Mechanical Properties of Fully Recycled Aggregate Concrete Reinforced with Steel Fiber and Polypropylene Fiber.

The study and utilization of fully recycled aggregate concrete (FRAC), in which coarse and fine aggregates are completely replaced by recycled aggregates, are of great significance in improving the recycling rate of construction waste, reducing the carbon emission of construction materials, and alleviating the ecological degradation problems currently faced. In this paper, investigations were carried out to study the effects of steel fiber (0.5%, 1.0%, and 1.5%) and polypropylene fiber (0.9 kg/m3, 1.2 kg/m3 and 1.5 kg/m3) on the properties of FRAC, including compressive strength, splitting tensile strength, the splitting tensile load-displacement curve, the tensile toughness index, flexural strength, the load-deflection curve, and the flexural toughness index. The results show that the compressive strength, splitting tensile strength, and flexural strength of fiber-reinforced FRAC were remarkably enhanced compared with those of ordinary FRAC, and the maximum increase was 56.9%, 113.3%, and 217.0%, respectively. Overall, the enhancement effect of hybrid steel-polypropylene fiber is more significant than single-mixed fiber. Moreover, the enhancement of the crack resistance, tensile toughness, and flexural toughness obtained by adding steel fiber to the FRAC is more significant than that obtained by adding polypropylene fiber. Furthermore, adding polypropylene fiber alone and mixing it with steel fiber showed different FRAC splitting tensile and flexural properties.

A fNIRS investigation of menopausal-related symptoms and brain cortical activity in menopause.

BACKGROUND: This study aimed to delineate the association between menopausal-related symptoms and brain cortical hemodynamics in peri-postmenopause women. METHODS: Cross-sectional data from a total of 358 Han-Chinese women who visited the Menopause Clinic in the Shanghai Sixth People's Hospital from August 2019 to August 2022. Menopausal-related symptoms were analyzed through Kupperman index (KMI) scale and PSQI scale, while cerebral blood flow was measured using a functional near-infrared spectroscopy (fNIRS). Multiple linear regression model was used to assess the risk factors for subregions of brain hemodynamic response. RESULTS: After adjusting for confounding factors, we identified that menopausal symptom (B = -1.575, 95 % CI (-2.661, -0.488), p = 0.005) and duration of menopause (B = -14.583, 95 % CI (-26.753, -4.192), p = 0.007) were independently associated with the lower brain hemodynamic response in the prefrontal lobe, while in the temporal lobe, overweight (BMI ≥ 24 kg/m2) was negatively associated with the lower brain cortical activity (B = -36.882, 95 % CI (-72.708, -1.056), p = 0.044) after adjusting for other confounding variables. CONCLUSIONS: Our findings proposed that menopausal symptom and overweight should be attached great importance to the postmenopausal women, which provides clinical evidence for the feasible early detection and effective prevention such as menopausal hormone therapy (MHT) of brain health in postmenopausal women.

Insulin sensitivity, ß cell function, and adverse pregnancy outcomes in women with gestational diabetes.

