Acute cardiac injury and acute kidney injury associated with severity and mortality in patients with COVID-19

OBJECTIVE

To determine the incidence and risk factors for acute cardiac injury (ACI) and acute kidney injury (AKI), and then investigate their effect on severity and mortality in patients with COVID-19.

PATIENTS AND METHODS

A total of 1249 patients with COVID-19 were included in this retrospective study. Predictors of ACI and AKI were investigated. Multivariable-logistic regression models were used to determine the association of ACI (or AKI) with severity and mortality.

RESULTS

Median age of patients was 36 years and 61.9% were male. ACI and AKI were observed in 53 (4.2%) and 91 (7.3%) of patients, respectively. Patients with age > 60 years, chronic heart disease, decreased lymphocyte and increased CRP, PCT, and ESR on hospital admission, and Lopinavir/Ritonavir use showed higher odds of ACI. Patients with age > 60 years, male, obesity, hypertension, chronic kidney disease, decreased lymphocyte and increased CRP, PCT, and ESR on hospital admission showed higher odds of AKI. Increased Hs-cTnI (> 300 ng/L), Pro-BNP (> 2500 pg/ml) and decreased e-GFR (< 60 ml/min) revealed higher adjusted mortality.

CONCLUSIONS

ACI and AKI were not common in COVID-19 patients in Shanghai, China. However, patients with ACI/AKI had higher severity-rate and mortality-rate when compared to those without ACI/AKI.

[Effects of surgical and endovascular treatment of blood blister-like aneurysms of the internal carotid artery]

Objective: To explore the clinical characteristics, therapeutic methods and effects of blood blister-like aneurysms (BBA) of the supraclinoid segment of the internal carotid artery (ICA). Methods: A total of 40 patients with BBAs of the ICA treated at Department of Neurosurgery of West China Hospital between January 2010 and January 2016 were retrospectively reviewed. There were 14 males and 26 females with the mean age of 44.7 years (ranging from 25 to 64 years). There were 38 patients presented with subarachnoid hemorrhage (SAH), and 2 patients were found incidentally with unruptured aneurysms in regular examination. Surgical treatment was performed in 22 patients, including direct clipping, clipping over wrapping and trapping. Endovascular treatment with single or multiple stents and coiling was performed in 18 patients. Clinical outcomes were assessed with modified Rankin Scale. The patients were followed up with CT angiography. Results: Direct clipping of BBA was performed in 18 patients, clipping over wrapping in 3 patients and trapping of ICA in 1 patient. Intraoperative rupture occurred in 5 patients. Postoperative cerebral infarction developed in 6 cases, 4 patients died. Single stent-assisted coiling was performed in 8 cases, and multiple stents with coiling in 10 patients. Procedure-related hemorrhage occurred in 2 patients, postoperative massive cerebral infarction developed in 1 patient with stent-assisted coiling. The follow-up time was 26.8 months (ranging from 6 to 72 months), among the patients with surgery, good results (modified Rankin Scale 0-2) were achieved in 16 patients; one patient was score 3, and the other was 4. In endovascular group, 15 patients had good results and one with mRS 4. Follow-up angiography revealed recurrence of BBA in 2 patients treated with stent and coiling, which was retreated with coiling. No recurrence was found in surgical group. Conclusions: BBA of the supraclinoid ICA is a specific and complicated intracranial aneurysm with high risk and complications no matter the treatment is surgical or endovascular, take proper operation methods could achieve satisfactory results.

Sex Influences on the Penetrance of IL-1β and IL-1RN Genotypes for Rheumatoid Arthritis in the Chinese Population

Polymorphism (variable number of tandem repeats) in the second intron of the interleukin-1 receptor antagonist ( IL-1Ra) gene and two single nucleotide polymorphisms at positions −511 and +3954 of the IL-1β gene may be associated with an increased risk of rheumatoid arthritis (RA). This study used sex stratification to investigate a correlation of the three genetic polymorphisms with the risk of RA, on patients with RA and healthy controls. Polymerase chain reaction (PCR) and polymerase chain reaction–restriction fragment length polymorphism (PCR–RFLP) were performed. The frequencies of the IL-1β+ 3954 allele and genotype in female patients were significantly different compared with the controls; but in males, only the frequency of the IL-1β+ 3954 allele was different. The frequency of the IL-1RN genotype in patients was not statistically different compared with the controls; however, the frequency of IL-1RN allele in female patients was different. The association of the three polymorphisms with the susceptibility to RA appears to be significantly affected by gender.

