Malnutrition significantly affected centenarian prognoses: A prospective study with 5-year follow-up.

BACKGROUND: The world is currently facing a much-needed conundrum, and population aging has become an important worldwide problem. Appropriate nutritional intervention could prolong survival time and reduce mortality rate. However, scarce study has involved the effects of nutrition on survival time in centenarians and evaluated the malnutrition with prognostic nutritional index (PNI) in relation to healthy aging. This prospective study was designed to investigate the effects of malnutrition through PNI assessment on mortality rate and survival time with 5-year follow-up in Chinese centenarians. METHODS: A household survey was conducted on the centenarians in 18 cities and counties of Hainan province, and malnutrition was evaluated by PNI as an effective tool in 423 centenarians followed up for 5-year. RESULTS: Prevalence of malnutrition was 19.4%. Body mass index (BMI) was significantly lower and malnutrition was significantly more in the dead group than those in the survival group (all P < 0.05). Multivariate Cox regression analysis indicated that BMI [Hazard ratio (HR): 0.913; 95%CI: 0.854-0.977] negatively affected mortality rate, whereas malnutrition (HR: 2.630; 95%CI:1.474-4.695) positively affected mortality rate in centenarians (all P < 0.05). When BMI was <18.5 kg/m2, malnutrition (HR: 4.401; 95%CI: 1.948-9.943) also positively affected mortality rate (P < 0.05). CONCLUSIONS: This prospective study with 5-year follow-up demonstrated that malnutrition had positive effect on mortality rate, especially when BMI was lower than 18.5 kg/m2, in Chinese centenarians. In order to reduce mortality rate and prolong survival time, it is essential to pay attention to malnutrition in elderly population.

Prediabetes Progression and Regression on Objectively- Measured Physical Function: A Prospective Cohort Study.

BACKGRUOUND: Prediabetes leads to declines in physical function in older adults, but the impact of prediabetes progression or regression on physical function is unknown. This study assessed this longitudinal association, with physical function objectivelymeasured by grip strength, walking speed, and standing balance, based on the Health and Retirement Study enrolling United States adults aged >50 years. METHODS: Participants with prediabetes were followed-up for 4-year to ascertain prediabetes status alteration (maintained, regressed, or progressed), and another 4-year to assess their impacts on physical function. Weak grip strength was defined as <26 kg for men and <16 kg for women, slow walking speed was as <0.8 m/sec, and poor standing balance was as an uncompleted fulltandem standing testing. Logistic and linear regression analyses were performed. RESULTS: Of the included 1,511 participants with prediabetes, 700 maintained as prediabetes, 306 progressed to diabetes, and 505 regressed to normoglycemia over 4 years. Grip strength and walking speed were declined from baseline during the 4-year followup, regardless of prediabetes status alteration. Compared with prediabetes maintenance, prediabetes progression increased the odds of developing weak grip strength by 89% (95% confidence interval [CI], 0.04 to 2.44) and exhibited larger declines in grip strength by 0.85 kg (95% CI, -1.65 to -0.04). However, prediabetes progression was not related to impairments in walking speed or standing balance. Prediabetes regression also did not affect any measures of physical function. CONCLUSION: Prediabetes progression accelerates grip strength decline in aging population, while prediabetes regression may not prevent physical function decline due to aging.

Development of a Fluorescent Immunochromatographic Assay Based on Quantum Dot-Functionalized Two-Dimensional Monolayer Ti3C2 MXene Nanoprobes for the Simultaneous Detection of Influenza A Virus and SARS-CoV-2.

