Racial and gender differences in the relationship between sarcopenia and bone mineral density among older adults.

Both sarcopenia and low bone mineral density (BMD) have become public health concerns. We found that presarcopenic and/or sarcopenic individuals were more likely to have lower BMD. And this relationship has race and sex-specific discrepancy. PURPOSE: The purpose of the study was to investigate the racial and gender differences in the relationship between sarcopenia and BMD among older adults. METHODS: Totally, 5476 subjects (mean age = 65.7 ± 6.4) of non-Hispanic White (n = 3297), non-Hispanic Black (n = 1265), and non-Hispanic Asian (n = 914) were analyzed. Sarcopenia was defined according to the revised European consensus on definition and diagnosis of sarcopenia (EWGSOP2). General linear model and multivariable linear regression model were used to examine the relationship between sarcopenia and regional/whole body BMD stratified by race and sex. Adjustments were conducted for physiological, behavioral, and disease factors. RESULTS: Comparing with normal older participants, presarcopenic and sarcopenic elderly were more likely to have lower BMD. Although the difference was not statistically significant in a few sub-groups, among the three racial groups, the strongest association between sarcopenia and BMD was found in non-Hispanic Black people, followed by non-Hispanic White people and non-Hispanic Asian people. In addition, significant differences of BMD across sarcopenia stages were found in more sub-groups in women than in men after adjusting for covariates. CONCLUSIONS: In this older cohort, sarcopenia is significantly related to low regional/whole-body BMD, and these associations vary by race and sex. Consideration in race and sex is warranted when developing strategies to maintain or minimize BMD loss.

Detecting causal relationship between metabolic traits and osteoporosis using multivariable Mendelian randomization.

By adopting the extension approaches of Mendelian randomization, we successfully detected and prioritized the potential causal risk factors for BMD traits, which might provide us novel insights for treatment and intervention into bone-related complex traits and diseases. INTRODUCTION: Osteoporosis (OP) is a common metabolic skeletal disease characterized by reduced bone mineral density (BMD). The identified SNPs for BMD can only explain approximately 10% of the variability, and very few causal factors have been identified so far. METHODS: The Mendelian randomization (MR) approach enables us to assess the potential causal effect of a risk factor on the outcome by using genetic IVs. By using extension methods of MR-multivariable MR (mvMR) and MR based on Bayesian model averaging (MR-BMA)-we intend to estimate the causal relationship between fifteen metabolic risk factors for BMD and try to prioritize the most potential causal risk factors for BMD. RESULTS: Our analysis identified three risk factors T2D, FG, and HCadjBMI for FN BMD; four risk factors FI, T2D, HCadjBMI, and WCadjBMI for FA BMD; and three risk factors FI, T2D, and HDL cholesterol for LS BMD, and all risk factors were causally associated with heel BMD except for triglycerides and WCadjBMI. Consistent with the mvMR results, MR-BMA confirmed those risk factors as top risk factors for each BMD trait individually. CONCLUSIONS: By combining MR approaches, we identified the potential causal risk factors for FN, FA, LS, and heel BMD individually and we also prioritized and ranked the potential causal risk factors for BMD, which might provide us novel insights for treatment and intervention into bone-related complex traits and diseases.

[The feasibility of digital guidance drill template assisted expansive open-door laminoplasty].

Objective: To explore The feasibility of digital guidance drill templates assisted expansive open-door laminoplasty. Methods: Ten specimens of normal adult cervical spine (C3-7) were selected, including six males and four females. The specimens aged 42-67 years, with an average age of (43.6±4.2) years. After CT scanning, the date was imported into Mimics software in DICOM format. 3D models were reconstructed and the position and depth of troughs on the open side and hinge side were selected for expansive open-door laminoplasty. Drill templates were designed and exported in STL, manufactured by 3D printing finally. Then drill templates were attached to the posterior part of cervical lamina and spinous process. Under guidance of templates, troughs of both sides were conducted by using a high-speed drill. Then the lamina is elevated and instrumentations were implanted. Postoperative CT scanning was conducted to record the fracture of trough on the hinge side. 3D reconstruction was performed again to compare the position and depth between theory and actual trough on both sides by paired t test. Results: A total of 50 drill templates were designed and manufactured. There was no occurrence of hinge fracture after operation. In C3-7, the distance range between the theory position of troughs on the open side and the midline was 11.8-14.4 mm, while in actual it was 11.4-14.0 mm. The distance range between the theory position of troughs on the hinge side and the midline was 11.6-14.3 mm; in actual, it was 10.9-14.0 mm. The theory depth range of trough on the hinge side was 3.0-3.8 mm, while the actual depth was 3.1-3.8 mm. According to the statistical analysis, the difference in the position of trough on the open side, the position of trough on the hinge side and the depth of trough on the hinge side between theory and actual were not statistically significant (all P>0.05). Conclusion: Digital guided template assisted open-door laminoplasty is a feasible technique, which can improve the accuracy and safety of the position and depth of the trough, and has clinical application value.

