This study aimed to investigate the correlation between changes in intestinal toxicity and compositional alterations of Euphorbiae Ebracteolatae Radix(commonly known as Langdu) before and after milk processing, and to explore the detoxification mechanism of milk processing. Mice were intragastrically administered the 95% ethanol extract of raw Euphorbiae Ebracteolatae Radix, milk-decocted(milk-processed), and water-decocted(water-processed) Euphorbiae Ebracteolatae Radix. Fecal morphology, fecal water content, and the release levels of inflammatory cytokines tumor necrosis factor-α(TNF-α) and interleukin-1β(IL-1β) in different intestinal segments were used as indicators to evaluate the effects of different processing methods on the cathartic effect and intestinal inflammatory toxicity of Euphorbiae Ebracteolatae Radix. LC-MS/MS was employed to analyze the small-molecule components in the raw product, the 95% ethanol extract of the milk-processed product, and the milky waste(precipitate) formed during milk processing, to assess the impact of milk processing on the chemical composition of Euphorbiae Ebracteolatae Radix. The results showed that compared with the blank group, both the raw and water-processed Euphorbiae Ebracteolatae Radix significantly increased the fecal morphology score, fecal water content, and the release levels of TNF-α and IL-1β in various intestinal segments(P<0.05). Compared with the raw group, all indicators in the milk-processed group significantly decreased(P<0.05), while no significant differences were observed in the water-processed group, indicating that milk, as an adjuvant in processing, plays a key role in reducing the intestinal toxicity of Euphorbiae Ebracteolatae Radix. Mass spectrometry results revealed that 29 components were identified in the raw product, including 28 terpenoids and 1 acetophenone. The content of these components decreased to varying extents after milk processing. A total of 28 components derived from Euphorbiae Ebracteolatae Radix were identified in the milky precipitate, of which 27 were terpenoids, suggesting that milk processing promotes the transfer of toxic components from Euphorbiae Ebracteolatae Radix into milk. To further investigate the effect of milk adjuvant processing on the toxic terpenoid components of Euphorbiae Ebracteolatae Radix, transmission electron microscopy(TEM) was used to observe the morphology of self-assembled casein micelles(the main protein in milk) in the milky precipitate. The micelles formed in casein-terpenoid solutions were characterized using particle size analysis, fluorescence spectroscopy, ultraviolet spectroscopy, and Fourier-transform infrared(FTIR) spectroscopy. TEM observations confirmed the presence of casein micelles in the milky precipitate. Characterization results showed that with increasing concentrations of toxic terpenoids, the average particle size of casein micelles increased, fluorescence intensity of the solution decreased, the maximum absorption wavelength in the UV spectrum shifted, and significant changes occurred in the infrared spectrum, indicating that interactions occurred between casein micelles and toxic terpenoid components. These findings indicate that the cathartic effect of Euphorbiae Ebracteolatae Radix becomes milder and its intestinal inflammatory toxicity is reduced after milk processing. The detoxification mechanism is that terpenoid components in Euphorbiae Ebracteolatae Radix reassemble with casein in milk to form micelles, promoting the transfer of some terpenoids into the milky precipitate.
Animals ; Mice ; Milk/chemistry* ; Drugs, Chinese Herbal/chemistry* ; Male ; Tumor Necrosis Factor-alpha/immunology* ; Intestines/drug effects* ; Interleukin-1beta/immunology* ; Tandem Mass Spectrometry ; Female

