bluuebunny/crossref_metadata_2025 huggingface dataset:
Inverse Correlation between CD4+CD25HighCD127low/− Regulatory T-Cells and Serum Immunoglobulin A in Patients with New-Onset Ankylosing Spondylitis
Authors: Zhao S-S , Hu J-W , Wang J , Lou X-J , Zhou L-L
Published: February 2013

This study investigated the role of regulatory T (Treg) cells in patients with new-onset, treatment-naïve ankylosing spondylitis (AS). Levels of CD4+CD25highCD127low/- Treg cells in the peripheral blood of 14 AS patients and 18 age-matched healthy volunteers were investigated by flow cytometry and correlations with serum levels of immunoglobulin A (IgA) and AS activity, as assessed by the Bath AS Disease Activity Index (BASDAI), were analysed. The number of peripheral blood CD4+CD25highCD127low/- Treg cells in AS patients was found to be significantly lower than in healthy controls and was inversely correlated with serum IgA levels. There was no significant correlation between CD4+CD25highCD127low/- Treg cell numbers and BASDAI scores. It is concluded that CD4+CD25highCD127low/-Treg cells may play a role in the pathogenesis and activity of AS.
Solitary Intracranial Rosai-Dorfman Disease: Case Report and Literature Review
Authors: Cao XY , Luan SH , Bao WM , Shen C , Yang BJ
Published: February 2013

Rosai-Dorfman disease is a well-established autoimmune histioproliferative disorder, and solitary central nervous system involvement is rare. A 35-year-old man presented with headache and transient blurred vision of 4 months' duration and weakness of the left extremities for 1 month. He had left temporal hemianopsia, a right nasal visual field defect of the upper medial quadrant and decreased muscle strength of the left extremities. Magnetic resonance imaging (MRI) showed a contrast-enhancing tentorium-based lesion in the right trigone, intruding into the right lateral ventricle. The lesion was totally resected. Rosai-Dorfman disease was confirmed pathologically by an inflammatory infiltrate in the absence of an infectious agent, emperipolesis and positive S100 staining. From a review of the literature on Rosai-Dorfman disease in the central nervous system it is concluded that follow-up MRI should be performed in order to detect possible recurrence and that this rare entity should be considered in the differential diagnosis of intracranial lesions.
Corticotropin-Releasing Hormone Enhances the Invasiveness and Migration of Ishikawa Cells, Possibly by Increasing Matrix Metalloproteinase-2 and Matrix Metalloproteinase-9
Authors: Jo YH , Choi YJ , Kim HO , Yoon KS , Lee BY , Jung MH , Huh CY
Published: February 2013

Corticotropin-releasing hormone (CRH), synthesized in the hypothalamus, is also produced at several extrahypothalamic sites and in normal endometrial cells. CRH exerts antiproliferative activity on oestrogen-dependent tumour cell lines (Ishikawa cells and breast cancer cells) via the CRH receptor-1. This study investigated the potential role of CRH as a factor affecting endometrial migration and invasion in Ishikawa cells, and the possible mechanisms involved in this process. Increasing concentrations of CRH (1, 10 and 100 nM) significantly reduced the proliferation of Ishikawa cells but increased the invasiveness these cells compared with the control group. All three concentrations of CRH significantly increased matrix metalloproteinase (MMP)-2 and MMP-9 levels in Ishikawa cells. In conclusion, CRH inhibited the growth of Ishikawa cells but enhanced their invasiveness, possibly by increasing MMP-2 and MMP-9 levels. These findings suggest that CRH might induce invasion and migration by upregulating MMP-2 and MMP-9 in endometrial cancer.
Large Intervening Non-Coding RNA HOTAIR is Associated with Hepatocellular Carcinoma Progression
Authors: Geng YJ , Xie SL , Li Q , Ma J , Wang GY
Published: February 2013

Increasing evidence suggests that large intervening non-coding RNAs (lincRNAs) regulate key pathways in cancer invasion and metastasis. In this observational retrospective study, the expression of the oncogenic lincRNA HOX transcript antisense RNA (HOTAIR) gene was measured in 63 patients with hepatocellular carcinoma (HCC) following hepatic resection. The HOTAIR gene was significantly overexpressed in HCC tissues compared with adjacent non-tumour tissues. Patients with high HOTAIR gene expression in their tumours had an increased risk of recurrence after hepatectomy. There was also a significant correlation between HOTAIR expression and lymph node metastasis. In vitro assays in the HCC cell line Bel7402 demonstrated that knockdown of HOTAIR lincRNA reduced cell proliferation and was associated with reductions in levels of matrix metalloproteinase-9 and vascular endothelial growth factor protein, which are important for cell motility and metastasis. In conclusion, HOTAIR lincRNA might be a potential biomarker for the existence of lymph node metastasis in HCC.
Involvement of Nuclear Factor κB (NF-κB) in the Downregulation of Cyclo-Oxygenase-2 (COX-2) by Genistein in Gastric Cancer Cells
Authors: Li Y-S , Wu L-P , Li K-B , Liu Y-P , Xiang R , Zhang S-B , Zhu L-Y , Zhang L-Y
Published: February 2013

