Association between weight-adjusted-waist index and gallstones: an analysis of the National Health and Nutrition Examination Survey.

BACKGROUND: The weight-adjusted-waist index (WWI) is a novel obesity index, and gallstones are associated with obesity. This study aimed to investigate the possible relationship between WWI and gallstones. METHODS: The datasets from the National Health and Nutrition Examination Survey (NHANES) 2017-2020 were used in a cross-sectional investigation. Multivariate linear regression models were used to examine the linear connection between WWI and gallstones incidence. Fitted smoothing curves and threshold effect analysis were used to describe the nonlinear relationship. RESULTS: The study comprised 8004 participants over the age of 20, including 833 reported with gallstones. Participants in the higher WWI tertile tended to have a higher gallstones prevalence. In the final adjusted model, a positive association between WWI and gallstones prevalence was observed (OR = 1.34, 95% CI: 1.20‒1.49). Participants in the highest WWI tertile had a significantly 71% higher risk of gallstones than those in the lowest WWI tertile (OR = 1.71, 95% CI: 1.35‒2.17). A nonlinear correlation was found between the WWI and gallstones prevalence, with an inflection point of 12.7. CONCLUSIONS: Our study found that higher WWI levels connected with increased prevalence of gallstones. However, more prospective studies are needed to validate our findings.

A prospective cohort study on decreased serum apelin-13 levels after human aneurysmal subarachnoid hemorrhage: associations with severity and prognosis.

Apelin-13 may have neuroprotective effects. We aimed to determine whether serum apelin-13 could serve as a potential biomarker for severity, delayed cerebral ischemia (DCI), and prognosis after human aneurysmal subarachnoid hemorrhage (aSAH). In this prospective, observational, cohort, single-center study of 139 patients with aSAH and 139 healthy individuals, serum apelin-13 levels were determined. The indicators of stroke severity were the Hunt-Hess scale and the modified Fisher grading scale. The prognostic parameters were DCI and 6-month worse prognosis (Extended Glasgow Outcome Scale scores of 1-4). Using binary logistic regression analysis, the relationship between serum apelin-13 levels and prognosis was reported as odds ratios (ORs) with 95% confidence intervals (CIs). Under the receiver operating characteristic curve, prognostic abilities were shown as areas under the curve (AUCs) with 95% CIs. Serum apelin-13 levels were substantially lower in patients than in controls (median, 28.8 versus 48.6 ng/ml; P < 0.001), in patients with DCI than in non-DCI patients (median, 14.9 versus 31.6 ng/ml; P < 0.001), and in patients with worse prognosis than in those with good prognosis (median, 16.3 versus 33.7 ng/ml; P < 0.001). Serum apelin-13 levels were independently correlated with Hunt-Hess scores (beta, -6.836; 95% CI, -8.963-4.708; VIF, 2.219; P = 0.001) and modified Fisher scores (beta, -3.350; 95% CI, -6.151-0.549; VIF, 1.562; P = 0.019). Serum apelin-13 levels were an independent predictor of DCI (OR, 0.951; 95% CI, 0.914-0.990; P = 0.022) and worse prognosis (OR, 0.954; 95% CI, 0.916-0.993; P = 0.013). Serum apelin-13 levels significantly differentiated DCI and poor prognosis, with AUCs of 0.753 (95% CI, 0.656-0.850) and 0.791 (95% CI, 0.713-0.868) respectively. Using the Youden method, serum apelin-13 levels < 19.3 ng/ml distinguished the risk of DCI with 64.7% sensitivity and 77.1% specificity, and serum apelin-13 levels < 30.2 ng/ml discriminated the development of worse prognosis with 89.1% sensitivity and 63.4% specificity. Serum apelin-13 levels combined with Hunt-Hess scores and modified Fisher scores displayed a significantly higher AUC than any one of them for prognostic prediction (all P < 0.05). Decreased serum apelin-13 levels, which are strongly correlated with disease severity, independently predicted poor outcomes following aSAH, substantializing serum apelin-13 as a useful prognostic biomarker of aSAH.

[Clinical analysis of modified Chaiping decoction in treating HBeAg-negative chronic hepatitis B].

