bluuebunny/crossref_metadata_2025 huggingface dataset:
Increase in Body Mass Index, Waist Circumference and Waist-to-Height Ratio is Associated with High Blood Pressure in Children and Adolescents in China
Authors: Hu Y-H , Reilly KH , Liang Y-J , Xi B , Liu J-T , Xu D-J , Yan Y-K , Xie B , Li X-Y
Published: February 2013

This study compared the association between blood pressure (BP) and obesity in 1145 Chinese children and adolescents (608 males, 537 females) using data from the 2006 China Health and Nutrition Survey. Obesity was diagnosed by body mass index (BMI), waist circumference (WC) and waist-to-height ratio (WHtR). Analysis of variance was used to analyse the difference in BP among different subgroups. Odds ratios (OR) were calculated and multivariate logistic regression analysis was carried out. The prevalence of high systolic and diastolic BP increased directly with corresponding increments in BMI, WC and WHtR, although the prevalence and OR of high BP were higher when increased BMI was combined with WC (OR 3.39; 95% confidence interval [CI] 1.79, 6.41) or WHtR (OR 3.28; 95% CI 1.71, 6.30). In conclusion, increased BMI, WC and WHtR were directly associated with high BP in Chinese children and adolescents.
Gasless Laparoscopy versus Conventional Laparoscopy in Uterine Myomectomy: A Single-Centre Randomized Trial
Authors: Wang J-J , Yang F , Gao T , Li L , Xia H , Li H-F
Published: February 2013

In a single-centre, randomized trial, gasless laparoscopic myomectomy was compared with conventional laparoscopic myomectomy. The study examined feasibility, safety, reliability and post-operative outcomes. Estimated blood loss, duration of surgery, early post-operative outcomes and length of hospital stay were recorded. Compared with conventional laparoscopic myomectomy, gasless laparoscopy resulted in significantly lower intra-operative blood loss (median 100 ml vs 80 ml, respectively) and duration of surgery (median 94 min vs 71 min, respectively). Post-operative abdominal drainage volume was significantly lower after gasless laparoscopy than after conventional laparoscopy (median 100 ml vs 240 ml). There was no significant difference between duration of post-operative fever, post-operative time to flatus or length of hospital stay. Both forms of laparoscopy are suitable for uterine myomectomy, and comparison of these methods showed that gasless laparoscopy had potential advantages over conventional laparoscopy.
Haemodynamic Brain Response to Visual Sexual Stimuli is Different between Homosexual and Heterosexual Men
Authors: Hu S-H , Wang Q-D , Xu Y , Liao Z-L , Xu L-J , Liao Z-L , Xu X-J , Wei E-Q , Yan L-Q , Hu J-B , Wei N , Zhou W-H , Huang M-L , Zhang M-M
Published: February 2013

The underlying neurobiological factors involved in sexual orientation are largely unknown. This study investigated whether neural circuits or different cognitive processes accounted for differences in brain activation in 14 heterosexual and 14 homosexual males. Brain scans were undertaken in each subject using functional magnetic resonance imaging while they viewed different sexual stimuli, i.e. heterosexual couple stimuli (HCS), gay couple stimuli (GCS), lesbian couple stimuli (LCS) and neutral stimuli (NS). Ratings of sexual attractiveness of the stimuli were assessed. Subjective sexual arousal was induced by HCS and GCS in heterosexual and homosexual men, respectively. Sexual disgust was induced by GCS and LCS in heterosexual and homosexual men, respectively. Compared with viewing NS, viewing sexual stimuli induced significantly different brain activations, most of which had the characteristics of cognitive processes. These observations suggest that different cognitive patterns may be the major cause of different subjective responses to sexual stimuli between heterosexual and homosexual men.
Alterations of Serum Lipid and Inflammatory Cytokine Profiles in Patients with Coronary Heart Disease and Chronic Periodontitis: A Pilot Study
Authors: Tang K , Lin M , Wu Y , Yan F
Published: February 2013

Serum lipid and inflammatory cytokine profiles were assessed in 124 in-patients with coronary heart disease (CHD) (CHD group) and 43 inpatients with no evidence of CHD (control group). In all patients, research questionnaires and examinations of periodontal health were conducted and venous blood samples were analysed. Both groups were divided into two subgroups according to the presence or absence of chronic periodontitis in individual patients. The prevalence of chronic periodontitis was higher in patients from the CHD group than in the control group. Levels of total cholesterol, triglycerides, low-density lipoprotein, oxidized low-density lipoprotein, high-sensitivity C-reactive protein, interleukin-6 and tumour necrosis factor-a were significantly higher in CHD patients with chronic periodontitis than in those without periodontitis. In conclusion, chronic periodontitis may be associated with CHD.
Renal Haemodynamics in Patients with Liver Cirrhosis Assessed by Colour Ultrasonography
Authors: Wang Y , Liu L-P , Bai W-Y , Wen S-B , Dan H-J , Luan Y-Y , Zeng M-X , Hu B
Published: February 2013

Colour Doppler flow imaging was used in this prospective, cross-sectional study to analyse renal haemodynamics in 50 cirrhotic patients and 15 healthy controls. Mean renal arterial resistive index (RI) was higher in cirrhotic patients than in healthy controls. Mean RI was also higher in cirrhotic patients with non-refractory ascites than in those without ascites, suggesting that the degree of renal vasoconstriction varies with the severity of ascites. A gradient of RI values across the main renal artery, interlobar artery and interlobular renal artery was retained in cirrhotic patients even in the decompensatory stage with non-refractory ascites but was not present in the decompensatory stage with refractory ascites. The disappearance of this gradient may be an important prognostic factor in the development of hepatorenal syndrome (HRS). An inverse correlation between creatinine clearance and interlobular arterial RI was shown for all cirrhotic patients suggesting that even patients with refractory ascites are in a prophase of HRS.
A Randomized, Double-Blind Trial of Palonosetron Compared with Ondansetron in Preventing Postoperative Nausea and Vomiting after Gynaecological Laparoscopic Surgery
Authors: Park SK , Cho EJ
Published: February 2013

