bluuebunny/crossref_metadata_2025 huggingface dataset:
Inactivation of Smad4 is a prognostic factor in intrahepatic cholangiocarcinoma
Authors: YAN Xue-qiang , ZHANG Wei , ZHANG Bi-xiang , LIANG Hui-fang , ZHANG Wan-guang , CHEN Xiao-ping
Published: January 2024

Background

Smad4 is found mutated in many cancers. It acts as a tumor suppressor in the regulation of TGF-β signaling pathway. The objective of this work was to study the expression of Smad4 in intrahepatic cholangiocarcinoma (ICC) and its relationship with the biological behavior and prognosis of the disease.

Methods

Forty-nine paraffin-embedded ICC specimens and nine normal liver tissues were analyzed by immunohistochemical methods using Smad4 monoclonal antibodies. The expression of Smad4 was compared with the clinical pathological characteristics of the patients.

Results

The expression of Smad4 was 100% positive in normal liver tissues, which was higher than that in the ICC (44.9%). Negative labeling of the Smad4 protein was found in 26.1% (6/23) of well-differentiated ICCs and 61.5% (16/26) of poorly to moderately differentiated ICCs, and 34.3% (12/35) and 71.4% (10/14) showed negative Smad4 labeling (P=0.018) of ICC at pathological Tumor Node Metastasis (pTNM) stage I-II and pTNM stage III-IV separately. Furthermore, 72% (8/11) of lymph node metastatic ICCs and 73.3% (11/15) of intrahepatic metastatic ICCs showed negative labeling of the Smad4 protein. The loss of Smad4 expression in those metastatic ICCs was significantly more severe compared with non-metastatic ICCs (P=0.000).

Conclusions

The expression of Smad4 was associated with the histological grade, clinical stage, and metastasis of ICC (P <0.05). The detection of Smad4 may be helpful in determining the degree of malignancy and prognosis of ICC.
Comprehensive treatment for gas gangrene of the limbs in earthquakes
Authors: WANG Yue , LU Bo , HAO Peng , YAN Meng-ning , DAI Ke-rong
Published: January 2024

Background

Mortality rates for patients with gas gangrene from trauma or surgery are as high as 25%, but they increase to 50%-80% for patients injured in natural hazards. Early diagnosis and treatment are essential for these patients.

Methods

We retrospectively analyzed the clinical characteristics and therapeutic results of 19 patients with gas gangrene of the limbs, who were injured in the May 2008 earthquake in the Wenchuan district of China's Sichuan province and treated in our hospital, to seek how to best diagnose and treat earthquake-induced gas gangrene.

Results

Of 226 patients with limbs open injuries sustained during the earthquake, 53 patients underwent smear analysis of wound exudates and gas gangrene was diagnosed in 19 patients. The average elapsed time from injury to arrival at the hospital was 72 hours, from injury to definitive diagnosis was 4.3 days, and from diagnosis to conversion of negative findings on wound smear analysis to positive findings was 12.7 days. Anaerobic cultures were also obtained before wound closure. The average elapsed time from completion of surgery to recovery of normal vital signs was 6.3 days. Of the 19 patients, 16 were treated with open amputation, two with closed amputation, and 1 with successful limb salvage; 18 patients were successfully treated and one died.

Conclusions

In earthquakes, rapid, accurate screening and isolation are essential to successful treatment of gas gangrene and helpful in preventing nosocomial diffusion. Early and thorough debridement, open amputation, and active supportive treatment can produce satisfactory therapeutic results.
18F-FDG PET/CT makes a significant contribution to diagnosis of malignancy in patients with cervical lymphadenopathy: a study using optimal scale regression tests
Authors: OUYANG Lin , SHI Zhao-yin , LIN Zhi-gang
Published: January 2024

Background

The specificity and precision of lymphadenopathy assessment using US, CT and MRI are generally unsatisfactory, while fluorodeoxyglucose-positron emission tomography/computed tomography (18F-FDG PET/CT) can support this process by providing additional information about the lymph node features. However, which image features of 18F-FDG PET/CT play the key role in the diagnosis and cutoffs of malignant cervical lymphadenopathy still needs to be determined by further studies. Our study aimed to identify 18F-FDG PET/CT abnormalities that would assist in making a reliable diagnosis of malignant cervical lymphadenopathy in enlarged cervical lymph nodes of patients with unknown primary diseases.

Methods

One hundred and ninety-one consecutive patients of cervical lymphadenopathy with unknown primary causes were examined by 18F-FDG PET/CT from May 2007 to October 2011 and a definite diagnosis was established by pathologic biopsy. 18F-FDG PET/CT images were evaluated to identify the relevant abnormalities. All image features were analyzed by optimal scale regression tests to determine the important factors that were predictive for the diagnosis of malignant cervical lymphadenopathy and the cutoffs.

Results

The factors studied in 18F-FDG PET/CT images for predicting malignant cervical lymphadenopathy were sex, age, node location, size, shape, margins, maximum standard uptake value (SUV), mean SUV, FDG uptake pattern and number of nodes. It was found that mean SUV, maximum SUV, FDG uptake pattern, location, size and margins were the important risk factors of cervical lymph nodes that could predict malignant cervical lymphadenopathy. Signs of mean SUV≥2.5 (or maximum SUV≥3.5), nodular FDG uptake pattern, location of IIA, III, IV, VB, VI and VII regions, size≥1.5 cm and vague margins had their optimal diagnostic accuracy (Ac) and Youden index (YI), further, combination of any three factors of these six important risk factors would led to the best diagnostic Ac of 96% and YI of 0.93.

