Associations between the use of red yeast rice preparations and adverse health outcomes: An umbrella review of meta-analyses of randomized controlled trials.

BACKGROUND: Red yeast rice (RYR), a natural lipid-lowering agent, is widely used in clinical practice. However, the existing meta-analyses concerning the safety of RYR preparations have yielded inconsistent results, and the credibility of the evidence has not been quantified. OBJECTIVE: This study was designed to evaluate the existing evidence and offer a comprehensive understanding of the associations between the use of RYR preparations and various adverse health outcomes. SEARCH STRATEGY: Seven literature databases were searched from inception to May 5, 2023, using medical subject headings and free-text terms (e.g., "red yeast rice," "Xuezhikang," and "Zhibitai"). INCLUSION CRITERIA: Meta-analyses that investigated and quantitatively estimated associations between the use of RYR preparations and adverse health outcomes were included in this study. DATA EXTRACTION AND ANALYSIS: Two researchers independently extracted data using a standardized data collection table; any disagreements were resolved by consulting a third researcher. Based on the participant, intervention, comparator and outcome (PICO) framework in each eligible meta-analysis, a series of unique associations between the use of RYR preparations and adverse health outcomes were determined. The associations' effect estimates were re-evaluated using random-effect models. RESULTS: Fifteen meta-analyses, comprising 186 (164 unique) randomized controlled trials, were identified. Based on A MeaSurement Tool to Assess Systematic Reviews version 2, 3 (20%) and 12 (80%) of these meta-analyses had low and critically low confidence, respectively. A total of 61 unique associations between the use of RYR preparations and adverse health outcomes were extracted from eligible meta-analyses. Based on the random-effect models, 10 (16.4%) associations indicated a significant protective effect of RYR preparations against adverse health outcomes, while 5 (8.2%) indicated an increased risk of adverse health outcomes related to uric acid, alanine transaminase and aspartate transaminase levels. The other 46 (75.4%) associations showed no significant difference between the use of RYR preparations and control treatments. Regarding the credibility of the evidence, 21 (34.4%), 34 (55.7%) and 6 (9.8%) associations showed moderate, low and very low credibility, respectively. CONCLUSION: The evidence examined in this study suggests that RYR preparations are safe; however, the credibility of the evidence was not high. Further high-quality evidence is required. Please cite this article as: Ma ZY, Yang SP, Li Y, Xu TT, Yang YL, Yang HY, Li HB, Zhou LJ, Diao Y, Li SY. Associations between the use of red yeast rice preparations and adverse health outcomes: An umbrella review of meta-analyses of randomized controlled trials. J Integr Med. 2024; 22(2): 126-136.

Establishment and comparison of piecewise linear regression models to measure thyroid volume by 2D and 3D ultrasound.

OBJECTIVE: Compared thyroid volumes measured by 2-D and 3-D US with those of resected specimens and proposed new models to improve measurement accuracy. METHODS: This study included 80 patients who underwent total thyroidectomy. One 2D_model and one 3D_model were developed using piecewise linear regression analysis. The accuracy of these models was compared using an ellipsoid model (2-D_US value × 0.5), 3-D_US value, and Ying's model [1.76 + (2-D_US value × 0.38)]. RESULTS: The new 2D_model was: V=2.66 + (0.71 * X1) - (1.51 * X2). In this model, if 2-D_US value <= 228.39, X1 = 2-D_US value and X2 = 0; otherwise, X1 = 2-D_US value and X2 = 2-D_US value - 228.39. The 3D_model was: V= 2.90 + (1.08 * X1) + (2.43 * X2). In this model, if 3-D_US value <= 102.06, X1 = 3-D_US value and X2 = 0; otherwise, X1 = 3-D_US value and X2 = 3-D_US value - 102.06. The accuracy of the new models was higher than that of the 3-D_US value, the ellipsoid model, and Ying's model (P<0.05). CONCLUSION: The models established are more accurate than the traditional ones and can accurately measure thyroid volume.

Healthy Lifestyle and Quality of Life in Post-Operative Colorectal Cancer Patients: A Five-Month Observational Study.

