Comparison of the C-TIRADS, ACR-TIRADS, and ATA guidelines in malignancy risk stratification of thyroid nodules.

Background: To compare the diagnostic performance in determining the malignancy of thyroid nodules and the fine needle aspiration (FNA) recommendations of the guidelines set forth by the Superficial Organ and Vascular Ultrasound Group of the Society of Ultrasound in Medicine of the Chinese Medical Association in 2020 [2020 Chinese Thyroid Imaging Reporting and Data System (C-TIRADS)], the American College of Radiology in 2017 (2017 ACR-TIRADS) and the American Thyroid Association in 2015 (2015 ATA guidelines). Methods: From January 2021 to December 2021, 1,228 thyroid nodules with definitive postoperative histopathology and ultrasound (US) examination within 3 months before surgery in Shantou Central Hospital were enrolled in this study. We collected the data in 2022. The participants formed a consecutive series. The clinical and US features of the nodules were retrospectively reviewed and categorized according to the 2020 C-TIRADS, the 2017 ACR-TIRADS and the 2015 ATA guidelines. The diagnostic performance and unnecessary FNA rates of the three guidelines were calculated. Results: The 2017 ACR-TIRADS had the highest diagnostic performance [area under the receiver operating characteristic curve (AUROC) 0.938], followed by the 2020 C-TIRADS (AUROC 0.933) and the 2015 ATA guidelines (AUROC 0.928). The ATA guidelines had the highest specificity (93.38%), accuracy (92.10%) and positive predictive value (PPV) (80.56%) among the three guidelines. There were no significant differences in the sensitivity and negative predictive value (NPV) among the three guidelines. The sensitivity, specificity, PPV, NPV and accuracy of the FNA recommendations based on the C-TIRADS were 84.25%, 58.76%, 38.92%, 92.28% and 64.82%, respectively, which were higher than those of the ACR-TIRADS (57.53%, 42.94%, 23.93%, 76.43% and 46.42%, respectively) and the ATA guidelines (62.67%, 13.25%, 18.39%, 53.22% and 25.00%, respectively). Compared with the ACR-TIRADS (76.07%) and the ATA guidelines (81.61%), the C-TIRADS showed advantages in the unnecessary FNA rate (61.08%), especially in nodules larger than 20 mm. Conclusions: The 2020 C-TIRADS, the 2017 ACR-TIRADS and the 2015 ATA guidelines can effectively predict the malignancy risk of thyroid nodules. Compared with the 2017 ACR-TIRADS and the 2015 ATA guidelines, the 2020 C-TIRADS may offer a meaningful reduction in FNA recommendations with the highest efficacy in distinguishing thyroid carcinoma.

The effect of dietary carbohydrate and calorie restriction on weight and metabolic health in overweight/obese individuals: a multi-center randomized controlled trial.

BACKGROUND: Both low-carbohydrate (LC) and calorie-restricted (CR) diets have been shown to have metabolic benefits. However, the two regimens have yet to be thoroughly compared. We conducted a 12-week randomized trial to compare the effects of these diets separately and in combination on both weight loss and metabolic risk factors in overweight/obese individuals. METHODS: A total of 302 participants were randomized to LC diet (n = 76), CR diet (n = 75), LC + CR diet (n = 76), or normal control (NC) diet (n = 75) using a computer-based random number generator. The primary outcome was the change in body mass index (BMI). The secondary outcomes included body weight, waist circumference, waist-to-hip ratio, body fat, and metabolic risk factors. All participants attended health education sessions during the trial. RESULTS: A total of 298 participants were analyzed. BMI change over 12 weeks was - 0.6 (95% CI, - 0.8 to - 0.3) kg/m2 in NC, - 1.3 (95% CI, - 1.5 to - 1.1) kg/m2 in CR, - 2.3 (95% CI, - 2.6 to - 2.1) kg/m2 in LC, and - 2.9 (95% CI, - 3.2 to - 2.6) kg/m2 in LC + CR. LC + CR diet was more effective than LC or CR diet alone at reducing BMI (P = 0.001 and P < 0.001, respectively). Furthermore, compared with the CR diet, the LC + CR diet and LC diet further reduced body weight, waist circumference, and body fat. Serum triglycerides were significantly reduced in the LC + CR diet group compared with the LC or CR diet alone. Plasma glucose, homeostasis model assessment of insulin resistance, and cholesterol concentrations (total, LDL, and HDL) did not change significantly between the groups during the 12-week intervention. CONCLUSIONS: The reduction of carbohydrate intake without restricting caloric intake is more potent to achieve weight loss over 12 weeks when compared to a calorie-restricted diet in overweight/obese adults. The combination of restricting carbohydrate and total calorie intake may augment the beneficial effects of reducing BMI, body weight, and metabolic risk factors among overweight/obese individuals. TRIAL REGISTRATION: The study was approved by the institutional review board of Zhujiang Hospital of Southern Medical University and registered at the China Clinical Trial Registration Center (registration number: ChiCTR1800015156).