Conclusions

Signs of mean SUV, maximum SUV, FDG uptake pattern, location, size and margins of node in 18F-FDG PET/CT imaging are important predictive factors of malignant cervical lymphadenopathy. A combination of multiple factors may yield a higher diagnostic efficacy.
Mycophenolate mofetil affects monocyte Toll-like receptor 4 signaling during mouse renal ischemia/reperfusion injury
Authors: ZHANG Yan-xia , ZHANG Jian-rong , WANG Zhi-gang
Published: January 2024

Background

Mycophenolate mofetil (MMF) has been used to prevent transplant rejection for many years and has been shown to have protective effects against renal failure. The objective was to investigate the effect of MMF on monocyte Toll-like receptor 4 (TLR4) signaling in the early stages of renal ischemia/reperfusion injury (IRI) of mice.

Methods

Sixty BALB/C mice were randomly divided into two groups: an IRI group, in which renal IRI was induced by clamping the renal pedicles for 45 minutes, and an MMF group, in which MMF was given (40 mg•kg-1•d-1, intraperitoneally) from 2 days before renal IRI. The plasma creatinine level and renal tissue damage of each group mice were observed 6, 12, 24, and 48 hours after reperfusion. The concentration of plasma high-mobility group box 1 (HMGB-1) (TLR4 ligand), interleukin 6 (IL-6), monocyte chemoattractant protein-1 (MCP-1), and tumor necrosis factor α (TNF-α) and the expression of TLR-4 on monocytes were determined.

Results

The plasma creatinine concentration in the MMF group was lower compared to the IRI group (after reperfusion of 6, 12, 24, or 48 hours, P <0.05). Pathological analysis showed that the renal damage was slighter, TLR-4 expression was reduced (after reperfusion of 6, 12, 24, or 48 hours, P <0.05), and the concentration of cytokines in the plasma was lower (P <0.05) in the MMF group. No differences in the concentrations of HMGB-1 were observed (P >0.05).

Conclusion

Monocyte TLR4 signaling is important in the early stage of kidney IRI, but MMF can inhibit it and improve renal function.
Impact of chronic kidney disease on serum tumor markers concentrations
Authors: TONG Hong-li , DONG Zhen-nan , WEN Xin-yu , GAO Jing , WANG Bo , TIAN Ya-ping
Published: January 2024

Background

Serum tumor markers have always been of clinical importance in the diagnosis, monitoring disease progression and therapy efficacy for patients with malignant diseases. However, elevated serum tumor markers are found in some benign conditions, especially in chronic kidney disease (CKD). The elevation of them in CKD might cause confusion and misuse of these tumor markers. We conducted this retrospective study to investigate which of the five widely used tumor markers including carcinoembryonic antigen (CEA), alpha-fetoprotein (AFP), cytokeratin 19 fragment antigen 21-1 (Cyfra21-1), squamous cell carcinoma antigen (SCC) and neuron specific enolase (NSE) are affected markedly by CKD, in order to use them more effectively.

Methods

Serum tumor marker concentrations, biochemical, hematological parameters, and urinalysis were measured in CKD patients and healthy controls. The positive rate and median tumor markers' level in CKD patients and controls, and those in CKD patients stratified by CKD grade were compared using nonparametric rank tests. Correlation analysis of serum tumor markers and other parameters in CKD patients were performed using the Spearman correlation coefficient. Multivariate Logistic regression analysis was used to estimate the important variables that caused elevated serum concentrations of these markers in CKD patients.

Results

The overall positive rates and serum concentrations of Cyfra21-1, SCC, CEA in CKD group were significantly higher than those in control group. Positive rate and serum concentrations of those tumor markers increased as kidney function decreased. Both univariate analysis and multivariate regression analysis showed that the elevations of those tumor markers were not only associated with kidney function, but also with nutritional status.

Conclusions

Serum concentrations of Cyfra21-1, SCC, CEA are significantly influenced by kidney function, as well as nutritional status. Therefore, in clinical work, the indices of kidney function and nutritional status could be simultaneously measured to improve interpretation of the results of those tumor marker concentrations.

Chin Med J 2013;126 (2): 274-279
Clinical utilization of microembolus detection by transcranial Doppler sonography in intracranial stenosis-occlusive disease
Authors: WU Xiu-juan , XING Ying-qi , WANG Juan , LIU Kang-ding
Published: January 2024

Objective

To discuss the clinical ultiliazation and significance of microembolus detection by transcranial Doppler (TCD) sonography in intracranial stenosis-occlusive disease.

Data sources

All related articles in this review were mainly searched from PubMed published in English from 1996 to 2012 using the terms of microembolic signal, transcranial Doppler, intracranial stenosis, stroke.

Study selection

Original articles and reviews were selected if they were related to the clinical utilization of microembolus detection in intracranial stenosis-occlusive disease.

Results

Intracranial stenosis is a significant cause of cerebral emboli, and microembolus detection by TCD sonography were widely used in exploring the mechanisms of ischemic stroke with intracranial stenosis (including the middle cerebral artery stenosis and the vertebral-basilar stenosis), evaluating the prognosis of acute stroke, evaluating the therapeutic effects, and predicting the recurrent events of stroke.

Conclusion

Microembolus detection by TCD sonography plays an important role in the cerebral ischemic stroke patients with intracranial stenosis.
Major causes of fever of unknown origin at Peking Union Medical College Hospital in the past 26 years
Authors: SHI Xiao-chun , LIU Xiao-qing , ZHOU Bao-tong , ZHANG Li-fan , MA Xiao-jun , DENG Guo-hua , LI Tai-sheng , SHENG Rui-yuan , WANG Ai-xia
Published: January 2024

Background

Despite the recent advances in medicine, fever of unknown origin (FUO) remains a diagnostic and therapeutic challenge even to expert physicians. To increase the knowledge of FUO, we conducted a retrospective study to investigate the causes of FUO and the change of major causes of FUO during the past 26 years.

