bluuebunny/crossref_metadata_2025 huggingface dataset:
Characterization of hospital waste in Lahore, Pakistan
Authors: Munir Sobia , Batool Syeda Adila , Chaudhry Muhammad Nawaz
Published: January 2024

Background

It is a common practice in developing countries that medical/infectious waste openly dumped with municipal solid waste. This paper presented a generation and characterization study of hospital waste. Determination of the waste composition is a basic step for selecting the most efficient treatment method of hospital waste.

Methods

Stratified random sampling was used to collect the samples of general as well as medical wastes for seven days. Medical waste was sorted into 10 categories whereas general waste was classified into 11 categories. Incineration was observed thoroughly for observing flaws in the incineration process. Data was analyzed by using SPSS software version 16.0.

Results

The studied hospital produced an average 297 kilograms of medical waste daily and it comprises plastics (71.0%), glass (13.9%), papers etc. (3.8%), cotton/dressings (5.7%), masks/gloves/sheets (0.3%) diapers (0.4%), wasted machines used in operation theaters (2.0%) and blades (0.1%). Laboratories, cancer ward, nursery ward, OPD and emergency ward are the largest infectious waste producing departments in the hospital. The hospital produced an average 3 511 kilograms of general waste daily in which organics constitute (44.3%), diapers etc. (42.8%), demolition materials (3.7%), plastic waste mixing medical plastic waste (2.5%), miscellaneous (2.14%), cloth/clothes (1.6%), cardboard (1.3%), papers (0.8%), cotton dressings (0.28%), glass (0.27%) and iron materials (0.18%). Other alarming facts are: medical waste is recycled in study area, after incineration of hospital waste, ash simply dumped in the premises of the hospital without any liner system.

Conclusions

The studied hospital produces 10% of infectious waste and 90% of general waste. The largest components of the infectious waste are plastic and glass. Organics and diapers are major components of the general waste coming from different sites of the hospital. Lack of training, inadequate knowledge regarding to the composition of the infectious waste and risks associated with the waste are the major issues which must be addressed and resolved.
The percentage of peripheral blood blasts on day 7 of induction chemotherapy predicts response to therapy and survival in patients with acute myeloid leukemia
Authors: Gao Sujun , Tan Yehui , Liu Xiaoliang , Su Long , Yu Ping , Han Wei , Cui Jiuwei , Li Wei
Published: January 2024

Background

Rapid clearance of peripheral blood blasts (PBBs) predicts complete remission (CR) and survival in patients with acute myeloid leukemia (AML). We aimed to explore the correlation between induction therapy response, outcome, and the PBB percentage.

Methods

Forty-six consecutive patients with de novo AML (excluding acute promyelocytic leukemia) were enrolled in this study. Flow cytometry was performed to identify cells with a leukemia-associated aberrant immunophenotype in the initial bone marrow aspirate and in peripheral blood on day 7 of induction therapy.

Results

The PBB percentage on day 7 (D7PBBP) was significantly lower in patients who achieved CR (0.03% (0.0%, 0.45%)) than in those who did not (10.85% (1.13%, 19.38%); u =-3.92, P <0.001). The CR rate was significantly higher among patients with a D7PBBP of <0.945% (84.62%, 22/26) than among those with a D7PBBP of ≥0.945% (25.0%, 5/20; χ
2
= 16.571, P <0.001). D7PBBP was significantly correlated with overall survival (OS; r=-0.437, P=0.003) and relapse-free survival (RFS; r=-0.388, P=0.007). OS and RFS were significantly higher in patients with a D7PBBP of <0.43% than in those with a D7PBBP of ≥0.43% (P <0.001 and P=0.039, respectively). D7PBBP was also found to be an independent prognostic indicator in multivariate analysis for both OS (P=0.036) and RFS (P=0.035).

Conclusion

D7PBBP may be an important risk factor for the achievement of complete remission, for overall survival, and for relapse-free survival.
Clinical experience of surgical intervention for severe acute pancreatitis
Authors: Xu Yuan , Shao Qinshu , Yang Jin , Yu Xiaojun , Xu Ji
Published: January 2024

Background

The controversy on the treatment strategy for severe acute pancreatitis (SAP) has never stopped for the past century. Even now surgical procedures play a decisive role in the treatment of SAP, especially in managing the related complications, but the rational indications, timing, and approaches of surgical intervention for SAP are still inconclusive.

Methods

Clinical data of 308 SAP patients recruited during January 2000-January 2013, including 96 conservatively treated cases plus 212 surgically intervened cases, were comparatively analyzed. Based on the initial surgical intervention time, the surgical intervention group was split into two: early intervention group (within 2 weeks) 103 cases, and late intervention group (after 2 weeks) 109 cases.

Results

In the conservative treatment group, the cure rate was 82.29% (79/96), the death rate was 13.54% (13/96), and 4 cases self-discharged, while in the surgical intervention group, the cure rate was 84.43% (179/212) and the death rate was 10.85% (23/212) with 10 cases self-discharged. The difference was of no statistical significance between these two groups (P >0.05). In surgical intervention group, the death rate 15.53% (16/103) in the early surgical intervention group was higher than that of late surgical intervention group 6.42% (7/109), and the difference was statistically significant (P <0.05).

