[Changes in platelet related parameters in obese patients after sleeve gastrectomy].

To compare changes in platelet related parameters in obese patients before and after sleeve gastrectomy (SG), we retrospectively analyzed the clinical data of 31 obese patients who underwent SG in Peking Union Medical College Hospital from December 2012 to September 2020. Results showed that compared with those before surgery, platelet count (PLT) decreased significantly at 2-12 weeks of follow-up (P=0.009), while platelet distribution width (PDW), mean platelet volume (MPV), and large platelet ratio (P-LCR) increased significantly at the same periods of follow-up after operation (P<0.001). However, the levels of PDW, MPV, and P-LCR began to decrease at 16-55 weeks when compared with those at 2-12 weeks of follow-up (P<0.01). PLT was positively correlated with white blood cells and neutrophils at 2-12 weeks of follow-up and positively correlated with high sensitivity C-reactive protein at 16-55 weeks of follow-up after operation (P<0.05).

[The relationship among depression, anxiety, stress and addictive substance use behavior in 5 935 secondary vocational students].

Objective: To investigate the relationship among depression, anxiety, stress and addictive substance use behavior in secondary vocational students. Methods: Cluster sampling method and the Adolescent Health-related Behaviors Questionnaire were used to collect demographic characteristics, psychological symptoms, and addictive substance usage among 5 935 students in nine vocational schools in Chongqing, Zhaoqing, Ningbo, and Taiyuan. Multivariate logistic regression analysis was used to analyze the relationship between the addictive substance use behavior and psychological factors. Results: The detection rates of depression, anxiety and stress were 46.5% (n=2 762), 58.7% (n=3 483), and 29.8% (n= 1 770), respectively. The prevalence of addictive substances was 74.8% (n=4 440), traditional drugs was 0.8% (n=50), new drugs was 2.8% (n=166), other addictive drugs was 4.1% (n=241). Multivariate logistic regression analysis showed that compared with the normal psychological states of secondary vocational students, the OR value of mild depression tendency alcohol and tobacco use behavior of secondary vocational students was 1.45; the OR values of mild anxiety, moderate anxiety, severe anxiety and very serious anxiety were 1.46, 1.46, 1.71, and 1.83, respectively; the traditional drugs use behaviors were 5.51, and 2.61, respectively, for the severe anxiety and very serious anxiety. Compared with the normal psychological state of secondary vocational students, the OR values of the severe anxiety and very severe anxiety were 2.56, and 2.66, respectively, for severe anxiety and very serious anxiety. Compared with normal psychological status of secondary vocational students, the OR values of mild, moderate, severe, and very severe anxiety were 2.14, 2.47, 2.39, and 3.45, respectively; all P values <0.05. Conclusion: Anxiety and mild depression were risk factors of tobacco and alcohol use in secondary vocational students; severe and above anxiety were the risk factors of drug use in secondary vocational students; anxiety was the risk factor for other addictive drug use in secondary vocational students.

[The progression of parenteral and enteral nutrition based on new guidelines].

As people are getting a better understanding of organism's metabolism and the concept of disease treatment is being continuously updated, parenteral and enteral nutrition become an inter discipline subject that serves for the clinic and involves a number of disciplines. Just in the past five years, related guidelines at home and abroad have been published as much as more than 40. In order to better serve the clinical decision making, this text attempts to give a carding and interpretation from the three aspects of nutrition screening and assessment, the implementing of nutritional intervention and the progress of special nutrition support. It is observed that the standard clinical nutrition diagnosis and treatment process has been formed consensus. But in the practical application, there are still many details need to confirm and further study.

[New progress of BRAF gene and thyroid cancer].

