bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluando la calidad de las aplicaciones Low-Code: Un mapeo sistemático de la literatura
Authors:   Universidad Abierta Interamericana, Botto-Tobar Miguel , Neil Carlos
Published: January 2024

El desarrollo de plataformas de desarrollo low-code ha tenido como objetivo democratizar la creación de software, permitiendo a personas sin profundos conocimientos de programación construir aplicaciones. Esta democratización ha reducido las solicitudes de TI y ha permitido que los equipos de TI se centren en proyectos más complejos y especializados. Estas plataformas son altamente personalizables y adaptables para satisfacer necesidades comerciales específicas, lo que ha llevado a su creciente popularidad entre las empresas que buscan optimizar sus procesos de desarrollo y mantenerse competitivas en el panorama digital actual. Sin embargo, la falta de calidad en las aplicaciones desarrolladas mediante estas plataformas es un desafío importante, ya que estas aplicaciones pueden ser más complejas de lo que parecen. El objetivo es abordar la falta de calidad en las aplicaciones desarrolladas mediante plataformas low-code. Para ello, se busca implementar modelos, metodologías, guías y estándares de calidad, además de aprovechar tecnologías y técnicas específicas para garantizar que estas aplicaciones cumplan con los requisitos y necesidades de los usuarios finales. Para alcanzar el objetivo mencionado, se proponen varios métodos y enfoques: implementación de modelos y metodologías; soporte técnico; uso de técnicas de Deep Learning y Machine Learning; realización de pruebas exhaustivas; utilización de contenedores; aprovechamiento de tecnologías como Blockchain y plataformas para el desarrollo de aplicaciones virtuales. Los resultados obtenidos podrían implicar un aumento en la satisfacción de los usuarios finales y una mayor confianza en la utilización de estas plataformas para el desarrollo de software. Las plataformas de desarrollo low-code ofrecen diversos beneficios para las empresas y los equipos de desarrollo, como tiempos de desarrollo más rápidos, costos reducidos, mayor flexibilidad y una reducción de solicitudes de TI. Sin embargo, la falta de calidad en las aplicaciones desarrolladas a través de estas plataformas es un desafío que debe ser abordado. La implementación de modelos, metodologías, guías y estándares de calidad, junto con el uso de tecnologías avanzadas como la inteligencia artificial, pueden contribuir a mejorar la calidad de estas aplicaciones y garantizar que satisfagan las necesidades y expectativas de los usuarios finales.
Experimental Medications Made with Сetraria islandica Showing Antiviral Activity against Influenza A Virus
Authors: Makarevich E. V. , Protsenko M. A. , Mazurkov O. Yu. , Filippova E. I. , Mazurkova N. A.
Published: January 2024

Background. To date, virologists have identified more than 25,000 influenza virus А serotypes, and their number will increase in the future. Therefore, the development of new antiviral drugs will always be relevant.

The aim of the study is to obtain and test the chemical composition and antiviral activity of the lichen Cetraria islandica extracts against the influenza A virus.

Material and methods. Samples of lichen Cetraria islandica (aqueous and ethanol extracts) were tested for toxic properties and antiviral activity against influenza A virus in MDCK cell culture.

Results. Samples of aqueous and ethanol extracts of Cetraria islandica were obtained; their chemical composition was described. In MDCK cell culture, the extracts exhibited antiviral activity against human influenza virus А/H3N2 and avian influenza virus А/H5N1. When studying the mechanism of action of Cetraria islandica extracts, it was noted that Cetraria islandica samples possess pronounced antiviral properties against avian influenza A/chicken/Kurgan/05/2005 (H5N1) and human influenza A/Aichi/2/68 (H3N2) at the stage of their adsorption and reproduction.

Conclusions. Samples of Cetraria islandica have antiviral activity at the stage of adsorption and reproduction of influenza A virus in MDCK cell culture. The ethanol extract shows a higher antiviral efficacy compared to the aqueous extract.
The Effect of Shock Gentamicin Concentrations on the Formation of Resistance and Small Colony Variants in Staphylococcus aureus
Authors: Gostev V. V. , Kalinogorskaya O. S. , Sulian O. S. , Chulkova P. S. , Sopova J. V. , Velizhanina M. E. , Pleshkov V. Yu. , Ageevets V. A. , Sidorenko S. V.
Published: January 2024

