Insulin Autoimmune Syndrome – An after-meal roller coaster ride / Journal of the ASEAN Federation of Endocrine Societies

@#Hypoglycemic disorders are rare in persons without diabetes, and clinical evaluation to identify its etiology can be challenging. We present a case of insulin autoimmune syndrome induced by carbimazole in a middle-aged Chinese man with underlying Graves’ disease, which was managed conservatively with a combination of dietary modification and alpha-glucosidase inhibitor.

Exploration of silicon functions to integrate with biotic stress tolerance and crop improvement

In the era of climate change, due to increased incidences of a wide range of various environmental stresses, especially biotic and abiotic stresses around the globe, the performance of plants can be affected by these stresses. After oxygen, silicon (Si) is the second most abundant element in the earth's crust. It is not considered as an important element, but can be thought of as a multi-beneficial quasi-essential element for plants. This review on silicon presents an overview of the versatile role of this element in a variety of plants. Plants absorb silicon through roots from the rhizospheric soil in the form of silicic or monosilicic acid. Silicon plays a key metabolic function in living organisms due to its relative abundance in the atmosphere. Plants with higher content of silicon in shoot or root are very few prone to attack by pests, and exhibit increased stress resistance. However, the more remarkable impact of silicon is the decrease in the number of seed intensities/soil-borne and foliar diseases of major plant varieties that are infected by biotrophic, hemi-biotrophic and necrotrophic pathogens. The amelioration in disease symptoms are due to the effect of silicon on a some factors involved in providing host resistance namely, duration of incubation, size, shape and number of lesions. The formation of a mechanical barrier beneath the cuticle and in the cell walls by the polymerization of silicon was first proposed as to how this element decreases plant disease severity. The current understanding of how this element enhances resistance in plants subjected to biotic stress, the exact functions and mechanisms by which it modulates plant biology by potentiating the host defence mechanism needs to be studied using genomics, metabolomics and proteomics. The role of silicon in helping the plants in adaption to biotic stress has been discussed which will help to plan in a systematic way the development of more sustainable agriculture for food security and safety in the future.

Shen-fu injection alleviates acute renal injury by reducing cytokine levels and modulating apoptosis in a porcine hemorrhagic shock model

ABSTRACT Purpose Shen-fu injection (SFI) was used to intervene in the resuscitation of porcine hemorrhagic shock (HS) model to study its protective effects on acute kidney injury. Methods After 60 min of HS, 28 animals were randomly assigned into four groups. The groups were as follows: hemorrhagic shock group (HS); HS resuscitation with shed-blood group (HSR); HS resuscitation with shed-blood and SFI (1 mL·kg-1) group (HSR-SFI); and the sham operation group (Sham). The bloods were analyzed for serum creatinine (sCr), cystatin C (CysC) and neutrophil gelatinase-associated lipocalin (NGAL). BAX, Bcl-2, and caspase-3 protein expressions by Western blot analysis and immunohistochemical staining. The renal tissues were removed and pathologic changes were observed. Results Mean aortic pressure (MAP) in HSR-SFI groups were higher than that in HSR groups after shock. At the 6th hour after shock, the urine volume per hour in the HSR-SFI groups was more than that in the HSR groups. The sCr, NGAL, CysC and cytokine levels of HSR-SFI groups were lower. The Bcl-2 expression was increased in the HSR-SFI groups. The BAX and caspase-3 expressions were reduced. The histopathologic score in the HSR-SFI was lower. Conclusions SFI may reduce the risk of acute kidney injury (AKI) following hemorrhagic shock by attenuating systemic inflammatory responses, and regulating the expression of apoptosis-related proteins.

Special strategies and management of urological diseases during the COVID-19 pandemic: initial experiences from a Medical Center of China

ABSTRACT Although urological diseases are not directly related to coronavirus disease 2019 (COVID-19), urologists need to make comprehensive plans for this disease. Urological conditions such as benign prostatic hyperplasia and tumors are very common in elderly patients. This group of patients is often accompanied by underlying comorbidities or immune dysfunction. They are at higher risk of COVID-19 infection and they tend to have severe manifestations. Although fever can occur along with urological infections, it is actually one of the commonest symptoms of COVID-19; urologists must always maintain a high index of suspicion in their clinical practices. As a urological surgeon, how we can protect medical staff during surgery is a major concern. Our hospital had early adoption of a series of strict protective and control measures, and was able to avoid cross-infection and outbreak of COVID-19. This paper discusses the effective measures that can be useful when dealing with urological patients with COVID-19.