[Analysis of clinical prognosis of 68 patients with gastric mucosa-associated lymphoid tissue lymphoma].

Objective: To explore the clinical features and prognosis of gastric mucosa-associated lymphoid tissue lymphoma. Methods: The data of patients with gastric mucosa-associated lymphoid tissue lymphoma diagnosed and treated at Peking University Cancer Hospital from 2000 to 2019 were collected, and their clinical characteristics, treatment options and effects, and prognosis were retrospectively analyzed. Results: The median age of 68 patients was 56 years old, and the ratio of men to women was 0.6∶1.0. Early patients accounted for about 76% (52/68). The most commonly used treatment is Helicobacter pylori eradication, followed by radiotherapy and chemotherapy. The total effective rate is 94%, of which the complete remission rate is 72%. With a median follow-up of 44 months, the 5-year progression-free survival (PFS) rate was 73%, and the overall survival (OS) rate was 83%. Prognostic factor analysis showed that albumin level (P=0.011) and international prognostic index (IPI)(P=0.017) are independent prognostic indicators of PFS, The 5-year PFS rate of patients with normal and reduced albumin was 77% and 50%, respectively, and the 5-year PFS rate of patients with IPI score<2 points and IPI ≥ 2 points was 80% and 48%, respectively. Lactate dehydrogenase (LDH) (P=0.016) and albumin level (P=0.025) are independent prognostic indicators of OS, and the 5-year OS rates of patients with normal and elevated LDH were 87% and 67%, respectively. The 5-year OS rates of patients with normal albumin and reduced were 92% and 73%, respectively. Conclusions: Gastric mucosa-associated lymphoid tissue lymphoma is sensitive to treatment and has a good prognosis. The patient's albumin and lactate dehydrogenase levels are independent prognostic indicators.

[Study on the best entry region and trajectory of anterior transpedicular root screws].

Objective: To evaluate the best entry region and trajectory of anterior transpedicular root screws (ATPRS). Methods: From January 2018 to May 2019, 50 cervical CT date integral of healthy people were selected from Ningbo No. 6 Hospital and were confirmed no obvious defect. Of these, 24 cases were males and 26 were females, aged 20-49 (32±5) years. The CT data was imported into Mimics by DICOM format, then 3D reconstruction was performed. In the coronal plane, the area from the centreline of the anterior of C(3-7) to the left Z-line(marked a line through the intersection of the anterior of the luschak joint and upper endplates, parallel to the centralline of the anterior of the vertebral body) was divided into nine areas. Then virtual screw with diameter of 3.5 mm was inserted. Record the length of screw of each area (L), the angle between screw and the posterior of the vertebral body in horizontal plane(α), the angle between screw and the anterior of the vertebral body in sagittal plane (ß), individually. The data between groups were compared by independent sample t test. Results: The best regions were zone 9 of C(3), C(4); zone 8, 9 of C(5); zone 2-3, 5-9 of C(6); zone 1-9 of C(7) in men. And these were zone 9 of C(3); zone 3, 6, 8 and 9 of C(4), C(5); zone 2-3, 5-9 of C(6); zone 1-9 of C(7) in women. The distribution of best region was almost the same in men and women, zone 9 of each segment was the best region, and the screw length was the longest. It increased gradually from C(3) to C(7). C(3) had the least region, C(4) and C(5) had less, while C(6) and C(7) had the most. The horizontal angle of C(3-7) in men and women were 44.0°-47.2°, 40.2°-45.3° in zone 1, 4 and 7, respectively; 35.1°-41.4°, 34.6°-38.7° in zone 2, 5 and 8, respectively; 30.0°-37.2°, 30.2°-34.5° in zone 3, 6 and 9, respectively; and it demonstrated a gradually decreased trend. The sagittal angle of C(3-7) in men and women was 85.3°-97.4°, 80.5°-88.9° in zone 1-3, respectively; 101.2°-113.7°, 101.0°-109.3° in zone 4-6, respectively; 116.6°-128.8°, 119.9°-125.3° in zone 7-9, respectively; and it demonstrated a gradually increased trend. There was no significant difference in the horizontal and sagittal angle between men and women (both P>0.05). Conclusions: Anterior transpedicular root screw is a feasible internal fixation technique. It has wide region and the Z-line can be used as a reference for screw placement.

[Prognostic evaluation of nutritional indicators in patients with limited-stage small cell lung cancer].

