Objective · To investigate association between serum 25-hydroxyvitamin D3 [25(OH)D3] level and diabetic peripheral neuropathy (DPN) in elderly patients with type 2 diabetes mellitus and explore its value in clinical practice for early screening and prevention of DPN. Methods · A total of 188 elderly patients with type 2 diabetes mellitus were enrolled in this cross-sectional study, including 100cases with DPN and 88 cases without. Clinical data was collected and serum levels of 25(OH)D3, glycosylated hemoglobin (HbA1c), blood lipids and hepatic and renal functions were determined in all patients. Spearman correlation analysis was used to evaluate relationship between each index and 25(OH)D3, and Logistic regression was used for statistical analysis of risk factors for DPN. Results · The median of serum 25(OH)D3 level was significantly lower in the patients with DPN (34.95 nmol/L) than that of the patients without DPN (52.6 nmol/L)(P<0.01). Spearmancorrelation analysis showed that there existed a negative correlation between the level of 25(OH)D3 and age, HbA1c and fasting blood glucose (r=-0.37, -0.53, and -0.29, respectively, P<0.01). The multiple Logistical regression analysis revealed that the 25(OH)D3 level was an independent risk factor for DPN. The odds ratio of serum 25(OH)D3 was 15.5 (OR=15.50, 95% CI=2.00 ~ 119.62) for the lowest quartile versus the highest quartile. Conclusion · The decreased level of 25(OH)D3 may increase risks for the occurrence of DPN in the elders with type 2 diabetes mellitus and monitoring the level of 25(OH)D3 contributes to early detection of DPN.

Objective To investigate the relationship between the expression of Fascin and breast cancer prognosis. Methods Paraffin sections of breast cancer from 110 patients were investigated by immunohostochemistry with monoclonal anti-fascin antibody. Data of the Fascin expression and clinicopathological variables were analyzed for disease-free survival(DFS)and overall survival(OS)by Kaplan-miere and cox model. Results The expression of Fascin was significantly associated with ER negative,PR negative and lymph node metastasis,but not with age,HER2 status and tumor size. The patients with positive expression of Fascin had shorter disease free survival time than those without Fascin expression. Conclusion High expression of Fascin is associated with poor prognosis in breast cancer. Fascin is an independent prognostic indicator of disease-free survival time.

Objective:To investigate the clinical incidence of the three mesial root canals of mandibular first molars. Methods: Incidence and morphology of the three mesial root canals of mandibular first molars were determined by probing the fissure or grooves between the mesiobuccal and mesiolingual root canal orifices and X-ray analysis. Results: Of the 222 mandibular first molars, 13 of the molars had three mesial root canals. The incidence rate was 5.85 %. Conclusion: Although the incidence rate of the three mesial root canals of mandibular first molars was very low, the dental operative microscope was helpful for the diagnosis.

A novel method based on cross sensitivity of cataluminescence (CTL) on nano-Ti3CeY2O11 was proposed for simultaneous determination of formaldehyde, benzene and sulfur dioxide in air.The relations between the concentrations of formaldehyde, benzene and sulfur dioxide and their CTL intensities were respectively ascertained at three wavelengths.The accurate concentrations of formaldehyde, benzene and sulfur dioxide can be calculated by superimposed total CTL intensities.The three analysis wavelengths are 420 nm, 535 nm and 680 nm.The surface temperature of the sensitive materials is 280℃.The carrier gas flow rate is 130 mL/min.The detection limits (3σ) are 0.04 mg/m3 for formaldehyde, 0.05 mg/m3 for benzene and 0.10 mg/m3 for sulfur dioxide, respectively.The linear ranges of CTL intensity versus analyte concentration are 0.08-75.60 mg/m3 for formaldehyde, 0.1-101.40 mg/m3 for benzene and 0.3 to 115.00 mg/m3 for sulfur dioxide.The recoveries of 12 testing standard samples by this method are 96.4%-103.7% for formaldehyde, 97.8%-102.5% for benzene and 97.2%-103.3% for sulfur dioxide.Common coexisting substances, such as acetaldehyde, toluene, hydrogen sulfide, ammonia, methanol, ethanol and carbon dioxide, do not disturb the determination.The relative deviation of CTL signals of continuous 200 h detection for gaseous mixture containing formaldehyde, benzene and sulfur dioxide is less than 2%, which shows the longevity of the nanometer composite oxide to formaldehyde, benzene and sulfur dioxide.This method makes full use of the cross sensitive phenomenon, and can realize the on-line analysis of formaldehyde, benzene and sulfur dioxide in air.

Frailty is an important geriatric syndrome and has gradually become one of the major focuses in geriatric research.Frailty is the result of interaction between multiple factors working on multiple systems,and is closely related to adverse health consequences.Therefore,early identification and assessment of frailty is very important for effective management of high risk individuals.This article reviews the current frailty assessment tools and examines their advantages and disadvantages.

