[Effect of Zuogui Jiangtang Jieyu Formula on intestinal flora and short-chain fatty acid metabolism in rats with diabetes mellitus complicated with depression].

This study aimed to investigate the regulatory effects of Zuogui Jiangtang Jieyu Formula(ZJJ) on the intestinal flora, short chain fatty acids(SCFAs), and neuroinflammation in rats with diabetes mellitus complicated depression(DD). The DD model was established in rats and model rats were randomly divided into a model group, a positive drug(metformin + fluoxetine) group, a ZJJ low-dose group, and a ZJJ high-dose group, with eight rats in each group. Another eight rats were assigned to the blank group. Subsequently, depressive-like behavior test was conducted on the rats, and cerebrospinal fluid samples were collected to measure pro-inflammatory cytokines [interleukin-1ß(IL-1ß), interleukin-6(IL-6), and tumor necrosis factor-α(TNF-α)]. Blood serum samples were collected to measure proteins related to the hypothalamic-pituitary-adrenal axis(HPA axis), including corticotropin-releasing hormone(CRH), adrenocorticotropic hormone(ACTH), and cortisol(CORT), as well as glucose metabolism. Gut contents were collected from each group for 16S rRNA sequencing analysis of intestinal flora and SCFAs sequencing. The results indicated that ZJJ not only improved glucose metabolism in DD rats(P<0.01) but also alleviated depressive-like behavior(P<0.05) and HPA axis hyperactivity(P<0.05 or P<0.01). Besides, it also improved the neuroinflammatory response in the brain, as evidenced by a significant reduction in pro-inflammatory cytokines in cerebrospinal fluid(P<0.05 or P<0.01). Additionally, ZJJ improved the intestinal flora, causing the intestinal flora in DD rats to resemble that of the blank group, characterized by an increased Firmicutes abundance. ZJJ significantly increased the levels of SCFAs(acetic acid, butyric acid, valeric acid, and isovaleric acid)(P<0.01). Therefore, it is deduced that ZJJ can effectively ameliorate intestinal flora dysbiosis, regulate SCFAs, and thereby improve both glucose metabolism disturbances and depressive-like behavior in DD.

Association between red blood cell distribution width-to-albumin ratio and prognosis in non-ischaemic heart failure.

AIMS: Red blood cell distribution width-to-albumin ratio (RAR), an innovate biomarker of inflammation, can independently predict adverse cardiovascular outcomes. However, the association between RAR and prognosis in patients with non-ischaemic heart failure (NIHF) remains unclear. METHODS AND RESULTS: A total of 2077 NIHF patients admitted to the Heart Failure Care Unit, Fuwai Hospital, were consecutively enrolled from December 2006 to October 2017 in this retrospective study. The primary endpoint was a composite outcome of all-cause mortality and heart transplantation. The correlation between RAR and the composite outcome was assessed by the Kaplan-Meier survival analysis and the Cox regression analysis. Incremental predictive values and the clinical performance of RAR for all-cause mortality or heart transplantation were also assessed based on a 12-variable traditional risk model. The median follow-up time in this study was 1433 (1341, 1525) days. As the gender no longer satisfied the Cox proportional risk assumption after 1150 days, we set 1095 days as the follow-up time for analysis. A total of 500 patients reached the composite outcome. Multivariable Cox regression showed that per log2 increase of RAR was significantly associated with a 132.9% [hazard ratio 2.329, 95% confidence interval (CI) 1.677-3.237, P < 0.001] increased risk of all-cause mortality or heart transplantation. Better model discrimination [concordance index: 0.766 (95% CI 0.754-0.778) vs. 0.758 (95% CI 0.746-0.770), P < 0.001], calibration (Akaike information criterion: 1487.3 vs. 1495.74; Bayesian information criterion: 1566.25 vs. 1569.43; Brier score: 1569.43 vs. 1569.43; likelihood ratio test P < 0.001), and reclassification (integrated discrimination improvement: 1.35%, 95% CI 0.63-2.07%, P < 0.001; net reclassification improvement: 13.73%, 95% CI 2.05-27.18%, P = 0.034) were improved after adding RAR to the traditional model (P < 0.001 for all). A higher overall net benefit was also obtained in the threshold risk probability of 20-55%. CONCLUSIONS: High level of RAR was an independent risk factor of poor outcome in NIHF.

[Characteristics and Sources of PM2.5 Pollution During Winter in Handan City from 2016 to 2020].

