[Mediating effect of physical activity on association between sedentary leisure-time and obesity indexes among hypertensive individuals].

Objective: To explore the mediating effect of physical activity on association between sedentary leisure-time and obesity indexes among hypertensive individuals. Methods: After excluding of those with a prior history of heart disease, stroke and cancer, a total of 20 178 hypertensive participants in the China Kadooire Biobank (CKB) study from Wuzhong district of Suzhou city were included. Mediating effect analysis was used to analyze the mediating effect of physical activity (PA) on correlation between sedentary leisure-time and body fat percentage (BFP), waist circumference (WC) and body mass index (BMI). Results: After adjusted for age, gender, smoking status, alcohol consumption, education levels, intake frequencies of meat and intake frequencies of fresh fruit, sedentary leisure-time (SLT) was negatively correlated with PA (ß=-0.246, P<0.001), but positively associated with BFP (ß=0.061, P<0.001), WC (ß=0.087, P<0.001) and BMI (ß=0.071, P<0.001). After including the mediator variable PA, the direct effect of SLT on obesity index was still significant. PA was negatively correlated with BFP, WC and BMI (ß=-0.052, -0.083 and -0.028, respectively, P<0.001). Analysis of mediating effect indicated that the association of SLT with BFP, WC and BMI were partly mediated by PA, the proportion of mediating effect was 20.820%, 23.421% and 9.915%. Stratified by gender, PA had mediating effect on SLT and all obesity indexes in women, while only on SLT and BFP and WC in men. Conclusions: There is a significant mediating effect of PA on correlation between SLT and obesity indexes among hypertensive individuals. Hypertensive patients should increase the level of physical activity and reduce sedentary behavior to achieve a profounder healthy effect.

[Analysis of influencing factors of shunt dysfunction after transjugular intrahepatic portosystemic shunt in liver cirrhosis accompanied with portal vein thrombosis].

Objective: To investigate the efficacy of shunt after transjugular intrahepatic portosystemic shunt (TIPS) in liver cirrhosis accompanied with portal vein thrombosis (PVT). Methods: Forty-four cases with liver cirrhosis accompanied with PVT who underwent TIPS treatment from January 2015 to May 2018 were retrospectively analyzed. Clinical baseline data of the patients were collected. Portal vein pressure gradient (PVPG) before and after the surgery was recorded. Shunt patency was observed at 3, 6, 12, 18 and 24 months after the surgery. The influencing factors were determined by univariate and multivariate analysis. Results: Transjugular intrahepatic portosystemic shunt was successfully established in all 44 cases. The postoperative PVPG was lower than preoperative (P < 0.01). The shunt patency rate after TIPS in PVT was 18.2% (n = 8). The cumulative shunt patency rates at 3, 6, 12, 18, and 24 months after surgery were 95.5%, 90.7%, 90.7%, 86.8% and 74.4%, respectively. Univariate analysis showed that diabetes history, platelet level and prothrombin time-international normalized ratio were associated with postoperative shunt dysfunction. Multivariate analysis showed that diabetes history (P = 0.007, OR = 28.606) was an independent risk factor for postoperative shunt dysfunction. Conclusion: TIPS is a safe and feasible procedure, which can effectively reduce the portal pressure in liver cirrhosis accompanied with PVT. Diabetic patients have a higher risk of postoperative shunt dysfunction. Therefore, clinical intervention should be strengthened for high-risk patients.

SIRT3 retards intervertebral disc degeneration by anti-oxidative stress by activating the SIRT3/FOXO3/SOD2 signaling pathway.

