Association of blood chromium and rare earth elements with the risk of DNA damage in chromate exposed population

Pollution of heavy metals often occurs in combination with multiple metal ions. Whether the genetic damage among chromate exposed population correlated with rare earth elements (REEs) was still not well elucidated. A total of 291 participants from a chromate production plant were recruited in the present study. The DNA oxidative damage was evaluated by urinary 8-hydroxydeoxyguanosine (8−OHdG) and the concentrations of chromium (Cr) and 15 REEs accumulated in the peripheral blood of participants were determined. The results showed that significant DNA oxidative damage was observed in chromate exposed workers. Blood REEs levels in the exposed group were significantly higher than the control group and blood REEs increased in a concentration dependent manner with Cr. Additionally, significant correlations were observed between blood Cr and 10 REEs concentrations. Blood Cr had a significant positive correlation with urinary 8−OHdG. Blood Cr and Yttrium had a positive interactive effect on urinary 8−OHdG. Collectively, the results suggested workers who had been working in the chromate plant were simultaneously exposed to chromate and a variety of REEs, which could have interactive effects on the DNA damage of workers.     

Two Chinese pedigrees for adenomatous polyposis coli: new mutations at codon 1309 and predisposition to phenotypic variations

Familial adenomatous polyposis (FAP) is an autosomal dominant inherited disease caused by a mutation in the adenomatous polyposis coli (APC) gene. Some studies have attempted to correlate mutations at codon 1309 with classic FAP (≥100 colorectal polyps). We report two Chinese FAP pedigrees with new frameshift mutations at codon 1309, in which affected individuals manifest phenotypic variations. Comprehensive physical examinations were performed for all living individuals and the medical data of deceased patients were collected. Screening of the APC and human mutY homolog (MUTYH) genes for germline mutations was conducted by direct polymerase chain reaction (PCR) sequencing. In two pedigrees, a heterozygous deletion in exon 16 of the APC gene was present in all FAP patients but absent in the unaffected individuals. There were no changes to the MUTYH gene. The first pedigree, with a new frameshift mutation at c.3926_3930 del AAAAG (p. Glu1309Aspfs X4), exhibited obvious differences in the polyp number such that the proband manifested only three colorectal polyps, whereas another patients showed the symptoms of classic FAP. The second pedigree, also traced a new mutation at c.3922_3925 del AAAG (p. Glu1309Argfs X11). Although all of the patients presented with classic polyposis, one of them exhibited a delayed onset of colorectal cancer in his 50s. Two novel mutations at codon 1309 in two Chinese families suffering from FAP could enrich the germline mutation spectrum of the APC gene. Families of individuals might manifest different phenotypes, even with an identical codon 1309 mutation, unlike in previous studies.     

Triglyceride-glucose index and short-term functional outcome and in-hospital mortality in patients with ischemic stroke

Background and aimsThe triglyceride-glucose (TyG) index has been demonstrated as an independent marker of ischemic stroke. Whether TyG index predicts short-term outcomes in patients with ischemic stroke remains uncertain. The aim of the study was to investigate the early prognosis value of TyG index in ischemic stroke patients.Methods and ResultsA total of 3216 acute ischemic stroke patients from 22 hospitals were included in this analysis. The TyG index was calculated as ln (fasting triglyceride [mg/dL] × fasting glucose [mg/dL]/2). Logistic regression model was performed to estimate the relationship between TyG index and unfavorable functional outcome of death or disability (modified Rankin Scale score of 4–6) at discharge. Risk reclassification with TyG index to predict unfavorable functional outcome was analyzed.During hospitalization, 748 patients (23.3%) experienced poor functional outcome and 105 patients (3.3%) died from all causes. The multivariable adjusted odds ratios for the highest versus lowest quartile of TyG index was 1.62 (95% CI 1.15–2.29) for unfavorable functional outcome at discharge. The addition of TyG index to the conventional model improved the risk reclassification (net reclassification improvement 10.37%; integrated discrimination improvement 0.27%; both p < 0.05) for poor functional outcome. Moreover, TyG index was associated with an odds ratio (95% CI) of 1.26 (1.02–1.55) for an ordinal shift in mRS score and 2.49 (1.21–5.12) for in-hospital mortality.ConclusionsHigher TyG index was associated with higher risk of unfavorable functional outcome at discharge and in-hospital mortality, implicating the significant short-term prognostic effect of TyG index in patients with ischemic stroke.     