Objective: To explore the effect of nutritional status pre-and during chemoradiotherapy on the prognosis of patients with limited- stage small cell lung cancer (LS-SCLC). Methods: We retrospectively collected medical records of 172 LS-SCLC patients undergoing concurrent chemoradiotherapy in our hospital from 2000 to 2014, with 126 males and 46 females. The data of complete blood count and hepatic and renal function were collected before initial treatment, before radiotherapy, 4 weeks during radiotherapy, and 1 month after complete of treatment. The prognostic nutritional index(PNI)was calculated. Kaplan-Meier method was used to calculate the survival rate. Log-rank test was performed used to compare the survival differences between groups. Multivariate prognostic analysis was performed using Cox regression model. Results: The median overall survival (OS) was 21 months, with median progression-free survival (PFS) of 11 months. At the beginning of treatment, patients with pre-treatment PNI ≥ 53 had significantly superior OS (median 37 vs 15 months, P=0.001) and PFS (median 16 vs 10 months, P=0.017). Patients with pre-treatment hemoglobin ≥140 g/L and <140 g/L had an median OS of 32 months and 17 months (P=0.019), and median PFS of 16 months and 9 months (P=0.040), respectively. During chemoradiation, patients with elevated hemoglobin had similar median OS compared with those had decreased hemoglobin (27 vs 18 months, P=0.063, but superior median PFS (15 vs 9 months, P=0.017). Multivariate analysis revealed that prophylactic cranial irradiation, pre-treatment hemoglobin ≥140 g/L, and pretreatment PNI ≥53 were independent predictors of OS and PFS in patients with LS-SCLC. Conclusion: Pre-treatment nutritional status and the changes of nutritional status during chemoradiotherapy is significantly associated with the prognosis of patients with limited-stage small cell lung cancer. The patients with better pre-treatment nutritional status have a better prognosis.

[Significance of anti-carbamylated protein antibodies in patients with rheumatoid arthritis-associated intersitial lung disease].

OBJECTIVE: To evaluate the value of anti-carbamylated protein (CarP) antibody in the diagnosis of rheumatoid arthritis-associated intersitial lung diseas (RA-ILD). METHODS: Clinical and laboratory data and serum samples of patients with RA between December 2017 and June 2019 in Department of Rheumatology, General Hospital of Ningxia Medical University were collected. The patients were subclassified as RA-ILD and RA-without ILD based on computed tomography scans of the chest, Enzyme 1inked immunosorbent assay (ELISA) was used to assess anti-CarP antibody in the serum of each group. The occurrence of ILD and other laboratory indexes were analyzed. Comparison of measurement data between the 2 groups was performed by two independent sample t-test or Mann-Whitney U nonparametric test, while the count data were compared by Chi square test; Receiver operating characteristic curve (ROC) was drawn to determine the cut-off value of anti-CarP antibody to RA-ILD diagnosis and to analyze its diagnostic efficacy. RESULTS: The anti-CarP antibody level in the RA-ILD group was 21.14 (12.29, 29.75), which was significantly higher than that in the RA-without ILD group 11.6 (6.66, 19.05) (P=0.000). The difference was statistically significant (P<0.05). The positive rate of anti-CarP antibody in RA-ILD group (53%) was significantly higher than that in RA-without ILD group (16%) (P<0.05); There was no significant differences in the levels of rheumatoid factor (RF) and anti-cyclic citrullinated peptide (CCP) between the two groups (P>0.05). The age and disease activity score (DAS28) in the RA-ILD group were significantly higher than those in the RA-withhout ILD group (P<0.05). The proportion of men and smoking in the RA-ILD group was higher than that in the RA-without ILD group, but the difference was not statistically significant. The ROC curve showed that the anti-CarP antibody had a cut off value of 20.56 U/mL, with the sensitivity of 53.50%, and specificity of 84.20%, the area under the ROC curve were 0.76. Spearman correlation analysis showed that rheumatoid factor (RF) and age were positively correlated with anti-CarP antibody (r=0.172, P=0.043; r=0.200, P=0.006). Anti-CarP antibody level was not associated with the DAS28 score, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), anti-CCP antibody, swollen joint count, and tender joint count (P>0.05). CONCLUSION: The anti-CarP antibody level in RA-ILD patients is higher than that in RA-without ILD, suggesting that anti-CarP antibody may have a role in the development of RA-ILD.

[Mobile terminal-based survey on the birth characteristics for Chinese newborns].