Methods

The clinical data were retrospectively analyzed from 997 patients with FUO hospitalized at the Peking Union Medical College Hospital (PUMCH) between January 2004 and October 2010. Furthermore, the results were compared to that reported in previous studies of FUO in PUMCH since 1985.

Results

Of the 997 FUO cases, definite diagnosis was eventually achieved in 797 (79.9%) patients. The most common cause of FUO was infectious diseases (479 cases, 48.0%), with tuberculosis accounting for 45.3% (217/479) of the cases of infections. One hundred and sixty-eight (16.9%) patients were diagnosed with connective tissue diseases, with Still's disease and vasculitis accounted for 31.5% (53/168) and 24.4% (41/168) of this category, respectively. Neoplasms and miscellaneous causes were found in 7.9% (79/997) and 7.1% (71/997), respectively. However, no definite diagnosis had been made in the remaining 200 (20.1%) cases until they were discharged from the hospital.

Conclusions

During different periods, infectious diseases, especially tuberculosis, were the leading etiology of FUO and the proportion of tuberculosis had no significant difference. While the frequency of neoplasms was descending, the proportion of lymphoma in neoplasm was ascending; the frequency of undiagnosed cases was increasing, but in most FUO cases the causes can be diagnosed eventually after careful analysis of clinical data.
Effects of triterpenic acid from Prunella vulgaris L. on glycemia and pancreas in rat model of streptozotozin diabetes
Authors: ZHOU Qiao-xia , LIU Feng , ZHANG Jing-shuo , LU Ji-guang , GU Zhen-lun , GU Gui-xiong
Published: January 2024

Background

The effects of triterpenic acid from Prunella vulgaris L. (TAP) on diabetes and its mechanism are uncertain. The aim of this study was to investigate the effects of TAP on antihyperglycemic, antioxidant, and pancreas-protective in streptozotozin (STZ)-diabetic rats.

Methods

The diabetic model was produced by injection of 60 mg/kg STZ. Blood was drawn from the tail vein of rats after 72 hours. Rats with blood glucose ≥16.7 mmol/L were considered diabetic. Diabetic rats were randomly divided into four groups: (1) Diabetes rat (STZ), (2) Diabetic rats treated with 50 mg/kg of triterpenic acid from Prunella vulgaris L (STZ+TAP50), (3) Diabetic rats treated with 100 mg/kg TAP (STZ+TAP100), and (4) Diabetic rats treated with 200 mg/kg TAP (STZ+TAP200). Normal rats (n=10) acted as the control group (NC). TAP was administered by the intragastric route once each day for six weeks. Body weight and the concentration of blood glucose (BG) were measured after three and six weeks. Fructosamine (FMN), malondialdehyde (MDA), and nitric oxide (NO), and the activities of nitric oxide synthase (NOS) and superoxide dismutase (SOD) in serum were determined after six weeks using commercially available kits following the manufacturer's instructions. Pathologic changes in pancreatic β-cells were also investigated by microscopic examination after hematoxylin-eosin (HE) staining. The level of SOD mRNA in pancreatic β-cells was measured by polymerase chain reaction (PCR).

Results

The levels of BG, FMN, NO, and MDA and the activities of NOS in serum in the four diabetes groups were significantly increased compared with the control group (P <0.01). The activity of SOD in serum and the body weight was significantly decreased compared with the control group (P <0.01). After administration of TAP to diabetic rats for six weeks, the body weight and the levels of BG, FMN, MDA, NO and the activity of NOS in serum decreased significantly compared with the STZ group in a dose-dependent manner. The activity of SOD in serum and body weight increased significantly compared with the STZ group in a dose-dependent manner. In addition, diabetic rats showed a significant decrease in SOD mRNA expression in pancreatic β cells. However, these changes were reversed by TAP. Histopathological examination also showed the protective effect of TAP on pancreatic β cells.

Conclusions

Triterpenic acid from Prunella vulgaris L. has an anti-diabetic effect, by controlling blood glucose and antioxidants, and has a protective effect on the pancreas.
A comparative study on the medium-long term results of endovascular repair and open surgical repair in the management of ruptured abdominal aortic aneurysms
Authors: HAN Yan-shuo , ZHANG Jian , XIA Qian , LIU Zhi-min , ZHANG Xiao-yu , WU Xiao-yu , LUN Yu , XIN Shi-jie , DUAN Zhi-quan , XU Ke
Published: January 2024

Background

Although it is generally acknowledged that patients with ruptured abdominal aortic aneurysm (rAAA) obtain the greatest benefit from endovascular repair (EVAR), convincing evidence on the medium-long term effect is lacking. The aim of this study was to compare and summarize published results of rAAA that underwent EVAR with open surgical repair (OSR).

Methods

A search of publicly published literature was performed. Based on an inclusion and exclusion criteria, a systematic meta-analysis was undertaken to compare patient characteristics, complications, short term mortality and medium-long term outcomes. A random-effects model was used to pool the data and calculate pooled odds ratios and weighted mean differences. A quantitative method was used to analyze the differences between these two methods.