Гентамицин является одним из компонентов комбинированной терапии инфекционных эндокардитов, вызванных Staphylococcus aureus, включая метициллинорезистентные штаммы (methicillin-resistant S.aureus, MRSA). Цель исследования — анализ влияния десяти 6-часовых циклов воздействия высоких концентраций (16 мкг/мл) гентамицина in vitro на изменение фенотипа и генотипа аминогликозидочувствительных штаммов S.aureus, относящихся к четырём сиквенс-типам: ST5 (ATCC 29213), ST8, ST97 и ST22 (MRSA). Для всех штаммов, кроме ATCC 29213, после селекции отмечалось увеличение МПК гентамицина до 8–64 мкг/мл. Один штамм (SA0937) диссоциировал на три морфотипа, включая мелкоколониевый вариант (small colony variant, SCV). Вариант производного штамма SA0937 с колониями нормального размера характеризовался ассоциированной устойчивостью к даптомицину за счёт мутации P314L в MprF. Формирование устойчивости не сопровождалось изменением скорости роста, кроме морфотипа SCV. Для штамма ATCC 29213 после селекции отмечалось появление толерантности, проявляющейся в увеличении эффективного киллинга до 14 ч в 24-часовом time-killing эксперименте с концентрацией антибиотика 16 мкг/мл. У штамма ATCC 29213 выявлены мутации в пептидил т-РНК гидролазе (Pth). У трёх штаммов были обнаружены делеции в гене atpG, входящим в состав АТФ-синтазного комплекса. У остальных производных штаммов были выявлены делеции и мутации в генах метаболизма менахинона hepS, menA и трансляционном факторе элонгации G (fusA). Таким образом, использование гентамицина сопряжено с возможным быстрым формированием устойчивости и толерантности, не связанными с приобретением генов аминогликозид-модифицирующих ферментов. Выявление SCV ассоциировано с неблагоприятными клиническими исходами. При использовании комбинированной терапии необходимо учитывать, что существует возможность формирования устойчивости к даптомицину на фоне селекции гентамицином.
Bilateral bidirectional superior cavopulmonary shunt is more beneficial in medium and long term clinical outcomes than unilateral shunt
Authors: XU Yao-qiang , LIU Ying-long , LÜ Xiao-dong , LI Yong-qing , YU Cun-tao
Published: January 2024

Background

The present study was aimed to compare the effects of bilateral and unilateral bidirectional superior cavopulmonary shunt (b-BDG and u-BDG) on pulmonary artery growth and clinical outcomes.

Methods

The 51 subjects enrolled in this study were divided into two groups: those receiving b-BDG (n=21) and those receiving u-BDG (n=30). Clinical records were reviewed retrospectively at a mean of 43.3 months after BDG procedures. Chi square and t-tests were performed to analyze the data.

Results

Left and right pulmonary artery diameters increased 27%-37% in both groups. The pulmonary artery index increased 37.2% after b-BDG and 27.0% after u-BDG. b-BDG patients experienced a significant decrease in mean hemoglobin concentration and hematocrit value, and a correlated change in postoperative diameter of left pulmonary artery (LPA) and pulmonary artery index (y=0.2719, x=-1.8278; R=0.564, P=0.008). The change ratio of hemoglobin and postoperative LPA were also correlated in b-BDG patients (y= -0.0522x + 0.3539; R=-0.479, P=0.028). Only one b-BDG patient versus twelve u-BDG patients needed total cavopulmonary connections 31.8 months after BDG surgery (P=0.0074). Moreover, only one (4.8%) b-BDG patient but eight u-BDG patients (26.7%) developed pulmonary arteriovenous malformations.

Conclusions

b-BDG increases bilateral pulmonary blood flow and promotes growth of bilateral pulmonary arteries, with preferable physiological outcomes to u-BDG. Results may imply that subsequent Fontan repair may not always be needed.
Using intramyocardial electrograms combined with other noninvasive methods for monitoring acute rejection following human heart transplantation
Authors: JIA Yi-xin , MENG Xu , SUN Ling-bo , HAN Jie , CHEN Yang-tian
Published: January 2024

Background

Acute allograft rejection in heart transplantation remains as one of the major complications. Obligatory graft surveillance is still achieved with the invasive and expensive endomyocardial biopsy (EMB). Our study aimed to study the use of intramyocardial electrograms combined with other noninvasive methods for the monitoring of acute rejection after human heart transplantation.

Methods

Permanent pacemakers were implanted in 58 patients undergoing heart transplantations. Intramyocardial electrograms (IMEG) were recorded periodically and the results were compared with those from EMBs. The R wave amplitude of the IMEG was used as the index value, the average R wave amplitude at the third week following transplantation was considered as the baseline, and a reduction of >20% compared with the baseline was regarded as a positive result. EMB was performed in cases of positive IMEG results and also at other times. Other noninvasive methods were used to help the diagnosis. Acute rejection (AR) was defined as International Society of Heart-Lung Transplantation grade IIIA or higher.

Results

We obtained 1231 IMEG records and 127 EMBs. Of the total 127 EMBs, 53 were positive, in which there were 42 IMEG positive results and 11 negative, while in the rest 74 negative EMBs, there were 9 IMEG positive results and 65 negative. The sensitivity of IMEG for the diagnosis of AR was 79.2%, and the specificity was 87.8%. The positive predictive value was 82.4% and the negative predictive value was 85.5%. Of the total of 1231 IMEG records, 51 were positive and 1180 were negative. Excluding 11 proved by EMB to be false negative, if the other 1169 were considered as no evidence of rejection, through the other noninvasive methods, AR diagnosed by this noninvasive monitoring strategy, the sensitivity was 79.2%, and the specificity was 99.2%. The positive predictive value was 82.4% and the negative predictive value was 99.1%.

