bluuebunny/crossref_metadata_2025 huggingface dataset:
Relationship between cerebral hemodynamics, tissue oxygen saturation, and delirium in patients with septic shock: a pilot observational trial
Authors: Feng Qing , Ai Meilin , Huang Li , Peng Qianyi , Ai Yuhang , Zhang Lina
Published: March 2020

Background Patients with septic shock are prone to have impaired cerebral autoregulation and to have an imbalance in cerebral oxygen metabolism. Transcranial doppler (TCD) and tissue oxygen saturation monitoring were performed to observe the changes in cerebral hemodynamic indices of the middle cerebral artery, and in cerebral and peripheral tissue oxygen saturation (StO 2 ) to identify risk factors for sepsis-associated delirium (SAD). Methods Patients with septic shock that were admitted to the Department of Critical Care Medicine of Xiangya Hospital of Central South University from May 2018 to March 2019 were prospectively enrolled, which were divided into an SAD group and a non-SAD group according to the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). Both groups were compared with respect to patient characteristics, blood gas analysis indexes, organ function indicators, cerebral hemodynamic index, cerebrovascular automatic regulation function (transient hyperemia response rate, THRR index), the changes in regional cerebral oxygen saturation, and peripheral tissue oxygen saturation. Results The incidence of SAD was 39% (20/51). The overall 28-day mortality rate was 43% (22/51). Compared with the non-SAD group, patients in the SAD group required a longer mechanical ventilation time (5 days [95% confidence interval (CI) 2, 6] vs 1day [95% CI 1, 4], p=0.015) and ICU stay (9 days [95% CI 5, 20] vs 5 days [95% CI 3, 9], p=0.042) and has a higher 28-day mortality rate(65% vs 29%, p=0.011).Multivariate regression analysis showed that the THRR index (OR=5.770, 95% CI:1.222-27.255; p=0.027)and mean value of regional cerebral oxygen saturation (rSO 2 ) <55% (OR=3.864, 95% CI:1.026-14.550;p=0.046) were independent risk factors for SAD. Conclusions SAD has a high incidence in septic patients and is associated with poor prognosis. Our results provide a clinical basis for improving early detection and treatment of SAD.
Elevated Blood Urea Nitrogen are associated with Recurrence of post-operative Chronic Subdural Hematoma
Authors: Wang Ning , Hu Jiangnan , Oppong-Gyebi Anthony , Zhu Xuanhao , Li Yihao , Yang Jianjing , Zhuge Qichuan , Ruan Linhui , Ye Sheng
Published: March 2020

BACKGROUND Chronic subdural hematoma (CSDH) is fundamentally treatable with about 2-31% recurrence rate. Recently, there has been renewed interest in the association between Blood Urea Nitrogen (BUN) and intracranial lesion. Therefore, this paper attempts to show the relationship between BUN and CSDH recurrence. METHODS A total of 661 CSDH cases with Burr-hole Irrigation (BHI) were enrolled from December 2014 to April 2019. The analyzed parameters included age, gender, comorbidities, laboratory investigations, medication use and hematoma location. The cases were divided into recurrence and non-recurrence groups while postoperative BUN concentration was further separated into quartiles (Q1 ≤ 4.0 mmol/L, 4.0 < Q2 ≤ 4.9 mmol/L, 4.9 < Q2 ≤ 6.4 mmol/L, Q4 > 6.4 mmol/L). Restricted cubic spline regressions and logistic regression models were performed to estimate the effect of BUN on CSDH recurrence. RESULTS CSDH recurrence was observed in 97(14.8%) cases. Significant distinctions were observed between recurrence and non-recurrence groups in BUN quartiles of cases ( P =0.004). After adjusting for the potential confounders, the odds ratio of recurrence was 3.124 (95%CI =1.509–6.468, p = 0.002) for the highest quartile of BUN compared with the lowest quartile. In multiple-adjusted spline regression, high BUN level visually showed significantly high OR value of recurrence risk. CONCLUSIONS Elevated BUN at post-operation is significantly associated with the recurrence of CSDH, and it is indicated that high levels of serum BUN after evacuation may be served as a risk factor for CSDH recurrence.
Expression and function of dinkkopf 4 in oral squamous cell carcinoma and in vitro
Authors: Cai Xinjia , Yao Zhigang , Huang Junhui
Published: March 2020

Background Oral squamous cell carcinoma accounts for about 90% of malignant tumors of the head and neck, and its 5-year survival is less than 50%. The number of new cases of oral cancer worldwide is expected to increase by 62% in 2035. Wnt/β-catenin signal pathway plays a role in the tumorigenesis and progression of cancer. dinkkopf 4 is involved in a variety of cancers as a molecule in Wnt/β-catenin signal. To our knowledge, the study of DKK4 in OSCC has not been reported. Methods The well differentiated oral squamous cell carcinoma and normal oral mucosa samples were collected from Department of Pathology of Xiangya Stomatological Hospital of Central South University. Human oral epithelial cell HOEC and human oral squamous cell carcinoma cell TSCC1 were cultured for experiments. The plasmid vector was constructed to inhibit the expression of DKK4 to form TSCC1-shDKK4 cells and TSCC1-NC cells were transfected with blank plasmid. Cell proliferation was detected by CCK-8 test. Apoptosis was detected by Annexin V-FITC/PI assay. Cell migration was detected by Transwell assay. IBM SPSS Statistics 24.0 and GraphPad Prism 8 were performed for statistical analysis and graphing. Results We found that the expression of DKK4 and β-catenin increased in OSCC and in vitro (P<0.05). dinkkopf 4 may promote the expression of β-catenin in OSCC. The proliferation and migration of TSCC1-shDKK4 cells decreased and the apoptosis of TSCC1-shDKK4 cells increased (P<0.01). Conclusions dinkkopf 4 may promote the proliferation and migration of OSCC cells and inhibit the apoptosis of OSCC cells in vitro by regulating Wnt/β-catenin signal pathway.
Clinical implications of serum Mac-2-binding protein (M2BPGi) as novel biomarkers of advanced hepatic fibrosis in diabetes
Authors: Park Huiyul , Kim Mimi , Jun Dae Won , Park Hoon-ki
Published: March 2020