Health-related quality of life (HRQOL) is an important indicator of treatment effectiveness. An unhealthy lifestyle can have a negative impact on quality of life. This study aimed to investigate changes in health-related lifestyle over time after surgery for colorectal cancer and their impact on HRQOL. Healthy lifestyle habits examined in this study included physical activity, smoking, alcohol consumption, fruit and vegetable intake, sleep, and obesity levels. An observational study design was used. A total of 75 post-operative colorectal cancer patients were recruited from two medical centers in Taiwan. Data were collected through structured questionnaires. Mean HRQOL scores at 1, 3, and 5 months after discharge were 102.5 (SD = 18.8), 102.9 (SD = 20.1), and 103.0 (SD = 18.9), respectively. A generalized estimating equation analysis showed that alcohol consumption (p = 0.009), fruit and vegetable intake (p = 0.020), physical activity (p = 0.023), sleep quality (p < 0.001), and obesity (p = 0.035) were important predictors of post-operative quality of life in patients with colorectal cancer. The impact of smoking on HRQOL did not reach statistical significance. Colorectal cancer patients tend to have better HRQOL after surgery if they stay physically active, eat enough fruits and vegetables, and sleep well.

Metformin ameliorates thymus degeneration of mice by regulating mitochondrial function.

As the main lymphoid organ, the thymus degenerates with age. The loss of thymic epithelial cells is mainly related to thymus degeneration and reduced T cells development. As an insulin sensitizer, metformin is a first-line drug for the treatment of diabetes and has been shown to prolong the lifespan of mice, but the mechanism is still unclear. In this study, we explored the therapeutic effect of metformin on thymus degeneration in the accelerated aging mice, which was established by intraperitoneal injection D-galactose (120 mg/kg/day) for eight weeks. Metformin was intragastrically given with 100 or 300 mg/kg body weight per day, respectively, for six weeks. Histological examination showed that metformin administration could alleviate thymus atrophy caused by D-galactose. In addition, metformin therapy increased mitochondrial membrane potential, with a reduction in mitochondrial reactive oxygen species, MDA and SOD levels, and restored mitochondrial balance through enhanced expression of dynamin-related protein 1 (Drp1). Furthermore, metformin altered T lymphocyte subsets and cellular senescent cells; the expression of FoxN1, Aire and Sox2 of thymic epithelial cells also increased. Thus, metformin presented a positive effect on thymic degeneration through improving mitochondrial function. Taken together, these findings revealed an unexpected complexity in the anti-aging of this widely used drug.

Influence of albumin and physical activity on postoperative recovery in patients with colorectal cancer: An observational study.

PURPOSE: The study explores the influences of nutrition-related factors (albumin, hemoglobin, and obesity) and lifestyles (physical activity, fruit and vegetable intake, smoking, and drinking) on the length of hospital stay in postoperative colorectal cancer patients. METHODS: This study is a cross-sectional design. A convenience sample of 106 preoperative colorectal cancer patients was recruited from a medical center in Taiwan. Data were collected using self-reported questionnaires and from patients' medical records. RESULTS: The median length of hospital stay was ten days with an interquartile range (IQR) of 8-11.25 days. The results of the log-link Gamma generalized linear model showed that albumin (B = -0.16, p = 0.007) and physical activity (B = -0.14, p = 0.001) were significant predictors of the length of hospital stay after controlling for demographics and disease characteristics. The influences of anemia, obesity, fruit and vegetable intake, smoking, and drinking on the length of hospital stay were insignificant. CONCLUSIONS: Patients with hypoalbuminemia and a low level of physical activity undergo a more extended postoperative hospital stay. The study findings inform clinicians of the influencing factor of the patients' recovery and provide a foundation for developing interventions to decrease hospital stay length.

Health self-management experiences of colorectal cancer patients in postoperative recovery: A qualitative study.