The mechanism and research progress of obeticholic acid in the intervention of non-alcoholic fatty liver disease / 国际药学研究杂志

Non-alcoholic fatty liver disease(NAFLD)is a relatively common chronic liver disease with imbal- anced lipid metabolism, and its incidence is increasing year by year. NAFLD is closely related to bile acid excretion, ab- normal bile acid synthesis and liver fibrosis. Farnesolid X receptor(FXR)regulates bile acid transport, inhibits bile acid synthesis and resists liver fibrosis. Obeticholic acid is a targeted drug for the treatment of NAFLD targeting the farnesol X receptor, which can effectively regulate fat metabolism and blood sugar balance. This review summarizes the mechanism and research progress of obeticholic acid intervention in NAFLD, and provides a theoretical basis for its foundamental re- search and clinical application.

Prevalence of hypoglycaemia among insulin-treated pregnant women with diabetes- who achieved tight glycaemic control / Journal of the ASEAN Federation of Endocrine Societies

@#<p><strong>OBJECTIVE: </strong>To determine the prevalence of hypoglycaemia using continuous glucose monitoring system (CGMS) among insulin-treated pregnant women with diabetes whose glycosylated haemoglobin (HbA1c) were <6.0% and identify the risk factors associated with hypoglycaemia occurrence.</p><p><strong>METHODOLOGY:</strong> We conducted a cross-sectional study using 6-days CGMS to detect the prevalence of hypoglycaemia in 31 insulin-treated pregnant women with diabetes who achieved HbA1c <6.0%. Patients were required to log-keep their self-monitoring blood glucose (SMBG) readings and hypoglycaemia events.</p><p><strong>RESULTS:</strong> Eight women experienced confirmed hypoglycaemia with additional seven experienced relative hypoglycaemia, giving rise to prevalence rate of 45.2% (one had both confirmed and relative hypoglycaemia). Nine relative hypoglycaemia and 17 confirmed hypoglycaemic events were recorded. Sixteen (94%) out of 17 confirmed hypoglycaemia events recorded by CGMS were asymptomatic and were missed despite performing regular SMBG. Nocturnal hypoglycaemia events were recorded in seven women. Univariable analysis did not identify any association between conventional risk factors and hypoglycaemia events in our cohort.</p><p><strong>CONCLUSION:</strong> Insulin-treated pregnant women with diabetes who achieved HbA1c < 6.0% were associated with high prevalence of hypoglycaemia. Asymptomatic hypoglycaemia is common in our cohort and frequently missed despite regular SMBG. Present study did not identify any association between conventional risk factors and hypoglycaemia events in our cohort.</p>

Analysis on the risk of dengue fever in Guangxi / 天津医药

Objective To explore the causes of dengue fever resurgence in Guangxi, and to analyze the risk factors of dengue fever. Methods The descriptive epidemiological analysis was conduced based on the dengue fever data reported from 2006 to 2015, and the surveillance results of aedes and antibody levels in health population from 2013 to 2015 in Guangxi. Results Before 2013, dengue fever was imported from foreign country in Guangxi, accounting for 95.35％(42/45), and 75.71％of the imported cases was imported from Southeast Asia. The local outbreak of dengue fever was happened in 2014, accounted for 94.02％(849/903) of the total number of 10 years. From onset to diagnosis, Guangxi dengue fever cases need 0-70 d (median time interval is 6 d). Cases were reported year-round, but the peak season for the onset of dengue fever was from September to November, accounting for 96.46％of all cases (871/903). The number of cases reported in Nanning was the most (83.37％), followed by Wuzhou city (7.44％) and Guilin city (4.81％), and all the three cities had dengue fever outbreaks. The cases were mainly commercial service staff (27.80％) and houseworkers and unemployed people (18.16％). Results of aedes monitoring showed that the density of aedes was high in Guangxi. In more than 50％ of the monitoring seasons the breteau index (BI) stayed greater than 20. However, the antibody positive rate was only 3％ in the healthy residents of Guangxi. Conclusion The risk of dengue fever is high in Guangxi. Therefore, it is essential to emphasizing idea of prevention and control, strengthening immigration surveillance, improving diagnosis ability, enhancing public health education, and expanding monitoring range.

Application of psychological intervention combined with midazolam in local anesthesia of ophthalmology / 中国生化药物杂志

Objective To investigate the clinical effect of psychological intervention and midazolam in local anesthesia of ophthalmology. Methods Two groups of patients were according to the actual condition of the eye determines the choice of surgical treatment, control group received local anesthesia midazolam, research group was given midazolam provide psychological intervention before local anesthesia, recorded at different time points in two groups of patients in pain. Results The success rate of surgery in two eyes was 100.00%. The scores of NRS scale were significantly lower in the study group at the time of operation, at the end of the operation and at the postoperative 6h than in the control group (P<0.05). Conclusion Psychological intervention and midazolam combined with ophthalmic surgery can significantly improve the local anesthesia effect, and help to ensure the success rate and prognosis of patients.