OBJECTIVE: To describe the birth characteristics for Chinese newborns, to assess the feasibility of collecting basic data on maternal and child health, and to conduct relevant epidemiological studies by using mobile terminals. METHODS: From June 2016 to January 2017, pregnant women who delivered in hospitals were recruited in 166 hospitals scattered across 23 provinces of China. The data on their maternal and child health including delivery mode, gestational age and birth weight, were collected by self-administered questionnaires embedded in a mobile application. The incidences or means of cesarean section, preterm birth, birth weight, length and head circumference were calculated and compared with recognized national data, including 2005 Growth Standards for Chinese Children Under 7 Years of Age, 2006 World Health Organization Child Growth Standards and 2014 Chinese Neonatal Birth Weight Standards by Gestational Age. RESULTS: A total of 9 986 women were investigated, among whom those aged ≥35 years accounted for 11.7% and those received well education (college and above) accounted for 70.2%. The rate of cesarean section, preterm delivery, low birth weight and macrosomia were 38.1%, 4.5%, 2.2%, and 7.8%, respectively. The means were (3.33±0.44) kg [male (3.36±0.44) kg, female (3.29±0.43) kg] for birth weight, (50.97±2.32) cm [male (51.04±2.32) cm, female (50.89±2.32) cm] for birth length, and (33.99±1.56) cm [male (34.01±1.57) cm, female (33.97±1.55) cm] for head circumference, respectively. As compared with the national data, the cesarean section rate and birth weights by gestational age for term-born neonates were similar to the latest national data in 2014, while the means of birth weight and length were obviously higher than those of the 2005 Growth Standards for Chinese Children Under 7 Years of Age and 2006 World Health Organization Child Growth Standards. CONCLUSION: As compared with the national data 10 years ago, the mean birth weights for male and female newborns were increased by 40 g and 80 g respectively and mean lengths by 0.6 cm and 1.3 cm, but changes for mean head circumferences were negligible, indicating that the physical health condition for Chinese newborns improved significantly over past 10 years and emerging information technology likely provided a new approach for epidemiological research.

[Preliminary study of sequential multi-modality adjuvant chemotherapy and radiation for advanced endometrial cancer].

Objective: To evaluate the clinical outcomes and feasibility of multi-modality adjuvant chemotherapy and radiation, which was conducted as postoperative chemotherapy, radiation, and consolidation chemotherapy (CRC) mode for the treatment of advanced endometrial cancer. Methods: A retrospective analysis of 124 patients with International Federation of Gynecology and Obstetrics (FIGO) stages Ⅲ and Ⅳ endometrial cancer from Jan. 2004 to Oct. 2012 was conducted in Peking University People's Hospital and Beijing Obstetrics and Gynecology Hospital. Inclusion criteria were comprehensive staging procedure including hysterectomy, bilateral salpingo-oophorectomy, and (or) selective pelvic aortic lymphadenectomy, and treatment with adjuvant chemotherapy and (or) radiation. The average age of these patients was (55.9±8.4) years old (range from 23 to 79 years old). According to different postoperative adjuvant treatment modes, the patients were divided into CRC group, chemotherapy-radiotherapy (CR) group and single chemotherapy (C) group. The survival and side effects of the three groups were compared. Results: (1) One hundred and twenty-four patients with advanced stage endometrial cancer were identified and received postoperative adjuvant therapies.Sixty-one (49.2%, 61/124) cases of them received postoperative CRC fashion, 19 (15.3%, 19/124) received postoperative CR and 44 (35.5%, 44/124) cases received C. The age, stage, grade and type of surgery of the three groups were not significantly different (all P>0.05); while, the pathology, chemotherapy cycles and chemotherapy regimens differed significantly (all P<0.05). (2) The progression-free survivals (PFS) of the patients with CRC, CR, and C group were (121±7), (68±15), and (100±11) months, respectively. The 3-year PFS rates were 87.9%, 43.7%, and 61.4%, respectively. The 5-year PFS rates were 82.2%, 36.4%, and 61.4%, respectively. The above indicators were significantly higher in the CRC group than in the CR group (all P<0.01), and there was no difference between the CRC group and the C group (P=0.037). The overall survival (OS) of patients with CRC, CR, and C group were (128±6), (80±12), and (99±10) months, respectively. The 3-year OS rates were 87.8%, 72.4%, and 67.1%, the 5-year OS rate were 84.2%, 54.3%, and 64.1%, respectively. The above indicators were significantly higher in the CRC group than those in the CR group and C group (all P<0.01). (3) There was no difference in the frequency of adverse effects either chemotherapy, such as severe bone suppression or radiotherapy; hepatotoxicity,blood transfusion, dose modifications; or cycle delays between the CRC, CR and C group (all P>0.05). (4) In the univariate analysis shown that, stage, the fashion of postoperative adjuvant therapy and type of surgery were risk factors for tumor progression in patients with advanced endometrial cancer (P<0.05). After adjusted for FIGO stage and type of surgery, the tumor progression hazard ratio (HR) was 3.931 (95%CI: 1.734-8.914, P=0.001) for the CR group and 2.188 (95%CI: 1.010-4.741, P=0.047) for the C group, compared to the CRC group. Conclusion: Sequential CRC delivered in a "sandwich" fashion for the treatment in advanced endometrial cancer could significantly improve the 3-year and 5-year OS rates and have a similar adverse effect profile compared with other sequencing modalities.