BACKGROUND: The potential impact of ß cell function and insulin sensitivity on adverse pregnancy outcomes in women with gestational diabetes mellitus (GDM) remains uncertain. We aimed to investigate the association between ß cell dysfunction, insulin resistance, and the composite adverse pregnancy outcomes. METHODS: This observational study included 482 women diagnosed with GDM during pregnancy. Quantitative metrics on ß cell function and insulin sensitivity during pregnancy were calculated using traditional equations. The association of ß cell dysfunction and insulin resistance with the risk of the composite adverse pregnancy outcomes was investigated using multivariable-adjusted logistic regression models. RESULTS: Multivariable-adjusted odds ratios (ORs) of adverse pregnancy outcomes across quartiles of homeostatic model assessment for insulin resistance (HOMA-IR) were 1.00, 0.95, 1.34, and 2.25, respectively (P for trend = 0.011). When HOMA-IR was considered as a continuous variable, the multivariable-adjusted OR of adverse pregnancy outcomes was 1.34 (95% confidence interval 1.16-1.56) for each 1-unit increase in HOMA-IR. Multivariable-adjusted ORs of adverse pregnancy outcomes across quartiles of homeostatic model assessment for ß cell function (HOMA-ß) were 1.00, 0.51, 0.60, and 0.53, respectively (P for trend = 0.068). When HOMA-ß was considered as a continuous variable, the multivariable-adjusted OR of adverse pregnancy outcomes was 0.57 (95% CI 0.24-0.90) for each 1-unit increase in HOMA-ß. However, other quantitative metrics were not associated with the composite adverse pregnancy outcomes. CONCLUSIONS: We demonstrated a significant association of ß cell function and insulin sensitivity with the risk of adverse pregnancy outcomes. We have provided additional evidence on the early identification of adverse pregnancy outcomes besides the glycemic values.

Association of sleep characteristics with renal function in menopausal women without recognized chronic kidney disease.

Objective: To delineate the association between sleep characteristics and renal function in peri-post menopause free of Chronic kidney disease (CKD) as well as cardiometabolic and hormone indicators. Methods: Cross-sectional data from a total of 823 Han-Chinese women aged 40-67 years who visited the Menopause Clinic in the Shanghai Sixth People's Hospital from November 2011 to November 2020 were analyzed through the Pittsburgh Sleep Quality Index (PSQI) and serum cystatin C (Cys-C). Logistic regression models were used to assess the association between cumulative/each sleep parameter and renal function after adjusting for cardiometabolic variables. Results: After confounding factors, we identified that poor perceived sleep quality, shorter sleep duration (<6 h), low sleep efficiency (<75%), delayed sleep latency and worse sleep disturbance elevated more than doubled the odds ratio for declining renal function (≥0.91 mg/dL, the highest Cys-C) in postmenopause in a graded fashion. Meanwhile, multiple logistic regression analysis revealed that sleep disorder (PSQI ≥ 8), late postmenopause, highest quartile independently increased the odds ratio for declining renal function (OR 2.007, 95% CI: 1.408-2.861, OR = 3.287, 95%CI: 3.425-8.889, OR = 2.345, 95% CI: 1.310-4.199, respectively), while participants with menopausal hormone replacement (MHT) lower the odds of declining renal function (OR = 0.486, 95% CI: 0.324-0.728). Conclusion: The findings proposed that maintaining good sleep quality should be attached great importance to postmenopausal women, which provides clinical evidence for the feasible early detection and effective prevention such as MHT of renal disease progression in postmenopausal women.

Properties of a Novel Salmonella Phage L66 and Its Application Based on Electrochemical Sensor-Combined AuNPs to Detect Salmonella.

Salmonella is widespread in nature and poses a significant threat to human health and safety. Phage is considered as a new tool for the control of food-borne pathogens. In this study, Salmonella phage L66 (phage L66) was isolated from sewage by using Salmonella Typhimurium ATCC 14028 as the host bacterium, and its basic properties were obtained by biological and bioinformatics analysis. Phage L66 had a broad host spectrum, with an optimal infection complex of 0.1 and an optimal adsorption rate of 90.06%. It also exhibited thermal stability between 30 °C~60 °C and pH stability pH from 3 to 12, and the average lysis amount was 46 PFU/cell. The genome sequence analysis showed that the genome length of phage L66 was 157,675 bp and the average GC content was 46.13%. It was predicted to contain 209 genes, 97 of which were annotated with known functions based on the evolutionary analysis, and phage L66 was attributed to the Kuttervirus genus. Subsequently, an electrochemical sensor using phage L66 as a recognition factor was developed and the working electrode GDE-AuNPs-MPA-Phage L66 was prepared by layer-by-layer assembly for the detection of Salmonella. The slope of the impedance was 0.9985 within the scope from 20 to 2 × 107 CFU/mL of bacterial concentration. The minimum detection limit of the method was 13 CFU/mL, and the average spiked recovery rate was 102.3% with a relative standard deviation of 5.16%. The specificity and stability of this sensor were excellent, and it can be applied for the rapid detection of Salmonella in various foods. It provides a phage-based electrochemical biosensor for the detection of pathogenic bacteria.