Application of psychological intervention combined with midazolam in local anesthesia of ophthalmology / 中国生化药物杂志

Objective To investigate the clinical effect of psychological intervention and midazolam in local anesthesia of ophthalmology. Methods Two groups of patients were according to the actual condition of the eye determines the choice of surgical treatment, control group received local anesthesia midazolam, research group was given midazolam provide psychological intervention before local anesthesia, recorded at different time points in two groups of patients in pain. Results The success rate of surgery in two eyes was 100.00%. The scores of NRS scale were significantly lower in the study group at the time of operation, at the end of the operation and at the postoperative 6h than in the control group (P<0.05). Conclusion Psychological intervention and midazolam combined with ophthalmic surgery can significantly improve the local anesthesia effect, and help to ensure the success rate and prognosis of patients.

Effect of Low-frequency Electroacupuncture on Substance P Expression in the Spinal Dorsal Horn in SNI Neuralgia Rats / 上海针灸杂志

Objective To investigate the intervening effect of low-frequency electroacupuncture on rat neuralgia and its regulating effect on substance P (SP) in the spinal dorsal horn. Method SD rats were randomized to normal, sham operation (sham SNI), operation (SNI) and electroacupuncture (SNI+EA) groups, 8 rats each. A rat model of neuralgia was made by spared sciatic nerve injury (SNI). Points Zusanli(ST36) and Kunlun(BL60) on the operation side were given 2 Hz electroacupuncture once daily for 14 days. The rat hind paw withdrawal threshold (PWT) was measured on the operation side to observe its pain hypersensitivity. SP-positive expression in the spinal dorsal horn on the operation side was determined by immunofluorescence. Result Operative side PWT decreased significantly in the SNI group of rats (P<0.01). Electroacupuncture increased operative side PWT in the SNI neuralgia rats (P<0.01). Pain threshold onthe healthy side had no marked change in the SNI group of rats (P>0.05). SP-positive expression in the spinal dorsal horn increased on the operation side (P<0.01) and also on the healthy side (P<0.05) in the SNI group of rats. Electroacupuncture decreased SP-positive expression in the spinal dorsal horn on the operation side in the SNI rats (P<0.01). Electroacupuncture did not significantly change SP-positive expression in the spinal dorsal horn on the healthy side (P>0.05). PWT on the operation and healthy sides and SP-positive cell expression in the spinal dorsal horn on the operation and healthy sides had no marked changes in the SNI group of rats (P>0.05). Conclusion Low-frequency electroacupuncture can relieve rat neuralgia. Its mechanism may be related to it inhibiting SP-positive expression in the spinal dorsal horn on the operation side.

Facilitating the measurement of circulatory hydrogen sulfide with fluorescence probe-coated microplates / 北京大学学报(医学版)

Objective:The hydrogen sulfide (H2 S) role in pathogenesis of various diseases were wildly addressed in recent decade.The circulatory (plasma or serum) and biological fluid H2S measurement is still an enormous issues due to the technical limitation.This paper aimed to develop a novel measurement method based on fluorescence probe.Methods:Firstly,20 μL ethanol was used to dissolve 100 pmol fluorescence probe,then added in a 96-well plate.An equal volume of ethanol was also added to the blank well of the plate.The plate was placed in a dark room for about 1 h until the fluorescence probe was evenly coated in the 96-well microplate and dried.The plate was frozen at-20 ℃ for later use.Secondly,the plasma or serum sample was added with saturated ammonium sulfate buffer (pH 7.8) and then centrifuged to remove the proteins.The equal volume supernatant liquid was added to the probecoated well and the probe-uncoated well.The plate was incubated in a dark environment at 37 ℃ for 2 h.Finally,after incubation,the fluorescence density was acquired at λEx/λEm 340/445 nm in a microplate reader.The differences of the fluorescence density values between the probe-coated well and probeuncoated well were counted and H2S concentration of plasma/serum was calculated by standard curve with NaHiS.Results:The method had high sensitivity (from 0.3 to 100 μmol/L) and specificity for measuring H2S as compared with other biologically relevant reactive sulfur species and sulfur-containing amino acid.Serum H2S concentrations were assayed in 188 health volunteers using this method [(12.1 ±3.5) μmol/L,95％ CI:4.6-19.8 μmol/L],and the frequency distribution showed a normal tendency(one-sample Kolmogorov-Smirnov test,P ＞ 0.1).The serum H2S concentrations in 30 hypertension patients were decreased compared with 22 age-and gender-matched health individuals (paired-samples t test,t =9.937,P ＜ 0.001).There were no differences of H2S concentration in serum [(19.66 ±2.32) μmol/L] or plasma [(18.67 ±2.07) μmol/L],between the samples acquired from artery [(19.34 ±0.51) μmol/L] or vein [(18.99 ±0.50) μ mol/L] of male Wistar rats (repeated measurement of ANOVA,P =0.38).One week frozen samples did not affect the detection.The values of the repeated measurement did not differ (two-way ANOVA,P ＞ 0.05).Conclusion:The present method is easily performed with high sensitivity,specificity and repeatability for circulatory H2S.It is also quick and may apply for large samples.

