Serum tumor markers expression(CA199,CA242,and CEA)and its clinical implications in type 2 diabetes mellitus

BACKGROUND Glucose and lipid metabolic disorder in patients with type 2 diabetes mellitus(T2DM)is associated with the levels of serum tumor markers of the digestive tract,such as cancer antigen(CA)199.Therefore,tumor markers in T2DM are important.AIM To evaluate the expression of serum tumor markers[CA199,CA242,and carcinoembryonic antigen(CEA)]and the clinical implications of the expression in T2DM.METHODS For this observational study conducted at Hefei BOE Hospital,China,we enrolled 82 patients with first-onset T2DM and 51 controls between April 2019 and December 2020.Levels of fasting blood glucose(FBG),tumor markers(CA199,CEA,and CA242),glycosylated hemoglobin(HbA1c),etc.were measured and group index levels were compared.Moreover,FBG and HbA1c levels were correlated with tumor marker levels.Tumor markers were tested for diagnostic accuracy in patients with>9%HbA1c using the receiver operating curve(ROC)curve.RESULTS The T2DM group had high serum FBG,HbA1c,CA199,and CEA levels(P<0.05).A comparative analysis of the two groups based on HbA1c levels(Group A:HbA1c≤9%;Group B:HbA1c>9%)revealed significant differences in CEA and CA199 levels(P<0.05).The areas under the ROC curve for CEA and CA199 were 0.853 and 0.809,respectively.CA199,CEA,and CA242 levels positively correlated with HbA1c(r=0.308,0.426,and 0.551,respectively)and FBG levels(r=0.236,0.231,and 0.298,respectively).CONCLUSION As compared to controls,serum CEA and CA199 levels were higher in patients with T2DM.HbA1c and FBG levels correlated with CA199,CEA,and CA242 levels.Patients with poorly controlled blood sugar must be screened for tumor markers.

老年非酒精性脂肪性肝病的营养状况及能量代谢特点

背景随着全球人口老龄化和非酒精性脂肪性肝病(nonalcoholic fatty liver disease,NAFLD)增长,老年NAFLD人群特点的研究尤为重要.目的观察老年NAFLD患者的营养状态和能量代谢特点.方法回顾性分析2017-01/2019-01天津市第三中心医院消化科就诊的NAFLD老年患者118例,进行人体成分分析仪分析及应用代谢车评估营养及能量代谢指标,与老年非脂肪肝组进行比较.统计分析中正态分布计量资料采用独立样本t检验,非正态分布计量资料采用Mann-Whitney U检验,二元Logistic回归分析老年NAFLD发生的危险因素.结果人体成分分析显示老年NAFLD组腰臀脂肪比、体脂肪含量较老年非脂肪肝组明显增加(腰臀脂肪比0.95 vs 0.92,体脂肪27.20 kg vs 19.60 kg,P<0.005);代谢车测定结果显示老年NAFLD组静息能量消耗均高于老年非脂肪肝组(1769.00 kcal/d vs 1323.00 kcal/d,P<0.05);进一步比较老年NAFLD患者轻度脂肪肝组与中重度脂肪肝组,轻度脂肪肝组体脂肪、腰臀脂肪比、基础代谢、静息能量消耗明显低于中重度脂肪肝患者.结论在老年NAFLD患者中存在营养失衡和能量代谢紊乱,随脂肪肝程度加重更为显著,通过人体成分分析仪和代谢车以综合评价和监测老年NAFLD患者的营养及能量代谢状态,为疾病干预治疗提供依据.

直接抗病毒药物治疗慢性丙型肝炎48周临床观察

背景慢性丙型肝炎(chronic hepatitis C,CHC)是全球公共卫生问题,随着直接抗病毒药(direct antiviral therapy,DAA)在中国的应用,DAA药物成为目前国内慢性丙型肝炎抗病毒一线方案,但目前真实世界DAA治疗后长期疗效数据尚少.目的观察慢性丙型肝炎患者接受直接抗病毒药物抗病毒治疗后48 wk病毒学应答及临床疗效.方法连续收集2018-04-01/2020-04-30在天津市第三中心医院接受DAA治疗的初治CHC患者,评估治疗基线、治疗结束、治疗后12 wk及48 wk的病毒学应答及肝肾功能、肝硬度、APRI及临床结局.结果共收集291例应用DAA治疗的CHC患者,纳入145例完成抗病毒治疗及随访的CHC患者进入本研究.其中肝硬化患者占28.3%,基因型1b、2a、3a、6a分别占78.0%、17.2%、2.8%、2.0%.DAA治疗结束、治疗后12 wk及48 wk获得持续病毒学应答(sustained virological response,SVR)比例分别为100%、97.9%和97.2%,其中基因型1b、2a、3a、6a的SVR48分别为97.3%、96%、100%、100%.治疗结束后48 wk与基线相比较,丙氨酸氨基转移酶、天冬氨酸氨基转移酶、总胆红素及白蛋白的复常率分别为93.2%、91.7%、73.3%及97.7%.治疗结束后48 wk肝硬度(liver stiffness measurement,LSM)及APRI与基线水平相比均明显下降(LSM 12.5 vs 10.2kpa P<0.01;APRI 0.34 vs 0.13 P<0.01),肝硬化组及非肝硬化组患者均有明显下降(P<0.05).48 wk随访期间,其中4例(2.8%)CHC患者进展为肝硬化,8例(5.6%)肝硬化患者进展为肝硬化失代偿,3例(2.1%)肝硬化患者发生新发肝细胞癌(hepatocellular carcinoma,HCC).结论本研究真实世界中慢性丙型肝炎患者应用DAA治疗后48 wk,总体病毒持续应答率较高,肝功能、肝硬度及APRI值均明显改善.2.1%患者出现新发HCC.