Menopausal Symptoms and Sleep Quality in Women Aged 40-65 Years.

The study examined the relationship between menopausal symptoms and sleep disturbances and the related influencing factors. Methods. We recruited women aged 40-65 years who attended the menopause clinic at Shanghai Jiao Tong University's Sixth People's Hospital from February 2011 to November 2019. The Menopause Rating Scale (MRS) was used to collect women's menopausal symptoms, and the Pittsburgh Sleep Quality Index (PSQI) was used to evaluate the subjects' sleep condition. We used logistic regression models to identify the relationship between menopausal symptoms and sleep quality. Results. A total of 1341 participants were recruited in this study. The most frequent three symptoms assessed by MRS were fatigue (72.9%), sleep disturbance (67%), and hot flashes with night sweats (65%). Participants' age was significantly associated with the severity of menopausal syndrome (P < 0.01). According to the PSQI sleep evaluation, 66.9 percent of participants had sleep disturbances (PSQI > 5). Logistic regression analysis revealed that women with mild, moderate, or severe menopausal syndrome had a 3-, 7-, and 17-fold increased chance of having sleep disturbances compared to women without menopausal syndrome. Conclusion. Women aged 40-65 years were found to have a significantly higher risk of menopausal syndrome and sleep disturbances.

EIS biosensor based on a novel Myoviridae bacteriophage SEP37 for rapid and specific detection of Salmonella in food matrixes.

Recently, using bacteriophages as new molecular probes in reliable platforms for the detection of bacterial pathogens has attracted more and more increasing attentions. In this paper, a novel isolated Myoviridae bacteriophage SEP37 was covalently immobilized onto gold nanoparticles (AuNPs) modified gold disk electrode (GDE) surfaces using cysteamine (Cys) as a crosslinker. Substrates of GDE-AuNPs-Cys-Phage SEP37 and specific capture of Salmonella cells had been characterized using scanning electron microscopy (SEM) separately. Cyclic voltammetry (CV) and electrochemical impedance spectroscopy (EIS) were used to study the electrochemical response of the biosensor interface manufacturing and bacterial capture process. Under the optimal experimental conditions, this phage-based EIS biosensor was able to detect Salmonella with a wide linear range from 2 × 101 to 2 × 106 colony forming unit (CFU)/mL within 30 min in spiked lake water and lettuce samples, with a limit of detection (LOD) of 17 CFU/mL. The detection linear range of spiked chicken samples was 2 × 102 to 2 × 105 CFU/mL, with a LOD of 1.3 × 102 CFU/mL. In combination with a pre-enrichment process for 3.5 h, this assay could reach a LOD of 1 CFU/mL in chicken breast meat samples. Besides, this phage-based EIS biosensor provided good reproducibility and stability. This phage-based EIS biosensor opens a new opportunity for the detection of pathogenic bacteria using the inherent selectivity of bacteriophage recognition.

Uremic toxin indoxyl sulfate induces dysfunction of vascular smooth muscle cells via integrin-ß1/ERK signaling pathway.