Conclusions

IMEG can be used as a noninvasive method for monitoring AR following heart transplantation. It is a continuous, safe and inexpensive method, and could reduce the need for EMB combined with other noninvasive methods, without reducing the detection of rejection.
The regulating role of mutant IκBα in expression of TIMP-2 and MMP-9 in human glioblastoma multiform
Authors: HU Yu-hua , YU Li-Jie , SHAO En-de , WU Jian-liang , JI Jian-wen
Published: January 2024

Background

Our previous studies demonstrated that mutant IκBα (IκBαM) inhibited the occurrence, growth and angiogenesis of human glioblastoma multiform (GBM). However, the specific mechanism by which IκBαM regulates protein-degrading enzymes secreted from GBM to inhibit invasion and metastasis has remained unclear. The aim of the present study was to investigate the regulatory role and significance of IκBαM genes in the expression of tissue inhibitor of metalloproteinase (TIMP)-2 and matrix metalloproteinase (MMP)-9 in human GBM.

Methods

We established the following four GBM cell lines stably expressing IκBαM by plasmid construction, gene transfection and screening for IκBαM protein expression: mutant IκBα-transfected cells (G36δ-M), wild-type IκBα-transfected cells (G36δ-W), empty plasmid transfected cells (G36δ-P) and untransfected cells (G36δ). The TIMP-2 and MMP-9 expression was detected by RT-PCR and Western blotting. Tumor cells were then implanted subcutaneously into nude mice to establish an animal model of ectopic tumor growth, and TIMP-2 and MMP-9 expression was determined by immunohistochemical methods.

Results

The results showed that there was a significant increase in TIMP-2 expression and a significant decrease in MMP-9 expression in the G36δ-M group at both the RNA and protein levels compared with the G36δ-W group, G36δ-P group and G36δ group. Similar results were observed in the immunohistochemical staining analysis of tumor tissues. In the G36δ-M group, TIMP-2 expression was significantly higher while MMP-9 expression was significantly lower than in the other three groups.

Conclusions

Our findings indicate that IκBαM inhibits the activation of NF-κB. It significantly up-regulates TIMP-2 expression in human malignant glioma cells and down-regulates the expression of MMP-9. Thus, IκBαM maintains the integrity of the extracellular matrix and further inhibits the growth and metastasis of tumor tissues.
Overexpression or knock-down of runt-related transcription factor 1 affects BCR-ABL-induced proliferation and migration in vitro and leukemogenesis in vivo in mice
Authors: YANG Li-jun , YU Wei-dong , DU Jun-bao , CHAO Shuang , CHEN Min-xia , ZHAO He-hua , GUO Jing-zhu
Published: January 2024

Background

Runt-related transcription factor 1 (Runx1) plays a crucial role in hematogenesis and its dysfunction may contribute to leukemogenesis. However, it is not clear whether or not abnormal expression of Runx1 will induce leukemia and how the change of Runx1 expression level could affect BCR-ABL-induced leukemogenesis. In the present study, we aimed to analyze if abnormal expression of Runx1 in BaF3 cells alone would induce leukemogenesis. And we also wanted to know if abnormal expression of Runx1 in leukemic cells would affect leukemogenesis. Furthermore, we investigated whether overexpression or knock-down of Runx1 in BaF3 cells would induce leukemogenesis.

Methods

Plasmids containing full-length Runx1 cDNA were transduced into BaF3 cells and BaF3-P185wt cells (BCR-ABL transformed BaF3 cells) by electroporation. Plasmids containing a short hairpin RNA of Runx1 were transduced into BaF3 cells and BaF3-P185wt cells by electroporation. Runx1 expression level was quantified by Western blotting and quantitative real-time PCR. The effects of overexpression or knock-down of Runx1 on proliferation, apoptosis and migration of cells were detected in vitro. Then, using MSCV-P185wt-EGFP as a control, we transplanted MSCV-P185wt-Runx1 cells or MSCV-P185wt-shRNA cells into Balb/c mice through tail vein and observed tumorgenesis of the different phenotypes.

Results

In vitro analysis revealed that overexpression of Runx1 in P185wt cells could inhibit cell proliferation and slow down cell migration; while knock-down of Runx1 could promote cell proliferation and speed up cell migration. In vivo analysis indicated that mice transplanted with MSCV-P185wt-Runx1 survived longer than controls. In contrast, mice transplanted with MSCV-P185wt-shRNA survived shorter than the control group. Gross pathological analysis revealed that the MSCV-P185wt-Runx1 group had less severe splenomegaly and hepatomegaly compared to the control group, and the MSCV-P185wt-shRNA group had more severe splenomegaly and hepatomegaly. No splenomegaly or hepatomegaly was detected in mice transplanted with MSCV-BaF3-Runx1 cells or MSCV-BaF3-shRNA cells. Both the mice of MSCV-BaF3-Runx1 group and MSCV-BaF3-shRNA group were healthy with no sign of leukemia for up to three months.