This randomized, double-blind study evaluated the relative efficacy of palonosetron (a new, selective 5-hydroxytryptamine type 3 [5-HT3] receptor antagonist) and ondansetron in preventing postoperative nausea and vomiting (PONV) in patients undergoing gynaecological laparoscopic surgery. Patients received either palonosetron 0.075 mg ( n = 45) or ondansetron 8 mg ( n = 45), intravenously, immediately before induction of general anaesthesia. The occurrence of nausea and vomiting and the severity of nausea according to a visual analogue scale were monitored immediately after the end of surgery and during the following 24 h. The incidence of PONV was significantly lower in the palonosetron group compared with the ondansetron group (42.2% vs 66.7%, respectively). There were no significant statistical differences in the visual analogue scale for nausea. In conclusion, palonosetron 0.075 mg was more effective than ondansetron 8 mg in preventing PONV.
Intravenous Lidocaine for Effective Pain Relief after Inguinal Herniorrhaphy: A Prospective, Randomized, Double-Blind, Placebo-Controlled Study
Authors: Kang H , Kim B-G
Published: February 2013

This prospective, randomized, double-blind, placebo-controlled study evaluated the effectiveness of intravenous lidocaine to reduce post-operative pain in 64 inguinal herniorrhaphy patients. Intravenous bolus injection of 1.5 mg/kg lidocaine followed by a continuous lidocaine infusion of 2 mg/kg per h was randomly assigned to 32 patients (lidocaine group) and intravenous normal saline bolus injection followed by infusion of normal saline was assigned to 32 other patients (control group). Visual analogue scale pain scores, fentanyl consumption and the frequency at which analgesia was administered from a patient-controlled analgesia device (measured by number of button pushes) were significantly lower in the lidocaine group than in the control group until 12 h after surgery. Total fentanyl consumption (patient-controlled plus investigator-controlled rescue administration) and the total number of button pushes were significantly lower in the lidocaine group than in the control group. It is concluded that intravenous lidocaine injection reduced post-operative pain after inguinal herniorrhaphy, is easy to administer and may have potential to become routine practice for this type of surgery.
Transgenic Expression of Human IGF1 in Intervertebral Degenerative Discs
Authors: Huang ZQ , Zheng ZM , Yan J
Published: February 2013

This study investigated the role of human insulin-like growth factor-1 (hIGF-1; encoded by the hIGF1 gene) on intervertebral disc degeneration. A total of 24 male New Zealand rabbits of an intervertebral disc degeneration (IVDD) model were randomly divided into three groups where the following were injected into the lumbar 4 – 5 and 5 – 6 discs: second generation adenovirus containing cytomegalovirus hIGF1 (Ad/CMV- hIGF1); 100 μg/l hIGF-1 protein; or phosphate-buffered saline. At 1, 2, 4 and 8 weeks post-injection, intervertebral disc samples were harvested. Human IGF-1 protein was detected using Western blot analysis, and aggrecan and collagen type II gene fragments were quantified using reverse transcription—polymerase chain reaction. At week 1 post-injection, hIGF-1 protein levels were similar in the Ad/CMV- hIGF1 and hIGF-1 groups. By week 2 the level had decreased substantially in the hIGF-1 group. At week 4 it was still present in the Ad/CMV- hIGF1 group and, by week 8, no protein was detected in any of the three groups. Aggrecan and collagen type II mRNA levels increased in the Ad/CMV- hIGF1 group 1 – 4 weeks post-injection, but declined by week 8, while both decreased steadily over 8 weeks in the other two groups. In conclusion, hIGF1 gene expression lasted for 4 weeks and stimulated the synthesis of aggrecan and collagen type II in the Ad/CMV- hIGF1 group.
Functional Recovery after Transplantation of Neural Stem Cells Modified by Brain-Derived Neurotrophic Factor in Rats with Cerebral Ischaemia
Authors: Zhu JM , Zhao YY , Chen SD , Zhang WH , Lou L , Jin X
Published: February 2013

Functional recovery after transplantation of brain-derived neurotrophic factor (BDNF)-modified neural stem cells (NSCs) was evaluated in a rat model of cerebral ischaemia damage induced by temporary middle cerebral artery occlusion (tMCAO). Western blotting and enzyme-linked immunosorbent assay demonstrated up-regulated BDNF protein expression by rat embryonic NSCs transfected with the human BDNF gene ( BDNF—NSCs). BDNF–NSCs stimulated neurite outgrowth in co-cultured dorsal root ganglion neurons, suggesting that BDNF increased neurogenesis in vitro. In vivo, BDNF promoted recovery of tMCAO. Phosphate-buffered saline, untransformed NSCs or BDNF–NSCs were introduced into the penumbra zone of the right striatum of tMCAO rats and neurological function deficit was assessed for up to 12 weeks using the neurological severity score (NSS). The NSS was significantly lower in the BDNF–NSC transfected transplant group than in all the other groups from week 10. BDNF–NSCs recovered 1 week after transplantation expressed BDNF protein. Transplanted NSCs had differentiated into mature neurons 12 weeks after transplantation. Transgenic NSCs have potential as a therapeutic agent for brain ischaemia.
The Necessity of Voiding Cystourethrography in Children with Prenatally Diagnosed Hydronephrosis
Authors: Hwang HH , Cho MH , Ko CW
Published: February 2013

