[Difficulties and prospects of standardized management of type 1 diabetes].

Type 1 diabetes patients require lifelong dependence on insulin therapy. It is a long-term challenge for patients to effectively deliver exogenous insulin to maintain glucose levels within the individual's target range as safely as possible for preventing the development and progression of diabetes complications. The management of type 1 diabetes involves multidisciplinary collaboration, referral from different hospitals, and effective diabetes education and management for patients and family members. Compared with the more mature diseases management system in the United States and the United Kindom, the standardized management of type 1 diabetes patients in China started late. Moreover, there are still some difficulties at present. Whereas, with the exploration and efforts of the hospitals at all levels for the management of type 1 diabetes patients, standardization of type 1 diabetes management will gradually step forward and truly realize the lifelong management for patients.

[Intrauterine balloon tamponade combined with temporary abdominal aortic balloon occlusion in the management of women with placenta accreta spectrum:a randomized controlled trial].

Objective: To access the effectiveness and safety of the intrauterine balloon tamponade verse gauze packing combined with temporary abdominal aortic balloon occlusion in the management of placenta accreta spectrum (PAS). Methods: This was an open-label, randomized controlled trial conducted in Nanjing Drum Tower Hospital. The patients suspected with PAS for uterine preservation surgery under the multidisciplinary team care were recruited between Aug 2015 and Jan 2018. When bleeding could not be achieved after fetus delivered, and a temporary abdominal aortic balloon occlusion and the compression sutures as needed, the women were randomly allocated 1∶1 into balloon tamponade (n=81) or gauze packing (n=80) group. The primary outcome was successful bleeding arrests by avoiding second line surgeries. The secondary outcomes included the volume of blood loss during and after cesarean section, the rate of PPH, incidence and amount of blood transfusion, hysterectomy, postpartum pain, ICU admission, need for re-laparotomy, and the length of hospital stay, readmission, and interventional radiology complications. Results: All the women [100% (81/81)] in the balloon group were obtained hemostasis without further intervention, significantly higher than 88% (70/80) in the gauze group (P=0.001). Before uterine tamponade, blood loss were 820 ml (620-1 230) ml and 850 ml (605-1 442) ml, while placenta bed were sutured in 96%（78/81, 77/80） respectively (P>0.05).The proportion of blood loss≥1 000 ml was higher in the gauze group than that in the balloon group (P=0.006). Maternal adverse events involving total blood loss, puerperal morbidity and postpartum pain occurred more frequently in the gauze group (P<0.05). The following outcome showed no statistically significant difference between the two groups: the vascular occlusion time, the dose of radiation, and interventional radiology complication (P>0.05). The median volume infused into the lower and upper balloons is 70 ml (50-100 ml) and 180 ml (100-240 ml). Conclusions: Incrauterine balloon tamponade is as effective as gauze packing in hemostasis following the placenta delivery in PAS. Compared with gauze packing, the uterine balloon tamponade is more effective.

[Imported falciparum malaria in Suzhou City: a report of two cases in 2019].

The demographic features, epidemiology, diagnosis and treatment of two cases with falciparum malaria imported into Suzhou City in 2019 were reported. These findings indicate a risk of imported malaria in visitors besides high prevalence in migrant labors, and much attention should be paid to children that are at a high risk of infections.

A case of IgG4-related retroperitoneal fibrosis with multiple involvement.