It is noteworthy that the incidence of thyroid cancer around the world has increased significantly in recent decades, raising an imperative need to research its pathogenesis, diagnosis and treatment. Up to now, fine needle aspiration biopsy (FNAB) of thyroid has been acknowledged to discriminate benign from malignant thyroid nodules with the highest sensitivity and specificity. However, 10% to 40% thyroid nodules cannot be discriminated by FNAB. Therefore, it is vitally important to look for highly-correlated tumor makers in molecule level. BRAF mutation is a focus in thyroid cancer research, and some studies showed that this mutation is essential to the onset and development of thyroid cancer, especially papillary thyroid cancer. Joint detection of BRAF mutation could improve diagnostic sensitivity of thyroid cancer, which is crucial for thyroid cancer diagnosis and classification. As for treatment, the discovery of target gene enabled molecule therapy for thyroid cancer, raising hopes for patients with thyroid cancer that refractory to conventional treatments. Currently, many molecule therapeutics relating to BRAF has already undergone clinical trials. It is believed that further research on BRAF-thyroid cancer relationship could create a new field for diagnosis and treatment of thyroid cancer, and set a mode for discovering others molecule markers.

Development of a cyclic voltammetry method for the detection of Clostridium novyi in black disease.

Black disease is an acute disease of sheep and cattle. The pathogen is the obligate anaerobe, Clostridium novyi. Due to difficulties of anaerobic culturing in the country or disaster sites, a simple, rapid, and sensitive method is required. In this study, an electrochemical method, the cyclic voltammetry method, basing on loop-mediated isothermal amplification (LAMP), electrochemical ion bonding (positive dye, methylene blue), was introduced. DNA extracted from C. novyi specimens was amplified through the LAMP reaction. Then the products combined were with methylene blue, which lead to a reduction in the oxidation peak current (ipA) and the reduction peak current (ipC) of the cyclic voltammetry. The changes of ipA/ipC were real-time measured by special designed electrode, so the DNA was quantitatively detected. The results displayed that this electrochemical detection of C. novyi could be completed in 1-2 h with the lowest bacterial concentration of 10(2) colony forming units/mL, and high accuracy (96.5%), sensitivity (96%), and specificity (97%) compared to polymerase chain reation. The cyclic voltammetry method was a simple and fast method, with high sensitivity and high specificity, and has great potential to be a usable molecular tool for fast diagnosis of Black disease.

Dual-source dual-energy computed tomography angiography for active gastrointestinal bleeding: a preliminary study.

AIM: To assess the utility of dual-source dual-energy computed tomography angiography (DSDECTA) in the diagnosis of active gastrointestinal bleeding (GIB). MATERIALS AND METHODS: From June 2010 to September 2011, 58 consecutive patients with clinical signs of active GIB underwent DSDECTA. Two radiologists, blinded to clinical data, interpreted images from DSDECTA independently, with discordant interpretation resolved by consensus. The standards of reference included digital subtraction angiography, endoscopy, surgery, or final pathology reports. Sensitivity, specificity, positive (PPV) and negative (NPV) predictive values, and accuracy of DSDECTA for detection of active GIB were evaluated. Receiver-operating characteristic (ROC) analysis was undertaken and the area under the curve (AUC) calculated. RESULTS: Active GIB source was identified in 39 of 58 patients (67.2%), all of which were confirmed by one or more reference standard. Negative DSDECTA results were obtained in 19 patients (32.8%). Of these, 15 patients did not require any further intervention and were discharged without incident. The overall sensitivity, specificity, PPV, NPV, and accuracy of DSDECTA was 88.6, 100, 100, 73.7, and 91.4%, respectively. The AUC was 0.935 ± 0.063. The dose reduction of a dual-phase DSDECTA protocol was approximately 30%, compared with that of a triple-phase protocol used in a previous study. CONCLUSION: DSDECTA can act as an accurate method for detection and localization of active GIB and has a relatively low radiation dose.

DNA detection of Clostridium difficile infection based on real-time resistance measurement.