BACKGROUND: Protein-bound uremic toxins (PBUTs) are reported to be one of the major culprits in chronic kidney disease-cardiovascular disease (CKD-CVD) development, yet its mechanism is not fully clear. Our previous study confirmed elevated expression of integrin-ß1 (ITGß1) in vascular smooth muscle cells of uremic patients. Thus, this study aimed to explore the relationship between PBUTs and ITGß1 in uremic vasculature injury. METHODS: Human umbilical vein smooth muscle cells (HUVSMCs) and endothelial cells (HUVECs) were treated with two representative PUBTs, indoxyl sulfate (IS) and p-cresyl sulfate (PC). Both cells were measured for the expression of ITGß1 and downstream signaling pathways and assayed for proliferation, migration, adhesion and apoptosis. RESULTS: The IS treatments were observed with significantly up-regulated ITGß1 in HUVSMCs but not in HUVECs, while PC did not induce ITGß1 alteration in either HUVSMCs or HUVECs. Furthermore, overexpression of ITGß1 revealed activated downstream signal-regulated kinase (ERK) signaling pathway with promoted focal adhesion, migration, proliferation but no apoptosis in HUVSMCs by IS. These functional and pathway alterations could be significantly suppressed by RNA interference of ITGß1. More importantly, the application of ERK1/2 inhibitor significantly suppressed the focal adhesion, migration and proliferation of HUVSMCs. CONCLUSION: We first demonstrated that ITGß1/ERK signaling pathway mediated abnormal focal adhesion, migration and proliferation of vascular smooth muscle cells stimulated by IS. ITGß1/ERK signaling may serve as a novel therapeutic target for CKD-CVD.

Nitrogen addition, rather than altered precipitation, stimulates nitrous oxide emissions in an alpine steppe.

Anthropogenic-driven global change, including changes in atmospheric nitrogen (N) deposition and precipitation patterns, is dramatically altering N cycling in soil. How long-term N deposition, precipitation changes, and their interaction influence nitrous oxide (N2O) emissions remains unknown, especially in the alpine steppes of the Qinghai-Tibetan Plateau (QTP). To fill this knowledge gap, a platform of N addition (10 g m-2 year-1) and altered precipitation (±50% precipitation) experiments was established in an alpine steppe of the QTP in 2013. Long-term N addition significantly increased N2O emissions. However, neither long-term alterations in precipitation nor the co-occurrence of N addition and altered precipitation significantly affected N2O emissions. These unexpected findings indicate that N2O emissions are particularly susceptible to N deposition in the alpine steppes. Our results further indicated that both biotic and abiotic properties had significant effects on N2O emissions. N2O emissions occurred mainly due to nitrification, which was dominated by ammonia-oxidizing bacteria, rather than ammonia-oxidizing archaea. Furthermore, the alterations in belowground biomass and soil temperature induced by N addition modulated N2O emissions. Overall, this study provides pivotal insights to aid the prediction of future responses of N2O emissions to long-term N deposition and precipitation changes in alpine ecosystems. The underlying microbial pathway and key predictors of N2O emissions identified in this study may also be used for future global-scale model studies.

Correlation between menopausal symptoms and everyday cognition in Chinese (peri)menopausal women.

OBJECTIVE: The aim of this study was to evaluate the relationship between the severity of menopausal symptoms and everyday cognitive decline in Chinese peri and postmenopausal women. METHODS: The peri and postmenopausal Chinese Han female who first visited the menopausal clinic of Shanghai Jiao Tong University Affiliated Sixth People's Hospital was selected as the study participants. The general questionnaire was used to obtain the sociodemographic characteristics of the study participants. The menopausal rating scale (MRS) was used to assess the severity of menopausal symptoms. The short version of the Everyday Cognition (ECog-12) scales was used to assess everyday cognitive performance. RESULTS: A total of 295 women were included, with an average age of 51.12 ± 5.15 years. The average ECog scores were 1.51 ± 0.49 and the average MRS scores were 6.89 ± 4.77. In multiple linear regression analysis, after adjusting for confounding factors age, body mass index (BMI), monthly income, occupational status, education level, menopausal status, parity, regular exercise, and history of chronic diseases, complaints of anxiety and physical/mental fatigue were positively correlated with everyday cognitive decline. CONCLUSIONS: Menopausal anxiety and physical/mental fatigue were the independent predictors of everyday cognition.

