Oś MIF/CD74 jako cel terapii metforminą w podocytopatii cukrzycowej — rzeczywista praktyka kliniczna

Introduction：To observe the effects of metformin on urinary excretion of MIF, CD74 and podocalyxin in type 2 diabetics and to explore its possible renoprotective mechanisms. Methods: 202 uncontrolled type 2 diabetics, who were previously prescribed sulfonylurea monotherapy(n=100) or sulfonylurea in combination with metformin (n=102) were enrolled in the study. The amount of macrophage migration inhibitory factor(MIF) and CD74 in serum, urinary MIF to creatine ratio(UMCR), urinary CD74 to creatine ratio(UCCR), urinary albumin to creatine ratio(UACR) and urinary podocalyxin to creatine ratio (UPCR) were determined. Results: Metabolic parameters including fasting blood glucose, postprandial 2 hours blood glucose, hemoglobin A1c, MIF and CD74 in serum were comparable between the two groups. Moreover, metformin add-on therapy showed significantly better efficacy in reducing UMCR, UCCR, UPCR and UACR in comparison with those in sulfonylurea monotherapy group, respectively. UPCR had positive correlation with UACR, UMCR and UCCR (r＝0.73, r=0.69, r=0.62, P < 0.01), respectively. Conclusions: Metformin could present its podocyte-protective capacity in type 2 diabetics and the underlying mechanisms may be partly attributed to its effects in suppressing MIF-CD74 axis mediated inflammatory cascade response. Wstęp: Celem pracy było zaobserwowanie efektów działania metforminy na wydalanie MIF, CD74 i podokaliksyny w moczu pacjentów z cukrzycą typu 2 oraz zbadanie jej możliwych mechanizmów nefroprotekcyjnych. Materiał i metody: W badaniu wzięło udział 202 pacjentów z niewyrównaną cukrzycą typu 2, którym zalecono wcześniej monoterapię sulfonylomocznikiem (n = 100) lub sulfonylomocznikiem skojarzonym z metforminą (n = 102). Podczas badania określono ilość czynnika hamującego migrację makrofagów (MIF) i CD74 w surowicy krwi, wskaźnik MIF/kreatynina (urinary MIF to creatinine ratio; UMCR), wskaźnik CD74/kreatynina (urinary CD74 to creatinine ratio; UCCR), wskaźnik albumina/kreatynina (urinary albumin to creatinine ratio; UACR) oraz wskaźnik podokaliksyna/kreatynina (urinary podocalyxin to creatinine ratio; UPCR). Wyniki: Parametry metaboliczne, w tym glikemia na czczo, stężenie glukozy we krwi dwie godziny po posiłku, hemoglobina A1c, MIF i CD74 w surowicy krwi były porównywalne w obu grupach. Ponadto, terapia z dodatkiem metforminy wykazała znacznie lepszą skuteczność w redukowaniu wskaźników UMCR, UCCR, UPCR i UACR w porównaniu z grupą, w której zastosowano monoterapię sulfonylomocznikiem. Wskaźnik UPRC wykazywał dodatnią korelację ze wskaźnikami UACR, UMCR i UCCR (odpowiednio: r = 0,73, r = 0,69, r = 0,62, p &lt; 0,01). Wnioski: Metformina może wykazywać zdolność do ochrony podocytów u pacjentów z cukrzycą typu 2, a mechanizmy leżące u pod­staw tego procesu mogą być częściowo przypisane jej właściwościom hamowania kaskady reakcji zapalnych zależnych od osi MIF-CD74

An Online Full-Body Motion Recognition Method Using Sparse and Deficient Signal Sequences