The association between retinal vasculature changes and stroke:a literature review and Meta-analysis

AIM： To determine the association between retinal vasculature changes and stroke.METHODS： MEDLINE and EMBASE were searched for relevant human studies to September 2015 that investigated the association between retinal vasculature changes and the prevalence or incidence of stroke; the studies were independently examined for their qualities. Data on clinical characteristics and calculated summary odds ratios （ORs） were extracted for associations between retinal microvascular abnormalities and stroke, including stroke subtypes where possible, and adjusted for key variables. RESULTS： Nine cases were included in the study comprising 20 659 patients, 1178 of whom were stroke patients. The retinal microvascular morphological markers used were hemorrhage, microaneurysm, vessel caliber, arteriovenous nicking, and fractal dimension. OR of retinal arteriole narrowing and retinal arteriovenous nicking and stroke was 1.42 and 1.91, respectively, indicating that a small-caliber retinal arteriole and retinal arteriovenous nicking were associated with stroke. OR of retinal hemorrhage and retinal microaneurysm and stroke was 3.21 and 3.83, respectively, indicating that retinal microvascular lesions were highly associated with stroke. Results also showed that retinal fractal dimension reduction was associated with stroke （OR： 2.28 for arteriole network, OR： 1.80 for venular network）.CONCLUSION： Retinal vasculature changes have a specific relationship to stroke, which is promising evidence for the prediction of stroke using computerized retinal vessel analysis.

Calcium-dependent activation of CPK12 facilitates its cytoplasm-to-nucleus translocation to potentiate plant hypoxia sensing by phosphorylating ERF-Ⅶ transcription factors

Calcium-dependent protein kinases(CDPKs/CPKs)are key regulators of plant stress signaling that translate calcium signals into cellular responses by phosphorylating diverse substrate proteins.However,the molecular mechanism by which plant cells relay calcium signals in response to hypoxia remains elusive.Here,we show that one member of the CDPK family in Arabidopsis thaliana,CPK12,is rapidly activated during hypoxia through calcium-dependent phosphorylation of its Ser-186 residue.Phosphorylated CPK12 shuttles from the cytoplasm to the nucleus,where it interacts with and phosphorylates the group Ⅶ ethylene-responsive transcription factors(ERF-Ⅶ)that are core regulators of plant hypoxia sensing,to enhance their stabilities.Consistently,CPK12 knockdown lines show attenuated tolerance of hypoxia,whereas transgenic plants overexpressing CPK12 display improved hypoxia tolerance.Nonethelss,loss of function of five ERF-Ⅶ proteins in an erf-vii pentuple mutant could partially suppress the enhanced hypoxia-tolerance phenotype of CPK12-overexpressing lines.Moreover,we also discovered that phosphatidic acid and 14-3-3κ protein serve as positive and negative modulators of the CPK12 cytoplasm-to-nucleus translocation,respectively.Taken together,these findings uncover a CPK12-ERF-Ⅶ regulatory module that is key to transducing calcium signals from the cytoplasm into the nucleus to potentiate hypoxia sensing in plants.

Geodesic Structure of a Non-linear Magnetic Charged Black Hole Surrounded by Quintessence

This paper aims to investigate the geodesic motion in the spacetime of a non-linear magnetic charged black hole surrounded by quintessence. By varying the Lagrangian corresponding to the metric, the orbital motion equation has been obtained. The effects of the magnetic charge Q, positive normalization factor C, angular momentum b, and energy E on time-like and null geodesic motion are discussed from three aspects: orbital stability, orbital types, and circular orbits. By comparing the effects of the above parameters C, b on the effective potential, it is found that quintessence has an impact on the types and stability of orbits. In addition, for time-like orbital motion, when 3.443113 ≤ b ≤ 6.392 578(for fixed C = 0.0002, M = 1, Q = 0.7), there are bound orbits, and within this range, the stable circular orbits exist,and the radii of the innermost and outermost stable circular orbit are r = 5.912 654 and r = 56.745 933, respectively. For null orbital motion, the orbital types have only unstable circular orbit which occur at r = 2.951 072(E2= E22= 0.4),absorb orbits and escape orbits, but no stable circular orbits, and bound orbits.