluster of four methods that rank significantly better than the other methods, with one clear winner. The inter-scanner robustness ranking shows that not all the methods generalize to unseen scanners. The challenge remains open for future submissions and provides a public platform for method evaluation.

[Post-marketing multi-center safety surveillance of inactivated enterovirus A71 vaccine (Vero cell)]

Objective: To evaluate the post-marketing safety profiles of the inactivated enterovirus type 71 (EV-A71) vaccine (Vero cell) after routine inoculation. Methods: Eleven cities of Zhejiang Province, Fengtai district of Beijing, Qinnan district, two counties as Pingle and Pingguo of Guangxi Zhuang Autonomous Region, and Dongtai city of Jiangsu Province were selected as the field sites. A total of 45 239 subjects were enrolled in this study from children who seeked the vaccination of EV-A71 vaccine during the period from July, 2016 to June, 2018. Different sampling method were adopted in different sites. All vaccinated children were invited to participate in the study in Fengtai and Dongtai, however, systematic sampling method were adopted in other sites. Active surveillance was conducted and information about adverse reactions (ARs) occurred in 30 min, 3 d and 30 d following each dose of EV-A71 immunization was collected by field observation, phone-call or face-to-face interview. The incidence of ARs in different types, symptoms and grades were described. Results: In total, there were 45 239 children who received 71 243 doses EV-A71 vaccine. The overall incidence of ARs was 1.079% (769 doses), with the highest incidence of 1.182% (177/14 973) in 5-11 month group and the lowest incidence of 0.849% (18/2 119) in ≥ 36 month group among different age groups. There was a higher incidence in solicited ARs, which was 1.047% (746 doses). The incidences of grade 1 and grade 2 ARs were also higher, which were 0.404% (288 doses) and 0.554% (395 doses), respectively. No grade 4 ARs occurred. The doses of the first and the second vaccination was 40 736 and 30 507, respectively, and the incidences of ARs were 1.281% (522 doses) and 0.810% (247 doses). Also, the incidences of ARs were 0.091% (37 doses) and 0.043% (13 doses) in local, and 1.168% (476 doses) and 0.760% (232 doses) in system. The symptoms of ARs after the two doses of vaccination were basically the same. Redness at the injection site was the most common local ARs after each dose vaccination, with doses of 24 and 11, while fever was the most common systemic ARs, with doses of 362 and 190. Moreover, ARs mainly occurred in 30 min to 3 d after each dose vaccination, with incidence of 1.016% (414 doses) and 0.698% (213 doses) in the first and second dose, respectively. Conclusion: The ARs had a low incidence after vaccination in children and most were mild or moderate. EV-A71 vaccine with good safety is suitable for inoculation in a large scale.

Association between phosphodiesterase type 5 inhibitors use and risk of melanoma: a meta-analysis

This meta-analysis aimed to clarify the actual association between the phosphodiesterase type 5 inhibitors (PDE5-Is) use and the risk of melanoma in erectile dysfunction (ED) patients. A systematic literature search was conducted in online databases in October, 2016 to identify studies focusing on the association between PDE5-Is use and the risk of melanoma. Summarized multivariate adjusted risk ratios (RRs) and 95% confidence intervals (CIs) were calculated to assess the strength of associations. A total of six clinical trials containing more than one million participants were included. ED patients  using PDE5-Is shared a significant high risk of melanoma (RR=1.12, 95% CI=1.03-1.21, p=0.006). Positive associations were observed in all kinds of prescriptions: single prescription (RR=1.20, 95% CI=1.06-1.35, p=0.003), medium number of prescription (RR=1.15, 95% CI=1.01-1.30, p=0.03), and high number of prescription (RR=1.18, 95% CI=1.05-1.34, P=0.006). Additionally, PDE5-Is were also found to be significantly associated with increased risk of basal cell carcinoma (RR=1.14, 95% CI=1.09-1.19, p<0.00001). Our study indicates that PDE5-Is use could significantly increase the risk of melanoma and basal cell carcinoma. However, the risk of melanoma did not rise significantly with the increased number of prescriptions. Consequently, owing to the lack of information about other potential synergistic factors, it is difficult for us to make a solid conclusion that application of PDE5-Is is the direct cause of increased risk of melanoma. Their relationship needs to be validated by further evidences.