[Study on the effect of oxidative stress on the cardiac injury induced by MEHP in rats].

Objective: This study was to investigate the effects of MEHP on isolated rat heart and explore its mechanism. Methods: The experiments were performed with Langendorff-perfused rat heart with a Langendorff apparatus. 35 SD rats were used in the experiment and there were 5 rats per group. MEHP at doses of 3.125, 6.250, 12.500 and 25.000 µmol/L were given to the hearts for 25 minutes. Effects of NAC at concentration of 5 mmol/L were evaluated by co-treatment with 12.500 or 25.000 µmol/L MEHP. Data was collected per 5 minutes for 25 minutes. The heart rate, LVDP, LVEDP, dp/dtmax, and dp/dtmin were measured and analyzed using a PL3508 Data Acquisition and Analysis System. 200 waves at least were required each time. LDH contents in heart lavage fluid were determined by photometric assays using the automated biochemical analyzer. A section of the heart tissue was used for histopathological examination. DCFH-DA method was used to detect the levels of reactive oxygen species in different groups of heart tissues. Results: There was a concentration dependent decrease of heart rate (P<0.05) . At concentrations of 6.250, 12.500 and 25.000 µmol/L, MEHP significantly decreased the LVDP, dp/dtmax and dp/dtmin (P<0.05) , and this decrease is more pronounced with perfusion time. As the MEHP was given up to 6.250, 12.500 and 25.000 µmol/L, a statistical significance was found in the increase of LVEDP (P<0.05) . For dp/dtmin, a significant increase was observed at the concentration of 3.125 µmol/L when perfused with 10 and 15 min (P<0.05) , but this increase disappeared over time. LDH in cardiac perfusate increased as the MEHP given a higher concentration (P<0.05) . Compared with the control group, Histopathological analysis showed edema of myocardial tissue and cells, and inflammatory cells infiltration and myocardial cells necrosis were obvious in the MEHP perfusion groups. Myocardial ROS levels of the four MEHP treatment groups were all significantly higher than that of control group (P<0.05) . These heart damage induced by MEHP could be attenuated by NAC in different degrees. Conclusion: MEHP can induce damage to myocardial tissue of isolated rat heart and one possible mechanism is the oxidative stress.

Pinopode score around the time of implantation is predictive of successful implantation following frozen embryo transfer in hormone replacement cycles.