The postnatal persistence of fetal hydronephrosis requires further evaluation to establish whether pathological abnormalities are present. This study determined the necessity for voiding cystourethrography (VCUG) to identify vesicoureteral reflux (VUR) in children ( n = 195) with prenatally diagnosed hydronephrosis. Among the study population, the prevalence of VUR was 17.4% (24 males, 10 females). There was a poor correlation between the severity of hydronephrosis, ureteral dilatation, presence of bilateral hydronephrosis and presence of VUR. Except for the frequency of urinary tract infections and the presence of renal damage on 99mTc-dimercaptosuccinic acid scans, VCUG was the only reliable method for confirming VUR in this study. The diagnosis of VUR is important for the early detection of renal damage. Further information is needed to develop the optimal approach to the evaluation of prenatal hydronephrosis, with reliable parameters that avoid invasive procedures such as VCUG.
Preoperative Diagnostic Role of Hyperbilirubinaemia as a Marker of Appendix Perforation
Authors: Atahan K , Üreyen O , Aslan E , Deniz M , Çökmez A , Gür S , Avci A , Tarcan E
Published: February 2013

This retrospective study investigated preoperative markers of appendix perforation in 351 acute appendicitis cases: group 1, appendicitis not histologically confirmed; group 2, appendicitis without perforation or gangrenous changes; and group 3, histologically confirmed perforated appendicitis with gangrenous changes. In group 3, symptom duration was significantly longer, and white blood cell (WBC) and bilirubin values significantly higher, than for the other groups. Symptom duration, gender, bilirubin and elevated WBC were significantly associated with early diagnosis of acute appendicitis in univariate analysis. Multivariate analysis identified increased WBC counts and male gender as independent variables for the early diagnosis of acute suppurative appendicitis, and symptom duration, total bilirubin and elevated WBC as independent variables for identifying appendix perforation amongst acute suppurative appendicitis patients. Receiver operating characteristic curve analysis showed good discrimination of bilirubin and moderate discrimination of WBC as markers of appendix perforation. It is concluded that assessment of preoperative total bilirubin is useful for the differential diagnosis of perforated versus acute suppurative appendicitis, whereas WBC assessment is effective for diagnosing the presence versus absence of appendicitis. Symptom duration, WBC and total bilirubin should be used as independent parameters in the early diagnosis of appendix perforation.
Using an Abnormal Increase in Postexercise Systolic Blood Pressure to Diagnose Coronary Artery Disease in Gerontal Patients
Authors: Yu ZL , Yang XJ , Zhu JZ , Gu HM , Wang GQ , Hui J , Jiang WP
Published: February 2013

Data from 66 patients ≥ 60 years old with suspected coronary artery disease (CAD) were studied to determine the diagnostic value of an abnormal increase in postexercise systolic blood pressure (SBP) for detecting CAD in gerontal patients. Treadmill exercise testing (TET) and selective coronary angiography (CAG) were carried out and SBP was measured pre-TET and at each minute during a 6-min post-TET recovery phase. Abnormal increase in postexercise SBP was defined as a higher SBP compared with that measured earlier during the 6-min post-TET period. An abnormal increase of ≥ 7 mmHg in postexercise SBP had a statistically significantly better specificity, and also showed higher sensitivity and accuracy, than ST-segment depression ≥ 1 mV in identifying gerontal patients with CAD. The combination of ST-segment depression and abnormal SBP resulted in further improvement of the specificity for detecting CAD. It is concluded that measurement of abnormal increase in postexercise SBP may be a sensitive indicator of gerontal CAD.
The Effect of Posterior Scleral Reinforcement for High Myopia Macular Splitting
Authors: Ji Xueying , Wang Jinguo , Zhang Jinsong , Sun Hongliang , Jia Xiyu , Zhang Weihong
Published: February 2013

This study investigated the effect of posterior scleral reinforcement for high myopia macular splitting in 15 patients with high myopia and macular splitting (20 eyes), including three eyes with shallow retinal detachment. Main outcome measures included best-corrected visual acuity, refractive error, axial length, optical coherence tomography (OCT) findings and post-surgical complications. Best-corrected visual acuity, myopial dioptres and axial length reduced significantly post-surgery. The OCT findings showed different degrees of reduction in the split-cavity between inner and outer retinal layers, and that retinal thickness declined significantly post-operatively. No serious complications were observed. Posterior scleral reinforcement was effective, with a good safety profile, for patients with high myopia macular splitting with or without retinal detachment.
Solitary Intracerebral Chondroma without Meningeal Attachment: A Case Report with Review of the Literature
Authors: Zhan R-Y , Pan X-F , Wan S , Lan P , Zhang Y-C , Weng N-C , Yan M , Zhou Y-Q
Published: February 2013

Intracranial chondromas are rare, benign cartilaginous tumours that account for < 0.3% of primary intracranial tumours. They usually originate from the basal synchondrosis and are extradural though, extremely rarely, they can be intracerebral. Here the case of a 45-year old female is presented with a solitary intracerebral chondroma located in the right frontal lobe with no meningeal attachment. The epidemiology, aetiology, clinical behaviour, radiological features, histological features and treatment of the case are discussed with a review of previous cases reported in the literature.
Silencing of the GnRH Type 1 Receptor Blocks the Antiproliferative Effect of the GnRH Agonist, Leuprolide, on the Androgen-Independent Prostate Cancer Cell Line DU145
Authors: Ko YH , Ha YR , Kim JW , Kang SG , Jang HA , Kang SH , Park HS , Cheon J
Published: February 2013