Wavelength calibration of birefringent interferometers for 2-D measurement of plasma flow.

Imaging birefringent interferometers are used to measure plasma flow in 2-D via the Doppler shift of a spectral emission line. Applications include plasma physics study in fusion energy experiments and in the Earth's upper atmosphere. We present a new, to the best of our knowledge, method for wavelength calibration that does not require measurement at the rest wavelength of the targeted spectral line, nor measurement using a tuneable laser source. This is useful when such light sources are not available. Fringes measured at known wavelengths from the emission lines of gas-discharge lamps are used to constrain an instrument model which can generate the required calibration data. In the process, optical path difference, dispersion and misalignments are characterized. The "2π ambiguity" of interferogram phase data is handled using circular statistics, allowing the wavelength span of the calibration lines to far exceed the unambiguous measurement range of the instrument. The technique is demonstrated to an accuracy of ±1 pm (±0.7 km/s flow-equivalent) over a 40 nm visible wavelength range.

Gut Microbiota Serves a Predictable Outcome of Short-Term Low-Carbohydrate Diet (LCD) Intervention for Patients with Obesity.

To date, much progress has been made in dietary therapy for obese patients. A low-carbohydrate diet (LCD) has reached a revival in its clinical use during the past decade with undefined mechanisms and debatable efficacy. The gut microbiota has been suggested to promote energy harvesting. Here, we propose that the gut microbiota contributes to the inconsistent outcome under an LCD. To test this hypothesis, patients with obesity or patients who were overweight were randomly assigned to a normal diet (ND) or an LCD group with ad libitum energy intake for 12 weeks. Using matched sampling, the microbiome profile at baseline and end stage was examined. The relative abundance of butyrate-producing bacteria, including Porphyromonadaceae Parabacteroides and Ruminococcaceae Oscillospira, was markedly increased after LCD intervention for 12 weeks. Moreover, within the LCD group, participants with a higher relative abundance of Bacteroidaceae Bacteroides at baseline exhibited a better response to LCD intervention and achieved greater weight loss outcomes. Nevertheless, the adoption of an artificial neural network (ANN)-based prediction model greatly surpasses a general linear model in predicting weight loss outcomes after LCD intervention. Therefore, the gut microbiota served as a positive outcome predictor and has the potential to predict weight loss outcomes after short-term LCD intervention. Gut microbiota may help to guide the clinical application of short-term LCD intervention to develop effective weight loss strategies. (This study has been registered at the China Clinical Trial Registry under approval no. ChiCTR1800015156). IMPORTANCE Obesity and its related complications pose a serious threat to human health. Short-term low-carbohydrate diet (LCD) intervention without calorie restriction has a significant weight loss effect for overweight/obese people. Furthermore, the relative abundance of Bacteroidaceae Bacteroides is a positive outcome predictor of individual weight loss after short-term LCD intervention. Moreover, leveraging on these distinct gut microbial structures at baseline, we have established a prediction model based on the artificial neural network (ANN) algorithm that could be used to estimate weight loss potential before each clinical trial (with Chinese patent number 2021104655623). This will help to guide the clinical application of short-term LCD intervention to improve weight loss strategies.

Non-Insulin Antidiabetes Treatment in Type 1 Diabetes Mellitus: A Systematic Review and Meta-Analysis