PURPOSE: Health self-management helps improve health-related quality of life and life satisfaction, as well as cancer survival. The study aim was to explore the essence of the health self-management experiences and support needs of colorectal cancer patients after surgeries. METHODS: The study was based on phenomenology research methodology. Purposive sampling was used to obtain a heterogeneous sample to provide rich information regarding the research questions. Participants were recruited from colorectal surgery outpatient clinics in a hospital in Taiwan. Data were collected by semi-structured in-depth interviews and analyzed by thematic content analysis. Strategies adapted from Lincoln and Guba were used to enhance the trustworthiness of the study. RESULTS: Ten participants, 5 males and 5 females, were interviewed. Their health self-management experience fell into 3 overarching themes and 9 related subthemes. Our results show that (1) seeking support when experiencing discomfort, (2) when life changes, re-adjust accordingly, and (3) staying positive and self-perseverance are the essences of the health self-management experiences and support needs of postoperative colorectal cancer patients. CONCLUSIONS: Postoperative colorectal cancer patients experienced tremendous physical and psychosocial challenges after returning home from the hospital. Although burdened with multiple stressors, these patients were able to seek support, learning to practice self-care, facing cancer positively, and exhibit positive growth in life. Patients with colorectal cancer have to constantly adjust to the impacts of their diseases. The study results may provide as a reference for supporting postoperative adjustment and promoting health self-management among patients with colorectal cancer.

Combination of high-frequency ultrasound and virtual touch tissue imaging and quantification improve the diagnostic efficiency for mild carpal tunnel syndrome.

BACKGROUND: Carpal tunnel syndrome (CTS) is the most common entrapment symptom in the peripheral nerves. High-frequency ultrasound (HFUS) is widely used in the diagnosis of CTS. Virtual Touch Tissue Imaging and Quantification (VTIQ), which provides more information about the hardness of organization, is used to diagnose CTS. However, the data of diagnostic value of them in various degrees of CTS are limited. Whether the combination of HFUS and VTIQ can improve the diagnostic efficiency also remains unknown. The study aimed to explore the diagnostic value of HFUS and VTIQ in various degrees of CTS and whether combination of HFUS and VTIQ could improve the diagnostic efficiency of CTS. METHODS: A collection and analysis of 133 CTS patients and 35 volunteers from January 2016 to January 2019 were performed. We compared the clinical characteristics, cross-sectional area (CSA) value and shear wave velocity SWVmean value of CTS group with volunteer group. RESULTS: The CSA value and SWVmean value of CTS cohort were significantly higher than volunteer group (10.79 ± 2.88 vs. 8.06 ± 1.39, p < 0.001, 4.36 ± 0.95 vs. 3.38 ± 1.09, p < 0.001, respectively). The area under the curve (AUC) of receiver operating characteristic (ROC) curve of CSA value and SWVmean value were 0.794 and 0.757, respectively. Hierarchical analysis of CSA value and SWVmean value showed that the AUC in the moderate and severe CTS group were higher than in mild CTS group. Furthermore, the CSA value combined with SWVmean value used to diagnose mild CTS was 0.758, which was higher than that of single CSA value or single SWVmean value. CONCLUSIONS: Both HFUS and VTIQ technology were feasible to evaluate CTS. HFUS was suitable for use in diagnosis of moderate and severe CTS. For mild CTS, combination of HFUS and VTIQ was relevant to improve the diagnostic efficiency of CTS.

Nomograms for predicting overall survival and cancer-specific survival in young patients with pancreatic cancer in the US based on the SEER database.

BACKGROUND: The incidence of young patients with pancreatic cancer (PC) is on the rise, and there is a lack of models that could effectively predict their prognosis. The purpose of this study was to construct nomograms for predicting the overall survival (OS) and cancer-specific survival (CSS) of young patients with PC. METHODS: PC patients younger than 50 years old from 2004 to 2015 in the Surveillance, Epidemiology, and End Results (SEER) database were selected and randomly divided into training set and validation set. Univariable and forward stepwise multivariable Cox analysis was used to determine the independent factors affecting OS. The Fine and Gray competing risk regression model was used to determine the independent factors affecting CSS. We used significant variables in the training set to construct nomograms predicting prognosis. The discrimination and calibration power of models were evaluated by concordance index (C-index), calibration curve and 10-flod cross-validation. RESULTS: A total of 4,146 patients were selected. Multivariable Cox analysis showed that gender, race, grade, pathological types, AJCC stage and surgery were independent factors affecting OS. The C-index of the nomogram predicting OS in training and validation was 0.733 (average = 0.731, 95% CI [0.724-0.738]) and 0.742 (95% CI [0.725-0.759]), respectively. Competing risk analysis showed that primary site, pathological types, AJCC stage and surgery were independent factors affecting CSS. The C-index of the nomogram predicting CSS in training and validation set was 0.792 (average = 0.765, 95% CI [0.742-0.788]) and 0.776 (95% CI [0.773-0.779]), respectively. C-index based on nomogram was better in training and validation set than that based on AJCC stage. Calibration curves showed that these nomograms could accurately predict the 1-, 3- and 5-year OS and CSS both in training set and validation set. CONCLUSIONS: The nomograms could effectively predict OS and CSS in young patients with PC, which help clinicians more accurately and quantitatively judge the prognosis of individual patients.

