OBJECTIVETo observe postoperative glucose tolerance, gastric inhibitory polypeptide (GIP) , and glucogan-like peptide-1 (GLP-1) in normal glucose level dogs after undergoing gastric bypass procedures, and to explore the mechanism of gastric bypass procedures to treat type 2 diabetes.

METHODSThe 6 dogs with normal glucose tolerance had undergone gastric bypass procedures, and measure preoperative and postoperative oral and intravenous glucose tolerance (at time points 1, 2, and 4 weeks) through changes in blood glucose, insulin, gastric inhibitory polypeptide (GIP), glucagon-like peptide-1 (GLP-1), and measure preoperative and postoperative week 4 pancreatic tissue morphology.

RESULTSSecond weeks after operation, the fasting blood sugar was (3.58 ± 0.33) mmol/L, and significantly lower than preoperative (t = 3.571, P < 0.05). The GLP-1 level before oral glucose tolerance test (OGTT) and 30 minutes after OGTT were (0.90 ± 0.21) and (0.91 ± 0.19) pmol/L respectively, and significantly higher than preoperative (t value were -3.660 and -2.971, P < 0.05). GLP-1 levels began to decrease in the second week after surgery. After 4 weeks, the index recovered to the preoperative level. Four weeks after surgery when compared with preoperative, islet morphology, islet number (6.8 ± 0.8 and 7.1 ± 0.8 respectively) and islet cells (16.7 ± 2.5 and 16.3 ± 3.1 respectively) did not change significantly (P > 0.05).

CONCLUSIONGastric bypass procedures could be briefly affect normal glucose tolerance in dogs' blood glucose, insulin and diabetes-related gastrointestinal hormones.

Animals ; Blood Glucose ; Diabetes Mellitus, Type 2 ; Dogs ; Gastric Bypass ; Gastric Inhibitory Polypeptide ; Glucagon ; Glucagon-Like Peptide 1 ; blood ; Glucose ; Insulin ; blood

Objective To evaluate the additional role of 99mTc-MIBI SPECT-CT imaging before parathyroidectomy (PTX) for secondary hyperparathyroidism (SHPT) patients.Methods A total of 359 SHPT patients from the First Affiliated Hospital of Nanjing Medical University were enrolled in the study from April 2011 to January 2016.Patients were divided into two groups according to the difference of 99mTc-MIBI imaging techniques preoperatively.Patients in group A had dual-phase 99mTc-sestamibi parathyroid scintigraphy performed only.Patients in group B had SPECT-CT parathyroid scintigraphy added in the early phase.With the parathyroid glands confirmed by pathology after operation being the referencc,scnsitivity,specificity,consistency and surgical success rates of the patients in two groups were compared.Results 359 patients (166 men and 193 women) were enrolled,among which 339 on hemodialysis and 20 on peritoneal dialysis.The average age of those patients was (45.90± 11.20) years and median dialysis age was 84 (60.0,120.0) months.Total detection sensitivity,specificity,consistency in group A (169 patients) were 65.54％,56.52％,65.24％ and in group B (190 patients) were 73.84％,84.62％,74.21％ respectively.Total sensitivity and consistency were higher in group B than those in group A (P ＜ 0.01),while no difference in total specificity was observed between two groups (P=0.055).In group A,detection sensitivity of parathyroid glands were 47.56％,77.44％,57.14％ and 79.88％ in right upper gland (RU),right lower gland (RL),left upper gland (LU) and left lower gland (LL) respectively.Consistency in group A were 48.52％,77.51％,56.21％ and 78.70％ respectively.In group B,sensitivity were 58.33％,83.78％,69.78％ and 82.89％ in RU,RL,LU and LL respectively.Consistency in group B were 59.47％,84.21％,70.53％ and 82.63％ respectively.Sensitivity and consistency of upper glands were lower than lower glands in both groups (P ＜ 0.01).When SPECT-CT was added,sensitivity and consistency of upper glands for both sides were higher in group B than those in group A,while no difference of surgical success rates was found between two groups (87.57％ vs 92.63％,P=0.107).Conclusion 99mTc-MIBI SPECT-CT can be combined with anatomic image effectively and increase the sensitivity and consistency of total and upper parathyroid glands.It can also make the accurate location of the lesions,which improves the efficiency of the operation.

