High-glucose inhibits human fibroblast cell migration in wound healing via repression of bFGF-regulating JNK phosphorylation.

One of the major symptoms of diabetes mellitus (DM) is delayed wound healing, which affects large populations of patients worldwide. However, the underlying mechanism behind this illness remains elusive. Skin wound healing requires a series of coordinated processes, including fibroblast cell proliferation and migration. Here, we simulate DM by application of high glucose (HG) in human foreskin primary fibroblast cells to analyze the molecular mechanism of DM effects on wound healing. The results indicate that HG, at a concentration of 30 mM, delay cell migration, but not cell proliferation. bFGF is known to promote cell migration that partially rescues HG effects on cell migration. Molecular and cell biology studies demonstrated that HG enhanced ROS production and repressed JNK phosphorylation, but did not affect Rac1 activity. JNK and Rac1 activation were known to be important for bFGF regulated cell migration. To further confirm DM effects on skin repair, a type 1 diabetic rat model was established, and we observed the efficacy of bFGF on both normal and diabetic rat skin repair. Furthermore, proteomic studies identified an increase of Annexin A2 protein nitration in HG-stressed fibroblasts and the nitration was protected by activation of bFGF signaling. Treatment with FGFR1 and JNK inhibitors delayed cell migration and increased Annexin A2 nitration levels, indicating that Annexin A2 nitration is modulated by bFGF signaling via activation of JNK. Together with these results, our data suggests that the HG-mediated delay of cell migration is linked to the inhibition of bFGF signaling, specifically through JNK suppression.

[Cerebral microbleeds detected on T2-weighted gradient echo magnetic resonance and its clinical significance].

OBJECTIVE: To explore the diagnostic value of T2-weighted gradient-echo magnetic resonance imaging (MRI) in cerebral microbleeds (CMBs) and its clinical significance. METHODS: The distribution of CMBs and follow-up observations were performed by routine T1WI, T2WI and T2-weighted gradient echo sequence in 634 patients clinically suspected for stroke. RESULTS: In 149 patients, a total of 1140 CMBs occurred predominantly in cortex-subcortical area (n = 471, 41.31%), basal ganglia (n = 289, 25.35%), thalamus (n = 199, 17.45%), brain stem (n = 90, 7.89%) and cerebellum (n = 91, 7.98%). Among them, 137 patients had various degrees of ischemic brain changes, displayed iso-intensity or hypo-intensity on T1WI, hyper-intensity on T2WI and FLAIR in basal ganglia, white matter around sided ventricle and brain stem. There were 23 patients with cerebral infarction and 5 with CMBs after hemorrhagic brain stroke. And 12 of them had new hemorrhagic stroke in 2-6 months. CONCLUSION: T2-weighted gradient echo MRI has obvious advantages in the detection of CMBs. The presence of CMBs suggests a risk of cerebral hemorrhage.

Difference in blood pressure between supine and sitting positions in diabetic and non-diabetic subjects.

BACKGROUND: This study was designed to investigate whether there was any difference in blood pressure (BP) readings between sitting and supine positions in diabetic and non-diabetic subjects. MATERIAL/METHODS: BP in sitting and supine position was measured in 356 patients with type 2 diabetes (study group) and in 356 age- and sex-matched non-diabetic subjects (control group). RESULTS: The systolic and diastolic BP in the supine position was significantly higher than in the sitting position in both groups (P<0.001). The BP increment in the supine position was similar in the study and control groups (P>0.05). Multivariate logistic regression analysis of the study group showed that age was an independent predictor for the systolic pressure increment (P=0.001), whereas body mass index was an independent predictor for the increment in diastolic BP (P=0.04). The levels of sitting BP were inversely correlated with the pressure increments in the supine position in the diabetic patients (P<0.001). CONCLUSIONS: In diabetic and non-diabetic subjects, BP in a supine position is higher than in the sitting position. In diabetic patients, age, body mass index and the levels of sitting BP seem to have significant impact on the pressure increment from a sitting to the supine position.

Differences in blood pressure readings between supine and sitting positions in hypertensive patients.