Objective The effects of interactions between genetic and environmental factors on the noise-induced hearing loss (NIHL) are still unclear. This study aimed to assess interactions among gene polymorphisms, noise metrics, and lifestyles on the risk of NIHL. Methods A case-control study was conducted using 307 patients with NIHL and 307 matched healthy individuals from five manufacturing industries. General demographic data, lifestyle details, and noise exposure levels were recorded. The Kompetitive allele-specific polymerase chain reaction (KASP) was used to analyze the genotypes of 18 SNPs. Results GMDR model demonstrated a relevant interaction between NRN1 rs3805789 and CAT rs7943316 (P = 0.0107). Subjects with T allele of rs3805789 or T allele of rs7943316 had higher risks of NIHL than those with the SNP pair of rs3805789-CC and rs7943316-AA (P < 0.05). There was an interaction among rs3805789, rs7943316, and kurtosis (P = 0.0010). Subjects exposed to complex noise and carrying both rs3805789-CT and rs7943316-TT or rs3805789-CT/TT and rs7943316-AA had higher risks of NIHL than those exposed to steady noise and carrying both rs3805789-CC and rs7943316-AA (P < 0.05). The best six-locus model involving NRN1 rs3805789, CAT rs7943316, smoking, video volume, physical exercise, and working pressure for the risk of NIHL was found to be the interaction (P = 0.0010). An interaction was also found among smoking, video volume, physical exercise, working pressure, and kurtosis (P = 0.0107). Conclusion Concurrence of NRN1 and CAT constitutes a genetic risk factor for NIHL. Complex noise exposure significantly increases the risk of NIHL in subjects with a high genetic risk score. Interactions between genes and lifestyles as well as noise metrics and lifestyles affect the risk of NIHL.

Adult ; Aged ; Betacoronavirus ; COVID-19 ; Coronavirus Infections/diagnosis* ; Diagnosis, Differential ; Female ; Humans ; Male ; Middle Aged ; Pandemics ; Pneumonia/diagnosis* ; Pneumonia, Viral/diagnosis* ; Retrospective Studies ; SARS-CoV-2

Objective:To observe the changes of metabolic parameters and islet function,and to explore the relationships between liver fat content (LFC) and islet function in inpatients of type 2 diabetes mellitus patients with different duration.Methods:Totally 214 diabetic patients and 65 non-diabetes patients from January 2016 to March 2017 were collected.LFC was determined by proton magnetic resonance spectrum analysis (1H-MRS),the first-phase insulin secretion was estimated by arginine test,and insulin secretion index (HOMA-β) and insulin resistance index (HOMA-IR) were assesses by homeostasis model assessment.The changes of the parameters and their relationships were analyzed in each group.Results:Along with the course of disease,the first-phase insulin secretion,HOMA-β and LFC decreased gradually,some parameters such as serum creatinine (SCr),high density lipoprotein cholesterol (HDL-c) and microalbuminuria increased gradually,while there was no significant change in HOMA-IR.Correlation analysis demonstrated that the beta cell function (including the firstphase insulin secretion and HOMA-β) was positively associated with LFC,body mass index (BMI),body weight,waist circumference,hip circumference,serum uric acid (UA),aspartate aminotransferase (AST),triglyceride (TG),waist-hip ratio (WHR,only HOMA-β),alanine aminotransferase (ALT,only the first-phase insulin secretion) and glutamyl transferase (GGT,only the first-phase insulin secretion),all P＜0.05,and was negatively associated with glycosylated hemoglobin (HbA1c),the course (only the first-phase insulin secretion),HDL-c (only the first-phase insulin secretion),all P＜0.01.There were no correlations between beta cell function and the other factors including gender,age,urea nitrogen (BUN),SCr,total cholesterol (TC),low density lipoprotein cholesterol (LDL-c).Stepwise regression analysis showed that there was independently positive correlation between the first-phase insulin secretion and BMI.There were independently positive correlations between HOMA-β and HOMA-IR and BMI in diabetic patients.Conclusions:Along with the course of disease,the degree of insulin resistance is not significantly changed,while the beta cell function and LFC decreased gradually.

Objective: To investigate the effect of short-term very low calorie diet(VLCD)on the weight of hospitalized patients with obesity and the patients' compliance.Methods: From November 2015 to November 2016,30 inpatients with obesity or overweight in Zhongshan Hospital received VLCD intervention with total calorie intake of 800 kcal/d (1 kcal= 4.186 8 kJ)during hospitalization.The body weight before and after VLCD intervention were compared and the tolerance was observed.After discharge,the diet and weight data were followed up for 6 months.Results:After short-term VLCD intervention for(8 ± 3)d,the body weight decreased from(95.93 ± 23.28)kg to(92.86 ± 22.78)kg(P<0.001).No severe adverse effects were observed.The long-term compliance of patients on VLCD was relatively poor.Conclusions:Short-term VLCD can significantly induce the weight loss in patients with obesity,which is well tolerated.While the long-term compliance on VLCD is relatively poor and should be strengthened in the future.