OBJECTIVETo investigate the effect of lamivudine, interferon alpha and oxymatrine treatment for surviving hepatic failure patients with hepatitis B.

METHODS200 hepatitis B patients, including 100 subacute or acute-on-chronic hepatic failure survivals (group A), and 100 chronic (group B, n=100) hepatic failure survivals, were enrolled in this study. Patients in group A received interferon alpha (n=35), lamivudine (n=33) , or combinational lamivudine and oxymatrine (n=32) therapy for six months; Patients in group B received lamivudine (n=49), or combinational lamivudine and oxymatrine (n=51) therapy for six months, respectively. After the treatment, all patients were followed-up for six months.

RESULTSAt the end of follow-up, all patients in group A survived, while in group B three patients (6.1%) receiving lamivudine, and four (7.8%, P>0.05) receiving combinational therapy died; more than 90% of all survivals had their HBV DNA loss. The HBeAg/anti-HBe seroconversion rate in patients of group A treated with interferon alpha (9/17, 52.9%) was higher than that in patients treated with combinational lamivudine and matrine (5/16, 31.3%, P<0.05), which was higher than that in the patients treated with lamivudine alone (1/17, 5.9%, P<0.01), and the Knodell histological activity index score in patients treated with lamivudine (7.2+/-0.8, P<0.05) was lower than that in patients treated with interferon alpha (8.2+/-1.3, P<0.05), and the best efficacy was found in receiving combinational therapy (6.9+/-0.7, P<0.01); Lamivudine or lamivudine in combination with matrine significantly inhibited the intrahepatic inflammatory activities, but had no effect on the existing fibrosis in group B patients.

CONCLUSIONLong term nucleotide analogues treatment may delay the progress of fibrosis in hepatitis B-induced hepatic failure survivals, and the administration of matrine in time may further enhance the anti-fibrotic effect of nucleotide analogues.

Adolescent ; Adult ; Alkaloids ; administration & dosage ; therapeutic use ; Antiviral Agents ; administration & dosage ; therapeutic use ; DNA, Viral ; blood ; Drug Therapy, Combination ; Female ; Follow-Up Studies ; Hepatitis B ; complications ; drug therapy ; pathology ; Hepatitis B e Antigens ; blood ; Hepatitis B virus ; drug effects ; Humans ; Interferon-alpha ; administration & dosage ; therapeutic use ; Lamivudine ; administration & dosage ; therapeutic use ; Liver Failure ; blood ; drug therapy ; pathology ; Liver Function Tests ; Male ; Middle Aged ; Quinolizines ; administration & dosage ; therapeutic use ; Treatment Outcome ; Young Adult

Objective To evaluate the relations between hypertensive disorders (HDP) in pregnancy and early-term birth.Methods A total of 3 474 pregnant women were consecutively recruited.Demographic information was collected in early pregnancy.HDP was diagnosed in the first,second and third trimesters,respectively.On the basis of precise evaluation on gestation age,early-term birth was defined as gestational age of 37-38 weeks + 6 days.Logistic regression models were conducted to examine the associations between HDP and early-term birth.Results The current study included 3 260 pregnant women,with the rates of HDP,pregnancy-induced hypertension syndrome and pre-eclampsia as 6.0％ (n=194),4.2％ (n=137) and 1.8％ (n=57),respectively.After controlling for potential confounders,no significant differences between pregnancy-induced hypertension syndrome and early-term birth (OR=1.49,95％C1:0.94-2.36) were found.Pre-eclampsia appeared to have increased the risk of early-term birth (OR=4.46,95％ CI:2.09-9.54).Conclusion Pre-eclampsia could significantly increase the risk of early-term birth.This finding suggested that early detection and intervention programs were helpful in reducing the risk of early-term birth.