To increase awareness of IgG4-related retroperitoneal fibrosis (IgG4-RRPF) and reduce clinical misdiagnosis. We report a 79-year-old man with multiple organs involvement of IgG4-RRPF, who developed right lower extremity edema, hemoptysis and fever. The abdomen computed tomography (CT) scan image showed lymph nodes enlargement. The positron emission tomography/CT scan image showed pancreatic malignancy with multiple nodal lymph node metastasis, lung fibroblast proliferation, and right lung apex bullae. The chest CT scan image showed pulmonary multiple lymph nodes with calcification in the mediastinum. Posterior peritoneum magnetic resonance imaging showed the body and tail of the pancreas parenchymatous mass. The serum IgG4 concentration was high. The fibrous connective tissue with IgG4-positive plasma cells infiltration in the left supraclavicular lymph node biopsy was found. Fiberoptic bronchoscopy showed diffuse alveolar hemorrhage, and the transbronchial lung biopsy found no cancer cells. The patient was treated with glucocorticoids and immunosuppressive agents. After 2 months treatment, the patient showed rapid improvement. This is a case of IgG4-RRPF with multiple organs involvement. Glucocorticoid is the first-line treatment.

Monoacylglycerol lipase inhibitors produce pro- or antidepressant responses via hippocampal CA1 GABAergic synapses.

The probability of suffering the mood disorder depression is up to 30% in women and 15% in men during their life span. Pharmacological options for depression are limited: conventional antidepressants have low efficacy and a delayed onset of action (several weeks). Here we investigate the antidepressant actions of inhibitors of monoacylglycerol lipase (MAGL), the major degradative enzyme of the endocannabinoid 2-arachidonoylglycerol. A low-dose of MAGL inhibitors produces antidepressant effects on acute stress-exposed mice, through glutamatergic synaptic long-term depression (LTD), without significant effects on chronic corticosterone-exposed mice. In contrast, a high-dose of MAGL inhibitors produces pro- or antidepressant effects on acute stress- or chronic corticosterone-exposed mice, respectively, through GABAergic synaptic disinhibition. In the hippocampus, in vivo inhibition of MAGL induces a CB1 cannabinoid receptor (CB1R)-dependent suppression of inhibitory GABAergic synapses and an in vivo LTD of excitatory glutamatergic synapses. LTD induction requires CB1R in astroglial cells (but not in GABAergic or glutamatergic neurons) and postsynaptic glutamate receptors. The conventional antidepressant fluoxetine produces rapid or delayed antidepressant effects in acute stress- or chronic corticosterone-exposed mice, respectively. We propose that depression-like behavior of animals in response to acute stress is the normal behavioral response, and thus, MAGL inhibitors, which produce antidepressant effects in chronic corticosterone-exposed animals through GABAergic synaptic disinhibition, represent a new class of rapidly-acting and long-lasting antidepressants.

[Effects of ligustilide on the extracellular recombinant human heat shock protein 60 induced inflammatory reactions in the THP-1 cells and the related mechanisms].