In order to evaluate the efficacy and side effects of the non-insulin antidiabetes medications as an adjunct treatment in type 1 diabetes mellitus (T1DM), we conducted systematic searches in MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials for randomized controlled trials published between the date of inception and March 2020 to produce a systematic review and meta-analysis. Overall, 57 studies were included. Compared with placebo, antidiabetes agents in adjunct to insulin treatment resulted in significant reduction in glycosylated hemoglobin (weighted mean difference [WMD], –0.30%; 95% confidence interval [CI], –0.34 to –0.25%; P<0.01) and body weight (WMD, –2.15 kg; 95% CI, –2.77 to –1.53 kg; P<0.01), and required a significantly lower dosage of insulin (WMD, –5.17 unit/day; 95% CI, –6.77 to –3.57 unit/day; P<0.01). Compared with placebo, antidiabetes agents in adjunct to insulin treatment increased the risk of hypoglycemia (relative risk [RR], 1.04; 95% CI, 1.01 to 1.08; P=0.02) and gastrointestinal side effects (RR, 1.99; 95% CI, 1.61 to 2.46; P<0.01) in patients with T1DM. Compared with placebo, the use of non-insulin antidiabetes agents in addition to insulin could lead to glycemic improvement, weight control and lower insulin dosage, while they might be associated with increased risks of hypoglycemia and gastrointestinal side effects in patients with T1DM.

Epidemiological characteristics of traumatic spinal cord injury in China in 2018 / 中华创伤杂志

Objective:To analyze the incidence and epidemiological characteristics of traumatic spinal cord injury in China in 2018.Methods:Multi-stage stratified cluster sampling was used to randomly select hospitals capable of treating patients with spinal cord injury from 3 regions，9 provinces and 27 cities in China to retrospectively investigate eligible patients with traumatic spinal cord injury admitted in 2018. National and regional incidence rates were calculated. The data of cause of injury，injury level，severity of injury，segment and type of fracture，complications，death and other data were collected by medical record questionnaire，and analyzed according to geographical region，age and gender.Results:Medical records of 4，134 patients were included in this study，with a male-to-female ratio of 2.99∶1. The incidence of traumatic spinal cord injury in China in 2018 was 50.484 / 1 million （95% CI 50.122-50.846）. The highest incidence in the Eastern region was 53.791 / 1 million （95% CI 53.217-54.365）. In the whole country，the main causes of injury were high falls （29.58%），as well as in the Western region （40.68%），while the main causes of injury in the Eastern and Central regions were traffic injuries （31.22%，30.10%）. The main injury level was cervical spinal cord in the whole country （64.49%），and the proportion of cervical spinal cord injury in the Central region was the highest （74.68%），and the proportion of lumbosacral spinal cord injury in the Western region was the highest （32.30%）. The highest proportion of degree of injury was incomplete quadriplegia （55.20%），and the distribution pattern was the same in each region. A total of 65.87% of the patients were complicated with fracture or dislocation，77.95% in the Western region and only 54.77% in the Central region. In the whole country，the head was the main combined injury （37.87%），as well as in the Eastern and Central regions，while the proportion of chest combined injury in the Western region was the highest （38.57%）. A total of 32.90% of the patients were complicated with respiratory complications. There were 23 patients （0.56%） died in hospital，of which 17（73.91%） died of respiratory dysfunction. Conclusions:The Eastern region of China has a high incidence of traumatic spinal cord injury. Other epidemiological features include high fall as the main cause of injury cervical spinal cord injury as the main injury level，incomplete quadriplegia as the main degree of injury，head as the main combined injury，and respiratory complications as the main complication.

Non-Insulin Antidiabetes Treatment in Type 1 Diabetes Mellitus: A Systematic Review and Meta-Analysis

In order to evaluate the efficacy and side effects of the non-insulin antidiabetes medications as an adjunct treatment in type 1 diabetes mellitus (T1DM), we conducted systematic searches in MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials for randomized controlled trials published between the date of inception and March 2020 to produce a systematic review and meta-analysis. Overall, 57 studies were included. Compared with placebo, antidiabetes agents in adjunct to insulin treatment resulted in significant reduction in glycosylated hemoglobin (weighted mean difference [WMD], –0.30%; 95% confidence interval [CI], –0.34 to –0.25%; P<0.01) and body weight (WMD, –2.15 kg; 95% CI, –2.77 to –1.53 kg; P<0.01), and required a significantly lower dosage of insulin (WMD, –5.17 unit/day; 95% CI, –6.77 to –3.57 unit/day; P<0.01). Compared with placebo, antidiabetes agents in adjunct to insulin treatment increased the risk of hypoglycemia (relative risk [RR], 1.04; 95% CI, 1.01 to 1.08; P=0.02) and gastrointestinal side effects (RR, 1.99; 95% CI, 1.61 to 2.46; P<0.01) in patients with T1DM. Compared with placebo, the use of non-insulin antidiabetes agents in addition to insulin could lead to glycemic improvement, weight control and lower insulin dosage, while they might be associated with increased risks of hypoglycemia and gastrointestinal side effects in patients with T1DM.