Genistein induces growth inhibition in various human cancer cell lines but its mechanism of action remains unknown. This study determined whether the effect of genistein is mediated via suppression of cyclo-oxygenase (COX)-2 protein, and elucidated the mechanism of action of this effect in the human gastric cancer cell line BGC-823. Genistein treatment inhibited cell proliferation and induced apoptosis in a dose- and time-dependent manner; Western blotting analysis indicated a significant dose-dependent decrease in COX-2 protein levels. Genistein treatment exerted a significant inhibitory effect on activation of the transcription factor nuclear factor κB (NF-κB). Additionally, the NF-κB inhibitor pyrrolidine dithiocarbamate caused a reduction in COX-2 protein levels and NF-κB activation, similar to the effect of genistein. Suppression of COX-2 protein may be important for the antiproliferative and proapoptotic effects of genistein in BGC-823 cells, and these effects may be partly mediated through the NF-κB pathway.
Reduction of Microemulsion Propofol-Induced Injection Pain via Target-Controlled Remifentanil Infusion
Authors: Chae Y-J , Min S-K , Park S-K , Kim S-M , Won Y-J , Cho H-B
Published: February 2013

The intravenous injection of microemulsion propofol to induce anaesthesia causes more intense and frequent pain than lipid emulsion propofol. This study investigated whether different target effect-site concentrations of remifentanil could prevent pain due to microemulsion propofol injection. In total, 96 patients were randomly assigned to one of three groups receiving target effect-site concentrations of remifentanil 0 (control group), 4 or 6 ng/ml, followed by injection with microemulsion propofol. Remifentanil pretreatment significantly reduced the incidence and severity of injection pain compared with the control group. Although no difference in pain reduction between the two remifentanil-treated groups was observed, those receiving a target effect-site concentration of 6 ng/ml exhibited an increased rate of complications, compared with those receiving 4 ng/ml. In conclusion, prior administration of remifentanil at a target effect-site concentration of 4 ng/ml is a useful strategy to decrease the injection pain of microemulsion propofol.
Imbalance of Interleukin-18 and Interleukin-18 Binding Protein in Children with Henoch-Schönlein Purpura
Authors: Wang YB , Shan NN , Chen O , Gao Y , Zou X , Wei DE , Wang CX , Zhang Y
Published: February 2013

The balance between interleukin-18 (IL-18) and its endogenous antagonist, IL-18 binding protein (IL-18BP), was evaluated in children with Henoch-Schönlein purpura (HSP). Plasma IL-18 and IL-18BP levels and peripheral blood mononuclear cell IL-18 mRNA expression were significantly higher in patients with active HSP ( n = 30) than in healthy controls ( n = 20); IL-18BP mRNA expression was similar in active HSP and controls. Plasma levels and mRNA expression of IL-18 and IL-18BP in patients in remission ( n = 19) were similar to those in controls. The ratios of IL-18 / IL-18BP plasma levels and IL-18 / IL-18BP mRNA levels in active HSP were significantly higher than in patients in remission and healthy controls. Thus, adequate IL-18BP to block the proinflammatory activity of IL-18 may not be present in active HSP and regulation of the IL-18 / IL-18BP balance might provide a potential therapeutic strategy.
The Influence of Dietary Carbohydrate Content on Glycaemia in Patients with Glucokinase Maturity-Onset Diabetes of the Young
Authors: Klupa T , Solecka I , Nowak N , Szopa M , Kiec-Wilk B , Skupien J , Trybul I , Matejko B , Mlynarski W , Malecki MT
Published: February 2013

Mutations in the glucokinase ( GCK) gene result in maturity-onset diabetes of the young (MODY). Pharmacotherapy is not effective in GCK MODY. Thus, nutritional intervention seems to be the only therapeutic option. This study evaluated the effect of the quantity of dietary carbohydrate on glucose levels in 10 GCK mutation carriers: seven with MODY and three with prediabetes. All patients were exposed to high-carbohydrate diets for 2 days and then switched to low-carbohydrate diets (60% versus 25% of the daily calorie intake) for another 2 days, after a 1-day washout. Glucose levels were assessed by continuous blood glucose monitoring. In patients with GCK MODY on high-carbohydrate diets, glucose levels were significantly higher, and more hyperglycaemic episodes occurred, compared with patients on low-carbohydrate diets. This short-term observational study suggested that diets with a modestly limited carbohydrate content may improve glycaemic control in patients with GCK MODY.
Elevated Levels of Immunoglobulin E May Indicate Steroid Resistance or Relapse in Adult Primary Nephrotic Syndrome, Especially in Minimal Change Nephrotic Syndrome
Authors: Tan Y , Yang D , Fan J , Chen Y
Published: February 2013

Immunoglobulin E (IgE) antibodies may play a role in the development of kidney diseases that are related to hypersensitivity reactions. Patients with idiopathic nephrotic syndrome often exhibit increased serum IgE levels and this may be related to sensitivity to steroid treatment. In the present study, the serum IgE levels in 120 patients with different types of primary nephrotic syndrome (PNS) were analysed and found to be significantly elevated in cases of minimal change nephrotic syndrome (MCNS) compared with membranous nephropathy or membranoproliferative glomerulonephritis. No difference in serum IgE level was observed between cases of steroid-sensitive nephrotic syndrome (SSNS) or steroid-resistant nephrotic syndrome, although the serum IgE level was significantly elevated in SSNS patients in relapse compared with SSNS patients in remission. In MCNS patients, 73.6% exhibited SSNS regardless of their serum IgE level at diagnosis. It is concluded that elevated levels of IgE may be a feature of steroid resistance or relapse, indicating prognostic significance in adult PNS, particularly in MCNS.
The Influence of Obesity on Postoperative Inflammatory Cytokine Levels
Authors: Chung M-Y , Hong S-J , Lee J-Y
Published: February 2013