Accurate and rapid detection of the influenza A virus (FluA) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can effectively control their spread. We developed a colorimetric and fluorescent dual-functional two-channel immunochromatographic assay (ICA) biosensor to simultaneously detect the above-mentioned viruses. A unique two-dimensional Ti3C2-QD immunoprobe was established by adsorbing dense quantum dots (QDs) onto the light green monostromatic Ti3C2 MXene surface, resulting in light green colorimetric and superior fluorescence signals and guaranteeing high sensitivity, stability, and excellent liquidity for ICA detection. Rapid visual screening for FluA and SARS-CoV-2 infections was applicable via a green colorimetric signal. Sensitive and quantitative detection of viruses in their early stages of infection was performed by using the fluorescence signal. Our proposed Ti3C2-QD-ICA biosensor can simultaneously detect 1 ng/mL or 2.4 pg/mL FluA and 1 ng/mL or 6.2 pg/mL SARS-CoV-2 via its colorimetric or fluorescence signals, respectively, with a short testing time (20 min), good reproducibility, specificity, and accuracy. In addition, this method demonstrated sensitivity higher than that of the conventional AuNP-based ICA method in throat swab samples. Hence, our proposed Ti3C2-QD-ICA method can be potentially applied for the rapid, ultrasensitive, and multiplex detection of respiratory viruses.

Cumulative muscle strength and risk of diabetes: A prospective cohort study with mediation analysis.

AIMS: Previous studies assessing the association of muscle strength with risk of diabetes have seldomly accounted for the cumulative exposure over time. This study examined the association of 4-year cumulative muscle strength with risk of diabetes in middle-aged and older adults. METHODS: We included participants without diabetes, who had 3 repeated measurements of muscle strength, which was assessed by grip strength (normalized by body-weight) and chair-rising time, over 4 years. Cumulative muscle strength was calculated based on trapezoid rule. Logistic regression analysis and mediation analysis for cumulative blood pressure were performed. RESULTS: We included 3731 and 3799 participants with data on cumulative grip strength and cumulative chair-rising time, respectively. The odds of diabetes were gradually reduced with increments in cumulative grip strength or decrements in cumulative chair-rising time, with the corresponding odds ratio being 0.79 and 0.89 per 1 standard deviation change after multivariable-adjustment. Cumulative systolic blood pressure mediated 10.8% and 14.2% of the associations of diabetes with cumulative grip strength and cumulative chair-rising time, respectively. Cumulative grip strength also correlated inversely with blood pressure, glycemia, and inflammation. CONCLUSIONS: Higher cumulative muscle strength was associated with lower risk of diabetes and better cardiometabolic health in middle-aged and older Chinese adults.

Cumulative Muscle Strength and Risk of Cardiovascular Disease and All-cause mortality: A Prospective Cohort Study.

BACKGROUND: The existing literature regarding the association between muscle strength and cardiovascular disease (CVD) and all-cause mortality relies mostly on a single measurement of muscle strength but has seldomly focused on the accumulated exposure. OBJECTIVE: This study explored the association between cumulative muscle strength and risks of CVD and all-cause mortality in middle-aged and older adults. METHODS: A total of 6,972 patients from the China Health and Retirement Longitudinal Study, who underwent 3 repeated measurements of muscle strength over 4 years and were followed-up for another 3 years for CVD and all-cause mortality outcomes participated in this study. Muscle strength was evaluated by grip strength and chair-rising time. Cumulative muscle strength was calculated as the area under the curve. Odds ratio (OR) and 95% confidence intervals (CIs) were analyzed. RESULTS: The odds of CVD and all-cause mortality decreased as cumulative grip strength increased or cumulative chair-rising time decreased. For each 1 standard deviation (SD) increment in cumulative grip strength, the multivariable-adjusted OR for CVD and all-cause mortality were 0.81 (95% CI 0.73-0.91) and 0.85 (95% CI 0.73-0.99), respectively. For each 1 SD decrease in cumulative chair-rising time, the corresponding OR were 0.81 (95% CI 0.75-0.88) and 0.87 (95% CI 0.77-0.98), respectively. However, neither the change-slope of grip strength nor that of chair-rising time was related to decreased OR of CVD or of all-cause mortality. CONCLUSIONS: Cumulative muscle strength was associated with a reduced risk of CVD and all-cause mortality in middle-aged and older Chinese adults.

An integrated fluorescent lateral flow assay for multiplex point-of-care detection of four respiratory viruses.

