[Non-alcoholic fatty liver disease increases the incidence rate of type 2 diabetes mellitus: a cohort study based on a rural town elderly population of southern Jiangsu].

Objective: To investigate the impact of non-alcoholic fatty liver disease (NAFLD) on the incidence of type 2 diabetes mellitus (T2DM) in an elderly population. Methods: A rural elderly population of Kunshan city, Jiangsu Province were used as the research subject. Prior diabetes mellitus, heavy alcohol consumption and incomplete data were excluded from prospective cohort study analysis. Annual physical examination and follow-up were conducted from 2007 to 2016. T2DM onset, death and loss to follow-up visits were observed as the research subject end points. According to the baseline physical examination results, the study subjects were divided into NAFLD and control groups, and further baseline data of both groups were analyzed whether there were match. The cumulative incidence rate of T2DM were statistically analyzed and compared between the two groups. Simultaneously, the relationship between the two groups of various indexes and the newly developed T2DM were analyzed using Kaplan-Meier. The variables with P < 0.1 were selected and incorporated into the Cox proportional hazard regression model. The impact of NAFLD on the incidence of T2DM was analyzed in an elderly population. Results: At baseline, there were statistically significant differences in the distribution of age, sex, waist circumference, body mass index, systolic blood pressure, diastolic blood pressure, direct bilirubin, blood urea nitrogen and triglycerides between NAFLD and non-NAFLD groups. However, fasting blood glucose, serum creatinine, total bilirubin, total cholesterol, low density lipoprotein cholesterol and high-density lipoprotein cholesterol had no statistically significant differences between the two groups. After nine years of follow-up, 207 newly developed T2DM cases, 52 NAFLD cases and 155 control group were selected as the study subjects. The cumulative incidence rates were 4.25%, 10.34%, and 3.55%, respectively. Kaplan-Meier analysis result showed that there were statistically significant differences in the cumulative incidence rates between the two groups from five-year. NAFLD had increased the T2DM risk in an elderly population by approximately 2.14 times (2.14 CI: 1.132 ~ 4.047) at five-year, and then had increased year by year thereafter. Univariate analysis showed that T2DM risk was 2.76 times higher in NAFLD than non-NAFLD groups (95% CI: 2.015 ~ 3.777). After adjustment for gender, age, body mass index, waist circumference, systolic blood pressure, diastolic blood pressure, serum creatinine, triglyceride, total cholesterol, high-density lipoprotein cholesterol and low-density lipoprotein cholesterol, T2DM risk ratio was 1.68 times higher in NAFLD than control groups (95% CI: 1.163 ~ 2.425). Conclusion: NAFLD is an independent long-term risk factor for the T2DM onset in an elderly population.

[Perceived organizational support and emotional stability modify the effect of depression tendency on burnout in doctors].

Objective: To explore and analyze the relationship between burnout, depression, perceived organizational support and emotional stability, as well as their interaction on burnout, so as to provide reference for improving the situation of burnout on doctors. Methods: By cluster random sampling, a cross-sectional survey of doctors in a municipal hospitals of Zhengzhou in June to August, 2015, Henan Province was conducted. The questionnaires of Maslach Burnout Inventory-General Survey (MBI-GS) , Perceived organizational support, Eysenck Personality Questionnair-Revission Short Scale of China (EPQ-RSC) and Center for Epidemiological Studies Depression Scale (CES-D) were used for questionnaire survey and analysis. Multiple regression analysis was used to explore the interaction of organizational support and emotional stability on depressive tendency and occupational burnout. Results: Among the 389 doctors, 147 were males and 242 were females. Age M (P(25), P(75)) was 33.0 (29.0, 40.0) years, and length of work M (P(25), P(75)) was 7.0 (4.0, 16.0) years. Burnout was positively correlated with depression tendency and emotional stability (r=0.571, 0.453, P<0.01) , while burnout was negatively correlated with perceived organizational support (r=-0.260, P<0.01) . The interaction among depression tendency, perceived organizational support and emotional stability was statistically significant (ß=-0.002, P<0.05) , the independent effect on burnout is 1.0% (ΔR(2)=0.010) , the positive effect of emotional stability was the largest (ß=0.550) , followed by the positive effect of depression tendency (ß=0.494) . When the tendency of depression increased, the burnout of doctors with high perceived organizational support and emotional stability was higher than those with high perceived organizational support and emotional instability and those with low perceived organizational support (P<0.01) . Conclusion: Emotional stability is the main factor affecting the effect of depression tendency on doctors' burnout. Doctors with stable emotion and high perceived organizational support showed obvious changes in burnout when depression tendency increased, and showed stronger burnout.