Background Appropriate strategy for screening, identification, and linkage to care of patients with advanced fibrosis in general population is unsolved issue. The aim of this study was to find reference value and clinical role of Mac2 binding protein glycan isomer (M2BPGi) in health check-up setting.Methods Adult subjects (n=1,073) who underwent a health check-up at the healthcare center were finally included for analysis, except for 952 subjects with risk factors for liver disease and insufficient data. Body composition analyzed by using the Bioelectrical Impedance Analysis (BIA). M2BPGi quantification based on a lectin antibody sandwich immunoassay. Fatty liver diagnosed by using abdominal sonography.Results Reference value of M2BPGi was 0.5~1.0 C.O.I in the average risk group. Serum M2BPGi showed a positive correlation with metabolic parameters as well as age. Prevalence of abnormal M2BPGi (> 1.0) was higher in low muscle mass (4.7%, vs 17.4%, p=0.002), metabolic syndrome (14.2% vs. 30.4%, p=0.003) and hypertension (21.8%, vs. 58.7%, p<0.001) compare to healthy control. M2BPGi had a positive correlation with estimated fibrosis formulae such as FIB-4 (R=0.293, p< 0.001) and NAFLD fibrosis score (R=0.248, p<0.001). While the prevalence of advanced fibrosis in total population was just 1.6% (FIB-4 >2.65), the prevalence of advanced fibrosis increased to 50% in high M2BPGi (> 1.0) group with diabetes. It was 31.25 times higher than total population group.Conclusions There was high possibility of advanced hepatic fibrosis in subjects with abnormal M2BPGi levels (> 1.0) in diabetes.
Risk of rebleeding from gastroesophageal varices after initial treatment with cyanoacrylate: a systematic review and pooled analysis.
Authors: Hu Zixuan , Zhang Decai , Swai Joel , Liu Tao , Liu Shaojun
Published: March 2020

Background Cyanoacrylate alone or in combination with other interventions, can be used to achieve variable rates of successes in preventing rebleeding. Our study aims to assess the pooled risk of gastric and esophageal varices rebleeding after an initial treatment with cyanoacrylate alone and/or in combination with other treatments, by systematic review of literature and pooled analysis.Methodology PubMed, EMBASE, SCOPUS and the Cochrane library were searched for studies that reported the risk of rebleeding during the follow-up period after treatment of gastric or esophageal varices with either cyanoacrylate alone or in combination with other treatments. Standard error, upper and lower confidence intervals at 95% confidence interval for the risk, were obtained STATA Version 15 which was also used to generate forest plots for pooled analysis. Random or fixed effect model was used depending on the heterogeneity (I2).Results A total of 39 studies were found to report treatment of either gastric or esophageal varices with either cyanoacrylate alone or in combination with other treatments. When gastric varices are treated with cyanoacrylate alone, the risk of rebleeding during the follow-up period is 0.16(Confidence Interval: 0.13-0.18). When combined with lipiodol; polidocanol or sclerotherapy the rebleeding risks are 0.13 (CI:0.03-0.22), 0.10(CI:0.02-0.19) and 0.10(CI:0.05-0.18), respectively. When combined with percutaneous transhepatic variceal embolization; percutaneous transhepatic variceal embolization; endoscopic ultrasound guided coils; or with ethanolamine, the rebleeding risk are 0.10(CI:0.03-0.17), 0.10(CI:0.03-0.17), 0.07(CI:0.03-0.11) and 0.08(CI:0.02-0.14), respectively. When esophageal varices are treated with cyanoacrylate alone, the risk of rebleeding is 0.29(CI:0.11-0.47). When combined with percutaneous transhepatic variceal embolization; sclerotherapy; or band ligation, the risks of rebleeding are 0.16(CI:0.10-0.22), 0.12(CI:0.04-0.20) and 0.10(CI:0.04-0.24), respectively. When combined with transjugular intrahepatic portosystemic shunt; or ethanolamine, the risks of rebleeding are 0.06(CI:-0.01-0.12) and 0.02 (CI:-0.02-0.05), respectively.Conclusion In treating both gastric and esophageal varices, cyanoacrylate produces better results in terms of lower risk of rebleeding when combined with other treatments than when used alone. The combination of cyanoacrylate with ethanolamine or with endoscopic ultrasound guided coils produces lowest risk of rebleeding in esophageal and gastric varices, respectively. We call upon randomized trials to test these hypotheses.
Lower levels of serum albumin are associated with impairment of cognitive function in cirrhotic patients with early-stage hepatic encephalopathy: An exploratory data analysis of phase II/III clinical trials of rifaximin in Japan
Authors: Kaji Kosuke , Okita Kiwamu , Suzuki Kazuyuki , Sato Ikuya , Fujisawa Masaki , Yoshiji Hitoshi
Published: March 2020