To explore the characteristics and sources of PM2.5 pollution in winter of Handan City in the past five years, PM2.5 samples were collected in winter of 2016 to 2020, and eight types of water-soluble inorganic ions were analyzed. The principal component analysis(PCA) model was used to analyze the types of pollution sources, and the backward trajectory and potential source contribution factor(PSCF) were used to simulate the transport trajectory and pollution sources. The results showed that the PM2.5 concentration in winter of 2018 was the highest, increasing by 60.44%, 25.46%, 91.43%, and 21.53% compared with that in 2016, 2017, 2019, and 2020, respectively. In the winter of 2020, the concentration of water-soluble inorganic ions(WSIIs) decreased by 18.86% compared with that in 2016, and WSIIs/PM2.5 decreased to 26.69%. The PM2.5 concentration(110.20-209.65 µg·m-3) at night was higher than that in the daytime(95.21-193.00 µg·m-3). The concentration of NO3- and NH4+ increased more at night. On the contrary, the concentration and proportion of Cl-decreased annually. In the winter of 2020, the daytime concentrations of K+, Ca2+, Na+, and Mg2+ decreased by 69.72%, 97.10%, 90.91%, and 74.51% compared with that of 2018, and the night concentrations decreased by 66.67%, 95.38%, 91.67%, and 77.78%, respectively. In 2020, the concentrations of NO3-, SO42-, and NH4+ on polluted days were 4.90, 5.80, and 5.20 times those on non-polluted days, with the largest increase in five years. PCA results showed that the main sources of pollution were secondary sources, coal sources, biomass combustion sources, and road and building dust. The backward trajectory and PSCF analysis results showed that pollution transport continued to exist between south-central Mongolia and central Inner Mongolia in winter and was influenced by the transport between northern Henan and Handan and central Hebei and Handan in winter of 2016 and 2017, whereas the latter had a greater impact in winter of 2018-2020.

Targeting the Main Sources of Reactive Oxygen Species Production: Possible Therapeutic Implications in Chronic Pain.

Humans have long been combating chronic pain. In clinical practice, opioids are first- choice analgesics, but long-term use of these drugs can lead to serious adverse reactions. Finding new, safe and effective pain relievers that are useful treatments for chronic pain is an urgent medical need. Based on accumulating evidence from numerous studies, excess reactive oxygen species (ROS) contribute to the development and maintenance of chronic pain. Some antioxidants are potentially beneficial analgesics in the clinic, but ROS-dependent pathways are completely inhibited only by scavenging ROS directly targeting cellular or subcellular sites. Unfortunately, current antioxidant treatments donot achieve this effect. Furthermore, some antioxidants interfere with physiological redox signaling pathways and fail to reverse oxidative damage. Therefore, the key upstream processes and mechanisms of ROS production that lead to chronic pain in vivo must be identified to discover potential therapeutic targets related to the pathways that control ROS production in vivo. In this review, we summarize the sites and pathways involved in analgesia based on the three main mechanisms by which ROS are generated in vivo, discuss the preclinical evidence for the therapeutic potential of targeting these pathways in chronic pain, note the shortcomings of current research and highlight possible future research directions to provide new targets and evidence for the development of clinical analgesics.

Incidence and cost of vertebral fracture in urban China: a 5-year population-based cohort study.

BACKGROUND: Osteoporotic vertebral fractures cause pain and disability, which result in a heavy socioeconomic burden. However, the incidence and cost of vertebral fractures in China are unknown. We aimed to assess the incidence and cost of clinically recognized vertebral fractures among people aged 50 years and older in China from 2013 to 2017. MATERIALS AND METHODS: This population-based cohort study was conducted by using Urban Employee Basic Medical Insurance (UEBMI) and Urban Resident Basic Medical Insurance (URBMI) data in China from 2013 to 2017, which covered more than 95% of the Chinese population in urban areas. Vertebral fractures were identified by the primary diagnosis (i.e. International Classification of Diseases code or text of diagnosis) in UEBMI and URBMI. The incidence and medical cost of these clinically recognized vertebral fractures in urban China were calculated. RESULTS: A total of 271 981 vertebral fractures (186 428, 68.5% females and 85 553, 31.5% males) were identified, with a mean age of 70.26 years. The incidence of vertebral fractures among patients aged 50 years and over in China increased ~1.79-fold during the 5 years, from 85.21 per 100 000 person-years in 2013 to 152.13 per 100 000 person-years in 2017. Medical costs for vertebral fractures increased from US$92.74 million in 2013 to US$505.3 million in 2017. Annual costs per vertebral fracture case increased from US$3.54 thousand in 2013 to US$5.35 thousand in 2017. CONCLUSION: The dramatic increase in the incidence and cost of clinically recognized vertebral fractures among patients aged 50 and over in urban China implies that more attention should be given to the management of osteoporosis to prevent osteoporotic fractures.

Higher Prevalence of Generalized Pustular Psoriasis in Asia? A Population-Based Study Using Claim Data in China and a Systematic Review.