Conclusions

Overexpression or knock-down of Runx1 gene in BaF3 cells alone could not induce leukemogenesis. However, in BaF3-P185wt cells, alteration of Runx1 expression could affect BCR-ABL-induced proliferation and migration in vitro and leukemogenesis in vivo.
Vascular endothelial growth factor up-regulates the expression of intracellular adhesion molecule-1 in retinal endothelial cells via reactive oxygen species, but not nitric oxide
Authors: ZHANG Xiao-ling , WEN Liang , CHEN Yan-jiong , ZHU Yi
Published: January 2024

Background

The vascular endothelial growth factor (VEGF) is involved in the initiation of retinal vascular leakage and nonperfusion in diabetes. The intracellular adhesion molecule-1 (ICAM-1) is the key mediator of the effect of VEGFs on retinal leukostasis. Although the VEGF is expressed in an early-stage diabetic retina, whether it directly up-regulates ICAM-1 in retinal endothelial cells (ECs) is unknown. In this study, we provided a new mechanism to explain that VEGF does up-regulate the expression of ICAM-1 in retinal ECs.

Methods

Bovine retinal ECs (BRECs) were isolated and cultured. Immunohistochemical staining was performed to identify BRECs. The cultured cells were divided into corresponding groups. Then, VEGF (100 ng/ml) and other inhibitors were used to treat the cells. Cell lysate and the cultured supernatant were collected, and then, the protein level of ICAM-1 and phosphorylation of the endothelial nitric oxide synthase (eNOS) were detected using Western blotting. Griess reaction was used to detect nitric oxide (NO).

Results

Western blotting showed that the VEGF up-regulated the expression of ICAM-1 protein and increased phosphorylation of the eNOS in retinal ECs. Neither the block of NO nor protein kinase C (PKC) altered the expression of ICAM-1 or the phosphorylation of eNOS. The result of the Western blotting also showed that inhibition of phosphatidylinositol 3-kinase (PI3K) or reactive oxygen species (ROS) significantly reduced the expression of ICAM-1. Inhibition of PI3K also reduced phosphorylation of eNOS. Griess reaction showed that VEGF significantly increased during NO production. When eNOS was blocked by L-NAME or PI3K was blocked by LY294002, the basal level of NO production and the increment of NO caused by VEGF could be significantly decreased.

Conclusion

ROS-NO coupling in the retinal endothelium may be a new mechanism that could help to explain why VEGF induces ICAM-1 expression and the resulting leukostasis in diabetic retinopathy.
Mitochondrial DNA 4977-bp deletion correlated with reactive oxygen species production and manganese superoxide dismutase expression in gastric tumor cells
Authors: WANG Juan , LÜ You-yong
Published: January 2024

Background

Mitochondrial DNA 4977-bp deletion (ΔmtDNA4977) was reported in many human neoplasia. However, its biological significance remains to be evaluated and the molecular mechanism needs to be investigated. In this study, we analyzed the frequency of ΔmtDNA4977 in gastric cancer (GC) cell lines and tissues, as well as reactive oxygen species (ROS) contents and manganese superoxide dismutase (MnSOD) expression levels in GC cell lines to explore its biological significance and molecular mechanism.

Methods

Semi-quantitative PCR and real-time PCR were used to detect the incidence of ΔmtDNA4977 in 13 GC cell lines and 272 human gastric tissues (108 GC specimens and the respective adjacent normal tissues, and 56 normal gastric mucosa from non-cancer patients). We further identified intracellular ROS production by flow cytometry and MnSOD expression by semi-quantitative reverse transcription-PCR (RT-PCR) and Western blotting. Statistical analyses were carried out using the Logistic regression analysis and Kaplan-Meier method.

Results

Based on our earlier study, we optimized the PCR amplification condition by reducing the cycle number. In this study, we systematically documented the high incidence of ΔmtDNA4977 in GC cell lines (10/13, 76.9%), GC tissues (86/108, 79.6%), matched normal tissues (73/108, 67.6%), and normal gastric mucosa of non-cancer patients (29/56, 51.8%). A significantly higher incidence of mutated ΔmtDNA4977 was observed in GC tissues with respect to the adjacent normal tissues (79.6% vs 67.6%, P=0.045), and they were both higher than that in normal controls (P <0.05). Most importantly, we linked the ΔmtDNA4977 mutations with the expression level of MnSOD and ROS contents. The cell lines containing lower expression level of MnSOD was found to have generally higher frequent ΔmtDNA4977 and more ROS.

Conclusion

The decreased anti-oxidative ability, which leads to increased ROS contents, is correlated with the mtDNA damage during gastric carcinogenesis.