This study investigated the mechanism of action of a gonadotropin-releasing hormone (GnRH) agonist, leuprolide, on proliferation of the hormone-refractory prostate cancer cell line DU145, transfected with short hairpin RNA (shRNA), to reduce expression of the GNRHR1 gene (which encodes the GnRH type 1 receptor). DU145 cell proliferation in the presence of leuprolide (10−9 and 10−7 M) or control medium was measured before and after GnRHR1 knockdown. Reverse transcription—polymerase chain reaction and Western blot analysis were used to measure the degree of GNRHR1 silencing. DU145 cells treated with leuprolide (10−9 and 10−7 M) showed significant growth inhibition compared with control-treated DU145 cells. Transfection with GNRHR1–shRNA significantly decreased GNRHR1 expression at 48 h. DU145 cells transfected with silencing GNRHR1–shRNA showed normal growth patterns; however, there was no significant inhibition of proliferation of DU145 cells transfected with GNRHR1–shRNA compared with cells transfected with control—shRNA in response to leuprolide. These data demonstrated that the antiproliferative effect of leuprolide was mediated by the GnRHR1.
Differences in Left Ventricular Diastolic Dysfunction between Eccentric and Concentric Left Ventricular Hypertrophy in Hypertensive Patients with Preserved Systolic Function
Authors: Masugata H , Senda S , Inukai M , Murao K , Hosomi N , Iwado Y , Noma T , Kohno M , Himoto T , Goda F
Published: February 2013

Left ventricular (LV) hypertrophy (LVH) may be eccentric or concentric (2 × LV posterior wall thickness relative to LV end-diastolic dimension ≤ 0.42 or > 0.42, respectively). The LV diastolic function between age-matched hypertensive patients with eccentric and concentric LVH was compared in the present study. Echocardiography was used to measure LV mass index (LV mass/body surface area; LVMI) as an index of LVH. LV diastolic function was assessed by measurements of peak early transmitral flow velocity ( E)/peak late transmitral flow velocity ( A) (the E/A ratio), peak early diastolic mitral annular velocity ( e′) and the E/e′ ratio. Although LVMI, E/A and e′ did not differ between the two groups, E/e′ was significantly higher (worse) in patients with concentric LVH (13.4 ± 5.4) than in those with eccentric LVH (11.1 ± 3.6). Among hypertensive patients with LVH, those with concentric LVH may, therefore, have more severe LV diastolic dysfunction than those with eccentric LVH even if their LVMIs, which reflect the degree of LVH, are similar.
Circulating Antibodies to Carcinoembryonic Antigen Related to Improved Recurrence-Free Survival of Patients with Colorectal Carcinoma
Authors: Wu X-J , Fang Y-J , Lin J-Z , Lu Z-H , Li L-R , Chen G , Ding P-R , Kong L-H , Pan Z-Z , Wan D-S
Published: February 2013

This prospective study evaluated the prognostic value of antibodies to carcinoembryonic antigen (anti-CEA), detected by indirect immunosorbent assay, in the serum of colorectal carcinoma patients. Serum carcinoembryonic antigen (CEA) concentrations, measured by electrochemiluminescence immunoassay, were elevated in 26 (37.7%) of 69 patients with colorectal cancer and could not be detected among the 28 patients with benign intestinal conditions or 37 healthy individuals who comprised the control groups. Anti-CEA immunoglobulin (Ig)G or IgM was detected by immunonephelometry in 44 (63.8%) patients with colorectal cancer, three (10.7%) with benign intestinal conditions and four (10.8%) healthy blood donors. Differences in antibody detection frequencies between the cancer patient group and the control groups were statistically significant. Titres of anti-CEA correlated significantly with CEA levels and Dukes' cancer stage. Antibody titre was an independent, significant, favourable predictor for 5-year recurrence-free survival. It is concluded that measurement of serum anti-CEA combined with CEA might be useful as a tumour marker and to assess prognosis. These results need to be confirmed in large, well-controlled, randomized clinical trials.
Otitis Media with Effusion in Primary Schools in Princes' Islands, Istanbul: Prevalence and Risk Factors
Authors: Aydemir G , Ozkurt FE
Published: February 2013

The prevalence of otitis media with effusion (OME) and environmental risk factors were investigated in 423 children aged 7 – 12 years at three primary schools in Princes' Islands, Istanbul, Turkey. An ear, nose and throat examination, including tympanometry, was performed in April (end of the school year) and the families completed a questionnaire about potential risk factors. Type B or C2 tympanograms were taken as indicating OME. The overall prevalence of OME was 16%. OME was significantly associated with numbers of episodes of upper respiratory tract infections (URTI) and acute otitis media (AOM) during the previous year, class size and snoring, but not with allergic symptoms, kindergarten years, breast-feeding duration, parental smoking, domestic animals at home, numbers of siblings and family members, type of home heating, parents' educational level or monthly income. Four or more URTIs and two or more AOM episodes in a year, snoring and class size larger than 20 were risk factors for OME.
Bronchopulmonary Infection with Lophomonas Blattarum: A Case Report and Literature Review
Authors: Zhang X , Xu L , Wang LL , Liu S , Li J , Wang X
Published: February 2013

Human infection with Lophomonas blattarum is extremely rare. The clinical manifestations of 45 cases of bronchopulmonary L. blattarum infection occurring in China, including one case diagnosed and treated at the authors' hospital, are described. The most common manifestations included fever, cough with expectoration, chest stuffiness or shortness of breath, bronchiectasis and pulmonary abscess. A course of metronidazole treatment lasting 14 – 38 days was effective in controlling the disease. The diagnosis of L. blattarum infection should be based on one or more of bronchoscopic brush smear, bronchoscopic biopsy smear and bronchoalveolar lavage.
Haploidentical Allogeneic Haematopoietic Stem Cell Transplantation as Salvage Therapy for Engraftment Failure after Unrelated and Autologous Stem Cell Transplantation: A Case Report and Review of the Literature
Authors: Tan Y-M , Fu H-R , Luo Y , Shi J-M , Ye X-J , Zheng Y-L , Xiao H-W , Hu Y-X , Huang H
Published: February 2013