The complete chloroplast genome of Tibetan medicine Gentianopsis paludosa.

Gentianopsis paludosa (Mum.) Ma is an important species in Tibetan folk medicine, but its wild populations are shrinking roughly due to the increasing demand for it. Gentianopsis paludosa is presently at risk of over-exploitation, so it needs urgent conservation. Here, we report the complete sequence of the chloroplast genome of G. paludosa. The genome was 51,121 bp in length with 129 genes comprising 84 protein-coding genes, 37 tRNA genes, and eight rRNA genes. The overall GC content of G. paludosa chloroplast genome was is 36.67%. The phylogenomic analysis suggested that G. paludosa forms a clade with species in Halenia and Swertia, indicating that the G. paludosa is more closely related to Halenia and Swertia than that of Gentiana.

Soil Fungal Community Composition, Not Assembly Process, Was Altered by Nitrogen Addition and Precipitation Changes at an Alpine Steppe.

Global climate change and nitrogen deposition have been having broad impacts on microorganisms. On the Qinghai-Tibetan Plateau (QTP), the responses of soil microbial community assemblage and diversity to nitrogen deposition and changes in precipitation are poorly understood, especially in the alpine steppe. In this study, we conducted a field manipulative experiment of nitrogen deposition and precipitation amount in an alpine steppe on the northeastern QTP and investigated the responses of community composition, diversity, and community assemblage of soil fungi. Soil fungal community compositions were significantly altered under nitrogen addition, precipitation change, and their interaction, and positively related with soil moisture, soil pH, and plant species richness. However, they were negatively related to soil mineralizable N and soil available P content. Operational taxonomic units (OTU) richness and Chao 1 index decreased under nitrogen addition combined with precipitation reduction treatment, whereas the Shannon-Wiener index declined only under precipitation increment treatment. Convergent fungal community assembly processes were not acutely altered by both nitrogen addition and precipitation changes, indicating that environmental filtering was a dominant ecological process controlling fungal community assemblage. By elucidating the above questions, the study enhanced our ability to predict the responses of soil fungal communities to nitrogen deposition and precipitation changes at alpine steppes on the QTP in the future.

A retrospective analysis reveals a predictor of survival for the patient with paraquat intoxication.

Feasible and accurate predictors are urgently needed to evaluate the survival for patients with paraquat poisoning since the high mortality of paraquat poisoning always resulted in the loss of both life and money. Multiple predictors have been developed to predict prognosis of the patients with PQ poisoning, which however heavily depend on the time of admission to hospitals. Here we reported a feasible and accurate prognosis predictor for patients with paraquat poisoning that is independent of the time of admission to hospitals. Patients with paraquat poisoning were enrolled in this study according to the inclusion and exclusion criteria, which were grouped into survivors and non-survivors based on the 90-days follow-up investigation. The concentration of paraquat in serum and urine, and the baseline clinical parameters associated with the injuries of the liver, kidney, and lung were evaluated to predict the survival of these patients by using receiver operating characteristic curve (ROC) analysis, univariate and multivariate cox regression analyses. A total of 114 patients was included in this study with a survival rate of 54.4%. The median survival days of non-survivors were 6.0 (95%Cl: 4.0-7.8). A new predictor, namely paraquat concentration-associated multiorgan injury index (PCAMII), was established by integrating serum and urine paraquat concentration, serum creatinine, alanine aminotransferase, aspartate transaminase, total and direct bilirubin, at different weighting coefficients, with the accuracy of about 90%. The model to predict the survival probability by PCAMII was established with good fitness (R2 = 0.9325), providing the simulated survival rates comparable to the clinical data. PCAMII, which is independent of hospital admission time, is a feasible and accurate marker to predict the survival rate of patients with PQ poisoning.

Association of snoring and body composition in (peri-post) menopausal women.