This work established a highly sensitive and specific quantum dot nanobeads-based lateral flow assay for multiplex detection of four respiratory virus markers at point of care. The respiratory virus antigens were detected by fluorescent lateral flow strips within 20 min. The limits of detection for SARS-CoV-2 antigen, IAV antigen, IBV antigen, and ADV antigen were 0.01 ng/mL, 0.05 ng/mL, 0.31 ng/mL, and 0.40 ng/mL, respectively, which were superior to that of conventional AuNPs-based colorimetric lateral flow assay. The coefficients of variation of the test strip were 6.09%, 2.24%, 7.92%, and 12.43% for these four antigens, which indicated that the proposed method had good repeatability. The specificity of the detection system was verified by different combinations of these four respiratory viruses and several other respiratory pathogens. These results indicated that this method could simultaneously detect SARS-CoV-2, IAV, IBV and ADV in a short assay time, showing the remarkable potential for the rapid and multiplex detection of respiratory viruses in resource-limited settings.

Combined HTR1A/1B methylation and human functional connectome to recognize patients with MDD.

OBJECTIVES: This study aimed to use a machine-learning method to identify HTR1A/1B methylation and resting-state functional connectivity (rsFC) related to the diagnosis of MDD, then try to build classification models for MDD diagnosis based on the identified features. METHODS: Peripheral blood samples were collected from all recruited participants, and part of the participants underwent the resting-state fMRI scan. Features including HTR1A/1B methylation and rsFC were calculated. Then, the initial feature sets of epigenetics and neuroimaging were separately input into an all-relevant feature selection to generate significant discriminative power for MDD diagnosis. Random forest classifiers were constructed and evaluated based on identified features. In addition, the SHapley Additive exPlanations (SHAP) method was adapted to interpret the diagnostic model. RESULTS: A combination of selected HTR1A/1B methylation and rsFC feature sets achieved better performance than using either one alone - a distinction between MDD and healthy control groups was achieved at 81.78% classification accuracy and 0.8948 AUC. CONCLUSION: A high classification accuracy can be achieved by combining multidimensional information from epigenetics and cerebral radiomic features in MDD. Our approach can be helpful for accurate clinical diagnosis of MDD and further exploring the pathogenesis of MDD.

The status and risk factors for anxiety/depression in patients with atrophic chronic gastritis: a cross-sectional study.

BACKGROUND: Atrophic chronic gastritis (ACG) is a preneoplastic condition of gastric carcinoma. Numerous studies have shown anxiety and depression can affect gastrointestinal function, which may promote gastrointestinal disorders development and progression. Thus, we hypothesized that anxiety and depression may enhance the development and progression of ACG. In this study, we aimed to analyse risk factors for anxiety and depression in ACG patients and integrate these risk factors to construct an effective clinical prediction model. METHODS: In total, 118 ACG patients were included from July 2021 to May 2022. Anxiety and depression were assessed utilizing the Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9). Data were collected on demographic characteristics, lifestyle, and dietary habits. Risk factors for anxiety and depression were explored with univariate analysis and multivariate stepwise logistic regression, and risk prediction models were built. RESULTS: Among 118 ACG patients, 36.4% had anxiety, 25.4% had depression, and 21.2% had both anxiety and depression. Poor sleep quality [odd ratio (OR) 4.32, 95% confidence interval (CI): 1.60-11.65, P=0.004] was positively associated with risk of anxiety, while smoking (OR 0.15, 95% CI: 0.03-0.68, P=0.014) and weekly exercise time (OR 0.89, 95% CI: 0.79-0.99, P=0.037) were negatively associated with risk of anxiety. The area under the receiver operating characteristic (ROC) curve was 80.3%, 95% CI: [0.722-0.885]. The sensitivity was 72.1%, and the specificity was 78.7%. Poor sleep quality (P<0.001, OR 23.89, 95% CI: 4.05-141.05), high salt diet (P=0.004, OR 6.94, 95% CI: 1.86-25.96), family history of tumours (P=0.020, OR 6.10, 95% CI: 1.33-27.93), and abdominal pain (P=0.018, OR 4.44, 95% CI: 1.29-15.23) were positively associated with the risk of depression, with an area under the ROC curve of 77.3%, 95% CI: 0.687-0.860. The sensitivity was 83.3%, and the specificity was 62.5%. CONCLUSIONS: Potential anxiety and depression in ACG patients can be identified early by referring to risk factors and protective factors. The prediction model could be used to detect anxiety and depression in ACG patients at their earliest stage and provide meaningful suggestions for ACG patients.