The Anti-proliferative Effects of Recombinant Human Lysozyme on Human Gastric Cancer Cells

We investigated the anti-proliferative effects of recombinant human lysozyme (rHlys) on gastric cancer cell lines and normal human lung fibroblasts. Using conventional molecular cloning techniques we purified rHlys, which we incubated with cultured cells and measured the effects on cell proliferation and viability. At concentrations of 100 and 1000 μg/l, rHlys significantly inhibited the growth of human gastric cancer cell lines. In contrast, 10 and 50 μg/l of rHlys stimulated gastric cancer cell growth. None of the concentrations of rHlys affected cell viability. Only the highest concentration of rHlys (1000 μg/l) inhibited human lung fibroblast growth. Our results suggest that 100 μg/l is the optimum growth inhibiting concentration, which inhibited cancer cell growth but not normal cell growth. Our in vitro findings suggest that genetically engineered rHlys might inhibit human gastric cancer cell proliferation in vivo, so it might warrant further investigation as a potential novel anti-cancer agent.

Genetic polymorphisms in the carbonic anhydrase VI gene and dental caries susceptibility

We investigated the role of 7 single nucleotide polymorphisms in the carbonic anhydrase (CA) VI gene (rs2274328, rs17032907, rs11576766, rs2274333, rs10864376, rs3765964, and rs6680186) and the possible association between these polymorphisms and dental caries susceptibility in a Northwestern Chinese population. We collected samples from 164 high caries experience and 191 very low caries experience and conducted a case-control study according to the number of decayed, missing, and filled teeth index and genotyped the 7 polymorphisms using a 384-well plate format with the Sequenom MassARRAY platform. Individuals carrying the rs17032907 TT genotype were more likely to have an increased risk of dental caries compared with carriers of the C/C genotype in the co-dominant model, with an odds ratio (95% confidence interval) of 2.144 (1.096-4.195). We also found that the haplotype (ACA) (rs2274328, rs17032907 and rs11576766) was associated with a low number of decayed, missing, and filled teeth index with an odds ratio (95% confidence interval) of 0.635 (0.440-0.918). However, we found no association between dental caries susceptibility and the rs2274328, rs11576766, rs2274333, rs10864376, rs3765964, and rs6680186 polymorphisms and other haplotypes. The rs17032907 genetic variant and the haplotype (ACA) of CA VI may be associated with dental caries susceptibility.

Antitumour effect of sesquiterpene (+)-chabranol on four human cancer cell lines by inducing apoptosis and autophagy

OBJECTIVE

To investigate the effects and mechanisms of sesquiterpene (+)-chabranol on proliferation of a panel of four human tumour cell lines (BGC-823, SGC-7901, SSMC-7721 and HepG2).

METHODS

Cell viability was assessed using a standard methyltetrazolium assay; cell-cycle analysis of BGC-823 cells was performed by flow cytometry. Transmission electron microscopy (TEM) was used to examine the ultrastructure of BGC-823 cells exposed to (+)-chabranol. Apoptosis was investigated by evaluating DNA laddering, using gel electrophoresis.

RESULTS

(+)-Chabranol had a marked time- and concentration-dependent inhibitory effect on BGC-823 cell proliferation. The effect was less marked in SGC-7901, SSMC-7721 and HepG2 cells. Exposure of BGC-823 cells to (+)-chabranol arrested the cell cycle at G(1). Evidence of apoptosis and autophagy was observed by TEM; DNA laddering in BGC-823 cells supported the presence of apoptosis.

CONCLUSIONS

This study suggested that (+)-chabranol has antitumour activity against BGC-823 cells, and may exert its action by inhibition of proliferation and induction of apoptosis and autophagy. With further development, (+)-chabranol may represent a potential novel treatment for poorly differentiated gastric cancer.

Correlation analysis of the urban heat island effect and the spatial and temporal distribution of atmospheric particulates using TM images in Beijing

This study combines the methods of observation statistics and remote sensing retrieval, using remote sensing information including the urban heat island (UHI) intensity index, the normalized difference vegetation index (NDVI), the normalized difference water index (NDWI), and the difference vegetation index (DVI) to analyze the correlation between the urban heat island effect and the spatial and temporal concentration distributions of atmospheric particulates in Beijing. The analysis establishes (1) a direct correlation between UHI and DVI; (2) an indirect correlation among UHI, NDWI and DVI; and (3) an indirect correlation among UHI, NDVI, and DVI. The results proved the existence of three correlation types with regional and seasonal effects and revealed an interesting correlation between UHI and DVI, that is, if UHI is below 0.1, then DVI increases with the increase in UHI, and vice versa. Also, DVI changes more with UHI in the two middle zones of Beijing.

The association of IL-6 and IL-6R gene polymorphisms with chronic periodontitis in a Chinese population

OBJECTIVE

The aim of our investigation is to reveal the association of interleukin-6 (IL-6) and interleukin-6 receptor (IL-6R) gene polymorphisms with chronic periodontitis in Northwestern Chinese Han Population.

