Helicoselective Synthesis of Indolohelicenoids through Organocatalytic Central-to-Helical Chirality Conversion.

We report the helicoselective and convergent construction of indolohelicenoids with excellent efficiency and stereocontrol. This reaction proceeds through a chiral-phosphoric-acid-catalyzed enantioselective cycloaddition and eliminative aromatization sequence, which can be finely controlled by adjusting the reaction temperature. Mechanistic studies reveal that the chiral phosphoric acid cooperatively serves as both a bifunctional and Brønsted acid catalyst, enabling one-pot central-to-helical chirality conversion. Additionally, the optical properties of the synthesized indolohelicenoids were characterized to explore their potential applications in organic photoelectric materials.

Comparison of the therapeutic effects of 15 mg and 30 mg initial daily prednisolone doses in patients with subacute thyroiditis: a multicenter, randomized, open-label, parallel-controlled trial.

INTRODUCTION: Current guidelines recommendations for the initial dose of prednisolone (PSL) in the treatment of subacute thyroiditis (SAT) are based on low-quality studies. We designed a randomized controlled trial (RCT) to compare the efficacy and safety of using a low initial dose of PSL with a standard initial dose of PSL in SAT patients. PATIENTS AND METHODS: This open-label RCT was conducted at five hospitals in China from June 2019 to January 2022. SAT patients with moderate-to-severe pain or a poor response to non-steroidal anti-inflammatory drugs (NSAIDs) were randomly assigned in a 1:1 ratio to the experimental and control groups. The initial dose of PSL was 15 mg/d in the experimental group and 30 mg/d in the control group. The primary outcome was the total duration of PSL treatment, with non-inferiority prespecified with a margin of 7 days. Clinical trial registration number: ChiCTR1900023884. RESULTS: The full analysis set included 60 patients (30 in each group). The mean duration of PSL treatment in the experimental and control group was 34.62 ± 14.12 and 41.18 ± 16.89 days, respectively, meeting the non-inferiority criterion (pnon-inferiority = 0.0006). The total dose of PSL used in the experimental group was lower than in the control groups (330 vs 595 mg, p < 0.0001). There were no differences in the mean time to pain relief and complete resolution, the occurrence of recurrence, hypothyroidism, or adverse events between the groups. CONCLUSIONS: The initial dose of 15 mg/d of PSL was not inferior to the dose of 30 mg/d in terms of efficacy and showed a similar safety profile. A low initial dose of PSL could be recommended for Chinese adult SAT patients who have a suboptimal response using NSAIDs or experience moderate-to-severe pain.KEY MESSAGESLow initial dose (15 mg/d) of prednisolone was non-inferior to the standard initial dose of prednisolone (30 mg/d) in treatment duration, time to pain relief, or the prevalence of hypothyroidism, recurrence, and adverse reactions in the treatment of subacute thyroiditis.Patients with subacute thyroiditis administered a low initial dose of prednisolone had a lower total dose of prednisolone compared to those receiving the standard dose of prednisolone.

Daily higher tea consumption is associated with a reduced risk of type 2 diabetes: A cohort study and updated systematic review and meta-analysis.

Tea is abundant in phytochemicals (such as polyphenols and theaflavins), which have a hypoglycemic effect. Previous studies investigating the relationship between tea consumption and the risk of type 2 diabetes mellitus (T2DM) have yielded inconsistent results. We hypothesized that tea consumption would be associated with a reduced risk of T2DM. This cohort study used data from the China Health and Nutrition Survey, involving a total of 5199 participants initially recruited in 1997 and subsequently followed until 2009. Consumption of any variety of tea was tracked using structured questionnaires, and T2DM was diagnosed according to the American Diabetes Association's criteria. We also performed a systematic literature search of PubMed, Web of Science, and EMBASE for publications through September 2021, including 19 cohort studies comprising 1,076,311 participants. In our cohort study, the logistic regression model showed a relative risk (RR) of T2DM among tea drinkers of 1.02 (95% confidence interval [CI], 0.82-1.28) compared with non-tea drinkers. Although our updated meta-analysis showed no significant association between tea consumption and T2DM on the whole (pooled RR of 0.96 [0.91-1.00]), compared with the non-tea-drinking group, participants consuming 4 or more cups of tea per day had a 17% reduced risk of T2DM, with an RR of 0.83 (95% CI, 0.76-0.90). These data support our hypothesis that tea consumption at higher doses (e.g., ≥4 cups/day) is associated with a reduced risk of T2DM.