BACKGROUND: Little attention has been paid to whether snoring frequency is associated with body composition in menopausal women, particularly in China. This study objected to investigate the association between self-reported snoring and body composition in (peri-post) menopausal Chinese women as well as metabolic indicators. METHODS: This cross-sectional study enrolled 715 participants aged 40-67 years from the Menopause Clinic in the Shanghai Sixth People's Hospital. Participants were categorized into four subgroups stratified by self-reported snoring frequency: never, rarely (< 1 night per week), occasionally (1-2 nights per week), regularly (≥3 nights per week), while body composition was measured using bioelectrical impedance analysis (BIA). Besides, blood sample were collected to test the glycolipid indicators. RESULTS: In our sample of investigation, regular snoring (≥3 nights per week) was found to be an independent risk factor for higher fat mass (total, upper limbs, trunk), with the highest risk of 2.4 times for fat mass of trunk after adjusting for metabolic confounders(p = 0.003). Meanwhile, regular snoring was independently associated with higher fat mass (total and each segment) only in menopausal transition (p = 0.023). CONCLUSIONS: We suggested that self-reported regular snoring may be taken as a simple alternative to predict higher fat mass (≥17.11 kg, upper quartile) in menopausal women. Similarly, body composition should be attached to the great importance to those who in menopausal transition in order to help to prevent obstructive sleep apnea (OSA).

Examining differences in phylogenetic composition enhances understanding of the phylogenetic structure of the shrub community in the northeastern Qinghai-Tibetan Plateau.

Periodic climatic oscillations and species dispersal during the postglacial period are two important causes of plant assemblage and distribution on the Qinghai-Tibet Plateau (QTP). To improve our understanding of the bio-geological histories of shrub communities on the QTP, we tested two hypotheses. First, the intensity of climatic oscillations played a filtering role during community structuring. Second, species dispersal during the postglacial period contributed to the recovery of species and phylogenetic diversity and the emergence of phylogenetic overdispersion. To test these hypotheses, we investigated and compared the shrub communities in the alpine and desert habitats of the northeastern QTP. Notably, we observed higher levels of species and phylogenetic diversity in the alpine habitat than in the desert habitat, leading to phylogenetic overdispersion in the alpine shrub communities versus phylogenetic clustering in the desert shrub communities. This phylogenetic overdispersion increased with greater climate anomalies. These results suggest that (a) although climate anomalies strongly affect shrub communities, these phenomena do not act as a filter for shrub community structuring, and (b) species dispersal increases phylogenetic diversity and overdispersion in a community. Moreover, our investigation of the phylogenetic community composition revealed a larger number of plant clades in the alpine shrub communities than in the desert shrub communities, which provided insights into plant clade-level differences in the phylogenetic structures of alpine and desert shrub communities in the northeastern QTP.

Nitrogen Fertilizer Levels Affect the Growth and Quality Parameters of Astragalus mongolica.

Owing to overexploitation, wild resources of Astragalus mongolica, a Chinese herbal plant that is widely distributed in the arid and semi-arid areas of Northern China, have gradually become exhausted, and therefore, commercial cultivation is increasingly important to meet the growing demand for astragalus and reduce the pressure on wild populations. Nitrogen level is an important factor that affects the yield and quality of A. mongolica. However, uniform standards for fertilization among production areas have not yet been determined. In this study, the effect of nitrogen fertilizer treatment on the yield and quality of A. mongolica in the Qinghai-Tibet Plateau was explored using a control treatment (no added nitrogen, N0) and five different nutrient levels: 37.5 kg/ha (N1), 75 kg/ha (N2), 112.5 kg/ha (N3), 150 kg/ha (N4), and 187.5 kg/ha (N5). According to grey relational analysis, the optimal nitrogen fertilizer treatment was the N4 level followed by the N5 and N2 levels. Nitrogen fertilizer significantly increased the root biomass, plant height, root length, and root diameter. However, nitrogen fertilization had no significant effect on the content of Astragaloside IV and mullein isoflavone glucoside. The content of ononin and calycosin continually accumulated throughout the growing period. The results showed that the ononin and calycosin content under N4 and N2 is higher than other levels and there is not significantly different between different nitrogen fertilizer levels about them. The content of formononetin decreased gradually with the progression of the growing season. The optimal nitrogen fertilizer treatment for A. mongolica is recommended to be 150 kg/ha and the content of active compounds and yield were observed to reach the maximum in October.