Synthesized OH-radical rich bacteria cellulosic pockets with photodynamic bacteria inactivation properties against S. ureus and E. coli.

Inulin as an external carbon source was used as the fructose substitute to Gluconacetobacter xylinus (ATCC 10245) bacterial strain in a successful synthesis of cellulosic pockets to be used in drug delivery and storage. It was observed that inulobiose trans conformation was in agreement with ϕ = Ψ = ω = 180° and angular rotation of Ï´ (C1-C2-0-CI''), Ï´ (C2-0-C 1'-C2') and Ï´ (0-C1'-C2'-0') respectively. A bacterial susceptibility test revealed a successful inactivation of Staphylococcus aureus and Escherichia coli in the presence of photons. Fourier Transform Infrared Spectroscopy analysis confirmed an OH absorption was verified at 3423 cm-1. Pocket drug uptake test revealed a highly absorbent structure with the thermal stability directly proportional to the increase in drug uptake, while the increase in the degree of polymerization resulted in the increase in antioxidant activity and rate of bacterial inactivation. HYPOTHESIS: Inulin as an inert polysaccharide is neutral to cellular activity, therefore, could not be an agent for bacteria inactivation.

Circulating LncRNAs Analysis in Patients with Type 2 Diabetes Reveals Novel Genes Influencing Glucose Metabolism and Islet ß-Cell Function.

BACKGROUND/AIMS: The islet is an important endocrine organ to secrete insulin to regulate the metabolism of glucose and maintain the stability of blood glucose. Long noncoding RNAs (lncRNAs) are involved in a variety of biological functions and play key roles in many diseases, including type 2 diabetes (T2D). The aim of this study was to determine whether lncRNA-p3134 is associated with glucose metabolism and insulin signaling in pancreatic ß cells. METHODS: LncRNA microarray technology was used to identify the differentially expressed circulating lncRNAs in T2D patients. RT-PCR analyses were performed to determine the expression of lncRNA-p3134 in 30 pairs of diabetic and non-diabetic patients. The correlation of lncRNA-p3134 to clinical data from T2D patients was analyzed. LncRNA-p3134 was overexpressed in Min6 cells and db/db mice by adenovirus-mediated technology. CCK-8, TUNEL, Western blot, glucose-stimulated insulin secretion (GSIS), ELISAs and immunochemistry were performed to determine the effect of lncRNA-p3134 on proliferation, apoptosis and insulin secretion both in vitro and vivo. RESULTS: The circulating level of lncRNA-p3134 was higher in diabetic patients than in non-diabetic controls and was correlated with fasting blood glucose and HOMA-ß levels. The lncRNA-p3134 had risen by 4 times in serum exosomes but nearly unchanged in exosome-free samples. The secretion of lncRNA-p3134 was dynamically modulated by glucose in both Min6 cells and isolated mouse islet cells. LncRNA-p3134 positively regulate GSIS through promoting of key regulators (Pdx-1, MafA, GLUT2 and Tcf7l2) in ß cells. In addition, the overexpression of lncRNA-p3134 resulted in a decreased apoptosis ratio and partially reversed the glucotoxicity effects on GSIS function in Min6 cells. The restoration of insulin synthesis and secretion the increase of the insulin positive cells areas by upregulation of lncRNA-p3134 in db/db mice confirmed the compensatory role of lncRNA-p3134 to preserve ß-cell function. Furthermore, a protective effect of lncRNA-p3134 on GSIS by positive modulation of PI3K/Akt/mTOR signaling was also confirmed. After blocking the PI3K/AKT signals with their specific inhibitor, the effect of overexpressed lncRNA-p3134 on insulin secretion was obviously attenuated. CONCLUSION: Taken together, the results of this study provide new insights into lncRNA-p3134 regulation in pancreatic ß cells and provide a better understanding of novel mechanism of glucose homeostasis.