Conclusions

Both conservative treatment and surgical intervention play important roles in the treatment of SAP, and the indication, timing, and procedure should be strictly followed. Surgery earlier than 2 weeks after onset of the disease is not recommended in patients with necrotizing pancreatitis only when there are specific indications, such as multiple organ failure, which does not improve despite active treatment, and in those who develop abdominal compartment syndrome.
Diabetic bladder dysfunction
Authors: Guiming Liu , Firouz Daneshgari
Published: January 2024

Objective

To review studies on diabetic bladder dysfunction (DBD), a common and bothersome complication of diabetes mellitus.

Data sources

We performed a search of the English literature through PubMed. The key words used were “diabetes” and “bladder dysfunction” or “cystopathy”. Our own data and perspective are included in the discussion.

Study selection

Studies containing data relevant to DBD were selected. Because of the limited length of this article, we also referenced reviews that contain comprehensive amalgamations of relevant literature.

Results

The classic symptoms of DBD are decreased bladder sensation, increased bladder capacity, and impaired bladder emptying with resultant elevated post-void residual urine. However, recent clinical and experimental evidence indicate a strong presence of storage problems such as urge incontinence in diabetes. Recent studies of DBD in animal models of type 1 diabetes have revealed temporal effects of diabetes, causing an early phase of compensatory bladder function and a later phase of decompensated bladder function. The pathophysiology of DBD is multifactorial, including disturbances of the detrusor, urothelium, autonomic nerves, and urethra. Polyuria and hyperglycemia play important but distinctive roles in induction of bladder dysfunction in type 1 diabetes. Polyuria causes significant bladder hypertrophy in the early stage of diabetes, whereas oxidative stress in the bladder caused by chronic hyperglycemia may play an important role in the late stage failure of bladder function.

Conclusions

DBD includes time-dependent and mixed manifestations. The pathological alterations include muscle, nerve, and urothelium. Polyuria and hyperglycemia independently contribute to the pathogenesis of DBD. Treatments for DBD are limited. Future clinical studies on DBD in type 1 and type 2 diabetes should be investigated separately. Animal studies of DBD in type 2 diabetes are needed, from the natural history to mechanisms. Further understanding of the molecular mechanisms of DBD will provide multiple potential targets for therapeutic intervention.
Deaths of obstructive lung disease in the Yangpu district of Shanghai from 2003 through 2011: a multiple cause analysis
Authors: Cheng Yi , Han Xue , Luo Yong , Xu Weiguo
Published: January 2024

Background

Obstructive lung disease (OLD, chronic obstructive pulmonary disease or asthma) is an important cause of death in older people. There has been no exhaustive population-based mortality study of this subject in Shanghai. The objective of this study was to use a multiple cause of death methodology in the analysis of OLD mortality trends in the Yangpu district of Shanghai, from 2003 through 2011.

Methods

We analyzed death data from the Shanghai Yangpu District Center for Disease Control and Prevention for Medical Cause of Death database, selecting all death certificates for individuals 40 years or older on which OLD was listed as a cause of death.

Results

From 2003 to 2011, there were 8 775 deaths with OLD listed, of which 6 005 (68%) were identified as the underlying cause of death. For the entire period, a significantly decreasing trend of age standardized rates of death from OLD was observed in men (-6.2% per year) and in women (-5.7% per year), similar trends were observed in deaths with OLD. The mean annual rates of deaths from OLD per 100 000 were 161.2 for men and 80.8 for women from 2003 to 2011. While, as the underlying cause of death, the main associated causes of death were as follows: cardiovascular diseases (70.7%), cerebrovascular diseases (13.3%), diabetes (8.6%), and cancer (4.3%). The associated causes and the principal overall underlying causes of death were cardiovascular diseases (37.0%), cancer (30.3%), and cerebrovascular disease (15.3%). A significant seasonal variation, with the highest frequency in winter, occurred in deaths identified with underlying causes of chronic bronchitis, other obstructive pulmonary diseases, and asthma.

Conclusions

Multiple cause mortality analysis provides a more accurate picture than underlying cause of total mortality attributed on death certificates to OLD. The major comorbidities associated with OLD were cardiovascular disease, cancer, and cerebrovascular disease. From 2003 to 2011, the mortality rate from OLD decreased substantially in the Yangpu district of Shanghai.
Mixed phenotype acute leukemia
Authors: Zixing Ye , Shujie Wang
Published: January 2024

Objective

To highlight the current understanding of mixed phenotype acute leukemia (MPAL).

Data sources

We collected the relevant articles in PubMed (from 1985 to present), using the terms “mixed phenotype acute leukemia”, “hybrid acute leukemia”, “biphenotypic acute leukemia”, and “mixed lineage leukemia”. We also collected the relevant studies in WanFang Data base (from 2000 to present), using the terms “mixed phenotype acute leukemia” and “hybrid acute leukemia”.

Study selection

We included all relevant studies concerning mixed phenotype acute leukemia in English and Chinese version, with no limitation of research design. The duplicated articles are excluded.

Results

MPAL is a rare subgroup of acute leukemia which expresses the myeloid and lymphoid markers simultaneously. The clinical manifestations of MPAL are similar to other acute leukemias. The World Health Organization classification and the European Group for Immunological classification of Leukaemias 1998 criteria are most widely used. MPAL does not have a standard therapy regimen. Its treatment depends mostly on the patient's unique immunophenotypic and cytogenetic features, and also the experience of individual physician. The lack of effective treatment contributes to an undesirable prognosis.