Background Because covert hepatic encephalopathy (CHE) has been shown to affect the prognosis of cirrhotic patients, early diagnosis of HE is a prerequisite for preservation of patients’ quality of life and for prophylaxis of overt HE. Currently, neuropsychological tests are used for the diagnosis of early-stage HE including CHE. However, it would be inefficient to apply them to all cirrhotic patients. Thus, some biomarkers correlated with the above diagnostic modalities are available for screening examination. The aim of this study was to identify a clinical parameter to predict impairment of cognitive function in cirrhotic patients with early-stage HE.Methods This exploratory data analysis was based on the data from 172 patients with cirrhotic or idiopathic portosystemic shunt (PSS) in phase II/III trials of rifaximin in Japan. Their data at baseline before treatment with rifaximin were utilized to analyze the relationship between cognitive dysfunction and different clinical parameters We Classification and regression trees (CART) were constructed to identify clinical profiles related to cognitive dysfunction, as indicated by the prolongation of time required for the number connection test (NCT-B).Results CART analysis detected age 65 years as the variable for the initial split, and serum albumin level was selected as the variable for the second split among patients aged ≤ 65 years. In 27 cirrhotic patients aged ≤ 65 years without PSS, receiver-operating characteristic curve analysis revealed that the optimal albumin level cutoff point was 3.05 g/dL, and the area under the curve was 0.80 for the prolongation of NCT-B time, which was higher than that of other HE-related parameters including the branched-chain amino acids-to-tyrosine ratio (0.46), the prothrombin time–international normalized ratio (PT-INR) (0.68), serum ammonia (0.61), and total bilirubin (0.69).Conclusions Lower serum albumin level as a clinical biomarker associated with impaired cognitive function is available as a screening examination for early-stage HE in cirrhotic patients aged ≤ 65 years without PSS before undergoing neuropsychological tests.
Curative Effect and Safety of Tolvaptan Combined with Traditional Diuretics in Treatment of Patients with Cirrhotic Ascites and Relevant Research on its Dose: A Systematic Review with Meta-Analysis of Randomized Controlled Trials
Authors: Li Xin , Liu Shidong , Zhang Hui , Liang Fuxiang , Miao Long , Xu Hao , Zhao Zhenjie , Zhou Wence
Published: March 2020

Background Tolvaptan is a receptor antagonist of highly selective vasopressin V2, and it can promote excretion of water without electrolyte.Aims To evaluated curative effect and safety of Tolvaptan in treatment of cirrhotic ascites, and its relationship with drug dose.Methods Computer retrieval of PubMed, EMbase and The Cochrane Library was carried out to search the clinical trials of cirrhotic ascites treatment by Tolvaptan. The time limit of retrieval is from the database setup to May 31, 2019. 2 researchers independently screened studies, extracted the data and crosschecked. RevMan 5.3 software was used for Meta-analysis.Results Finally, 6 articles and 848 patients were included in the study. Meta-analysis indicates that after the intervention for 7 days, serum sodium ion concentration of the combined diuretic group obviously increased, compared with the traditional diuretic group (WMD=2.92mmol/L, 95%CI [2.15, 3.70], P<0.001). In addition, Tolvaptan also can decrease patients’ ascites amount through increasing liquid discharge. However, the drug dose has no obvious correlation with the reduction degree of ascites amount. The rise of blood uric acid is the major adverse event in the treatment of cirrhotic ascites patients by Tolvaptan (OR=6.01, 95%CI [1.11, 32.56], P=0.04). When the dose of Tolvaptan rose to 15mg or 30mg, the total incidence of adverse events was obviously higher than it of traditional diuretic group.Conclusion Tolvaptan combined with traditional diuretics has good curative effect for the patients with cirrhotic ascites. As its adverse reactions, the recommended dose of Tolvaptan is 7.5mg in the combined therapy.Registration number: The meta-analysis was registered prospectively on the PROSPERO database (ID: CRD42019143480).
Effect of TrkB-PLC/IP3 pathway on intestinal inflammatory factors and enterocyte apoptosis in mice with colitis
Authors: Xu Guangmeng , Sun Yajuan , He Huaiqiang , Xue Qiuli , Liu Yajie , Dong Lihua
Published: March 2020

Background This study aimed to explore the effect of TrkB-PLC/IP3 pathway on intestinal inflammatory factors and enterocyte apoptosis in mice with colitis.Methods Forty 8-week SPF C57BL/6J mice were randomly and averagely divided into normal group (healthy mice), control group (sham-operated mice), model group (model mice without any treatment), and K252a group (model mice with the treatment of 100 μmoL/kg TrkB-PLC/IP3 pathway inhibitor for 5 d before clysis). Mice in model and K252a groups were used to establish ulcerative colitis models after medication.Results There were no significant changes of the content of serum tumor necrosis factor-α (TNF-α) and TNF-γ and protein expressions of TNF-α and TNF-γ in the colon tissues (all P >0.05), a significant increase of disease activity index, colon mucosa damage index, tissue damage index scores, content and protein expressions of serum interleukin-4 (IL-4) and IL-8, and a significant decrease of content and protein expressions of serum IL-10 (all P <0.05) in model and K252a groups, as compared to normal and control groups. Mice in model and K252a groups had blocked enterocyte cycle progression, raised apoptosis ratio, significantly increased mRNA and protein expressions of Caspase3, Bax, FasL and Fas, and significantly reduced mRNA and protein expressions of p-TrkB, PLC-γ1, IP3 and Bcl-2 (all P <0.05). Moreover, intestinal inflammation and apoptosis induced by colitis in K252a group became more aggravated through the inhibition of TrkB-PLC/IP3 pathway activity.Conclusions Inhibition of TrkB-PLC/IP3 pathway can promote the expression of intestinal inflammatory factors and enterocyte apoptosis in mice with colitis.
Improving phage titre through examining point of infection
Authors: Ali Junaid , Rafiq Qasim , Ratcliffe Elizabeth
Published: March 2020