Engraftment failure is a rare but life-threatening complication of haematopoietic stem cell transplantation (HSCT) and treatment of this condition is often challenging. This case report describes a patient with acute myeloid leukaemia and engraftment failure after unrelated donor allogeneic stem cell transplantation. Rescue treatment with granulocyte-colony stimulating factor and reinfusion of autologous ‘back-up’ stem cells failed, but transplantation of haploidentical donor stem cells following a fludarabine and antithymocyte globulin (ATG)-based conditioning regimen resulted in haematological reconstitution and long-term disease-free survival. The use of haploidentical donor stem cell transplantation as salvage therapy after engraftment failure in adult patients has not, to the authors' knowledge, been previously reported. Additionally, a review of the relevant literature is presented. This case report and literature review suggest that reinfusion of cryopreserved ‘back-up’ haematopoietic stem cells is a safe and effective salvage therapy for engraftment failure after allogeneic HSCT. Haploidentical donor stem cell transplantation after a fludarabine and ATG-based conditioning regimen could provide effective second-line therapy in adult patients.
Extracranial Skeletal Metastasis in Anaplastic Oligodendroglioma: Case Report and Review of the Literature
Authors: Wu Y , Liu B , Qu L , Tao H
Published: February 2013

A case of anaplastic oligodendroglioma with femoral metastasis is presented in a 37-year old male with a 2-year history of progressive headaches and dizziness associated with a 2-month history of epilepsy and right hemiparesis. Magnetic resonance imaging (MRI) demonstrated a solid temporoparietal tumour and the patient underwent a left temporal craniotomy and subtotal resection followed by limited-field radiation therapy. The pathological diagnosis was anaplastic oligodendroglioma. The patient presented with left hip pain 3 years later. Radiography and computed tomography demonstrated osteosclerosis of the left proximal femur, and MRI revealed an intramedullary metastatic lesion. Total body 99mTc-methylene diphosphonate bone scan showed hyperactivity in the lesion and open biopsy confirmed it was a metastasis from the cerebral oligodendroglioma. The patient was treated with temozolomide and, to date, there is no sign of recurrence or progression in either the brain or the femur. Seven previously reported cases of extracranial skeletal metastasis from anaplastic oligodendroglioma are reviewed. Co-deletion of chromosome arms 1p and 19q and O6-methylguanine DNA methyltransferase status remain the most important prognostic and predictive markers.
Upper Gastrointestinal Haemorrhage: Predictive Factors of In-Hospital Mortality in Patients Treated in the Medical Intensive Care Unit
Authors: Skok P , Sinkovič A
Published: February 2013

This prospective, cohort study assessed the independent predictors of in-hospital mortality in patients with acute upper gastrointestinal haemorrhage admitted to the medical intensive care unit (MICU) at the University Clinical Centre Maribor, Slovenia. Using univariate, multivariate and logistic regression methods the predictors of mortality in 54 upper gastrointestinal haemorrhage patients (47 men, mean ± SD age 61.6 ± 14.2 years) were investigated. The mean ± SD duration of treatment in the MICU was 2.8 ± 2.9 days and the mortality rate was 31.5%. Significant differences between non-survivors and survivors were observed in haemorrhagic shock, heart failure, infection, diastolic blood pressure at admission, haemoglobin and red blood cell count at admission, and lowest haemoglobin and red blood cell count during treatment. Heart failure (odds ratio 59.13) was the most significant independent predictor of in-hospital mortality. Haemorrhagic shock and the lowest red blood cell count during treatment were also important independent predictive factors of in-hospital mortality.
Comparison of the Protoscolocidal Effectiveness of Hypertonic Saline, Povidone—Iodine and Albendazole Solutions in an Experimental Lung Hydatid Cyst Model
Authors: Yetim T Durgun , Basoglu A , Sengul A Taslak , Yetim I , Bekdemir O Serdar , Hokelek M
Published: February 2013

Secondary hydatidosis is an important problem encountered during the surgical treatment of hydatid cysts. This study describes an experimental model of secondary hydatidosis by cyst inoculation, used to explore whether simultaneous inoculation of protoscolocidal agents could prevent secondary hydatidosis. Fertile cyst fluid was injected into the pleural space of rabbits alone (group 1, n = 8), and in combination with 2% albendazole solution (group 2, n = 8), 20% hypertonic saline (group 3, n = 8) or 10% povidone—iodine (group 4, n = 8). Computed tomography imaging of the thorax, indirect haemagglutination (IHA) titres and eosinophil counts were used to determine cyst development. After 16 months, three control rabbits had pneumothorax, seven had cysts and four had parenchymal nodules. Histopatho logical investigation of nodules revealed 87.5% cyst formation. Pleural thickening was observed in rabbits from all groups. Cyst formation rates, IHA titres and eosinophilia counts were higher in group 1 than in groups 2 – 4. This study demonstrated the experimental formation of secondary hydatidosis and found that topical protoscolocidal agents were beneficial in preventing cyst recurrence.
T Helper 17 Cells and Regulatory T-Cell Imbalance in Paediatric Patients with Asthma
Authors: Wei B , Zhang H , Li L , Li M , Shang Y
Published: February 2013

