TXNIP-NLRP3-GSDMD axis-mediated inflammation and pyroptosis of islet ß-cells is involved in cigarette smoke-induced hyperglycemia, which is alleviated by andrographolide.

Epidemiologic surveys have indicated that cigarette smoking is an important risk factor for diabetes, but its mechanisms remain unclear. Andrographolide, an herb traditionally utilized in medicine, provides anti-inflammatory benefits for various diseases. In the present work, 265 patients with Type 2 diabetes (T2D) were investigated, and male C57BL/6 mice were exposed to cigareete smoke (CS) and/or to intraperitoneally injected andrographolide for 3 months. To elucidate the mechanism of CS-induced hyperglycemia and the protective mechanism of andrographolide, MIN6 cells were exposed to cigarette smoke extract (CSE) and/or to andrographolide. Our data from 265 patients with T2D showed that urinary creatinine and serum inflammatory cytokines (interleukin 6 (IL-6), IL-8, IL-1ß, and tumor necrosis factor α (TNF-α)) increased with smoking pack-years. In a mouse model, CS induced hyperglycemia, decreased insulin secretion, and elevated inflammation and pyroptosis in ß-cells of mice. Treatment of mice with andrographolide preserved pancreatic function by reducing the expression of inflammatory cytokines; the expression of TXNIP, NLRP3, cleaved caspase 1, IL-1ß; and the N-terminal of gasdermin D (GSDMD) protein. For MIN6 cells, CSE caused increasing secretion of the inflammatory cytokines IL-6 and IL-1ß, and the expression of TXNIP and pyroptosis-related proteins; however, andrographolide alleviated these changes. Furthermore, silencing of TXNIP showed that the blocking effect of andrographolide may be mediated by TXNIP. In sum, our results indicate that CS induces hyperglycemia through TXNIP-NLRP3-GSDMD axis-mediated inflammation and pyroptosis of islet ß-cells and that andrographolide is a potential therapeutic agent for CS-induced hyperglycemia.

Prediction model comparison for gestational diabetes mellitus with macrosomia based on risk factor investigation.

PURPOSE: To establish a feasible prediction model for gestational diabetes mellitus (GDM) with macrosomia based on risk factors analysis. METHODS: A total of 1981 GDM pregnant women with macrosomia were enrolled in this retrospective study. The potential risk factors were revealed between the GDM women with and without macrosomia based on questionnaire and clinical data analysis. Then, prediction models including logistic regression (LR), decision tree (DT), support vector machine (SVM) and artificial neural networks (ANN) were constructed using these risk factors. Effect evaluation was performed based on model forecasting ability and model practicability such as accuracy, true positive (TP) rate, false positive (FP) rate, recall, F-measure, and receiver operating characteristic curve (ROC). RESULTS: The risk factors analysis showed that factors such as triglyceride (TG), high-density lipoprotein-cholesterol (HDL-c) and ketone body were risk factors for GDM with macrosomia. Then, the forecasting model was constructed, respectively. Based on these risk factors as variables, the overall classification accuracy of the four forecasting models was 86%. DT model had the highest overall classification accuracy. SVM model had advantages over the other three models in terms of TP rate. Among the comparison parameters including overall ROC curve, ANN model was the highest, followed by LR model. CONCLUSION: Among four forecasting models, ANN might be the optimal predication model, which had a certain practical value for the clinical screening of GDM women combined with macrosomia. Furthermore, HDL-c, TG, and ketone body might be potential risk factors for GDM with macrosomia.

Efficacy of re-resection versus radiofrequency ablation for recurrent Barcelona Clinic Liver Cancer stage 0/A hepatocellular carcinoma (HCC) after resection for primary HCC.

BACKGROUND: Whether repeat surgical resection (RSR) or radiofrequency ablation (RFA) is a better option for recurrent hepatocellular carcinoma (HCC) after resection for primary HCC remains controversial. This study was to investigate the clinical efficacy of RSR versus RFA in the treatment of recurrent HCC at Barcelona Clinic Liver Cancer (BCLC) stage 0/A after resection of primary HCC. METHODS: The patients treated by RSR (n=57) or RFA (n=51) for recurrent BCLC stage 0/A HCC in the Affiliated Hospital of Nantong University and Third Affiliated Hospital of Second Military Medical University from January 2008 to March 2018 were included. The general condition, clinicopathological characteristics, and survival were analyzed, and the baseline features and long-term survival were compared between two groups. RESULTS: The baseline characteristics were comparable between two groups. The 1-, 3-, and 5-year survival rates were 96.5%, 80.9%, and 60.6% in RSR group, respectively, and 96.1%, 76.8%, and 59.4% in RFA group, respectively (P=0.48). The 1-, 3-, and 5-year overall survival (OS) rates after treatment for recurrent HCC were 78.9%, 50.5%, and 29.7% in RSR group, respectively, and 80.3%, 50.9%, and 26.0% in RFA group, respectively (P=0.67). The 1-, 3-, and 5-year disease-free survival rates were 68.4%, 39.4%, and 26.6% in RSR group, respectively, and 62.8%, 32.8%, and 20.4% in RFA group, respectively (P=0.55). The incidence of treatment-related complications was significantly higher in the RSR than in the RFA group (42.11% vs. 11.76%, P<0.001). The median hospital stay was significantly shorter in the RFA than in the RSR group (3 vs. 9 days, P<0.001). CONCLUSIONS: RSR and RFA have similar survival benefits in the treatment of recurrent BCLC stage 0/A HCC. RFA is superior to RSR in terms of hospital stay and incidence of treatment-related complications.