Bacteriophages are viruses that cause the lysis of bacteria. They have recently been used to combat antimicrobial resistant infections as an alternative therapy to antibiotics. Their production and propagation, however, remains understudied and will be key to obtaining titres required for future clinical studies and research. Previous work suggests that temperature of infection significantly influences the production process and output yield of phage, with a reduction in temperature from 37ºC to 28ºC resulting in significant increases in productivity for multiple host-phage systems. The current study aimed to build upon this previous work by examining different temperature conditions at the point of infection to determine the effect on harvest phage titre improvements. Investigations were conducted at different culture scales ranging from 20mL shake flasks to 3L stirred tank bioreactor cultures to investigate process differences when scaling from laboratory bench-scale to initial industrial scale fermentations. Additionally, the kinetics of phage infection were investigated. In small scale cultures, the greatest phage bursts and harvest titres were generated by maintaining cultures under static 28 o C incubation during infection compared to agitation and temperature reduction from 37 o C. Investigating the dynamics around the point of infection will help to inform scalable processes for manufacture of phage for a variety of applications ranging from direct therapeutic application to self-assembling bio-templates for nanostructure synthesis.
Laparoscopic assisted pancreaticoduodenectomy vs. totally laparoscopic pancreaticoduodenectomy for malignant tumor: a retrospectively controlled study
Authors: Yao Guo-Liang , Zhai Jing-Ming
Published: March 2020

Background Laparoscopic pancreaticoduodenectomy was now accepted worldwide with potential advantages over open pacreaticoduodenectomy. The defect was time wasting with the prone of increased postoperative complications. To assess the potential superiority and feasibility of laparoscopic assisted pancreaticoduodenectomy (LAPD) comparing to totally laparoscopic pancreaticoduodenectomy (TLPD), we introduce this study.Methods Retrospectively analyzed the relation data from the patients who had laparoscopic pancreaticodedunostomy due to malignant tumor in The First Affiliated Hospital of Henan University of Science and Technology during January 2015 to July 2019. Complications and operation time were compared. SPSS 16.0 was employed for analysis.Results Both groups had almost the same baseline characteristics, such as Sex (P=0.880), Age (P=0.861), ASA (P=0.559), BMI (P=0.854), pancreatic duct size (P=0.623), pancreatic texture (P=0.573) and tumor origin (P=0.878). LAPD was association to shorter operation time (231.6±43.7 min VS. 305.4±55.3 min; P=0.047), pancreaticojejunostomy time (13.8±4.2 min VS. 41.6±9.4 min; P=0.007), gastrojejunostomy time (10.9±3.0 min VS. 24.8±6.5 min; P=0.014) and jejunojejunostomy time (7.8±2.4 min VS. 23.4±5.8 min; P=0.005). No statistical difference was observed relation to resection time (P=0.864), cholangiojejunostomy time (P=0.897), blood loss (P=0.723), number of required transfusion (P=0.809), and incision length (P=0.183). Both groups had comparable conversion to open approach (P=0.402). LAPD had comparable complications to TLPD, such as pancreatic leakage (P=0.328), biliary leakage (P=0.673), bleeding (P=0.889), pneumonia (P=0.809) and thrombosis (P=0.443) and incision infection (P=0.889). No statistical difference was observed relation to visual analogue score at 1 day postoperatively (P=0.913) and hospitalization (P=0.137).Conclusions Laparoscopic assisted pancreaticoduodenectomy with open pancreaticojejunostomy should be a choice for certain surgeons with less operation time.
Conjunctival polymerase chain reaction-tests of 2019 novel coronavirus in patients in Shenyang,China
Authors: Xu Li , Zhang Xinyue , Song Wei , Sun Baijun , Mu Jinping , Wang Bing , Wang Zhiqian , Cao Yehong , Dong Xue
Published: March 2020

Background We report the laboratory results of conjunctival PCR-tests and some clinical features of these patients infected with COVID-19 in shenyang China.Methods We collected conjunctival samples of the patients to do the laboratory tests by PCR.Medical observed patients were enrolled if they had clinical symptoms. Then we analysed the PCR results and clinical features in order to find some relationships.Results The study include 14 confirmly diagnosed cases ,16 suspected cases and some medical observed patients.1 of the identified case coverted from suspected case.22 medical observed cases were removed because none of them converted to identified cases.1 of the suspected converted to identified case recently.All the conjunctival results of PCR-test were negative.Discussion The reasons of the negative detection results of PCR in conjunctival swabs were discussed.Conclusion Conjunctiva may be a transmission way of COVID-19.And ocular conjunctival swabs could be a diagnostic method for identifying the infection of COVID-19.Emphasis on the false-negative results is vital.
Identification and validation of a commercial cryopreservation medium for the practical preservation of Dirofilaria immitis microfilaria
Authors: Shirozu Takahiro , Soga Akira , Fukumto Shinya
Published: March 2020