Conclusion

Our understanding about MPAL is still limited. The diagnostic criteria have not been unified. The treatment of MPAL remains to be investigated. The prognostic factor is largely unclear yet. A better diagnostic criteria and targeted therapeutics will improve the therapy effect and a subsequently better prognosis.
Total knee arthroplasty for severe valgus knee deformity
Authors: Zhou Xinhua , Wang Min , Liu Chao , Zhang Liang , Zhou Yixin
Published: January 2024

Background

Primary total knee arthroplasty (TKA) in severe valgus knees may prove challenging, and choice of implant depends on the severity of the valgus deformity and the extent of soft-tissue release. The purpose of this study was to review 8 to 11 years (mean, 10 years) follow-up results of primary TKA for varient-III valgus knee deformity with use of different type implants.

Methods

Between January 2002 and January 2005, 20 women and 12 men, aged 47 to 63 (mean, 57.19±6.08) years old, with varient-III valgus knees underwent primary TKA. Of the 32 patients, 37 knees had varient-III deformities. Pie crusting was carefully performed with small, multiple inside-out incisions, bone resection balanced the knee in lieu of soft tissue releases that were not used in the series. Cruciate-retaining knees (Gemini MKII, Link Company, Germany) were used in 13 knees, Genesis II (Simth & Nephew Company, USA) in 14 knees, and hinged knee (Endo-Model Company, Germany) in 10 knees. In five patients with bilateral variant-III TKAs, three patients underwent 1-stage bilateral procedures, and two underwent 2-stage procedures. All implants were cemented and the patella was not resurfaced. The Hospital for Special Surgery (HSS) knee score was assessed. Patients were followed up from 8 to 11 years.

Results

The mean HSS knee score were improved from 50.33±11.60 to 90.06±3.07 (P <0.001). The mean tibiofemoral alignment were improved from valgus 32.72°±9.68° pre-operation to 4.89°±0.90° post-operation (P <0.001). The mean range of motion were improved from 93.72°±23.69° pre-operation to 116.61±16.29° post-operation (P <0.001). No patients underwent revision. One patient underwent open reduction and internal fixation using femoral condylar plates for supracondylar femoral fractures secondary to a fall at three years. Three patients developed transient peroneal nerve palsies, which resolved within nine months. Two patients developed symptomatic deep vein thrombosis that was managed with rivaroxaban and thrombo-embolic deterrent stockings. There was no incidence of pulmonary embolism. Postoperative patient satisfaction was 80.7±10.4 points in the groups. Prosthetic survival rate was 100% at mean 10 years postoperative.

Conclusions

Not only hinged implants can be successfully used in variant-III valgus knees. As our results show, if proper ligament balancing techniques are used and proper ligament balance is attained, the knee may not require the use of a more constrained components. Our results also present alternative implant choices for severe knee deformities.
Increasing trend of prevalence of infertility in Beijing
Authors: Zhang Hongxia , Wang Shuyu , Zhang Songwen , Wang Tao , Deng Xiaohong
Published: January 2024

Background

Infertility is one of the most important and underappreciated reproductive health problems in developing countries. However, epidemiological data in the Chinese population are still sparse. The aim of the present study was to determine the current prevalence and prevalence trend of infertility in Beijing, and to identify the risk factors associated with infertility.

Methods

This cross-sectional study was conducted in Beijing in 2012. A stratified cluster sampling method was used to select 12 448 couples of whom the female partners were born between 1955 and 1985. All subjects were interviewed face to face. Infertility was defined as the failure to achieve a clinical pregnancy after 12 months of regular unprotected sexual intercourse.

Results

Of the 12 448 couples, 12 342 (99.1%) answered the questions appropriately. The prevalence of infertility was 4.2% (3.1% as primary and 1.1% as secondary infertility). An increase in the prevalence of infertility according to the age of the female partner was found: 1.3% infertility for married females born in the 1950s and 11.4% for married females born in the 1980s. The increase was found in both urban and suburban areas. In addition, a Logistic regression showed that for the female partner, higher education levels, an older age at first marriage, adverse occupational conditions, mental labor and pre-pregnancy contraception after marriage were all significantly associated with a higher risk of infertility.

Conclusion

The prevalence of infertility has increased significantly among couples in Beijing, possibly because of an interaction among multiple factors.
Targeting gallbladder carcinoma: bone marrow-derived stem cells as therapeutic delivery vehicles of myxoma virus
Authors: Weng Mingzhe , Zhang Mingdi , Qin Yiyu , Gong Wei , Tang Zhaohui , Quan Zhiwei , Wu Kejin
Published: January 2024

Background

Gallbladder carcinoma (GBC) has a high mortality rate, requiring synergistic anti-tumor management for effective treatment. The myxoma virus (MYXV) exhibits a modest clinical value through its oncolytic potential and narrow host tropism.

Methods

We performed viral replication assays, cell viability assays, migration assays, and xenograft tumor models to demonstrate that bone marrow-derived stem cells (BMSCs) may enhance efficiency of intravenous MYXV delivery.

Results

We examined the permissiveness of various GBC cell lines towards MYXV infection and found two supported single and multiple rounds of MYXV replication, leading to an oncolytic effect. Furthermore, we found that BMSCs exhibited tropism for GBC cells within a Matrigel migration system. BMSCs failed to affect the growth of GBC cells, in terms of tumor volume and survival time. Finally, we demonstrated in vivo that intravenous injection of MYXV-infected BMSCs significantly improves the oncolytic effect of MYXV alone, almost to the same extent as intratumoral injection of MYXV.