Precipitation and nitrogen addition enhance biomass allocation to aboveground in an alpine steppe.

There are two important allocation hypotheses in plant biomass allocation: allometric and isometric. We tested these two hypotheses in an alpine steppe using plant biomass allocation under nitrogen (N) addition and precipitation (Precip) changes at a community level. An in situ field manipulation experiment was conducted to examine the two hypotheses and the responses of the biomass to N addition (10 g N m-2 y-1) and altered Precip (±50% precipitation) in an alpine steppe on the Qinghai-Tibetan Plateau from 2013 to 2016. We found that the plant community biomass differed in its response to N addition and reduced Precip such that N addition significantly increased aboveground biomass (AGB), while reduced Precip significantly decreased AGB from 2014 to 2016. Moreover, reduced Precip enhanced deep soil belowground biomass (BGB). In the natural alpine steppe, the allocation between AGB and BGB was consistent with the isometric hypotheses. In contrast, N addition or altered Precip enhanced biomass allocation to aboveground, thus leading to allometric growth. More importantly, reduced Precip enhanced biomass allocation into deep soil. Our study provides insight into the responses of alpine steppes to global climate change by linking AGB and BGB allocation.

Maternal glycemic parameters and adverse pregnancy outcomes among high-risk pregnant women.

Objective: We aimed to investigate the association between maternal glycemic parameters and adverse pregnancy outcomes among high-risk pregnant women. Research design and methods: A total of 1976 high-risk pregnant women were enrolled between 2015 and 2017. All participants received a 75 g oral glucose tolerance test during the 24-30 gestational weeks and complete birth and delivery information was collected. Adverse pregnancy outcomes were defined as premature birth, birth weight >90th percentile, primary cesarean section, and pre-eclampsia. Logistic regression models were used to assess the association between five maternal glycemic parameters during pregnancy (fasting glucose, 1-hour glucose, 2-hour glucose, HbA1c, and serum 1,5-anhydroglucitol (1,5-AG)) and adverse pregnancy outcomes. Results: Of 1976 participants, 498 were diagnosed with gestational diabetes. The multivariable-adjusted ORs of adverse pregnancy outcomes for each one unit increase (1 mmol/L, 1%, or 1 µg/mL) were 2.32 (95% CI 1.85 to 2.92) for fasting glucose, 1.07 (95% CI 1.01 to 1.15) for 1-hour glucose, 1.03 (95% CI 0.96 to 1.10) for 2-hour glucose, 1.77 (95% CI 1.34 to 2.33) for HbA1c, and 0.96 (95% CI 0.94 to 0.98) for 1,5-AG, respectively. When all five glycemic parameters were simultaneously entered into the multivariable-adjusted model, only fasting glucose was significantly associated with total and individual adverse pregnancy outcomes. Receiver operating characteristic curve showed that fasting glucose plus any one of other four glycemic parameters had significantly enhanced the sensitivity of detecting adverse pregnancy outcomes. Conclusions: Fasting glucose at 24-30 gestational weeks was strongly associated with adverse pregnancy outcomes. Fasting glucose combined with one additional glycemic measurement showed non-inferiority indicating that post-load glycemic measurement was not necessary in detecting adverse pregnancy outcomes among high-risk pregnant women.