MATERIAL AND METHODS

A case-control study of 199 cases of chronic periodontitis patients and 216 healthy controls was performed. Genomic DNA was isolated from whole venous blood, and four single nucleotide polymorphisms (IL-6 -572 G/C and -1363 G/T, IL-6R -183 G/A and +48892 A/C) were analysed using polymerase chain reaction, followed by restriction fragment length polymorphism analysis and sequencing methods.

RESULTS

Our SNP analyses showed that the distribution of the IL-6 -572 G/C and IL-6R -183 G/A polymorphisms did not differ between patients and controls. The frequency of the IL-6 -1363 G/T genotype GG was significantly increased chronic periodontitis cases (P = 0.023, odds ratio (OR) = 2.825 adjusted for gender and age.) The IL-6R +48892 A/C polymorphisms genotype CC was found to be protective against chronic periodontitis (P = 0.004, OR = 0.318 adjusted for gender and age.). In addition, compared with the other haplotypes, haplotype A(+48892) A(-183) was significantly associated with chronic periodontitis, with an odds ratio of 0.720 (P = 0.0235).

CONCLUSION

Our results suggest that the IL-6 -1363 G/T and IL-6R +48892 A/C polymorphisms may contribute to genetic susceptibility to chronic periodontitis in Northwestern Chinese Han population.

Up-Regulation of CXC Chemokine Receptor 4 Expression in Chronic Atrial Fibrillation Patients with Mitral Valve Disease May Be Attenuated by Renin–Angiotensin System Blockers

This study characterized CXC chemokine receptor 4 (CXCR4) expression in patients with mitral valve disease and chronic atrial fibrillation (AF). Forty-eight patients with chronic AF formed two groups based on whether they were treated with or without renin–angiotensin system (RAS) blockers (AF + RAS group; n = 25, or AF – RAS group; n = 23). The controls comprised 17 mitral valve disease patients with sinus rhythm (SR group). CXCR4 mRNA and protein levels in the left atria were significantly higher in the AF – RAS and AF + RAS groups than in the SR group. CXCR4 expression was significantly lower in the AF + RAS group than the AF – RAS group. More CD34+ cells expressed CXCR4 in the AF – RAS and AF + RAS groups than in the SR group. Angiotensin II, collagen I and left atrial diameter significantly positively correlated with CXCR4 expression in the AF – RAS group. These results suggest that CXCR4 expression is up-regulated in chronic AF patients with mitral valve disease, is associated with atrial remodelling, and that these effects are attenuated by RAS blockers.

Association of ACE, ACE2 and UTS2 polymorphisms with essential hypertension in Han and Dongxiang populations from north-western China

To assess the significance of polymorphisms of the genes for angiotensin-converting enzyme (ACE), angiotensin-converting enzyme 2 (ACE2) and urotensin II (UTS2) as risk factors for essential hypertension in two populations from north-western China, we enrolled 198 patients with essential hypertension and 131 healthy controls from the Han population and 120 patients with essential hypertension and 102 healthy controls from the Dongxiang population. Polymerase chain reaction (PCR) and PCR-restriction fragment length polymorphism were used to analyse gene polymorphisms. The results provided evidence that genetic variants of UTS2 and ACE2 may play a role in the development of essential hypertension in these populations. Polymorphisms of ACE were not associated with essential hypertension in either population. This is the first report showing that the S89N single-nucleotide polymorphism of the UTS2 gene is associated with essential hypertension.

Homocysteine accelerates senescence and reduces proliferation of endothelial progenitor cells

Our previous studies showed that homocysteine (Hcy) reduces endothelial progenitor cell (EPC) numbers and impairs functional activity. However, the mechanisms by which Hcy reduces EPCs numbers and activity remain to be determined. Recent studies have demonstrated that reduced EPCs numbers and activity was associated with EPCs senescence which involved telomerase activity. Therefore, we investigated whether Hcy accelerates the onset of EPCs senescence through telomerase inactivation, leading to cellular dysfunction. EPCs were isolated from peripheral blood and characterized. After ex vivo cultivation, EPCs became senescent as determined by acidic beta-galactosidase staining. Hcy dose-dependently accelerated the onset of EPCs senescence in culture. Moreover, Hcy decreased proliferation of EPCs as assessed by BrdU incorporation assay and colony-forming capacity. To get further insights into the underlying mechanisms of these effects induced by Hcy, we measured telomerase activity and determined the phosphorylation of Akt by using western blot. Hcy significantly diminished telomerase activity and Akt phosphorylation. Taken together, the results of the present study demonstrated that Hcy accelerated the onset of EPCs senescence, leading to cellular dysfunction. The effect of Hcy might be dependent on telomerase inactivation, and Akt dephosphorylation also appeared to play a major role. In addition, atorvastatin had a preventative effect against Hcy-induced EPCs senescence.