Chin Med J 2009;122(4):431–436
Predictors and clinical significance of the positive cone margin in cervical intraepithelial neoplasia III patients
Authors: SUN Xiao-guang , MA Shui-qing , ZHANG Jin-xia , WU Ming
Published: January 2024

Background

Conization is being widely accepted for diagnosis and treatment of cervical intraepithelial neoplasia (CIN). There is controversy as to which factors are most predictive of a positive cone margin and the clinical significance of it. We conducted this study to identify the predictive factors and to evaluate the clinical significance of a positive cone margin in CIN III patients.

Methods

A retrospective review was conducted of 207 patients who had undergone conization due to CIN III from January 2003 to December 2005 at Peking Union Medical College Hospital. Of these, 67 had a subsequent hysterectomy. Univariate and multivariate analysis were utilized to define the predictive factors for a positive cone margin, and to compare the pathologic results of conization with subsequent hysterectomy.

Results

One hundred and fifty-one (72.9%) were margin free of CIN I or worse, 37 (17.9%) had CIN lesions close to the margin and 19 (9.2%) had margin involvement. Atotal of 56 cases (27.1%) had positive cone margins (defined as the presence of CIN at or close to the edge of a cone specimen). Univariate analysis showed that the parity, cytological grade, multi-quadrants of CIN III by punch biopsy, gland involvement, as well as the depth of conization were significant factors correlated with a positive cone margin (P <0.05). However the age, gravidity, grade of dysplasia in punch biopsy, as well as the cone methods were not significantly correlated (P >0.05). Multivariate analysis revealed that the cytological grade (OR=1.92), depth of conization (OR=2.03), parity (OR=3.02) and multi-quadrants of CIN III (OR=4.60) were significant predictors with increased risk for positive margin. The frequency of residual CIN I or worse in hysterectomy specimens was found to be 55.6% (20/36) in patients who were margin free, 71.4% (15/21) in patients with CIN occurring close to margin, and 80.0% (8/10) in patients with margin involvement. The frequency of residual CIN III or worse was found to be 13.9% (5/36), 23.8% (5/21) and 50.0% (5/10) respectively in different groups.

Conclusions

Cytological grade, depth of conization, parity and multi-quadrants of CIN III in punch biopsy were significant factors with increased risk in predicting a positive cone margin. Margin status of conization did not mean the presence or absence of CIN, but rather the varied frequency of residual CIN in specimens of subsequent hysterectomy. In view of this fact, it is suggested that the margin status of conization be a valuable surrogate marker for clinical management of CIN III.
Issues on the selection of non-inferiority margin in clinical trials
Authors: HOU Yan , WU Xiao-yan , LI Kang
Published: January 2024

Objective

The determination of non-inferiority margin is an important and confusing issue which directly influences the acceptability of a new medication. We reviewed the published literature, International Conference on Harmonization of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH) Guidelines and Committee for Proprietary Medicinal Products (CPMP) papers on the selection of non-inferiority margin and the corresponding statistical tests in clinical trials, in order to provide practical recommendations and suggestions for establishing reference criteria for the non-inferiority margin in China.

Data sources

The literature on the selection of a non-inferiority margin and statistical tests was mainly extracted from relevant English articles on non-inferior clinical trials published from 1990 to 2007. The starting point (1990) was chosen due to lack of such papers published prior to 1990. This literature was searched via PubMed, Medline and Chinese Knowledge Information (CNKI). ICH guidelines and CPMP papers were downloaded from their official websites. The keywords “clinical trial”, “non-inferiority” and “non-inferiority margin” were used.

Study selection

Forty-three original articles and critical reviews, ICH E10 guideline and CPMP papers were selected.

Results

The non-inferiority testing with treatment difference and ratio are commonly used, where the non-inferiority margin is determined with and without historical data. Traditionally, this margin is treated as a fixed value, while developed methods take the variation into account in the determination of this margin, on which the test depends is more convincing. The mixed margin consisting of a margin based on treatment difference and a margin based on treatment ratio can exactly control the type I error at the desirable level and obtain a better power. In this review, we also provide some recommendations and suggestions for the selection of the non-inferiority margin in the western countries and China.

Conclusions

Besides the magnitude and variability of the standard control and placebo effects, the determination of the margin depends on other factors, such as, the safety profiles of the two comparative therapies, method of administration and product cost. Hence the margin should be made specifically for a certain case. Reference criteria for different medications should be given to avoid the arbitrary conclusion.
Intracoronary nitroprusside in the prevention of the no-reflow phenomenon in acute myocardial infarction
Authors: PAN Wei , WANG Lan-feng , YU Jia-hui , FAN Ying , YANG Shu-sen , ZHOU Li-jun , LI Yue , LI Wei-min
Published: January 2024

Background

No-reflow phenomenon during percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) is a predictive factor of continuous myocardial ischemia, ventricular remodeling and cardiac dysfunction, which is closely associated with a worse prognosis. This study aimed to evaluate intracoronary nitroprusside in the prevention of the no-reflow phenomenon in AMI.

