Association of body mass index with risk of prediabetes in Chinese adults: A population‐based cohort study

Aims/IntroductionOverweight and obesity in adults are strongly associated with an increased risk of prediabetes, and this study set out to gain a better understanding of the optimal body mass index (BMI) range for assessing the risk of prediabetes in the Chinese population.Materials and MethodsThe cohort study included 100,309 Chinese adults who underwent health screening. Participants were divided into six groups based on the cut‐off point for BMI recommended by the World Health Organization (underweight: <18.5 kg/m², normal‐weight: 18.5–24.9 kg/m², pre‐obese: 25.0–29.9 kg/m², obese class I: 30.0–34.9 kg/m², obese class II: 35.0–39.9 kg/m², and obese class III ≥40 kg/m²). The association of BMI with prediabetes and the shape of the correlation were modeled using multivariate Cox regression and restricted cubic spline regression, respectively.ResultsIn the multivariate Cox regression model, with normal weight as the control group, underweight people had a lower risk of developing prediabetes, whereas obese and pre‐obese people had a higher risk of prediabetes. Additionally, in the restricted cubic spline model, we found that the association of BMI with prediabetes follows a positive dose–response relationship, but does not conform to the pattern of obesity paradox. Among the general population in China, a BMI of 23.03 kg/m² might be a potential intervention threshold for prediabetes.ConclusionsThe national cohort study found that the association of BMI with prediabetes follows a positive dose–response relationship, rather than a pattern of obesity paradox. For Chinese people with normal weight, more attention should be paid to glucose metabolism when BMI exceeds 23.03 kg/m².     

家庭参与式一体化照护对早产儿生长发育 及家庭照护能力的影响

目的 探讨基于家庭参与式护理模式的一体化照护对早产儿生长发育及家庭照护能力的影响。方法 选取74例早产儿及其家庭作为研究对象,随机分为干预组和对照组各37例。对照组接受早产儿常规护理;干预组接受基于家庭参与式护理模式的一体化照护方案,由专业照护团队在早产儿出生时、出生后及出院后提供全程一体化照护支持服务。比较两组早产儿的生长发育、母乳喂养情况及早产儿家庭照护能力。结果 两组各36例完成全程随访。两组早产儿在出生时、1月龄、3月龄身长、体质量、头围比较,差异无统计学意义(均P>0.05)。干预组早产儿在出院前、1月龄、3月龄的纯母乳喂养率显著高于对照组,且干预组父母在出院时家庭照护能力评分显著高于对照组(均P<0.05)。结论 基于家庭参与式护理模式的一体化照护能够有效促进早产儿纯母乳喂养、提高早产儿家庭照护能力,为早产儿顺利过渡至家庭照护提供有利保障。     

Exosomes Derived from Glioma Cells under Hypoxia Promote Angiogenesis through Up-regulated Exosomal Connexin 43

Glioblastoma multiform (GBM) is a highly aggressive primary brain tumor. Exosomes derived from glioma cells under a hypoxic microenvironment play an important role in tumor biology including metastasis, angiogenesis and chemoresistance. However, the underlying mechanisms remain to be elucidated. In this study, we aimed to explore the role of connexin 43 on exosomal uptake and angiogenesis in glioma under hypoxia. U251 cells were exposed to 3% oxygen to achieve hypoxia, and the expression levels of HIF-1α and Cx43, involved in the colony formation and proliferation of cells were assessed. Exosomes were isolated by differential velocity centrifugation from U251 cells under normoxia and hypoxia (Nor-Exos and Hypo-Exos), respectively. Immunofluorescence staining, along with assays for CCK-8, tube formation and wound healing along with a transwell assay were conducted to profile exosomal uptake, proliferation, tube formation, migration and invasion of HUVECs, respectively. Our results revealed that Hypoxia significantly up-regulated the expression of HIF-1α in U251 cells as well as promoting proliferation and colony number. Hypoxia also increased the level of Cx43 in U251 cells and in the exosomes secreted. The uptake of Dio-stained Hypo-Exos by HUVECs was greater than that of Nor-Exos, and inhibition of Cx43 by ^37,43gap27 or lenti-Cx43-shRNA efficiently prevented the uptake of Hypo-Exos by recipient endothelial cells. In addition, the proliferation and total loops of HUVECs were remarkably increased at 24 h, 48 h, and 10 h after Hypo-Exos, respectively. Notably, ^37,43gap27, a specific Cx-mimetic peptide blocker of Cx37 and Cx43, efficiently alleviated Hypo-Exos-induced proliferation and tube formation by HUVECs. Finally, ^37,43gap27 also significantly attenuated Hypo-Exos-induced migration and invasion of HUVECs. These findings demonstrate that exosomal Cx43 contributes to glioma angiogenesis mediated by Hypo-Exos, and suggests that exosomal Cx43 might serve as a potential therapeutic target for glioblastoma.     

The upregulated intestinal folate transporters direct the uptake of ligand-modified nanoparticles for enhanced oral insulin delivery

Transporters are traditionally considered to transport small molecules rather than large-sized nanoparticles due to their small pores. In this study, we demonstrate that the upregulated intestinal transporter (PCFT), which reaches a maximum of 12.3-fold expression in the intestinal epithelial cells of diabetic rats, mediates the uptake of the folic acid-grafted nanoparticles (FNP). Specifically, the upregulated PCFT could exert its function to mediate the endocytosis of FNP and efficiently stimulate the traverse of FNP across enterocytes by the lysosome-evading pathway, Golgi-targeting pathway and basolateral exocytosis, featuring a high oral insulin bioavailability of 14.4% in the diabetic rats. Conversely, in cells with relatively low PCFT expression, the positive surface charge contributes to the cellular uptake of FNP, and FNP are mainly degraded in the lysosomes. Overall, we emphasize that the upregulated intestinal transporters could direct the uptake of ligand-modified nanoparticles by mediating the endocytosis and intracellular trafficking of ligand-modified nanoparticles via the transporter-mediated pathway. This study may also theoretically provide insightful guidelines for the rational design of transporter-targeted nanoparticles to achieve efficient drug delivery in diverse diseases.     