Obesity is a chronic inflammatory state and adipose tissue serves as a source of inflammatory mediators. This study compared plasma levels of the proinflammatory cytokines interleukin-6 (IL-6) and tumour necrosis factor-α (TNF-α) in 20 morbidly obese patients (group O) undergoing laparoscopic Roux-en-Y gastric bypass surgery and in 20 non-obese control patients (group C) undergoing laparascopic gastrectomy. Blood was sampled preoperatively and at 3 and 24 h postoperatively. Postoperative IL-6 levels increased significantly in both groups, but were significantly lower in group O than in group C. Age- and anaesthetic time-adjusted IL-6 levels showed a significant increase at 24 h postoperatively compared with preoperative values in both groups; changes were significantly greater in group C. TNF-α levels did not change significantly over time, but were significantly lower in group O at 3 h postoperatively compared with group C. In conclusion, postoperative changes in IL-6 and TNF-α levels in morbidly obese patients were lower than in non-obese patients. Adipose tissue appears not to contribute to the acute postoperative inflammatory response.
Use of Laryngeal Mask Airway and Its Removal in a Deeply Anaesthetized State Reduces Emergence Agitation after Sevoflurane Anaesthesia in Children
Authors: Lee YC , Kim JM , Ko HB , Lee SR
Published: February 2013

This study investigated the effect of laryngeal mask airway (LMA) and removal while in a deeply anaesthetized state (deep removal) compared with endotracheal tube and extubation when awake or deeply anaesthetized on the incidence of emergence agitation in children after sevoflurane anaesthesia for subumbilical surgery. Patients (2 – 7 years) were randomly assigned to one of three groups: ET-A group ( n = 56, endotracheal tube and extubation whilst awake); ET-D group ( n = 56, endotracheal tube and deep extubation); LMA-D group (n = 56, experienced LMA and deep removal). The incidence of postoperative emergence agitation was significantly lower in the LMA-D patients compared with patients in the ET-A group (21.4% and 41.1%, respectively). Patients in the LMA-D group required a significantly shorter stay in the postanaesthetic care unit (PACU) than ET-A patients. There were no significant differences in the incidence of postoperative emergence agitation or length of stay in the PACU between the ETA and ET-D groups, or between the ET-D and LMA-D groups. In conclusion, using an LMA and deep removal decreased postoperative emergence agitation compared with using an endotracheal tube and awake extubation after paediatric sevoflurane anaesthesia.
Efficacy and Safety of Angiotensin II Type 1 Receptor Blocker/Calcium Channel Blocker Combination Therapy for Hypertension: Focus on a Single-Pill Fixed-Dose Combination of Valsartan and Amlodipine
Authors: Miura S , Saku K
Published: February 2013

Adequate lowering of blood pressure reduces the risk of hypertension-induced cardiovascular events. Worldwide, blood pressure is not optimally controlled and more effective management is needed. The efficacy and tolerability of angiotensin II type 1 receptor blockers (ARBs) have led to their widespread use. Calcium channel blockers (CCBs) are highly effective antihypertensives and amlodipine has a long half-life in the circulation. The combination of an ARB with a CCB as a single-pill, fixed-dose treatment is emerging as possibly the best therapy for preventing cardiovascular disease. Although many kinds of ARB are used in such combinations, amlodipine is mainly used as the CCB. Thus, differences in safety and efficacy among single-pill ARB/CCBs depend mainly on the ARB. Not all ARBs have the same effects and some of these may be molecular (or differential) rather than class (or common) effects. This review discusses the safety and efficacy of ARB/CCB combination therapy, with particular focus on a single-pill, fixed-dose combination of valsartan/amlodipine.
Anaemia and Prognosis in Acute Coronary Syndromes: A Systematic Review and Meta-Analysis
Authors: Liu Y , Yang YM , Zhu J , Tan HQ , Liang Y , Li JD
Published: February 2013

OBJECTIVE: This meta-analysis was conducted to summarize the association between anaemia and outcomes in patients with acute coronary syndromes (ACS). METHODS: MEDLINE®, Cochrane Library, OVID and EMBASE databases were searched to identify studies that examined the effect of anaemia on mortality or other adverse events (heart failure, cardiogenic shock or major bleeding). RESULTS: Nineteen studies met the final inclusion criteria (total number of patients 241 293). The risks of short-term mortality (odds ratio [OR] 2.77; 95% confidence interval [CI] 2.09, 3.65), long-term mortality (OR 2.03; 95% CI 1.52, 2.71), heart failure (OR 1.96; 95% CI 1.47, 2.62), cardiogenic shock (OR 1.95; 95% CI 1.04, 2.64) and major bleeding (OR 4.28; 95% CI 1.05, 17.14) were increased in patients with anaemia, compared with patients without anaemia. Anaemia was also associated with a higher risk of mortality (adjusted hazard ratio 1.49, 95% CI 1.24, 1.79). CONCLUSIONS: These study findings suggest that anaemia can be used to identify patients with ACS who are at a high risk of death or adverse events, and it may become a promising risk stratification factor in ACS.
Vaporized Perfluorocarbon Confers Protection against Acute Lung Injury by Inhibiting MMP-9 Expression without Protective Effects in other Organs
Authors: Han B , Zhao X , Huang X , Xie L
Published: February 2013

OBJECTIVE: Vaporized perfluorocarbon (PFC) is a treatment for lung injury; this study investigated its mode of action and potential protective effects on other organs, which are unclear. METHODS: Acute lung injury was induced by lung lavage with artificial seawater in 32 female New Zealand White rabbits. Animals received either conventional mechanical ventilation (CMV), positive end-expiratory pressure under CMV (PEEP), vaporized PFC ventilation, or positive end-expiratory pressure with vaporized PFC ventilation (PEEP + PFC). Histopathology of the lung, small intestine, liver and kidney were investigated. Matrix metalloproteinase (MMP)-9 mRNA levels in the lung were analysed. RESULTS: Pathological injury of the lung was significantly alleviated in the PEEP, PFC and PEEP + PFC groups compared with the CMV group. Tissue damage in the liver, kidney and small intestine was similar between all groups. MMP-9 mRNA levels in the PEEP, PFC and PEEP + PFC groups were significantly lower than those in the CMV group. CONCLUSIONS: Vaporized PFC ventilation can significantly alleviate lung injury but has no significant protective effect on other organs. Alleviation of lung injury may be associated with MMP-9 inhibition.
Serum Levels of Calcitonin Gene-Related Peptide and Substance P are Decreased in Patients with Diabetes Mellitus and Coronary Artery Disease
Authors: Wang LH , Zhou SX , Li RC , Zheng LR , Zhu JH , Hu SJ , Sun YL
Published: February 2013