Objective:To preliminarily assess the stability, effectiveness, and safety of the electrophysiological stimulation feedback instrument DS21 for non-invasive screening diabetes.Methods:Totally 46 cases were selected and divided into health control group (NC,n=17),impaired glucose regulation group(IGR, n=15), and diabetes group (DM, n=14) based on OGTT and diabetic history.All cases signed informed consent, were performed routine check-up and biochemical examination, and collected history, and underwent three times tests by electrophysiological stimulation feedback instrument.Three conductance values of this instrument were recorded for each case, the deviation of average values were calculated, to evaluate its stability and effectiveness, and the adverse reactions were observed.Results:The maximum of the mean conductance value deviation was 4.4, the minimum value was 0.2 in the 46 subjects, which were all less than 5.0, The conductance values were 77.9±5.2,70.4±5.7, and 54.7±11.4 in NC, IGR, and DM group, respectively.The trend of conductance value was NC >IGR > DM group.The difference of conductance values among groups was statistically significant (P<0.01).After adjusting for gender,age, and body mass index (BMI), the difference of conductance values among groups was still statistically significant (P<0.01).There was no adverse event in the test in 46 cases.Conclusions:Electrophysiological stimulation feedback instrument DS21 is stable, reliable.The conductance values are different in subject with different glucose metabolism.

Objective:To explore the value of arginine stimulation test in evaluating the first-phase insulin secretion and its guiding role for the treatment of type 2 diabetes mellitus.Methods:Totally 80 cases with newly diagnosed type 2 diabetes mellitus(NT2DM),male/female,54/26),162 type 2 diabetes subjects with effective treatment by lifestyle intervention or oral hypoglycemic drugs therapy(LIODT),male/female,79/83),160 subjects with insulin therapy(IT),,male/female,63/97 and 40 subjects with normal glucose level(NC,male/female,5/35)were admitted in the study in Department of Endocrinology,and the Physical Examination Center of Zhongshan Hospital,Fudan University.Arginine stimulation test was performed to assess the first-phase insulin secretion.Fasting and 2,4,6 min glucose(G),insulin(I)and c-peptide(CP)after arginine stimulating were tested.Objective:The Δ I,Δ I/G,Δ CP/G in arginine stimulation test were decreased significantly in the patients with NT2DM,LIODT and IT groups than those in the NC group(P<0.01).Among different groups of type 2 diabetes,Δ I,Δ CP,Δ I/G,ΔCP/G were decreased significantly in the IT group than the other two groups(P<0.01).The normal cut-off point of AIR was Δ I≥23.09 mU/L.Δ I,Δ I/G,Δ CP/G negatively correlated with fasting plasma glucose(FPG)and HbA1c,and Δ I,Δ CP,Δ I/G,Δ CP/G were negatively correlated with daily dose and numbers of oral diabetic medications after adjustment for gender,age,BMI.In the known type 2 diabetes groups(including LIODT and IT group),the optimal cut-off values from ROC curve for initiating insulin therapy were ΔI≤12.23 mU/L,and ΔCP≤0.97 ng/mL(P<0.01).Conclusions:Arginine stimulation test can effectively assess the first-phase insulin secretion.In type 2 diabetes,ΔI≤12.23 mU/L or ΔCP≤0.97 ng/mL suggest severely lost of first-phase insulin secretion,and need insulin therapy.

Objective To compare the applicability of different occupational health risk assessment methods in small furniture manufacturing industry. Methods American EPA inhalation risk model, Singapore semi-quantitative risk assessment model of occupational exposure to chemical substances and Australian Occupational Health and Safety Risk Assessment model, were used to assess the occupational health risk in a small furniture manufacturing industry from a city of Zhejiang Province. Results The results of American EPA model showed that the workers who exposed to benzene and formaldehyde had low risk of carcinogens, and who exposed to benzene and xylene had very high risk of non-carcinogens. According to Singapore semi-quantitative risk assessment model, there were low and medium health risk caused by toluene and xylene, and high risk caused by wood dust in preparation and polishing jobs. Similar to the results of other models, Australia qualitative risk assessment model showed that there were medium health risk caused by toluene and xylene, and high risk caused by benzene, wood dust and noise. All of the three methods could found the key risk control point in furniture manufacturing industry. The risk ratios of the three methods were higher than the toxic work classification ratio (P<0.01), and the risk ratio of EPA model were higher than the results of Singapore model and Australia model (P<0.05) . Conclusion All of the three methods can be applied to assess the occupational health risk in furniture manufacturing industry, and the combined application of multiple risk assessment methods can be used as one of the risk assessment strategies.