Conclusion

This study indicates that BMSCs are a promising novel vehicle for MYXV to clinically address gallbladder tumors.
Effect of catheter radiofrequency ablation on C-reactive protein, brain natriuretic peptide and echocardiograph in patients with persistent and permanent atrial fibrillation
Authors: Huang Qiong , Yuan Yiqiang , Qiu Chunguang , Zhao Yujie , Mao Youlin , Wang Ruimin , Wang Qian
Published: January 2024

Background

Radiofrequency catheter ablation (RFCA) for atrial fibrillation (AF) has developed rapidly, and is a commonly performed ablation in many major hospitals throughout the world, due to its satisfactory results. The aim of this study was to detect the effect of RFCA on C-reactive protein (CRP), brain natriuretic peptide (BNP), and echocardiograph in patients with persistent and permanent AF.

Methods

A total of 120 patients (71 males, mean age (50.8±12.0) years) with persistent and permanent AF undergoing RFCA under guidance of the Carto merge technique were studied. Left atrial diameter (LAD), right atrial diameter (RAD), left ventricular ejection fraction (LVEF), CRP, and BNP were observed 3, 6 and 12 months after RFCA and compared with results before RFCA. The recurrence of atrial arrhythmias was observed 3 and 12 months after the procedure.

Results

Compared with that before RFCA, LAD and RAD decreased and LVEF increased significantly after RFCA. Meanwhile, the levels of CRP and BNP were reduced significantly at 3, 6, and 12 months after RFCA (P<0.05). In the non-recurrent patients, LVEF was increased significantly compared with the recurrent patients at 3, 6, and 12 months after RFCA (P<0.05). CRP and BNP levels were decreased significantly in the non-recurrent patients compared with the recurrent patients at 3, 6, and 12 months after RFCA (P<0.05). After one or two applications of RFCA, during a follow-up of 12 months, 12 patients (10.0%) had AF, 10 patients (8.3%) had atrial flutter, and 5 patients had atrial tachycardia (4.2%).

Conclusions

Conversion of AF to sinus rhythm by RFCA, has been shown to reduce LA size and improve LVEF. It can also significantly decrease the levels of CRP and BNP in patients with persistent and permanent AF and reduce the risk of inflammation and developing heart failure.
Metformin inhibits nuclear factor-κB activation and inflammatory cytokines expression induced by high glucose via adenosine monophosphate-activated protein kinase activation in rat glomerular mesangial cells in vitro
Authors: Gu Junfei , Ye Shandong , Wang Shan , Sun Wenjia , Hu Yuanyuan
Published: January 2024

Background

The renoprotective mechanisms of adenosine monophosphate (AMP)-activated protein kinase (AMPK) agonist - metformin have not been stated clearly. We hypothesized that metformin may ameliorate inflammation via AMPK interaction with critical inflammatory cytokines. The aim of this study was to observe the effects of metformin on expression of nuclear factor-κB (NF-κB), monocyte chemoattractant protein-1 (MCP-1), intercellular adhesion molecule-1 (ICAM-1) and transforming growth factor-beta 1 (TGF-β1) induced by high glucose (HG) in cultured rat glomerular mesangial cells (MCs).

Methods

MCs were cultured in the medium with normal concentration glucose (group NG, 5.6 mmol/L), high concentration glucose (group HG, 25 mmol/L) and different concentrations of metformin (group M1, M2, M3). After 48-hour exposure, the supernatants and MCs were collected. The expression of NF-κB, MCP-1, ICAM-1, and TGF-β1 mRNA was analyzed by real time polymerase chain reaction. Western blotting was used to detect the expression of AMPK, phospho-Thr-172 AMPK (p-AMPK), NF-κB p65, MCP-1, ICAM-1, and TGF-β1 protein.

Results

After stimulated by HG, the expression of NF-κB, MCP-1, ICAM-1, TGF-β1 mRNA and protein of MCs in group HG increased significantly compared with group NG (P <0.05). Both genes and protein expression of NF-κB, MCP-1, ICAM-1, TGF-β1 of MCs induced by high glucose were markedly reduced after metformin treatment in a dose-dependent manner (P <0.05). The expression of p-AMPK increased with the rising of metformin concentration, presenting the opposite trend, while the level of total-AMPK protein was unchanged with exposure to HG or metformin.

Conlusion

Metformin can suppress the expression of NF-κB, MCP-1, ICAM-1 and TGF-β1 of glomerular MCs induced by high glucose via AMPK activation, which may partly contribute to its reno-protection.
Prognostic value of clinical and pathological factors for surgically treated localized clear cell renal cell carcinoma
Authors: Teng Jingfei , Gao Yi , Chen Ming , Wang Kai , Cui Xingang , Liu Yushan , Xu Danfeng
Published: January 2024

Background

Surgical resection is the most effective treatment for renal cell carcinoma (RCC). Currently several prognostic factors and models are used for outcome prediction. However, whether intratumoral changes are independent prognostic factors for RCC or not remains unclear. The aim of the study was to investigate the prognostic roles of intratumoral changes in surgical treated localized clear cell renal cell carcinoma (ccRCC).

Methods

Patients who received partial or radical nephrectomy between 2004 and 2009 in our center were retrospectively reviewed. Univariate and multivariate analyses were used to assess gender, age, body mass index (BMI), intratumoral hemorrhage, tumor necrosis, cystic degeneration, sarcomatoid change, Ki-67 expression, Fuhrman grade, and T stage on recurrence-free survival (RFS) and cancer-specific survival (CSS).