We used a newly developed electrochemical method, real-time resistance measurement, based on loop-mediated isothermal amplification (LAMP), with real-time resistance monitoring and derivative analysis. DNA extracted from specimens was amplified through LAMP reaction. The 2 products of LAMP, DNA and pyrophosphate, both are negative ions; they combine with positive dye (crystal violet) and positive ions (Mg(2+)), which leads to an increase in the resistivity of the reaction liquid. The changes of resistivity were measured in real-time with a specially designed resistance electrode, to detect Clostridium difficile DNA. We found that electrochemical detection of C. difficile could be completed in 0.5-1 h, with a detection limit of 10(2) CFU/mL, with high accuracy (95.0%), sensitivity (91.1%), and specificity (97.3%) compared to PCR methods. C. difficile is commonly associated with antibiotic-induced diarrhea. Due to the difficulty in performing anaerobic culture and cytotoxicity neutralization assays, a simple, rapid, sensitive, and accurate method is preferred. We conclude that real-time resistance measurement is a rapid, sensitive, and stable method for the diagnosis of C. difficile infection that could be applied to gene chips and pocket instruments.

[The perforator flap of ipsilateral nasolabial sulcus used to repair the defect after the eradication of nasal vestibular squamous cell carcinoma].

Objective: To investigate the feasibility of only surgical resection for nasal vestibular squamous cell carcinoma and the efficacy of perforator flap of ipsilateral nasolabial sulcus in repairing postoperative defects. Methods: The clinical data of 8 cases with squamous cell carcinoma of the nasal vestibule who admitted to Department of Facial Plastic and Reconstructive Surgery, Eye & ENT Hospital, Fudan University were analyzed, including 6 males and 2 females, aged from 38 to 75 years. The tumor of the nasal vestibule was eradicated in time after making definite diagnosis of lesions, then the perforators flap of the ipsilateral nasolabial sulcus was used for repairment, without performing further chemotherapy or radiotherapy after surgery. The tumor recurrence, facial appearance, nostril form, donor area scar, nasal ventilation function, and cutaneous sensation were evaluated after surgery. Descriptive analysis was used in this research. Results: There were 2 cases of stage T1 and 6 cases of stage T2 in 8 cases. After 32 to 45 months of following-up, no recurrence accurred and all the flaps survived well. However, there was about 2 mm necrosis of the transplanted flap in the lateral foot of the alar in one case, which was healed well by carrying out wound care after 10 d. And the dark color flap was occurred in another case, showing the flap's backflow trouble, yet it was improved with addressing timely during 5 d postoperation. Pincusion-like deformity of the transplanted flap occurred in 4 cases (50%), which subsided gradually after 6 months. The morphology of the anterior nostril was altered in 4 cases (50%), but there was no ventilation trouble and no need for addressment in any case. The postoperative facial appearance was rated as excellentor good with hidden scar in the donor site, and the sensation of the transplanted flaps was indistinct from the surrounding tissue after 3 months. Conclusions: Surgical resection of nasal vestibular squamous cell carcinoma with tumor stage T1-2 is a feasible treatment. And it is the one of the best reconstructive methods of the perforator flap of the ipsilateral nasolabial sulcus to repair the deformities after the surgery.

Atypical ductal hyperplasia of the breast diagnosed by ultrasonographically guided core needle biopsy.

PURPOSE: We analysed the ultrasonographic (US) features of atypical ductal hyperplasia (ADH) of the breast diagnosed by US-guided core needle biopsy (CNB) with the aim of identifying factors that affect the underestimation of ADH. MATERIALS AND METHODS: A total of 134 ADH lesions sampled by US-guided CNB were reviewed retrospectively. All lesions were evaluated for pattern, size, lesion characteristics and margins, and the corresponding surgical outcome or imaging follow-up was obtained. Each patient's clinical and radiological features were analysed to identify factors involved in ADH underestimation. RESULTS: The prevalence of malignancy in each pattern of lesions following surgical excision was 32/81 (40%) for solid masses, 14/31 (45%) for ductal patterns, 5/17 (29%) for complex cystic lesions and 2/5 (40%) for architectural distortions. Based on the results of surgical and US follow-up, none of the category 3 lesions was proven to be a malignancy. Malignancy was found in 17 (21%) of the 80 BI-RADS (Breast Imaging Reporting and Data System) category 4a lesions, 20 (74%) of the 27 category 4b lesions, 12 (92%) of the 13 category 4c lesions, and four (100%) of the four category 5 lesions. Lesions with a higher US assessment category, lacking circumscribed margins, or a mammographic finding of suspected malignancy were all significantly associated with underestimation (p < 0.05 for each). CONCLUSION: US is useful in evaluating ADH lesions and in clarifying the indication for biopsy of these lesions. Familiarity with the frequency associated with malignancy for each feature will improve the utility of US in the work-up of these breast abnormalities.