Small RNA-seq and hormones in the testes of dwarf hamsters (Cricetulus barabensis) reveal the potential pathways in photoperiod regulated reproduction.

Photoperiod regulates the functions and development of gonadal organs of seasonally breeding animals, resulting in breeding peaks in specific seasons. miRNA plays an important role in the regulation of testicular physiological functions. However, the relationship between photoperiods and miRNA levels in testes has yet to be conclusively determined. We investigated testicular miRNA of striped dwarf hamster (Cricetulus barabensis) responses to different photoperiods (long daylength [LD], moderate daylength [MD], and short daylength [SD]) and the potential pathways involved in photoperiod regulated reproduction. Testicular weights and reproductive hormone levels were measured in each of photoperiod treatments after 30 days. The concentrations of testosterone (T) and dihydrogen testosterone (DHT) in testes and Gonadotropin-releasing hormone (GnRH), follicle-stimulating hormone (FSH), and luteinizing hormone (LH) in serum were higher in MD than in the other two groups. Testicular weights were heaviest in MD. Small RNA-seq was performed for the testes of hamsters in three groups. A total of 769 miRNAs were identified, of which 83 were differentially expressed between LD, MD, and SD. GO and KEGG analysis of target genes revealed that some miRNAs influence testicular activities by regulating the pathways related to cell apoptosis and metabolism. Gene expression pattern analysis showed that the MAPK signaling pathway may be the core pathway for photoperiodic regulation of reproduction. These results suggest that moderate daylength is more suitable for hamster reproduction while long daylength and short daylength may regulate reproduction through different molecular pathways.

Structure and magnetism of electrospun porous high-entropy (Cr1/5Mn1/5Fe1/5Co1/5Ni1/5)3O4, (Cr1/5Mn1/5Fe1/5Co1/5Zn1/5)3O4 and (Cr1/5Mn1/5Fe1/5Ni1/5Zn1/5)3O4 spinel oxide nanofibers.

High-entropy oxide nanofibers, based on equimolar (Cr,Mn,Fe,Co,Ni), (Cr,Mn,Fe,Co,Zn) and (Cr,Mn,Fe,Ni,Zn) combinations, were prepared by electrospinning followed by calcination. The obtained hollow nanofibers exhibited a porous structure consisting of interconnected nearly strain-free (Cr1/5Mn1/5Fe1/5Co1/5Ni1/5)3O4, (Cr1/5Mn1/5Fe1/5Co1/5Zn1/5)3O4 and (Cr1/5Mn1/5Fe1/5Ni1/5Zn1/5)3O4 single crystals with a pure Fd3̄m spinel structure. Oxidation state of the cations at the nanofiber surface was assessed by X-ray photoelectron spectroscopy and cation distributions were proposed satisfying electroneutrality and optimizing octahedral stabilization. The magnetic data are consistent with a distribution of cations that satisfies the energetic preferences for octahedral vs. tetrahedral sites and is random only within the octahedral and tetrahedral sublattices. The nanofibers are ferrimagnets with relatively low critical temperature more similar to cubic chromites and manganites than to ferrites. Replacing the magnetic cations Co or Ni with non-magnetic Zn lowers the critical temperature from 374 K (Cr,Mn,Fe,Co,Ni) to 233 and 105 K for (Cr,Mn,Fe,Ni,Zn) and (Cr,Mn,Fe,Co,Zn), respectively. The latter nanofibers additionally have a low temperature transition to a reentrant spin-glass-like state.

Heterostructured and Mesoporous Nb2O5@TiO2 Core-Shell Spheres as the Negative Electrode in Li-Ion Batteries.