ObjectiveTo explore the application value of real-time contrast-enhanced ultrasound (RTCEU) in improving the detection rate of transrectal ultrasound-guided prostate biopsy.

METHODSThis prospective study included 91 male patients with abnormally high PSA (4－20 μg/L) or abnormalities in DRE or MRI, who underwent 12+X prostate biopsy following conventional transrectal ultrasonography (TRUS) and RTCEU examination. We compared the numbers of suspected prostatic nodules before and after RTCEU as well as the detection rates of prostate cancer between conventional TRUS-guided 12PBx and 12PBx plus lesion-targeted biopsy procedures.

RESULTSTotally, 57 of the 86 suspected lesions on TRUS (66.3%), and 108 of the 118 abnormal nodules on RTCEU (91.5%) were confirmed to be prostate cancer. RTCEU achieved a significantly higher detection rate than TRUS (P<0.01). A total of 39 cases of prostate cancer (42.8%) were detected by RTCEU, while only 28 (30.7%) by TRUS, with statistically significant difference in the detection rate between the two procedures (P=0.033).

CONCLUSIONSReal-time contrast-enhanced ultrasound can significantly improve the detection rate of prostate cancer and provide a valuable guide to targeted prostate biopsy.

Contrast Media ; Endoscopic Ultrasound-Guided Fine Needle Aspiration ; Humans ; Magnetic Resonance Imaging ; Male ; Prospective Studies ; Prostate ; diagnostic imaging ; pathology ; Prostate-Specific Antigen ; blood ; Prostatic Neoplasms ; blood ; diagnostic imaging ; pathology ; Ultrasonography, Interventional

BACKGROUNDThe conventional approaches to diabetes screening are potentially limited by poor compliance and laboratory demand. This study aimed to evaluate the performance of fasting plasma glucose (FPG) and postprandial urine glucose (PUG) in screening for diabetes in Chinese high-risk population.

METHODSNine hundred and nine subjects with high-risk factors of diabetes underwent oral glucose tolerance test after an overnight fast. FPG, hemoglobin A1c, 2-h plasma glucose (2 h-PG), and 2 h-PUG were evaluated. Diabetes and prediabetes were defined by the American Diabetes Association criteria. The area under the receiver operating characteristic (ROC) curve was used to evaluate the diagnostic accuracy of 2 h-PUG, and the optimal cut-off determined to provide the largest Youden index. Spearman correlation was used for relationship analysis.

RESULTSAmong 909 subjects, 33.4% (304/909) of subjects had prediabetes, and 17.2% (156/909) had diabetes. The 2 h-PUG was positively related to FPG and 2 h-PG (r = 0.428 and 0.551, respectively, both P < 0.001). For estimation of 2 h-PG ≥ 7.8 mmol/L and 2 h-PG ≥ 11.1 mmol/L using 2 h-PUG, the area under the ROC curve were 0.772 (95% confidence interval [CI ]: 0.738-0.806) and 0.885 (95% CI: 0.850-0.921), respectively. The corresponding optimal cut-offs for 2 h-PUG were 5.6 mmol/L and 7.5 mmol/L, respectively. Compared with FPG alone, FPG combined with 2 h-PUG had a higher sensitivity for detecting glucose abnormalities (84.1% vs. 73.7%, P < 0.001) and diabetes (82.7% vs. 48.1%, P < 0.001).

CONCLUSIONFPG combined with 2 h-PUG substantially improves the sensitivity in detecting prediabetes and diabetes relative to FPG alone, and may represent an efficient layperson-oriented diabetes screening method.

Aged ; Asian Continental Ancestry Group ; Blood Glucose ; metabolism ; Diabetes Mellitus ; blood ; diagnosis ; urine ; Fasting ; blood ; Female ; Glucose Tolerance Test ; Humans ; Male ; Mass Screening ; methods ; Middle Aged ; Postprandial Period ; physiology