Background Dirofilaria immitis is a parasitic nematode transmitted by mosquitoes and the cause of heartworm disease in dogs and dirofilariasis in humans and other mammals. The parasite is endemic worldwide. Vector stage research requires a reliable supply of D. immitis microfilariae (mf). It is believed that cryopreserved mf would retain viability and provide a powerful tool for vector stage research. However, reports on cryopreservation of D. immitis mf are limited. Therefore, this study aimed to validate commercial cryopreservation media to establish a practical, convenient, and reproducible storage procedure for D. immitis mf.Methods Six different commercially available cryopreservation media were compared with the traditional polyvinylpyrrolidone-dimethyl sulfoxide (PVP-DMSO) preservation solution. In vitro viability of purified D. immitis mf and mf-infected total blood was analyzed using a motility assay and propidium iodide staining. In vivo infectivity of Aedes aegypti mosquitoes with cryopreserved mf was assessed using a mosquito survival test and quantifying the number of infective third stage larvae (L3) after 13 d post-infection.Results Purified mf cryopreserved in CultureSure showed the best viability when compared to mf cryopreserved in the remaining five commercially available media and PVP-DMSO. Viability of mf in mf-infected total blood cryopreserved in CultureSure varied with the ratio of infected blood to CultureSure. Optimum results were obtained with 200 µL mf-infected blood:800 µl CultureSure. CultureSure was also the optimum medium for cryopreserving mf prior to infectivity of Ae. aegypti. The number of L3 was approximately the same for CultureSure cryopreserved mf (3×-concentrated solution) and non-cryopreserved fresh mf.Conclusions CultureSure is an optimal commercial cryopreservation solution for the storage of D. immitis purified mf, mf-infected total blood, and mf used for in vivo mosquito experiments. Furthermore, this study describes an easy preservation method for clinical D. immitis -infected blood samples facilitating vector stage studies, as well as the education of veterinarians.
SR stress in locomotor muscles of patients with chronic obstructive pulmonary disease
Authors: Qaisar Rizwan , Qayyum Mughal , Muhammad Tahir
Published: March 2020

Background The potential contribution of chronic dysregulation of sarcoplasmic reticulum (SR) protein homeostasis (a condition called SR stress) to skeletal muscle loss is poorly understood. We investigated the degree of activation of SR stress in locomotor muscles of patients with chronic obstructive pulmonary disease (COPD), a respiratory disease with systemic manifestations. Methods We analyzed the markers of SR stress and associated pathologies in vastus lateralis muscles of 60-65 years old male healthy controls and patients with mild (COPD stages 1 & 2) and advanced (COPD stages 3 & 4) COPD (N = 6-8 / group). Results Skeletal muscle proteins expressions of GRP94, BiP, CHOP and ATF were significantly elevated in advanced COPD (≈53%, ≈3.6 fold, ≈3.5 fold and ≈3.2 fold, respectively) compared with healthy controls. The expression of downstream markers of SR stress including apoptosis, inflammation and autophagy was increased, while the maximal activity of SR Ca2+ ATPase (SERCA) enzyme was significantly reduced in advanced COPD (≈41%) than healthy controls. Single muscle fiber diameter and cytoplasmic domain per myonucleus were significantly smaller (≈14% and 13%, respectively) in patients with advanced COPD than healthy controls. These changes in SR dysfunction were accompanied by substantially elevated levels of global oxidative stress including lipid peroxidation and mitochondrial ROS production. Conclusion Taken together, our data suggests that the muscle weakness in advanced COPD is in part driven by elevated SR stress and its pathological consequences. The data provided can lead to potential therapeutic interventions of SR dysfunction for muscle detriment in COPD.
Decline in the incidence of tuberculosis among HIV-infected patients enrolled in HIV care, treatment and support programme from 2011 to 2014 in Mainland Tanzania
Authors: Majigo Mtebe Venance , Somi Geoffrey , Joachim Agricola , Manyahi Joel , Nondi Joseph , Sambu Veryeh , Rwebembera Anath , Makyao Neema , Ramadhani Angera , Maokola Werner , Todd Jim , Matee Mecky I
Published: March 2020

Background Despite improvements in access to antiretroviral therapy (ART), mortality in people living with human immunodeficiency virus (PLHIV) is still high and largely attributed to Tuberculosis (TB) infection. In sub-Saharan Africa, approximately 80% of HIV related mortality cases are associated with TB. Relatively little is known about incidence of TB among PLHIV in Tanzania and the determinant factors. We report incidence rate of confirmed TB and determine association with selected demographic and program related factors based on data in the national HIV care and treatment program from 2011 to 2014. Methods The Tanzania National AIDS Control Programme, Care and Treatment database was used to obtain information of all HIV clients enrolled in the HIV Care and Treatment Program between January 2011and December 2014. We analyzed retrospective cohort data to assess TB incidence rate per 1000 person-years. A multivariable Cox proportional hazards regression model was used to estimate hazard ratios and 95% confidence intervals for putative associated factors. Results Over the period of four years, there were 22,071 confirmed cases of pulmonary TB in 1,323,600 person years. The overall TB incidence was around 16.7 (95% CI 16.4 -16.9) cases per 1000 person years. The annual incidence rate decreased by 12.4% from 17.0 (95% CI 16.5-17.4) in 2011 to 14.9 (95% CI 14.5-15.4) in 2014. TB incidence rate was significantly higher in persons not using ART and in males than females. The incidence of TB was higher in patients with advanced HIV disease and decreased with increasing age. The overall prevalence of TB was 2.2% with peak prevalence of 2.5% in 2013 and being higher among children < 15 years (3.2%) in the same year. Conclusion The study found an overall decrease of incidence of TB in PLHIV. Our results underline the current recommendations of HIV test and treat and provision of TB preventive therapy for those PLHIV without active TB after intensified TB case-finding.
Double versus single T-tube drainage for frank cysto-biliary communication in patients with hepatic cystic echinococcosis: A retrospective cohort study with median 11 years follow-up
Authors: Shalayiadang Paizula , Jiang Tiemin , Yimiti Yusufu , Ran Bo , Aini Abudusalamu , Zhang Ruiqing , Guo Qiang , Ahan Ayifuhan , Abulizi Abuduaini , Aimaiti Dilimiureti , Wen Hao , Shao Yingmei , Aji Tuerganaili
Published: March 2020