Niobium pentoxides have received considerable attention and are promising anode materials for lithium-ion batteries (LIBs), due to their fast Li storage kinetics and high capacity. However, their cycling stability and rate performance are still limited owing to their intrinsic insulating properties and structural degradation during charging and discharging. Herein, a series of mesoporous Nb2O5@TiO2 core-shell spherical heterostructures have been prepared for the first time by a sol-gel method and investigated as anode materials in LIBs. Mesoporosity can provide numerous open and short pathways for Li+ diffusion; meanwhile, heterostructures can simultaneously enhance the electronic conductivity and thus improve the rate capability. The TiO2 coating layer shows robust crystalline skeletons during repeated lithium insertion and extraction processes, retaining high structural integrity and, thereby, enhancing cycling stability. The electrochemical behavior is strongly dependent on the thickness of the TiO2 layer. After optimization, a mesoporous Nb2O5@TiO2 core-shell structure with a ∼13 nm thick TiO2 layer delivers a high specific capacity of 136 mA h g-1 at 5 A g-1 and exceptional cycling stability (88.3% retention over 1000 cycles at 0.5 A g-1). This work provides a facile strategy to obtain mesoporous Nb2O5@TiO2 core-shell spherical structures and underlines the importance of structural engineering for improving the performance of battery materials.

The Photoperiod Regulates Granulosa Cell Apoptosis through the FSH-Nodal/ALK7 Signaling Pathway in Phodopus sungorus.

The photoperiod regulates the seasonal reproduction of mammals by affecting the follicle development, for which the granulosa cells provide nutrition. However, the underlying mechanism remains unclear. Here, Djungarian hamsters (Phodopus sungorus) were raised under different photoperiods to study the ovarian status and explore the potential mechanism of the follicle development mediated by the FSH-Nodal/ALK7 signaling pathway. Compared with the moderate daylight (MD) group, the short daylight (SD) group exhibited a significant decrease in the ovarian weight and increase in the atretic follicle number and granulosa cell apoptosis, whereas the long daylight (LD) group showed an increase in the ovarian weight, the growing follicle number, and the antral follicle number, but a decrease in the granulosa cell apoptosis. Based on these findings, the key genes of the Nodal/ALK7 signaling pathway controlling the granulosa cell apoptosis were studied using the quantitative real-time polymerase chain reaction and western blotting. In the SD group, the follicle-stimulating hormone (FSH) concentration significantly decreased and the Nodal/ALK7/Smad signaling pathways were activated, while the phosphatidylinositol 3-kinase (PIK3)/Akt signaling pathway was inhibited. The BAX expression was significantly increased, while the Bcl-xL expression was significantly decreased, leading to an increase in the caspase-3 activity, the granulosa cell apoptosis, and ovarian degeneration. However, in the LD group, the FSH concentration significantly increased, the Nodal/ALK7/Smad signaling pathway was inhibited, and the PIK3/Akt signaling pathway was activated. Taken together, our results indicate that the photoperiod can regulate the apoptosis of the granulosa cells by regulating the concentration of FSH, activating or inhibiting the Nodal/ALK7 signaling pathway, thereby affecting the ovarian function. Our research provides an important theoretical basis for understanding the photoperiod-regulated mechanisms of the mammalian seasonal reproduction.

Associations between Consumption of Dietary Fibers and the Risk of Type 2 Diabetes, Hypertension, Obesity, Cardiovascular Diseases, and Mortality in Chinese Adults: Longitudinal Analyses from the China Health and Nutrition Survey.