Results

A total of 378 patients were included in our study. In univariate analysis, age, BMI, intratumoral hemorrhage, tumor necrosis, sarcomatoid change, Ki-67 expression level, Fuhrman grade, and T stage were prognostic factors for RFS. Age, BMI, tumor necrosis, sarcomatoid change, Ki-67 expression level, Fuhrman grade, and T stage were prognostic factors effecting CSS. In multivariate analysis, age, BMI, tumor necrosis, sarcomatoid change, Ki-67, Fuhrman grade, and T stage were independent prognostic factors for both RFS and CSS.

Conclusion

Intratumoral changes such as tumor necrosis and sarcomatoid change are independent prognostic factors for ccRCC.
Vocal cord mucosal flap for the treatment of acquired anterior laryngeal web
Authors: Xiao Yang , Wang Jun , Han Demin , Ma Lijing , Ye Jingying , Xu Wen
Published: January 2024

Background

Anterior glottic web is one type of laryngeal stenosis. Previous surgical methods had some drawbacks, such as large surgical trauma, long postoperative recovery time, and multiple-stage surgery. This study aimed to explore better treatment to repair anterior glottis web.

Methods

We performed vocal cord mucosal flap procedure on 32 patients with anterior laryngeal webs. All subjects received vocal cord scar releasing and vocal cord mucosal flap repair and suture under general anesthesia with self-retaining laryngoscope.

Results

All 32 patients completed surgery in one stage, without postoperative laryngeal edema, difficulty in breathing, or other complications. After the surgery, the anterior commissure of vocal cords recovered to a decent triangle shape in 28 patients; however, in four patients there were 2 to 3 mm adhesion residuals on the anterior ends of the vocal cords, accompanied by scar appearance of bilateral vocal cords. The GRB score, voice handicap index scores, and maximum phonation time score significantly improved in all patients after the surgery. There was no evidence of recurrent laryngeal webbing in the 6-month follow-up.

Conclusion

Vocal cords mucosal flap repair surgery has the advantages of less trauma, quick recovery, and significant improvement of the voice in the treatment of laryngeal webs.
Duration of hypertension is associated with cognitive function: a cross-sectional study in Chinese adults
Authors: Li Tuo , Bai Yu , Xiang Junwu , Wang Rui , Bai Jie , Tuo Xiping , Zhao Zhongxin
Published: January 2024

Background

Hypertension (HTN) is a very prevalent public health problem and as the population ages, cognitive impairment (CI) is also going to be a public health burden. However, the relationship between hypertension duration and cognitive function declination worldwide is still unknown. The aim of the study was to investigate the effects of HTN duration on CI in Chinese population.

Methods

At baseline, 1 386 HTN patients and 293 normotensive (NT) people were enrolled. The HTN patients were further divided into four subgroups (duration of HTN <6 years, 6–10 years, 11–20 years, and >20 years) according to the HTN duration and were screened for cognitive function with neuropsychological tests including mini-mental-stateexamination (MMSE) and clock-drawing-test (CDT) in comparison with the NT group.

Results

More HTN patients had CI (45.3%) than NT subjects (30.4%), and increased with HTN duration (P <0.000 1). Compared with the scores of MMSE and CDT in the NT group, the declines were higher in the HTN patients (P <0.000 1), and in the four HTN subgroups, both MMSE and CDT scores fall when the HTN duration increased (P <0.05). Furthermore, in the HTN population without CI, the trend in alteration of CI was relatively mild but still existed (P <0.05).

Conclusion

People with HTN are more likely to have CI and the possibility and aggravation increases the prolongation of HTN duration, both in amnesic and nonamnesic function.
Chinese cohort study of chronic kidney disease: design and methods
Authors: Gao Bixia , Zhang Luxia , Wang Haiyan , Zhao Minghui
Published: January 2024

Background

Chronic kidney disease (CKD) is a common disorder associated with multiple adverse clinical consequences, especially cardiovascular risk and end-stage renal disease. A recent national survey demonstrated that CKD has become a leading health problem in China. There is an urgent need to implement an in-depth investigation of the CKD burden and also to explore underlying mechanisms of CKD progression and it association with adverse consequences.

Methods

The Chinese Cohort Study of Chronic Kidney Disease (C-STRIDE) is the first national CKD cohort in China. It will enroll approximately 3 000 pre-dialysis CKD patients aged between 18 and 74 years and follow-up for at least 5 years. Questionnaires, anthropometric measures, laboratory tests, and biomaterials will be collected at baseline and annually. The principal clinical outcomes of the C-STRIDE consist of renal disease events, cardiovascular events, and death. Based on the longitudinal clinical data and biomaterials, the risk factors with CKD progression and other outcomes will be analyzed, and candidate markers and predicted models will be established.

Conclusion

The C-STRIDE would provide important evidence for underlying mechanisms of CKD progression, valuable information for clinical guidelines, and healthcare policies in China.
Human infection with a novel avian-origin influenza A (H7N9) virus: serial chest radiographic and CT findings
Authors: Dai Jian , Zhou Xianmei , Dong Danjiang , Liu Yin , Gu Qin , Zhu Bin , Wu Chao , Cai Hourong
Published: January 2024

Background

Rapidly progressive pneumonia infection with H7N9 virus is a novel disease, and limited information is available concerning serial chest radiographic and computed tomography (CT) findings. The aim of this study was to evaluate the changes in serial radiologic findings in patients with H7N9 pneumonia.