Objective:To evaluate the performance of an artificial intelligent (AI)-based automated digital cell morphology analyzer (hereinafter referred as AI morphology analyzer) in detecting peripheral white blood cells (WBCs).Methods:A multi-center study. 1. A total of 3010 venous blood samples were collected from 11 tertiary hospitals nationwide, and 14 types of WBCs were analyzed with the AI morphology analyzers. The pre-classification results were compared with the post-classification results reviewed by senior morphological experts in evaluate the accuracy, sensitivity, specificity, and agreement of the AI morphology analyzers on the WBC pre-classification. 2. 400 blood samples (no less than 50% of the samples with abnormal WBCs after pre-classification and manual review) were selected from 3 010 samples, and the morphologists conducted manual microscopic examinations to differentiate different types of WBCs. The correlation between the post-classification and the manual microscopic examination results was analyzed. 3. Blood samples of patients diagnosed with lymphoma, acute lymphoblastic leukemia, acute myeloid leukemia, myelodysplastic syndrome, or myeloproliferative neoplasms were selected from the 3 010 blood samples. The performance of the AI morphology analyzers in these five hematological malignancies was evaluated by comparing the pre-classification and post-classification results. Cohen′s kappa test was used to analyze the consistency of WBC pre-classification and expert audit results, and Passing-Bablock regression analysis was used for comparison test, and accuracy, sensitivity, specificity, and agreement were calculated according to the formula.Results:1. AI morphology analyzers can pre-classify 14 types of WBCs and nucleated red blood cells. Compared with the post-classification results reviewed by senior morphological experts, the pre-classification accuracy of total WBCs reached 97.97%, of which the pre-classification accuracies of normal WBCs and abnormal WBCs were more than 96% and 87%, respectively. 2. The post-classification results reviewed by senior morphological experts correlated well with the manual differential results for all types of WBCs and nucleated red blood cells (neutrophils, lymphocytes, monocytes, eosinophils, basophils, immature granulocytes, blast cells, nucleated erythrocytes and malignant cells r>0.90 respectively, reactive lymphocytes r=0.85). With reference, the positive smear of abnormal cell types defined by The International Consensus Group for Hematology, the AI morphology analyzer has the similar screening ability for abnormal WBC samples as the manual microscopic examination. 3. For the blood samples with malignant hematologic diseases, the AI morphology analyzers showed accuracies higher than 84% on blast cells pre-classification, and the sensitivities were higher than 94%. In acute myeloid leukemia, the sensitivity of abnormal promyelocytes pre-classification exceeded 95%. Conclusion:The AI morphology analyzer showed high pre-classification accuracies and sensitivities on all types of leukocytes in peripheral blood when comparing with the post-classification results reviewed by experts. The post-classification results also showed a good correlation with the manual differential results. The AI morphology analyzer provides an efficient adjunctive white blood cell detection method for screening malignant hematological diseases.

Bioorthogonal fluorogenic probes are becoming an ideal tool for live-cell fluorescence imaging. With the tetrazine bioorthogonal fluorogenic probe that displays fluorescence enhancement, the tetrazine plays the dual-role of a bioorthogonal reaction unit and the fluorescence quenching unit. The "off" and "on" states of the fluorescence probe are mainly controlled through inverse electron demand Diels-Alder (IEDDA) bioorthogonal reaction. We designed a series of turn-on tetrazine fluorescent probes with Donor-π-Acceptor (D-π-A) structure to achieve a high signal-to-noise ratio and specificity of fluorescence imaging. This series of probes reacted with the dienophile bicyclononyne, and then generated pyridazine structure in-situ that acted as an electron acceptor, resulting in a new D-π-A effect of fluorescent dyes, turning on the intramolecular charge transfer (ICT) effect. By adjusting the electron-donating groups and the degree of conjugation, tunable fluorescence spectra between 400-647 nm with fluorescence turn-on enhanced up to 500-fold have been achieved. This research lays the foundation for the further optimization of tetrazine bioorthogonal fluorescent probes and their applications in molecular imaging and biomedical fields.

OBJECTIVETo evaluate the associations between pregestational body mass index (BMI), weight gain during first half of pregnancy and the risk for gestational diabetes mellitus (GDM).