Results

A search of the published literature showed that fourteen English language papers comprising totally 1213 patients with rAAA (435 EVAR and 778 OSR) would be suitable for this study. Furthermore, 13 Chinese studies were included, including 267 patients with rAAA totally, among which 238 patients received operation. The endovascular method was associated with more respiratory diseases before treatment (OR=1.81, P=0.01), while there are more patients with hemodynamic instability before treatment in OSR group (OR=1.53, P=0.031). Mean blood transfusion was 1328 ml for EVAR and 2809 ml for OSR (weighted mean difference (WMD) 1500 ml, P=0.014). The endovascular method was associated with a shorter stay in intensive care (WMD 2.34 days, P <0.001) and a shorter total postoperative stay (WMD 6.27 days, P <0.001). The pooled post-operative complication rate of respiratory system and visceral ischemia seldom occurred in the EVAR group (OR=0.48, P <0.001 and OR=0.28, P=0.043, respectively). The pooled 30-day mortality was 25.7% for EVAR and 39.6% for OSR, and the odds ratio was 0.53 (95% confidence interval (CI) 0.41-0.70, P <0.001). There was not, however, any significant reduction in the medium-long all-cause mortality rate (HR=1.13, P=0.381) and re-intervention rate (OR= 2.19, P=0.243) following EVAR. In EVAR group, nevertheless, incidence of type I endoleak was significantly lower than type II endoleak (OR=0.33, P=0.039) at late follow-up period.

Conclusions

On the basis of this systematic review, rAAA EVAR results in less blood use for transfusion, shorter operation time, shorter intensive care unit and hospital stays, and lower 30-day mortality. However, in the medium-long term, it is not associated with a reduction in all-cause mortality.
Serum uric acid levels correlate with recurrence of paroxysmal atrial fibrillation after catheter ablation
Authors: HE Xiao-nan , LI Song-nan , ZHAN Jin-liang , XIE Shuang-lun , ZHANG Zhi-jun , DONG Jian-zeng , YU Rong-hui , LONG De-yong , TANG Ri-bo , MA Chang-sheng
Published: January 2024

Background

Recently there has been a great deal of interest in the role of serum uric acid (SUA) in atrial fibrillation (AF). The objective of this study was to establish whether there is a relationship between levels of SUA and recurrence of paroxysmal AF after catheter ablation.

Methods

Three hundred and thirty patients diagnosed with paroxysmal AF were analyzed. Patients were categorized into quartiles on the basis of their pre-operative SUA measurement and follow-up, and Kaplan-Meier estimation with a Log-rank test was used for the analysis of the influence of SUA on the recurrence of AF. Pre-procedural clinical variables were correlated with the clinical outcome after ablation using multivariate Logistic analysis. A Cox proportional hazards model was used to estimate the relationship between SUA and the recurrence of AF.

Results

After a mean follow-up of (9.341±3.667) (range 3.0-16.3) months, recurrence rates from the lowest SUA quartile to the highest SUA quartile were 16.0%, 26.4%, 28.3%, and 29.3% respectively (P=0.014). After adjustment for gender, body mass index (BMI), hypertension, serum levels of high sensitivity C-reactive protein (hsCRP), triglyceride (TG), left atrial diameter (LA), estimated glomerular filtration rate (eGFR), and SUA, there was an increased risk of recurrence in subjects in the highest SUA quartile compared with those in the lowest quartile (hazard ratio 2.804, 95% confidence interval 1.466-5.362, P=0.002). Following multivariate Logistical analysis, SUA was found to be an independent predictor of recurrence (hazard ratio 1.613, 95% confidence interval 1.601-1.625, P=0.014).

Conclusion

In a retrospective study of patients with paroxysmal AF undergoing catheter ablation, elevated preoperative SUA levels were associated with a higher rate of recurrence of AF.
Health related quality of life among patients with chronic graft-versus-host disease in China
Authors: MO Xiao-dong , XU Lan-ping , LIU Dai-hong , CHEN Yu-hong , ZHANG Xiao-hui , CHEN Huan , HAN Wei , WANG Yu , WANG Feng-rong , WANG Jing-zhi , LIU Kai-yan , HUANG Xiao-jun
Published: January 2024

Background

Chronic graft-versus-host disease (GVHD), the commonest long-term complication after allogeneic hematopoietic stem cell transplantation (HSCT), has a negative impact on patients' health related quality of life (HRQoL). This study was designed to investigate the HRQoL in patients with chronic GVHD in China.

Methods

Two hundred and sixty-four patients with chronic GVHD who were ≥24 months post-HSCT and had been in continuous complete remission since HSCT were enrolled in this retrospective study. HRQoL was evaluated using an SF-36 questionnaire. Multivariate analysis was used to identify the factors that affect HRQoL in patients with chronic GVHD.

Results

HRQoL in patients categorized as having mild and moderate chronic GVHD was significantly better than in those in the severe category. In the moderate chronic GVHD category, markedly poorer HRQoL was observed in patients with both multiple organ involvement and more severe organ impairment than in those without these factors. According to multivariate analysis, chronic GVHD severity had the greatest significant negative impact on patients' HRQoL; whereas being female was associated with a negative impact on psychological health.

Conclusion

Chronic GVHD severity strongly correlates with negative impacts on patients' HRQoL.
Zoledronic acid inhibits growth of hepatocellular carcinoma cells in vitro and in vivo
Authors: LIU Quan , TAO Yong-hui , BAI Rui-zhen , CHANG Shu-jian , HUA Dong
Published: January 2024

Background

Growing preclinical evidence shows that zoledronic acid (ZOL) exhibits direct antitumor activity in various cancer cell lines. However, the cytotoxic effects of ZOL on human hepatocellular carcinoma (HCC) cells have not been established. In the present study, we investigated the effect of ZOL on HCC both in vitro and in vivo.

Methods

Cytotoxicity and cell cycles were assessed with Sulforhodamine B colorimetric assay and flow cytometry. Expression levels of cell cycle phase-linked proteins were examined. The effect of ZOL on HCC in vivo was explored based on H22-subcutaneous injection (s.c.) and H22-intraperitoneal injection (i.p.) mice model.