STUDY QUESTION: Is pinopode measurement of any prognostic value? SUMMARY ANSWER: Pinopode expression was significantly associated with the occurrence of pregnancy after frozen embryo transfer. WHAT IS KNOWN ALREADY: Pinopodes are expressed in the endometrium during the implantation period. Pinopode measurement has been proposed as a marker of endometrial receptivity. STUDY DESIGN, SIZE, DURATION: A prospective cohort study was conducted at the Center of Reproductive Medicine, Sir Run Run Shaw Hospital, between 2014 and 2016, recruiting 172 women with infertility and undergoing frozen embryo transfer following IVF treatment. Among 172 participants, 46 women took part in the first study to quantify the daily changing pattern of pinopodes 3-7 days after the initiation of progesterone therapy in the hormone replacement cycles and the remaining 126 women with infertility participated in a study to examine the relationship between pinopode count and pregnancy outcome following frozen embryo transfer in hormone replacement cycles. PARTICIPANTS/MATERIALS, SETTING, METHODS: The mean age of participants was 29 years old. All participants received an artificial hormone replacement protocol capable of supporting successful implantation. Endometrial biopsies from 46 women were obtained 3, 4, 5, 6 and 7 days after the initiation of progesterone therapy (P + 3, n = 6; P + 4, n = 6; P + 5, n = 11; P + 6, n = 13; P + 7, n = 10, respectively). Another 126 endometrial biopsies were obtained precisely 6 days after the initiation of progesterone. Scanning electron microscopy was used to capture the pinopode images, followed by use of the image J program to quantify the count and subtype of the pinopodes. MAIN RESULTS AND THE ROLE OF CHANCE: We found that at least 60 microscopic fields were necessary to achieve a reproducible result. An intra-observer variability study showed good agreement between two measurements regarding the developing pinopode (DP) subtype (r = 0.95) and the fully developed pinopode (FDP) subtype (r = 0.86) but not for the regressing (RP) pinopode subtype (r = 0.39). The proportion of DP/total pinopodes (TP) declined rapidly form day P + 4 to a minimum on day P + 6. The percentage of FDP/TP increased rapidly from day P + 4 to reach a peak on day P + 6. On the other hand, the percentage of RP/TP reached a peak on day P + 7. Participants who conceived had a significantly (P = 0.011) higher percentage of FDP/TP on day P + 6 and significantly (P = 0.005) lower percentage of DP/TP on the same day compared with participants who did not become pregnant. Using a scoring system incorporating the percentages of DP and FDP, it was found that the pregnancy rate and the embryo implantation rate of women with a high pinopode score (82.3%; 63.0%) was significantly (P = 0.001; P = 0.046) higher than that of women with a low pinopode score (53.3%; 46.7%), respectively. There remains a possibility that the observations could have arisen due to chance. LIMITATIONS, REASONS FOR CAUTION: This study examined pinopode count and subtype in the HRT cycles, and it is uncertain whether the same observations apply to in natural cycles. WIDER IMPLICATIONS OF THE FNDINGS: Pinopodes have been questioned as a potential marker of endometrial receptivity for many years. Our results suggested that pinopode measurement may be of value in predicting pregnancy. STUDY FUNDING/COMPETING INTEREST(S): The study was supported by the grants from the general project of medicine and health in Zhejiang Province of China (2015KYA142; 2018KY106), the Key Research and Development Program of Zhejiang Province (2017C03022) and the National Natural Science Foundation of China (81701514).The funders had no role in the study design, data collection and analysis, decision to publish or preparation of the manuscript. We have no competing interests to declare. TRIAL REGISTRATION NUMBER: ISRCTN26300668.

Socioeconomic status and bone mineral density in adults by race/ethnicity and gender: the Louisiana osteoporosis study.

Low bone mineral density (BMD) and osteoporosis have become a public health problem. We found that non-Hispanic white, black, and Asian adults with extremely low education and personal income are more likely to have lower BMD. This relationship is gender-specific. These findings are valuable to guide bone health interventions. INTRODUCTION: The evidence is limited regarding the relationship between socioeconomic status (SES) and bone mineral density (BMD) for minority populations in the USA, as well as the relationship between SES and BMD for men. This study explored and examined the relationship between SES and BMD by race/ethnicity and gender. METHODS: Data (n = 6568) from the Louisiana Osteoporosis Study (LOS) was examined, including data for non-Hispanic whites (n = 4153), non-Hispanic blacks (n = 1907), and non-Hispanic Asians (n = 508). General linear models were used to estimate the relationship of SES and BMD (total hip and lumbar spine) stratified by race/ethnicity and gender. Adjustments were made for physiological and behavioral factors. RESULTS: After adjusting for covariates, men with education levels below high school graduate experienced relatively low hip BMD than their counterparts with college or graduate education (p < 0.05). In addition, women reporting a personal annual income under $20,000 had relatively low hip and spine BMD than their counterparts with higher income level(s) (p < 0.05). CONCLUSIONS: Establishing a conclusive positive or negative association between BMD and SES proved to be difficult. However, individuals who are at an extreme SES disadvantage are the most vulnerable to have relatively low BMD in the study population. Efforts to promote bone health may benefit from focusing on men with low education levels and women with low individual income.

Cytosolic proteome profiling of monocytes for male osteoporosis.

In male Caucasians with discordant hip bone mineral density (BMD), we applied the subcellular separation and proteome profiling to investigate the monocytic cytosol. Three BMD-associated proteins (ALDOA, MYH14, and Rap1B) were identified based on multiple omics evidence, and they may influence the pathogenic mechanisms of osteoporosis by regulating the activities of monocytes. INTRODUCTION: Osteoporosis is a serious public health problem, leading to significant mortality not only in aging females but also in males. Peripheral blood monocytes (PBMs) play important roles in bone metabolism by acting as precursors of osteoclasts and producing cytokines important for osteoclast development. The first cytosolic sub-proteome profiling analysis was performed in male PBMs to identify differentially expressed proteins (DEPs) that are associated with BMDs and risk of osteoporosis. METHODS: Here, we conducted a comparative proteomics analysis in PBMs from Caucasian male subjects with discordant hip BMD (29 low BMD vs. 30 high BMD). To decrease the proteome complexity and expand the coverage range of the cellular proteome, we separated the PBM proteome into several subcellular compartments and focused on the cytosolic fractions, which are involved in a wide range of fundamental biochemical processes. RESULTS: Of the total of 3796 detected cytosolic proteins, we identified 16 significant (P < 0.05) and an additional 22 suggestive (P < 0.1) DEPs between samples with low vs. high hip BMDs. Some of the genes for DEPs, including ALDOA, MYH14, and Rap1B, showed an association with BMD in multiple omics studies (proteomic, transcriptomic, and genomic). Further bioinformatics analysis revealed the enrichment of DEPs in functional terms for monocyte proliferation, differentiation, and migration. CONCLUSIONS: The combination strategy of subcellular separation and proteome profiling allows an in-depth and refined investigation into the composition and functions of cytosolic proteome, which may shed light on the monocyte-mediated pathogenic mechanisms of osteoporosis.