[Analysis of influencing factors and causes of death in elderly residents with non-alcoholic fatty liver disease].

Objective: To understand and analyze the incidence rate, risk factors, independent risk factors and the causes of death in elderly population with non-alcoholic fatty liver disease (NAFLD). Furthermore, analyze the relationship between metabolic syndrome (MS) and mortality rate in patients with NAFLD to provide evidence for the prevention and control of NAFLD in the elderly population. Methods: A total of 7 619 elderly people aged over 60 years, and local household registered in Kunshan city, Jiangsu province in 2016 were included as subjects to analyze the incidence rate, influencing factors and causes of death in patients with NAFLD and the relationship between MS and mortality rate in patients with NAFLD. According to different data, using Kruskal-Wallis H test, analysis of variance, t-test, chi-square test or logistic regression analysis were performed. Results: The prevalence of NAFLD was14.10% (1 074/7 619) among the elderly over 60 years in Kunshan city, Jiangsu province in 2016, and the female prevalence rate was significantly higher than that of males (P < 0.05). When the body mass index (BMI) was < 32 (kg/m(2)), the prevalence of NAFLD increased with the increase of BMI index. When BMI was 18.5-23.9 kg/m2, 24-27.9 kg/m(2) and > 32 kg/m(2), the prevalence of NAFLD was significantly higher in females than males (P < 0.05). There was no significant difference in prevalence between males and females with BMI <18.5 kg/m(2) and 28~31.9 kg/m(2) (P > 0.05). BMI gradually decreased (P < 0.05) with the increase of age, and the incidence of NAFLD showed a downward trend (P < 0.05). An independent risk factors for NAFLD (P < 0.01) were gender (OR = 0.616), age (OR = 0.970), waist circumference (OR = 1.065), triglycerides (OR = 1.162), BMI (OR = 1.238), and diastolic blood pressure (OR = 1.012). The probability of NAFLD combined with three and four kinds of MS was significantly higher than control group (P < 0.05). Subjects' mortality rate during the follow-up period was 1.94%, 2.23% in the NAFLD group, and 1.89% in the control group. Average life expectancy was 75.58 years in NAFLD group and 78.68 years in the control group. All deaths in NAFLD groups were associated with MS, and 70.83% combined with three or more MS. The primary cause of death in NAFLD group was tumors (37.5%), followed by cardiovascular disease (16.67%) and three cases died directly from MS. Conclusion: The prevalence of NAFLD in the elderly population in Kunshan city, Jiangsu province is relatively low, which may be associated with local diet and high-intensity workouts. MS disorders represented by obesity and diabetes mellitus are closely associated to the onset of NAFLD. Obesity is the most important risk factor for the incidence of NAFLD in the local elderly population over 60 years old. However, the risk of NAFLD should not be neglected in people with normal BMI, especially in aged women, and the weight control should be the most important means to prevent and control NAFLD. NAFLD may increase mortality rate and reduce life expectancy in the elderly population. The main reason to cause death in the elderly with NAFLD is cardiovascular disease and malignant tumors. Simultaneously, multiple MS development may increase the death rate in elderly with NAFLD.

[Application of multi-slice spiral CT to assess vascular volume for the diagnosis and treatment of gastric varices].