Comparison of Placebo Effect between Asian and Caucasian Type 2 Diabetic Patients: A Meta-Analysis / 中华医学杂志(英文版)

<p><b>Background</b>Placebo was defined as any therapy that is used for its nonspecific psychological and physiologic effect but has no specific pharmacologic impact on the condition being treated. Besides medication therapies, studies have found that the optimal dietary approach as well as physical activity and education are useful to control hyperglycemia in patients with type 2 diabetes (T2DM). The aim of this study was to evaluate the placebo effects of antidiabetic therapies in Asian and Caucasian T2DM patients and make a comparison between the two ethnicities.</p><p><b>Methods</b>A search using the MEDLINE database, EMBASE, and Cochrane Database was performed, from when recording began until December 2016. The main concepts searched in English were sulfonylurea (SU); alpha glucosidase inhibitors (AGI); metformin (MET); thiazolidinediones (TZD); dipeptidyl peptidase-4 inhibitors (DPP-4i); sodium-glucose cotransporter 2 inhibitors (SGLT2i); glucagon-like peptide-1 receptor agonist (GLP-1RA); type 2 diabetes (T2DM); placebo controlled; and randomized controlled trials. Using the Cochrane instrument, we evaluated the adequacy of randomization, allocation concealment procedures, and blinding.</p><p><b>Results</b>This study included 63 studies with a total of 7096 Asian patients involved and 262 studies with a total of 27,477 Caucasian patients involved. In Caucasian population, the use of placebo led to significant reductions of glycosylated hemoglobin (HbA1c), -0.683% (P = 0.008) in SU monotherapy treatment, -0.193% (P = 0.001) in DPP-4i treatment, and -0.230% (P < 0.001) in SGLT2i treatment, respectively. In Asian population, the use of placebo resulted in significant decreases of HbA1c, -0.162% (P = 0.012) in DPP-4i treatment and -0.269% (P = 0.028) in GLP-1RA add-on therapy, respectively. The placebo also significantly reduced body weight. In Caucasian population, placebo use resulted in 0.833 kg (P = 0.006) weight loss by SU treatment and 0.953 kg (P = 0.006) weight loss by GLP-1RA treatment. In Asian population, the placebo led to a weight change of 0.612 kg (P < 0.001) by GLP-1RA analog treatment. The changes of HbA1c and weight due to the placebo effect in other treatments were not significant in both Asian and Caucasian population. Comparisons of the placebo effect on HbA1c change and weight change in each treatment group indicated that no significant difference was found between Asian and Caucasian population.</p><p><b>Conclusions</b>The overall differences of the placebo effect on HbA1c changes as well as on body weight changes were not significant between Asian and Caucasian T2DM patients. The placebo effect on HbA1c changes and weight changes was not associated with baseline age, gender, baseline body mass index, baseline HbA1c, duration of diabetes, or study duration.</p>

Intravoxel incoherent motion diffusion-weighted imaging for discriminating the pathological response to neoadjuvant chemoradiotherapy in locally advanced rectal cancer.

To investigate the usefulness of intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) in discriminating the pathological complete response (pCR) to neoadjuvant chemoradiotherapy (nCRT) in locally advanced rectal cancer (LARC), 42 patients underwent preoperative IVIM-DWI before (pre-nCRT) and after nCRT (post-nCRT). The values of pre-nCRT and post-nCRT IVIM-DWI parameters (ADC, D, D* and f), together with the percentage changes (∆% parametric value) induced by nCRT, were compared between the pCR (tumour regression grade [TRG] 4) and non-pCR (TRG 0, 1, 2 or 3) groups and between the GR (TRG 3 or 4) and PR (TRG 0, 1 or 2) groups based on the Dworak TRG system. After nCRT, the ADC and D values for LARC increased significantly (all P < 0.05). The TRG score revealed a positive correlation with pref (r = 0.357, P = 0.020), postD (r = 0.551, P < 0.001) and Δ%D (r = 0.605, P < 0.001). The pCR group (n = 10) had higher preD*, pref, postD, ∆%ADC and ∆%D values than the non-pCR group (n = 32) (all P < 0.05). The GR group (n = 15) exhibited higher postD, ∆%ADC and ∆%D values than the PR group (n = 27) (all P < 0.05). Based on ROC analysis, ∆%D had a higher area under the curve value than ∆%ADC (P = 0.009) in discriminating the pCR from non-pCR groups. In conclusion, IVIM-DWI may be helpful in identifying the pCR to nCRT for LARC and is more accurate than traditional DWI.

Relationship between abnormal activation of HGF/c-Met signaling pathway and EGFR-TKI acquired resistance in non-small cell lung cancer / 国际肿瘤学杂志

Targeted therapy such as the epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI)has made huge progress in treatment of non-small cell lung cancer (NSCLC).However,the emergence of acquired drug resistance is an inevitable result of the targeted therapy.The hepatocyte growth fac-tor/c-mesenchymal-epithelial transition factor (HGF /c-Met)signaling pathway participates in cell formation, migration,angiogenesis and other important cellular processes of multiple tumors.The abnormal activation of this signaling pathway plays the pivotal role in the acquired resistance to EGFR-TKI.Recently,some clinic tri-als prove that HGF /c-Met inhibitors can make clinical benefit of some NSCLC patients with acquired drug re-sistance of EGFR-TKI.