Background: Partial peri-cystectomy is one of the major surgical approaches for hepatic cystic echinococcosis (CE) and has been practiced in most centers worldwide. Cysto-biliary communication (fistula, leakage, rupture) is a problematic issue in CE patients. T-tube is a useful technique in situations where exploration and decompression are needed for common bile duct (CBD), however, postoperative biliary complications for cystic cavity still remains to be studied in depth. Materials and Methods: A retrospective cohort analysis of CE cases in our single center database from 2007 March to 2012 December was performed. Patients (n=51) were divided into two cohorts: double T-tube drainage (one at CBD for decompression and one at the fistula for sustaining in cystic cavity, n=23) group and single T-tube drainage cohort (only one at CBD for decompression, n=28). Short-/long-term postoperative complication focusing on biliary system was recorded in detail and they were followed-up for median 11 years.Results: Overall biliary complication rates for double and single T-tube drainages were 17.4% vs. 35.7%. Short-term complications ranged from minor to major leakages, cavity infection and abscess formation, and prevalence was 17.4% vs. 21.4% respectively for double and single T-tube groups; most importantly, double T-tube drainage group had predominant advantage regarding long-term complications (0% vs. 14.3%), which was biliary stricture needing surgery and it was observed in single T-tube drainage group.Conclusions: Double T-tube drainage had better outcomes without procedure specific postoperative biliary complications than single T-tube drainage. Meanwhile, we recommend long-term follow-up when comparing residual cavity related biliary complication in CE patients as it could happen lately.
Durability of Single Tablet Regimen for Patients with HIV infection in Southern Taiwan: data from a real world setting
Authors: Tsai Hung-Chin , Chang Hui-Min , Chou Chen-Hsi
Published: March 2020

Background: A single-tablet regimen (STR) has been associated with better drug adherence. However, the durability of different STRs was unknown in the real world settings. Our aim was to investigate the durability of different initial STR regimens in patients starting STR in southern Taiwan Method: This was a retrospective study of antiretroviral-naive patients that initiated first-line antiretroviral regimens with STRs between May 2016 and December 2017. The primary endpoint was time to virological failure (defined as plasma HIV RNAs≧200 copies/mL after 24 weeks). Secondary endpoints were STR discontinuation due to toxicity/intolerance. Survival analysis was done using Kaplan–Meier and Cox regression. Results: Two hundred and twenty-three patients were included: Over a median (IQR) of 86 (60-112) weeks, 25 patients (11%) experienced virological failure; the 1 year probability of virological failure was 11% (8/70) for Atripla, 7% (4/54) for Complera and 13% (13/99) for Triumeq. Fifty-six patients (25%) discontinued their STRs owing to toxicity/intolerance. When compared to Atripla, treatment with Complera (AHR 8.39, CI 1.98-35.58, p=0.004) and Triumeq (AHR 8.40, CI 2.39-29.54, p=0.001) were more likely to have treatment failure. However, when the risk of treatment failure was compared between two different STRs, treatment with Complera was not found to have higher risk of treatment failure when compared to Atripla (log rank test p=0.116). The predictors for treatment failure included age≦30 years old (AHR 3.73, CI 1.25-11.17, p=0.018), switch between different STR (AHR 2.3, CI 1.18-4.50, p=0.001) and free of active syphilis infection (AHR 0.24, CI 0.08-0.73, p=0.012). The risk factor for treatment discontinuation included younger age≦30 years old (AHR 3.82, CI 1.21-12.37, p=0.023), treatment with Atripla (AHR 8.65 , CI 2.64-28.39 , p<0.001) and free of active syphilis infection (AHR0.16, CI 0.04-0.62, p=0.006). Conclusion: Younger age was associated with treatment failure and drug discontinuation. Active syphilis infection s/p treatment was associated with free from treatment failure and discontinuation. This probably driven by the more frequently sexual health education and counseling when patients had syphilis infection. The STR durability was dependent on the drug toxicity/intolerance, age and syphilis infection
Identification of AC003986.3 as an independent risk factor for glioma patient survival and functional analysis
Authors: Liu Qinglin , Ge Huijian , Liu Peng , Li Youxiang , Jiang Peng
Published: March 2020

Background To validate the potential of AC003986.3 in predicting glioma patient survival and analyze its underlying function and mechanism. Methods Gene expression and clinical features of the patients were obtained from The Cancer Genome Atlatls. Correlation between AC003986.3 expression profile and patient clinical features and survival were analyzed. Multivariate Cox regression was employed to determine the risk factors for patient survival and construct the prediction model for survival. Validation of the multivariate Cox regression model was tested by comparing the survival curves between the model-predicted high and low death risk subgroups and calculating the accuracy of predicting 1, 2, 3, and 5 years survival by the model. Target genes were predicted with Ensemble Browser. Gene set enrichment analysis was performed to explore AC003986.3 related gene sets enrichment in Gene Ontology and Kyoto Encyclopedia of Genes and Genomes pathways. Results 655 samples with gene expression and complete clinical features were obtained from The Cancer Genome Atlas. Clinical features enrolled in this study were follow up time, survival status, race, gender, race and pathological grade. AC003986.3 expression was positively related to patient age and pathological grade. High AC003986.3 expression glioma patients suffered a poorer survival than those with low expression. Multivariate Cox regression revealed that AC003986.3 expression was an independent risk factor for patient survival irrespective of age and pathological grade. Predicted by Ensemble Browser, TWIST1 was the target of AC003986.3. Gene set enrichment analysis revealed that AC003986.3 related gene sets were mainly enriched in cell metabolism. Conclusions AC003986.3 expression is closely related to age and pathological grade in glioma patients, and is an independent risk factor for patient survival irrespective of age and pathological grade. AC003986.3 is mainly involved in regulating tumor cell metabolism, and this effect is probably mediated by TWIST1.
Comprehensive analysis of circRNAs from steatotic livers after ischemia and reperfusion injury by next generation RNA sequencing
Authors: Qu Xiaoye , Zheng Chao , Wang Bingrui , Wang Fang , Sun Xuehua , Gao Yueqiu , Xia Qiang , Kong Xiaoni
Published: March 2020