Objective: To investigate the effects of ligustilide(LIG) on extracellular recombinant human heat shock protein 60 (HSP60) induced inflammatory reactions in the THP-1 cells and the related mechanisms. Methods: THP-1 cells were differentiated to macrophages by incubation with phorbol-12-myristate-13-acetate (PMA). The immunofluorescence method was used to screen the optimum transfection concentration of MyD88 siRNA.The macrophages were divided into six groups(n=3), including blank control(siRNA transfection reagent), model(siRNA transfection reagent+ HSP60 10 mg/L), negative control(MyD88 negative control+ HSP60 10 mg/L), LIG group(siRNA transfection reagent+ HSP60 10 mg/L+ LIG 20 mg/L), RNA interfering(RNAi) group(MyD88 siRNA+ HSP60 10 mg/L) and RNAi+ LIG group(MyD88 siRNA+ HSP60 10 mg/L+ LIG 20 mg/L). The protein expression level of MyD88 and phospho-nuclear factor-κB(p-NF-κB) in macrophages and the level of tumor necrosis factor-α(TNF-α) and interleukin-6(IL-6) in the culture supernatant were assessed by Western blot analyses or ELISA, respectively. Results: (1)The protein expression levels of MyD88 (1.196±0.125 vs. 0.341±0.063, P<0.01) and p-NF-κB(0.817±0.034 vs. 0.312±0.046, P<0.01) were significantly higher in the model group than those in the blank control group.The protein expression levels of MyD88(0.554±0.043) and p-NF-κB(0.538±0.063) in the RNAi group were significantly lower than those in the model group (all P<0.01) but significantly higher than those in the blank control group (all P<0.05). The protein expression levels of MyD88(0.694±0.087, P<0.05) and p-NF-κB(0.669±0.043, P<0.01)in the LIG group were markedly lower than those in the model group, but higher than those in the RNAi group (P<0.05) and the blank control group (P<0.01). The protein expression levels of MyD88(0.409±0.069) and p-NF-κB(0.395±0.046) in the RNAi+ LIG group were significantly lower than in the model group (all P<0.01) and in the LIG group(P<0.05 or 0.01), and were similar to the blank control group(P>0.05). The expression level of p-NF-κB in the RNAi+ LIG group was significantly lower than in the RNAi group (P<0.05). (2) The contents of TNF-α((312.24±28.69) ng/L vs. (5.99±1.03) ng/L, P<0.01) and IL-6((233.45±57.77) ng/L vs. (2.25±0.67) ng/L, P<0.01) were significantly higher in the model group than in the blank control group. The contents of TNF-α((235.66±25.12) ng/L) and IL-6((131.59±13.99) ng/L) were significantly lower in the RNAi group than in the model group (P<0.01). The contents of TNF-α((258.13±44.80) ng/L) and IL-6((175.92±28.27) ng/L) were also significantly lower in the LIG group than in the model group(P<0.05) while the content of IL-6 was significantly higher in the LIG group than in the RNAi group(P<0.01). The contents of TNF-α((88.57±16.10) ng/L) and IL-6((59.99±10.31) ng/L) were significantly lower in the RNAi+ LIG group than those in the model group, the RNAi group and the LIG group(P<0.05 or 0.01). Conclusions: The MyD88/NF-κB signaling pathway is one of the key signaling pathways of human HSP60 induced inflammation in THP-1 cells. Ligustilide could exhibit the anti-inflammatory effect probably by inhibiting the MyD88/NF-κB signaling pathway.

Effect of sodium intake on renin level: Analysis of general population and meta-analysis of randomized controlled trials.

BACKGROUND: We evaluated the association between sodium intake and plasma renin levels in the cross sectional study and meta-analysis of randomized controlled trials, whether there is a persistent elevation of plasma renin by longer-term sodium intake restriction. METHODS: Plasma renin activity (PRA) and 24-h urine sodium (24HUNa) excretion were measured from individuals randomly selected from a community. Simple and multiple linear regression analyses adjusted for age, 24-h systolic blood pressure, 24-h average heart rate, fasting blood glucose and gender were performed. For meta-analysis, 74 studies published from 1975 to mid-2014 were identified in a systematic literature search using EMBASE, CINAHL, and MEDLINE. Random effects meta-analyses and a meta-regression analysis were performed. RESULTS: Among the 496 participants recruited, 210 normotensive and 87 untreated hypertensive subjects were included in the analysis. There was no significant association between PRA and 24HUNa in the total population, or hypertensive and normotensive individuals. In the meta-analysis, the standard mean difference (SMD) of renin level by sodium intake reduction was 1.26 (95% CI: 1.08 to 1.44, Z=12.80, P<0.001, I(2)=87%). In the meta-regression analysis, an increase in a day of intervention was associated with a fall in SMD by -0.04 (95% CI: -0.05 to -0.02, Z=-5.27, P<0.001, I(2)=86%), indicating that longer duration of reduced sodium intake would lead to lesser SMD of renin level. CONCLUSIONS: The present population based cross-sectional study and meta-analysis suggests that prolonged reduction in sodium intake is very unlikely associated with elevation of plasma renin levels.

MIM regulates the trafficking of bone marrow cells via modulating surface expression of CXCR4.