A Predictive Model of Risk Factors for Conversion From Major Depressive Disorder to Bipolar Disorder Based on Clinical Characteristics and Circadian Rhythm Gene Polymorphisms.

Background: Bipolar disorder (BD) is easy to be misdiagnosed as major depressive disorder (MDD), which may contribute to a delay in treatment and affect prognosis. Circadian rhythm dysfunction is significantly associated with conversion from MDD to BD. So far, there has been no study that has revealed a relationship between circadian rhythm gene polymorphism and MDD-to-BD conversion. Furthermore, the prediction of MDD-to-BD conversion has not been made by integrating multidimensional data. The study combined clinical and genetic factors to establish a predictive model through machine learning (ML) for MDD-to-BD conversion. Method: By following up for 5 years, 70 patients with MDD and 68 patients with BD were included in this study at last. Single nucleotide polymorphisms (SNPs) of the circadian rhythm genes were selected for detection. The R software was used to operate feature screening and establish a predictive model. The predictive model was established by logistic regression, which was performed by four evaluation methods. Results: It was found that age of onset was a risk factor for MDD-to-BD conversion. The younger the age of onset, the higher the risk of BD. Furthermore, suicide attempts and the number of hospitalizations were associated with MDD-to-BD conversion. Eleven circadian rhythm gene polymorphisms were associated with MDD-to-BD conversion by feature screening. These factors were used to establish two models, and 4 evaluation methods proved that the model with clinical characteristics and SNPs had the better predictive ability. Conclusion: The risk factors for MDD-to-BD conversion have been found, and a predictive model has been established, with a specific guiding significance for clinical diagnosis.

Preoperative malnutrition as an independent risk factor for the postoperative mortality in elderly Chinese individuals undergoing hip surgery: a single-center observational study.

Objective: Malnutrition is prevalent in elderly with hip fracture and higher than in community-dwelling older adults. Scarce studies have examined the association between preoperative malnutrition and postoperative mortality in elderly Chinese individuals with hip fracture. This study was designed to explore the effect of preoperative malnutrition on the postoperative long-term mortality in elderly Chinese individuals undergoing hip surgery. Methods: As a single-center observational study, this study included 263 consecutive patients above 70 years old with hip fracture and elective surgery. Preoperative nutritional status was evaluated by prognostic nutritional index (PNI). Patients were divided into one group with malnutrition (26 patients with PNI ⩽ 38) and the other group without malnutrition (169 patients with PNI > 38), respectively. Results: The overall malnutrition rate was 13.3% (26 patients). The postoperative long-term mortality rates of patients with and without malnutrition had statistically significant difference [10 patients (38.5%) and 32 patients (18.9%), p < 0.05]. Cox regression analysis showed that malnutrition (hazard ratio: 0.269, 95% confidence interval: 0.085-0.859, p < 0.05) and partial pressure of carbon dioxide (hazard ratio: 0.873, 95% confidence interval: 0.790-0.964, p < 0.05) were independent risk factors for the postoperative long-term mortality. Conclusion: This study demonstrated that preoperative malnutrition was an independent risk factor for the postoperative long-term mortality and resulted in a more than 2.5-fold increase of the postoperative long-term mortality in elderly Chinese individuals undergoing hip surgery.

Telomere is shortened in patients with irritable bowel syndrome in the Chinese population.