Although many studies have explored the relationship between total dietary fiber intake and the risk of chronic non-communicable diseases, the results are mixed. There is also a lack of research on the association between dietary fiber intake from different food sources and disease. Using data from the China Nutrition and Health Database from 2004 to 2015, Cox proportional risk models were used to explore the associations between total dietary fiber and fiber intake from different food sources and the occurrence of type 2 diabetes, hypertension, obesity, cardiovascular disease, and all-cause mortality. After multi-factorial adjustment, the hazard ratios (95% confidence interval) of total dietary fiber intake (quartile 4 vs. quartile 1) in type 2 diabetes, hypertension, obesity, cardiovascular disease, and all-cause mortality cohorts were 1.20 (0.93, 1.55), 0.91 (0.75, 1.12), 0.93 (0.64, 1.35), 1.13 (0.60, 2.12), 1.13 (0.60, 2.12), and 1.13 (0.84, 1.52). Whole-grain fiber intake was positively associated with hypertension but not with the occurrence of other diseases. No association was observed between legume fibers, fruit fibers, and vegetable fibers in the cohorts of type 2 diabetes, hypertension, obesity, cardiovascular diseases and all-cause mortality. Our study did not find any association between total dietary fiber and dietary fiber intake from different food sources and type 2 diabetes, obesity, cardiovascular disease, and all-cause mortality in the Chinese population. The role of dietary fiber in the Chinese population may be overestimated. More extraordinary efforts are needed to further confirm the association between dietary fiber and these diseases in the Chinese population.

The Association Between Plant-Based Diet Indices and Obesity and Metabolic Diseases in Chinese Adults: Longitudinal Analyses From the China Health and Nutrition Survey.

Background: A wide range of health benefits are associated with consuming a diet high in plant-based foods. Diet quality can be accurately assessed using plant-based diet indices, however there is inadequate evidence that plant-based diet indices are linked to obesity, hypertension, and type 2 diabetes (T2D), especially in Chinese cultures who have traditionally consumed plant-rich foods. Methods: The data came from the China Nutrition and Health Survey. Overall, 11,580 adult participants were enrolled between 2004 and 2006 and followed up until 2009 or 2015 (follow-up rate: 73.4%). Dietary intake was assessed across three 24-h recalls, and two plant-based dietary indices [overall plant-based diet indice (PDI) and healthy plant-based diet indice (hPDI)] were calculated using China Food Composition Code and categorized into quintiles. The study's endpoints were overweight/obesity, hypertension, and T2D. The Hazard ratio (HR) and dose-response relationship were assessed using the Cox proportional risk model and restricted cubic splines. The areas under the curve of the receiver operating characteristic curve analyses were used to evaluate the predictive performance of the PDI and hPDI. Results: During the median follow-up period of more than 10 years, 1,270 (33.4%), 1,509 (31.6%), and 720 (11.5%) participants developed overweight / obesity, hypertension, and T2D, respectively. The higher PDI score was linked with a reduced risk of overweight/obesity [HR: 0.71 (95% CI: 0.55-0.93), P-trend <0.001], hypertension [HR: 0.63 (95% CI: 0.51-0.79), P-trend <0.001], and T2D [HR: 0.79 (95% CI: 0.72-0.87), P-trend <0.001]. The hPDI score was inversely associated with overweight/obesity [HR: 0.79 (95% CI: 0.62-0.98), P-trend = 0.02] and T2D [HR: 0.84 (95% CI: 0.75-0.93), P-trend = 0.001]. In the aged <55-year-old group, subgroup analysis indicated a significant negative association between PDI/hPDI and overweight/obesity, hypertension, and T2D. There was no significant difference in the areas under the curve of the fully adjusted obesity, hypertension, and diabetes prediction models between PDI and hPDI. Conclusion: The PDI and hPDI scores were very similar in application in Chinese populations, and our findings highlight that adherence to overall plant-based diet index helps to reduce the risk of T2D, obesity, and hypertension in Chinese adults who habitually consume plant-based foods, especially for those aged <55 year. Further understanding of how plant-based diet quality is associated with chronic disease will be needed in the future, which will help develop dietary strategies to prevent diabetes, hypertension, and related chronic diseases.

Dietary recommendations for fasting days in an alternate-day intermittent fasting pattern: A randomized controlled trial.