Missing in metastasis (MIM) is abundantly expressed in hematopoietic cells. Here we characterized the impact of MIM deficiency on murine bone marrow (BM) cells. Although MIM(-/-) cells proliferated similarly to wild type (WT), they exhibited stronger response to chemokine stromal-derived factor 1 (SDF-1), increase in surface expression of CXCR4, impaired CXCR4 internalization and constitutive activation of Rac, Cdc42 and p38. Transplantation of MIM(-/-) BM cells into lethally irradiated mice showed enhanced homing to BM, which was abolished when mice were pretreated with a p38 antagonist. Interestingly, MIM(-/-) BM cells, including hematopoietic stem and progenitor cells (HSPCs), showed two- to fivefold increase in mobilization into the peripheral blood upon treatment with AMD3100. In vitro, MIM(-/-) leukocytes were susceptible to AMD3100 and maintained increased response to AMD3100 for mobilization even after transfer into WT mice. MIM(-/-) mice had also a higher level of SDF-1 in the circulation. Our data highlighted an unprecedented role of MIM in the homeostasis of BM cells, including HSPCs, through modulation of the CXCR4/SDF-1 axis and interactions of BM leukocytes with their microenvironments.

Influence of wavefront aberration on the imaging performance of the solar grating spectrometer.

The solar grating spectrometer is an important tool to study the thermodynamic properties of the solar atmosphere with different height distribution, but its imaging performance will be degraded by the wavefront aberration. On the other hand, narrow slit of the grating spectrometer will filter the wavefront aberration to a certain extent. In this paper, the mathematical relation between the wavefront aberration and the imaging performance of the grating spectrometer is derived. The numerical simulation is performed and is validated by the experiment. The results demonstrate that: The influence of the wavefront aberration with the different types and magnitudes on the spectral resolution and the energy utilization is different. The influence of the different slits on the wavefront aberrations is different. Generally, the smaller the slit is, the better the spectral resolution is. However, this is not true for the low-frequency dominated aberration, e.g. the defocus, since its low frequency will also be blocked by the narrow slit. If the influence of the filter slit on the wavefront aberration cannot be taken into account, it will lead to adaptive optics over-compensation.

Inflammatory response of a prostate stromal cell line induced by Trichomonas vaginalis.

While Trichomonas vaginalis, a cause of sexually transmitted infection, is known as a surface-dwelling protozoa, trichomonads have been detected in prostatic tissue from benign prostatic hyperplasia and prostatitis by immunoperoxidase assay or PCR. However, the immune response of prostate stromal cells infected with T. vaginalis has not been investigated. Our objective was to investigate whether T. vaginalis could induce an inflammatory response in prostate stromal cells. Incubation of a human prostate stromal myofibroblast cells (WPMY-1) with live T. vaginalis T016 increased expression of the inflammatory chemokines CXCL8 and CCL2. In addition, TLR4, ROS, MAPK and NF-κB expression increased, while inhibitors of TLR4, ROS, MAPKs and NF-κB reduced CXCL8 and CCL2 production. Medium conditioned by incubation of WPMY-1 cells with T. vaginalis stimulated the migration of human neutrophils and monocytes (THP-1 cells). We conclude that T. vaginalis increases CXCL8 and CCL2 production by human prostate stromal cells by activating TLR4, ROS, MAPKs and NF-κB, and this in turn attracts neutrophils and monocytes and leads to an inflammatory response. This study is the first attempt to demonstrate an inflammatory reaction in prostate stromal cells caused by T. vaginalis.

Association of BMP4 polymorphisms with isolated tooth agenesis in a Chinese Han population: a case-control study.