Successful treatment of mucormycosis infection after liver transplantation: report of a case and review of the literature.

Mucormycosis (zygomycosis) is a rare opportunistic fungal infection mainly affecting patients with diabetes mellitus, immunodeficiency, malignancies and solid organ transplant. We present a 55-year-old female with a mucormycosis infection primarily affecting the paranasal sinuses after liver transplantation. The patient presented with a one-week history of right-sided occipital headache and gradual loss of vision in the right eye just 6 months after liver transplantation. Imaging studies revealed a right-sided sphenoiditis with orbital apex involvement. The patient underwent endoscopic sinus surgery and the histology confirmed the diagnosis of mucormycosis. Aggressive surgical ablation of the infected parts, along with antifungal treatment and adjustment of her immunosuppressive maintenance resulted in a good outcome and long-term survival.

Influence of age on PPV of sonographic BI-RADS categories 3, 4, and 5.

PURPOSE: The purpose of this retrospective study was to calculate the positive predictive value (PPV) of sonographic Breast Imaging Reporting and Data System (BI-RADS) categories 3, 4, and 5 in different age groups to investigate whether age influences the PPV of the BI-RADS category in breast ultrasound. MATERIALS AND METHODS: From our sonography-guided core biopsy database of breasts between 2006 and 2008, we identified 2817 BI-RADS category 3, 4, and 5 lesions with known pathological diagnosis in 2587 women, all of whom underwent the earlier breast assessment via ultrasound with a sonographic BI-RADS lexicon and later sonography-guided core biopsy. All lesions were classified into three age groups (< 45, 45 - 59, and > 59 years). The age-related PPVs of each BI-RADS category among three age groups were calculated on the basis of pathological diagnoses and were compared using a χ(2)-test. RESULTS: The overall PPV of each BI-RADS category was 2.2 % in category 3, 6.5 % in category 4a, 35.2 % in category 4b, 79.6 % in category 4c, and 99.6 % in category 5. The age-related PPVs of category 3 varied significantly among the three age groups (0.9 % versus 3.9 % versus 2.0 % p = 0.048), and notably, the age-related PPV in group 2 was higher than the others. Additionally, there was a significant positive association between the age-related PPVs and increasing age in categories 4a and 4b (4a, p < 0.0001 and 4b, p = 0.0139), but not in categories 4c and 5 (4c, p = 0.1853 and 5, p = 0.2871). CONCLUSION: The incidence of female breast cancer differs not only in different sonographic BI-RADS categories, but also in different age groups. Therefore, more attention should be paid to the special age group that we found for sonographic BI-RADS categories 3, 4a, and 4b.

Breast metastases from lung carcinomas: a report of three cases.

Tumours metastasising to the breast are very infrequent, with an incidence of 0.4-6.6% of all breast tumours. Occasionally a breast mass is the first indicator of a tumour arising elsewhere. Development of metastases to the breast from a lung cancer is very rare and the prognosis for such patients is poor. We present three patients who had metastases to the breast presenting clinically as the primary origin. It is important to distinguish a primary breast cancer from a metastasis, as different therapies are offered with considerably different outcomes.

Efficiency of infiltration with bupivacain after modified radical mastectomy.