OBJECTIVE: The objective of this study was to investigate the impact of postures on blood pressure (BP) readings in patients with hypertension. METHODS AND RESULTS: BP was measured in 1,487 hypertensive patients in sitting and supine positions. The systolic (SBP) and diastolic (DBP) BP in supine position was 2.9 +/- 7.8mmHg and 0.9 +/- 5.4 mmHg higher, respectively, than in the sitting position (P <0.001). The greatest difference between supine and sitting SBP was found in those aged between 30 and 39 years (3.6 +/- 6.8 mmHg), and in those who were older than 80 years (5.3 +/- 7.9 mmHg).A greater difference between the supine and sitting DBP was identified in the groups > 60-years of age. Multivariate regression analysis showed that age and sex were independent predictors for the increment of BP in the supine position. CONCLUSION: There is a significant difference between supine and sitting SBP and DBP, with age and sex being the most important predicting factors.

Relationship between pericardial fluid B-type natriuretic peptide and ventricular structure and function.

BACKGROUND: We undertook this study to investigate the levels of pericardial B-type natriuretic peptide (BNP) and its relationship with ventricular structure and function. METHODS: Pericardial and plasma BNP concentrations were measured in 18 patients with congenital ventricular septal defect. RESULTS: The mean level of BNP in the pericardial fluid (324.8+/-137.3 pg/mL) was higher than the plasma (20.8+/-6.1 pg/mL) (p=0.03). Pericardial BNP was correlated with the plasma BNP (r=0.85, p<0.01). A good correlation was also found between the pericardial BNP and left atrial diameter, left ventricular end-diastolic and end-systolic diameter, left ventricular ejection fraction, right ventricular diameter and pulmonary artery systolic pressure (p<0.05). CONCLUSIONS: The levels of BNP in pericardial fluid were higher than in the plasma. Similar to plasma BNP, pericardial BNP is also related to the ventricular structure and function.

Changes in plasma B-type natriuretic peptide after allograft renal transplantation.

OBJECTIVE: To investigate the dynamic changes in plasma B-type natriuretic peptide (BNP) after allograft renal transplantation. METHODS: Plasma BNP was measured in 17 patients before and after unilateral allograft renal transplantation (study group) and in 17 age- and sex-matched healthy individuals (control group). RESULTS: Average BNP level in the study group was significantly higher than in the control group before renal transplantation (P < 0.001). After transplantation, blood pressure was reduced and left ventricular ejection fraction was increased (P < 0.01). There was also a substantial reduction in plasma BNP and blood creatinine following the surgery (P < 0.001). Graft dysfunction accompanied by significant rebound in plasma BNP levels was detected in four patients within 2 weeks of the surgery. CONCLUSION: Plasma BNP levels are elevated in patients with chronic renal failure. Allograft renal transplantation significantly reduces BNP. Sudden increases in plasma BNP after the transplantation are associated with allograft dysfunction. Together with other biomarkers, plasma BNP may be used to predict the changes in renal function after transplantation.

Anxiety symptoms in patients with hypertension: a community-based study.

OBJECTIVES: To investigate incidence and severity of anxiety symptoms in patients with hypertension. METHODS: A cross-sectional survey in 891 (432 females) hypertensive patients was conducted in a regional community. All patients were interviewed and detailed physical examination was performed. Zung self-rating anxiety scale (SAS) was used to evaluate the severity of anxiety symptoms. RESULTS: Anxiety was diagnosed on clinical grounds in 103 patients (11.6%) who also had a raw SAS score of more than 40. In all subjects surveyed, the average SAS score in females was higher than males (32.9+/- 7.1 vs 31.2+/-6.4, p < 0.001). The average SAS score was also higher in patients with hypertension of more than 3 years (32.4+/-7.0 vs 31.2+/-6.1, p = 0.01), in patients with severe hypertension (39.8+/-6.9 vs 29.6 4+/-4.5, p < 0.001), and in patients with a history of hospitalization for cardiovascular disorders (35.7+/-7.7 vs 31.7+/-6.6, p < 0.001). Multivariate regression analysis showed that female gender, duration of hypertension, and hospitalization history were independent predictors of anxiety symptoms (p < 0.05). CONCLUSIONS: Almost 12% of hypertensive patients have anxiety symptoms. Female gender, the duration of hypertension, and the history of hospitalization are associated with the occurrence and severity of anxiety symptoms in patients with hypertension.