METHODSA prospective cohort study was conducted among 1,914 local pregnant women, receiving the first prenatal examination during the first 14 weeks of gestation, in Ma'anshan of Anhui province from May 2013 to September 2014. The body weight and height were measured for these pregnant women and questionnaire surveys were conducted among them at enrollment, middle gestation and late gestation, respectively. During 24-28 week of gestation, 75 g oral glucose tolerance test was conducted for them. The independent and joint associations between pregestational BMI/weight gain and the risk of GDM were examined by using logistic regression model.

RESULTSThe prevalence of GDM was 14.73%. There was significant negative correlation between pregestational BMI and weight gain during the first half of pregnancy (r=-0.085, P<0.01), meanwhile the weight gain of GDM women was significantly higher than that of women without GDM. The women with pregestational overweight or obesity had increased risks of GDM. The results from the logistic regression analysis showed that the risk factors included age≥35 years (OR=3.06, 95% CI: 1.68-5.58), fasting plasma glucose level during early pregnancy (OR=2.17, 95% CI: 1.57-3.00), pregestational overweight (OR=2.08, 95% CI: 1.38-3.13), pregestational obesity (OR=3.73, 95% CI: 1.84-7.56).

CONCLUSIONPregestational overweight or obesity and body weight gain during pregnancy were associated with increased risk of GDM.

Body Mass Index ; Diabetes, Gestational ; epidemiology ; Female ; Glucose Tolerance Test ; Humans ; Obesity ; epidemiology ; Overweight ; epidemiology ; Pregnancy ; Prospective Studies ; Risk Factors ; Weight Gain

Objective: To investigate the relationships of intracranial compartment volumes with the severity of clinical symptoms before surgery, and the degree of symptom improvement one year after cerebrospinal fluid(CSF)shunt surgery in patients with idiopathic normal pressure hydrocephalus(iNPH). Methods: Twenty-one patients meeting the diagnosis criteria of international guidelines of iNPH and undergoing CSF shunt surgery in Department of Neurosurgery in our hospital from 2016 to 2017 were included.All patients underwent brain MRI measurement before surgery, and were evaluated by using 3-meter timed up and go test(TUG), minimum mental state examination(MMSE), idiopathic normal pressure hydrocephalus grading scale(iNPHGS)and modified Rankin scale(mRS)before and one year after CSF shunt procedures.The ventricular volume, brain volume, pericerebral CSF volume, total intracranial volume and Evans' index were measured in the pre-operative imaging of the brain.The following four pre-operative intracranial compartment volumes were calculated: the relative ventricular volume, brain volume ratio, pericerebral CSF volume ratio and the ratio of ventricular volume to pericerebral CSF volume. Results: The scores of gait, cognitive function and urinary function were improved after surgery in iNPH patients(all P<0.05). There were no significant difference in the correlation of intracranial compartment volumes(the relative ventricular volume, brain volume ratio, pericerebral CSF volume ratio and the ratio of ventricular volume to pericerebral CSF volume)and Evans' index with the severity of clinical symptoms including gait, cognitive function and urinary function before surgery, and with the degree of symptom improvement one year after surgery in iNPH patients(all P>0.05). There was no significant difference in intracranial compartment volumes between patients having improvement in mRS, TUG, MMSE and iNPHGS and patients having no improvement one year after surgery in iNPH patients(all P>0.05). Conclusions Patients with iNPH can benefit from CSF shunt surgery and have improvements of clinical symptoms including gait, cognitive function and urinary function.Preoperative intracranial compartment volumes(the relative ventricular volume, brain volume ratio, pericerebral CSF volume ratio and the ratio of ventricular volume to pericerebral CSF volume)and Evans' index have no correlations with the severity of clinical symptoms before surgery, and have no correlations with the degree of symptom improvement one year after surgery in iNPH patients.For this reason, preoperative intracranial compartment volumes and Evans' index cannot be used to predict whether or not CSF shunt surgery can improve specific clinical symptoms.