OBJECTIVE: This study evaluated serum levels of the neuropeptides calcitonin gene-related peptide (CGRP) and substance P (SP) in coronary artery disease (CAD) patients with and without a history of diabetes mellitus (DM). METHODS: Patients undergoing coronary angiography for suspected myocardial ischaemia were divided into four groups depending on their clinical status: control group (no CAD or DM; n = 44), DM group (DM without CAD; n = 46), CAD group (stable CAD without DM; n = 44) and DM + CAD group (stable CAD with DM; n = 50). Serum levels of CGRP and SP were determined using radioimmunoassays. RESULTS: CGRP and SP levels in the DM and CAD groups were significantly lower than in the control group. The lowest levels of CGRP and SP were observed in the DM + CAD group. There were no significant differences in CGRP and SP levels between the DM group and the CAD group. CONCLUSION: CGRP and SP may have a role in the pathogenesis of CAD in patients with diabetes.
Association of Sterol Regulatory Element-Binding Transcription Factor Gene Polymorphisms with Ischaemic Stroke
Authors: Jin X , Zeng F , Zhang N , Huang T , Meng Q , Liu Y
Published: February 2013

OBJECTIVE: To explore the association between polymorphisms of the sterol regulatory element-binding transcription factor ( SREBF) gene and ischaemic stroke. METHODS: The SREBF1c 54G>C and SREBPF2 1784G>C genotypes were assessed using restriction fragment length polymorphism analysis in 446 Han Chinese ischaemic stroke patients and 355 Han Chinese control subjects without cerebrovascular disease. RESULTS: The frequencies of the SREBF2 1784G>C CC genotype and the C allele were significantly higher in the ischaemic stroke group than in controls. Patients with ischaemic stroke who had the SREBF2 1784G>C CC genotype had significantly lower high-density lipoprotein (HDL) levels, compared with ischaemic stroke patients and control subjects with the GC or GG genotypes. Multivariate logistic regression analysis revealed a significant positive association between SREBF2 1784G>C and ischaemic stroke; an inverse association was observed between HDL level and risk of ischaemic stroke. CONCLUSIONS: The CC genotype of the SREBF2 1784G>C polymorphism was associated with an increased risk of ischaemic stroke, possibly through decreasing the HDL level, which was inversely associated with the risk of ischaemic stroke.
The Diagnostic Value of a Multivariate Logistic Regression Analysis Model with Transvaginal Power Doppler Ultrasonography for the Prediction of Ectopic Pregnancy
Authors: Chen Z-Y , Liu J-H , Liang K , Liang W-X , Ma S-H , Zeng G-J , Xiao S-Y , He J-G
Published: February 2013

OBJECTIVE: A multivariate logistic regression analysis model for predicting ectopic pregnancy in women with pregnancy of unknown location was designed and evaluated clinically. METHODS: Endometrial thickness, symmetry, resonance, pattern of echogenicity, helicine artery blood flow and blood flow resistance index (RI) in 129 patients with suspected early ectopic pregnancy were assessed by transvaginal power Doppler ultrasonography. Variables significant in univariate logistic regression analysis were included in a multivariate predictive logistic regression analysis model. RESULTS: The final predictive model included three factors: endometrial thickness ≤ 9 mm; a multilayered endometrial echogenicity pattern with prominent outer and midline hyperechogenic lines and an inner hypoechogenic region; and visible endometrial arterial blood flow. The area under the receiver operating characteristic curve of the model was 0.980. When RI was > 0.65 and the predictive probability > 0.50, diagnostic accuracy was high. The model correctly diagnosed 52/55 (94.5%) clinically confirmed ectopic pregnancy cases. CONCLUSION: This multivariate predictive logistic regression analysis model has clinical value for the differential diagnosis of early ectopic pregnancy when the pregnancy location is unknown.
The Value of Eliminating Foods According to Food-Specific Immunoglobulin G Antibodies in Irritable Bowel Syndrome with Diarrhoea
Authors: Guo Hong , Jiang Tao , Wang Jinliang , Chang Yongchao , Guo Hai , Zhang Weihong
Published: February 2013

OBJECTIVE: This study investigated the role of food intolerance in irritable bowel syndrome with diarrhoea (D-IBS). METHODS: Specific immunoglobulin G (IgG) antibodies against 14 common food antigens in the serum were measured in 77 patients with D-IBS and 26 healthy controls. Food-specific IgG antibodies were identified in 39 (50.65%) patients with D-IBS patients compared with four (15.38%) controls. For 12 weeks following the serological testing, 35 patients with D-IBS and food intolerance consumed diets that excluded the identified food. Changes in the main symptoms of D-IBS were evaluated before treatment and regularly during treatment in these patients. RESULTS: After 4 weeks' dietary therapy, most symptoms of D-IBS had improved. By 12 weeks, all symptom scores had decreased significantly compared with the baseline scores. CONCLUSIONS: The 12-week specific-food exclusion diets resulted in significant improvements in abdominal pain (bloating level and frequency), diarrhoea frequency, abdominal distension, stool shape, general feelings of distress and total symptom score compared with baseline in patients with D-IBS.
Detection of Breast Lesions using an Automated Breast Volume Scanner System
Authors: Zhang Q , Hu B , Hu B , Li WB
Published: February 2013