Methods

The two institutional ethics review boards approved this retrospective study. This study included 10 patients with H7N9 pneumonia. All patients underwent chest radiologic examinations at different time points. Serial radiologic images were systematically analyzed.

Results

All patients showed abnormal results on initial chest radiography and CT. The initial radiographic abnormalities were unilateral (n=9) and bilateral (n=1), including ground-glass opacities (GGOs) (n=5) and consolidation (n=5). The initial CT findings consisted of unilateral (n=6) and bilateral (n=4), including consolidation (n=10), GGOs (n=10), reticular opacities (n=2), and pleural effusion (n=3). Follow-up radiologic findings showed rapid development of consolidation or GGOs within two weeks after illness onset. Pneumomediastinum with secondary subcutaneous emphysema and pneumothorax were noted in two patients. Follow-up high resolution computed tomography (HRCT) after two weeks showed slow improvement in both size and opacity of the lesions. On HRCT after discharge, patients had substantial residual lesions such as irregular linear opacities, reticular opacities, parenchymal bands, traction bronchiectasis, and cystic lesions.

Conclusions

The most common radiologic findings at presentation are multifocal or diffuse areas of consolidation and GGOs in H7N9 pneumonia. HRCT in sequence can show more changes in rapid progression of disease and a slow decrease of both size and opacity of the lesions plays an important role in the evaluation of H7N9 pneumonia.
Effects of peroxisome proliferator-activated receptor-β/δ on sepsis induced acute lung injury
Authors: Wang Cairui , Zhou Guopeng , Zeng Zeng
Published: January 2024

Background

Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are the first steps in the development of multiple organ failure induced by sepsis. A systemic excessive inflammatory reaction is currently the accepted mechanism of the pathogenesis of sepsis. Several studies have suggested a protective role of the peroxisome proliferator activated receptor-β/δ (PPAR-β/δ) in related inflammatory diseases. But the role of PPARβ/δ in ALI remains uncertain. The aim of this study was to investigate the role and possible mechanism of PPARβ/δ in ALI induced by sepsis.

Methods

Cecal ligation and puncture (CLP) was used as a sepsis model. Rats were randomly divided into four groups, the control group (CON, n=6), sham-operation group (SHAM, n=12), cecal ligation and puncture group (CLP, n=30), GW501516 group (CLP+GW, n=25), which underwent CLP and were subcutaneously injected with the PPAR-β/δ agonist GW501516 (0.05 mg/100 g body weight). Survival was monitored to 24 hours after operation. Blood pressure, serum creatinine, blood urea nitrogen, aspartate aminotrasferase and alanine aminotrasferase were measured after CLP. Concentrations of tumor necrosis factor α (TNF-α) and interleukin (IL)-1β in serum were detected by enzyme linked immunosorbent assay (ELISA) kits. Lung tissue samples were stained with H&E and scored according to the degree of inflammation. Bacterial colonies were counted in the peritoneal fluid. Alveolar macrophages were cultured and incubated with GW501516 (0.15 μmol/L) and PPARβ/δ adenovirus and then treated with Lipopolysaccharide (2 μg/ml) for 2 hours. The TNF-α, IL-1β and IL-6 RNA in lung and alveolar macrophages were determined by real-time PCR. Phosphorylation of signal transducer and activator of transcription 3 (STAT3) in lung and alveolar macrophages was detected by Western blotting.

Results

GW501516 significantly increased the survival of septic rats, decreased histological damage of the lungs, reduced inflammatory cytokines in serum and lung tissues of septic rats and did not increase counts of peritoneal bacteria. In vitro, GW501516 and over-expression of PPARβ/δ attenuated gene expression of TNF-α, IL-1β and IL-6 in alveolar macrophages. Both in vivo and in vitro, PPARβ/δ inhibited the phosphorylation of STAT3.

Conclusion

PPARβ/δ plays a protective role in sepsis induced ALI via suppressing excessive inflammation.
Correlation of D-dimer level with the radiological severity indexes of pulmonary embolism on computed tomography pulmonary angiography
Authors: Ji Yingqun , Sun Bo , Juggessur-Mungur Keeran Sandya , Li Zhiyong , Zhang Zhonghe
Published: January 2024

Background

It is known that the main role of D-dimer has been as an exclusionary test in patients with suspected venous thromboembolism. However, the D-dimer is increasingly beginning to find clinical utility as a marker in the evaluation of the extent of the embolic disease. The aim of the study was to determine whether D-dimer levels predict the radiological markers of pulmonary embolism (PE) severity using Mastora score.

Methods

This prospective study involved 69 patients with acute PE proved by computed tomography pulmonary angiography (CTPA). The D-dimer level was noted. A pulmonary artery obstruction index (PAOI; Mastora score) ≥21.3% indicated severe obstruction of PE. A right ventricle/left ventricle (RV/LV) ratio >0.9 indicated RV dysfunction.

Results

The median D-dimer level and PAOI were 765 μg/L (95% CI: 750–1 205 μg/L) and 16.77% (95% CI: 16.32%-23.06%), respectively. The D-dimer level was positively correlated with PAOI (r=0.417, P <0.000 1). PAOI ≥21.3% was associated with high D-dimer levels (median, 993 μg/L (95% CI: 856–1 841 μg/L), Z=-2.991, P=0.003). The D-dimer level was correlated with the RV/LV ratio (r=0.272, P=0.024). RV/LV ratios >0.9 were associated with high D-dimer levels (median, 880 μg/L (95% CI: 764–1 360 μg/L), Z=-2.070, P=0.038). PAOI was positively correlated with the RV/LV ratio (r =0.390, P=0.001). After three months, both the PAOI and D-dimer levels decreased (Z=-7.009, P <0.000 1; Z=-6.976, P <0.000 1, respectively).