Direct uterine sampling using the SAP-l sampler device to detect endometrial lesions during histopathological examination.

AIMS: To evaluate the sampling adequacy and diagnostic accuracy of the endometrial SAP-l sampling device in detecting endometrial lesions based on histopathological examination. MATERIALS AND METHODS: In total, 182 patients who required an endometrial biopsy were enrolled in this study. All of the patients underwent endometrial biopsies with the SAP-l sampler prior to hysteroscopy (169/182) or dilatation and curettage (D&C) (13/182). Endometrial tissues were obtained at biopsy for histopathological examination. RESULTS: Ad- equate endometrial specimens were obtained in 148 of 182 patients (81.32%). Menopause (p = 0.000), endometrial thickness (p = 0.004), and the types of endometrial diseases (p = 0.009) differed significantly between the two groups. Among the 169 patients who underwent hysteroscopy, sampling scratches were observed in the uterine cavity in 147 cases (86.98%). Compared to traditional methods, such as hysteroscopy and D&C, the sampling diagnostic sensitivity, specificity, and positive and negative predictive values were 82.35%, 100%, 100% , and 97.76% for endometrial carcinoma (n=17) and 37.5%, 100%, 100% and 97.76% for endometrial atypical hyperplasia (n=8), respectively. Those that were misdiagnosed occurred because the lesions were focal or localized in a small part of the uterine cavity. The sampling diagnostic sensitivity for polyps (n=32) was 12.5%. Two patients with submucosal leiomyoma went undiagnosed based on the sample specimens. CONCLUSION: Endometrial sampling using the SAP-l sampler is a minimally invasive altemative technique for obtaining adequate endometrial specimens for histopathological examination. The SAP-l sampler was useful in detecting endometrial carcinoma and atypical hyperplasia cases that were not highly suspected to be localized; however, this method was not useful in detecting endometrial polyps and submucosal leiomyomas.

[Multidisciplinary treatment and survival analysis for 497 cases of pancreatic cancer with liver metastases].

OBJECTIVE: To explore the multidisciplinary therapeutic mode, clinical effect and prognostic factors of pancreatic cancer with liver metastases (PCLM). METHODS: We retrospectively selected 497 consecutive patients with PCLM who were pathologically diagnosed and treated at Tianjin Medical University Cancer Hospital, from January, 2000 to December, 2012. Clinical characteristics, treatment modality, survival condition and factors associated with prognosis of these cases were analyzed, and efficacy of multidisciplinary treatment model was evaluated. RESULTS: Of these patients, the male/female ratio was 1.85∶1, with a median age of 59. A total of 358 (72.0%) cases had synchronous liver metastases, and 173 (34.8%) cases complicated with extrahepatic metastases. The 0.5, 1, 3, 5 year survival rates of 497 patients were 44.1%, 19.7%, 3.2% and 2.2%, respectively, with a median survival (MS) of 5.4 months. Patients who were treated with 3 or more approaches (including surgery, chemotherapy, radiation therapy, interventional therapy, and physiotherapy) had a longer median survival time than patients treated with 2 or only 1 approach (MS: 8.6 vs 5.2 vs 4.6 months, P< 0.001). Multivariate analysis for clinical features and treatment modality showed that age, weight loss, ascites, karnofsky performance score (KPS), primary site resection, albumin, carbohydrate antigen (CA) 19-9, resection of liver metastases, radiation therapy and systemic chemotherapy were prognostic variables with statistical significance. CONCLUSIONS: PCLM is a refractory malignant tumor. Age >60, weight loss (≥10% within 3 months), ascites, KPS <80, albumin<35 g/L, and CA19-9 ≥500 U/ml were the most relevant predictors of poor survival. Multimodal treatment using curative resection of pancreatic cancer and/or liver metastases, systemic chemotherapy and radiation therapy may improve the prognosis and survival rate sufficiently.

Identification of microRNAs as diagnostic biomarkers in screening of head and neck cancer: a meta-analysis.

