The Integrated Bioinformatic Assay of Genetic Expression Features and Analyses of Traditional Chinese Medicine Specific Constitution Reveal Metabolic Characteristics and Targets in Steatosis of Nonalcoholic Fatty Liver Disease.

Purpose: In this study, our primary aim is to analyze the genetic expression feature and analyze specific Traditional Chinese medicine (TCM) constitution distribution in non-alcoholic fatty liver disease (NAFLD) and reveal the metabolic characteristic of NAFLD. Materials and Methods: For revealing genetic features, we obtained the gene expression data from the Gene Expression Omnibus (GEO) database of the National Center for Biotechnology Information (NCBI). The genetic data on NAFLD were analyzed by identifying differentially expressed genes (DEGs), associated pathways, co-expressed genetic networks, and gene set enrichment function. Concurrently, we assessed specific constitution distributions among local NAFLD patients through established TCM constitution models and determined the independent variable, including specific constitution to the NAFLD via the regression analyses. Results: The analyses on GEO datasets showed that simple steatosis in NAFLD is strongly associated with HOMA-insulin resistance (HOMA-IR). Analyses of GEO datasets revealed significantly altered genetic expression profiles between NAFLD and normal populations. For TCM constitution analyses, we demonstrated a decline in yin-yang harmony (YYH) and yang-asthenia (YAAC) constitution, whereas there was an increase in qi-stagnation (QSC) and phlegm-dampness (PDC) in NAFLD. The binary logistic regression analysis indicated that besides other metabolic parameters, YYH, qi asthenia (QAC), YYAC, and yin-asthenia (YAC) were the independent variables of NAFLD, while YAC was the independent variables of T2D. The multilinear regression analyses suggested that NAFLD, DM, BMI, waist, TC, TG, hypertension, ALT, AST, and YAC were the significant determinators of the FPG. Conclusion: This study presents a relatively comprehensive metabolic profile in steatosis of NAFLD, revealed by significant genetic expression feature alterations and different TCM constitution distribution in NAFLD. Through this method, the study intends to associate the genetic feature with the phenotype of TCM constitution. The results could be applied to assist integrative medicine research in exploring the appropriate personalized approaches for NAFLD.

Rare case of squamous cell carcinoma arising in a recurrent ovarian mature cystic teratoma of a young woman: A case report and review of the literature.

RATIONALE: Malignant transformations of ovarian mature cystic teratomas (MCTs) occur rarely, especially in young women. Although it is extremely difficult to diagnose them, serum tumor marker level testing in combination with the use of imaging techniques may be useful in preoperative diagnosis. PATIENT CONCERNS: We present the case of a 31-year-old Chinese woman with the malignant transformation of an ovarian MCT. The patient had a history of oophorocystectomy due to an MCT of the right ovary 6 years prior and a gemellary pregnancy owing to in vitro fertilization and embryo transfer. Her serum CA19-9 levels were persistently mildly elevated after the first surgery. DIAGNOSES: She was diagnosed with ovarian squamous carcinoma, arising from an MCT (International Federation of Gynecology and Obstetrics stage IA). INTERVENTIONS: A right salpingo-oophorectomy and omentectomy were performed and the patient underwent chemotherapy. OUTCOMES: The patient was disease-free at the 6-month follow-up. LESSONS: The malignant transformation of MCTs usually occurs in postmenopausal women with poor prognoses; it is very rarely observed in young women. Although the early detection and complete surgical resection of the tumor are crucial to survival, preoperative diagnosis of this malignancy is difficult. This case reiterates the fact that malignant transformation of MCTs can occur at any age. Rapid tumor growth along with persistently elevated tumor marker levels may be indicative of the malignant transformation of MCTs.

Astragalus polysaccharides affect insulin resistance by regulating the hepatic SIRT1-PGC-1α/PPARα-FGF21 signaling pathway in male Sprague Dawley rats undergoing catch-up growth.

The present study investigated the effects of Astragalus polysaccharides (APS) on insulin resistance by modulation of hepatic sirtuin 1 (SIRT1)­peroxisome proliferator­activated receptor (PPAR)­Î³ coactivator (PGC)­1α/PPARα­fibroblast growth factor (FGF)21, and glucose and lipid metabolism. Thirty male Sprague Dawley rats were divided into three groups: A normal control group, a catch­up growth group and an APS­treated (APS-G) group. The latter two groups underwent food restriction for 4 weeks, prior to being provided with a high fat diet, which was available ad libitum. The APS­G group was orally treated with APS for 8 weeks, whereas the other groups were administered saline. Body weight was measured and an oral glucose tolerance test (OGTT) was conducted after 8 weeks. The plasma glucose and insulin levels obtained from the OGTT were assayed, and hepatic morphology was observed by light and transmission electron microscopy. In addition, the mRNA expression levels of PGC­1α/PPARα, and the protein expression levels of SIRT1, FGF21 and nuclear factor­κB were quantified in the liver and serum. APS treatment suppressed abnormal glycolipid metabolism and insulin resistance following 8 weeks of catch­up growth by improving hepatic SIRT1­PPARα­FGF21 intracellular signaling and reducing chronic inflammation, and by partially attenuating hepatic steatosis. The suppressive effects of APS on liver acetylation and glycolipid metabolism­associated molecules contributed to the observed suppression of insulin resistance. However, the mechanism underlying the effects of APS on insulin resistance requires further research in order to be elucidated. Rapid and long­term treatment with APS may provide a novel, safe and effective therapeutic strategy for type 2 diabetes.