OBJECTIVE: This study investigated the clinical utility of an automated breast volume scanner (ABVS) system for the detection of breast lesions. METHODS: The breasts of 81 patients referred for ultrasonographic examination were scanned using the ABVS system and handheld ultrasonography independently by two experienced examiners. The ABVS was used to perform scans of the breast in three directions (anteroposterior, lateral and medial), with the addition of further inferior and superior scans if necessary. The scanning data were then stored and automatically reconstructed. For hand-held ultrasonography the whole breast was scanned radially from the outside to the centre of the nipple. RESULTS: The numbers of lesions reported by the two examiners were 89 and 99, respectively, using the ABVS (not statistically significant), compared with 60 and 85, respectively, using handheld ultrasonography (statistically significant). CONCLUSIONS: The ABVS system is an operator-independent method for automated breast scanning. It detected more breast lesions and provided additional information for the diagnosis of intraductal and malignant lesions compared with hand-held ultrasonography.
Decreased CD27 on B Lymphocytes in Patients with Primary Hepatocellular Carcinoma
Authors: Wang XD , Wang L , Ji FJ , Zhu JM , Ayana DA , Fang XD
Published: February 2013

OBJECTIVES: Hepatitis B virus (HBV) replicates in the liver and can lead to hepatocellular carcinoma (HCC). The B lymphocytes may provide a means for HBV to persist although the mechanism remains unknown. This study aimed to characterize B lymphocyte subset phenotypes and measure levels of B lymphocyte-related cytokines in HCC patients. METHODS: The study population included 38 HCC patients and 30 healthy control subjects. Phenotyping of B lymphocytes was performed by flow cytometry. Serum cytokine levels were measured using a cytometric bead array immunoassay. RESULTS: The ratio of naïve (CD29+CD27−) to memory (CD19+CD27+) B lymphocytes was significantly higher in HCC patients compared with healthy controls. The percentage of memory B lymphocytes decreased with the progression of HCC. Levels of interleukin (IL)-6 and IL-10 were significantly increased in HCC patients compared with healthy controls. CONCLUSIONS: The depletion of memory B lymphocytes may contribute to unresponsiveness to HBV or to HCC. This humoral defect might be related to raised production of IL-6 and IL-10.
Preoperative Lanreotide Treatment Improves Outcome in Patients with Acromegaly Resulting from Invasive Pituitary Macroadenoma
Authors: Li Z-Q , Quan Z , Tian H-L , Cheng M
Published: February 2013

OBJECTIVE: To investigate whether 3 months' preoperative treatment with lanreotide improved outcome in newly diagnosed patients with acromegaly resulting from invasive pituitary macroadenoma. METHODS: After baseline evaluation, untreated patients were randomized to undergo direct trans-sphenoidal surgery or lanreotide treatment (30 mg via intramuscular injection every 2 weeks, increased to 30 mg/week at week 8 if growth hormone nadir > 2.5 μg/l), for 3 months prior to surgery. Tumour shrinkage following lanreotide treatment was analysed. Cure was evaluated at 3 months postsurgery by measuring growth hormone and insulinlike growth factor-1 (IGF-1) levels. RESULTS: Preoperative lanreotide treatment significantly reduced mean tumour size. Growth hormone and IGF-1 levels were lower in the pretreatment group than in the direct surgery group at 3 months postsurgery. According to combined growth hormone and IGF-1 levels, significantly more patients were cured by trans-sphenoidal surgery in the pretreatment group compared with the direct surgery group (11 of 24 and five of 25 patients, respectively). CONCLUSIONS: Lanreotide treatment for 3 months before trans-sphenoidal surgery effectively reduced tumour size, and improved surgical cure rate, in newly diagnosed patients with acromegaly resulting from invasive pituitary macroadenoma.
Adipocytokines and Insulin Resistance across Various Degrees of Glucose Tolerance in Pregnancy
Authors: Skvarca A , Tomazic M , Krhin B , Blagus R , Janez A
Published: February 2013

OBJECTIVE: Gestational diabetes mellitus is characterized by progressive insulin resistance. Adipocytokines are thought to be associated with insulin resistance. This cross-sectional study evaluated the associations between serum concentrations of several adipocytokines and insulin resistance at different stages of glucose tolerance in pregnancy, using the homeostasis model assessment of insulin resistance (HOMA-IR) as a reference. METHODS: According to oral glucose tolerance test results, 74 pregnant women were divided into three groups: normal glucose tolerance ( n = 25); intermediate glucose tolerance ( n = 19); gestational diabetes mellitus ( n = 30). Adiponectin, leptin, resistin, visfatin and retinol-binding protein 4 (RBP4) concentrations were measured using enzyme-linked immunosorbent assays. RESULTS: Groups were comparable regarding age, week of gestation and body mass index before gestation. There were statistically significant between-group differences in HOMA-IR, but no significant differences regarding serum adipocytokine concentrations. CONCLUSIONS: Adiponectin, leptin, resistin, visfatin and RBP4 were not associated with the degree of glucose tolerance in pregnancy. Concentrations of these adipocytokines are not sufficiently sensitive to replace HOMA-IR in pregnancy.
Prevalence of the Metabolic Syndrome in the Yan-an Region of Northwest China
Authors: Li S-L , Yang Q , Lv S-Y , Zhang Y-L , Zhang J-A
Published: February 2013