Unique roles played by Acid-sensing ion channel 2.

The discovery of Acid-sensing ion channels (ASICs) provided us the theoretical basis to understand the pathological acidic environment. They belong to the degenerin/epithelial Na+ channel family and function once extracellular pH decreases to a certain level, and this characteristic make them spotlights in the regulation or response of pH change. As a regulatory system, keeping the intra- and extra-balance seems to be significant for ASICs, in which ASIC2 plays an important role. We surprisingly noticed that ASIC2 owns some distinctive properties, including its inter-system regulation, specific distribution and transporting patterns, influence on cell migration and the unique role in mechanosensitivity. Therefore, to conclude the functions and characterisitics of ASIC2 indeed assist the understanding of interaction among ASICs subunits and the regulation from extracellular environment to ASICs.

Association between the level of circulating adiponectin and prediabetes: A meta-analysis.

AIMS/INTRODUCTION: Adiponectin has been proposed to have an essential role in the regulation of insulin sensitivity and metabolism, but previous studies on levels of adiponectin in prediabetes remain inconsistent. The present study aimed to assess the differences of adiponectin levels between prediabetes patients and healthy controls by carrying out a meta-analysis. MATERIALS AND METHODS: We carried out a systematic literature search of PubMed, EMBASE, and other databases for case-control studies and cohort studies measuring adiponectin levels in serum or plasma from prediabetes patients and healthy controls. The pooled weighted mean difference (WMD) and 95% confidence interval (CI) were used to estimate the association between adiponectin levels and prediabetes. RESULTS: Three cohort studies and 15 case-control studies with a total of 41,841 participants were included in the meta-analysis. The results showed that circulating adiponectin levels in prediabetes patients were significantly lower than that of healthy controls (WMD -1.694 µg/mL; 95% CI -2.151, -1.237; P < 0.001). Subgroup analysis showed more significant differences between prediabetes patients and healthy controls when the ratio of the homeostatic model assessment of insulin resistance was >2.12 (WMD -2.95 µg/mL; 95% CI -4.103, -1.806; P < 0.001) and average age was >60 years (WMD -2.20 µg/mL; 95% CI -3.207, -1.201; P < 0.001). Additionally, WMD in adiponectin showed a trend of direct correlation in subgroups of homeostatic model assessment of insulin resistance ratio, body mass index and age. CONCLUSIONS: The present meta-analysis supports adiponectin levels in prediabetes patients being lower than that of healthy controls,indicating that the level of circulating adiponectin decreases before the onset of diabetes.

Nucleus pulposus cells derived IGF-1 and MCP-1 enhance osteoclastogenesis and vertebrae disruption in lumbar disc herniation.

STUDY DESIGN: Chronic strained lumbar disc herniation (LDH) cases were classified into bulging LDH, herniated LDH and prolapse LDH types according to imaging examination, and vertebrae disruptions were evaluated. Cytokines derived from the nucleus pulposus cells were detected, and their effects on osteoclastogenesis, as well as the mechanisms involved, were studied via an in vitro osteoclast differentiation system. OBJECTIVE: To clarify the mechanisms of lumbar vertebrae resorption induced by lumbar herniation. SUMMARY AND BACKGROUND DATA: Chronic strained lumbar disc herniation induced vertebrae erosion exacerbates quality of patients' life and clinical outcome. Although nucleus pulposus cells derived cytokines were reported to play an important role in this pathogenesis, the fundamental mechanisms underlying this process are still unclear. METHODS: Chronic strained lumbar disc herniation patients were diagnosed with CT scan and T2-weighted magnetic resonance imaging. RNA was extracted from 192 surgical specimens of the herniated lumbar disc and 29 surgical excisions of the lumbar disc from spinal injury patients. The expressions of osteoclastogenesis related cytokines and chemokines were examined using real time PCR. Monocytes were induced into osteoclast with M-CSF and RANKL in vitro, while the IGF-1 and MCP-1 were added into the differentiation procedure in order to evaluate the effects and explore the molecular mechanisms. RESULTS: Vertebrae erosion had a positive relationship with lumbar disc herniation severity types. In all of the osteoclastogenesis related cytokines, the IGF-1 and MCP-1 were the most highly expressed in the nucleus pulposus cells. IGF-1 enhances activation of NF-kB signaling directly, but MCP-1 upregulated the expression of RANK, so that enhanced cellular sensitivity to RANKL resulted in increasing osteoclastogenesis and activity. CONCLUSION: Lumbar herniation induced overexpression of IGF-1 and MCP-1 in nucleus pulposus cells aggravated vertebral erosions. Hence, this study suggests that targeting osteoclastogenesis related cytokines has potential clinical significance in the treatment of lumbar disc herniation patients.