To observe the clinical efficacy of modified Chaiping decoction for HBeAg-negative chronic hepatitis B under DaBianZheng theory(syndrome differentiation theory) guidance with understanding of purgative detoxing and modern pharmacology research of traditional Chinese medicine. The patients with HBeAg-negative chronic hepatitis B(n=119) were randomly divided into treatment group(n=69) and control group(n=50). The patients in treatment group were treated with the modified Chaiping decoction(6 doses per week, one dose every day in two times by oral administration), and the patients in control group were treated with lamivudine(LAM) (100 mg/time, once a day). All of patients were treated for 48 weeks. The liver functions, levels of DNA of hepatitis B virus (HBV-DNA) and clinical symptoms were observed at weeks 12, 24, 36 and 48 in both groups. The levels of ALT and HBV-DNA in serum were also observed 24 weeks and 48 weeks after treatment in two groups. There was no significant difference in total effective rate between treatment group and control group at week 24, but the total effective rate in treatment group was higher than that in the control group at weeks 12, 36 and 48(P<0.05); the improvement of liver functions in the treatment group was superior than that in the control group at weeks 12, 36 weeks and 48(P<0.01 or P<0.05), but there was no significant difference at week 24; the improvement of serum HBV-DNA in the treatment group was significantly lower than that in the control group at week 12(P<0.01), but there was no significant difference at weeks 24, 36 and 48; the negative converse rate of serum HBV-DNA in the treatment group was lower than that in the control group at weeks 12, 24 and 36(P<0.01 or P<0.05), but there was no significant difference at week 48; the improvement of fatigue, lassitude, abdominal distension and hypochondriac pain in treatment group was significantly better than that in the control group at weeks 12 and 24(P<0.01 or P<0.05), but there was no significant difference in the improvement of fatigue and hypochondriac pain at weeks 36 and 48; the abnormal rate of ALT in treatment group was significantly lower than that in the control group 24 weeks and 48 weeks after drug withdrawal(P<0.01); there was no significant difference in abnormal rate of serum HBV-DNA 24 weeks after drug withdrawal, but it was significantly lower than that in the control group 48 weeks after drug withdrawal(P<0.05). Modified Chaiping decoction with combination of long term medication and intermittent administration showed better clinical efficacy on HBeAg-negative chronic hepatitis B. Its prescription compositions shall be further optimized and consummated under guidance of disease differentiation and syndrome differentiation, and its clinical research on hepatic fibrosis and living quality shall be carried out.

The Effectiveness and Safety of Exenatide Versus Metformin in Patients with Polycystic Ovary Syndrome: A Meta-Analysis of Randomized Controlled Trials.

Polycystic ovary syndrome (PCOS) is an endocrine disorder that affects women of childbearing age, resulting in reproductive dysfunction, hyperinsulinemia, and obesity. While several drugs are currently approved for use in these patients, their relative effectiveness remains controversial. The purpose of this meta-analysis was to evaluate the reproductive efficacy and safety of exenatide, a glucagon-like peptide-1 receptor agonist, versus metformin, an insulin sensitizer, in the treatment of patients with PCOS. Nine randomized controlled trials (RCTs) were included, comprising 785 PCOS patients, of whom 385 received exenatide and 400 received metformin. Compared with metformin, exenatide was significantly more effective in treating these patients, as demonstrated by increased pregnancy rate (relative risk (RR) = 1.93, 95% confidence interval (CI) 1.28 to 2.92, P = 0.002), greater ovulation rate (RR = 1.41, 95% CI 1.11 to 1.80, P = 0.004), decreased body mass index (mean difference = - 1.72 kg/m2, 95% CI - 2.27 to - 1.18, P = 0.00001), and improved insulin resistance (standard mean difference = - 0.62, 95% CI - 0.91 to - 0.33, P < 0.0001). There was no significant difference in the occurrence of adverse events (gastrointestinal reactions, hypoglycemia, etc.) between the two therapies. However, given the moderate to high quality and possible bias of the included studies, the available evidence is inconclusive. More high-quality studies are needed to assess the effects of exenatide in order to provide stronger evidence for its use in this patient population.

Oreocharisguangwushanensis, a new species of Gesneriaceae from Sichuan Province, China.

A new species of Oreocharis, O.guangwushanensis from the Sichuan Province of south-western China, is described and illustrated here. This new species has a pink corolla that is different from other species of Oreocharis in southwest China and, although it is morphologically similar to O.ronganensis and O.reticuliflora, it has significant differences in the colour and shape of the corolla, the apex of the corolla limb, shape and indumentum of the filaments and a shorter pistil. A detailed description, colour photographs, distribution and habitat, as well as the IUCN conservation status, are also provided.