Objective To establish a Real-time quantitative PCR method (qPCR) for the detection of diatom UPA barcoding genes and evaluate its application in the drowning diagnosis. Methods The homologous sequences of diatoms UPA gene was obtained by Blast from GeneBank, based on which the universal primers for diatoms were designed. DNA were extracted from 2 common human symbiotic bacteria (Escherichia coli, Bifidobacterium longum), 3 species of planktonic bacteria, 15 species of planktonic algae, tissue samples (lung, liver and kidney) from human cadavers (28 drowning victims, 1 victims by non-drowning in the water, 3 victims deaths on land) in 32 cases. The specificity, sensitivity and repeatability of the designed primers were tested. The positive rates of diatoms detection in the drowning cases were calculated. The results of the real-time quantitative method were evaluated comparatively by Microwave Digestion-Vacuum Filtration-Automated Scanning Electron Microscopy (MD-VF-Auto SEM) and PCR-Capillary Electrophoresis (PCR-CE). Results The results showed that the primers UPA99 had strong specificity for the diatomaceae (Synedra radians, Navicula sp., Melosira varians, Cyclotella sp. and Nitzschia sp.) DNA. The melting curve of the amplified product was smooth; the peak was narrow; the melting temperature was (87±1)℃. The sensitivity of qPCR method was 1.56×10-5ng/μL with the detection range of 1.56×102ng/mL~1.56×10-5ng/μL, in contrast with the PCR-CE method (1.56×10-3ng/μL). This real-time PCR method showed high repeatability and stability with the coefficient of variation less than 2%. The detection rate of lung, liver and kidney was 89.3%, 71.4% and 64.3% respectively. Conclusion The established qPCR method, based on the universal primers designed for diatom UPA gene, has high specificity, high sensitivity and good repeatability. With a promising prospect for application, qPCR is suitable for drowning diagnosis.

Objective To investigate the relationship between occupational noise exposure and glycated hemoglobin (HbA1c) levels, as well as prediabetes diagnosed by HbA1c. Methods A total of 1 181 workers from a cigarette factory were selected as the research subjects using a judgment sampling method. Workers were divided into control, low-level noise exposure and high-level noise exposure groups, consisting of 236, 359, and 586 individuals, respectively. The blood sample was collected for HbA1c test and occupation noise exposure intensity in workplace was detected by an area-sampling method. Results There were no statistical significant differences in HbA1c levels and prediabetes prevalence among the three groups of workers (all P>0.05). After adjusting for potential confounding factors such as years of service, gender, smoking, pack-years of smoking, alcohol consumption, and body mass index, multiple linear regression analysis showed that the high-level noise exposure group had higher HbA1c level than the control group (P<0.05). Multivariable logistic regression analysis results showed that the high-level noise exposure group had higher risk of prediabetes compared with the control group (P<0.05). Conclusion Occupational noise exposure could be a risk factor for the increased HbA1c levels and prediabetes incidence among the occupational population. More attention should be paid to the effects of occupational noise exposure on the HbA1c level in occupational health surveillance.

BACKGROUNDThe extended-spectrum beta-lactamase (ESBL)-producing Klebsiella pneumoniae has increasingly become a major contributor to nosocomial infections and can exhibit multiple antibiotic resistance. Previous studies have focused on the resistance genes in ESBL-producing strains, and the resistance-associated genetic environment of non-ESBL-producing strains has been ignored until now. Here, we investigated the occurrence and characteristics of non-ESBL-producing K. pneumoniae, which potentially carries unexpressed resistance genes.

METHODSK. pneumoniae strains were collected from five medical institutions in China from February 2010 to August 2013. The VITEK-2 ESBL detection system was used as a primary screen to identify the ESBL-producing phenotype, and the three primary types of ESBL-associated genes (CTX, SHV, and TEM) were detected by polymerase chain reaction (PCR) to confirm the strains presenting with a non-ESBL-producing phenotype. mRNA expression in the non-ESBL-producing strains was further screened by reverse-transcription PCR (RT-PCR) to validate their transcriptional efficiency.

RESULTSOut of 224 clinically isolated antibiotic-sensitive K. pneumoniae strains with a non-ESBL-producing phenotype, 5 (2.2%) were identified to carry inactivated ESBL blaSHV genes with intact upstream promoter regions and resistance gene sequences. Interestingly, three of the five antibiotic-sensitive K. pneumoniae strains containing ESBL blaSHV genes still exhibited mRNA transcription of blaSHV, while the other two exhibited no mRNA transcription.

CONCLUSIONThese findings suggest that inactivated ESBL genes exist in non-ESBL-producing antibiotic-sensitive K. pneumoniae strains, which have the potential to transform the strain into an ESBL phenotype if an inappropriate application or overdose of antibiotics is implemented during clinical management.

Anti-Bacterial Agents ; pharmacology ; China ; Drug Resistance, Multiple, Bacterial ; genetics ; Humans ; Klebsiella pneumoniae ; drug effects ; enzymology ; genetics ; Microbial Sensitivity Tests ; beta-Lactamases ; genetics

Alzheimer's disease (AD), the most common neurodegenerative disorder, is characterized by memory loss and cognitive dysfunction. The accumulation of misfolded protein aggregates including amyloid beta (Aβ) peptides and microtubule associated protein tau (MAPT/tau) in neuronal cells are hallmarks of AD. So far, the exact underlying mechanisms for the aetiologies of AD have not been fully understood and the effective treatment for AD is limited. Autophagy is an evolutionarily conserved cellular catabolic process by which damaged cellular organelles and protein aggregates are degraded via lysosomes. Recently, there is accumulating evidence linking the impairment of the autophagy-lysosomal pathway with AD pathogenesis. Interestingly, the enhancement of autophagy to remove protein aggregates has been proposed as a promising therapeutic strategy for AD. Here, we first summarize the recent genetic, pathological and experimental studies regarding the impairment of the autophagy-lysosomal pathway in AD. We then describe the interplay between the autophagy-lysosomal pathway and two pathological proteins, Aβ and MAPT/tau, in AD. Finally, we discuss potential therapeutic strategies and small molecules that target the autophagy-lysosomal pathway for AD treatment both in animal models and in clinical trials. Overall, this article highlights the pivotal functions of the autophagy-lysosomal pathway in AD pathogenesis and potential druggable targets in the autophagy-lysosomal pathway for AD treatment.