Objective: To differentiate the inflow and outflow channels of gastric varices in cirrhotic portal hypertension patients using multi-slice spiral CT (MSCT), and to assess the relationship between calculable CT volume of gastric varices and the amount of tissue adhesive. Methods: 97 cases with cirrhotic gastric varices who were admitted from November 2013 to August 2017 were selected. The type and shape of gastric varices were observed before tissue glue injection treatment by MSCT. The correlation between CT volume of gastric varices and the amount of tissue adhesive was evaluated by Spearman rank correlation coefficient and Univariate linear regression analysis. Results: MSCT showed that Le, g type had the highest proportion (54.6%), followed by Le, g, Lg (20.6%). Le, Lg and Lgf type accounted for 17.5%, and 5.2%, respectively, while Lgf+b accounted for 2.1%. On MSCT, varices of the gastric fundus were in the direction from bottom to top, and 75% of the fundus had a large curved side varices combined with gastric and renal shunt. Under the gastroscopy, varices in the small curved side of the gastric fundus from near to far were formless. In addition, varices in the large curved side of the gastric fundus when observed from different angles to the direction of blood flow (reverse gastroscope) were 72.7% (near and far) or 20.5 % (far and near). There was a positive correlation between CT volume (R = 0.97, P < 0.001) and the amount of tissue adhesive (Y(1) = 0.35 + 0.65X1, Univariate linear regression equation; ρ = 0.89, P < 0.001, Spearman correlation analysis). Conclusion: MSCT can recognize the vascular shape and inflow and outflow channels of gastric varices. A positive correlation between CT volume and the amount of tissue adhesive, suggested that the CT volume measurement before treatment could be used as one of the method to predict the amount of tissue adhesive.

[Piperine inhibits the transformation of endothelial cells into fibroblasts].

Objective: To investigate the role of piperine on the transformation of endothelial cells into fibroblasts. Methods: Cultured human umbilical vein endothelial cells (HUVECs, 4-6 passage) were used for the main experiments. The transformation models of endothelial cells into fibroblasts were induced by transforming growth factor ß (TGF-ß) stimulation. HUVECs were divided into 6 groups: control group, TGF-ß group and 4 groups treated with various concentrations of piperine (1, 5, 10, 20 µmol/L). CKK-8 was used to detect cell proliferation. The CD31/α-smooth muscle actin (α-SMA) expression level was detected by fluorescent staining. The vascular endothelial cadherin (VE-cadherin)/vimentin expression was detected by immunofluorescence staining. RT-PCR was used detect the mRNA expressions of transformation markers. Western blot was used to detect the protein expression of snail and twist. Results: TGF-ß increased HUVECs proliferation (P<0.05), which could be significantly inhibited by 10 and 20 µmol/L of piperine, but not by 1 and 5 µmol/L of piperine. Immunofluorescence results demonstrated that TGF-ß increased HUVECs transformation to fibroblasts as shown by downregulated expression of endothelial markers CD31, VE-cadherin, and upregulated expression of α-SMA and vimentin, again, these effects could be attenuated by 10 and 20 µmol/L piperine. The expression levels of collagen type Ⅰ and type Ⅲ were significantly higher in TGF-ß group than in control group (P<0.05), significantly lower in TGF-ß+10 µmol/L piperine group and TGF-ß+20 µmol/L piperine group than in TGF-ß group (P<0.05).In addition, RT-PCR results showed that TGF-ß increased mRNA expression of transformation markers (snail1, snail2, twist1, twist2), while 10 and 20 µmol/L of piperine could significantly downregulated the mRNA expressions of these markers. The protein expression levels of snail and twist were significantly higher in TGF-ß group than in control group (both P<0.05), which was significantly lower in TGF-ß+20 µmol/L piperine group than in TGF-ß group (both P<0.05). Conclusions: Piperine can inhibit the transformation of endothelial cells into fibroblasts. This effect might be viewed as one of the potential mechanisms of reduced myocardial fibrosis post piperine treatment.