Conclusion

D-dimer levels are positively correlated with PE burden and right ventricle dysfunction on CTPA, and can help monitor the therapeutic response.
Expression of suppressor of cytokine signaling 1 in the peripheral blood of patients with idiopathic pulmonary fibrosis
Authors: Bao Zhiyao , Zhang Qiurui , Wan Huanying , He Ping , Zhou Xin , Zhou Min
Published: January 2024

Background

Idiopathic pulmonary fibrosis (IPF) is a progressive diffuse parenchymal disease with a poor prognosis. A variety of cytokines and chemokines are involved in its pathophysiology. The aim of this study was to evaluate the clinical features in IPF patients with the expression of suppressor of cytokine signaling 1 (SOCS-1), which acts as a negative regulator of cytokine signaling.

Methods

IPF patients (n=20) and healthy controls (n=16) were included in this study. The expression of SOCS-1 was analyzed in peripheral blood mononuclear cells (PBMC) of subjects using RT-PCR. Interleukin 4 (IL-4), transforming growth factor β1 (TGF-β1) and type I collagen expression were also analyzed in each individual using enzyme-linked immunosorbent assay (ELISA). The clinical characteristics of IPF patients were delineated. These results were analyzed by SPSS13.0 statistics software.

Results

SOCS-1 mRNA expression was significantly decreased in the PBMC of IPF patients compared with healthy controls; serum levels of IL-4 and TGF-β1 were higher in IPF patients. The patients with lower expression of SOCS-1 developed lower percentage of forced vital capacity (FVC%) and DLCO/VA. A patients' SOCS-1 mRNA level was negatively correlated with serum levels of IL-4, and negatively correlated with their high-resolution computed tomography (HRCT) scores.

Conclusions

SOCS-1 mRNA can be detected in PBMC, and it is down-regulated in IPF patients. The expression of SOCS-1 is associated with the severity of IPF patients' symptoms, so it might be the predictor of disease severity. SOCS-1 might play an important role in IPF by reducing the expression of the T helper type 2 (Th2) cell-related cytokine IL-4.
Hepatocyte growth factor improves right ventricular remodeling in pulmonary arterial hypertensive rats via decreasing neurohormonal activation and inhibiting apoptosis
Authors: Wang Xiaolin , Wang Yongjin , Rong Shuling , Ma Hongbiao , Ma Qing , Zhao Junqing
Published: January 2024

Background

Hepatocyte growth factor (HGF) inhibits the development of pulmonary artery hypertension (PAH) by reducing pulmonary artery pressure and right ventricle (RV) hypertrophy. However, whether HGF can prevent RV remodeling via inhibiting apoptosis in RV cardiomyocytes and decreasing neurohormonal activation remains unknown.

Methods

The PAH and subsequent RV remodeling in rats were induced by subcutaneous injection of monocrotaline (MCT). The PAH rats were transfected with adenovirus carrying HGF (Ad-HGF) via intratracheal instillation. Three weeks after transfection, the hemodynamics indexes were measured, serum levels for angiotonin II (ANG II) and brain natriuretic peptide (BNP) were determined by ELISA. Histological analysis was used to assess the RV hypertrophy and fibrosis. The cardiomyocyte apoptosis in RV was assayed by TUNEL staining. The mRNA expression of BNP, angiotensin-converting enzyme (ACE), Bax and Bcl-2 in RV was determined by reverse transcriptase polymerase chain reaction (RT-PCR), the protein expression of transforming growth factor (TGF)-β1 and tumor necrosis factor (TNF)-α in RV was determined by Western blotting.

Results

HGF treatment significantly decreased the mean PAH, RV systolic pressure, serum ANG II and BNP levels. HGF treatment also significantly decreased the RV hypertrophy, collagen deposition, and the number of apoptotic cardiomyocytes. Moreover, HGF treatmemt significantly decreased the expression of BNP, ACE, Bax, TGF-β1, and TNF-α, while it significantly increased the expression of Bcl-2.

Conclusions

Gene transfer of HGF decreases MCT-induced PAH and improves RV remodeling. This effect is mediated not only by improving the hemodynamics but also by decreasing neurohormonal activation and inhibiting cardiomyocytes apoptosis. HGF gene treatment may be an effective strategy for improving RV remodeling in MCT-induced PAH.
Changes of sulfur dioxide, nuclear factor-κB, and interleukin-8 levels in pediatric acute lymphoblastic leukemia with bacterial inflammation
Authors: Wu Wanshui , Jia Yongrui , Du Shuxu , Tang Hong , Sun Yangling , Sun Liming
Published: January 2024

Background

Bacterial inflammation is a common complication in patients with leukemia, and sulfur dioxide (SO2) is a bioactive molecule in modulating Gram-negative bacilli infection. This study aimed to examine the changes in SO2, nuclear factor-κB (NF-κB), and interleukin-8 (IL-8) levels in pediatric acute lymphoblastic leukemia (ALL) with Gram-negative bacterial inflammation.