The TCM syndrome classification of different immune status of chronic HBV infection and T,B and NK cells subgroup correlation studies / 重庆医学

Objective To investigate the different immune status of TCM classification and the levels of T and B cells and the re-lationship between the NK cells .Methods Three different immune state of patients with chronic HBV were divided into asthenia syndrome(AS) group and sthenia syndrome(SS) group ,and then we detected the peripheral blood lymphocyte subsets and NK cells ,and compared the above each index analysis .Results In three different immune status ,all patients with AS and SS groups CD4+ T cell percentages are lower than normal control group (P control group> the AS group (P<0 .05) .Three different immune status ,the ratio of CD4+ /CD8+ SS group were significantly lower than the AS group or control group ,in a state of immune clearance the SS and the AS group B lymphocyte percentage were higher than the control group ,the percentage of NK cells was lower than the control group (P<0 .05) .Conclusion Chronic HBV infection have immune dysfunction ;HBV infected different immune status of TCM classification have relationship with T and B cell subsets and NK cells ,and the immune function test has certain clinical application value for the judgment of TCM syndrome type .

Study on the injury mechanism of Ang-Ⅱ to mice podocyte in the high glucose environment / 中国医师杂志

Objective To cultivate mice glomerular podocyte with high glucose and high Ang-Ⅱ,observe the morphocytology of podocyte,and investigate protein kinase C (PKC) activity,the expressions of nephrin and CD2-associated protein (CD2AP),and apoptosis of podocyte with injuries cultivations.Methods The conditions immortalization mice podocyte cell lines was cultivated,after passage and differential induce,the cell lines was divided into six groups:normal group,high glucose group,high Ang-Ⅱ] group,the above two mixed group,intervened group of PKC inhibitor,and hypertonic group.After 72 hours,cell apoptosis rate was detected with flow cytometer; PKC activity was detected with enzyme linked immunosorbent assay (ELISA) in 24 hours and 48 hours ; The expressions of nephrin and CD2AP mRNA were detected by real time-polymerase chain reaction (RT-PCR).Results (1)After 24 hours,the PKC of high glucose group and high Ang-Ⅱ group were more activated than normal group [(47.09 ± 1.19) pmol/L,(42.93 ±0.71) pmol/L,P ＜0.05].The activated phenomenon was more obvious in the mixed group.Compared to 24 hours [(58.75 ±0.71) pmol/ L,P ＜ 0.01],PKC was more activated in 48 hours (P ＜ 0.05).(2) Nephrin mRNA was reduced in podocyte exposed to high glucose and high Ang-Ⅱ at least 24 hours (56.87 ± 0.74,48.54 ± 0.86,P ＜ 0.05),and was reduced more in mixed group (11.7 ± 1.54,P ＜ 0.01).(3) CD2AP mRNA was reduced in podocyte exposed to high glucose,high Ang-Ⅱ,and mixed environment at least 48 hours (56.09 ± 1.46,67.68 ±2.58,and 54.08 ±2.74,P ＜0.05).The decrease trend of nephrin and CD2AP mRNA was restrained by PKC inhibitor(90.75 ± 1.33,P ＜0.05).(4) After 48 hours and 72 hours,the apoptosis rates of high glucose group,high Ang-Ⅱ group,and mixed group were risen compared to normal group (P ＜ 0.05).The increase of apoptosis rate can be restrained by PKC inhibitor.Conclusions High glucose,and high Ang-Ⅱ can activate the podocytes PKC activity,inhibit the expression of nephrin and CD2AP mRNAs,and induce podocyte apoptosis.PKC signaling pathway plays an important role in the injury mechanism of Ang-Ⅱ and high glucose to mice podocyte.