Benchmark on Automatic 6-month-old Infant Brain Segmentation Algorithms: The iSeg-2017 Challenge

Accurate segmentation of infant brain magnetic resonance (MR) images into white matter (WM), gray matter (GM), and cerebrospinal fluid (CSF) is an indispensable foundation for early studying of brain growth patterns and morphological changes in neurodevelopmental disorders. Nevertheless, in the isointense phase (approximately 6-9 months of age), due to inherent myelination and maturation process, WM and GM exhibit similar levels of intensity in both T1-weighted (T1w) and T2-weighted (T2w) MR images, making tissue segmentation very challenging. Despite many efforts were devoted to brain segmentation, only few studies have focused on the segmentation of 6-month infant brain images. With the idea of boosting methodological development in the community, iSeg-2017 challenge (http://iseg2017.web.unc.edu) provides a set of 6-month infant subjects with manual labels for training and testing the participating methods. Among the 21 automatic segmentation methods participating in iSeg-2017, we review the 8 top-ranked teams, in terms of Dice ratio, modified Hausdorff distance and average surface distance, and introduce their pipelines, implementations, as well as source codes. We further discuss limitations and possible future directions. We hope the dataset in iSeg-2017 and this review article could provide insights into methodological development for the community.

[Association between gestational weight gain and adverse pregnancy outcomes: a prospective study]

Objective: To explore the association between gestational weight gain (GWG) and adverse pregnancy outcomes. Methods: A prospective study was conducted among 1 220 healthy singleton pregnant women in the first trimester of pregnancy, from Chengdu city, Sichuan province. Pre-gestational body mass and other basic information were collected through a set of questionnaires. Weight at the last week before delivery was measured and GWG was classified by IOM criteria (2009). Related information on pregnancy outcomes was collected after delivery, through the hospital information system. Multiple non-conditional logistic regression models were used to test the association between GWG and adverse pregnancy outcomes. Results: In total, data on 1 045 pregnant women were analyzed. Compared with adequate GWG, excessive GWG was associated with the increased risks of cord entanglement and large for gestational age (OR=1.641, 95%CI: 1.197-2.252; OR=1.678, 95%CI: 0.132-2.488), respectively. Additionally, when compared with the adequate GWG, insufficient GWG was associated with the increased risk of preterm delivery (OR=3.189, 95%CI: 1.604-6.341). Conclusions: Both excessive and insufficient GWG appeared associated with the pregnancy outcomes. Weight monitoring should be strengthened for pregnant women to reduce related risks on adverse pregnancy outcomes.

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

WHAT IS KNOWN AND OBJECTIVE

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

METHODS

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

RESULTS AND DISCUSSION

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

WHAT IS NEW AND CONCLUSION

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

[Three-dimensional architecture of intraosseous vascular anatomy of the hamate: a micro-computed tomography study]

OBJECTIVE

To obtain three-dimensional intraosseous artery of the hamate and to provide the vascular anatomy basis of hamate fracture fixation.

METHODS

PbO (lead monoxide, Sinopharm Chemical Reagent Beijing Co. Ltd) was ground into particles less than 40 μm and suspended in turpentine oil (Chemical Reagent Beijing Co. Ltd) at ratios of 1 g : 1.5 mL, 1 g : 1 mL and 1 g : 0.5 mL. Three specimens were investigated. Brachial arteries were cannulated and perfused with lead-based contrast agent. Hamates were harvested and scanned using micro-computed tomography (microCT). The acquisition protocols were as follows: CT scan setup: total rotation [Degrees], 360; rotation steps, 360; X-ray detector setup: transaxial, 2048; axial, 2048; exposure time, 1 500 ms, Binning, 1; system magnification: high-med. X-ray tube setup: 80 kV, 500 mA current. The down-sampling factor used in the reconstruction was 2. The effective voxel size of the final image was 27.30 μm. The three-dimensional model of the hamate was generated and the distribution and pattern of vessels were evaluated.

RESULTS

There were abundant extraosseous vessels around the hamate. They were mainly running in the tendons and ligaments around the hamate. Four vascular zones were identified on the hamate surface. They were on the palmar platform of the hamate body, on the dorsal side, on the ulnar side and on the tip of hamulus, namely. There were anastomoses among 4 vascular zones. We did not observe any vessels penetrating through the articular cartilage. The extraosseous vessels of the vascular zones gave a number of intraosseous branches into the hamate. The hamate body received intraosseous blood supply from the dorsal, palmar and ulnar while the hamulus from the palmar, ulnar and hamulus tip. There were some intraosseous branches anastomosing with each other.