OBJECTIVES: To evaluate the prevalence of the metabolic syndrome in a sample population from northwest China, and to determine the optimal cut-off point for waist circumference for diagnosing the metabolic syndrome in this population. METHODS: A total of 1290 residents of the Yan-an region of China completed a cross-sectional survey, physical examination and laboratory tests. The International Diabetes Federation (IDF), Chinese Diabetes Society (CDS), and the National Cholesterol Education Program Adults Treatment Panel-III (NCEP—ATPIII) criteria were used to assess the prevalence of the metabolic syndrome and its relationship with age and gender. RESULTS: According to the NCEP—ATPIII, CDS and IDF diagnostic criteria, the prevalence of the metabolic syndrome was 15.8%, 20.4% and 26.4%, respectively. The optimal cut-off point for waist circumference was ≥ 86.5 cm for men and ≥ 80.5 cm for women. CONCLUSIONS: The prevalence of the metabolic syndrome in the Yan-an region was significantly higher than that in other regions of China, and participants with the metabolic syndrome were much younger than those in other Chinese regions.
H-Reflex and Clinical Examination in the Diagnosis of Diabetic Polyneuropathy
Authors: Millán-Guerrero RO , Trujillo-Hernández B , Isais-Millán S , Prieto-Díaz-Chávez E , Vásquez C , Caballero-Hoyos JR , García-Magaña J
Published: February 2013

OBJECTIVES: To determine among adult patients with type-2 diabetes mellitus the proportion diagnosed with diabetic polyneuropathy (DPN) by clinical evaluation and by the Hoffmann reflex (H-reflex). In addition, the predictive value of the H-reflex in the diagnosis of DPN was evaluated. METHODS: Studies were carried out on 150 adult patients referred for neuropathy screening. Diagnostic criteria for DPN were at least two abnormalities in clinical neurophysiological examinations and electrophysiological testing (H-reflex and nerve conduction velocity). Logistic regression analysis was performed to identify unique contributions of study characteristics to positive versus negative outcomes. RESULTS: H-reflex was absent in 39.3% (59/150) and latency was prolonged in 43.3% (65/150) of patients. Ulnar nerve motor branch nerve conduction showed prolonged latency in 9.3% (14/150) of patients. Logistic regression analysis indicated that the H-reflex was significantly associated with positive outcomes. CONCLUSION: The H-reflex could have a predictive value in DPN, providing more quantitative information regarding diagnosis than conventional nerve conduction studies.
Stem Cell Transplantation in Cardiovascular Disease: An Update
Authors: Teng M , Geng Z , Huang L , Zhao X
Published: February 2013

Despite the development of novel therapeutic strategies, cardiovascular diseases remain the main cause of morbidity and mortality worldwide. Many phase 1 and 2 clinical trials have reported the safety, feasibility and promising potential of stem cell transplantation, however, the optimal cell types, timing of infusion, cell dosage and routes of administration remain to be determined. This paper reviews the findings of various clinical studies and discusses the challenges facing the delivery of stem cell therapy in cardiovascular diseases.
Association between Lysyl Oxidase G473A Polymorphism and Ovarian Cancer in the Han Chinese Population
Authors: Wang X , Cong J-L , Qu L-Y , Jiang L , Wang Y
Published: February 2013

OBJECTIVE: Lysyl oxidase (LOX) is an extracellular enzyme critical for the cross-linking of collagens and elastin. A single-nucleotide polymorphism of LOX G473A is associated with various diseases. This retrospective study investigated the association between LOX G473A polymorphism and susceptibility to ovarian cancer in the Han Chinese population. METHODS: The LOX variant G473A was detected by polymerase chain reaction—restriction fragment length polymorphism in patients with ovarian cancer and healthy control subjects. RESULTS: The frequencies of the LOX 473AA genotype and the A allele were significantly higher in patients with ovarian cancer ( n = 318) than in control subjects ( n = 406) (odds ratio [OR] 2.30, 95% confidence interval [CI] 1.36, 3.87; OR 1.57, 95% CI 1.23, 2.00; respectively). The prevalence of the GA genotype, AA genotype and A allele were significantly higher in patients with more advanced stages of ovarian cancer compared with those with primary stage disease. CONCLUSIONS: This study suggests that LOX G473A polymorphism is a new risk factor for ovarian cancer and that LOX protein might be a possible therapeutic target in ovarian cancer.
Prediction of Outcome in Critically Ill Elderly Patients using APACHE II and SOFA Scores
Authors: Qiao Q , Lu G , Li M , Shen Y , Xu D
Published: February 2013

OBJECTIVE: Performances of the Acute Physiology and Chronic Health Evaluation II (APACHE II) score and the Sequential Organ Failure Assessment (SOFA) score were assessed in predicting mortality outcome in critically ill elderly patients. METHODS: Mean APACHE II and SOFA scores were compared in 106 intensive care unit patients aged > 65 years classified as survivors or deaths. The discriminatory ability of the scores was evaluated using the area under the receiver operating characteristic (ROC) curve. Calibration was assessed using the Hosmer—Lemeshow test. RESULTS: Mean APACHE II and SOFA scores in survivors were lower than in those who died. There was a positive correlation between the APACHE II and SOFA scores. The area under the ROC curve was 0.76 for the APACHE II score and ranged from 0.74 for the initial SOFA score to 0.98 for the maximum SOFA score. Hosmer—Lemeshow values for the APACHE II score and various SOFA scores indicated that predictions based on these scores closely fit the observed outcomes. CONCLUSIONS: APACHE II and SOFA scores can accurately predict mortality outcome in critically ill elderly patients, especially the maximum SOFA score and the difference between the maximum and initial SOFA scores.
Arg555Gln Mutation of TGFBI Gene in Geographical-Type Reis—Bücklers Corneal Dystrophy in a Chinese Family
Authors: Piao Mz , Zhou Xt , Wu Lc , Chu Ry
Published: February 2013