Proteomics insights into the effects of MSTN on muscle glucose and lipid metabolism in genetically edited cattle.

The molecular mechanism underlying myostatin (MSTN)-regulated metabolic cross-talk remains poorly understood. In this study, we performed comparative proteomic and phosphoproteomic analyses of gluteus muscle tissues from MSTN-/- transgenic cattle using a shotgun-based tandem mass tag (TMT) 6-plex labeling method to explore the signaling pathway of MSTN in metabolic cross-talk and cellular metabolism during muscle development. A total of 72 differentially expressed proteins (DEPs) and 36 differentially expressed phosphoproteins (DEPPs) were identified in MSTN-/- cattle compared to wild-type cattle. Bioinformatics analyses showed that MSTN knockout increased the activity of many key enzymes involved in fatty acid ß-oxidation and glycolysis processes in cattle. Furthermore, comprehensive pathway analyses and hypothesis-driven AMP-activated protein kinase (AMPK) activity assays suggested that MSTN knockout triggers the activation of AMPK signaling pathways to regulate glucose and lipid metabolism by increasing the AMP/ATP ratio. Our results shed new light on the potential regulatory mechanism of MSTN associated with metabolic cross-talk in muscle development, which can be used in animal breeding to improve meat production in livestock animals, and can also provide valuable insight into treatments for obesity and diabetes mellitus in humans.

Knockdown of protein kinase CK2 blocked gene expression mediated by brain-derived neurotrophic factor-induced serum response element.

One of the principal signaling pathway outcomes from brain-derived neurotrophic factor (BDNF) is the activation of antiapoptotic pathways. In addition to the role of extracellular signal-regulated kinase 1/2 and phosphatidylinositol-3 kinase, BDNF activates protein kinase CK2 to mediate its neuroprotective effect. The inhibition of CK2 activity has been shown to induce apoptosis. Although serum response element (SRE)-mediated transcription has been reported to be activated by BDNF and that the phosphorylation of serum response factor (SRF) by CK2 has been shown to enhance its DNA binding activity, the biological relevance of these interactions remains largely unclear. In the present study, we found that SRE-mediated transcription, CK2 activity, and SRF phosphorylation increased in PC12 cells under BDNF treatment. The transfection of CK2α siRNA blocked the enhancing effect of BDNF on SRE-mediated transcription, SRF phosphorylation, and Mcl-1 gene expression. Moreover, the blockade of CK2 diminished the antiapoptotic effects of BDNF on SRE-mediated transcription, Mcl-1 gene expression, and cell viability under rotenone-induced cytotoxicity. Our data may assist in the development of therapeutic strategies for inhibiting apoptosis during neurodegeneration.

Betulinic acid impairs metastasis and reduces immunosuppressive cells in breast cancer models.

Breast cancer is the most common female cancer with considerable metastatic potential, explaining the need for new candidates that inhibit tumor metastasis. In our study, betulinic acid (BA), a kind of pentacyclic triterpenoid compound derived from birch trees, was evaluated for its anti-metastasis activity in vitro and in vivo. BA decreased the viability of three breast cancer cell lines and markedly impaired cell migration and invasion. In addition, BA could inhibit the activation of stat3 and FAK which resulted in a reduction of matrix metalloproteinases (MMPs), and increase of the MMPs inhibitor (TIMP-2) expression. Moreover, in our animal experiment, intraperitoneal administration of 10 mg/kg/day BA suppressed 4T1 tumor growth and blocked formation of pulmonary metastases without obvious side effects. Furthermore, histological and immunohistochemical analyses showed a decrease in MMP-9 positive cells, MMP-2 positive cells and Ki-67 positive cells and an increase in cleaved caspase-3 positive cells upon BA administration. Notably, BA reduced the number of myeloid-derived suppressor cells (MDSCs) in the lungs and tumors. Interestingly, in our caudal vein model, BA also obviously suppressed 4T1 tumor pulmonary metastases. These findings suggested that BA might be a potential agent for inhibiting the growth and metastasis of breast cancer.