Asthma is a chronic inflammatory disorder of the lung, which is thought to be determined by the balance between the T helper (Th)2 and Th1 responses. This study evaluated whether the balance between Th17 cells and regulatory T cells (Treg) was impaired in asthma patients. The proportion of peripheral blood Th17 cells of the total CD4+ cell population in asthma patients was significantly higher than in controls (mean ± SD 0.72 ± 0.5% versus 0.31 ± 0.4%, respectively). The proportion of peripheral Treg cells in asthma patients was significantly lower than in controls (mean ± SD 12.1 ± 4.6% versus 27.2 ± 7.5%, respectively). Analysis of mRNA generally confirmed the flow cytometry data, suggesting that the changes in cytokine levels were mediated at the transcription level. In paediatric asthma patients, the CD4+ T-cell phenotype was skewed toward the Th17 phenotype, suggesting that a Th17/Treg functional imbalance plays a role in asthma.
Phosphatidylinositol 3-Kinase-C2β Inhibits Cisplatin-Mediated Apoptosis via the Akt Pathway in Oesophageal Squamous Cell Carcinoma
Authors: Liu Z , Sun C , Zhang Y , Ji Z , Yang G
Published: February 2013

A major problem in treating oesophageal squamous cell carcinoma (ESCC) with cisplatin is the development of drug resistance. In order to determine whether phosphatidylinositol 3-kinase (PI3K)-C2β (encoded by the PIK3C2B gene) reduced the sensitivity of ESCC to cisplatin, transfected Eca109 cells that overexpressed PIK3C2B were produced. Additionally, PI3K-C2β-siRNA was used to silence endogenous PI3K-C2β in EC9706 cisplatin-resistant cells. The relationship between PIK3C2B expression and clinicopathological characteristics was also investigated in samples from 61 patients. The overexpression of PIK3C2B in Eca109 cells significantly inhibited cisplatin-induced apoptosis and cleavage of caspase-3. Knockdown of PI3K-C2β enhanced cisplatin-induced apoptosis in EC9706 cells. PIK3C2B expression was associated with an increased level of phosphorylated Akt. Based on the tumour samples, expression of PIK3C2B was associated with tumour metastasis and in vitro assay suggested that it mediated cell migration. These results indicated that PI3K-C2β, via the Akt signalling pathway, might play a key role in cisplatin resistance and that targeting this pathway might be useful in treating cisplatin-resistant tumours.
Osteopontin Levels are Elevated in Patients with Asthma
Authors: Zhao J-J , Yang L , Zhao F-Q , Shi S-M , Tan P
Published: February 2013

Osteopontin (OPN) plays a role in T cell-mediated immunity, but its involvement in Th2-associated allergic responses, especially asthma, has not been investigated. This cross-sectional case— control study was designed to determine whether serum OPN levels are elevated in asthma patients and whether these correlated with disease severity. Serum samples were obtained from patients with mild ( n = 42), moderate ( n = 48) and severe ( n = 39) asthma, and 41 healthy control subjects. OPN protein concentrations were measured by enzyme-linked immunosorbent assay and were found to be significantly higher in all three asthma patient groups compared with healthy controls. There was no significant association between OPN concentration and disease severity. The data suggest a role for OPN in the pathogenesis of asthma. Further studies are needed to clarify the involvement of OPN in various aspects of asthma.
Osteoporotic Vertebral Compression Fractures: Surgery versus Non-Operative Management
Authors: Tang H , Zhao J , Hao C
Published: February 2013

This 12-month retrospective study compared pain relief, quality of life (QoL), treatment cost-effectiveness and complication rates in patients with acute osteoporotic vertebral compression fracture (OVCF) undergoing percutaneous vertebroplasty (PVP; n = 58), percutaneous kyphoplasty (PKP; n = 55), or conservative medical therapy (CMT; n = 55). After surgery, Cobb angle and vertebral height were significantly improved in the PKP group. PVP and PKP patients had significantly less pain immediately after surgery than CMT patients, but this difference disappeared between weeks 2 −8, only to return from months 6 – 12. QoL was significantly better among the surgical groups after surgery and was lower in the CMT group than in the surgical groups. Treatment times were shorter with PVP and PKP, but costs were lower with CMT. The rate of secondary fractures during follow-up was greater with CMT. Overall, PVP was considered the first choice treatment for OVCF with refractory pain.
Determination of Ameliorable Health Impairment Influencing Health-Related Quality of Life among Patients with Silicosis in China: A Cross-Sectional Study
Authors: Liu HB , Yan B , Han B , Sun JK , Yang Y , Chen J
Published: February 2013

The association between health-related quality of life (HRQOL) and ameliorable health impairment was examined in 208 Chinese in-patients with silicosis, in April 2010. Median St George's Respiratory Questionnaire scores for symptom and activity impairment, social support rating scale and geriatric depression scale scores for patients were 57.24, 59.45, 35 and 5, respectively. Median 36-item short-form health survey physical component (PCS) and mental component (MCS) scores were 47.17 and 51.05, respectively. Lower than median PCS scores (< 47) were significantly associated with high levels of symptom and activity impairment. Lower than median MCS scores (< 51) were significantly associated with high levels of depression and activity impairment. Encouraging patients to participate in daily activities may alleviate activity impairment. Reasonable financial compensation may help to maintain and improve social support levels.
Difference in Pre- and Postchemotherapy Vascular Endothelial Growth Factor Levels as a Prognostic Indicator in Osteosarcoma
Authors: Qu Y , Xu J , Jiang T , Zhao H , Gao Y , Zheng C , Shi X
Published: February 2013

