The prevalence of obesity is increasing. It is associated with conditions such as type 2 diabetes mellitus, hypertension, dyslipidaemia and non-alcoholic fatty liver disease and together with its co-morbidities, obesity has become a fast-growing public health concern and health burden. However, weight loss has been shown to reduce the development and improve these conditions. This paper looks at the epidemiology, obesity-related comorbidities, in particular pre-diabetes, and the various strategies that can be implemented to prevent and treat this looming problem.

Four specific salt-tolerant fungi for dissolving phosphate rock (FM) w ere isolated from the coastal saline soils. It was found that the biomass and a b ility to release phosphate from the materials decreased with increasing of the N aCl content. During pH7.0～8.5, the biomass and ability of to release phospho rus from the materials of FM1 decreased sharply with pH rising, but the FM2 and FM4 decreased not considerably, optimal pH for FM3 was at pH8.5. At pH9.0, the bi oma ss and ability of to release phosphorus from the materials decreased quickly. F M2 was stable at alkaline and high salt content condition.

Objective To study the mechanisms of Curcumin-induced apoptosis on human gastric cancer cell line SGC-7901.Methods SC,C-7901 cells were treated with various concentrations of Curcumin and the growth inhibition rates of it were accessed by MTT method.Apoptosis of gastric cancer cells were in- spected by flow cytometry.The expression of Fas and survivin in gastric cancer cells were evaluated by west- ern blot.Results Curcumin could effectively inhibit the growth of gastric cancer cells in dose-dependent and time-dependent manners,the sub-peak appeared and the apoptotic rate was increased.The expressions of Fas was higher in Western blot,meanwhile,the expressions of survivin was decreased.Conclusion Curcumin could significantly inhibit the growth and induce apoptosis of gastric cancer cells(SGC-7901),Curcumin could probably through up-regulating Fas and down-regulating surviving to induce apoptosis.

OBJECTIVETo investigate the enhanced effect of bone marrow-derived dendritic cells (DC) pulsed with SVYDFFVWL, a MHC class I peptide located in 180-188 amino acid residues of human melanoma-associated antigen tyrosinase- related protein 2 ( hTRP2) on the immunity against melanomas elicited by adenovirus encoding hTRP2 (Ad hTRP2).

METHODSThe mice were intradermally immunized with Ad hTRP2, and three weeks later with Ad hTRP2 or DC/SVYDFFVWL once more. Analysis of CTL killing activity and IFN-gamma-producing CD8 + T cells in the total CD8 + T cells of spleen were made using in vivo CTL and intracellular staining of IFN-gamma, respectively. Additionally, the survival of mice was checked after the subcutaneous inoculation with mouse melanoma B16. F10 cells.

RESULTSThe 6 h CTL killing and IFN-gamma producing CD8 +T cells in the total CD8 ' T cells of spleens were 68. 40%+/-5. 50% and 0. 67%+/-0.16% in Ad hTRP2 (priming)-Ad hTRP2 (boosting) group,28. 50%+/-6.40% and 0.22%+/-0.07% in DC/SVYDFFVWL (priming)-DC/ SVYDFFVWL (boosting) group,and 98. 90%+/-0.90% and 1.05%+/-0.21% in Ad hTRP2 (priming)-DC/ SVYDFFVWI, (boosting) group, respectively. In the tumor-bearing model, none of mice survived in DC/SVYDFFVWL (priming)-DC/SVYDFFVWL (boosting) group, and just only 40% of mice were tumor-free in Ad hTRP2 (priming) -Ad hTRP2 (boosting) group, whereas 100% of mice survived in Ad hTRP2 (priming)-DC/SVYDFFVWL (boosting) group.

CONCLUSIONBoosting with DC/ SVYDFFVWL can significantly enhance the immunity against melanomas elicited by priming with Ad hTRP2, indicating that first priming with Ad hTRP2 and then boosting with DC/SVYDFFVWL is a potentially effective regimen for overcoming the disadvantage that anti-tumor immune response can not be significantly increased by readministration of adenovirus.