Effects of homocysteine on number and activity of endothelial progenitor cells from peripheral blood

The aim of this study is to investigate whether homocysteine (Hcy) has influences on endothelial progenitor cells (EPCs) number and activity. Total mononuclear cells (MNCs) were isolated from peripheral blood by Ficoll density gradient centrifugation, and then the cells were plated on fibronectin-coated culture dishes. After 7 d cultured, attached cells were stimulated with Hcy (to make a series of final concentrations: 10, 50, 100 and 200 micromol/l) or vehicle control for the respective time points (6, 12, 24 and 48 h). EPCs were characterized as adherent cells double positive for DiLDL uptake and lectin binding by direct fluorescent staining under a laser scanning confocal microscope. EPCs proliferation, migration and in vitro vasculogenesis activity were assayed with 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay, modified Boyden chamber assay and in vitro vasculogenesis kit, respectively. EPCs adhesion assay was performed by replating those on fibronectin-coated dishes, and then adherent cells were counted. Incubation of isolated human MNCs with Hcy dose and time dependently decreased the number of EPCs, maximum at 200 micromol/l, 24 h (approximately 50% reduction, P < 0.01). In addition, Hcy dose and time dependently impaired EPC proliferative, migratory, adhesive and in vitro vasculogenesis capacity. In conclusion, hyperHcy may induce the reduction of EPCs with decreased functional activity.

Tibetan population data on the multiplex short tandem repeat loci--D16S539, D7S820, and D13S317

The multiplex amplification system of three tetrameric short tandem repeats loci (D16S539, D7S820, and D13S317) have been analysed extensively in various populations for forensic application. Population genetic studies were carried out for these three loci in a population sample of 129 unrelated Tibetan individuals by using a multiplex polymerase chain reaction (PCR) followed by 4% polyacrylamide gel electrophoresis (PAGE) and silver staining. All loci were in accordance with the Hardy-Weinberg expectations. The observed heterozygosities of three loci-D16S539, D7S820, and D13S317 were 73.3%, 81.4% and 80.6%, respectively. The polymorphism information contents (PIC) were 0.84, 0.80 and 0.83, respectively. Comparing with Han population, there was no statistically significant difference except for D16S539 locus.

Location and migration of cations in Cu(2+)-adsorbed montmorillonite

Locations of Cu2+ ion in Cu(2+)-adsorbed montmorillonite have been studied by electron paramagnetic resonance (EPR), supplemented by X-ray diffraction (XRD) and differential thermal analysis (DTA). In the EPR spectra of Cu(2+)-adsorbed montmorillonite, three signals, corresponding to Cu2+ ion, have been simultaneously recorded. Some Cu2+ ions seemed to replace the original interlayer metal cations and some entered into the hexagonal cavities. A small fraction of Cu2+ ions penetrated into the octahedral vacancies. There were two ways for the adsorption of Cu2+ ion by montmorillonite--exchangeable and specific. On heating, the hydrated Cu2+ ion in the interlayer loses the coordinating water and then enters into the hexagonal cavities. When the heating temperature further increased, dehydroxylation occurs, which facilitates Cu2+ ion in the hexagonal cavities to penetrate into the octahedral vacancies.

Polyanhydrides. V. Branched polyanhydrides

The objective of the present study was to investigate the properties of branched polyanhydrides and compare them to the corresponding linear polymers. Sebacic acid was polymerized with 1,3,5 benzenetricarboxylic acid and poly(acrylic acid) to yield random and graft-type branched polyanhydrides. The polymerization was followed until the gel point and the resulting polymers were evaluated for their physico-chemical properties and degradation behaviour. Drug release from these polymers was studied using morphine as a model drug. The experiment showed that the molecular weights of branched polyanhydride were significantly higher (mol wt 250,000) than the molecular weight of linear poly(sebacic anhydride) (mol wt 80,000). In the case of poly(acrylic acid) branched polymers, the molecular weight increased linearly with increasing concentration of poly(acrylic acid). The specific viscosities of the branched polyanhydrides were lower than linear polyanhydrides with similar molecular weights. Except for the difference in molecular weights, there were no noticeable changes in the physico-chemical or thermal properties of the branched polymers and the linear poly(sebacic anhydride). The degradation of the branched polyanhydride was triphasic and the degradation rates were faster than for linear poly(sebacic anhydride). The release of morphine from the branched polymers was lower than the corresponding poly(sebacic anhydride). Release of morphine was much higher from the poly(acrylic acid) branched polymers compared to the 1,3,5 benzenetricarboxylic acid branched polymers and increased with increasing concentrations of the branching agent. However, in both cases the release rates and the total amounts of morphine released approached that of poly(sebacic anhydride).