OBJECTIVE: Tooth agenesis is a common craniofacial anomaly in human beings. Mounting evidence has demonstrated that the bone morphogenetic protein 4 gene (BMP4) plays an important role in tooth development. This case-control study was designed to evaluate the association of the polymorphism rs17563 in BMP4 gene with susceptibility of isolated human tooth agenesis in a Chinese Han population. PATIENTS AND METHODS: 335 tooth agenesis cases and 444 healthy controls were included in this study. RESULTS: Although no significant association was observed either in the overall or stratified analysis between the types and the severity of missing teeth. However, significant difference was observed between the anterior and posterior tooth agenesis (APTA) cases and the controls (p = 0.018 for allele distribution and OR = 0.39, 95% CI = 0.15-0.99). Furthermore, the heterozygote (TC) and dominant model (CC+TC) were associated with decreased risk of APTA compared with the control (phet = 0.018, ORhet = 0.39, 95% CIhet = 0.15-0.99 and pdom = 0.042, ORdom = 0.34, 95% CIdom = 0.13-0.87, respectively). CONCLUSIONS: These results indicated that rs17563 in BMP4 gene was potentially associated with APTA in Chinese Han population and further independent studies are required to verify these findings.

Differential antinociceptive effects of intrathecal administration of C-terminal esterified endomorphin-2 analogues in mice.

BACKGROUND: We have previously synthesized three esterified endomorphin-2 (EM-2) analogues 1-3 by substitution of C-terminus with methyl, ethyl and tert-butyl ester, respectively. Interestingly, the increase of EM-2 in bulkness of the esterified group decreased the µ-opioid receptor affinity but increased the δ-affinity. Presently, we extended our studies to investigate the antinociceptive potencies of these esterified analogues given intrathecally in the mouse tail-flick test. Also, the specific opioid receptor antagonists and antibodies against endogenous opioid peptides were used to determine whether there are any differential mechanisms on the antinociception produced by these analogues. METHODS: Antinociception was assessed using the 50 °C hot water tail-flick test. The drugs and antibodies were administered intrathecally. RESULTS: The ED50 value of analogue 1 was 1.34 nmol, exhibiting the highest analgesic effect. In contrast, the antinociceptive potency of analogue 2 was about twofold less potent than that of EM-2. The antinociception induced by analogues 1 and 2 was mediated by the stimulation of µ-opioid receptor in the spinal cord. However, the analogue 1-induced antinociception also contained an additional component that was mediated by the release of dynorphin A acting on κ-opioid receptor, which was similar to its parent EM-2. Notably, analogue 3 exhibited only slightly lower analgesia relative to EM-2, which may possibly be due to a direct stimulation of both µ- and δ-opioid receptors. CONCLUSIONS: Our results demonstrated that EM-2 and its analogues 1-3 produced differential antinociceptive effects when administered intrathecally. We concluded that C-terminal amide to esterification conversion changed the antinociceptive potencies and properties of EM-2.

Microwave-assisted one-step patterning of aqueous colloidal silver.

A new approach of utilizing microwave to pattern gradient concentric silver nanoparticle ring structures has been presented. The width and height of a single ring and the space between adjacent rings can be adjusted by changing the silver colloidal concentration and the microwave output power. By simply enhancing the ambient vapour pressure to the saturated value during microwave-assisted evaporation, sub-100 nm rings can be deposited in between adjacent micro-rings over a distance of millimetres. Combined with microwave sintering, this approach can also create conductive silver tracks in a single step, showing huge potential in fabricating micro- and nano-electronic devices in an ultra-fast and cost-effective fashion.

Hyperbaric oxygen therapy attenuates neuropathic hyperalgesia in rats and idiopathic trigeminal neuralgia in patients.