Results

ZOL inhibited the growth of SK-HEP-1 and H22 cells and induced S-phase arrest through downregulating cdc2 protein and upregulating cyclin A. It inhibited the growth of s.c tumors, and increased the survival of both H22-s.c. and H22-i.p. mice in vivo.

Conclusion

ZOL inhibits growth of HCC cells in vitro and in vivo.
Comparison of low-dose sequences of dual-source CT and echocardiography for preoperative evaluation of aortic valve disease
Authors: FENG Juan , WANG Xi-ming , JI Xiao-peng , LI Hai-ou , LI Qiao , GUO Wen-bin , WANG Zheng-jun
Published: January 2024

Background

Accurate evaluation of coronary artery, aortic valve annulus diameter (AVAD), and cardiac function in patients with aortic valve disease is of great significance for surgical strategy. In this study, we explored the preoperative evaluation of low-dose sequence (MinDose sequence) scan of dual-source CT (DSCT) for those patients.

Methods

Forty patients suspected for aortic valve disease (the experimental group) underwent MinDose sequence of DSCT to observe coronary artery, AVAD, and left ventricular ejection fraction (LVEF). Another 33 subjects suspected for coronary artery disease (the control group) underwent conventional retrospective electrocardiographically-gated sequence of DSCT. Two-dimensional transthoracic echocardiography (2D-TTE) and four-dimensional transthoracic echocardiography (4D-TTE) were applied in the experimental group to measure AVAD and LVEF and compared with MinDose-DSCT.

Results

There was a strong correlation between LVEFs measured by 2D-TTE and MinDose-DSCT (r=0.87, P <0.01), as well as between 4D-TTE and MinDose-DSCT (r=0.90, P <0.01). AVAD measured by MinDose-DSCT was in good agreement with corresponding measurements by 2D-TTE (r=0.90, P <0.01). The effective dose in the experimental group was 63.54% lower than that in the control group.

Conclusions

MinDose sequence of DSCT with a low radiation dose serving as a one-stop preoperative evaluation makes effective assessment of the coronary artery, AVAD, and LVEF for patients with aortic valve disease.
Clinical significance of costimulatory molecule B7-H3 expression on CD3+ T cells in colorectal carcinoma
Authors: MAO Yong , SUN Jing , WANG Wei-peng , ZHANG Xue-guang , HUA Dong
Published: January 2024

Background

B7-H3 has been widely studied in the context of tumor progression in recent years, and behaves as a tumor cell marker in a variety of tumors including colorectal carcinoma. The mechanism of B7-H3 in tumor progression is complicated and not clear yet. Studies have revealed that B7 family molecules are expressed on infiltrated lymphocytes as well as tumor cells in tumor microenvironment, which indicates that different expression pattern may lead to different clinical outcomes.

Methods

The expression of B7-H3 was detected in tissues of 98 colorectal carcinoma patients by using immunohistochemistry. Then the expression of B7-H3 on CD3+ T lymphocytes isolated from fresh cancer tissues of 12 colorectal carcinoma patients was analyzed by flow cytometry assay. The relationship between the expression of B7-H3 on CD3+ T lymphocytes and patients' clinical pathological parameters was demonstrated with statistical analysis.

Results

Patients with more CD3+ T cell infiltration survived much longer than patients with less CD3+ T cell infiltration (P <0.05); B7-H3 was highly expressed by infiltrating CD3+ T lymphocytes in colorectal carcinoma tissues. The expression of B7-H3 was found to be significantly related with lymph node metastasis status (P<0.05), but not with the patient's gender, age, tumor size, differentiation degree, depth of tumor invasion, Dukes' stage, distant metastasis and whether or not mucinous adenocarcinoma was present (P >0.05). Moreover, the survival time of patients with low expression of B7-H3 was obviously longer than those of high B7-H3 expression patients, but the seven-year survival rate showed no difference between the high and low B7-H3 expression patients (P>0.05).

Conclusion

The negative costimulatory molecule B7-H3 on infiltrating CD3+ T lymphocytes in colorectal carcinoma bears importance in the clinical pathological progress and prognosis of colorectal carcinoma.
Original article: Predictors to assess non-sentinel lymph node status in breast cancer patients with only one sentinel lymph node metastasis
Authors: YANG Ben , YANG Li , ZUO Wen-shu , GE Wen-kai , ZHENG Gang , ZHENG Mei-zhu , YU Zhi-yong , WANG Yong-sheng
Published: January 2024

Background

The purpose of this study was to investigate the feasibility of avoiding axillary lymph node dissection (ALND) for patients with only one sentinel lymph node (SLN) metastasis. The characteristics and predictive factors for non-sentinel lymph node (NSLN) metastasis of patients with single positive SLN were also analyzed.

Methods

Patients with no and only one SLN metastasis (0/n and 1/n group, n ≥2) were selected from 1228 cases of invasive breast carcinoma, who underwent axillary dissection in Shandong Cancer Hospital between November 1999 and December 2011, to compare the characteristics of NSLN metastasis between them. For the 1/n group, the factors that influenced the NSLN metastasis were analyzed by univariate and multivariate analysis.

Results

Differences of the NSLN metastasis between the 0/n and the 1/n groups were significant (P <0.001). There was no significant difference between the axillary lymph node metastasis on level III in 1/n group and 0/n group (P=0.570). When the total SLN number was ≥4 and with one positive case, the NSLN metastasis was not significantly different from that in the 0/n group (P=0.118). In the 1/n group, clinical tumor size (P = 0.012), over-expression of Her-2 (P=0.003), tumor grade (P=0.018) and the total number of SLN (P=0.047) significantly correlated with non-SLN metastasis. Clinical tumor size (P=0.015) and the expression of Her-2 (P=0.01) were independent predictive factors for non-SLN metastasis by the Logistic regression model.