Background Global organ shortage has enabled the permission of fatty livers for transplantation purpose, taking the risk of graft dysfunction related to the rapider ischemia/reperfusion injury (IRI) progress. Increasing evidence supports the role of circular RNAs as essential regulators of this progress. However, data about circular RNAs in ischemia and reperfusion injured steatotic livers are practically nonexistent. Methods In the present study, high-fat diet (HFD)-fed mice model was used to generate hepatic steatosis mice. RNA-sequencing was performed on IRI model or sham liver tissues both in HFD-fed mice to screen the significant differentially expressed circular RNAs. GO and KEGG analysis were applied to figure out the potential function of these screened circular RNAs. Results From this, we successfully found the expression of some circular RNAs were significantly altered in IRI livers after HFD-fed mouse models. To further validate sequencing data, one up-regulated circRNA and four down-regulated circular RNAs were examined in steatotic mice livers after IRI. The RNase R digestion experiment exhibited these circRNAs possessed high stability compared with linear RNAs and sequence alignment of their junction positions provided identical sequences by sanger sequencing following gel electrophoresis, demonstrating the circularity of these circular RNAs. The expression of four stable circRNAs undigested by RNase R were further validated by quantitative PCR. Conclusion In summary, this study reveals that circular RNAs emerge as novel and potentially efficient targets which involve in more severe damage of steatotic livers to IRI.
Regulation of Hippo/YAP signaling and esophageal squamous carcinoma progression by an E3 ubiquitin ligase PARK2
Authors: Zhou Xiaofeng , Li Yajie , Wang Weilong , Wang Sujie , Hou Jinghan , Zhang Aijia , Lv Benjie , Gao Can , Yan Ziyi , Pang Dan , Lu Kui , Ahmad Nor Hazwani , Zhu Jian , Wang Lidong , Zhang Lichen , Zhuang Ting , Li Xiumin
Published: March 2020

Background Esophageal squamous cell carcinoma (ESCC) is one of the most lethal malignancies in the world, while the overall five-year survival is less than 20%. Recent genomic sequencing analysis indicated the over-activation of Hippo/YAP signaling might play important roles for the carcinogenic process and progression for ESCC patients. However, little is known about the molecular mechanisms that controls Hippo signaling activity in ESCC. Methods YAP and PARK2 protein level were measured by western blot, while the Hippo classical target genes were measured by real-time PCR. WST1 assay were used to measure cell proliferation, the trans-well and wound healing were used to measure the cell migration and invasion capacity. Protein stability and ubiquitin assay were used to detect the YAP protein ubiquitin and stability. The immuno-precipitation assays were used to detect the protein interactions. Immuno-staining was used to detect the protein localization of YAP and PARK2, while the ubiquitin-based immuno-precipitation assays were used to detect the specific ubiquitination manner of YAP. Results Here, we identify a novel E3 ubiquitin ligase PARK2 as an inhibition factor for Hippo/YAP axis. We find that PARK2 depletion promotes ESCC progression both in vivo and in vitro through Hippo/YAP axis, while PARK2 overexpression suppresses ESCC tumor progression via Hippo signaling. Mechanistic study reveals that PARK2 could interact with YAP in the cytosol and promotes YAP K48-linked ubiquitination at K90 sites, which subsequently promotes YAP protein degradation in ESCC. Clinical sample of ESCC revealed that PARK2 is significantly decreased in ESCC, and relates to good prognosis in ESCC patients. Beside, PARK2 expression negatively correlates with tumor stage and YAP protein expression. Conclusions: Our study identifies an interesting mechanism of Hippo pathway regulation, by which PARK2 modulates ESCC cancer progression, and implies PARK2 could be a novel marker for therapeutics and diagnostics in human ESCC.
Factors of Successful Aging among Pre-Retirement Public Servants in Klang Valley, Malaysia
Authors: Ismail Aniza , Hairodin Khairul Rafizah , Miskam Hazlina Mohd , Shamsuddin Khadijah
Published: March 2020

Background: Following the global trend,Malaysia is moving towards an aging population. With the change in age ratio, there will be more age-related diseases and challenges that need to be managed appropriately. This study aimed to determine the prevalence of successful aging (SA) among pre-retirement Malaysian public servants and the predictors.Methods: A cross-sectional study was carried out among 1,064 pre-retirement public servants (50-60 years old) working in nine federal government agencies within the Klang Valley. Multistage sampling was applied with simple random sampling for selecting four out of 23 ministries and two agencies under each ministry. Purposive sampling was used for selecting the state and respondents. The respondents completed a self-administered questionnaire and their cognitive function was assessed using the Mini-Mental State Examination (MMSE). SA was defined as being able to fulfil all three criteria i.e. absence of six major chronic diseases and having both good physical and psycho-cognitive functions.Results: The prevalence of SA was 37.5%. Multiple logistic regression showed that the factors with higher odds of having SA were younger age (50–54 years old) (adjusted odds ratio [aOR] 1.32, 95% confidence interval [CI] 1.01-1.73), being physically active (aOR 1.39, 95%CI 1.05 -1.84), non-obese (aOR 2.14, 95%CI 1.52-3.02) and good social support (aOR 1.78, 95%CI 1.30-2.43).Conclusion: A minority of public servants in this study have SA. Employers in various agencies should play roles in promoting SA aiming for healthy behaviours and providing healthy working environments.
Article The Burden of Esophageal Cancer in China From 2013 to 2030 A Dynamic Cohort Modeling Study
Authors: LI Yuanyuan , Xu Junfang , Gu Yuxuan , Zhen Xuemei , Hu Xiaoqian , Sun Xueshan , Dong Hengjin
Published: March 2020