Research on peripheral T, B cell subsets and NK cells under different immune status and hepatitis B cirrhosis with chronic HBV infection / 实用医学杂志

Objective To explore the percentage changes of peripheral T , B cell subsets and NK cells in chronic HBV infectors under different immune states and hepatitis B cirrhosis . Methods Seventy-five chronic HBV infectors, including 20 cases with immune clearance, 20 cases with immunodeficiency (inactive) and 35 cases with cirrhosis, and 20 healthy control were enrolled. The percentages of peripheral T and B lymphocyte subsets and NK cells were detected by Flow Cytometry. The differences of the groups were analyzed. Results Comparing with the control group, CD4+T cells were decreased in the other four groups (P<0.05). The sequence of CD4+T cells, from high to low, was the control group, the immunodeficiency group, the immune clearance group, the compensated cirrhosis group and the de-compensated cirrhosis group. CD4+/CD8+T cell and NK cell were lower , but CD8+T cell and B cell were higher in immune clearance group than that of the control group (P < 0.05). Patients in immunodeficiency group had lower ratio of CD4+/CD8+T cell and higher CD8+T cell than those in the control group (P < 0.05). In all the groups, patients with de-compensated cirrhosis showed highest ratio of CD4+ to CD8+ T cells and B cells, but lowest CD3+T, CD8+ T and NK cells (P < 0.05). Conclusions Results suggests immune dysfunction exists in patients with chronic HBV infection. It has potential clinical value in understanding patients′ immune states and progression of disease by detecting peripheral blood lymphocyte subsets and NK cells.

Effects of self-blood on the molding process of polymethyl methacrylate bone cement / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To evaluate whether the self-blood has influence on the molding process of polymethyl methacrylate (PMMA) bone cement, and to make sure whether it is valuable for the clinical practice.</p><p><b>METHODS</b>An in vitro study was performed to evaluate the prolonging-effect of self-blood on PMMA bone cement. The effect of prolonging was evaluated by the dough time (TD) and operable time (TO). Moreover, hardness test, squeezing value test and peak temperature test were also conducted to complete the evaluation of this program.</p><p><b>RESULTS</b>The self-blood, especially the plasma, could greatly prolong the handling time of PMMA bone cement without affecting its basic characteristics including hardness, leakage level and peak temperature. On the other hand, we found that in some abnormal conditions, for example with hyperlipemia, self-blood though can also prolong the handling time, would cause some side-effects.</p><p><b>CONCLUSION</b>We report a new effective way to prolong the handling time of PMMA bone cement by adding moderate amount of self-blood. But "individualized medicine" should be noticed because some abnormal conditions like hyperlipemia would cause undesired side-effects.</p>

Meta-analysis of clinical effects of transforaminal lumbar interbody fusion versus posterior lumbar interbody fusion on lumbar spondylolisthesis and lumbar instability in Chinese population / 中华老年医学杂志

Objective To evaluate the clinical effects of transforaminal lumbar interbody fusion (TLIF) versus posterior lumbar interbody fusion (PLIF) on lumbar spondylolisthesis and lumbar instability in Chinese patients.Methods Literatures about clinical effects of TLIF and PLIT on lumbar spondylolisthesis and lumbar instability were collected from Chinese academic literature database (CNKI),Chinese biomedical literature database (CMBdisc),Wanfang database and Chinese journals of orthopedics.Data from those literatures including operation time,bleeding volume,surgical complications,postoperative interspace height,visual analog scale (VAS) score,Oswestry Disability Index (ODI) and improvement rate of Japanese Orthopedic Association (JOA) score were analyzed by Stata SE 11.2 software.Results A total of 12 literatures met the inclusion criteria and 1041 cases were included (PLIF group,n=520; PLIF group,n=521).The operation time was longer in PLIF group than in TLIF group [standardized mean difference (SMD)=1.26,95％CI:0.58-1.94,P＜0.001].The bleeding volume was more in PLIF group than in TLIF group SMD=1.70,95％CI:0.94 2.46,P＜0.001).The surgical complications were more in PLIF group than in TLIF group (SMD=4.50,95％CI:2.65-7.64,P＜0.001).There were no statistical differences in postoperative interspace height,VAS score,ODI score,improvement rate of JOA score and fusion rate between the two groups [SMD=-0.07,-0.07,0.15,1.43,95％CI:-0.44-0.30,-0.27-0.13,-0.06-0.35,0.75-2.73,0.63-2.15,respectively,all P＞0.05].Conclusions TLIF has significant advantages on decreasing operation time,bleeding volume and risk of surgical complications as compared with PLIF.TLIF and PLIF have the same clinical efficacy on restoring and maintaining postoperative interspace height.