This retrospective analysis examined the difference in pre- and postchemotherapy levels of vascular endothelial growth factor (VEGF) as an indicator of osteosarcoma prognosis. VEGF protein levels were assessed immunohistochemically in primary tumour samples from 61 osteosarcoma patients diagnosed between February 2001 and July 2005. The difference in pre- and postchemotherapy VEGF protein reduction levels was categorized into weak (23 patients) and strong (38 patients). The 5-year survival rate was significantly lower in the weak VEGF reduction group (34.8%) than in the strong VEGF reduction group (73.7%). The weak VEGF reduction group had significantly higher rates of metastasis and recurrence. Multivariate analysis confirmed that the change in VEGF was an independent and significant factor for predicting a good prognosis. The analysis of VEGF will enable clinicians to tailor surgery and chemotherapy regimens more appropriately, earlier in the disease process.
Neurological Complications after Liver Transplantation
Authors: Yilmaz M , Cengiz M , Sanli S , Yegin A , Mesci A , Dinckan A , Hadimioglu N , Dosemeci L , Ramazanoglu A
Published: February 2013

This was a single-centre, prospective study to assess the frequency of neurological complications and their impact on prolonged hospitalization in 137 liver transplant patients presenting between September 1997 and June 2010. Neurological complications were seen in 22 (16%) patients during their postoperative stay in the intensive care unit. Complications included new-onset, recurrent headache (five patients), generalized seizures (four patients), dysarthria (two patients), delirium with agitation (three patients), persistent flapping tremor (two patients), alteration in level of consciousness (three patients), central pontine myelinolysis (one patient), myopathy (one patient) and visual hallucinations (one patient). Seizures were associated with immunosuppressive drug toxicity (tacrolimus). Myopathy presenting as quadriplegia was diagnosed by muscle biopsy. The patient with central pontine myelinolysis lived in a persistent vegetative state for 2 years and died of pneumonia. In conclusion, neurological complications are frequently encountered after liver transplantation, and are an important cause of severe morbidity and prolonged intensive care unit and hospital stay.
The Impact of Highly Active Antiretroviral Treatment on the Blood Profiles of Patients with Acquired Immune Deficiency Syndrome
Authors: Tang LL , Jin CZ , Wu LJ , Brockmeyer NH , Potthoff A , Wu NP
Published: February 2013

This study retrospectively investigated the short- and long-term impact of highly active antiretroviral treatment (HAART) on the blood profiles of patients with acquired immune deficiency syndrome (AIDS), and their relationship with disease progression. CD4+ T-cell count was measured by flow cytometry, plasma viral load of human immunodeficiency virus (HIV) RNA was detected by reverse transcription—polymerase chain reaction, and blood profile was determined by an automated analyser. CD4+ T-cell count, total lymphocyte count (TLC) and haemoglobin concentration improved gradually in patients with AIDS after the initiation of HAART. Long-term effective HAART significantly increased CD4+ T-cell counts TLC and haemoglobin concentrations, and reduced viral load to undetectable levels. An increase in haemoglobin was positively correlated with an increase in CD4+ T-cells. These findings suggest that TLC is a valuable tool for determining the initiation of HAART, and that the haemoglobin concentration could be an additional indicator for long-term monitoring of HAART in resource-limited settings.
Hirsutism Score and the Severity of Hyperandrogenism Associated with Polycystic Ovary Syndrome in the South-Eastern Region of Turkey
Authors: Demir B , Pasa S , Demir S , Tumer C , Atay AE , Gul T , Atamer Y
Published: February 2013

This study investigated the severity of hirsutism and its correlation with serum total testosterone (tT) levels in 87 patients with polycystic ovary syndrome (PCOS) and 85 healthy control subjects from the south-eastern region of Turkey. A wide range of variability exists in both hirsutism and modified Ferriman—Gallwey (mFG) scores. Similar mFG scores and serum tT levels were found compared with previous studies of general populations, but lower scores than those previously reported from Turkey. The incidence of hirsutism was lower in hyperandrogenic PCOS patients compared with non-hyperandrogenic PCOS patients. There was no correlation between serum tT levels and the rate of hirsutism in patients with PCOS. Heritability, testosterone receptor sensitivity, 5α reductase activity or environmental/socioeconomic factors may play a role in the development of clinical hirsutism. Larger scale studies are needed to clarify which other factors may be responsible and to confirm these results.
Comparison of the Minimally Invasive and Standard Medial Parapatellar Approaches for Total Knee Arthroplasty: Systematic Review and Meta-Analysis
Authors: Liu Z , Yang H
Published: February 2013

This systematic literature review analysed the efficacy of minimally invasive subvastus (SV) and midvastus (MV) approaches, compared with the standard medial parapatellar (MP) approach, for total knee arthroplasty. Fixed- and random-effect meta-analyses were performed to pool the results of primary studies assessing the mean difference of each clinical outcome. Length of hospital stay was significantly different between the MP and SV approaches, but not between the MP and MV approaches. Blood loss was significantly higher following MP compared with SV. The number of days to perform a straight-leg raise was significantly longer following MP than either MV or SV. In the first 6 months postsurgery, MV was associated with a better range of motion (ROM) than MP. No significant difference in ROM between MP and SV was apparent at 1 year postsurgery. Quadriceps muscle strength recovered significantly more slowly following MP compared with SV. Future studies should assess the efficacy of the quadriceps-sparing approach and compare minimally invasive approaches, assessing intrinsic postoperative differences.
Comparative Study of Different Surgical Transposition Methods for Ulnar Nerve Entrapment at the Elbow
Authors: Zhong W , Zhang W , Zheng X , Li S , Shi J
Published: February 2013