OBJECTIVE: The objective of this paper is to determine whether SIRT3 could retard intervertebral disc degeneration and study the mechanism. MATERIALS AND METHODS: We chose the 3-month mice to establish intervertebral disc degeneration model and study the effect of SIRT3 on the intervertebral disc by Western blotting, quantitative Real Time-Polymerase Chain Reaction (qRT-PCR), immunohistochemistry. Mouse nucleus pulposus cells were cultured to study the exact mechanism. RESULTS: The expression of SIRT3 was decreased in degenerated human nucleus pulposus. Intervertebral discs of mice treated with theacrine expressed more collagen II and less collagen X. In addition, nucleus pulposus cells stimulated with interleukin-1ß (IL-1ß) expressed less SIRT3 than that in the control group and nucleus pulposus cells with SIRT3 overexpress vectors expressed more collagen II FOXO3a and superoxide dismutase 2 (SOD2), indicating that SIRT3 could improve the intervertebral disc degeneration by anti-oxidative stress. CONCLUSIONS: SIRT3 is a protective factor for intervertebral discs and can reduce oxidative stress in the intervertebral disc.

Intrahepatic IFN-alpha expression in liver specimens from HBV-infected patients with different outcomes.

BACKGROUND: Interferon-alpha (IFN-α), an active cytokine, plays an important role in antiviral host responses, including protection against hepatitis B virus (HBV) infection. This study was designed to investigate the correlation between intrahepatic IFN-α expression levels and disease severity using liver biopsy specimens from HBV-infected patients with different outcomes. PATIENTS AND METHODS: Immunohistochemistry (IHC) was performed to detect intrahepatic IFN-α expression in liver biopsy specimens obtained from 69 HBV-infected patients with different outcomes (including 23 cases with chronic hepatitis B [CHB], 18 cases with severe hepatitis B [SHB], and 28 cases with liver cirrhosis [LC]). In situ hybridization (ISH) was carried out to measure the levels of HBV DNA in liver samples. In addition, the liver specimens of 33 healthy liver transplant donors without detectable liver diseases comprised a normal control (NC) group. RESULTS: The intrahepatic expression levels of IFN-α were higher in the HBV-infected patients than the NC group (p = 0.001). Intrahepatic IFN-α expression was also significantly higher in the SHB and CHB groups compared to the NC group (p = 0.001 and p = 0.001, respectively), while the intrahepatic HBV DNA levels of the SHB patients were higher than those of LC patients (p = 0.013). Furthermore, intrahepatic IFN-α expression was positively correlated with serum alanine aminotransferase (ALT) levels in CHB patients; no significant correlations were discovered between intrahepatic IFN-α expression and intrahepatic HBV DNA levels in all other sub-groups. CONCLUSIONS: Intrahepatic IFN-α expression may correlate with liver inflammation after hepatitis B virus infection, and IFN-α may play a vital role in the occurrence of SHB.

Remifentanil-sevoflurane interaction models of circulatory response to laryngoscopy and circulatory depression.

BACKGROUND: Sevoflurane and remifentanil are commonly combined to produce the hypnotic and analgesic effects required for clinical anaesthesia. Previous studies have characterized interactions between several i.v. drugs and inhalation agents. Aiming to extend this effort, we developed two new mathematical models to characterize the interactions manner and strength between sevoflurane and remifentanil. METHODS: Sixty-five adult Chinese patients undergoing elective operations received a target-controlled infusion of remifentanil (0-10 ng ml(-1)) and inhaled sevoflurane (0.3-3.4 vol.%) at various randomly selected target concentration pairs. After reaching pseudo-steady-state drug levels, the circulatory response to laryngoscopy and any circulatory depression (a side-effect) were observed for each pair of target concentrations. The pharmacodynamic interactions between sevoflurane and remifentanil were investigated by response surface methodology. NONMEM software was used to estimate the model parameters. RESULTS: The response surface models revealed significant synergy between sevoflurane and remifentanil. When the target remifentanil concentration was increased from 0 to 10 ng ml(-1), the C50, sevo decreased from 2.6 to 0.38 vol.% for the prevention of circulatory response to laryngoscopy and from 3.53 to 1.46 vol.% for the induction of circulatory depression. CONCLUSIONS: The new models can be used to characterize the interactions between these two drugs both qualitatively and quantitatively. Remifentanil significantly decreased the amount of sevoflurane required to eliminate patient response to clinical stimuli, thus reducing the likelihood of side-effects, specifically circulatory depression.