[Relationships between the enrichment of ETBF, Fn, Hp in intestinal and colorectal cancer].

Objective: To explore relationships between the enrichment of ETBF, Fn, Hp in feces, tissues and colorectal cancer. Methods: Feces, lesion tissue and adjacent tissue from 24 patients with colorectal cancer and 31 patients with adenomas were collected, and we collected Feces and tissue of 20 healthy control persons. Then the copy numbers of enterotoxigenic B. fragilis (ETBF), Fusobacterium nucleatum (Fn) and Helicobacter pylori (Hp) were determined by quantitative real-time PCR. Immunohistochemical method was used to examine the expression intensity of EGFR and p53, and the relationships between different expression intensity of EGFR, p53 and the numbers of three bacterias. Results: In the feces, copy numbers of ETBF and Fn were as follous: colorectal cancer group>adenomas group>healthy control group (P<0.05). Copy numbers of Hp were as follous: colorectal cancer group>healthy control group (P<0.01); adenomas group>healthy control group (P<0.01). In the tissue, copy numbers of ETBF, Fn were as follows: colorectal cancer group>adenomas group>healthy control group (P<0.05). Copy numbers of Hp were as follows: colorectal cancer group>healthy control group (P<0.01); adenomas group>healthy control group (P<0.01). Copy numbers of those three bacteria in the lesion tissue and the adjacent tissue had no significant difference. This happened both in colorectal cancer group and adenomas group. The different expression intensity of EGFR, p53 and the number of three bacteria showed no obviously statistical correlation(P>0.05). Conclusion: Adenomatous polyp and colorectal cancer patients show high enrichment of ETBF, Fn and Hp in both feces and tissues. ETBF, Fn and Hp probably contribute to the development of adenomatous polyp and colorectal cancer. Trial registration Chinese Clinical Trial Registry, ChiCTR-BOC-17012509.

Effects of calcium oxide treatment at varying moisture concentrations on the chemical composition, in situ degradability, in vitro digestibility and gas production kinetics of anaerobically stored corn stover.

The objective of this study was to determine the optimum conditions for calcium oxide (CaO) treatment of anaerobically stored corn stover by in situ and in vitro methods. Four ruminally cannulated, non-lactating, non-pregnant Holstein cows were used to determine the in situ effective degradabilities of dry matter (ISDMD), organic matter (ISOMD), neutral detergent fibre (ISNDFD), in vitro organic matter disappearance (IVOMD) and gas production in 72 h (GP72h ) of corn stover. A completely randomized design involving a 3 × 3 factorial arrangement was adopted. Ground corn stover was treated with different levels of CaO (3%, 5% and 7% of dry stover) at varying moisture contents (40%, 50% and 60%) and stored under anaerobic conditions for 15 days before analysis. Compared with untreated corn stover, the CaO-treated stover had increased ash and calcium (Ca) contents but decreased aNDF and OM contents. The moisture content, CaO level and their interaction affected (p < 0.01) the content of aNDF, ash and OM, and the ratio of aNDF/OM. The greatest ISDMD, ISOMD and ISNDFD were observed when stover was treated with 7% CaO and 60% moisture, while no differences (p > 0.01) in these in situ degradability parameters were observed between the stover treated with 5% CaO at 60% moisture content and those treated with 7% CaO at 60% moisture content. Corn stover treated with 5% CaO at 50% moisture had the maximum IVOMD and GP72 h among the treatments, and there was no difference (p > 0.01) between 50% and 60% moisture. Results from this study suggested that 5% CaO applied at 60% moisture could be an effective and economical treatment combination.

[Combination measurement of liver and spleen stiffness with portal vein width to evaluate risk of bleeding in esophageal and gastric varices patients].