This study compared the therapeutic effects of two techniques for surgical decompression treatment for ulnar nerve entrapment at the elbow: subcutaneous transposition and modified submuscular transposition with Z-lengthening of the pronator teres origin. A total of 278 patients with ulnar nerve entrapment (McGowan grades I-III) were randomly assigned to undergo one of these techniques. All patients were followed-up for 2 years. The effects were assessed by preoperative and postoperative cross-sectional area, motor conduction velocity, sensory conduction velocity and nerve action potential. All of these parameters improved after surgery in both groups. For patients with grade I disease, there were no significant differences between the two techniques. For patients with grade II and III disease, modified submuscular transposition was associated with significantly greater improvements compared with subcutaneous transposition. In conclusion, subcutaneous ulnar nerve transposition is recommended for grade I patients and modified submuscular ulnar nerve transposition for grade II and III patients.
The Incidence of Postoperative Nausea and Vomiting after Thyroidectomy using Three Anaesthetic Techniques
Authors: Won YJ , Yoo JY , Chae YJ , Kim DH , Park SK , Cho HB , Kim JS , Lee JH , Lee SY
Published: February 2013

The choice of anaesthetics can affect the incidence of postoperative nausea and vomiting (PONV). This study compared the incidence of PONV in 177 female patients who underwent thyroidectomy, with anaesthesia induced and maintained using one of three regimens: (i) sevoflurane (thiopental sodium 4–5 mg/kg and sevoflurane 2.0–2.5 vol% in 50% air); (ii) total intravenous anaesthesia (TIVA; propofol-remifentanil [target blood concentrations 2.5–3.5 μg/ml and 3.5–4.5 ng/ml, respectively]); or (iii) combined inhalation and intravenous anaesthesia (sevoflurane 1.0 vol% in 50% air plus propofol-remifentanil [target blood concentrations 1.5–2.5 μg/ml and 2.5–3.5 ng/ml, respectively]). The incidence and severity of PONV and the need for rescue antiemetics were assessed at 0–24 h postoperatively. Overall, the incidence of PONV was significantly lower in the TIVA and combined groups compared with the sevoflurane group (33.9%, 39.0% and 64.4%, respectively). In conclusion, the maintenance of anaesthesia with propofol-remifentanil or sevoflurane-propofol-remifentanil decreased the incidence of PONV compared with sevoflurane alone.
The Sparing Effect of Low-Dose Esmolol on Sevoflurane during Laparoscopic Gynaecological Surgery
Authors: Moon YE , Hwang WJ , Koh HJ , Min JY , Lee J
Published: February 2013

This double-blind, randomized, placebocontrolled study evaluated the sparing effect of esmolol on sevoflurane during laparoscopic gynaecological surgery in 54 patients between December 2009 and May 2010. The concentration of sevoflurane required to maintain adequate anaesthesia was determined. Patients received either a 0.5 mg/kg esmolol intravenous loading dose followed by infusion of 30 μg/kg per min or an identical volume of normal saline (placebo). During surgery the input concentration of sevoflurane was adjusted every 5 min to maintain systolic blood pressure within 15% of baseline and bispectral index at 50–60. Infusion of esmolol resulted in an 18.2% decrease in mean sevoflurane input concentration. Patients receiving esmolol had an earlier discharge from the postanaesthetic care unit and a lower mean fentanyl dose. In conclusion, intraoperative esmolol infusion decreased both the requirement for sevoflurane and postoperative administration of fentanyl.
Comparison of an Intraoperative Infusion of Dexmedetomidine or Remifentanil on Perioperative Haemodynamics, Hypnosis and Sedation, and Postoperative Pain Control
Authors: Jung HS , Joo JD , Jeon YS , Lee JA , Kim DW , In JH , Rhee HY , Choi JW
Published: February 2013

This prospective, randomized, double-blind study compared the effects of dexmedetomidine and remifentanil on haemodynamic stability, sedation and postoperative pain control in the postanaesthetic care unit (PACU). Fifty consecutive patients scheduled for total laparoscopic hysterectomy were randomly assigned to receive infusions of either dexmedetomidine (1 μg/kg) i.v. over 10 min followed by 0.2-0.7 μg/kg per h continuous i.v. infusion or remifentanil (0.8-1.2 μg/kg) i.v. over 1 min followed by 0.05-0.1 μg/kg i.v. per min, starting at the end of surgery to the time in the PACU. Modified observer's assessment of alertness scores were significantly lower in the dexmedetomidine group than in the remifentanil group at 0, 5 and 10 min after arrival in the PACU. Blood pressure and heart rate in the dexmedetomidine group were significantly lower than that recorded in the remifentanil group in the PACU. Dexmedetomidine, at the doses used in this study, had a significant advantage over remifentanil in terms of postoperative haemodynamic stability.
Serum Hepcidin in Haemodialysis Patients: Associations with Iron Status and Microinflammation
Authors: Xu Y , Ding XQ , Zou JZ , Liu ZH , Jiang SH , Chen YM
Published: February 2013

Hepcidin plays a key role in iron homeostasis. This cross-sectional study measured the serum hepcidin levels of 48 maintenance haemodialysis patients and 20 age-matched healthy control subjects using a competitive enzyme-linked immunosorbent assay (C-ELISA). Serum hepcidin, interleukin (IL)-6 and high-sensitivity C-reactive protein levels were significantly higher in maintenance haemodialysis patients compared with control subjects. In all patients, there was a positive correlation between serum hepcidin levels and ferritin, transferrin saturation and IL-6, and an inverse correlation between serum hepcidin and unsaturated iron-binding capacity, total iron-binding capacity (TIBC) and transferrin. Linear regression analyses showed that ferritin and TIBC were independently associated with serum hepcidin levels. In conclusion, serum hepcidin levels are associated with iron status and microinflammation (defined as hsCRP < 15 mg/l, without clinical manifestation of inflammation) in maintenance haemodialysis patients. The C-ELISA method for measuring serum hepcidin should facilitate the routine measurement of hepcidin in clinical practice.