Conclusion Under certain conditions, breast cancer patients with single SLN metastasis could avoid ALND.
Evaluation on the efficacy and safety of domestic bivalirudin during percutaneous coronary intervention
Authors: XIANG Ding-cheng , GU Xiao-long , SONG Yao-ming , HUANG Wei-jian , TANG Liang-qiu , YIN Yao-hui , GENG Shao-hua , ZHOU Hao , FAN Wen-mao , HU Rong , PAN Chun-mei , ZHANG Yi , XIAO Fang-yi , WAN Huai-bin , LIU Zeng-zhang
Published: January 2024

Background

Bivalirudin was widely used as an anticoagulant during coronary interventional procedure in western countries. However, it was not available in China before this clinical trial was designed. This randomized, single-blind and multicenter clinical trial aimed to evaluate the efficacy and the safety of domestic bivalirudin during percutaneous coronary intervention (PCI).

Methods

A randomized, single-blind, multicenter trial was designed. Elective PCI candidates in five centers were randomized into a bivalirudin group and a heparin group, which were treated with domestic bivalirudin and non-fractional heparin during the PCI procedure. The efficacy was evaluated by comparing the activated coagulation time (ACT), the procedural success rate (residual stenosis <20% in target lesions without any coronary artery related adverse events within 24 hours after PCI), and the survival rate without major adverse cardiac events at 30 days after PCI between the two groups. Safety was evaluated by the major/minor bleeding rate.

Results

A total of 218 elective PCI patients were randomized into a bivalirudin group (n=110) and heparin group (n=108). Except for two patients needing additional dosing in the heparin group, the ACT values of all other patients in both groups were longer than 225 seconds at 5 minutes after the first intravenous bolus. Procedural success rates were respectively 100.0% and 98.2% in the bivalirudin group and heparin group (P>0.05). Survival rates without major adverse cardiac events at 30 days after PCI were 100.0% in the bivalirudin group and 98.2% in the heparin group (P>0.05). Mild bleeding rates were 0.9% and 6.9% (P<0.05) at 24 hours, and 1.9% and 8.8% (P<0.05) at 30 days after PCI in the bivalirudin group and heparin group respectively. There was one severe gastrointestinal bleeding case in the heparin group.

Conclusions

Domestic bivalirudin is an effective and safe anticoagulant during elective PCI procedures. The efficacy is not inferior to heparin, but the safety is superior to heparin.
Efficacy and safety of Cimicifuga foetida extract on menopausal syndrome in Chinese women
Authors: ZHENG Ting-ping , SUN Ai-jun , XUE Wei , WANG Ya-ping , JIANG Ying , ZHANG Ying , LANG Jing-he
Published: January 2024

Background

It is now recognized that Cimicifuga foetida extract is effective in alleviating menopausal symptoms. But the durations reported were usually short. This paper compares the clinical effects of different regimens of three-month course on climacteric symptoms in Chinese women, so as to evaluate the efficacy and safety of Cimicifuga foetida extract.

Methods

This was a prospective, randomized trial. Ninety-six early menopausal women were recruited and randomly assigned into 3 groups to take different kinds of medicine for 3 months; participants were given Cimicifuga foetida extract daily in group A (n=32), given estradiol valerate and progesterone capsule cycle sequentially in group B (n=32), and given estradiol valerate and medroxyprogesterone acetate cycle sequentially in group C (n=32). The questionnaires of Kupperman menopause index, Menopause-Specific Quality of Life, and Hospital Anxiety and Depression Scale were finished before and after the treatment. The status of vaginal bleeding and breast tenderness was recorded every day.

Results

Eighty-nine participants (89/96, 92.7%) completed the treatment. Kupperman menopause index decreased after taking the medicine for 3 months in each group (with all P<0.001), but the score after the treatment was higher in group A than in the other 2 groups. Except for the score of sexual domain in group A (P=0.103), the scores of all domains of the Menopause-Specific Quality of Life decreased significantly after the treatment in all groups (with all P≤0.01). Score of anxity decreased significantly in group A (P=0.015) and B (P=0.003). Incidence of breast tenderness was 12.9% (4/31) in group A, 36.7% (11/30) in group B, and 14.3% (4/28) in group C. Incidence of vaginal bleeding was 6.5% (2/31) in group A, 26.7% (8/30) in group B, and 82.1% (23/28) in group C.

Conclusions

Cimicifuga foetida extract is effective and safe in the treatment of menopausal syndrome. It is worth extending its use in the treatment of climacteric complaints, especially among those having contradiction for hormone replacement therapy.
Electrophysiological characteristics of cardiomyocyte-like cells from rat bone marrow derived mesenchymal stem cells by four inductors
Authors: LIU Bo-wu , An-lin LÜ , HOU Jing , HUANG Wei , HOU Hong , HOU Zhao-lei , DA Jing , AI Shi-yi
Published: January 2024

Background

Bone marrow derived mesenchymal stem cells (BMdMSCs) can differentiate into cardiomyocyte-like cells induced by different inductors individually or collectively. In this study, by inducing BMdMSCs with p53 inhibitor (p-fifty three inhibitor-alpha, PFT-α), 5-azacytidine (5-AZA), angiotensin-II (Ang-II) and bone morphogenic protein-2 (BMP-2) we compared the influences of four inductors on the differentiation of rat BMdMSCs into caridomyocyte like-cells.