BACKGROUND AND AIM: Telomere shortening is an accepted indicator of aging. Many studies have investigated an association between leukocyte telomere length (LTL) and psychiatric disorders. Mental or psychological factors could be an important cause of irritable bowel syndrome (IBS). However, there are currently few research evaluating correlations between LTL and IBS. METHODS: We examined associations between LTL and IBS using quantitative polymerase chain reaction in independent cohorts, including 205 patients with IBS and 189 healthy controls. Furthermore, we examined whether mental or psychological factors, types of IBS, duration of IBS and antidepressants had an association with LTL in patients with IBS. RESULTS: Among total samples, patients with IBS presented shorter LTL when compared to healthy controls (P < 0.0001). Moreover, in subgroup analyses of patients with IBS, not only the LTL in patients with IBS caused by mental or psychological factors was shorter (P < 0.0001), but also in patients with IBS that were caused by other factors (P = 0.0082). Furthermore, LTL in patients with IBS who had taken antidepressants for more than 1 month was longer than that in patients with IBS who did not take antidepressants or took for less than 1 month (P < 0.0001). CONCLUSIONS: This is the first study to describe the relationship between LTL and IBS. This study showed significantly shorter telomeres in patients with IBS. Our findings suggest that LTL may hold the potential to serve as a predictor of IBS diagnosis.

CpG Island Methylator Phenotype Modulates the Immune Response of the Tumor Microenvironment and Influences the Prognosis of Pancreatic Cancer Patients.

BACKGROUND: CpG island methylator phenotype (CIMP), featured with concurrent and widespread hypermethylation of a cluster of CpGs, has been reported to play an important role in carcinogenesis. Limited studies have investigated the role of CIMP in pancreatic cancer (PC). The aim of this study was to explore the CIMP in PC patients and its impact on the immune response of the tumor microenvironment and prognosis. METHODS: DNA methylation, somatic mutation, mRNA, and corresponding clinical data of PC patients were downloaded from TCGA (184 patients) and the ICGC (264 patients). Univariate and multivariate regression analyses were used to identify prognosis-related CpGs. Consensus clustering analysis was used for identification of the CIMP in PC patients. ESTIMATE and CIBORORT were used for estimation of the tumor microenvironment (TME) in PC patients. RESULTS: In the TCGA PC cohort, 22,450 differential CpGs, including 12,937 hypermethylated CpGs and 9,513 hypomethylated CpGs, were identified between 184 PC patients and 10 normal controls. Univariate and multivariate Cox analysis further screened out 72 OS-related CpGs, and three distinct CIMP groups with distinctly different prognosis and molecular features, including the CIMP-L subgroup, CIMP-M subgroup, and CIMP-H subgroup, were identified based on unsupervised consensus clustering analysis of these CpGs. Patients of the CIMP-H subgroup had poorer OS and RFS, while patients of the CIMP-L subgroup had better OS and RFS. The CIMP status was also an independent prognostic factor for OS and PFS. In molecular features, significantly higher somatic mutation burden and tumor mutational burden were found in patients of the CIMP-H subgroup compared to those of the CIMP-L subgroup. Besides, lower stromal score, immune score, and higher cancer stemness indices and tumor purity were also found in patients of the CIMP-H subgroup compared to those of the CIMP-L subgroup. Correspondingly, significant total T cells, total B cells, CD8 T cells, memory CD4 T cells, and higher regulatory T cells were found in patients of the CIMP-H subgroup. Moreover, significantly lower expression of immune checkpoint genes, such as PD-1, CTLA4, CD86, VTCN1, and LAG-3, was also found in patients of the CIMP-H subgroup compared to those of the CIMP-L subgroup. In the end, we validated the CIMP status in PC patients of the ICGC dataset. CONCLUSION: The CIMP may modulate the immune response of the tumor microenvironment and influence the prognosis of pancreatic cancer patients, which may help to make an assertion to provide specific and efficient treatment options for patients of different subtypes.

Identification of New Biomarker for Prediction of Hepatocellular Carcinoma Development in Early-Stage Cirrhosis Patients.