Noninvasive evaluation of gastric emptying and gastric wall thickness in SLE patients.

OBJECTIVE: The objective of this study is to evaluate the gastric emptying in patients with systemic lupus erythematosus (SLE) with gastrointestinal involvement using three-dimensional (3D) ultrasonography. METHODS: The gastric emptying times at 25% (T1), 50% (T2), and 75% (T3) of SLE patients with gastrointestinal involvement (n = 40) and healthy controls (n = 80) were evaluated and compared. In addition, the correlations among the gastric wall thickness, SLE disease activity index (SLEDAI), and upper gastrointestinal symptoms were calculated. RESULTS: The gastric wall thickness was correlated with the SLEDAI (r = 0.928, p < 0.001) and the upper gastrointestinal symptom index (r = 0.848, p < 0.001). The emptying times T1, T2, and T3 of the SLE patients were 17.08 ± 2.65 min (mean ± standard deviation), 39.85 ± 6.54 min, and 83.58 ± 7.12 min, respectively. For healthy controls, they were 19.65 ± 5.39 min, 41.08 ± 7.51 min, and 70.34 ± 8.03 min. The T1 of the SLE patients was shorter (p < 0.01), while the T3 was longer (p < 0.001). Moreover, T3 in the SLE group had the best correlation with the upper gastrointestinal symptom index (r = 0.553, p < 0.001). T1 in the SLE group was anti-correlated with early satiety (r = -0.366, p < 0.05). CONCLUSIONS: Combining the emptying times T1 and T3, as well as the gastric wall thickness, the SLEDAI and the upper gastrointestinal symptoms index can provide accurate clinical diagnosis of SLE with gastric involvement.

Evaluation of gastric blood supply in diabetic patients with gastroparesis by contrast-enhanced ultrasound.

OBJECTIVE: Improvement in regional blood flow has been shown to ameliorate diabetic gastroparesis. We compared the gastric blood supply in patients with diabetes with gastroparesis with that in healthy subjects, by using contrast-enhanced ultrasound (CEUS). METHODS: 30 healthy subjects and 40 patients with diabetic gastroparesis were enrolled. The CEUS parameters of greater curvatures of the antrum (GCOA) and lesser curvatures of the antrum (LCOA), including peak intensity (PI) and the area under the curve (AUC), were compared between the two groups. RESULTS: Intraclass correlation coefficient (ICC) for PI in healthy subjects measured on CEUS were 0.831-0.857 and 0.803-0.823, respectively. Intra-ICC and inter-ICC values for AUC were 0.805-0.823 and 0.813-0.815, respectively. In both groups, no significant difference was observed in PI and AUC values of GCOA and LCOA (p > 0.05). The PI and AUC of GCOA and LCOA in the diabetes group were less than those in the normal group (p < 0.05). CONCLUSION: CEUS can assess stomach wall vascularity with a high reproducibility. Microcirculation in the antrum of patients with diabetic gastroparesis is poorer than that of normal group, which is consistent with the mechanisms of diabetic neuropathy. CEUS can be used for evaluation of microvascular perfusion in patients with stomach wall disease. Advances in knowledge: This was the first study to use CEUS for assessment of blood supply of the gastric wall and to compare microvascular perfusion between healthy individuals and patients with diabetes with gastroparesis.

Application of contrast-enhanced ultrasonography and ultrasonography scores in rheumatoid arthritis.