A CO2-responsive smart fluid based on supramolecular assembly structures varying reversibly from vesicles to wormlike micelles.

CO2-responsive smart fluids have been widely investigated in the past decade. In this article, we reported a CO2-responsive smart fluid based on supramolecular assembly structures varying from vesicles to wormlike micelles. Firstly, oleic acid and 3-dimethylaminopropylamine reacted to form a single-chain weak cationic surfactant with a tertiary amine head group, N-[3-(dimethylamino)propyl]oleamide (NDPO). Then, 1,3-dibromopropane was used as the spacer to react with NDPO to form a gemini cationic surfactant, trimethylene α,ω-bis(oleate amide propyl dimethyl ammonium bromide) (GCS). By controlling the feed ratio of 1,3-dibromopropane and NDPO, we found that the mixtures of GCS and NDPO with the molar ratio of 7 : 3 approximately could form vesicles in aqueous solution by supramolecular self-assembly. After bubbling CO2, the tertiary amine of NDPO was protonated. The packing parameter of the mixed surfactants reduced accordingly, accompanied by the transition of aggregates from vesicles to wormlike micelles. As a result, the zero-shear viscosity of the solution increased by more than four orders in magnitude. When the solid content of GCS/NPDO mixtures was higher than 5 wt% in solution, the sample treated by CO2 behaved as a gel over a wide frequency range with shear-thinning and self-healing properties. In addition, the sol-gel transition could be repeatedly and reversibly switched by cyclically bubbling CO2 and N2. Our effort may provide a new strategy for the design of CO2-responsive smart fluids, fostering their use in a range of applications such as in enhanced oil recovery.

Correction: A CO2-responsive smart fluid based on supramolecular assembly structures varying reversibly from vesicles to wormlike micelles.

[This corrects the article DOI: 10.1039/D0RA03854G.].

[Blockade of TLR4/NF-κB pathway promotes the inflammation of Acinetobacter baumannii-infected rats].

Objective To explore the effects of TLR4 on Acinetobacter baumannii (A. baumannii) infection in a rat model. Methods Healthy male SD rats were divided into normal control group, TAK-242 treated group, A. baumannii treated group, TAK-242 and A. baumannii combined treatment group. Rats of TAK-242-treated group were prepared by caudal vein injection of TAK-242 (1 mg/kg). A. baumannii were isolated from intensive care unit (ICU) and the freshly grown bacteria (1×108 CFU/mL) were prepared. Each normal or TAK-242-treated rat was inoculated with 50 µL A. baumannii through trachea. The bronchoalveolar lavage fluid (BALF) and blood were collected at 72 hours after inoculation. The histopathology of lung was evaluated by HE staining. TNF-α and IL-6 were detected by ELISA. The level of phosphorylated NF-κBp65 (p-NF-κBp65) in peripheral blood mononuclear cells (PBMCs) was detected by Western blot analysis. Results A. baumannii were eliminated within 72 hours in normal rats, whereas bacteria continued to replicate rapidly in the lungs of TAK-242 A. baumannii treated group. The pulmonary inflammatory was more severe than the normal rats. The levels of TNF-α and IL-6 increased markedly after the infection. However, the levels of TNF-α and IL-6 in the TAK-242 combined with A. baumannii treated group were lower than those in the A. baumannii treated group. The level of p-NF-κBp65 increased significantly in the PBMCs of the normal rats 72 hours after infected with A. baumannii, but increased slightly in the TAK-242 combined with A. baumannii treated group. Conclusion TLR4/NF-κB pathway plays an important role in the process of A. baumannii infection, and TLR4 can be used as a target molecule in the treatment of A. baumannii infection.

[Activation of platelet activating factor receptor by Acinetobacter baumannii results in oxidative stress and apoptosis in human bronchial epithelial cells].

