Impact of ENPP1 K121Q on Change of Insulin Resistance after Web-Based Intervention in Korean Men with Diabetes and Impaired Fasting Glucose

Ectoenzyme nucleotide pyrophosphate phosphodiesterase 1 (ENPP1) gene has been studied in relation to type 2 diabetes mellitus (T2DM) and insulin resistance (IR). We hypothesized that the difference in genotype may be one of the factors that affect the outcome of intervention. We genotyped 448 men with fasting glucose≥5.6 mM/L, including 371 in subjects with K allele (KK) (69 control group [CG]; and 302 intervention group [IG]) and 77 in subjects with Q allele (KQ+QQ) (13 CG and 64 IG). The web-based intervention based on a lifestyle modification was delivered by e-mail once a month for 10 months. In the KK, IG demonstrated significantly decreased levels of fasting serum insulin (FSI) as compared to CG and homeostasis model of assessment of insulin resistance (HOMA-IR). In the KQ+QQ IG group, hemoglobin A1c (HbA1c), FSI and HOMA-IR were significantly decreased, and showed further reduction in the HOMA-IR than KQ+QQ CG. After analysis of covariance, K121Q did significantly influence the change of HbA1c in CG after appropriate adjustment. In a multivariate model, BMI change predicted HOMA-IR change (adjusted β=0.801; P=0.022) in KK IG subjects with T2DM. ENPP1 K121Q did not influence the change in IR. However, individuals with T2DM carrying the K121 variant are very responsive to the effect of BMI reduction on HOMA-IR.

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Application of Lidocaine Jelly on Chest Tubes to Reduce Pain Caused by Drainage Catheter after Coronary Artery Bypass Surgery

The objective of this study was to assess the effect of lidocaine jelly application to chest tubes on the intensity and duration of overall pain, chest tube site pain and the required analgesics for postoperative pain relief in coronary artery bypass graft (CABG) patients. For patients in group L, we applied sterile 2% lidocaine jelly on the chest tubes just before insertion, and for patients in group C, we applied normal saline. Overall visual analogue scale (VAS), maximal pain area with their VAS were documented postoperatively, and the frequency that button of patient-controlled analgesia was pressed (FPB) and total fentanyl consumption were assessed. The number of patients who complained that tube site was the most painful site was significantly higher in group C than in group L (85% vs. 30% at extubation, P<0.001). The overall VAS score was significantly higher in group C than in group L (39.14±12.49 vs. 27.74±13.76 at extubation, P=0.006). After all of the tubes were removed, the VAS score decreased more in group C (5.74±4.77, P<0.001) than in group L (3.05±2.48, P<0.001). FPB and total fentanyl consumption were significantly higher in group C than in group L (73.00, 59.00-78.00 vs. 34.00, 31.00-39.25, P<0.001; 2,214.65±37.01 vs. 1,720.19±361.63, P<0.001, respectively). Lidocaine jelly application is a very simple way to reduce postoperative pain by reducing chest tube site pain after CABG. (Clinical Trials Registry No. ACTRN 12611001215910)     

A Case Report of Testicular Sparganosis Misdiagnosed as Testicular Tumor

Sparganosis is a parasitic infestation of human by plerocercoid larvae. Sparganum is usually reported to be found in the subcutaneous tissues as well as other organs, including scrotum. However, testicular sparganosis is extremely rare, because of strong capsule of tunica albuginea. An urban-living 54-yr-old Korean man presented with left scrotal pain for 6 yr. Both testes look normal physically. Ultrasonography revealed poorly defined, heterogeneous mass with increased echogenicity in the left testis. This case was misdiagnosed as testicular tumor and underwent orchiectomy, but was diagnosed as testicular sparganosis by histopathology. Sparganosis should be included for differential diagnosis of testis tumor in countries where sparganosis is prevalent.

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Prevalence of Osteoporosis in Female Patients with Advanced Knee Osteoarthritis Undergoing Total Knee Arthroplasty

This study sought to demonstrate bone mineral density (BMD) conditions in elderly female patients with knee osteoarthritis (OA) undergoing total knee arthroplasty (TKA). In addition, we sought to determine whether their BMD conditions differ from those of community-based females without knee OA. Finally we sought to determine whether clinical statuses are related to BMD in the knee OA patients. BMD conditions in 347 female patients undergoing TKA and 273 community-based females were evaluated. Additionally, comparative analyses of BMD between age and body mass index-matched knee OA groups (n=212) and the control groups (n=212) were performed. In the pre-matched knee OA group, regression analyses were performed to determine whether preoperative clinical statuses were related to BMD. Considerable prevalence of coexistent osteoporosis (31%) was found in the pre-matched knee OA patients undergoing TKA. We found no significant differences of the BMD T-scores and the prevalence of osteoporosis between the age and body mass index-matched knee OA and control groups. In the pre-matched knee OA patients, poorer preoperative clinical scores were related to poorer BMD T-scores in the proximal femur and/or lumbar spine. Our study suggests that more attention should be paid to identify and treat osteoporosis in elderly female patients with advanced knee OA undergoing TKA.

