A study of the effect of suboptimal glycemic control on subclinical myocardial systolic function in patients with T2DM

Objective·To explore the relationship between poor blood glucose control and early impaired cardiac function in patients with type 2 diabetes mellitus (T2DM).Methods·Eighty-three patients diagnosed with T2DM in Jiading Branch of Shanghai General Hospital from June 2021 to March 2022 were selected and divided into two groups according to the level of hemoglobin A1c (HbA1c): satisfactory control of glycaemia (SCG) group and less satisfactory control of glycaemia (LSCG) group. Fifty-four subjects were in the control group. Echocardiography was performed to obtain left ventricular structural and functional parameters and left ventricular subendocardial, medial and subepicardial global longitudinal strain (GLS): GLSendo, GLSmid, and GLSepi. The parameters were compared by using analysis of variance. The correlation analysis was performed by Pearson correlation analysis and multiple linear regression analysis. The diagnostic performance of longitudinal strain in differentiating subclinical myocardial dysfunction in patients with T2DM was analyzed by receiver operator characteristic (ROC) curve.Results·The thickness of the ventricular septum and the posterior wall of the left ventricle were thicker in the LSCG group than in the SCG group and the control group (all P0.05). Compared with the control group, the left ventricular diastolic function index E/e (early peak flow velocity by Doppler/early and atrial diastolic velocity of the mitral annulus by tissue Doppler imaging) was higher in both the LSCG group and the SCG group (all P 0.05). There was no significant difference in left ventricular ejection fraction among the three groups (P>0.05). Compared with LSCG group, GLSendo, GLSmid and GLSepi were higher in the SCG group and control group (all P0.05). HbA1c was an independently negative factor of GLSmid and GLSepi (β= -0.198 and -0.239, all P<0.05). GLSendo, GLSmid and GLSepi had moderate diagnostic performance between the LSCG group and SCG group, with areas under the curve (AUC) of 0.754 (95%CI 0.624‒0.884), 0.755 (95%CI 0.624‒0.885), and 0.751 (95%CI 0.619‒0.882), respectively.Conclusions·T2DM patients with unsatisfactory glycemic control have reduced myocardial contractility, and this subclinical myocardial damage is independently negatively correlated with the level of HbA1c

Ruthenium- and Rhodium-Catalyzed Chemodivergent Couplings of Ketene Dithioacetals and α‑Diazo Ketones via C–H Activation/Functionalization

Chemodivergent coupling of α-acylketene dithioacetals with diazo compounds has been realized under catalyst control. The Ru­(II)-catalyzed C–H activation occurred at the olefinic position, and 1:2 coupling with α-diazoketoesters leads to furfurylation. In contrast, the Rh­(III)-catalyzed C–H functionalization occurred at both the olefinic and the <i>ortho</i> C­(aryl)–H positions, and [4 + 2] annulation afforded naphthalenones. Synthetic applications have been performed to demonstrate the usefulness of the coupling system

Abnormalities of frontal-parietal resting-state functional connectivity are related to disease activity in patients with systemic lupus erythematosus.

Cerebral involvement is common in patients with systemic Lupus erythematosus (SLE) and is characterized by multiple clinical presentations, including cognitive disorders, headaches, and syncope. Several neuroimaging studies have demonstrated cerebral dysfunction during different tasks among SLE patients; however, there have been few studies designed to characterize network alterations or to identify clinical markers capable of reflecting the cerebral involvement in SLE patients. This study was designed to characterize the profile of the cerebral activation area and the functional connectivity of cognitive function in SLE patients by using a task-based and a resting state functional magnetic resonance imaging (fMRI) technique, and to determine whether or not any clinical biomarkers could serve as an indicator of cerebral involvement in this disease. The well-established cognitive function test (Paced Visual Serial Adding Test [PVSAT]) was used. Thirty SLE patients without neuropsychiatric symptoms and 25 age- and gender-matched healthy controls were examined using PVSAT task-based and resting state fMRI. Outside the scanner, the performance of patients and the healthy controls was similar. In the PVSAT task-based fMRI, patients presented significantly expanded areas of activation, and the activated areas exhibited significantly higher functional connectivity strength in patients in the resting state. A positive correlation existed between individual connectivity strength and disease activity scoring. No correlation with cerebral involvement existed for serum markers, such as C3, C4, and anti-dsDNA. Thus, our findings may shed new light on the pathologic mechanism underlying neuropsychiatric SLE, and suggests that disease activity may be a potential effective biomarker reflecting cerebral involvement in SLE

Additional file 1 of Uncoupling of the center-to-periphery arterial stiffness gradient and pulse pressure amplification in viral pneumonia infection

Supplementary Material

The effects of oxaliplatin-based adjuvant chemotherapy in high-risk stage II colon cancer with mismatch repair-deficient: a retrospective study