OBJECTIVES: The aims of this study were to explore the safety and effectiveness of alternate-day fasting in Chinese people and to compare weight loss outcomes and safety when consuming a high-protein (HP) versus a normal protein (NP) diet versus a nutritional meal replacement (MR) on fasting days. METHODS: This was a randomized, open, parallel-controlled, interventional, exploratory trial, that included a 3-d run-in period and a 28-d intervention period. Adult participants without restriction of body mass index (N = 60) were randomly assigned to three alternative-day fasting (ADF) intervention groups: group HP, group NP, and group MR. The primary outcome was weight change from baseline at 28 d. RESULTS: Overall participants lost an average of 2.53 kg. Mean triacylglycerols, total cholesterol, and low-density lipoprotein were significantly reduced by 0.10, 0.15, and 0.11 mmol/L, respectively. The mean hunger scale on day 1 of fasting was 18.73 at breakfast and 45.25 at dinner. The mean hunger scale on the last day of fasting decreased significantly, to 10.89 at breakfast and 18.93 at dinner. Weight loss of groups HP, NP, and MR were 2.16, 2.63, and 2.94 kg, respectively; groups did not differ significantly (P = 0.841). The most common adverse events were dizziness, heart palpitations, and fatigue. CONCLUSIONS: ADF is an effective, short-term weight loss strategy that was tolerated by most Chinese participants. We suggest that dietary patterns during fasting days is less important, and that calorie restriction during those days should be the focus.

A Dehydrogenative Inverse Electron Demand Diels-Alder Reaction for the Synthesis of Functionalized Pyranones.

An efficient dehydrogenative inverse electron demand Diels-Alder reaction of isopropyl and prenyl benzene derivatives with electron-deficient dienes followed by decarboxylation has been reported for the first time. The much broader substrate scope of dienophiles and electron-deficient dienes led to biologically valuable pyranones in good to excellent yields.

C-Reactive Protein Levels in relation to Incidence of Hypertension in Chinese Adults: Longitudinal Analyses from the China Health and Nutrition Survey.

OBJECTIVE: To explore the association between high sensitivity C-reactive protein (hs-CRP) levels and incident hypertension, as well as the association between hs-CRP levels and related covariates, in a Chinese adult population. METHODS: This study was based on the China Health and Nutrition Survey, a continuing open, large-scale prospective cohort study. Adult participants who were free of hypertension were included at baseline survey in 2009 and were followed up in 2015 (follow-up rate: 77.45%). The hs-CRP was measured using the immunoturbidimetric method and divided into three groups: low-risk group (0 ≤ hs-CRP <1 mg/L), average-risk group (1 ≤ hs-CRP <3 mg/L), and high-risk group (3 ≤ hs-CRP ≤10 mg/L). Definite diagnosis of hypertension in the follow-up survey in 2015 was the endpoint event of this study. The areas under the curve (AUC) of the receiver operating characteristic (ROC) curve analyses were used to evaluate the predictive value of the hs-CRP. RESULTS: 3794 participants were finally included as study sample, of whom 912 developed hypertension during a 6-year follow-up period (incidence: 24.1%). The incidences of hypertension in hs-CRP low-risk, average-risk, and high-risk groups were 17.6% (200/1135), 25.9% (521/2015), and 29.7% (191/644), respectively. Spearman's correlation analyses showed that there was significant positive correlation between hs-CRP levels and waist circumference, total triglycerides, total cholesterol, age, body mass index, and homeostasis model assessment of insulin resistance index. Stepwise regression analyses showed that participants in the hs-CRP high-risk group had a 46.2% higher risk of developing hypertension compared with those in the hs-CRP low-risk group (odds ratio: 1.462, 95% confidence interval: 1.018-2.101). Baseline systolic and diastolic blood pressure levels and waist circumference contributed the most to the development of hypertension with R 2 of 0.076, 0.052, and 0.039, respectively, while hs-CRP had lower area under the curve (AUC) for hypertension, adding baseline BP and WC to the prediction model increased the AUC to 0.708 (95% CI: 0.681-0.735). CONCLUSION: This study revealed a weak positive association between CRP levels and future incidence of hypertension in the Chinese population. The combination of hs-CRP with baseline BP and waist circumference (WC) had a higher predictive value for hypertension (AUC: 0.708), but the predictive value was still limited.

Hydrogen Bond Assisted Central-to-Spiro Chirality Transfer and Central-to-Axial Chirality Conversion: Asymmetric Synthesis of Spirocycles.