Methods

Ninety-two consecutive patients with AMI, who underwent primary PCI within 12 hours of onset, were randomly assigned to 2 groups: intracoronary administration of nitroprusside (group A, n=46), intracoronary administration of nitroglycerin (group B, n=46). The angiographic results were observed. The real-time myocardial contrast echocardiography (RT-MCE), including contrast score index (CSI), wall motion score index (WMSI), transmural contrast defect length (CDL) and serious WM abnormal length (WML) were recorded at 24 hours and 1 week post-PCI.

High sensitivity C-reactive protein (Hs-CRP) was examined by immune rate nephelometry. N-terminal prohormone brain natriuretic peptide (NT-proBNP) was tested with enzyme-linked immunosorbent assay. Patients were followed up for six months. Major adverse cardiac events (MACE) were recorded.

Results

The incidence of final TIMI-3 flow in group A was much higher than that in Group B (P <0.05), final corrected TIMI frame count (cTFC) in group A decreased significantly than that in group B (P <0.01). The CSI, CDL/LV length, WMSI and WL/LV length in group A were significantly lower than that in group B (P <0.01). Levels of Hs-CRP and NT-proBNP at 1 week post-PCI decreased significantly in group A than that in group B (P <0.01). Patients were followed up for 6 months and the incidence of MACE in group A was significantly lower than that in group B (P <0.05).

Conclusion

Intracoronary nitroprusside can improve myocardial microcirculation, leading to the decrease of the incidence of no-reflow phenomenon and better prognosis.
Comparison of main lactobacillus species between healthy women and women with bacterial vaginosis
Authors: YAN Dong-hui , Zhi LÜ , SU Jian-rong
Published: January 2024

Background

The normal microbial flora of the vagina plays an important role in preventing genital and urinary tract infections in women. Thus an accurate understanding of the composition and ecology of the ecosystem is important to understanding the etiology of these diseases. This study aimed to compare the characteristics of main lactobacillus species between healthy women and women with bacterial vaginosis (BV) by quantitative culture and PCR methods.

Main lactobacillus species include L. crispatus, L. gasseri, L. jensenii and L. iners.

Methods

A total of 150 Women attending Gynecology Outpatient Clinic of Beijing Friendship Hospital, were diagnosed as having BV because three or more of the following criteria were met (standard of Amsel's composite criteria): homogeneous discharge, elevated vaginal pH (pH >4.5), production of amines, and presence of “clue” cells. Those with less than three of the criteria were considered as healthy. Simultaneously, smears were made of vaginal fluid and Gram stained, then were assessed qualitatively as normal (grade I), intermediate (grade II), or consistent with BV (grade III).

Gardnerella vaginalis were identified by using Vitek 2 Compact and PCR methods. Lactobacillus species were identified by PCR methods. Gardnerella vaginalis and lactobacilli colony counts were determined by calculating the most number of colonies of each species in the appropriate plates (colonies between 10 and 300), corrected by the dilution of the sample in the plates, and multiplied by 10 (to account for plating 100 μl), in order to get colony forming units per milliliter of vaginal secretion.

Results

BV was diagnosed in 31% (46/150) patients using the composite criteria, the remainder being regarded as healthy. The majority of patients with BV had a smear assessed as grade III (91%, 42/46) and minority of them had a smear assessed as grade II (9%, 4/46). The majority of healthy women had a smear assessed as grade I (64%, 67/104).

Smears assessed as grade II were found (36%, 37/104) among patients diagnosed as healthy, with less than three of the composite criteria. L. crispatus was cultured from 94% of healthy women and 83% of women with BV, with the former colonies count average value of 106 and the latter of 103. L. gasseri, L. iners, and L. jensenii were cultured from 85%, 68% and 43% of healthy women; and 28%, 89% and 44% of BV women, respectively.

Conclusions

The quantities of four lactobacillus species except L. jensenii had a significant difference between healthy women and women with BV. Our results provide support for the negative association between L. iners and L. gasseri. Although L. crispatus were existent both in healthy and BV positive women's vagina, the numbers of L. crispatus were significantly different for the dominant number in healthy women. Smears of vaginal fluid and Gram stain play an important guiding role in bacteria culture.
Prognostic impact of splenectomy on advanced proximal gastric cancer with No. 10 lymph node metastasis
Authors: HUANG Chang-ming , WANG Jia-bin , LU Hui-shan , ZHENG Chao-hui , LI Ping , XIE Jian-wei , ZHANG Xiang-fu
Published: January 2024

Background

This study evaluated the prognostic impact of D2 lymphadenectomy combined with splenectomy in patients with advanced proximal gastric cancer and lymph node metastasis at the splenic hilum (No. 10 lymph nodes).