Methods

Fifty-five ALL children were enrolled in this study, including 30 males and 25 females, aged 3-13 years, and the median age was 7.8 years. All these children who accepted chemotherapy for ALL were divided into the control group (before chemotherapy), the infection group (after chemotherapy with infection), and the recovery group (the infection was controlled after 1 week). The serum level of SO2 was detected using high performance liquid chromatography with fluorescence assay, and NF-κB and IL-8 levels were measured by enzyme-linked immunosorbent assay (ELISA). Human THP-1 cells were cultured, induced, and differentiated into macrophages, which were divided into five groups and each group was cultured with different stimulators: lipopolysaccharide (LPS) group, LPS+L-aspartate-β-hydroxamate (HDX) group, LPS+SO2 group, SO2, and control groups. NF-κB level and IL-8 protein contents by ELISA were examined in each group.

Results

In comparison with those of the control group, levels of serum SO2, NF-κB, and IL-8 of the infection group were significantly increased (P <0.05), while those of the recovery group were significantly decreased (P <0.05). A positive correlation was found between levels of serum SO2 and intracellular NF-κB/IL-8, and the correlation coefficients were 0.671 and 0.798 (P <0.05), respectively. According to the results found in human THP-1 cells, levels of NF-κB and IL-8 in LPS group were significantly increased compared with those of the control group (P <0.05); when compared with those in LPS group, levels of NF-κB in LPS+HDX group further increased significantly (P <0.05); however, the NF-κB levels of LPS+SO2 group decreased significantly (P <0.05).

Conclusion

SO2 may play an anti-inflammatory role during the process of inflammation by inhibiting the activation and transcription of NF-κB.
Diagnosis of pancreatic carcinoma based on combined measurement of multiple serum tumor markers using artificial neural network analysis
Authors: Yang Yingchi , Chen Hui , Wang Dong , Luo Wei , Zhu Biyun , Zhang Zhongtao
Published: January 2024

Background

Artificial neural network (ANN) has demonstrated the ability to assimilate information from multiple sources to enable the detection of subtle and complex patterns. In this research, we evaluated an ANN model in the diagnosis of pancreatic cancer using multiple serum markers.

Methods

In this retrospective analysis, 913 serum specimens collected at the Department of General Surgery of Beijing Friendship Hospital were analyzed for carbohydrate antigen 19-9 (CA19-9), carbohydrate antigen 125 (CA125), and carcinoembryonic antigen (CEA). The three tumor marker values were used as inputs into an ANN and randomized into a training set of 658 (70.31% were malignant) and a test set of the remaining 255 samples (70.69% were malignant). The samples were also evaluated using a Logistic regression (LR) model.

Results

The ANN-derived composite index was superior to each of the serum tumor markers alone and the Logistic regression model. The areas under receiver operating characteristic curves (AUROC) was 0.905 (95% confidence Interval (CI) 0.868-0.942) for ANN, 0.812 (95% CI 0.762-0.863) for the Logistic regression model, 0.845 (95% CI 0.798-0.893) for CA19-9, 0.795 (95% CI 0.738-0.851) for CA125, and 0.800 (95% CI 0.746-0.854) for CEA. ANN analysis of multiple markers yielded a high level of diagnostic accuracy (83.53%) compared to LR (74.90%).

Conclusion

The performance of ANN model in the diagnosis of pancreatic cancer is better than the single tumor marker and LR model.
MicroRNA 145 may play an important role in uveal melanoma cell growth by potentially targeting insulin receptor substrate-1
Authors: Yang Li , Qiming Huang , Xuehui Shi , Xiang Jin , Li Shen , Xiaolin Xu , Wenbin Wei
Published: January 2024

Background

MicroRNAs (miRNAs) contribute to tumorigenesis by acting as either oncogenes or tumor suppressor genes. In this study, we investigated the role of miR-145 in the pathogenesis of uveal melanoma.

Methods

Expression profiles of miRNAs in uveal melanoma were performed using Agilent miRNA array. Quantitative real-time polymerase chain reaction was used to screen the expression levels of miR-145 in normal uveal tissue, uveal melanoma tissue, and uveal melanoma cell lines. Lenti-virus expression system was used to construct MUM-2B and OCM-1 cell lines with stable overexpression of miR-145. Cell proliferation, cell cycle, and cell apoptosis of these miR-145 overexpression cell lines were examined by MTT assay and flow cytometry respectively. The target genes of miR-145 were predicted by bioinformatics and confirmed using a luciferase reporter assay. The expression of insulin-like growth factor-1 receptor (IGF-1R), insulin receptor substrate-1 (IRS-1) proteins was determined by Western blotting analysis. IRS-1 was knocked down in OCM-1 cells. TUNEL, BrdU, and flow cytometry assay were performed in IRS-1 knocked down OCM-1 cell lines to analyze its function.

Results

Forty-seven miRNAs were up regulated in uveal melanoma and 61 were down regulated. miR-145 expression was significantly lower in uveal melanoma sample and the cell lines were compared with normal uveal sample. Overexpression of miR-145 suppressed cell proliferation by blocking the G1 phase entering S phase in uveal melanoma cells, and promoted uveal melanoma cell apoptosis. IRS-1 was identified as a potential target of miR-145 by dual luciferase reporter assay. Knocking down of IRS-1 had similar effect as overexpression of miR-145.

Conclusion

miR-145 might act as a tumor suppressor in uveal melanoma, and downregulation of the target IRS-1 might be a potential mechanism.