BACKGROUND: Liver cirrhosis is one of the major drivers of hepatocellular carcinoma (HCC). In the present study, we aimed to identify and validate new biomarker for early prediction of HCC development in early-stage cirrhosis patients. METHODS: mRNA expression and clinical parameters of GSE63898, GSE89377, GSE15654, GSE14520, and TCGA-HCC cohort and ICGC-HCC cohort were downloaded for analysis. Wilcoxon test was performed to identify DEGs. Univariate and multivariate Cox regression analysis were used to develop the risk signature, and ROC analysis was performed to analyze the predictive accuracy and sensitivity of the risk signature. RESULTS: There were 42 DEGs (including 28 upregulated genes and 14 downregulated genes) found in early-stage liver cirrhosis patients before developing HCC from GSE1565442. Then, a risk signature consisting of 8 DEGs could effectively classify early-stage cirrhosis patients into high-risk group with shorter HCC development time and low-risk group with longer HCC development time from GSE15654. Multivariate Cox analysis indicated that the risk signature was an independent prognostic factor for the prediction of HCC development and ROC analysis showed that the signature exhibited good predictive efficiency in predicting 2-, 5-, and 10-year HCC development. Mechanistically, significantly higher proportions of CD8 T cells were found to be enriched in cirrhosis patients with low risk score, and higher CD8 T cells were associated with longer HCC development time. Besides, the signature was an independent prognostic factor for poorer prognosis of early-stage liver cirrhosis patients of GSE15654. Moreover, the signature could also separate HCC patients from healthy controls and was also associated with the poorer prognosis of HCC patients from three HCC cohorts. Finally, we also identified HDAC inhibitors, such as trichostatin A, to be a potential chemopreventive treatment for the prevention of HCC development by targeting risk signature based on CMap analysis. CONCLUSION: A risk signature was developed and validated for early prediction of HCC development, which may be a useful tool to set up individualized follow-up interval schedules.

Comparative Analysis of Clinical and Imaging Features of Osteomalacia and Spondyloarthritis.

Aim: To compare the clinical and radiological characteristics of osteomalacia and spondyloarthritis/ankylosing spondylitis (SpA/AS) in order to provide a basis for differential diagnosis. Methods: We carried out a retrospective analysis of patients who were diagnosed with osteomalacia at the First Medical Center of 301 Hospital (Beijing, China) from January 2012 to January 2019. The clinical and radiological data of all patients were collected; at the same time, we selected age- and gender-matched patients with SpA/AS for comparison. Results: We enrolled a total of 76 patients, 38 with osteomalacia, and 38 with SpA/AS. The mean ages of the two groups were, respectively 44.62 ± 14.90 years and 44.85 ± 9.76 years (P > 0.05). Of patients with osteomalacia, 65.79% (n = 25) had previously been misdiagnosed with SpA/AS. In the osteomalacia and SpA/AS groups, there were, respectively 31 and 33 patients with low back pain, 22 and 13 patients with peripheral arthralgia, and 13 and 3 patients with heel pain. Alkaline phosphatase (ALP) level was significantly higher in the osteomalacia than in the SpA/AS group (P < 0.05). Serum phosphorus levels, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) levels, and bone mineral density (BMD) were significantly lower in the osteomalacia group than the SpA/AS group (P < 0.05). Twenty-five patients in the osteomalacia group underwent sacroiliac-joint magnetic-resonance imaging (SIJ-MRI); abnormalities were found in 10 of these patients, seven of whom met the definition for positive SIJ-MRI according to 2009 Assessment of SpondyloArthritis international Society (ASAS) criteria. All seven presented with bilateral sacral involvement. Logistic-regression analysis found that the odds ratio (OR) for bone erosion score was 0.551; the higher this score, the lower the possibility of osteomalacia. Conclusion: Clinical and radiological presentations of patients with osteomalacia could highly simulate those of patients with spondyloarthritis; identifying the differences between these two diseases could effectively decrease the misdiagnosis rate.

Characteristics of Gut Microbiota in Cerulein-Induced Chronic Pancreatitis.