OBJECTIVE: Mutations of the transforming growth factor β-induced ( TGFBI) gene were studied in a Chinese family with Reis—Bücklers corneal dystrophy (RBCD). METHODS: Six family members with RBCD and six unaffected family members were investigated. The pedigree showed a typical dominant inheritance pattern. Genomic DNA was extracted from peripheral leucocytes from all study participants. Exons 4, 12 and 14 of the TGFBI gene were analysed using polymerase chain reaction, and standard automated sequencing was performed. Corneal tissue sampled from the proband during phototherapeutic keratectomy was examined using transmission electron microscopy (TEM). RESULTS: A typical geographical pattern of fine opacities in Bowman's layer of the cornea was seen in all six patients on slit-lamp examination. An Arg555Gln (R555Q) mutation of the TGFBI gene was identified in all six patients but was absent in all unaffected family members. TEM revealed rod-shaped bodies in Bowman's layer of the cornea. CONCLUSIONS: In this Chinese family an R555Q mutation of the TGFBI gene was associated with RBCD. As the RBCD phenotype is usually associated with an R124L mutation, this novel genotype—phenotype correlation may prompt further investigation of Bowman's layer corneal dystrophy.
Evaluation of Stroke Volume Variation Obtained by the FloTrac™/Vigileo™ System to Guide Preoperative Fluid Therapy in Patients Undergoing Brain Surgery
Authors: Li J , Ji Fh , Yang Jp
Published: February 2013

OBJECTIVE: The accuracy of stroke volume variation (SVV) obtained by the FloTrac™/Vigileo™ system in otherwise healthy patients undergoing brain surgery was assessed. METHODS: Anaesthesia was induced in 48 patients with minimal fluid infusion. Before surgery, fluid volume loading was performed by infusion with Ringer's lactate solution in 200 ml steps over 3 min, repeated successively if the patient responded with an increase in stroke volume of ≥ 10%, until the increase was < 10% (nonresponsive). RESULTS: A total of 157 volume loading steps were performed in the 48 patients. Responsive and nonresponsive steps differed significantly in baseline values of blood pressure, heart rate and SVV. Significant correlations were found between the change in stroke volume after fluid loading and values of blood pressure, heart rate and SVV before fluid loading, with SVV the most sensitive variable. CONCLUSION: Stroke volume variation obtained using the FloTrac™/Vigileo™ system is a sensitive predictor of fluid responsiveness in healthy patients before brain surgery.
Expansion and De Novo Occurrence of Y Chromosome Microdeletions Occurring via Natural Vertical Transmission in Northeastern China
Authors: Dai R-L , Sun L-K , Yang X , Li L-L , Zhu H-B , Liu R-Z
Published: February 2013

OBJECTIVE: To determine characteristics of classical and partial deletions of the Y chromosome azoospermia factor (AZF) region transmitted from father to son by natural fertilization. METHODS: Patients from northeastern China with primary male infertility ( n = 10) and their fathers were investigated. Healthy fertile men and women were recruited as positive and negative controls, respectively. The Y chromosome microdeletions were detected by polymerase chain reaction. Serum concentrations of reproductive hormones were determined by electrochemiluminescence immunoassay and enzyme-linked immunosorbent assay. RESULTS: Expansions of microdeletions were observed in seven father-son pairs; de novo microdeletions were found in the remaining three father-son pairs. The Y chromosome microdeletions were larger in sons than in their fathers. Patients with infertility had significantly higher levels of follicle stimulating hormone and lower levels of inhibin B than fertile men. CONCLUSIONS: The Y chromosome micro deletions were transmitted from father to son via natural transmission. These microdeletions may expand during transmission or arise de novo, possibly resulting in reduced fertility.
Development and Feasibility Study of an Algorithm for Intraoperative Goal-Directed Haemodynamic Management in Noncardiac Surgery
Authors: Feldheiser A , Conroy P , Bonomo T , Cox B , Garces T Ruiz , Spies C ,   ON BEHALF OF THE ANAESTHESIA WORKING GROUP OF THE ENHANCED RECOVERY AFTER SURGERY (ERAS®)) SOCIETY
Published: February 2013

This study developed an evidence-based, goal-directed haemodynamic management algorithm to standardize intraoperative haemodynamic therapy. A systematic literature search identified three haemodynamic management goals: stroke volume optimization by fluid therapy; maintenance of a target mean arterial pressure by vasopressor therapy; maintenance of a target cardiac index ≥ 2.5 l/min per m2 by inotropic therapy. The algorithm was adapted to international standards and consensus was reached through a modified Delphi method at international meetings. Implementation of the algorithm into routine intraoperative management in noncardiac surgery was shown to be feasible. Compared with conventional haemodynamic management, use of the algorithm significantly reduced length of hospital stay, requirement for ventilation and incidence of prolonged hospital stay, thereby resulting in reduced hospital costs.
Efficacy and Tolerability of Celecoxib versus Naproxen in Patients with Osteoarthritis of the Knee: A Randomized, Double-Blind, Double-Dummy Trial
Authors: Essex Mn , Bhadra P , Sands Gh
Published: February 2013