Corrosion Behavior of Alx(CrFeNi)1−x HEA under Simulated PWR Primary Water

High-entropy alloys (HEAs) have great potential as accident-tolerant fuel (ATF) cladding. Aluminum-forming duplex (BCC and FCC) stainless-steel (ADSS) is a candidate for ATF cladding, but the multiphase composition is detrimental to its corrosion resistance. In this paper, two single-phase HEAs were prepared by adjusting the content of each element in the ADSS alloy. The two HEAs were designed as Al_0.05(CrFeNi)_0.95(FCC) and Al_0.25(FeCrNi)_0.75(BCC). Their corrosion behavior under simulated pressurized water reactor (PWR) primary water was investigated. The corrosion products and corrosion mechanisms of these two HEAs were explored. The results show that the corrosion resistance of HEA alloys containing FCC is better than that of BCC and ADSS alloys. At the same time, the reason why the BCC structure composed of these four elements is not resistant to corrosion is revealed.     

老年患者肺部感染抗菌药物应用分析

目的探讨老年患者肺部感染抗菌药物的合理应用。方法采用回顾性调查方法,对120例老年患者肺部感染抗菌药物使用的合理性进行统计分析。结果15例革兰阳性(G+)球菌感染,主要应用阿奇霉素磷酸二氢钠、阿莫西林克拉维酸钾进行治疗;18例G+球菌、革兰阴性(G-)球菌、G-杆菌混合感染,主要给予加替沙星氯化钠注射液治疗;6例G+球菌、G-球菌混合感染;G+球菌支原体混合感染6例,应用阿莫西林克拉维酸钾治疗;15例支原体感染,主要应用阿莫西林克拉维酸钾、阿奇霉素磷酸二氢钠治疗;42例未检出致病菌,未作病原学检测18例。在收集的病例中,哌拉西林钠舒巴坦钠、加替沙星注射液为主要应用药物。结论老年患者基础疾病较多,肺部感染以混合病原菌感染多见。药物治疗多给予阿莫西林克拉维酸钾、阿奇霉素磷酸二氢钠、加替沙星氯化钠注射液、哌拉西林钠舒巴坦钠等抗菌药物。合理应用抗菌药物,应从药物敏感性试验和合理联用等方面加强,以减少耐药性和药物不良反应的发生。     

Optimization of photo-biomodulation therapy for wound healing of diabetic foot ulcers in vitro and in vivo

Unclear optical parameters make photo-biomodulation (PBM) difficult to implement in diabetic foot ulcer (DFU) clinically. Here, 12 wavelengths (400–900 nm) were used to conduct PBM to heal DFU wounds in vitro and in vivo. PBM at 10 mW/cm² and 0.5–4 J/cm² with all 12 wavelengths promoted proliferation of diabetic wound cells. In a mimic DFU (mDFU) rat model, PBM (425, 630, 730, and 850 nm, and a combination light strategy) promoted mDFU healing. The positive cell proliferation, re-epithelialization, angiogenesis, collagen synthesis, and inflammation were possible mechanisms. The combination strategy had the best effect, which can be applied clinically.     

乙型肝炎与肾素—血管紧张素—醛固酮系统的关系

作者用放射免疫法测定了30例(68例次)乙型肝炎(乙肝)患者和35名正常人的血浆血管紧张素Ⅱ(AT Ⅱ)水平。结果表明,30例乙肝患者AT Ⅱ明显高于35名正常人;各型乙肝患者AT Ⅱ升高值与病情轻重一致,8例肝肾综合征(HRS)患者ATⅡ显著高于未并发HRS者。用巯甲丙脯酸(CPT)治疗后,ATⅡ明显下降,肾功能改善。提示AT Ⅱ升高可能是HRS发生的原因之一,CPT可能抑制了ATⅡ的产生,对HRS有一定疗效。     

趋化因子BLC表达载体构建及在肿瘤细胞中的表达

目的 建立真核表达重组体pcDNA-BLC的稳定转染细胞株,为研究趋化因子BLC的抗肿瘤免疫作用机制奠定基础。方法 以小鼠脾脏组织总RNA为模板,通过RT-PCR扩增BLC全长cDNA,并将扩增的cDNA片段插入pcDNA3．1( )真核表达质粒,构建重组质粒pcDNA-BLC,重组子经限制性内切酶酶切分析及测序鉴定后,用脂质体转染技术导入Colon26细胞,经G418筛选建立稳定转染细胞株。用免疫印迹法(Western Blot)鉴定转染细胞表达的蛋白质,证实BLC存在。用趋化实验证实转染细胞株表达的BLC有生物学活性。结果 真核表达重组体pcDNA-BLC构建成功,pcDNA-BLC稳定转染细胞株表达有生物学活性的BLC。结论 成功建立了BLC的稳定转染细胞株,为研究BLC的抗肿瘤免疫作用机制继而发展肿瘤疫苗奠定了基础。