BACKGROUND: Although clinical trials and animal models have evaluated the alterations of the microbiome in chronic pancreatitis (CP), the gut microbiota composition and diversity in cerulein-induced CP is unknown. This study aimed to evaluate the changes of gut microbiota in a CP mice model, and to determine whether these gut microbiota changes were consistent with those in patients with CP. METHODS: A total of ten male C57BL/6j mice were randomly divided into two groups. The experimental group were injected intraperitoneally with cerulein, while the normal control group received comparable injections of saline, the entire molding process lasted 6 weeks. Histology analysis was used to assess pancreatic morphological changes and fibrosis, meanwhile the gut microbiota composition and diversity were analyzed by high throughput sequencing. Spearman correlation analysis was used to determine whether body weight and weight changes were associated with changes in gut microbial abundance. RESULTS: The bacterial richness and diversity of CP mice decreased, and the gut microbiota changed, including lower levels of Firmicutes, decreased Firmicutes/Bacteroidetes ratio and increased abundance of Bacteroidetes, Actinobacteria and Verrucomicrobia. We found statistically significant differences in body weight and weight changes between the two groups. However, there was no significant correlation between alterations of gut microbiota and in body weight and weight changes. CONCLUSION: Our results showed that the gut microbiota in cerulein-induced CP was changed.

Microbial Intervention as a Novel Target in Treatment of Non-Alcoholic Fatty Liver Disease Progression.

BACKGROUND/AIMS: Emerging evidence suggests a close link between gut microbiota and non-alcoholic fatty liver disease (NAFLD). In this study, we aimed to investigate the association between gut microbiota and the DNA methylation of adiponectin (an adipocyte-specific adipocytokine) in rats, following diet-induced NAFLD. METHODS: 50 male SD rats were randomly divided into five groups with or without a high fat diet (HFD), antibiotics, and probiotics, in order to establish an imbalanced gut microbiota and probiotic treatment model in NAFLD rats. After 13 weeks of treatment, blood, liver, and cecal tissue samples were collected. Serum lipids, liver function indexes by biochemical analyzers, and changes in liver pathology with hematoxylin-eosin (HE) and masson staining were detected. Furthermore, the serum adiponectin by enzyme-linked immunosorbent assay (ELISA) and liver adiponectin methylation levels in the promoter regions by pyrophosphate sequencing were determined. High throughput Illumina sequencing targeted microbial 16S genes, bioinformatics and statistical analysis identified cecal-associated gut microbiota. RESULTS: HFD with antibiotic exposure showed the most severe steatohepatitis and a severe gut microbiota alteration. Reduced bacterial diversity was also seen and the abundances of Firmicutes, Lactobacillus, Cyanobacteria, Acidobacteria, Chlamydiae, Chlamydiales, Rubrobacteria, Verrucomicrobia, Blautia, Shewanella, Bacteroides, Bacteroides acidifaciens, and Bacteroides uniformis, were shown to be partly reversed by probiotic treatment. Decreased serum adiponectin levels and increased DNA methylation levels of adiponectin promoter regions were also markedly associated with the NAFLD progression during gut microbiota alteration. CONCLUSION: Our results suggested that both gut microbiota alteration and adiponectin variability may be drivers of NAFLD progression and that targeting the gut microbiota, such as via administration of a probiotic, may delay NAFLD progression via adiponectin.

Progressive pseudorheumatoid dysplasia with new-found gene mutation of Wntl inducible signaling pathway protein 3.

BACKGROUND: As one kind of osteochondrodysplasia, progressive pseudorheumatoid dysplasia (PPD) is also known as spondyloepiphyseal dysplasia tarda with progressive arthropathy or arthropathy progressive pseudorheumatoid of childhood. PPD is a very rare disease, especially in China, and has an estimated prevalence of 1/1000000 due to lacking definite prevalence survey. It is an autosomal recessive disorder caused by gene mutation of Wntl inducible signaling pathway protein 3 (WISP3). Its basic pathological change is persistent degeneration and loss of articular cartilage in multiple joints. Its clinical appearances include bone enlargement, platyspondyly, irregular endplate, secondary osteoarthritis, extensive osteoporosis, joint rigidity and function loss. Clinical diagnosis of PPD is made based on clinical appearance and imaging examinations, whereas its definite diagnosis depends on gene sequencing. PPD has no severe effect on life span, but causes high disability rate and very poor prognosis. There are only case reports with limited information in China. CASE PRESENTATION: One female patient was diagnosed as PPD and secondary osteoarthritis. She had typical clinical appearance and imaging examinations, and received individualized therapeutic regimens. She had a gene mutation (c.72delT, p.T24TfsX4) of WISP3. This gene mutation has not been reported by previous literatures and included in Single Nucleotide Polymorphism Database. CONCLUSIONS: As the first time, this paper reported a patient with PPD caused by new-found gene mutation (c.72delT, p.T24TfsX4) of WISP3.