The asymmetric construction of chiral spiroenones bearing both axial and spiro-central chirality has been established for the first time by a central-to-spiro chirality transfer and a central-to-axial chirality conversion from chiral 2,3-diarylbenzoindolines. Mechanistic studies indicate the hydrogen bonds play important roles in this process, providing an efficient strategy for enantioselective construction of spirocyclic backbones via simultaneously controlling spiro-central and axial chirality in one operation.

Organocatalytic cycloaddition-elimination cascade for atroposelective construction of heterobiaryls.

The first chiral phosphoric acid (CPA) catalyzed cycloaddition-elimination cascade reaction of 2-naphthol- and phenol-derived enecarbamates with azonaphthalenes has been established, providing a highly atroposelective route to an array of axially chiral aryl-C3-benzoindoles in excellent yields with excellent enantioselectivities. The success of this strategy derives from the stepwise process involving CPA-catalyzed asymmetric formal [3 + 2] cycloaddition and subsequent central-to-axial chirality conversion by elimination of a carbamate. In addition, the practicality of this reaction had been verified by varieties of transformations towards functionalized atropisomers.

Association between sleep duration and weight gain and incident overweight/obesity: longitudinal analyses from the China Health and Nutrition Survey.

OBJECTIVE: To evaluate the association between sleep duration and weight gain and incident overweight/obesity in the population of China. METHODS: Data were derived from the China Health and Nutrition Survey. Adult participants with baseline data of sleep duration and body mass index (BMI) and who received at least one follow-up evaluation were selected to analyze the association of sleep duration with weight gain (n = 12,871) and incident overweight/obesity (n = 7,752). Daily sleep duration was categorized into five groups: ≤ 6, 7, 8 (as reference), 9, and ≥ 10 h. The study outcomes were weight gain ≥ 5 kg and incident overweight/obesity (BMI ≥ 24 kg/m2). RESULTS: Adjusted Cox proportional hazards models showed that only short sleep duration (≤ 6 h) significantly increased the risk of weight gain ≥ 5 kg (HR: 1.160, 95% CI: 1.005-1.339, p < 0.001) and incident overweight/obesity (HR: 1.403, 95% CI: 1.185-1.660, p < 0.001), whereas sleep duration 9 h was significantly associated with a lower risk of incident overweight/obesity (HR: 0.817, 95% CI: 0.700-0.953, p = 0.010). No significant correlation was found between long sleep duration (> 10 h) and the risk of weight gain ≥ 5 kg and incident overweight/obesity. CONCLUSION: Short sleep duration is a risk factor for the development of weight gain ≥ 5 kg and incident overweight/obesity in Chinese adults, whereas long sleep duration had no effect on future obesity.

Copper(I)/DDQ-Mediated Double-Dehydrogenative Diels-Alder Reaction of Aryl Butenes with 1,4-Diketones and Indolones.

A copper(I)/DDQ-mediated double-dehydrogenative Diels-Alder (DDDA) reaction of simple butenes with 1,4-diketones and indolones has been established for the first time. This strategy is based on a tandem double-dehydrogenation/Diels-Alder reaction from nonprefunctionalized starting materials, in which both a diene and dienophile were in situ generated via activation of fourfold inert C(sp3)-H bonds in one catalytic system.

Comparison of the therapeutic effects of 15 mg and 30 mg initial dosage of prednisolone daily in patients with subacute thyroiditis: protocol for a multicenter, randomized, open, parallel control study.

BACKGROUND: Subacute thyroiditis (SAT) is the most common cause of thyroid pain. Several clinical guidelines recommend that patients who fail to respond to full doses of non-steroidal anti-inflammatory drugs (NSAIDs) should be treated instead with oral corticosteroid therapy. However, albeit strong recommendations, the treatment protocol is based on low-quality evidence and high-quality clinical trials are lacking with respect to the optimal initiation dosage and usage of corticosteroid. We aimed to evaluate whether 15 mg/day of prednisolone (PSL) as the initial dosage could provide non-inferiority effectiveness but with lower risk and more safety compared with 30 mg/day of PSL as the initial dosage. METHODS/DESIGN: This is a multicenter, open-label, randomized, parallel trial that will be conducted at five academic hospitals in China. A total of 90 adult patients diagnosed with SAT who present moderate to severe pain or fail to respond to full doses of NSAIDs will be randomly assigned with a 1:1 ratio to the low initial PSL dosage group (15 mg daily) and standard initial PSL dosage group (30 mg daily). The primary endpoint is the time period (days) required for PSL treatment (including PSL treatment for recurrence). DISCUSSION: Our randomized controlled trial will try to determine the optimal protocol in the treatment of SAT by providing high-quality evidence. TRIALS REGISTRATION: Chinese Clinical Trial Register, ChiCTR1900023884. Registered on 15 June 2019.