Relationship of "weekend warrior" and regular physical activity patterns with metabolic syndrome and its associated diseases among Chinese rural adults.

Little is known about the "weekend warrior" pattern of physical activity (PA) where people perform all their PA in 1 or 2 sessions per week. We investigated the relationship of weekend warrior and other PA patterns with metabolic syndrome (MS) and its associated diseases. Data on sociodemographic and lifestyle characteristics were collected from the Nantong Metabolic Syndrome Study that included 13,505 women and 6,997 men between 2007 and 2008. Compared with inactive participants, weekend warriors were at lower risk of MS, diabetes, and hypertension; respective odds ratios (95% confidence intervals) for men and women were 0.58 (0.43-0.79) and 0.67 (0.52-0.86), 0.52 (0.34-0.79) and 0.52 (0.33-0.83), and 0.79 (0.63-0.99) and 0.71 (0.57-0.89). Similar results were observed with regular activity, at a frequency of >3 sessions per week. Both weekend warrior and regular PA patterns showed a 10-60% decrease in abnormal triglycerides, glucose, and blood pressure in both sexes; abnormal waist circumference in men only; and abnormal high-density lipoprotein in women only. Our observed cross-sectional relationships reflect that >150 min/week of moderate PA or 75 min/week vigorous-intensity PA is needed to prevent MS and its component diseases, even if in a short-bout, intermittent PA pattern. ABBREVIATIONS: MS: Metabolic syndrome; WC: Waist circumference; TG: Triglycerides; HDL-c: High-density lipoprotein cholesterol; BP: Blood pressure; SBP: Systolic blood pressure, DBP: Diastolic blood pressure; PA: Physical activity; JIS: Joint Interim Statement; CVD: Cardiovascular disease; ATP III: US Third Report of the National Cholesterol Education Program, the Adult Treatment Panel; IDF: International Diabetes Federation; IPAQ: International Physical Activity Questionnaire; BMI: Body mass index; CDC: the Nantong Centers for Disease Control; OR: Odds ratio; CI: Confidence interval; SD: Standard deviation; IQR: Interquartile range.

Association between social support and health-related quality of life among Chinese seafarers: A cross-sectional study.

BACKGROUND: Seafarers have reported impaired health and health-related quality of life (HRQOL). Social support might increase HRQOL, but little is known about this association among Chinese seafarers. The aim of this study was to describe social support and explore its association with HRQOL among Chinese seafarers. METHODS: A cross-sectional survey was conducted in the ports of Nantong and Rugao, China, from April to December 2013. A total of 917 Chinese seafarers were interviewed on social support, mental distress, perceived occupational stress, and HRQOL using the following self-administered questionnaires: The Social Support Rating Scale, Self-rating Depression Scale, Occupational Stress Questionnaire, and the World Health Organization Quality of Life-BREF (WHOQOL-BREF) questionnaire. Hierarchical linear regression modelling was used to analyze the association between seafarers' subjective level of social support and their HRQOL. RESULTS: Of the 917 male Chinese seafarers included in the study, 40.7% perceived high levels of social support, and 39.1% were highly satisfied with their overall quality of life (QOL). Hierarchical regression analysis showed significant associations between level of social support and all health dimensions in the WHOQOL-BREF, even after adjusting for depressive symptoms, occupational stress, occupational activities, sleep duration, and other relevant covariates. Compared with the medium or low level social support group, seafarers with a high level of social support had better QOL scores in the general facet health and QOL (ß = 2.43, p<0.05), and the physical health (ß = 3.23, p<0.001), psychological health (ß = 5.56, p<0.001), social relation (ß = 6.07, p<0.001), and environment domains (ß = 4.27, p<0.001). In addition, depression, occupational stress, occupational activities, and sleep duration were found to be determinants of seafarers' HRQOL. CONCLUSIONS: Chinese seafarers have poorer HRQOL than the general population, but social support has a significant positive effect on their HRQOL. Efforts to improve social support should be undertaken.

Associations of metabolic disorder factors with the risk of uncontrolled hypertension: a follow-up cohort in rural China.