The effect of older-person centered and integrated health management model on multiple lifestyle behaviors: A randomized controlled trial from China.

OBJECTIVE: To investigate the effectiveness of the older-centered Integrated Health Management Model Project (OPCHMP) for multiple lifestyle behaviours in the elderly. METHODS: A 2-arm, parallel, randomized controlled trial was conducted in Nanjing. The elderly were recruited from multiple community health service centres. The intervention group was intervened and received a personalized, 2-year OPCHMP. The control group only received usual care. Adherence to healthy lifestyle behaviours (ATHLBS) is the primary outcome, obtained through a self-reported composite health behaviour score. The secondary outcomes were health indicators. General estimating equation models were performed to analyse longitudinal dichotomous data and continuous data. RESULTS: 637 (intervention = 323; control = 314) participants were included in the study. The participants mean age was 70.53 ±â€¯6.07 years. Significant ATHLBS correction was achieved after 24-month follow-up in the intervention group, comparing to controls. And the intervention group reported significantly better health indicators. CONCLUSION: OPCHMP had positive effect on multiple lifestyle habits in elderly population, which is very encouraging.

Multimorbidity and health-related quality of life among the community-dwelling elderly: A longitudinal study.

OBJECTIVES: Multimorbidity is a growing public health problem. The objective of this study was to investigate the impact of multimorbidity on health-related quality of life (HRQoL) of the elderly. METHODS: A 24-month longitudinal study was conducted on the community-dwelling elderly. There were 411 elderly persons with complete follow-up. Information on thirteen chronic conditions was collected at baseline. Via a multi-dimensional scale, HRQoL was measured at baseline, 18 and 24 months post-baseline, respectively. Exploratory factor analyses were performed to identify multimorbidity patterns. The linear mixed effects models were conducted to analyze the associations between all dimensions of HRQoL and multimorbidity including distinct multimorbidity patterns. RESULTS: Multimorbidity was found to be negatively associated with HRQoL except memory function. We identified three multimorbidity patterns, which were mainly labelled as degenerative disorders, digestive/respiratory disorders, cardiovascular/metabolic disorders, respectively. And three multimorbidity patterns were associated with lower HRQoL including general health, body function, self-care ability and social adaptability. Besides, the elderly with the multimorbidity pattern mainly labelled as digestive/respiratory disorders or cardiovascular/metabolic disorders had a decline on emotion than those without multimorbidity. According to the analysis of the longitudinal data of the sample, general health, self-care ability, emotion and social adaptability of the participants decreased in different degrees every month. CONCLUSIONS: Multimorbidity was associated with lower HRQoL of the community-dwelling elderly. Distinct multimorbidity patterns had various impacts on different dimensions of HRQoL. Further studies should be carried out to investigate effective measures to improve HRQoL of the elderly with multimorbidity.

Gout mimicking spondyloarthritis: case report and literature review.

Gout is clinically characterized by episodes of monoarthritis, which not only typically affects the peripheral joints but also occasionally affect the axial joint, such as the sacroiliac joint (SIJ), and often mimics spondyloarthritis (SpA). Two cases of gout mimicking SpA are presented in the current paper. One patient was a 32-year-old man with a history of asymmetrical oligoarthritis of ankle and metatarsophalangeal joints (MTPJ). He had left gluteal pain for 2 weeks. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed the bone erosion of the left SIJ. T1-weighted MRI showed hypointense T1 and hyperintense T2 signals of the left SIJ. The other patient was a 24-year-old man with left back pain and hip pain for 4 months and intermittent fever for 3 months. He had a history of gout for 3 years. Both patients underwent CT-guided sacroiliac biopsy, and monosodium urate (MSU) crystals were shown by polarized microscopy. Gout can often mimic SpA and seldomly affects the SIJ. Thus, its correct diagnosis and adequate therapy can halt the development of such damaging complications.