BACKGROUND: Few studies have reported the burden of generalized pustular psoriasis (GPP), a severe and potentially life-threatening skin disease, especially at a national level. OBJECTIVES: The aim of this study is to estimate the nationwide burden of GPP in China and make a systemic review of the published data. METHODS: We conducted a population-based study using Urban Basic Medical Insurance in China from 2012 to 2016. GPP cases were identified by primary diagnoses including the international classification of Diseases codes (ICD-10: L40.1 and ICD-9: 694.3). A systematic review was conducted using relevant databases up to January 2022. RESULTS: The crude prevalence and incidence of GPP in 2016 were 1.403 (95% confidence interval [CI]: 1.115-1.691) and 0.629 (95% CI: 0.483-0.775) per 100,000 person-years, respectively. The rates were higher in males than in females for both prevalence (1.429 vs. 1.135) and incidence (0.635 vs. 0.520). The prevalence and incidence showed a bimodal age distribution, with the first peak occurring in the 0- to 3-year age-group and the second peak occurring in the 30- to 39-year age-group. The per capita total cost per year for 1 patient with GPP was 609.26 (± 45.77) US dollars. Seven studies were identified in a systematic review, according to which the prevalence (per 100,000) of GPP tended to be higher in Asian countries (0.746-8.178 in Japan and 12.230 in Korea) than in France (0.176), Sweden (6.25), and Brazil (0.7). CONCLUSIONS: This is the largest study concerning the disease burden of GPP, and in this study, the prevalence seemed to be higher in Asia. Although the direct economic burden of GPP did not seem high during the study period, the future usage of biologics and the humanistic burden should also be considered for policy-related decision-making.

Sustained over-expression of calpain-2 induces age-dependent dilated cardiomyopathy in mice through aberrant autophagy.

Calpains have been implicated in heart diseases. While calpain-1 has been detrimental to the heart, the role of calpain-2 in cardiac pathology remains controversial. In this study we investigated whether sustained over-expression of calpain-2 had any adverse effects on the heart and the underlying mechanisms. Double transgenic mice (Tg-Capn2/tTA) were generated, which express human CAPN2 restricted to cardiomyocytes. The mice were subjected to echocardiography at age 3, 6, 8 and 12 months, and their heart tissues and sera were collected for analyses. We showed that transgenic mice over-expressing calpain-2 restricted to cardiomyocytes had normal heart function with no evidence of cardiac pathological remodeling at age 3 months. However, they exhibited features of dilated cardiomyopathy including increased heart size, enlarged heart chambers and heart dysfunction from age 8 months; histological analysis revealed loss of cardiomyocytes replaced by myocardial fibrosis and cardiomyocyte hypertrophy in transgenic mice from age 8 months. These cardiac alterations closely correlated with aberrant autophagy evidenced by significantly increased LC3BII and p62 protein levels and accumulation of autophagosomes in the hearts of transgenic mice. Notably, injection of 3-methyladenine, a well-established inhibitor of autophagy (30 mg/kg, i.p. once every 3 days starting from age 6 months for 2 months) prevented aberrant autophagy, attenuated myocardial injury and improved heart function in the transgenic mice. In cultured cardiomyocytes, over-expression of calpain-2 blocked autophagic flux by impairing lysosomal function. Furthermore, over-expression of calpain-2 resulted in lower levels of junctophilin-2 protein in the heart of transgenic mice and in cultured cardiomyocytes, which was attenuated by 3-methyladenine. In addition, blockade of autophagic flux by bafilomycin A (100 nM) induced a reduction of junctophilin-2 protein in cardiomyocytes. In summary, transgenic over-expression of calpain-2 induces age-dependent dilated cardiomyopathy in mice, which may be mediated through aberrant autophagy and a reduction of junctophilin-2. Thus, a sustained increase in calpain-2 may be detrimental to the heart.

Prevalence and incidence of pseudomyxoma peritonei in urban China: A nationwide retrospective cohort study.

BACKGROUND: Pseudomyxoma peritonei (PMP) is an extremely rare condition. Information regarding the disease burden of PMP in developing countries is limited. This study aimed to determine the epidemiology of PMP in China. METHODS: PMP data were extracted from the national databases of Urban Basic Medical Insurance. All cases were identified using the International Classification of Diseases (ICD) codes and Chinese diagnostic terms. The national prevalence from 2012 to 2016 and incidence in 2016 were estimated. RESULTS: In total, 153 patients with PMP were identified. The crude prevalence of PMP in 2016 was 2.47 (95% confidence interval [CI] 1.71 to 3.23) per million person-year, with a higher prevalence in females than males. Prevalence increased with age, with the first peak in those aged 15-29 years and the highest in those aged >80 years. The crude incidence of PMP in 2016 was 1.19 (95% CI 0.59 to 1.78) per million person-years. Similar to the prevalence, the rates were higher in women than in men. The incidence also increased with age, with the highest prevalence in those aged >80 years. Besides, the most frequent comorbidities before and after the first diagnosis of PMP were unspecified secondary malignancies and malignancies of unspecified sites, followed by abdominal malignant tumours. CONCLUSIONS: The rate of PMP was lower in mainland China than in European countries and increased with advancing age. Women were more likely to have PMP than men. Furthermore, an insufficient understanding of this rare disease presents a major challenge in accurately evaluating the disease burden.