OBJECTIVE: To evaluate the utility of combined liver stiffness measurement (LSM) and spleen stiffness measurement (SSM), by transient elastography, along with measurement of portal vein width (PVW) for evaluating risk of bleeding in patients with esophageal and gastric varices (EV). METHODS: A total of 73 patients with cirrhosis who were treated in the Department of Gastroenterology of the Second Affiliated Hospital of Xi'an Jiaotong University between April 2014 and March 2015 were included in the study. Child-Pugh classifications were obtained, portal vein widths were measured by ultrasound, liver and spleen stiffness were measured by transient elastography using FibroTouch®. Patients were examined by electronic endoscopy, upper abdominal computed tomography and standard serum testing. The serum indexes of fibrosis (aspartate aminotransferase (AST) to platelet ratio index (APRI), and AST to alanine aminotransferase ratio (AAR)) were calculated. Patients were grouped according to the results of gastroscopy, with severe (EV) and high risk of bleeding comprising group A and no or mild-to-moderate EV and low risk of bleeding comprising group B. Statistical analysis was carried out with t-test for continuous variables and χ(2) test for categorical variables to first screen out variables different between groups then the correlation with severe EV was assessed by generating receiver operating characteristic (ROC) curves. Lastly, binary logistic regression was used to evaluate the performance of combined variables for diagnosing severe EV and their predictive value for risk of bleeding. RESULTS: Group A and B showed significant differences for LSM, SSM and PVW (all P < 0.05). The cutoff values for diagnosing severe EV were 23.4 kPa for LSM, 40.3 kPa for SSM and 11.5 mm for PVW, with areas under the ROC curve (AUROC) as 0.655, 0.788 and 0.709 respectively. For combined measurements, the AUROC was 0.773 for LSM plus PVW and 0.840 for LSM plus PVW (with highest diagnostic performance). CONCLUSIONS: Combination of SSM plus PVW measurement shows high diagnostic performance for evaluating severe EV, and better performance than LSM plus SSM plus PVW and LSM plus PVW, with good predictive value for risk of EV bleeding.

Effects of replacing wild rye, corn silage, or corn grain with CaO-treated corn stover and dried distillers grains with solubles in lactating cow diets on performance, digestibility, and profitability.

The objective of this study was to measure the effects of partially replacing wild rye (Leymus chinensis; WR), corn silage (CS), or corn grain (CG) in dairy cow diets with CaO-treated corn stover (T-CS) and corn dried distillers grains with soluble (DDGS) on performance, digestibility, blood metabolites, and income over feed cost. Thirty tonnes of air-dried corn stover was collected, ground, and mixed with 5% CaO. Sixty-four Holstein dairy cows were blocked based on days in milk, milk yield, and parity and were randomly assigned to 1 of 4 treatments. The treatments were (1) a diet containing 50% concentrate, 15% WR, 25% CS, and 10% alfalfa hay (CON); (2) 15% WR, 5% CG, and 6% soybean meal were replaced by 15% T-CS and 12% DDGS (RWR); (3) 12.5% CS, 6% CG, and 5% soybean meal were replaced by 12.5% T-CS and 12%DDGS (RCS); (4) 13% CG and 6% soybean meal were replaced by 7% T-CS and 13% DDGS (RCG). Compared with CON treatment, cows fed RCS and RCG diets had similar dry matter intake (CON: 18.2 ± 0.31 kg, RCS: 18.6 ± 0.31 kg, and RCG: 18.4 ± 0.40 kg). The RWR treatment tended to have lower dry matter intake than other treatments. The inclusion of T-CS and DDGS in treatment diets as a substitute for WR, CS, or CG had no effects on lactose percentage (CON: 4.96 ± 0.02%, RWR: 4.97 ± 0.02%, RCS: 4.96 ± 0.02%, and RCG: 4.94 ± 0.02%), 4% fat-corrected milk yield (CON: 22.7 ± 0.60 kg, RWR: 22.1 ± 0.60 kg, RCS: 22.7 ± 0.60 kg, and RCG: 22.7 ± 0.60 kg), milk fat yield (CON: 0.90 ± 0.03 kg, RWR: 0.86 ± 0.03 kg, RCS: 0.87 ± 0.03 kg, and RCG: 0.89 ± 0.03 kg), and milk protein yield (CON: 0.74 ± 0.02 kg, RWR: 0.72 ± 0.02 kg, RCS: 0.73 ± 0.02 kg, and RCG: 0.71 ± 0.02 kg). Cows fed the RWR diet had higher apparent dry matter digestibility (73.7 ± 1.30 vs. 70.2 ± 1.15, 69.9 ± 1.15, and 69.9 ± 1.15% for RWR vs. CON, RCS, and RCG, respectively) and lower serum urea N (3.55 ± 0.11 vs. 4.03 ± 0.11, 3.95 ± 0.11, and 3.99 ± 0.11 mmol/L for RWR vs. CON, RCS, and RCG, respectively) than cows fed other diets. No significant differences were noted in apparent neutral detergent fiber digestibility among the treatments. Compared with CON treatment, the RWR, RCS, and RCG treatments generated an additional $0.77, $0.70, and $0.81 income over feed cost per cow per day, respectively. In conclusion, feeding diets containing a portion of T-CS and DDGS can improve profitability of the treatment groups without negatively affecting the lactation performance of mid- to late-lactation cows.