We evaluated how metabolic disorders affected antihypertension therapy. 2,912 rural Chinese patients with hypertension who provided blood samples, demographic and clinical data at baseline and after 1 year of antihypertension therapy were evaluated. At baseline, 1,515 patients (52.0%) were already receiving drug therapy and 11.4% of them had controlled blood pressure (BP). After 1 year, all 2,912 patients were receiving antihypertension therapy that was administered by community physicians, and 59.42% of them had controlled BP. Central obesity and abnormal triglyceride, high-density lipoprotein cholesterol, and glucose were associated with 15-70% higher risks of uncontrolled hypertension. Metabolic syndrome using the JIS criteria was associated with poor BP control (odds ratio: 1.71 and 1.54 for the baseline and follow-up datasets, respectively). The risk of uncontrolled hypertension increased with the number of metabolic disorders (p for trend <0.01). The presence of ≥3 metabolic disorder factors was associated with higher risks of poor BP control. The associations of metabolic factors and uncontrolled hypertension were stronger for the standard and modified ATP III criteria, compared to the IDF and JIS criteria. Metabolic factors were associated with less effective antihypertension therapy, and all definitions of metabolic syndrome helped identify patients with elevated risks of uncontrolled hypertension.

Prevalence of metabolic syndrome and its risk factors among rural adults in Nantong, China.

The prevalence of metabolic syndrome (MS) varies worldwide due to genetic and environmental factors. A population-based cross-sectional study, with 37,582 participants recruited in Nantong, China in 2007-2008 (stage I) and 2013 (stage II). Socio-demographic, lifestyle factors, disease history and fasting blood sample were collected. The prevalence of MS was much higher in 2013 (42.6%) than that in 2007-2008 (21.6%), which was significantly higher in older people in both stages. Participants with two or more familial history of diseases were associated with a higher MS prevalence compared to those who didn't have familial history of diseases. Total physical activity (PA) was associated with 24 and 19% decreased risk of MS in men and women. Occupational PA in moderate and vigorous intensity was associated with a 25%-45% decreased risk of MS. Female smokers who smoked more than 10 cigarettes per day or over 25 years were associated with 96 and 74% increased MS risk, respectively. The highest quartile of rice wine consumption was associated with a lower risk of MS with OR of 0.63 in women, compared with female non-drinkers. These findings indicated that PA and rice wine are two protective factors in MS prevention in rural areas of East China.

Performance Evaluation of Missing-Value Imputation Clustering Based on a Multivariate Gaussian Mixture Model.

BACKGROUND: It is challenging to deal with mixture models when missing values occur in clustering datasets. METHODS AND RESULTS: We propose a dynamic clustering algorithm based on a multivariate Gaussian mixture model that efficiently imputes missing values to generate a "pseudo-complete" dataset. Parameters from different clusters and missing values are estimated according to the maximum likelihood implemented with an expectation-maximization algorithm, and multivariate individuals are clustered with Bayesian posterior probability. A simulation showed that our proposed method has a fast convergence speed and it accurately estimates missing values. Our proposed algorithm was further validated with Fisher's Iris dataset, the Yeast Cell-cycle Gene-expression dataset, and the CIFAR-10 images dataset. The results indicate that our algorithm offers highly accurate clustering, comparable to that using a complete dataset without missing values. Furthermore, our algorithm resulted in a lower misjudgment rate than both clustering algorithms with missing data deleted and with missing-value imputation by mean replacement. CONCLUSION: We demonstrate that our missing-value imputation clustering algorithm is feasible and superior to both of these other clustering algorithms in certain situations.

Association of physical activity with risk of metabolic syndrome: findings from a cross-sectional study conducted in rural area, Nantong, China.

The prevalence of metabolic syndrome increases rapidly worldwide, and its association with physical activity (PA) varies with race and lifestyles. Little is known about the association in rural China. The Nantong Metabolic Syndrome Study recruited 13,505 female and 6997 male participants in 2007 and 2008. Socio-demographic characteristics, and physiological and behavioural data were collected. Logistic regression model was applied to estimate associations of metabolic syndrome and its components with different PAs. The overall metabolic syndrome prevalence was 21.6% in current study. Increasing total PA or moderate-to-vigorous-intensity occupational PA was associated with decreasing 5%-60% risk of having metabolic syndrome and abnormal metabolic syndrome components in both genders. An association between leisure-time PA and blood pressure was found in men, but no associations between leisure-time PA and metabolic syndrome components were found in women. Commuting PA, such as walking and taking bus, by bicycle and walking only, was associated with decrease of 20%-45% risk of several abnormal metabolic syndrome components in women. This study provides information for future investigation into the nature of these associations so that recommendations can be developed to reduce the prevalence of metabolic syndrome and its components among rural population in China.