Methods

BMdMSCs were collected from the bone marrow of Sprague Dawley rats and after the fourth generation, the purified cells were divided into five groups: 5-AZA (10 μmol/L), Ang-II (0.1 μmol/L), PFT-α (20 μmol/L), BMP-2 (10 μg/L) and control. The purity of the BMdMSCs and the cardiac differentiation rates were obtained by flow cytometry. The expressions of cTnT in the BMdMSCs after four weeks of induction were detected by immunofluorescence and the expressions of cTnI and Cx43 detected by Western blotting. The green fluorescent levels reflecting intracellular calcium transient function were determined by laser scanning confocal microscopy. The total potassium current levels of cells were measured on patch clamp.

Results

All inductors affected to a different degree the differentiation of BMdMSCs into cardiomyocyte-like cells and the expressions of cTnT, cTnI and Cx43 suggesting that the combination of inductors could be an improved method for cardiac regenerative medicine. In addition, the total potassium current level and calcium transient in PFT-α cardiomyocyte-like cells were higher than other groups.

Conclusions

The cardiac differentiation of BMdMSCs induced by PFT-α, 5-AZA, Ang-II and BMP-2 has been improved at different levels. PFT-α has an advantage of differentiation rate and electrophysiological function over other inductors.
Exploration of whole brain networks modulated by acupuncture at analgesia acupoint ST36 using scale-specific wavelet correlation analysis
Authors: CHENG Hao , YAN Hao , BAI Li-jun , WANG Bao-guo
Published: January 2024

Background

Previous studies have demonstrated that acupuncture could modulate various brain systems in the resting brain networks. Graph theoretical analysis offers a novel way to investigate the functional organization of the large-scale cortical networks modulated by acupuncture at whole brain level. In this study, we used wavelets correlation analysis to estimate the pairwise correlations between 90 cortical and subcortical human brain regions in normal human volunteers scanned during the post-stimulus resting state.

Methods

Thirty-two college students, all right-handed and acupuncture naïve, participated in this study. Every participant received only one acupoint stimulation, resulting in 16 subjects in one group. Both structural functional magnetic resonance imaging (fMRI) data (3D sequence with a voxel size of 1 mm3 for anatomical localization) and functional fMRI data (TR=1500 ms, TE=30 ms, flip angle=90°) were collected for each subject. After thresholding the resulting scale-specific wavelet correlation matrices to generate undirected binary graphs, we compared graph metrics of brain organization following verum manual acupuncture (ACU) and sham acupuncture (SHAM) groups.

Results

The topological parameters of the large-scale brain networks in ACU group were different from those of the SHAM group at multiple scales. There existed distinct modularity functional brain networks during the post-stimulus resting state following ACU and SHAM at multiple scales.

Conclusions

The distinct modulation patterns of the resting brain attributed to the specific effects evoked by acupuncture. In addition, we also identified that there existed frequency-specific modulation in the post-stimulus resting brain following ACU and SHAM. The modulation may be related to the effects of verum acupuncture on modulating special disorder treatment. This preliminary finding may provide a new clue to understand the relatively function-oriented specificity of acupuncture effects.
Effects of nasal continuous positive airway pressure treatment on insulin resistance and ghrelin levels in non-diabetic apnoeic patients with coronary heart disease
Authors: YANG Dan , LIU Zhi-hong , ZHAO Qing , LUO Qin
Published: January 2024

Background

Obesity is a common risk factor for several diseases. Obesity related hormone and increased insulin resistance (IR) may contribute to the effects of obstructive sleep apnoea on cardiovascular consequences. We investigated ghrelin and IR in non-diabetic apnoeic patients with stable coronary heart disease and assessed the effects of continuous positive airway pressure (CPAP).

Methods

Plasma ghrelin, glucose and insulin were measured in 22 patients with CPAP and 22 matched controls without CPAP at baseline and three months. Indexes including homeostasis model assessment IR (HOMA IR), HOMA S and HOMA β were calculated for the assessment of IR, insulin sensitivity and pancreatic β cell function.

Results

At three months follow-up, plasma ghrelin levels and HOMA IR in CPAP group were significantly decreased (P=0.002 and 0.046, respectively) while those in control group increased significantly (P=0.012 and 0.009, respectively). Significant moderate correlations were found between ghrelin vs. HOMA IR and ghrelin vs. HOMA S after CPAP, however, for those without CPAP, no significant associations were observed.

Conclusions

Short-term effective continuous positive airway pressure had a significant effect on lowering plasma ghrelin levels and IR, but not body fat. Further large scale and longer term studies are warranted to corroborate these findings.
Effect of total lumbar disc replacement on the treatment of discogenic low lumbar pain: preliminary outcomes
Authors: LI Zhi-yu , HAN Xiao , MA Sai , TIAN Wei
Published: January 2024

Background

Lumbar pedicle screw fixation and fusion are major procedures for treating discogenic low back pain (DLBP). However, due to its advantages of preserving the segmental motion and biomechanical simulation, artificial total lumbar disc replacement (TDR) is increasingly popular.

Methods

From 2007 to 2010, 68 DLBP patients were enrolled. TDR were performed on 34 patients and the other 34 controls underwent the traditional fixation procedure. Qualitative and quantitative evaluations were followed including the changes in range of motion (ROM) and interpedicle height (IPH) at the posterior intervertebral body of operated level, in 6 and 12 months, and 3 years, postoperatively.

Results

Qualitative results showed satisfying improvement in the two groups after 6 and 12 months, respectively, and the inter-group differences were significant (P >0.05). The results of ROM and IPH have shown significant differences between the TDR and spinal fusion groups (P <0.05).