Adherence patterns to oral hypoglycemic agents among primary care patients with type 2 diabetes

AimsTo examine patterns of adherence to oral hypoglycemic agents among primary care patients with type 2 diabetes mellitus and to assess whether these patterns were associated with baseline intervention allocation, sociodemographic characteristics, and clinical indicators.MethodsAdherence patterns were examined by Medication Event Monitoring System (MEMS) caps at baseline and 12 weeks. Participants (n = 72) were randomly allocated to a Patient Prioritized Planning (PPP) intervention or a control group. The PPP intervention employed a card-sort task to identify health-related priorities that included social determinants of health to address medication nonadherence. Next, a problem-solving process was used to address unmet needs involving referral to resources. Multinomial logistic regression examined patterns of adherence in relation to baseline intervention allocation, sociodemographic characteristics, and clinical indicators.ResultsThree patterns of adherence were found: adherent, increasing adherence, and nonadherent. Participants assigned to the PPP intervention were significantly more likely to have a pattern of improving adherence (Adjusted Odds Ratio (AOR)= 11.28, 95% confidence interval (CI)= 1.78, 71.60) and adherence (AOR=4.68, 95% CI=1.15, 19.02) than participants assigned to the control group.ConclusionPrimary care PPP interventions incorporating social determinants may be effective in fostering and improving patient adherence.     

Electroacupuncture at acupoints could predict the outcome of anterior nucleus thalamus high-frequency electrical stimulation in medically refractory epilepsy

Preliminary reports have demonstrated that anterior nucleus thalamus high-frequency electrical stimulation (ANT-HFS) is an effective treatment for patients who suffer from medically refractory epilepsy. However, its extensive application has been hampered by the high cost and the unpredictable outcome before the operation. Just like ANT-HFS in the brain, electroacupuncture (EA) at acupoints with electrical stimulation is also efficient in treating medically refractory epilepsy. Although the therapeutic mechanisms involve different activated positions, the neurotransmitters generated by the electrical stimulation are similar. It has been demonstrated that both ANT-HFS and EA at acupoints are related to an imbalance between the excitatory [glutamate (Glu), aspartate (Asp)] and inhibitory [GABA, glycine (Gly) and taurine (Tau)] neuronal transmitters. We, therefore, hypothesize that outcome of EA at acupoints can predict the therapeutic effect of ANT-HFS.     

Dose–response relationship between distinct serum uric acid trajectories and metabolic syndrome risk: A 5-year prospective cohort study

Background and aimsAlthough high serum uric acid (SUA) at baseline has been linked to increased risk for metabolic syndrome (MetS), the association of longitudinal SUA changes with MetS risk is unclear. We aimed to examine the effect of distinct SUA trajectories on new-onset MetS risk by sex in a Chinese cohort.Methods and resultsA total of 2364 women and 2770 men who were free of MetS in 2013 were enrolled in this study and followed up to 2018. Group-based trajectory modeling was applied to identify SUA trajectories. Cox proportional hazards model was used to evaluate the association between SUA trajectory and new-onset MetS. The dose–response relationship between SUA trajectories and MetS risk was examined by treating trajectory groups as a continuous variable. During a median follow-up of 48.0 months, 311 (13.16%) women and 950 (34.30%) men developed MetS. SUA trajectories (2013–2018) were defined as four distinct patterns in both women and men: “low”, “moderate”, “moderate-high”, and “high”. Compared with “low” SUA trajectory, the adjusted hazard ratio for incident MetS among participants with “moderate”, “moderate-high” and “high” trajectory was in a dose–response manner: 1.75 (95% CI: 1.08–2.82), 1.94 (95% CI: 1.20–3.14), and 3.05 (95% CI: 1.81–5.13), respectively, for women; 1.20 (95% CI: 0.97–1.49), 1.48 (95% CI: 1.19–1.85), and 1.66 (95% CI: 1.25–2.21), respectively, for men.ConclusionsElevated SUA trajectories are associated with increased risk for new-onset MetS in women and men. Monitoring SUA trajectories may assist in identifying subpopulations at higher risk for MetS.     

基于Curvelet变换的肺结节CT图像良恶性分类研究

目的早期肺癌患者的CT图像表现为结节状（在肺野内直径≤3cm的病灶），需要与结核球等良性病变鉴别开，以提高患者的5年生存率。方法本文基于Curvelet变换提取能量、熵、灰度均值及灰度标准差四种纹理特征值，按7：3比例将样本分为训练集与验证集。使用BP（back propagation）神经网络作为分类器。每一种纹理参数测试集的神经网络仿真值结合病理诊断结果绘制受试者工作特征曲线（receiver operator characteristic cllrve，ROC曲线），根据ROC下面积得到最优的几种纹理参数用于良恶性分类，并将分类结果与病理诊断结果进行比较。结果四种纹理参数构建的BP网络均具有诊断价值，每种纹理参数诊断价值各不相同，其中熵与灰度标准差的诊断价值优于能量与灰度均值，并且通过组合多种纹理参数可以提高诊断准确性。结论使用熵与灰度标准差两种纹理特征值构建BP神经网络能达到最好的分类效果，在一定程度上有利于肺癌的早期诊断。