Abstract Background For high-risk stageIImismatch repair deficient (dMMR) colon cancers, the benefit of adjuvant chemotherapy remains debatable. The principal aim of this study was to evaluate the prognostic value of high-risk factors and the effect of oxaliplatin-based adjuvant chemotherapy among dMMR stageIIcolon cancers. Methods Patients with stage II dMMR colon cancers diagnosed between June 2011 and May 2018 were enrolled in the study. Clinicopathological characteristics, treatment, and follow-up data were retrospectively collected. The high-risk group was defined as having one of the following factors: pT4 disease, fewer than twelve lymph nodes harvested (< 12 LNs), poorly differentiated histology, perineural invasion (PNI), lymphatic vascular invasion (LVI), or elevated preoperative carcinoembryonic antigen (CEA). The low-risk group did not have any risk factors above. Factors associated with disease-free survival (DFS) were included in univariate and multivariate Cox analyses. Results We collected a total of 262 consecutive patients with stage II dMMR colon cancer. 179 patients (68.3%) have at least one high-risk factor. With a median follow-up of 50.1 months, the low-risk group was associated with a tended to have a better 3-year DFS than the high-risk group (96.4% vs 89.4%; P = 0.056). Both elevated preoperative CEA (HR 2.93; 95% CI 1.26–6.82; P = 0.013) and pT4 disease (HR 2.58; 95% CI 1.06–6.25; P = 0.037) were independent risk factors of recurrence. Then, the 3-year DFS was 92.6% for the surgery alone group and 88.1% for the adjuvant chemotherapy group (HR 1.64; 95% CI 0.67–4.02; P = 0.280). Furthermore, no survival benefit from oxaliplatin-based adjuvant chemotherapy was observed in the high-risk group and in the subgroups with pT4 disease or < 12 LNs. Conclusions These data suggests that not all high-risk factors have a similar impact on stage II dMMR colon cancers. Elevated preoperative CEA and pT4 tumor stage are associated with increased recurrence risk. However, oxaliplatin-based adjuvant chemotherapy shows no survival benefits in stage II dMMR colon cancers, either with or without high-risk factors

Morphologic and Functional Connectivity Alterations of Corticostriatal and Default Mode Network in Treatment-Naïve Patients with Obsessive-Compulsive Disorder

<div><p>Background</p><p>Previous studies have demonstrated that structural deficits and functional connectivity imbalances might underlie the pathophysiology of obsessive-compulsive disorder (OCD). The purpose of the present study was to investigate gray matter deficits and abnormal resting-state networks in patients with OCD and further investigate the association between the anatomic and functional alterations and clinical symptoms.</p> <p>Methods</p><p>Participants were 33 treatment-naïve OCD patients and 33 matched healthy controls. Voxel-based morphometry was used to investigate the regions with gray matter abnormalities and resting-state functional connectivity analysis was further conducted between each gray matter abnormal region and the remaining voxels in the brain.</p> <p>Results</p><p>Compared with healthy controls, patients with OCD showed significantly increased gray matter volume in the left caudate, left thalamus, and posterior cingulate cortex, as well as decreased gray matter volume in the bilateral medial orbitofrontal cortex, left anterior cingulate cortex, and left inferior frontal gyrus. By using the above morphologic deficits areas as seed regions, functional connectivity analysis found abnormal functional integration in the cortical-striatum-thalamic-cortical (CSTC) circuits and default mode network. Subsequent correlation analyses revealed that morphologic deficits in the left thalamus and increased functional connectivity within the CSTC circuits positively correlated with the total Y-BOCS score.</p> <p>Conclusion</p><p>This study provides evidence that morphologic and functional alterations are seen in CSTC circuits and default mode network in treatment-naïve OCD patients. The association between symptom severity and the CSTC circuits suggests that anatomic and functional alterations in CSTC circuits are especially important in the pathophysiology of OCD. </p> </div

PVSAT baseline task activations for control subjects (A) and SLE patients (B).

<p>All of the reported activation clusters survived a FEW-corrected <i>p</i><0.05 at the voxel level and an extent threshold of 30 voxels. In control subjects, the activations were situated in the left superior and inferior parietal lobes, and the left inferior frontal gyrus. For SLE patients, significantly extended activation was found in the left hemisphere in the superior and inferior parietal lobes, the supplementary motor area, and the middle and inferior frontal gyrus. SLE patients (compared to controls) demonstrated increased activation mainly in the left supplementary motor area (C).</p

Positive correlation between total Y-BOCS score and brain gray matter volume and functional connectivity strength in abnormal areas.

<p>L, left; R, right; LOFC, lateral orbitofrontal cortex; MOFC, medial orbitofrontal cortex.</p

Results of functional connectivity strength analysis.

<p>Activation areas of the PVSAT task in normal controls were selected as ROIs to test for connectivity strength (A). Compared to the controls, SLE patients exhibited significantly intensified (<i>p</i><0.05) connectivity strength (B); nevertheless, the SLE disease activity index (SLEDAI) score was positively correlated (<i>r</i>=0.525, <i>p</i><0.05) with individual connectivity strength in patients (C).</p