Conclusion

With similar clinical improvements as the traditional spinal fusion method, TDR offered significantly better ROM and intervertebral foramen height.
Switching from morphine to fentanyl attenuates the decline of μ-opioid receptor expression in periaqueductal gray of rats with morphine tolerance
Authors: Dong Yan-peng , Sun Li , Liu Xiao-yan , Liu Ruo-shan
Published: January 2024

Background

Opioid switching is a therapeutic maneuver to improve analgesic response and/or reduce adverse side effects although the underlying mechanisms remain unknown. The μ-opioid receptor (MOR) has an important role in mediating the actions of morphine and other analgesic agents. This study is aimed at exploring the changes of MOR in the periaqueductal gray (PAG) in rats when morphine is substituted for equianalgesic fentanyl.

Methods

Forty rats were randomly assigned to five treatment groups: 7 days normal saline group (N group), 7 days fentanyl group (F group), 7 days morphine group (M group), 7 days morphine and 7 days fentanyl-switching group (MF group), and 14 days morphine group (MM group). Rats repeatedly received subcutaneous injections of morphine sulfate (10 mg/kg) or equianalgesic fentanyl sulfate (0.1 mg/kg) twice daily. Rats' antinociceptive response to thermal pain was evaluated by the tail flick latency assay. MOR mRNA and protein expression in the PAG were measured using RT-PCR and Western blotting analyses respectively.

Results

This study showed that after morphine was substituted with fentanyl on day 8, the tail flick latency (TFL) increased from (3.9±0.4) seconds to (11.4±0.4) seconds. The results also demonstrated that both MOR mRNA and protein expression in the PAG of rats in the MF group were less than that in the M group (P<0.05) but more than that in MM group (P<0.05).

Conclusions

Equianalgesic fentanyl was still antinociceptive effective in rats with morphine tolerance, which may be due to the switching from morphine to fentanyl attenuating the decline of MOR expression in the PAG of rats.
Benidipine has effects similar to losartan on the central blood pressure and arterial stiffness in mild to moderate essential hypertension
Authors: Ihm Sang-Hyun , Jeon Hui-Kyung , Chae Shung Chull , Li Do-Sun , Kim Kee-Sik , Choi Dong-Ju , Ha Jong-Won , Kim Dong-Soo , Kim Kye Hun , Cho Myeong-Chan , Baek Sang Hong
Published: January 2024

Background

Central blood pressure (BP) is pathophysiologically more important than peripheral BP for the pathogenesis of cardiovascular disease. Arterial stiffness is also a good predictor of cardiovascular morbidity and mortality. The effects of benidipine, a unique dual L-/T-type calcium channel blocker, on central BP have not been reported. This study aimed to compare the effect of benidipine and losartan on the central BP and arterial stiffness in mild to moderate essential hypertensives.

Methods

This 24 weeks, multi-center, open label, randomized, active drug comparative, parallel group study was designed as a non-inferiority study. The eligible patients (n=200) were randomly assigned to receive benidipine (n=101) or losartan (n=99). Radial artery applanation tonometry and pulse wave analysis were used to measure the central BP, pulse wave velocity (PWV) and augmentation index (AIx). We also measured the metabolic and inflammatory markers.

Results

After 24 weeks, the central BP decreased significantly from baseline by (16.8±14.0/10.5±9.2) mmHg (1 mmHg =0.133 kPa) (systolic/diastolic BP; P <0.001) in benidipine group and (18.9±14.7/12.1±10.2) mmHg (P <0.001) in losartan group respectively. Both benidipine and losartan groups significantly lowered peripheral BP (P <0.001) and Alx (P <0.05), but there were no significant differences between the two groups. The mean aortic, brachial and femoral PWV did not change in both groups after 24-week treatment. There were no significant changes of the blood metabolic and inflammatory biomarkers in each group.

Conclusion

Benidipine is as effective as losartan in lowering the central and peripheral BP, and improving arterial stiffness.
Interventions to improve chronic cyclosporine A nephrotoxicity through inhibiting renal cell apoptosis: a systematic review
Authors: Xiao Zheng , Li Cheng-wen , Shan Juan , Luo Lei , Feng Li , Lu Jun , Li Sheng-fu , Long Dan , Li You-ping
Published: January 2024

Objective

To reveal interventions for chronic cyclosporine A nephrotoxicity (CCN) and provide new targets for further studies, we analyzed all relevant studies about interventions in renal cell apoptosis.

Data sources

We collected all relevant studies about interventions for cyclosporine A (CsA)-induced renal cell apoptosis in Medline (1966 to July 2010), Embase (1980 to July 2010) and ISI (1986 to July 2010), evaluated their quality, extracted data following PICOS principles and synthesized the data.

Study selection

We included all relevant studies about interventions in CsA-induced renal cell apoptosis no limitation of research design and language) and excluded the duplicated articles, meeting abstracts and reviews without specific data.

Results

There were three kinds of intervention, include anti-oxidant (sulfated polysaccharides, tea polyphenols, apigenin, curcumin, spirulina, etc), biologics (recombinant human erythropoietin (rhEPO), a murine pan-specific transforming growth factor (TGF)-beta-neutralizing monoclonal antibody1D11, cartilage oligomeric matrix protein (COMP)-angiopoietin-1 and hepatocyte growth factor (HGF) gene), and other drugs (spironolactone, rosiglitazone, pirfenidone and colchicine). These interventions significantly improved the CCN, renal cell apoptosis and renal dysfunction through intervening in four apoptotic pathways in animals or protected renal cells from apoptosis induced by CsA and increased cell survival through respectively four pathways in vitro.

Conclusions

There are three group interventions for CCN. Especially anti-oxidant drugs can significantly improve CCN, renal cell apoptosis and renal dysfunction. Many drugs can improve CCN through intervening in Fas/Fas ligand or mitochondrial pathway with sufficient evidences. Angiotensin II, nitric oxide (NO) and endoplasmic reticulum (ER) pathways will be new targets for CCN.