OBJECTIVE: High-fat diet (HFD) and inflammation are two key contributors to nonalcoholic fatty liver disease (NAFLD). Shenling Baizhu powder (SLBZP), a classical herbal compound, has been successfully used to alleviate NAFLD. However, its specific mechanisms are not fully understood. In this study, we assessed the anti-NAFLD effect of SLBZP in vivo. METHODS: Rats were fed an HFD with or without SLBZP or with probiotics. At the end of week 16, an echo magnetic resonance imaging (EchoMRI) body composition analyser was used to quantitatively analyse body composition; a micro-computed tomography (micro-CT) imaging system was used to evaluate whole body and liver fat; and the Moor full-field laser perfusion imager 2 was used to assess liver microcirculation, after which, all rats were sacrificed. Then, biochemical indicators in the blood and the ultrastructure of rat livers were evaluated. Protein expression related to the liver Toll-like receptor 4 (TLR4)/Nod-like receptor family pyrin domain-containing 3 (NLRP3) signalling pathway was assessed using Western blot analysis. Further, high-throughput screening of 29 related inflammatory factors in liver tissue was performed using a cytokine array. RESULTS: SLBZP supplementation reduced body weight, serum free fatty acid, and insulin resistance index (P < 0.05). It also ameliorated liver microcirculation and ultrastructural abnormalities. EchoMRI and micro-CT quantitative analyses showed that treatment with SLBZP reduced fat mass and visceral fat (P < 0.05 and P < 0.01, respectively). In addition, SLBZP decreased the expression of lipopolysaccharide (LPS)-activated TLR4/NLRP3 signalling pathway-related proteins and altered the expression levels of some inflammatory cytokines in liver tissues. CONCLUSION SLBZP can inhibit NLRP3 inflammasome activation and interleukin-1β release by suppressing LPS-induced TLR4 expression in rats with HFD-induced NAFLD. Thus, SLBZP may be beneficial for the prevention and treatment of inflammatory damage and associated diseases.
Animals ; Liver ; NLR Family, Pyrin Domain-Containing 3 Protein ; Non-alcoholic Fatty Liver Disease/drug therapy* ; Powders ; Rats ; Toll-Like Receptor 4 ; X-Ray Microtomography

OBJECTIVETo understand the association between the blood glucose levels of pregnant women in second trimester detected by 75 gram oral glucose tolerance test (OGTT) and the birth weight of neonates.

METHODSDemographic information collection and OGTT were conducted for 3 081 pregnant women at ≤14 gestational weeks and 24-28 gestational weeks respectively. Multiple logistic regression analysis was done to identify the factors associated with the birth weight and the risks of large for gestational age (LGA) in three levels (FPG, OGTT-1 h and OGTT-2 h) of OGTT percentile group, multiple linear regression analysis was used to evaluate the relationships between maternal glucose levels and neonate birth weight.

RESULTSPre-pregnancy obesity (24.0 kg/m2≤BMI<28.0 kg/m2) (OR=1.4, 95%CI:1.0-2.0, P=0.029) and gestational diabetes mellitus (OR=2.4,95% CI: 1.8-3.2, P<0.001) were the risk factors. Pre-pregnancy underweight (BMI<18.5 kg/m2) (OR=1.6, 95%CI: 1.2-2.2, P=0.003), preeclampsia (OR=4.0, 95%CI: 1.9-8.4, P<0.001) increased the risk for small for gestational age (SGA). Multiple linear regression analysis showed neonate birth weight was positive correlated with maternal glucose levels (β were 91.99, 33.60, 32.00, respectively, P<0.001). Percentile groups of each OGTT level was linearly positive associated with increased mean value of neonate birth weight, and so with the risk of LGA.

CONCLUSIONSThere were positive correlations between maternal glucose levels and neonate birth weight. The risk of LGA increased with the maternal glucose levels, but there was no statistical association between SGA and maternal glucose levels. FPG level is one of the predictors of LGA. Active surveillance and control of maternal glucose level can effectively reduce the risk of LGA.

Birth Weight ; Blood Glucose ; analysis ; Cohort Studies ; Diabetes, Gestational ; Female ; Glucose Tolerance Test ; Humans ; Infant, Newborn ; Infant, Small for Gestational Age ; Logistic Models ; Obesity ; Pre-Eclampsia ; Pregnancy ; Pregnancy Trimester, Second ; blood ; Risk Factors ; Thinness