Background: This study aimed to predict the disease burden of esophageal cancer (EC) over the period 2013-2030 in China. Methods : A dynamic cohort Markov model was developed to simulate the EC prevalence, disability-adjusted life years (DALY), and the medical direct expenditure based on gender. JoinPoint Regression Program was used to calculate the average annual percentage change (AAPC) of EC prevalence and DALY rates, while the regression model was applied to analyze the changing trend of economic burden over time. Results: The predicted DALY rates per 100 000 people increased in both-sex (219.17 - 252.39) and males (302.89 – 384.31), while it decreased in females (131.21- 115.91). The years of life lost (YLL) accounted for the majority of DALYs. The AAPC were 0.8%(95% CI, 0.8%-0.9%), 1.4%(95% CI, 1.3%- 1.5%), and -0.7%(95% CI, -0.8%- -0.7%) in both-sex, males and females, respectively. The medical direct expenditure in both-sex, males, and females was predicted to increase by 165.35%, 194.04%, and 94.20%, respectively. Conclusions: EC still caused a severe burden on society. YLL was responsible for the majority of the DALYs, which highly suggesting the implementation of accurate prevention like screening and early diagnosis and treatment programs.
Mapping priority neighborhoods: A novel approach to cluster identification in HIV/AIDS population
Authors: Jagadesh Soushieta , Combe Marine , Couppié Pierre , Gozlan Rodolphe Elie , Nacher Mathieu
Published: March 2020

BackgroundUrban disadvantaged neighborhoods have higher HIV risk behavior and higher levels of AIDS-related mortality. Studies demonstrate that interventions at the community level focusing on risk groups have increased success rates than individual patient-based based management in the context of HIV/AIDS. We tested a novel approach to identify population groups in need of greater public health efforts to achieve UNAIDS 90-90-90.MethodsWe extracted retrospective data on 2141 HIV/AIDS patients, recruited from 1997-2017 in the regional hospitals in French Guiana. Self-organizing maps were constructed and clusters were identified based on demographic and socioeconomic variables such as age, sex, CD4 counts at Nadir, type of neighborhood, unemployment rate, and presence of opportunistic illness such as Histoplasmosis and Hepatitis B in the sample population.ResultsNeighborhood unemployment rates were identified to have a large impact in the distribution of HIV/AIDS. Also, the risk of disseminated histoplasmosis, the most common AIDS-defining illness in French Guiana, was not associated to any particular neighborhood suggesting that urban socioeconomic features are not the primary drivers of exposure risk.ConclusionSocioeconomically disadvantaged neighborhoods remain hotspots for HIV/AIDS. We conclude that SOM is an effective tool in the identification of risk clusters that may guide public health efforts to optimize HIV prevention and testing in French Guiana and other developing countries.
The need of close monitor of the patients infected with the 2019 novel coronavirus (SARS-Cov-2) in one designated medical institutions in Chengdu: a single-center, retrospective, observational study
Authors: Zhou Gui , Tan Yun-Hui , Lu Yi-Xiao , Luo Jiang-Cuo , Feng Jing , Li Juan , Yang Yun-Mei , Chen Long , Zhang Jianping
Published: March 2020

Objective: To study the clinical characteristics of COVID-19 patients in one designated medical institutions in Chengdu. Methods: 20 patients admitted to one hospital in designated medical institutions in Chengdu with laboratory confirmed SARS-Cov-2 infection. Data were collected from 26 January 2020 to 1 March 2020. Clinical data were collected using Self-constructed questionnaire refer to World health organization nCoV CASE RECORDFORM Version 1.2 28JAN2020. If information was not clear, The team will review the original data from the designated computer. Results: Of the 20 COVID-19 infected patients studied (median age 42.5 years), 4 patients became severe sick and one was critical deteriorated in the process of treatment, they were later transferred to the superior medical institutions for treatment. This patient died after admitted to the intensive care unit (ICU). The other two mild patients remained positive for pharyngeal swabs of SARS-Cov-2 more than 3 weeks, so they were quarantined in a medical facility without medication. All studied cases were infected by human to human transmission without taking protective measures. It requires further confirmation of transmission through contact within families. The most common symptoms at onset of illness were fever in 13 (65%) patients, cough in 9 (45%), headache in 3 (15%), fatigue in 6 (30%), diarrhoea in 3 (15%), and Abdominal pain in 2 (10%). Six patients (30%) developed shortness of breath on admission. The median time from exposure to onset of illness was 6.5 days (interquartile range 3.25-9 days), and from the onset of symptoms to first hospital admission was 3.5(1.25-7) days. Conclusion: Up to the end of February 2020, compared with patients initially infected with SARS-Cov-2 in Wuhan, the symptoms of patients in this study was relatively mild and the patients are easily cured and discharged from hospital. the patients with mild symptoms of COVID-19 is general type of patients infected with SARS-Cov-2 in China. However, The COVID-19 is a self-limiting disease with no effective drug to treat it, it is important to detect and identify severe cases from mild cases early.