Adenoviridae ; genetics ; Animals ; CD8-Positive T-Lymphocytes ; immunology ; Cancer Vaccines ; immunology ; Cell Line, Tumor ; Cells, Cultured ; Cytotoxicity Tests, Immunologic ; Dendritic Cells ; cytology ; immunology ; Female ; Genetic Vectors ; genetics ; Humans ; Immunization, Secondary ; methods ; Intramolecular Oxidoreductases ; immunology ; Melanoma, Experimental ; immunology ; pathology ; therapy ; Membrane Proteins ; immunology ; Mice ; Mice, Inbred C57BL ; Peptide Fragments ; immunology ; Survival Analysis ; T-Lymphocytes, Cytotoxic ; immunology

INTRODUCTIONObesity is a risk factor for type 2 diabetes mellitus (T2DM). Metabolic-bariatric surgery (MBS) results in significant weight loss with dramatic improvement in T2DM. This study analysed the effects of MBS on patients with T2DM in a tertiary centre in Singapore.

METHODSIndividuals with T2DM who underwent MBS in a single centre from September 2008 to May 2012, with at least 12 months of regular follow-up, were included in our study. The primary outcome measure was good glycaemic control (glycated haemoglobin [HbA1c] < 6.5%, with or without medications) 12 months after surgery. Secondary outcome measures were partial DM remission (fasting blood glucose [FBG] < 7.0 mmol/L and HbA1c < 6.5% without DM medications), complete DM remission (FBG < 5.6 mmol/L and HbA1c < 6.0% without DM medications), weight, body mass index, blood pressure, and fasting serum lipid, serum glucose and serum insulin levels.

RESULTSOf the 19 patients who met the inclusion criteria, 14 underwent gastric bypass and 5 underwent sleeve gastrectomy. At 12 months postoperatively, 17 (89.5%) patients achieved good glycaemic control. DM remission was achieved in 14 (73.7%) patients, with 10 (52.6%) attaining complete remission.

CONCLUSIONIn Singapore, MBS is an effective treatment modality for obese patients with T2DM. Despite the small sample size and lack of matched controls, the present study suggests that MBS is effective in achieving significant weight loss and eliciting a significant and sustainable improvement in the glycaemic control of patients with T2DM, for up to 12 months.

Adult ; Bariatric Surgery ; Blood Glucose ; analysis ; Body Mass Index ; Diabetes Mellitus, Type 2 ; prevention & control ; Female ; Glycated Hemoglobin A ; analysis ; Humans ; Insulin ; blood ; Lipids ; blood ; Male ; Middle Aged ; Obesity, Morbid ; surgery ; Prospective Studies ; Risk Factors ; Singapore ; Treatment Outcome

OBJECTIVETo analyze the clinical characteristics of 18 patients with isolated right sided infective endocarditis (RSIE) who hospitalized in our department between August 2005 and February 2009.

METHODSThe epidemiological and clinical data of 18 non-drug addicts with RSIE were retrospectively analyzed.

RESULTSThe incidence of RSIE accounted for 7.23% of all IE patients hospitalized in our department during the same period. Predisposing conditions were as follows: congenital heart disease (76.5%, 14/18), post operative procedures (3/18) and high dose glucocorticoids use (1/18). Fever (100%) was the most common clinical manifestation. Septic pulmonary embolism was the most prevalent complication (5/18). Staphylococci aureus (4/7) were the most common causative patho organisms, while the most common etiological organisms of left-sided and both-sided IE were Streptococci Viridans. Transthoracic echocardiography evidenced 17 cases of vegetations including 59.1% (13/22) tricuspid vegetations. There was no in-hospital death and the mean hospitalization duration was (22.0 +/- 18.9) days.

CONCLUSIONSCongenital heart diseases, but not intravenous drug abuse, were the most prevalent predisposing factors for RSIE in this cohort. Staphylococci aureus were the most common causative organisms.

Adolescent ; Adult ; Causality ; Child ; Child, Preschool ; Endocarditis, Bacterial ; diagnostic imaging ; epidemiology ; microbiology ; Female ; Heart Defects, Congenital ; epidemiology ; Humans ; Incidence ; Infant ; Male ; Retrospective Studies ; Staphylococcal Infections ; diagnostic imaging ; epidemiology ; Substance Abuse, Intravenous ; epidemiology ; Ultrasonography ; Young Adult

OBJECTIVETo explore curative effects of advanced elastic intramedullary nail technology in treating children with femoral subtrochanteric fracture.