BACKGROUND: Neuropathic pain after nerve injury is severe and intractable, and current drug and non-drug therapies offer very limited pain relief. Hyperbaric oxygen (HBO 2) has been clinically used for protection of the nervous system after acute injury. We investigated whether HBO 2 treatment could prevent and/or attenuate neuropathic pain in animals and in patients. METHODS: Mechanical allodynia and thermal hyperalgesia and neurochemical alterations of neuropathic pain were analysed in male, adult, Sprague-Dawley rats with sciatic nerve injury. Clinical trials were conducted in patients with idiopathic trigeminal neuralgia. RESULTS: Repetitive HBO 2 treatment [a combination of pressure at 3 atmosphere absolute (ATA) and pure oxygen] greatly inhibited behavioural signs of neuropathic pain manifested as thermal hyperalgesia and mechanical allodynia. Such an HBO 2 treatment also inhibited nerve injury-induced induction of c-Fos and activation of astrocytes and increased phosphorylation of NR2B receptor and the subsequent Ca 2+-dependent signals in rats. Neither high pressure (up to 3 ATA) nor pure oxygen alone resulted in analgesic effect. In clinical trials, one course of HBO 2 therapy (10 consecutive days) produced a rapid-onset, dose-dependent and long-lasting analgesic effects evidenced by the decreased doses of carbamazepine required for keeping patient pain at a minimum and decreased scores of visual analogue scales, which was used for patient's self-evaluation. CONCLUSIONS: These findings support that HBO 2 therapy is an effective approach for treating neuropathic pain in both animals and human beings and suggest that neural protection, anti-inflammation and inhibition of nerve injury-induced altered neural activity may contribute to the analgesic effect of HBO 2 therapy.

Ginsenoside Rg1 enhances endothelial progenitor cell angiogenic potency and prevents senescence in vitro.

This study investigated the effect of ginsenoside Rg1 on the functions of ex vivo cultivated endothelial progenitor cells (EPCs) and whether ginsenoside Rg1 prevented EPC senescence. EPCs isolated from peripheral blood from healthy volunteers were incubated with different concentrations of ginsenoside Rg1 and the effects were observed at different time points. Cell proliferation and in vitro vasculogenesis were assayed and flow cytometry was used to determine the effects of ginsenoside Rg1 on the cell cycle. Senescence and telomerase activity in EPCs were also assayed. It was found that ginsenoside Rg1 promoted EPC proliferation and vasculogenesis in dose-and time-dependent manners. Cell-cycle analysis showed that ginsenoside Rg1 increased the proliferative phase and decreased the resting phase of EPCs. ß-Galactosidase and telomerase activities increased. These results support the view that ginsenoside Rg1 induces EPC proliferation and angiogenesis, and inhibits EPC senescence.

Effect of air abrasion and dye on the surface element ratio and resin bond of zirconia ceramic.

The purpose of this study was to evaluate the effect of the surface element composition and roughness of dyed or non-dyed zirconia ceramic by air abrasion on the bond durability to resin luting cement. The sintered zirconia ceramic specimens were divided into four groups as follows: polished, dyed/polished, abraded, dyed/abraded. The surface roughness of each group was measured by a 3D laser scanning microscope. Energy-dispersive spectroscopy was applied for identifying and quantifying the elemental composition of the zirconia ceramic surfaces Each group had 20 shear test specimens of zirconia to Panavia F and was divided into two subgroups (n = 10) after 0 or 10 000 thermal cycles to receive the shear test. Compared with polishing, air abrasion significantly reduced the oxygen atom and weight ratio, increased the zirconium atom and weight ratio, increased R(a) and R(y) of zirconia ceramic surface, and also increased the bond strength of dyed and non-dyed zirconia ceramic to Panavia F after 0 and 10 000 thermal cycles. The dying procedure could affect the abraded and non-abraded zirconia ceramic surface oxygen and zirconia element ratios and surface characteristics. However, the dying procedure does not affect the resin bond strength and durability of zirconia ceramic.Corrections were made to this article on 3 November 2011. The footnote for the corresponding authors was incorrectly labelled.

Cationic liposomes as gene delivery system: transfection efficiency and new application.

As it has been generally reported that oppositely charged cationic liposomes (CLs) are superior to either neutral or anionic liposomes as gene delivery carrier, interest in the properties, structures, transfection mechanism of CLs and so forth arises unprecedentedly. However, our understanding about the mechanism of CLs-gene complexes (lipoplex)-cell interaction and factors influencing the transfection efficiency (TE) of CLs remains poor. In this article, we describe some new results aimed at elucidating the relationship between the chemical-physical properties of lipoplex with TE and introducing recent applications of CLs in gene therapy.