Molecular cloning and tissue distribution profiles of the chicken R-spondin1 gene.

Rspo1 belongs to the Rspo family, which is composed of 4 members (Rspo1-4) that share 40 to 60% sequence homology and similar domain organizations, and regulate the WNT signaling pathway via a common mechanism. Rspo1 plays a key role in vertebrate development and is an effective mitogenic factor of gastrointestinal epithelial cells. We report the cloning of chicken Rspo1 and its gene expression distribution among tissues. It contained an open reading frame of 783 bp encoding a protein of 260 amino acids, and its molecular weight was predicted to be 28.80 kDa. Reverse transcription-polymerase chain reaction-based gene expression analysis indicated that chicken Rspo1 was highly expressed in the stomach muscle tissue, but was expressed at low levels in the lung, brain, jejunum, cecum, ileum, spleen, pancreas, kidney, and glandular stomach. These results suggest that Rspo1 plays a major role in muscular immune protection.

[Clinical significance of the deep learning algorithm based on contrast-enhanced CT in the differential diagnosis of gastric gastrointestinal stromal tumors with a diameter ≤ 5 cm].

Objective: Contrast-enhanced CT is an important method of preoperative diagnosis and evaluation for the malignant potential of gastric submucosal tumor (SMT). It has a high diagnostic accuracy rate in differentiating gastric gastrointestinal stromal tumor (GIST) with a diameter greater than 5 cm from gastric benign SMT. This study aimed to use deep learning algorithms to establish a diagnosis model (GISTNet) based on contrast-enhanced CT and evaluate its diagnostic value in distinguishing gastric GIST with a diameter ≤ 5 cm and other gastric SMT before surgery. Methods: A diagnostic test study was carried out. Clinicopathological data of 181 patients undergoing resection with postoperative pathological diagnosis of gastric SMT with a diameter ≤ 5 cm at Department of Gastrointestinal Surgery of Renji Hospital from September 2016 to April 2021 were retrospectively collected. After excluding 13 patients without preoperative CT or with poor CT imaging quality, a total of 168 patients were enrolled in this study, of whom, 107 were GIST while 61 were benign SMT (non-GIST), including 27 leiomyomas, 24 schwannomas, 6 heterotopic pancreas and 4 lipomas. Inclusion criteria were as follows: (1) gastric SMT was diagnosed by contrast-enhanced CT before surgery; (2) preoperative gastroscopic examination and biopsy showed no abnormal cells; (3) complete clinical and pathological data. Exclusion criteria were as follows: (1) patients received anti-tumor therapy before surgery; (2) without preoperative CT or with poor CT imaging quality due to any reason; (3) except GIST, other gastric malignant tumors were pathologically diagnosed after surgery. Based on the hold-out method, 148 patients were randomly selected as the training set and 20 patients as the test set of the GISTNet diagnosis model. After the GISTNet model was established, 5 indicators were used for evaluation in the test set, including sensitivity, specificity, positive predictive value, negative predictive value and the area under the receiver operating curve (AUC). Then GISTNet diagnosis model was compared with the GIST-risk scoring model based on traditional CT features. Besides, in order to compare the accuracy of the GISTNet diagnosis model and the imaging doctors in the diagnosis of gastric SMT imaging, 3 radiologists with 3, 9 and 19 years of work experience, respectively, blinded to clinical and pathological information, tested and judged the samples. The accuracy rate between the three doctors and the GISTNet model was compared. Results: The GISTNet model yielded an AUC of 0.900 (95% CI: 0.827-0.973) in the test set. When the threshold value was 0.345, the sensitivity specificity, positive and negative predictive values of the GISTNet diagnosis model was 100%, 67%, 75% and 100%, respectively. The accuracy rate of the GISTNet diagnosis model was better than that of the GIST-risk model and the manual readings from two radiologists with 3 years and 9 years of work experience (83% vs. 75%, 60%, 65%), and was close to the manual reading of the radiologist with 19 years of work experience (83% vs. 80%). Conclusion: The deep learning algorithm based on contrast-enhanced CT has favorable and reliable diagnostic accuracy in distinguishing gastric GIST with a diameter ≤ 5 cm and other gastric SMT before operation.