[Chemical Characteristics and Sources of Atmospheric Aerosols in the Surrounding District of a Heavily Polluted City in the Southern Part of North China].

In order to explore the chemical composition and source profiles of atmospheric particulate matter in winter in the northern area of Handan, a heavily polluted city in the southern part of North China, PM1 and PM2.5 samples were collected and analyzed from November 23 to December 12, 2020. During the observation period, the daily average ρ(PM1)and ρ(PM2.5) were 114.53 µg·m-3 and 124.25 µg·m-3, respectively, and the ratio of PM1/PM2.5 was 83.3%-95.3%, which was significantly higher than those of other cities in the Beijing-Tianjin-Hebei region, indicating that air pollution of fine particulate matter, especially sub-micron particulate matter, was more serious in Handan. Compared with that during clean days, SNA (SO42-, NO3-, and NH4+) in PM1 increased by 14.5% during heavy pollution, and SNA in PM2.5 increased by 15.2%; the nitrogen oxidation rate (NOR) in particular increased by three times on heavy pollution days. With the deepening of pollution, the proportion of secondary organic carbon (SOC) in PM1 and PM2.5 increased by 22.0% and 12.5%, respectively. SOC tended to accumulate in small particles, whereas the proportion of primary organic carbon (POC) and elemental carbon (EC) in PM1 decreased by 15.4% and 6.6%, and the POC and EC in PM2.5 decreased by 8.2% and 4.3%, respectively. The above results indicated that secondary formation played an important role in the heavy pollution of particulate matter. With the aggravation of air pollution, the liquid water content of the particles increased, and both the sulfur oxidation ratio (SOR) and nitrogen oxidation ratio (NOR) increased, indicating that the aqueous phase chemical reaction made an important contribution to the formation of secondary inorganics. With the deepening of pollution, inorganic elements were on the rise; Se, As, Pb, and Zn were highly enriched in inorganic elements. The results of principal component analysis (PCA) showed that secondary formation, industrial emissions, vehicle exhaust, and biomass burning emissions were the main sources of particulate pollutants. The results of potential source contribution factor analysis (PSCF) showed that the high value areas of SO42-, NO3-, EC, OC, and inorganic elements were mainly from the north and southwest directions of the observation area.

[Evaluation of artificial digestion method on inspection of meat for Trichinella spiralis contamination and influence of the method on muscle larvae recovery].

OBJECTIVE: To evaluate the effect of artificial digestion method on inspection of meat for Trichinella spiralis contamination and its influence on activity and infectivity of muscle larvae. METHODS: The mice were inoculated orally with 100 muscle larvae of T. spiralis and sacrificed on the 30th day following the infection. The muscle larvae of T. spiralis were recovered by three different test protocols employing variations of the artificial digestion method, i.e. the first test protocol evaluating digestion for 2 hours (magnetic stirrer method), the second test protocol evaluating digestion for 12 hours, and the third test protocol evaluating digestion for 20 hours. Each test group included ten samples, and each of which included 300 encapsulated larvae. Meanwhile, the activity of the recovered muscle larvae was also assessed. Forty mice were randomly divided into a control group and three digestion groups, so 4 groups (with 10 mice per group) in total. In the control group, each mouse was orally inoculated with 100 encapsulated larvae of T. spiralis. In all of the digestion test groups, each mouse was orally inoculated with 100 muscle larvae of T. spiralis. The larvae were then recovered from the different three test groups by the artificial digestion protocol variations. All the infected mice were sacrificed on the 30th day following the infection, and the muscle larvae of T. spiralis were examined respectively by the diaphragm compression method and the magnetic stirrer method. RESULTS: The muscle larvae detection rates were 78.47%, 76.73%, and 68.63%, the death rates were 0.59%, 4.60%, and 7.43%, and the reduction rates were 60.56%, 61.94%, and 73.07%, in the Test Group One (2-hour digestion), Test Group Two (12-hour digestion) and Test Group Three (20-hour digestion), respectively. CONCLUSION: The magnetic stirrer method (2-hour digestion method) is superior to both 12-hour digestion and 20-hour digestion methods when assessed by the detection rate, activity and infectivity of muscle larvae.