OBJECTIVE: To investigate diagnostic value of ultrasonography scores (US) and contrast-enhanced ultrasonography (CEUS) in evaluating rheumatoid arthritis (RA) activity. METHODS: 39 patients with RA were included and the metacarpophalangeal, proximal interphalangeal, wrist, elbow and knee joints of them were examined by high frequency ultrasound. The severe joints and the related indexes (synovial thickness, synovial blood flow, joint effusion and bone erosion) were exposed. Then scores (0~3) were obtained and the sum was calculated. For 12 patients of the 39, 2.4 ml SonoVue was intravenously injected with observation of synovial enhancing. ROIs time-intensity curve (TIC) was obtained and the parameters including area under curve (AUC), peak intensity (PI) and time to peak (TTP) were analyzed. For 39 patients, the relationships among each parameters, ultrasonography scores, DAS28 scores and biochemical examinations (ESR, CRP, RF, anti-CCP) were analyzed. RESULTS: The US were significantly correlated with DAS28 Scores (r=0.823, P<0.01=. The correlation between US and CRP was better than that between DAS28 scores and CRP (rUS =0.692, rDAS28=0.526, P<0.01). The synovial thickness in US were correlated with DAS28 Scores and biochemical examinations (ESR, CRP) (rDAS28=0.852, rESR=0.779, rCRP=0.587, P<0.01. The AUC and PI in CEUS were significantly correlated with US (rAUC=0.832, rPI=0.809, P<0.01=. The correlations among AUC, PI and ESR were better than that between US and ESR (rAUC=0.907, rPI=0.851, rUS=0.836, P<0.01=. The correlations among AUC, PI and CRP were better than that between US and CRP (rAUC=0.855, rPI=0.854, rUS=0.692, P<0.01. CONCLUSIONS: US was almost identical with DAS28 Scores and biochemical examinations (ESR, CRP) in diagnosis of RA activity, while CEUS was almost identical with DAS28 Scores and biochemical examinations (ESR, CRP). In diagnosis of RA, US may be better than DAS28 Scores, while CEUS better than US. Both of them were useful for evaluation of RA activity.

Evaluation of gastric emptying in diabetic gastropathy by an ultrasonic whole stomach cylinder method.

In order to explore the accuracy of ultrasonic whole stomach cylinder measurement (UWSCM) in the evaluation of gastric emptying, we measured the gastric emptying times (ET) at 25% (T1), 50% (T2) and 75% (T3) of healthy subjects and patients with diabetic gastropathy by UWSCM and scintigraphy. The ET of patients were compared with their clinical symptom scores. We found that the ET measured by UWSCM showed no significant difference with scintigraphy (p > 0.05). The correlation between them was good, and the correlation coefficient of T3 reached 0.744 (p < 0.05). All emptying times in the diabetic patients were longer than those in the healthy subjects (p < 0.05). The T3 in the diabetic group measured by UWSCM had the best correlation with the symptom index (r = 0.469, p < 0.05). We conclude that ET measured by UWSCM is accurate and T3 combining the symptoms index provides an accurate clinical basis for gastropathy.

[Preliminary exploration on submucosal tunneling endoscopic resection for middle and lower esophagus submucosal tumors].

OBJECTIVE: To evaluate the efficacy and safety of submucosal tunneling endoscopic resection (STER) in the treatment of middle and lower esophagus submucosal tumors (SMT) originating from muscularis propria (MP) layer. METHODS: A total number of 33 esophagus submucosal tumor (SMT) originating from MP layer underwent tumor resection by STER after endoscopic ultrasonography (EUS) and CT examination at Endoscopy Center, Department of Gastroenterology, First Affiliated Hospital, Nanjing Medical University from March 2012 to March 2013. There were 17 males and 16 females with an age range of (50 ± 10) years. Their lesion size, lesion origin, pathology, operative duration and complication rate were analyzed. RESULTS: Among them, the origins were of submucosal (n = 4, 12.1%), superficial muscularis propria layer (SMP) (n = 18, 54.6%), deep muscularis layer (DMP) (n = 10, 30.3%) and serosa (n = 1, 3.0%). There were single tumor (n = 30, 90.9%), double tumors (n = 2, 6.1%) and triple tumors (n = 1, 3.0%). Except for 1 case of non-resected hemangioma, 36 operative specimens were examined pathologically, including 30 leiomyomas tumors (83.3%), 5 stromal tumors (GIST) (13.9%) and 1 lipoma tumor (2.8%). Thirty-two lesions were successfully resected by STER with a complete resection rate of 97.0%. Average lesion size was (1.7 ± 1.0) cm and average operative duration (49 ± 26) min. A number of (7.8 ± 2.5) hemostatic clips were used to close the mucosal incision site. Subcutaneous emphysema occurred in 3 patients (9.1%) while puncture and pneumothorax developed in one case (3.0%). All of them recovered uneventfully through conservative treatments. CONCLUSIONS: As a new safe, efficacious and feasible treatment for middle and lower esophagus submucosal tumors, STER may completely resect SMT and provide accurate histopathological evaluations. And it is feasible to regain the mucosal integrity of GI tract and prevent the occurrences of leakage and secondary infections.