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Simple preparation of graphene quantum dots with controllable surface states from graphite

Graphite is economic and earth-abundant carbon precursor for preparing graphene quantum dots (GQDs). Here, we report a facile and green approach to produce GQDs from graphite flakes via a pulsed laser ablation (PLA) method assisted by high-power sonication. A homogeneous dispersion of graphite flakes, caused by high-power sonication during PLA, leads to the formation of GQDs following a laser fragmentation in liquid (LFL) rather than laser ablation in liquid (LAL) mechanism. The final product of GQDs exhibits the distinct structural, chemical, and optical properties of pristine graphene itself. However, graphene oxide quantum dots (GOQDs) with abundant surface oxygen-rich functional groups are readily formed from graphite flakes when high-power sonication is not employed during the PLA process. GQDs and GOQDs show a significantly different luminescence nature. Hence, selective production of either functional GQDs or GOQDs can be achieved by simply turning the high-power sonication during the PLA process on and off. We believe that our modified PLA process proposed in this work will further open up facile and simple routes for designing functional carbon materials.

The proposed technique enables selectively producing graphene quantum dots (on-GQDs) and graphene oxide quantum dots (off-GOQDs) by depending on the applying sonication during the pulsed laser ablation process.     

肱动脉内皮功能与颅内动脉粥样硬化性狭窄的相关性

目的 探讨缺血性脑血管病患者肱动脉血流介导的血管扩张和非内皮依赖性血管舒张与颅内动脉狭窄的相关性。方法 将67例缺血性脑血管病患者根据有无颅内血管狭窄分为两组,颅内血管狭窄组和对照组。对两组患者一般资料及肱动脉血流介导的血管扩张功能、非内皮依赖性血管舒张功能进行对比分析,并进一步分析肱动脉血流介导的血管扩张功能、非内皮依赖性血管舒张功能与颅内血管狭窄数量的相关性。结果 颅内动脉狭窄组有50例,对照组有17例,年龄、肱动脉血流介导的血管扩张功能、非内皮依赖性血管舒张功能、高血压病、糖尿病、既往卒中或短暂性脑缺血发作史与颅内动脉硬化性狭窄相关,且肱动脉血流介导的血管扩张功能（rs-0.869,P0.000）与非内皮依赖性血管舒张功能 （rs－0.490,P0.000）分别与颅内血管狭窄的数量存在负相关关系。非条件Logistic回归分析得出肱动脉血流介导的血管扩张可作为评估颅内动脉硬化性狭窄的独立因素,以肱动脉血流介导的血管扩张功能值为2.95%时诊断颅内动脉硬化性狭窄的可能性最大。结论 颅内动脉硬化性狭窄患者存在肱动脉血流介导的血管扩张功能的降低,且肱动脉血流介导的血管扩张功能可能对颅内血管狭窄有一定的预测价值。     

Discovery of small molecule agonists targeting neuropeptide Y4 receptor using homology modeling and virtual screening

Neuropeptide Y4 receptor has the most significant effect on body weight and fat mass in its physiological functions, and the activation of Y4 receptor has explicit role on losing weight. The Y4 receptor has been successfully applied in the development of anti‐obesity agent, thus representing a potential therapeutic target for obesity treatment. Here, we reported the first discovery of small molecule agonists targeting Y4 receptor: three Y4 receptor models with active and inactive conformations were built, each model was submitted following structure‐based virtual screening, and finally six hits were identified as Y4 receptor agonists. These results confirm the reliability of the constructed Y4 receptor models and the proposed computational strategy for investigating novel Y4 receptor agonists. These new small molecule Y4 receptor agonists will contribute to the further development of Y4 agonists as potential therapeutics and functional probes.     