OBJECTIVE: To assess the efficacy and tolerability of celecoxib versus naproxen in patients with osteoarthritis (OA) of the knee. METHODS: This 6-month, randomized, double-blind, double-dummy trial was conducted at 47 centres in the USA. Patients with OA of the knee were randomized to receive 200 mg celecoxib orally once daily or 500 mg naproxen orally twice daily. The primary endpoint was defined as a 20% improvement from baseline to 6 months in Western Ontario and McMaster Universities (WOMAC) OA total score. RESULTS: A total of 586 out of 589 randomized patients received at least one dose of celecoxib ( n = 294) or naproxen ( n = 292). The primary endpoint (6-month response rate) was achieved by 52.7% and 49.7% of patients in the celecoxib and naproxen treatment groups, respectively. Significantly fewer discontinuations due to gastrointestinal adverse events occurred in patients receiving celecoxib than in those receiving naproxen (4.1% versus 15.1%, respectively). CONCLUSIONS: Over the 6-month study period, celecoxib provided similar improvements in OA symptoms to naproxen. In addition, celecoxib provided better upper gastrointestinal tolerability than naproxen.
Hemoglobin Decline in Chemotherapy Patients Prior to and after Policy Changes Affecting Use of Erythropoiesis-Stimulating Agents: 2006 – 2009
Authors: Hill Jw , Cong Z , Hess G , McGarvey N , Nordyke Rj
Published: February 2013

OBJECTIVE: Since 2007, the use of erythropoiesis-stimulating agents (ESAs) to treat anemia in cancer patients receiving chemotherapy has been increasingly restricted in the USA. This study assessed hemoglobin (Hb) decline over time among chemotherapy patients. METHODS: Episodes of chemotherapy care were identified in a large US-oncology electronic medical record database; weekly Hb levels were computed in the first 8 weeks. Unadjusted and adjusted proportions of patient-weeks with Hb decline > 1 g/dl (i.e. representing clinically significant decline) within 1 or 2 weeks were analyzed. RESULTS: Between 2006 and 2009, unadjusted proportions of patient-weeks with Hb decline > 1 g/dl increased (1-week, from 12.7% to 14.9%; 2-week, from 19.3% to 26.3%). Adjusted 1-week proportions in 2007 were similar to 2006, but increased in 2008 (odds ratio [OR] 1.135; 95% confidence intervals [CI] 1.067, 1.208) and in 2009 (OR 1.235; 95% CI 1.094, 1.395). Adjusted 2-week proportions had the same pattern. CONCLUSIONS: Since restrictions on ESA use were introduced in the USA, more patients have experienced a clinically significant Hb decline after chemotherapy initiation. Initiating anemia therapy at the earliest indicated opportunity may help reduce the risk of such declines.
Detection of KRAS Mutations and Their Associations with Clinicopathological Features and Survival in Chinese Colorectal Cancer Patients
Authors: Li Z , Chen Y , Wang D , Wang G , He L , Suo J
Published: February 2013

OBJECTIVE: Mutation of the KRAS (v-Ki-ras2 Kirsten rat sarcoma viral oncogene homologue) gene plays an important role in colorectal tumorigenesis. This study examined associations between KRAS gene mutations and clinicopathological and survival data in Chinese patients with colorectal cancer (CRC). METHODS: CRC patients were recruited for the detection of KRAS gene mutations using polymerase chain reaction and DNA sequencing. Data on clinicopathological features and survival times were collected. RESULTS: The study included 78 CRC patients. The overall mutation frequency of the KRAS gene at codons 12 and 13 was 33.3% (26/78). KRAS gene mutations were significantly associated with poor tumour differentiation and liver metastasis. Patients with the wild-type KRAS gene had significantly higher median survival times than patients with KRAS gene mutations (35.05 months versus 25.72 months). Those with KRAS gene mutations at codons 12 or 13 did not have significantly different median survival times (25.69 months versus 20.67 months, respectively). CONCLUSIONS: These findings suggest that a high frequency of KRAS gene mutations exists in Chinese patients with CRC, and that such mutations are associated with poor survival, tumour differentiation and liver metastasis in CRC patients.
Geography in school and a curriculum of survival
Authors: Lambert David
Published: February 2013

The economic and environmental crises that face humanity today require an educational response. This article accepts the proposition that education may play a part in preparing human beings to survive impacts of human-induced climate change for example. However, education, according to some conceptualizations, is also in crisis. It therefore appears far from clear what a ‘curriculum of survival’ consists of. This article adopts a sceptical viewpoint on education for sustainability. Rather than be concerned with ever tighter definitions of what this may mean, or prescriptions of more effective practices, it turns its gaze towards what is there already – the imperfect but long-standing idea and disciplinary enquiry called geography. Geography as the ‘world subject’ is of great salience. It is about human occupation of the planet and has always ultimately been concerned with survival. This article explores the two ideas of geography and education, and appeals for a re-assessment of the role of the ‘traditional’ disciplines, especially geography, in a curriculum of survival.
U.S. Policies for School Health Education
Authors: Tappe Marlene K. , Galer-Unti Regina
Published: February 2013

Children in K–12 settings comprise roughly one fifth of the population of the United States and are a cohort that has long drawn the interest of health educators. Early education and prevention efforts reduce human suffering, contribute to preparation for classroom learning, affect long-term health, and contain health costs due to preventable diseases. Despite the possible positive impact of a comprehensive approach, no broad-based federal legislation mandates regular school health education. Instead, the current state of school health education policy is a cobbled-together set of policies subsumed under existing laws. The purpose of this article is to provide information about the key legislation that is being used to promote school health education in the United States. Furthermore, the authors suggest opportunities for lobbying for the continuance of existing legislation and advocating for state and local operationalization of these policies. Finally, health educators are rallied to consider raising the issue of advocating for a more complete legislative strategy for school health education.
Confronting the Political Assault Day After Day
Authors: Pelias Ronald J.
Published: February 2013

In this brief essay, I describe the right-wiheadingng agenda that comes forward day after day, comes forward as a political assault. Isolating just five arbitrary days, I specify what I see as problematic claims by the right wing and offer alternative counter-narratives. I end by identifying actions I feel I should take to speak back to their agenda.