Methods

The clinical records of 216 patients with advanced proximal gastric cancer and No. 10 lymph node metastasis who underwent D2 curative resection were retrospectively analyzed. Seventy-three patients underwent simultaneous splenectomy (splenectomy group), while 143 patients did not (spleen-preserving group). Five-year survival rates, mean numbers of dissected No. 10 lymph nodes and metastatic No. 10 lymph nodes, and operative morbidity and mortality were calculated and compared between the two groups. Potential prognostic factors were evaluated by univariate and multivariate analysis.

Results

The 5-year survival rate was 30.0% for the splenectomy group and 19.7% for the spleen-preserving group (χ2=14.73, P <0.05). The mean numbers of dissected No. 10 lymph nodes and metastatic No. 10 lymph nodes in the splenectomy group were significantly greater than in the spleen-preserving group (P <0.05). Multivariate analysis revealed that the depth of invasion, splenectomy, and type of gastrectomy were independent prognostic factors. The survival rate for T3 patients with and without splenectomy was 38.7% and 18.9%, respectively (χ2 =15.03, P <0.05). For patients undergoing total gastrectomy, survival rates were 33.4% and 20.7%, respectively (χ2 =13.63, P<0.05). Operative morbidity and mortality in splenectomy group was 24.7% and 4.1%, respectively, and in the spleen-preserving group was 17.5% and 3.5%, respectively. The differences were not statistically significant (P >0.05).

Conclusions

Splenectomy is beneficial for No. 10 lymph node dissection in patients with advanced proximal gastric cancer. To improve patient prognosis, total gastrectomy with splenectomy is recommended for patients with T3 proximal gastric cancer who have No. 10 lymph node metastasis.
Bilateral primary breast lymphoma
Authors: Yi Jung Im , Chae Byung Joo , Bae Ja Seong , Kang Bong Joo , Lee Ahwon , Song Byung Joo , Jung Sang Seol
Published: January 2024

Primary breast lymphoma (PBL) is rare, accounting for 0.04%-0.50% of breast malignancies and 1.7% of extranodal lymphoma.1,2 The originally described diagnostic criteria for PBL2 remains the standard definition for this disease. These criteria are breast location as the clinical site of presentation, absence of history of previous lymphoma or evidence of widespread disease at diagnosis, close association of lymphoma with breast tissue in pathologic specimens, and involvement of ipsilateral lymph nodes if they develop simultaneously with PBL. Although the origin of the lymphocytes within the breast that give rise to lymphoma is unclear, these tumors may arise from mucosal-associated lymphoid tissue. While breast lymphoma is rare, either as a primary site or as secondary involvement, the latter is more common in patients having a diffuse disease.3 Most reports of PBL have been from single institutions, have involved a small number of cases, and have typically been retrospective. A limitation of these reports concerns the plethora of histological subtypes, various treatment modalities, and different staging systems that exist. Presently, we reported a 47-year-old female patient with bilateral PBL who presented with large and rapidly growing masses in both breasts, and compared this case with the available literatures.
Morphologic characteristics of late stent malapposition after drug-eluting stents implantation by optical coherence tomography follow-up
Authors: HOU Jing-bo , LIU Hui-min , MA Li-jia , YANG Shuang , MENG Ling-bo , HAN Zhi-gang , ZHANG Shuo , YU Bo
Published: January 2024

Background

Late stent malapposition was frequently observed after DES implantation, which has been associated with the occurrence of late stent thrombosis due to poor neointimal coverage. This study was designed to evaluate the frequency of late stent malapposition at least 1 year after different DESs implantation by optical coherence tomography (OCT).

Methods

Angiographic and OCT examinations were given to 68 patients who had received total 126 various DESs implantation for at least 1 year to detect late stent malapposition. Malapposed strut distance (MSD), malapposed strut area (MSA), reference lumen area (RLA) and reference stent area (RSA) were checked with off-line OCT analysis.

Results

Totally 26 Cypher Select stents, 15 Taxus Liberte stents, 51 Partner stents and 34 Firebird I stents were examined. Among 68 patients who underwent DES implantation, 7 patients (10.3%) had late malapposition. Average RSA, MSA and MSD were (7.9±2.8) mm2,(2.0±1.6) mm2 and (590±270) μm respectively. According to the MSA/RSA ratio, 4 patients had slight malapposition, 2 patients had moderate malapposition and 1 patient had severe malapposition.

Conclusions

Late stent malapposition is detected frequently after implantation of DES, but if this predisposes to late stent thrombosis and requires any specific therapy needs to be further elucidated.
A multicenter, phase III trial of hemocoagulase Agkistrodon: hemostasis, coagulation, and safety in patients undergoing abdominal surgery
Authors: WEI Jun-min , ZHU Ming-wei , ZHANG Zhong-tao , JIA Zhen-geng , HE Xiao-dong , WAN Yuan-lian , WANG Shan , XIU Dian-rong , TANG Yun , LI Jie , XU Jing-yong , ZHENG Qing-shan
Published: January 2024

Background

Hemocoagulase Agkistrodon for injection is a single component thrombin which has passed phases I and II clinical trials. The purpose of this phase III clinical trial was to evaluate the effect of Hemocoagulase Agkistrodon on hemostasis and coagulation in abdominal skin and subcutaneous incisions and to assess the safety of this agent in surgical patients.