Carbohydrate and amino acid metabolism and oxidative status in Holstein heifers precision-fed diets with different forage to concentrate ratios.

Previous work led to the proposal that the precision feeding of a high-concentrate diet may represent a potential method with which to enhance feed efficiency (FE) when rearing dairy heifers. However, the physiological and metabolic mechanisms underlying this approach remain unclear. This study used metabolomics analysis to investigate the changes in plasma metabolites of heifers precision-fed diets containing a wide range of forage to concentrate ratios. Twenty-four half-sib Holstein heifers, with a similar body condition, were randomly assigned into four groups and precision fed with diets containing different proportions of concentrate (20%, 40%, 60% and 80% based on DM). After 28 days of feeding, blood samples were collected 6 h after morning feeding and gas chromatography time-of-flight/MS was used to analyze the plasma samples. Parameters of oxidative status were also determined in the plasma. The FE (after being corrected for gut fill) increased linearly (P < 0.01) with increasing level of dietary concentrate. Significant changes were identified for 38 different metabolites in the plasma of heifers fed different dietary forage to concentrate ratios. The main pathways showing alterations were clustered into those relating to carbohydrate and amino acid metabolism; all of which have been previously associated with FE changes in ruminants. Heifers fed with a high-concentrate diet had higher (P < 0.01) plasma total antioxidant capacity and superoxide dismutase but lower (P ≤ 0.02) hydroxyl radical and hydrogen peroxide than heifers fed with a low-concentrate diet, which might indicate a lower plasma oxidative status in the heifers fed a high-concentrate diet. Thus, heifers fed with a high-concentrate diet had higher FE and antioxidant capacity but a lower plasma oxidative status as well as changed carbohydrate and amino acid metabolism. Our findings provide a better understanding of how forage to concentrate ratios affect FE and metabolism in the precision-fed growing heifers.

Diagnostic and prognostic significance of long noncoding RNA SSTR5-AS1 in patients with gastric cancer.