CONCLUSION

The extraosseous and intraosseous vessels of the hamate were more than what used to be considered. The hamate body and hamulus received blood supply from multiple directions and arteries anastomosed extensively both outside and inside the hamate, making it possible that the intraosseous perfusion survived after fracture. It is likely that the nonunion after the hamate fracture is not caused by the vascular damage but the malalignment of the fragments.

Antibacterial isoeugenol coating on stainless steel and polyethylene surfaces prevents biofilm growth

AIMS

Pathogenic bacteria can spread between individuals or between food items via the surfaces they share. Limiting the survival of pathogens on surfaces, therefore, presents an opportunity to limit at least one route of how pathogens spread. In this study, we propose that a simple coating with the essential oil isoeugenol can be used to circumvent the problem of bacterial transfer via surfaces.

METHODS AND RESULTS

Two commonly used materials, stainless steel and polyethylene, were coated by physical adsorption, and the coatings were characterized by Raman spectroscopy, atomic force microscopy and water contact angle measurements. We quantified and visualized the colonization of coated and uncoated surfaces by three bacteria: Staphylococcus aureus, Listeria monocytogenes and Pseudomonas fluorescens. No viable cells were detected on surfaces coated with isoeugenol.

CONCLUSIONS

The isoeugenol coating prepared with simple adsorption proved effective in preventing biofilm formation on stainless steel and polyethylene surfaces. The result was caused by the antibacterial effect of isoeugenol, as the coating did not diminish the adhesive properties of the surface.

SIGNIFICANCE AND IMPACT OF THE STUDY

Our study demonstrates that a simple isoeugenol coating can prevent biofilm formation of S. aureus, L. monocytogenes and P. fluorescens on two commonly used surfaces.

Osteopontin adsorption to Gram-positive cells reduces adhesion forces and attachment to surfaces under flow

The bovine milk protein osteopontin (OPN) may be an efficient means to prevent bacterial adhesion to dental tissues and control biofilm formation. This study sought to determine to what extent OPN impacts adhesion forces and surface attachment of different bacterial strains involved in dental caries or medical device–related infections. It further investigated if OPN’s effect on adhesion is caused by blocking the accessibility of glycoconjugates on bacterial surfaces. Bacterial adhesion was determined in a shear-controlled flow cell system in the presence of different concentrations of OPN, and interaction forces of single bacteria were quantified using single-cell force spectroscopy before and after OPN exposure. Moreover, the study investigated OPN’s effect on the accessibility of cell surface glycoconjugates through fluorescence lectin-binding analysis. OPN strongly affected bacterial adhesion in a dose-dependent manner for all investigated species (Actinomyces naeslundii, Actinomyces viscosus, Lactobacillus paracasei subsp. paracasei, Staphylococcus epidermidis, Streptococcus mitis, and Streptococcus oralis). Likewise, adhesion forces decreased after OPN treatment. No effect of OPN on the lectin-accessibility to glycoconjugates was found. OPN reduces the adhesion and adhesion force/energy of a variety of bacteria and has a potential therapeutic use for biofilm control. OPN acts upon bacterial adhesion without blocking cell surface glycoconjugates.

[Association between gestational weight gain per trimester/total gestational weight gain and gestational diabetes mellitus]

Objective: To understand the association between gestational weight gain (GWG) per trimester/total (GWG) and gestational diabetes mellitus (GDM). Methods: A prospective cohort study was conducted among 829 healthy pregnant women from Chengdu who delivered a singleton during March-September 2013. Basic information about pre-pregnancy was collected at the first time, exercise information per trimester, dietary intake information per trimester and gestational age at delivery were obtained by questionnaire. Weight at the (12 ± 1)^th, (28 ± 1)^th, (36 ± 1)^th and last week before delivery were measured. GDM was diagnosed according to the National Diabetes and Pregnancy Prevention Guidelines (2014). At last, a total of 682 pregnant women were analyzed. After controlling the potential confounders, multiple logistic regression models were used to test the associations between GWG per trimester/total GWG and GDM. Results: After adjusting for age at delivery, pre-pregnancy body mass index, family histories of type 2 diabetes and hypertension, exercise in the first trimester, parity and energy intake in trimester and other potential confounders. Compared with adequate GWG in the first trimester, insufficient and excessive GWG in the first trimester were associated with increased risk of GDM (OR=1.23, 95%CI: 0.63-2.38, and OR=2.20, 95%CI: 1.12-4.35). Compared with adequate GWG in the second trimester, insufficient and excessive GWG in the second trimester were associated with decreased risk of GDM (OR=0.47, 95%CI: 0.18-1.19, and OR=0.78, 95% CI: 0.43-1.42). Compared with adequate GWG in the third trimester, insufficient GWG in the third trimester was associated with increased risk of GDM (OR=1.48, 95%CI: 0.77-2.84), excessive GWG in the third trimester was associated with decreased risk of GDM (OR= 0.53, 95% CI: 0.28-0.99). Compared with adequate total GWG in pregnancy, insufficient GWG in pregnancy was associated with increased risk of GDM (OR=2.16, 95% CI: 1.04-4.46), excessive GWG in pregnancy was associated with decreased risk of GDM (OR=0.74, 95% CI: 0.38-1.46). Conclusions: Insufficient and excessive GWG in the first trimester were associated with increased risk of GDM, the first trimester may represent a critical period for risk of GDM. The effects of GWG in the second and third trimester on GDM need further study.