Thin slice three dimentional (3D) reconstruction versus CT 3D reconstruction of human breast cancer.

Background & objectives: With improvement in the early diagnosis of breast cancer, breast conserving therapy (BCT) is being increasingly used. Precise preoperative evaluation of the incision margin is, therefore, very important. Utilizing three dimentional (3D) images in a preoperative evaluation for breast conserving surgery has considerable significance, but the currently 3D CT scan reconstruction commonly used has problems in accurately displaying breast cancer. Thin slice 3D reconstruction is also widely used now to delineate organs and tissues of breast cancers. This study was aimed to compare 3D CT with thin slice 3D reconstruction in breast cancer patients to find a better technique for accurate evaluation of breast cancer. Methods: A total of 16-slice spiral CT scans and 3D reconstructions were performed on 15 breast cancer patients. All patients had been treated with modified radical mastectomy; 2D and 3D images of breast and tumours were obtained. The specimens were fixed and sliced at 2 mm thickness to obtain serial thin slice images, and reconstructed using 3D DOCTOR software to gain 3D images. Results: Compared with 2D CT images, thin slice images showed more clearly the morphological characteristics of tumour, breast tissues and the margins of different tissues in each slice. After 3D reconstruction, the tumour shapes obtained by the two reconstruction methods were basically the same, but the thin slice 3D reconstruction showed the tumour margins more clearly. Interpretation & conclusions: Compared with 3D CT reconstruction, thin slice 3D reconstruction of breast tumour gave clearer images, which could provide guidance for the observation and application of CT 3D reconstructed images and contribute to the accurate evaluation of tumours using CT imaging technology.

Limb-shaking transient ischemic attack responsive to nimodipine: A case report

Limb-shaking transient ischemic attack (TIA), a rare manifestation, is commonly caused by severe stenosis or occlusion of an extracranial internal carotid artery. Such patients are usually treated with surgical revascularization or anti-platelet therapy. We present a 56-year-old woman with 6 months’ episodic attacks starting with mouth skewed to the right and a sensation of ‘weakness’ involving predominantly her left arm, and at times, also involved the left leg. This was immediately followed by rhythmic jerky movements of the left arm and at times, also involved the left leg. Magnetic resonance angiography revealed severe stenosis of M1 segment of the right middle cerebral artery. The patient’s symptoms were signifi cantly improved by treatment with anti-platelet drugs and nimodipine.

Construction of quantitative real-time PCR detection system of transgenic tomato line Zeneca B,Da,F / 南方医科大学学报

<p><b>OBJECTIVE</b>To construct the plasmid reference molecules for detection of transgenic tomato line Zeneca B,Da,F using quantitative real-time PCR(qPCR).</p><p><b>METHODS</b>Three plasmid reference molecules pEasy-T3-APX, pEasy-T3-16A and pEasy-T3-16S were cloned based on reverse genetics, which contain the target fragments of tomato endogenous reference gene apx (ERG-apx), gene-specific sequence of pg(GS-pg) and construct-specific sequence of vectors pJR16S/pJR16A (CS-16S/CS-16A) of Zeneca B,Da,F, respectively. Primers and Taqman probes were designed by Beacon Designer 7.5.The specificity, sensitivity, reproducibility and the limit of detection(LOD) of the qualitative and quantitative PCR system based on the plasmid reference molecules were evaluated. PicoGreen was used to measure the DNA concentration of the plasmid reference molecules. Two sets of samples containing 1% or 0.1% (w/w) pEasy-T3-16A or pEasy-T3-16S mixed with pEasy-T3- APX as background DNA were prepared for evaluating the efficacy of the qPCR system.</p><p><b>RESULTS</b>The target fragments for qPCR detection were anchored, ERG-apx 108 bp, GS-pg 108 bp , CS-16S 109 bp and CS-16A 102 bp. The three plasmid reference molecules were confirmed at the expected sizes by restriction enzyme digestion. The qPCR results showed that the RSD of reproducibility were 0.2% to1.5%, LOD was 25 copies, R2 values for these standard curves were 0.994 ~0.998 and amplification efficiencies were 93.3%~102.4%.The bias between the test and true values of two sets of mixed samples ranged from -9.3% to 14.7% after adjusting by conversion factors(Cf).</p><p><b>CONCLUSION</b>The plasmid reference molecules and qPCR system for qualitative and quantitative detection of transgenic tomato line Zeneca B,Da,F have been established successfully.</p>