OBJECTIVE: Long noncoding RNAs (lncRNAs) display a functional effect on the pathogenesis of several diseases, including various tumors. Herein, we aimed to reveal the role of lncRNA somatostatin receptor 5 antisense RNA 1 (SSTR5-AS1) in gastric cancer (GC). PATIENTS AND METHODS: qRT-PCR was utilized for testing the SSTR5-AS1 expression in 158 paired primary GC tissues and corresponding normal gastric specimens. Receiver operating characteristic (ROC) curves were established to determine the diagnostic values of overexpression of SSTR5-AS1 in GC. A chi-square test was performed to analyze the correlation between SSTR5-AS1 expressions and several clinicopathological features in GC patients. Kaplan-Meier survival curve was constructed to estimate the overall survival (OS) and disease-free survival (DFS). Multivariate analyses were conducted to examine the prognostic value of SSTR5-AS1. RESULTS: We observed that SSTR5-AS1 expression was highly expressed in GC specimens compared with adjacent non-tumor specimens (p < 0.01). High SSTR5-AS1 expression was correlated with an advanced pathologic stage. The ROC curves showed that areas under the ROC curve (AUC) for SSTR5-AS1 is 0.8419. Moreover, high expression of SSTR5-AS1 was observed to be associated with distant metastasis (p = 0.021) and TNM stage (p = 0.042). Besides, survival analysis showed that GC patients with high SSTR5-AS1 expression suffered poorer OS (p = 0.020) and DFS (p = 0.0007). Multivariate assays demonstrated that increased expressions of SSTR5-AS1 could be an independent prognostic marker of OS and DFS of GC patients. CONCLUSIONS: Our findings indicate that SSTR5-AS1 served as a promising novel prognostic biomarker for GC.

[Clinical features and prognosis of 93 elderly patients with multiple myeloma].

Objective: To explore the clinical features and prognostic factors of elderly MM patients. Methods: A retrospectively analysis of clinical characteristics in 93 newly diagnosed MM patients with more than 70 years of old between August 2011 and August 2016. Based on age, basic activities of daily living scale, instrumental activities of daily living scale, Charlson comorbidity index at diagnosis, patients were divided into three groups: Fit (score=0, n=15) , Intermediate fitness (score=1, n=31) , Frail (score≥2, n=47) according to a geriatric assessment system proposed by Antonio Palumbo et al. The treatment response rate, progression free survival time (PFS) and overall survival (OS) of the three groups were analyzed. Results: Complete remission was 60.0% in Fit, 22.6% in Intermediate fitness and 12.8% in Frail (Fisher χ(2)=12.398, P=0.002) . The median PFS for the three groups were 31 months, 24 months and 13 months (χ(2)=17.832, P<0.001) . The median OS was not reached for Fit, 58 months for Intermediate fitness and 25 months for Frail (χ(2)=40.678, P<0.001) . In 47 Frail cases, patients who received chemotherapy containing new drugs (proteasome inhibitor or immune-modulator) had a longer PFS (17 months vs 9 months, χ(2)=6.454, P=0.011) and patients who achieved CR had prolonged PFS and OS than non-CR (PFS: 24 months vs 12 months, χ(2)=4.117, P=0.042; OS: 37 months vs 25 months, χ(2)= 6.507, P=0.011) . Conclusion: The health status of the elderly MM patients was associated with better response and longer PFS and OS. Given on those with poor health status, new drugs may have better PFS and prolonged OS.

Using fast moving electrode to achieve overvoltage breakdown of gas switch stressed with high direct voltages.

A small-scale fast risetime gas switch attached to a 50 Ω pulse forming line is tested. It includes a fast moving electrode and a fixed electrode. For the applied direct voltages, such as 2.8 kV, 2.0 kV, and 1.0 kV, the risetimes of this switch are tested to be ∼3.8 ns, ∼2.3 ns, and ∼1.1 ns, respectively, while the risetimes of a switch with two fixed electrodes are about ∼10.1 ns, ∼9.0 ns, and ∼3.6 ns. The results of high-speed photography and laser interferometry reveal that the moving electrode will obviously shorten discharge spark length but almost will not change the inter-electrodes gas pressure. The reason of shortening spark length is the existence of the discharge time delay of gas switch. After moving to the static breakdown spacing, the fast moving electrode will move on for an additional distance within the discharge time delay, which makes gas switch achieve overvoltage breakdown under high direct voltages and therefore leads to shorter spark length and faster switch risetime.