Lithium targeting of AMPK protects against cisplatin-induced acute kidney injury by enhancing autophagy in renal proximal tubular epithelial cells.

Autophagy has been demonstrated to be vital for kidney homeostasis and is centrally implicated in the pathogenesis of cisplatin-induced acute kidney injury (AKI). Lithium is a potent autophagy inducer in a number of cell types. However, it remains uncertain whether its autophagic activity is associated with a beneficial effect on renal tubular cells in AKI. This study aimed to examine the effect of lithium on renal autophagy in cisplatin-induced AKI. Mice or renal proximal tubular epithelial cells in culture were exposed to cisplatin-induced acute injury in the presence or absence of lithium treatment. AKI or tubular cell injury was evaluated, and cell signaling associated with autophagy was examined. Lithium pretreatment prominently ameliorated acute renal tubular damage in mice exposed to cisplatin insult, associated with enhanced autophagy in renal tubules, as assessed by measuring microtubule-associated protein 1A/1B-light chain 3 (LC3)BII/I expression and autophagosome formation. Consistently, in cisplatin-injured renal tubular cells in vitro, lithium enhanced autophagic activities, improved cell viability, and attenuated cell death. Mechanistically, lithium triggered AMPK-α phosphorylation and activation, which in turn positively correlated with the induced expression of autophagy-related molecules, like mammalian target of rapamycin and LC3BII/I. AMPK-α activation is likely required for lithium-induced tubular cell autophagy and protection in cisplatin-induced AKI because blockade of AMPK-α phosphorylation by compound C markedly abrogated lithium-induced autophagosome formation and mitigated the protective effect of lithium on AKI. Our findings suggest that lithium represents a promising therapeutic strategy for protecting renal tubular cells against cisplatin-induced AKI by enhancing autophagy via AMPK-α activation.-Bao, H., Zhang, Q., Liu, X., Song, Y., Li, X., Wang, Z., Li, C., Peng, A., Gong, R. Lithium targeting of AMPK protects against cisplatin-induced acute kidney injury by enhancing autophagy in renal proximal tubular epithelial cells.

Histopathological and proteomic analyses identify integrin-ß1 as a potential mediator of phlebosclerosis in uremic patients.

BACKGROUND: Patients with uremia have an excessive mortality from cardiovascular disease (CVD). Arterial remodeling is mainly responsible for uremia-induced CVD and has been well studied, yet venous remodeling is poorly understood. Here we investigate the histopathology and proteomic profiles of venous remodeling in uremic patients. METHODS: Forearm cephalic veins were isolated from nine uremic patients during surgeries for arteriovenous fistula, and from nine healthy controls when applying surgical debridement. Hematoxylin-eosin, Masson's trichrome, von Kossa, and immunohistochemistry (IHC) against proliferating cell nuclear antigen were stained for histopathology. Isobaric tags for relative and absolute quantitation (iTRAQ) proteomic analysis was executed to explore the proteome of the veins. The core regulatory protein was validated by western blot, IHC, and immunofluorescence. RESULTS: Phlebosclerosis, characterized by intimal rarefaction and medial thickening with disordered proliferation of vascular smooth muscle cells (VSMCs), was the prominent pathological manifestation of peripheral veins in uremic patients, while inflammatory cell infiltration, atherosclerosis or calcification were not obviously detected. iTRAQ analysis showed that 350 proteins were significantly changed in phlebosclerosis of uremic patients compared with healthy controls, of which integrin-ß1 (ITGß1) exhibited the strongest regulatory ability by intermolecular interaction network analysis. The enhanced ITGß1 expression was mainly co-expressed with the disordered proliferation of VSMCs while a little with vascular endothelial cells in the forearm cephalic veins of uremic patients. CONCLUSIONS: Phlebosclerosis is the prominent pathological manifestation in peripheral veins of uremic patients. This pathological alteration mainly attributes to the disordered proliferation of VSMCs, which is potentially mediated by ITGß1.