BACKGROUND: Pre-incisional infiltration of anaesthetic is proven to reduce postoperative pain in breast cancer surgery. However, studies of post-incisional infiltration for modified radical mastectomy are rare. The purpose of this study was to investigate whether post-incisional infiltration with bupivacaine provides improved postoperative pain relief and a cost-effective benefit. METHODS: This is a retrospective study. Between January 2006 and May 2008, 139 patients who received modified radical mastectomy were recruited to participate in the study. Patients receiving local infiltration received bupivacaine (0.5% bupivacaine, 5 ml diluted to 10 ml with distilled water) injected into the dermis surrounding the incision after wound suture. Pain intensity was evaluated using a Visual Analogue Scale (VAS) score and measurement of the required doses of meperidine and acetaminophen. The pain score was recorded every eight hours for three days. RESULTS: All patients were female. Seventy-two patients received local infiltration with bupivacaine after wound suture and 67 patients did not. There were no significant differences between the two patient groups in age, body weight and height, length of general anaesthesia and operative time. Hospital stay was significantly shorter for patients receiving local infiltration of bupivacaine. The VAS score was higher up to 16 hours post-surgery for patients who did not receive local infiltration. Meperidine and acetaminophen consumption was less for patients who received local infiltration (P = 0.010). CONCLUSION: Post-incisional wound infiltration with bupivacaine can relieve pain during the first 16 hours after surgery and shorten hospital stay, and it provides a cost-effective benefit.

A progesterone-receptor-positive huge retroperitoneal tumour mimics metastasis in a breast cancer patient: sarcomatoid renal cell carcinoma.

We report a rare case of breast cancer concomitant with progesterone-receptor-positive renal cell carcinoma. A 48-year-old woman was diagnosed as having infiltrating ductal carcinoma of the breast and underwent modified radical mastectomy. A synchronous retroperitoneal tumour was detected by sonography of the abdomen in a routine cancer staging. Initially, the tumour was diagnosed as a synchronous retroperitoneal metastasis by needle biopsy; further tests revealed that it was progesterone receptor-positive. The retroperitoneal tumour showed poor response to full courses of adjuvant chemotherapy for breast cancer. Subsequently, the patient underwent a radical operation that included nephrectomy. The final pathology confirmed a sarcomatoid renal cell carcinoma. The post-operative course was uneventful. The patient had no recurrence at the 1-year follow-up. In this report, accurate diagnosis and adequate treatment were discussed. An intra-abdominal tumour with progesterone receptor- (PR) positive features is usually considered to be metastatic in breast cancer patients. For breast cancer patients with a PR-positive retroperitoneal tumour, renal cell carcinoma should be differentiated from a metastatic lesion of breast cancer, even if PR-expression is rare in renal cell carcinoma. To the best of our knowledge, this is the first case of PR-positive expression in breast cancer concomitant with renal carcinoma. In clinical settings, it is challenging for the surgeon to make an accurate diagnosis and to provide prompt treatment in such cases.

Transgenic expression of haem oxygenase-1 in pancreatic beta cells protects non-obese mice used as a model of diabetes from autoimmune destruction and prolongs graft survival following islet transplantation.

AIMS/HYPOTHESIS: Haem oxygenase 1 (HO-1) has strong anti-apoptotic, anti-inflammatory and antioxidative effects that help protect cells against various forms of immune attack. We investigated whether transgenic expression of Ho-1 (also known as Hmox1) in pancreatic beta cells would protect NOD mice from autoimmune damage and prolong graft survival following islet transplantation. METHODS: To evaluate the protective effect of beta cell-specific HO-1 in autoimmune diabetes, we used an insulin promoter-driven murine Ho-1 construct (pIns-mHo-1) to generate a transgenic NOD mouse. Transgene expression, insulitis and the incidence of diabetes in mice were characterised. Lymphocyte composition, the development of T helper (Th)1, Th2 and T regulatory (Treg) cells, T cell proliferation and lymphocyte-mediated disease transfer were analysed. The potential effects of transgenic islets and islet transplantation on apoptosis, inflammation and the generation of reactive oxygen species (ROS) and reactive nitrogen species (RNS) were evaluated. RESULTS: Transgenic mice showed less severe insulitis and a lower incidence of diabetes than non-transgenic control littermates. Lymphocyte composition and functions were not affected. Islets from transgenic mice expressed lower levels of proinflammatory cytokines/chemokines, proapoptotic gene expression and amounts of ROS/RNS, and were more resistant to TNF-α- and IFN-γ-induced apoptosis. Islet grafts from transgenic mice also survived longer in diabetic recipients than control islets. CONCLUSIONS/INTERPRETATION: Transgenic overexpression of Ho-1 in beta cells protected NOD mice from diabetes and delayed the autoimmune destruction of islet grafts, providing valuable insight into the development of better strategies for clinical islet transplantation in patients with type 1 diabetes.