METHODSForm March 2009 to December 2010, 16 children with femoral subtrochanteric fracture were treated with advanced elastic intramedullary nail technology. There were 12 males and 4 females ranging in age from 7 to 15 years old with a mean of 9.8 years old. According to fracture classification, 9 cases were stable fractures (traverse or short oblique type) and 7 cases were unstable fractures (comminuted or long oblique type). Radiographs and complications were retrospectively reviewed. Fracture healing were evaluated according to Flynn criteria.

RESULTSAll children were followed up from 11 to 32 months with an average of 21 months. No incision infecton,bone nonunion and breakage of screw occurred. The fracture healing time was from 8 to 16 weeks with an average of 10.1 weeks. According to Flynn criteria, 14 cases got excellent results, 1 moderate and 1 poor.

CONCLUSIONAdvanced elastic intramedullary nail technology for the treatment of children with femoral subtrochanteric fracture is a safe and effective fixation, which is good for early mobilization, shorter the duration of hospital stays and reduce complications.

Adolescent ; Child ; Female ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; methods ; Hip Fractures ; surgery ; Humans ; Male

Adult ; Fatty Liver ; diagnostic imaging ; physiopathology ; Female ; Humans ; Liver ; diagnostic imaging ; Liver Circulation ; Male ; Middle Aged ; Ultrasonography, Doppler, Color

INTRODUCTIONNew-onset diabetes after transplantation (NODAT) is an increasingly recognised metabolic complication of kidney transplantation that is associated with increased morbidity and mortality. This study aimed to determine the incidence of NODAT and identify risk factors for development of NODAT among kidney allograft recipients in a single centre.

MATERIALS AND METHODSWe retrospectively reviewed all kidney allograft recipients in our centre between 1998 and 2007. NODAT were determined using criteria as per American Diabetes Association guidelines. Logistic regression analyses were performed to identify predictors of NODAT.

RESULTSAmong 388 patients included in the analysis, NODAT was reported in 94 patients (24.2%) after a median follow-up time of 52.1 months. The cumulative incidence of NODAT was 15.8%, 22.8% and 24.5% at 1, 3, and 5 years following transplantation. Seven clinical factors were independent predictors of NODAT: older age, HLA B13 and B15 phenotypes, use of sirolimus, acute rejections, higher pre-transplant and post-transplant (day 1) plasma glucose levels. Patients with NODAT had poorer outcomes in both graft and patient survival.

CONCLUSIONOur study demonstrates a significant risk and burden of NODAT in an Asian transplant population. Risk stratification and aggressive monitoring of blood glucose early post-transplantation is necessary to identify high-risk patients so that appropriate tailoring of immunosuppression and early institution of lifestyle modifications can be implemented.

Adult ; Blood Glucose ; analysis ; Diabetes Mellitus ; etiology ; genetics ; Female ; Graft Rejection ; complications ; HLA-B Antigens ; analysis ; Humans ; Immunosuppressive Agents ; Kidney Transplantation ; adverse effects ; Male ; Middle Aged ; Risk Factors

To explore the role of regulatory peptides in the secretion of bronchial epithelial cells (BECs), we observed the effects of four peptides, i.e.vasoactive intestinal peptide (VIP), epidermal growth factor (EGF), endothelin-1 (ET-1), and calcitonin gene-related peptide (CGRP), on the secretion of ILs from unstimulated or O3-stressed BECs. The results of the experiments showed that VIP exerted an inhibitory effect on the secretion of IL-1 and IL-8 from unstimulated and O3-stressed BECs, VIP also decreased the secretion of IL-5 from O3-stressed BECs; EGF promoted secretion of IL-1 and IL-8 from unstimulated BECs, but decreased the secretion of ILs from O3-stressed BECs; ET-1 and CGRP enhanced the secretion of IL-1, IL-5, and IL-8 from unstimlated BECs, CGRP also increased the secretion of ILs from O3-stressed BECs. The results obtained demonstrate that intrapulmonary regulatory peptides modulate the secretion of ILs from BECs, and may play an important part in transduction of inflammatory signals.
Animals ; Bronchi ; cytology ; Calcitonin Gene-Related Peptide ; pharmacology ; Cells, Cultured ; Endothelin-1 ; pharmacology ; Epidermal Growth Factor ; pharmacology ; Epithelial Cells ; drug effects ; secretion ; Female ; Interleukins ; secretion ; Male ; Rabbits ; Vasoactive Intestinal Peptide ; pharmacology