Treatment of Insulinomas by Laparoscopic Radiofrequency Ablation: Case Reports and Literature Review.

Despite its rarity, insulinoma is the most common type of pancreatic endocrine neoplasm, with an occurrence of 1 to 5 per million per year in the population. Surgical resection or enucleation is the first line of curative treatment choice for insulinoma. Eight patients with symptomatic insulinomas treated by radiofrequency ablation have been described since 2009. In the past two years, we treated two patients with symptomatic insulinomas (one in the pancreatic tail and the other in the pancreatic neck) successfully using laparoscopic radiofrequency ablation. Both patients achieved complete elimination without any significant complications. Our study suggests laparoscopic radiofrequency ablation could be developed as a safe and effective alternative treatment to surgery for the patients with insulinomas who refuse or are not eligible for surgery.

The PROMOTE study (High-protein and resistance-training combination in overweight and obesity) for short-term weight loss and long-term weight maintenance for Chinese people: a protocol for a pilot randomized controlled trial.

BACKGROUND: It is very important for clinicians and dieticians to explore reasonable weight management strategies for obese people that address both short-term weight loss and subsequent weight maintenance. We hypothesized that resistance training combined with a high-protein diet would result in similar short-term weight loss but better long-term weight maintenance than either a conventional low-fat diet control or a high-protein diet alone. METHODS/DESIGN: This is an 8-week randomized parallel controlled trial followed by a 24-week observational follow-up study. A 48-week supplementary follow-up study will be carried out if necessary. The study will be conducted between June 2019 and October 2020. The 90 overweight or obese participants will be randomly assigned to the conventional low-fat diet group, the high-protein diet group and the high-protein diet and resistance training combination group. Primary outcomes are body weight change at week 8 and week 24 compared with the baseline level. DISCUSSION: High-quality research on the effect of a high-protein diet combined resistance training on weight loss and weight maintenance is limited in the Chinese population. Our study will provide a basis for obesity management in China and will promote the development of exercise- and diet-related studies. TRIAL REGISTRATION: Chinese Clinical Trial Registry, ChiCTR1900023841. Registered on 14 June 2019.

Insufficient radiofrequency ablation-induced autophagy contributes to the rapid progression of residual hepatocellular carcinoma through the HIF-1α/BNIP3 signaling pathway.

Currently speaking, it is noted that radiofrequency ablation (RFA) has been the most widely used treatment for hepatocellular carcinoma (HCC) occurring in patients. However, accumulating evidence has demonstrated that the incidence of insufficient RFA (IRFA) may result in the identified rapid progression of residual HCC in the patient, which can greatly hinder the effectiveness and patient reported benefits of utilizing this technique. Although many efforts have been proposed, the underlying mechanisms triggering the rapid progression of residual HCC after IRFA have not yet been fully clarified through current research literature reviews. It was shown in this study that cell proliferation, migration and invasion of residual HepG2 and SMMC7721 cells were significantly increased after the IRFA was simulated in vitro. In other words, it is noted that IRFA could do this by enhancing the image of autophagy of the residual HCC cell via the HIF-1α/BNIP3 pathway. Consequently, the down-regulation of BNIP3 may result in the inhibition of the residual HCC cell progression and autophagy after IRFA. Our present study results suggest that IRFA could promote residual HCC cell progression in vitro by enhancing autophagy via the HIF-1α/BNIP3 pathway. For this reason, it is noted that the targeting of the BNIP3 may be useful in preventing the rapid growth and metastasis of residual HCC after IRFA. [BMB Reports 2019; 52(4): 277-282].