Objective To investigate the effect of platelet activating factor receptor (PAFR) on human bronchial epithelial (HBE) cells infected by Acinetobacter baumannii (A. baumannii). Methods HBE cells were divided into control group, ginkgolide B (GB) group, A. baumannii infected group, A. baumannii infection and inhibitor group. HBE cells were infected with low dose (1×103 CFU/mL), medium dose (1×105 CFU/mL) and high dose (1×107 CFU/mL) A. baumannii separated from clinical samples. The PAFR activity was blocked by the 10 µmol/L GB. The expression of PAFR was detected using Western blotting in HBE cells. The proliferation ability of HBE cells was detected using CCK-8 assay. The oxidative stress level was evaluated by superoxide dismutase (SOD) and malondialdehyde(MDA) kits. Apoptosis of HBE cells was observed by annexin V-FITC-V/PI staining. The phosphorylation level of PAFR and its downstream molecule JAK1/STAT1 in HBE cells were examined by Western blot analysis. Results Compared with the control group, the expression of PAFR increased significantly in A. baumannii infected group. A. baumannii infection could decrease cell vitality, but increase intracellular oxidative stress, apoptosis, and JAK1/STAT1 phosphorylation. Conclusion PAFR is an important mediator molecule for A. baumannii infection in HBE cells, and PAFR/JAK1/STAT1 signaling pathway plays an important role in the pulmonary infection of A. baumannii.

[Establishment of Acinetobacter baumannii-induced pneumonia model in mice].

Objective To establish Acinetobacter baumannii (A. baumannii)-induced pneumonia models in C57BL/6 mice, and study the molecule mechanism of A. baumannii infection. Methods Eighty C57BL/6 mice were divided into normal control group, cyclophosphamide-treated group, A. baumannii infection group, and cyclophosphamide-pretreated A. baumannii infection group. Immunodeficient mice were prepared by injecting cyclophosphamide intraperitoneally. A. baumannii was isolated from intensive care unit (ICU) and fresh bacteria (1×108 CFU/mL) were prepared. Each normal or immunodeficient mouse was inoculated with 50 µL A. baumannii through trachea. The lung, bronchoalveolar lavage fluid (BALF) and blood were collected at 6, 24 and 72 hours after inoculation. The numbers of white blood cells (WBCs) and neutrophils were detected by cell counting. The histopathology of the lung was evaluated by HE staining. Cytokines such as granulocyte macrophage colony-stimulating factor (GM-CSF), interferon γ (IFN-γ), interleukin 1ß (IL-1ß), IL-2, IL-4, IL-5, IL-6, IL-10, IL-12, tumor necrosis factor α (TNF-α) were detected by ELISA. Results A. baumannii was eliminated within 72 hours after infection in normal mice, whereas the bacteria continued to replicate rapidly in the lungs and blood in the immunodeficient mice. The numbers of WBCs and neutrophils were elevated markedly 6 hours post infection, and return to the normal within 72 hours. However, the numbers of WBCs and neutrophils continuously increased in cyclophosphamide-pretreated A. baumannii infection group, and the pulmonary inflammatory was more severe than that in the normal mice. The cytokines of blood increased markedly 6 hours post infection, and then decreased until 72 hours. However, the cytokines continuously increased in cyclophosphamide-pretreated A. baumannii infection group. Conclusion A. baumannii-induced pneumonia models in C57BL/6 mice were established successfully.

[Caspase-1 inhibitor AC-YVAD-CMK blocks IL-1ß secretion of bone marrow-derived macrophages induced by Acinetobacter baumannii].

Objective To explore the effect of caspase-1 selective inhibitor AC-YVAD-CMK on IL-1ß secretion of bone marrow-derived macrophages (BMDMs) induced by Acinetobacter baumannii (A. baumannii). Methods Macrophages were separated from C57BL/6 mice which were stimulated using different concentrations of A. baumannii. The level of IL-1ß in the culture supernatant was detected by ELISA. The expression of pro-IL-1ß mRNA and protein were detected using the real-time quantitative PCR and Western blot analysis, respectively. The role of caspase-1 in the secretion of IL-1ß was tested by AC-YVAD-CMK treatment to block caspase-1. Pneumonia models in C57BL/6 mice were prepared by A. baumannii inoculation. The level of IL-1ß in bronchoalveolar lavage fluid (BALF) and the morphology of lung were detected by ELISA or HE staining, respectively. Results IL-1ß level in the culture supernatant was up-reregulated by A. baumannii stimulation in a dose-dependent manner. The expression of pro-IL-1ß mRNA and protein were not significantly changed with A. baumannii stimulation. Mature IL-1ß secretion was blocked by AC-YVAD-CMK either in vitro or in vivo. The damage of lung induced by A. baumannii infection in mice was ameliorated by AC-YVAD-CMK. Conclusion AC-YVAD-CMK alleviates pulmonary pathological damage by reducing the caspase-1-mediated IL-1ß secretion.