[Assessment of comprehensive nutritional status and eating behavior among 311 middle aged and aged women with osteoporosis in Chengdu]

Objective: To investigate the comprehensive nutritional status and diet behavior of middle aged and elderly women with osteoporosis, and thereby to explore the relationship between diet behavior and comprehensive nutritional status. Methods: 311 middle-aged and elderly women with osteoporosis in Chengdu were included in this study. Mini Nutritional Assessment (MNA) was applied to assess their comprehensive nutritional status. Information of social-demographic characteristics and diet behavior (about meals, snacks and water drinking, etc.) of the subjects was collected by questionnaire. Chi square test was used to assess the differences in nutritional status among patients who have different eating behaviors. Logistic regression analysis was performed to evaluate the relationship between diet behaviors and comprehensive nutritional status. Results: The mean MNA score of subjects was 25.8±2.5. 20.3% (63/311) of the subjets were at risk of potential malnutrition, but there was no malnourished subjects found. 46.9% (46/311) of the subjects were in good appetite. 95.2% (296/311) of them had a fixed food intake each meal. 65.8% (198/311) of them had snacks every day, and the most common choice was fruit (86.4% (248/287)). 54.8% (165/311) of them had initiative drinking water habits, and the most common choice was plain boiled water (79.9%, 246/308). 76.5% (238/311) of them had daily portable water less than 1 500 ml. After adjusting the effects of age, occupation and education level, bad appetite (OR=3.50, 95%CI: 1.18-10.62), unfixed food intake (OR=7.27, 95%CI: 1.40-35.83), and seldom or never intake of snack (OR=3.71, 95%CI: 1.42-9.72) were risk factors for malnutrition risk, while tea drinking was protective factor(OR=0.31, 95%CI: 0.11-0.93). Conclusion: Risk of potential malnutrition and unhealthy diet behavior among the middle aged and elderly women with osteoporosis should be paid more attention. Unhealtghy diet behavior has a negative effect on their comprehensive nutritional status.

Glipizide blocks renal interstitial fibrosis by inhibiting AKT signaling pathway

OBJECTIVE

Diabetes affects the renal function at a certain stage. Oral medication glipizide plays a hypoglycemic effect mainly through releasing insulin, while more insulin is derived from islet β cells. It is still controversy whether antidiabetics. This study mainly intends to investigate the role of glipizide in inhibiting renal interstitial fibrosis.

MATERIALS AND METHODS

A total of 93 SD rats were purchased from Guangdong animal monitoring and established unilateral ureteral obstruction (UUO) model to simulate renal interstitial fibrosis. Forty rats in the experimental group received glipizide intraperitoneal injection for a week at 30 days after modeling, while another 40 rats in the control group received a normal saline injection. The last 10 rats were treated as blank group. Hematoxylin and eosin (HE) staining was applied to test renal interstitial fibrosis. Immunohistochemistry was used to detect fibronectin expression in glomerular and renal tubules. AKT signaling pathway related factors expression was measured by Western blot to determine AKT signal activation.

RESULTS

HE staining showed that the entire kidney cytoplasm red dye becomes shallow, renal medulla gradually disappears, renal tubular epithelial cells enlarge, vacuoles degeneration, renal tubule and collecting tube expansion, inflammatory cells infiltration after UUO modeling. Glipizide treatment decreased dilated renal tubule number, improved glomerulus integrity, and reduced inflammatory infiltration. Fibronectin level in the experimental group was significantly lower than that in control (p<0.05). Western blot revealed that p-AKT expression downregulated after glipizide treatment.

CONCLUSIONS

Glipizide blocks renal interstitial fibrosis by inhibiting AKT signaling pathway.