This paper presents a method to recognize continuous full-body human motion online by using sparse, low-cost sensors. The only input signals needed are linear accelerations without any rotation information, which are provided by four Wiimote sensors attached to the four human limbs. Based on the fused hidden Markov model (FHMM) and autoregressive process, a predictive fusion model (PFM) is put forward, which considers the different influences of the upper and lower limbs, establishes HMM for each part, and fuses them using a probabilistic fusion model. Then an autoregressive process is introduced in HMM to predict the gesture, which enables the model to deal with incomplete signal data. In order to reduce the number of alternatives in the online recognition process, a graph model is built that rejects parts of motion types based on the graph structure and previous recognition results. Finally, an online signal segmentation method based on semantics information and PFM is presented to finish the efficient recognition task. The results indicate that the method is robust with a high recognition rate of sparse and deficient signals and can be used in various interactive applications

Prediction of Crack Resistance of LFSMA-13 with and without Anti-Rut Agent Using Parameters of FTIR Spectrum under Different Aging Degrees

This paper aims to better analyze the crack resistance of lignin fiber reinforced SMA-13 (LFSMA-13) asphalt mixtures, with and without polymer anti-rut agent (ARA), under different aging degrees. IDEAL-CT test and Fourier transform infrared (FTIR) spectroscopy were utilized to analyze the relationships between the crack resistance of LFSMA-13, with and without ARA, and the parameters of the FTIR spectrum of the asphalt extracted from the test samples. A convenient testing method to predict the anti-crack ability of the mixtures in a road was also derived in this study. The test samples were prepared using the specifications listed by AASHTO. The fracture formation work (Winitial) and cracking index (CTIndex) in the IDEAL-CT test were adopted to reflect the cracking ability of the asphalt mixtures in both the crack formation stage and the crack propagation stage. The peak areas of the FTIR spectrum were utilized to reveal the chemical properties of the asphalt material inside the SMA-13 asphalt mixtures, with and without ARA under different aging degrees. Grey correlation analysis was adopted to choose the most suitable FTIR spectrum parameters to derive the prediction models of Winitial and CTIndex under different aging degrees. After conducting a series of tests, the results showed that the aging process could well affect the crack resistance of the test samples and the peak areas of the asphalt extracted from the mixtures. The FTIR parameters selected from the grey correlation analysis could be used to well predict the anti-crack ability of the asphalt mixtures

Transcranial alternating current stimulation for treating depression: a randomized controlled trial

Treatment of depression with antidepressants is partly effective. Transcranial alternating current stimulation can provide a non-pharmacological alternative for adult patients with major depressive disorder. However, no study has used the stimulation to treat first-episode and drug-naive patients with major depressive disorder. We used a randomized, double-blind, sham-controlled design to examine the clinical efficacy and safety of the stimulation in treating first-episode drug-naive patients in a Chinese Han population. From 4 June 2018 to 30 December 2019, 100 patients were recruited and randomly assigned to receive 20 daily 40-min, 77.5 Hz, 15 mA, one forehead and two mastoid sessions of active or sham stimulation (n = 50 for each group) in four consecutive weeks (Week 4), and were followed for additional 4-week efficacy/safety assessment without stimulation (Week 8). The primary outcome was a remission rate defined as the 17-item Hamilton Depression Rating Scale (HDRS-17) score = 50% in the HDRS-17), changes in depressive symptoms and severity from baseline to Week 4 and Week 8, and rates of adverse events. Data were analysed in an intention-to-treat sample. Forty-nine in the active and 46 in the sham completed the study. Twenty-seven of 50 (54%) in the active treatment group and 9 of 50 (18%) in the sham group achieved remission at the end of Week 8. The remission rate was significantly higher in the active group compared to that in the sham group with a risk ratio of 1.78 (95% confidence interval, 1.29, 2.47). Compared with the sham, the active group had a significantly higher remission rate at Week 4, response rates at Weeks 4 and 8, and a larger reduction in depressive symptoms from baseline to Weeks 4 and 8. Adverse events were similar between the groups. In conclusion, the stimulation on the frontal cortex and two mastoids significantly improved symptoms in first-episode drug-naive patients with major depressive disorder and may be considered as a non-pharmacological intervention for them in an outpatient setting. In a randomized double-blind controlled trial, Wang et al. show that 4 weeks of treatment with transcranial alternating current stimulation (tACS) reduces symptoms to a greater degree than sham stimulation in first-episode drug-naive patients with major depressive disorder