We studied the distribution profiles and repeatability of key exercise performance parameters in the first large multicentre trials to include these measurements in chronic obstructive pulmonary disease (COPD).After a screening visit, 463 subjects with COPD (mean¡SD forced expiratory volume in 1 s 43¡13% predicted) completed two run-in visits before treatment randomisation. At the run-in visits, measurements were conducted at rest, at a standardised time near end-exercise (isotime) and at peak exercise during constant work rate (CWR) cycle tests at 75% of each individual's maximum work capacity. The intraclass correlation coefficient was used to evaluate the test-retest repeatability of measurements of endurance time (ET), inspiratory capacity (IC), ventilation and dyspnoea intensity (Borg scale) during exercise.IC, ventilation and dyspnoea ratings were normally distributed; ET showed rightward skew (median,mean, skewness of 10.9 (much greater than zero)) with 16% of the sample exceeding 1 SD of the mean. ET was highly repeatable across run-in visits: 7.9¡4.8 and 8.4¡5.1 min (R50.84). IC values at rest, isotime and peak exercise were all highly repeatable (Ro0.87). Ventilation was repeatable over the same time-points (Ro0.92), as was dyspnoea intensity at isotime (R50.79) and at peak exercise (R50.81).In conclusion, key perceptual and ventilatory parameters can be reliably measured during CWR cycle exercise in multicentre clinical trials in moderate to very severe COPD.

Recent published studies on the association between non-alcoholic fatty liver disease (NAFLD) and cerebrovascular accident (CVA) risk have yielded conflicting findings. The aim of our study was to identify the potential association by pooling all available publications. A total of nine independent studies were included into our study. The pooled odd ratio (OR) with 95% confidence interval (95% CI) was calculated to weigh the strength for the relationship between NAFLD and CVA risk. We also conducted stratified analyses by study design, ethnicity and disease classification for further elucidation. The pooled results of the present meta-analysis showed that NAFLD was related to increased risk of CVA (OR = 2.32, 95% CI 1.84–2.93, P < 0.001). Besides, NAFLD is associated with increased risk of CVA among both Caucasians (OR = 2.27, 95% CI 1.77–2.90, P < 0.001) and Asians (OR = 2.81, 95% CI 1.43–5.51, P = 0.003). Moreover, the significant association was also observed in case-control studies (OR = 2.73, 95% CI 1.67–4.48, P < 0.001) and cohort studies (OR = 2.22, 95% CI 1.71–2.89, P < 0.001), respectively. In addition, NAFLD was shown to correlate with increased risk of cerebral hemorrhage (OR = 1.85, 95% CI 1.05–3.27, P = 0.034) and the ischemic stroke (OR = 2.51, 95% CI 1.92–3.28, P < 0.001). In conclusion, our findings firstly provide strong evidence for a risk effect of NAFLD on CVA development.

These outcomes strongly support the relationship between type 2 diabetes mellitus and an increased risk of acute pancreatitis. More fundamental research should be carried out to elucidate the biological mechanisms.

Lipoxin A (LXA), a kind of adipokines, is a potent stop signal of inflammation. Our preliminary study found that LXA of serum and intra-articular lavage fluid (IALF) was rapidly elevated in 2 h and rapidly reduced to normal level at 4 h after moderate-intensity treadmill exercise. The aim was to confirm the therapeutic effects of LXA during treadmill exercise on rat model of monosodium iodoacetate (MIA)-induced OA and the detailed mechanism of LXA on OA. One hundred and twenty-four male Sprague-Dawley rats were submitted to two different protocols. A single session of treadmill exercise: sixty-four rats were randomly divided into treadmill exercise of different intensities for 60 min only once (n = 4). Formal treadmill exercise: sixty rats were randomly divided into six groups (n = 10): control group (CG), knee OA group (OAG), OA with treadmill exercise of different intensities (OAL, OAM and OAH), and OAM + BOC-2 (an antagonist of LXA receptor). The rats were evaluated by ELISA, histology, immunohistochemistry and western blotting. Fibroblast-like synoviocytes (FLSs) were obtained from knee joint of rats. The effects of LXA on interleukin (IL)-1β induced FLSs were evaluated by western blotting and immunofluorescence. The results of ELISA, histological evaluation, western blotting and immunohistochemistry indicated that OAM had a better treatment which could be suppressed by BOC-2. Moreover, LXA could attenuate the expression of matrix metalloproteinase (MMP)-3 and MMP-13 and suppress the expression of nuclear factor-kappa B (NF-κB) p65 induced by IL-1β in FLSs. The therapeutic effects of LXA during treadmill exercise on MIA-induced OA via inhibiting NF-κB signaling pathway.

AimThe role of insulin glargine as a risk factor for cancer is controversial in human studies. The aim of this meta-analysis was to evaluate the relationship between insulin glargine and cancer incidence.MethodsAll observational studies and randomized controlled trials evaluating the relationship of insulin glargine and cancer risk were identified in PubMed, Embase, Web of Science, Cochrane Library and the Chinese Biomedical Medical Literature Database, through March 2012. Odds ratios (ORs) with corresponding 95% confidence interval (CI) were calculated with a random-effects model. Confidence in the estimates of the obtained effects (quality of evidence) was assessed by using the Grading of Recommendations Assessment, Development, and Evaluation approach.ResultsA total of 11 studies including 448,928 study subjects and 19,128 cancer patients were finally identified for the meta-analysis. Insulin glargine use was associated with a lower odds of cancer compared with non-glargine insulin use (OR 0.81, 95% CI 0.68 to 0.98, P = 0.03; very low-quality evidence). Glargine did not increase the odds of breast cancer (OR 0.99, 95% CI 0.68 to 1.46, P = 0.966; very low-quality evidence). Compared with non-glargine insulin, no significant association was found between insulin glargine and prostate cancer, pancreatic cancer and respiratory tract cancer. Insulin glargine use was associated with lower odds of other site-specific cancer. Conclusions Results from the meta-analysis don't support the link between insulin glargine and an increased risk of cancer and the confidence in the estimates of the effects is very low. Further studies are needed to examine the relation between insulin glargine and cancer risk, especially breast cancer.