Head and neck cancer (HNC) is one of the most prevalent cancers; it is often diagnosed at its advanced stage and has a low 5-year survival rate. Evidence suggests that noninvasive biomarker microRNAs (miRNAs) are valuable for early diagnosis of HNC. This meta-analysis assessed the diagnostic value of miRNAs in HNC detection. A systematic literature search for relevant studies up to August 4, 2014 was conducted in databases and other sources. Statistical analysis was conducted using STATA 12.0. Pooled sensitivity, specificity, and other parameters, together with a summary receiver operating characteristic curve were used to assess the overall performance of miRNA assays. Subgroup analyses and meta-regression were used to analyze heterogeneity, and a Deeks' funnel plot asymmetry test assessed publication bias. Twenty-four articles with 1856 HNC patients and 1375 controls were included. The pooled results were as follows: sensitivity, 0.80 (95%CI = 0.77-0.83); specificity, 0.80 (95%CI = 0.76-0.85); positive likelihood ratio, 4.1 (95%CI = 3.2-5.2); negative likelihood ratio, 0.25 (95%CI = 0.21-0.30); diagnostic odds ratio (DOR), 16 (95%CI = 11-24); and area under curve (AUC), 0.87 (95%CI = 0.84-0.89). We conducted subgroup analyses based on ethnicity, cancer type, miRNA profiling, and specimen types, and found that miRNA assays yielded the highest accuracy in esophageal cancer. Notably, the DOR was 99 and the AUC was 0.96 for the multiple miRNA test, indicating strong discrimination of cancer patients from healthy people. The meta-analysis indicates that noninvasive miRNAs are a promising diagnostic tool with moderate accuracy for HNC diagnosis.

Topological centrality-based identification of hub genes and pathways associated with acute viral respiratory infection in infants.

The objective of this study was to identify hub genes and pathways associated with acute respiratory infection (ARI) in infants based on gene expression profiles. Differentially expressed genes (DEGs) between ARI and normal (controls) infants were identified based on linear modeling of the microarray data using Limma package. A protein-protein interaction (PPI) network was constructed using the Search Tool for the Retrieval of Interacting Genes/proteins and clusters were obtained by employing the molecular complex detection algorithm. Topological centrality was applied to characterize the biological importance of genes in the network. Functional enrichment analysis of the genes was performed based on the expression analysis systematic explore test. In total, 116 DEGs between ARI and controls were identified. Of the 61 nodes and 189 edges in the PPI network generated with the DEGs, three clusters were mined. Six hub genes namely RPL6, RPL3, EEF1B2, RPL15, EEF1A1, and RPS2, which were identified based on the topological centrality measures, were evaluated further. Functional enrichment analysis revealed that DEGs were significantly enriched in terms of Gene Ontology translational elongation, structural constituent of ribosome, and cytosol. The most significant term of pathway analysis was "ribosome". In summary, this study suggests RPL6, RPL3, and RPL15 as hub genes and the ribosome pathway to be significantly associated with viral ARI in infants, which might also be used as potential markers for the viral etiology.

The response of meat ducks from 15 to 35 d of age to gossypol from cottonseed meal.

The objective of this study was to investigate the responses of meat ducks of 15 to 35 d of age to free gossypol (FG) from cottonseed meal (CSM) and to establish the maximum limits of dietary FG concentration based on growth performance, blood parameters, and tissue residues of gossypol. Nine hundred 15-d-old ducks were randomly allocated to 5 treatments with 10 cages/treatment and 18 ducks/cage on the basis of BW. Five isonitrogenous and isocaloric experimental diets were formulated on a digestible amino acid basis to produce diets in which 0% (without FG), 25% (36 mg FG/kg), 50% (75 mg FG/kg), 75% (111 mg FG/kg), and 100% (153 mg FG/kg) of protein from soybean meal were replaced by that from CSM. Increasing dietary FG content, BW, and ADG decreased (linearly, P<0.05, except for ADG of days 29 to 35), and F/G linearly increased (P<0.05). At 35 d, blood hemoglobin, mean corpuscular hemoglobin, and mean corpuscular hemoglobin concentration linearly decreased (P<0.05), while serum total protein, albumin, and globulin content linearly decreased (P<0.05), and the residue of gossypol in liver, kidney, heart, breast, and leg muscle linearly increased (P<0.001) with increases in dietary FG concentration. Ducks fed 36 mg FG/kg (5.83% CSM of diet) diet had a normal histological structure of liver, and muscle (breast and leg) had no residue of gossypol. The maximum limit of dietary FG concentration was estimated to range from a low of 36 mg/kg to maximize serum globulin concentration to a high of 124 mg/kg to minimize feed intake for 22 to 28 d on the basis of a quadratic broken-line model.