The relationship between acid-suppressing drugs and phytobezoar formation: a retrospective analysis and discussion of phytobezoar formation.

OBJECTIVES: Although phytobezoars are a rare cause of gastrointestinal obstruction, they are most commonly found in patients with previous gastric surgery. It is well known that predisposing factors of phytobezoar formation are ingestion of fruits containing soluble tannin, presence of dilute hydrochloric acid in the stomach, and gastric stasis or delayed emptying. We investigated whether intake of acid-suppressing drugs that neutralize gastric acidity or inhibit gastric acid secretion to constitute a hypo-acidic condition, increases the risk of phytobezoar formation. MATERIALS AND METHODS: Between September 1992 and October 2008, 32 patients (24 male and 8 female) with gastrointestinal phytobezoars were diagnosed either surgically or endoscopically at the Tri-Service General Hospital, Taipei, Republic of China. The data were collected from hospital records and analyzed retrospectively. RESULTS: Eighteen (56.25%) of all patients had previous gastric surgery and 6 (42.9%) of the 14 patients who had not undergone surgery had diabetes mellitus. The majority of admissions were during winter and spring (between October and March) (P < 0.01) and none of the patients had taken acid-suppressing drugs during the 6 months before detection of gastrointestinal phytobezoars. CONCLUSIONS: In our study, intake of acid-suppressing drugs did not increase the risk of phytobezoar formation in patients with normal gastric motility. Moreover, we believe that the major factor in phytobezoar formation is gastric stasis or delayed emptying, which sufficiently prolongs the retention period of materials in the stomach, while dilute hydrochloric acid is a minor factor.

Fast and Accurate Binary Response Mixed Model Analysis Via Expectation Propagation.

Expectation propagation is a general prescription for approximation of integrals in statistical inference problems. Its literature is mainly concerned with Bayesian inference scenarios. However, expectation propagation can also be used to approximate integrals arising in frequentist statistical inference. We focus on likelihood-based inference for binary response mixed models and show that fast and accurate quadrature-free inference can be realized for the probit link case with multivariate random effects and higher levels of nesting. The approach is supported by asymptotic calculations in which expectation propagation is seen to provide consistent estimation of the exact likelihood surface. Numerical studies reveal the availability of fast, highly accurate and scalable methodology for binary mixed model analysis. Supplementary materials for this article are available online.

Identification of PTK7 as a promising therapeutic target for thyroid cancer.

OBJECTIVE: To evaluate the possible involvement of PTK7 in the progression of human thyroid cancer and assess its potential effects on the proliferation and apoptosis of thyroid cancer. PATIENTS AND METHODS: Immunohistochemical (IHC) assays and clinical significance analysis were performed to explore the correlations between PTK7 expression and clinical characteristics of patients with thyroid cancer. Quantitative PCR assays and Immunoblot assays were performed to detect the expression of PTK7 in control or PTK7 shRNA plasmids transfected thyroid cancer cells. MTT assays were performed to detect the effects on the proliferation of thyroid cancer cells. Flow cytometry (FCM) assays were performed to assess the changes in cell apoptosis of thyroid cancer. Additionally, the effects of PTK7 on tumor growth were detected through in vivo tumor growth assays. RESULTS: PTK7 is highly expressed in human thyroid cancer tissues, and its expression levels are associated with the clinical characteristics, including TNM stage (p=0.015*), and intraglandular dissemination (p=0.024*) of patients with thyroid cancer. PTK7 ablation inhibits cell proliferation and stimulates cell apoptosis of thyroid cancer in vitro. Additionally, PTK7 contributes to tumor growth of thyroid cancer cells in mice. CONCLUSIONS: We demonstrated the involvement of PTK7in the progression of thyroid cancer, and therefore provided a novel and promising therapeutic target for thyroid cancer treatment.