Expression of interleukin-22/STAT3 signaling pathway in ulcerative colitis and related carcinogenesis.

AIM: To investigate the expression of interleukin (IL)-22 and its related proteins in biopsy specimens from patients with ulcerative colitis (UC) and UC-related carcinogenesis. METHODS: Biopsy specimens were obtained from patients with inactive (n = 10), mild-to-moderately active (n = 30), severely active (n = 34), initial (n = 30), and chronic UC (n = 44), as well as UC patients with dysplasia (n = 10). Specimens from patients without colonic abnormalities (n = 20) served as controls. Chronic colitis in experimental mice was induced by 2.5% dextran sodium sulfate. The expression levels of IL-22, IL-23, IL-22R1 and phosphorylated STAT3 (p-STAT3) were determined by immunohistochemistry. Bcl-2, cyclin D1 and survivin expression was detected by Western blotting. RESULTS: Patients with active UC had significantly more IL-22, IL-23, IL-22R1 and p-STAT3-positive cells than the patients with inactive UC and normal controls. Furthermore, IL-22 and related proteins were closely related to the severity of the colitis. The expression of IL-22 and IL-22R1 in the tissue of initial UC was stronger than in that of chronic UC, whereas the expression of p-STAT3 was significantly increased in chronic UC tissues. In dysplasia tissues, the expression level of IL-22 and related proteins was higher compared with controls. Mouse colitis model showed that expression of IL-22, IL-22R1 and IL-23 was increased with time, p-STAT3 and the downstream gene were also remarkably upregulated. CONCLUSION: IL-22/STAT3 signaling pathway may be related to UC and UC-induced carcinogenesis and IL-22 can be used as a biomarker in judging the severity of UC.

Hexaaqua-cobalt(II) bis-(5-acetyl-2-hy-droxy-benzoate) dihydrate.

In the title compound, [Co(H(2)O)(6)](C(9)H(7)O(4))(2)·2H(2)O, the Co(2+) cation lies on a twofold rotation axis and is coordinated by six water mol-ecules in a distorted octa-hedral geometry. In the 5-acetyl-2-hy-droxy-benzoate anion, the hy-droxy group links with the carboxyl-ate group via an intra-molecular O-H⋯O hydrogen bond and the acetyl group is twisted to the benzene ring at a dihedral angle of 16.99 (12)°. In the crystal structure, the cations, anions and water mol-ecules are linked by extensive O-H⋯O hydrogen bonding.

Bis-(2-methyl-1H-imidazole-κN)bis[2-(naphthalen-2-yl)acetato-κO]copper(II).

In the crystal structure of the title compound, [Cu(C(12)H(9)O(2))(2)(C(4)H(6)N(2))(2)], the Cu(II) cations are square-planar coordinated by two 1-naphthyl-acetate anions and two 2-methyl-imidazole ligands into discrete complexes that are located on centres of inversion. These complexes are linked into chains parallel to [010] by inter-molecular N-H⋯O hydrogen bonding between the N-H H atom of the 2-methyl-imidazole ligands and the carboxyl-ate O atoms that are not involved in metal coordination.

Bis(1-methyl-1H-imidazole-κN)bis-[2-(naphthalen-1-yl)acetato-κO]copper(II) monohydrate.

In the crystal structure of the title compound, [Cu(C(12)H(9)O(2))(2)(C(4)H(6)N(2))(2)]·H(2)O, the Cu(II) atom is coordinated by two 2-(naphthalen-1-yl)acetate anions and two 1-methyl-imidazole ligands, giving monomeric complexes with a square-planar coordination environment. Two complex mol-ecules and two water mol-ecules form a centrosymmetric ring system via O-H⋯O hydrogen bonds.