结直肠侧向发育型肿瘤黏膜下层侵犯的危险因素分析

目的 探索结直肠侧向发育型肿瘤黏膜下层浸润的危险因素。 方法 2015年11月—2019年2月,在大连医科大学附属第一医院消化内镜中心行内镜黏膜下剥离术治疗,直径≥2.0 cm的侧向发育型肿瘤病例211例（221处病变）纳入回顾性分析,根据术后病理分成黏膜下层侵犯组（13例患者,14处病变）和非黏膜下层侵犯组（198例患者,207处病变）,临床特征、内镜特征、手术特征、病理特征组间比较行χ2检验或连续矫正χ2检验或Fisher精确检验,多因素分析使用Logistic回归分析。 结果 单因素分析发现结直肠癌病史（P=0.037）、病变直径（P=0.036）、部位（P=0.024）、非抬举征（P=0.040）是黏膜下层浸润的影响因素。进一步多因素Logistic回归分析提示：有结直肠癌病史者较无结直肠癌病史者更易发生黏膜下层浸润（OR=3.76,95%CI：1.338～23.768,P=0.018）,直肠病变较右半结肠病变更易发生黏膜下层浸润（OR=7.091,95%CI：1.437～34.274,P=0.016）,直径≥2.5 cm病变较直径＜2.5 cm病变更易发生黏膜下层浸润（OR=6.297,95%CI：1.375～28.836,P=0.018）,非抬举征阳性病变较非抬举征阴性病变更易发生黏膜下层浸润（P=0.021,OR=5.373,95%CI：1.291～22.360）。 结论 对于结直肠侧向发育型肿瘤,患者有结直肠癌病史,以及病变直径≥2.5 cm、位于直肠、术中非抬举征阳性均是发生黏膜下层浸润的独立危险因素。     

Cryptotanshinone ameliorates renal ischaemia–reperfusion injury by inhibiting apoptosis and inflammatory response

Cryptotanshinone (CTS) is a natural compound from the Chinese herb Salvia miltiorrhiza. Previous studies demonstrated that CTS possesses anti‐apoptotic and anti‐inflammatory properties. However, its effects and underlying mechanism on renal ischaemia reperfusion (IR) injury remain unknown. In the present study, we investigated the effects of CTS on renal IR injury and its potential underlying mechanisms. Mice were randomized into four groups as follows: (a) sham operation + vehicle, (b) sham operation + CTS, (c) IR + vehicle, (d) IR + CTS. The CTS‐treated group were injected intraperitoneally with CTS (10 mg/kg/d) for 7 days prior to IR operation. Renal IR injury was induced by clamping the bilateral renal artery for 30 minutes followed by 24 hours of reperfusion. The mice were then killed to collect the serum and the kidneys for analysis. The results of the present study showed that CTS pretreatment significantly attenuates IR‐induced renal functional and morphological injuries, which was accompanied with inhibition of cell apoptosis and inflammatory response. Moreover, the phosphorylation of p38 mitogen‐activated protein kinase (MAPK) and the activation of nuclear factor‐κB (NF‐κB) signalling were inhibited by CTS. Therefore, CTS could be a useful therapeutic agent in the fight against renal IR injury.     

Trends and risk factors of elderly-onset Crohn's disease: A nationwide cohort study

BACKGROUND The incidence of inflammatory bowel disease(IBD)is increasing in Asia.Numerous risk factors associated with IBD development have been investigated.AIM To investigate trends and environmental risk factors of Crohn’s disease(CD)diagnosed in persons aged≥40 years in South Korea.METHODS Using the National Health Insurance Service database,a total of 14060821 persons aged>40 years who underwent national health screening in 2009 were followed up until December 2017.Patients with newly diagnosed CD were enrolled and compared with non-CD cohort.CD was identified according to the International Classification of Diseases 10th revision and the rare/intractable disease registration program codes from the National Health Insurance Service database.The mean follow-up periods was 7.39 years.Age,sex,diabetes,hypertension,smoking,alcohol consumption,regular exercise,body mass index,anemia,chronic kidney disease(CKD)and dyslipidemia were adjusted for in the multivariate analysis model.RESULTS During the follow-up,1337(1.33/100000)patients developed CD.Men in the middle-aged group(40-64 years)had a higher risk than women[adjusted hazard ratio(aHR)1.46,95%confidence interval(CI):1.29-1.66];however,this difference tended to disappear as the age of onset increases.In the middle-aged group,patients with a history of smoking[(aHR 1.46,95%CI:1.19-1.79)and anemia(aHR 1.85,95%CI:1.55-2.20)]had a significantly higher CD risk.In the elderly group(age,≥65 years),ex-smoking and anemia also increased the CD risk(aHR 1.68,95%CI:1.22-2.30)and 1.84(95%CI:1.47-2.30,respectively).Especially in the middle-aged group,those with CKD had a statistically elevated CD risk(aHR 1.37,95%CI:1.05-1.79).Alcohol consumption and higher body mass index showed negative association trend with CD incidence in both of the age groups.[Middle-aged:aHR 0.77(95%CI:0.66-0.89)and aHR 0.73(95% CI:0.63-0.84),respectively][Elderly-group:aHR 0.57(95% CI:0.42-0.78)and aHR 0.84(95%CI 0.67-1.04),respectively].For regular physical activity and dyslipidemia,negative correlation between CD incidences was proved only in the middle-aged group[aHR 0.88(95%CI:0.77-0.89)and aHR 0.81(95%CI:0.68-0.96),respectively].CONCLUSION History of cigarette smoking,anemia,underweight and CKD are possible risk factors for CD in Asians aged>40 years.