Simvastatin promotes osteogenic differentiation of mesenchymal stem cells in rat model of osteoporosis through BMP-2/Smads signaling pathway.

OBJECTIVE: By establishing osteoporosis (OP) model in rats, the specific regulatory effect of simvastatin on promoting the differentiation of mesenchymal stem cells (MSCs) into osteoblasts through the bone morphogenetic protein 2 (BMP-2)/Smads signaling pathway was investigated. MATERIALS AND METHODS: A total of 45 Sprague-Dawley rats were selected to establish the OP model by performing ovariectomy. The rats were divided into OP model group (OP group, n=15), 10-7 mmol/L simvastatin treatment group (SIM group, n=15), and normal control group (Control group, n=15). After the experimental period, the enzyme-linked immunosorbent assay (ELISA) was applied to observe the serum levels of tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and IL-1. Reverse Transcription-Polymerase Chain Reaction (RT-PCR) was adopted to detect the contents of the differentiation-associated genes [runt-related transcription factor 2 (RUNX2) and Osterix (Osx)]. Later, the bone marrow MSCs (BMSCs) were selected and divided into Control group, 10-7 mol/L simvastatin group (SIM group), and osteoinduction medium group (OM group). Cell morphology in each group was observed. The Cell Counting Kit-8 (CCK-8) was performed to determine the proliferation activity of BMSCs. ELISA was performed to measure the level of alkaline phosphatase (ALP). RT-PCR was conducted to examine the levels of key differentiation-associated gene RUNX2 and those in BMP-2/Smads pathway. Moreover, the Western blotting was adopted to analyze the expressions of RUNX2 and genes in BMP-2/Smads pathway. RESULTS: The serum levels of TNF-α, IL-6, and IL-1 in OP group were remarkably higher than those in the Control group, and their levels in the SIM group were close to those in the Control group. The elevated messenger ribonucleic acid (mRNA) levels of the key differentiation-associated factors RUNX2, osteoprotegerin (OPG), osteopontin (OPN), and Osx were observed in the SIM group. In vitro cell culture revealed that the cells were in a favorable growth status in the SIM group and OM group, mostly manifesting in fusiform or spindle shape, and proliferated rapidly. In addition, the ALP level notably increased in the two groups compared with that in the Control group (p<0.05). Both SIM group and OM group had evidently higher mRNA expression levels of RUNX2, OPG, OPN, and Osx than those in the Control group (p<0.05), consistent with the expression trends of the genes in BMP-2/Smads pathway. The Western blotting indicated that the expression levels of RUNX2 and genes in BMP-2/Smads pathway in the SIM group were significantly higher than those in the Control group. CONCLUSIONS: Simvastatin can promote the differentiation of MSCs into osteoblasts in the OP rat model through the BMP-2/Smads signaling pathway.

Circulating levels of leptin, adiposity and breast cancer risk.

The present case-control study was to investigate the relationships of plasma leptin level and anthropometric measures of adiposity with the risk of breast cancer. Questionnaire information, anthropometric measures and blood samples were taken before treatment from 297 incident cases with breast cancer and 593 controls admitted for health examination at the Tri-Service General Hospital, Taipei, between 2004 and 2006. Plasma levels of leptin were measured by RIA. Logistic regression analysis was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for assessing the associations. Overall, higher leptin concentrations were significantly associated with an increased risk of breast cancer (OR (95% CI) for top vs bottom tertile of leptin was 1.63 (1.07-2.49), P(trend)=0.009). Waist circumference was a significant anthropometric factor for breast cancer in both pre- and postmenopausal women. Furthermore, the associations of leptin with breast cancer risk remained after adjustment for obesity indices. These results suggest that leptin may have an independent role in breast tumorigenesis. Regardless of the impact of circulating leptin, more research is needed to elucidate molecular mechanisms and local leptin levels that are critical for the development of breast cancers.