Relationship between somatostatin receptors and activation of hepatic stellate cells / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Somafostatin receptors (SSTRs) have been suggested to involve in mediating the effect of somatostatin on hepatic stellate cells (HSCs) in an activation-dependent way. We, therefore, try to investigate the relationship between expression of SSTRs and activation of rat HSCs.</p><p><b>METHODS</b>HSCs were isolated from rats by in situ perfusion and single-step density gradient centrifugation. SSTR1-5 mRNA levels in the differentiated first passage HSCs were detected by means of a reverse transcription polymerase chain reaction. On the other hand, hepatic fibrosis was induced in adult male Sprague-Dawley rats by carbon tetrachloride intoxication, and the expression of SSTR1-5 in normal as well as fibrotic livers was measured by immunohistochemical staining.</p><p><b>RESULTS</b>SSTR mRNA and SSTR could not be found in freshly isolated rat HSCs or normal rat liver. However, SSTR1-3 mRNA appeared as HSCs became wholly activated, and could also be identified on the membrane of activated HSCs in the perisinusoid space, fibrous septa, etc.</p><p><b>CONCLUSION</b>The expression of SSTR1-3 in the rat HSC is closely related to its activation. This may reflect one of the main negative regulation mechanisms in the course of HSC activation.</p>

Mast cell subsets and neuropeptides in leprosy reactions

The immunohistochemical identification of neuropeptides (calcitonin gene-related peptide, vasoactive intestinal polypeptide, substance P, alpha-melanocyte stimulating hormone and gamma-melanocyte stimulating hormone) quantification of mast cells and their subsets (tryptase/chymase-immunoreactive mast cells = TCMC and tryptase-immunoreactive mast cells = TMC) were determined in biopsies of six patients with leprosy reactions (three patients with type I reaction and three with type II). Biopsies were compared with those taken from the same body site in the remission stage of the same patient. We found a relative increase of TMC in the inflammatory infiltrate of the reactional biopsies compared to the post-reactional biopsy. Also, the total number of mast cells and the TMC/TCMC ratio in the inflammatory infiltrate was significantly higher than in the intervening dermis of the biopsies of both periods. No significant difference was found regarding neuroptide expression in the reactional and post-reactional biopsies. The relative increase of TMC in the reactional infiltrates could implicate this mast cell subset in the reported increase of the immune response in leprosy reactions

The expression of NGFr and PGP 9.5 in leprosy reactional cutaneous lesions: an assessment of the nerve fiber status using immunostaining

The effects of reactional episodes on the cutaneous nerve fibers of leprosy patients was assessed in six patients (three with reversal reactions and three with erythema nodosum leprosum). Cryosections of cutaneous biopsy of reactional lesions taken during the episode and of another sample during the remission period were immunostained with anti-NGFr and anti-PGP 9.5 (indirect immunofluorescence). We found no significant statistical difference in the number of NGFr- and PGP 9.5-positive fibers between the reactional and post-reactional groups. A significant difference was detected between the number of NGFr and PGP 9.5-stained fibers inside of the reactional group of biopsy cryosections but this difference was ascribed to the distinct aspects of the nerve fibers displayed whether stained with anti-NGFr or with anti-PGP 9.5; NGFr-positive branches looked larger and so interpreted as containing more fibers. In addition, a substantial number NGFr-positive fibers were PGP 9.5-negative. No differences in the number of stained fibers among the distinct cutaneous regions examined (epidermis + upper dermis, mid and deep dermis) was detected. In conclusion, the number of PGP- and NGFr-positive fibers were not significantly different in the reactional and post-reactional biopsies in the present study. NGFr-staining of the nerve fibers is different from their PGP-imunoreactivity and the evaluation of the nerve fiber status on an innervated target organ should be carried out choosing markers for both components of nerve fibers (Schwann cells and axons)