Methods

This is a phase III, prospective, randomized, double-blind, and controlled multicenter clinical trial including 432 consecutive patients randomized into either a study group (injected with hemocoagulase Agkistrodon at 2 U, n=324) or a control group (injected with hemocoagulase Atrox, n=108). The hemostatic time, hemorrhagic volume, hemorrhagic volume per unit area, blood coagulation, and adverse events were measured and compared between the two groups.

Results

The mean hemostatic time in the study group was (36.8±18.7) seconds; the hemorrhagic volume was (3.77±3.93) g; and the hemorrhagic volume per unit area was (0.091±0.125) g/cm2. In the control group, the corresponding values were (38.1±19.7) seconds, (4.00±4.75) g, and (0.095±0.101) g/cm2, respectively. No significant difference in values existed between the two groups (P >0.05). Blood coagulation results and hepatic and renal function were also similar between the two groups. Adverse events were reported in two cases, but were deemed non-drug-related.

Conclusions

Hemocoagulase Agkistrodon has good hemostatic and coagulative function and is safe for the use of arresting capillary hemorrhage that occurs while incising the abdomen during surgery.
Prevalence, clinical characteristics and outcome in patients with chronic heart failure and diabetes
Authors: SHI Chuan , WANG Ling-jie , HU Dan-feng , LI Jin-ping , ZHU Tian-qi , SHAN Ying , ZHAO Jian-rong , ZHANG Feng-ru , SHEN Wei-feng
Published: January 2024

Background

Chronic heart failure (CHF) and diabetes mellitus portend high morbidity and mortality because of an interrelated pathophysiologic process. This large cohort study aimed to analyze the prevalence, clinical characteristics and long-term outcome of patients with CHF and diabetes.

Methods

A total of 1119 patients with NYHA functional class II-IV and left ventricular ejection fraction (LVEF) <45% between January 1995 and May 2009 were recruited. Clinical variables, biochemical and echocardiographic measurements were retrospectively reviewed, and composite major cardiac events (MCE) including death, heart transplantation, and refractory heart failure requiring multiple hospitalizations were recorded.

Results

The prevalence of CHF with diabetes was progressively increased with time (16.9% in 1995-1999; 20.4% in 2000-2004, and 29.1% in 2005-2009) and age (18.5% in <60 years, 26.6% in 60-80 years, and 26.6% in >80 years). Compared with CHF patients without diabetes, those with diabetes had worse cardiac function, more abnormal biochemical changes, and higher mortality. Treatment with glucose-lowering agents significantly improved LVEF and decreased MCE. An elevated serum HbA1c level was associated with large left ventricular end-systolic diameter (P <0.05), decreased LVEF (P <0.01) and reduced survival (P <0.05). Multivariable Logistic regression analysis revealed that after adjustment for confounding factors, NYHA functional class (OR 2.65, 95% CI 1.14-6.16, P=0.024) and HbA1c level ≥7% (OR 2.78, 95% CI 1.00-7.68, P=0.049) were independent risk factors for adverse outcomes in CHF patients with diabetes.

Conclusions

Prevalence of CHF with diabetes was increasing during past decades, and patients with CHF and diabetes had worse clinical profiles and prognosis. Aggressive anti-CHF and diabetes therapies are needed to improve overall outcomes for these patients.
Differentially expressed genes identified by microarray analysis following leptin treatment of hepatic stellate cells
Authors: ZHONG Li-hua , CHENG Jun , ZHU Li-ying
Published: January 2024

Background

Liver fibrosis is the process through which numerous chronic liver diseases develop into liver cirrhosis. Leptin can activate hepatic stellate cells (HSCs) and play an important role in the formation of liver fibrosis. However, the process by which leptin activates HSCs is complicated, and research on this process is limited. The aim of this study was to explore the related changes in gene expression and the control mechanisms involved in leptin activated HSCs to understand the overall mechanism of liver fibrosis development.

Methods

We cultivate rat HSCs, with and without stimulation by leptin, and extracted mRNA. Differentially expressed genes were detected by microarray analysis.

Results

The differentially expressed genes identified included six upregulated genes and six downregulated genes. The representative upregulated genes included short chain dehydrogenase (CY5/CY3=2.265) and pulmonary surfactant protein A1 (CY5/CY3=2.036). The significant downregulated gene encoded hepatic stearoyl coenzyme A desaturase 1 (SCD-1) (CY5/CY3=0.351).

Conclusion

Leptin might mediate the molecular biological mechanisms of liver fibrosis.
Up-regulation of the transient A-type K+ current (IA) in the differentiation of neural stem cells of the early postnatal rat hippocampus
Authors: GUO Hong-bo , HUANG Lian-yan , ZOU Yu-xi , ZOU Fei
Published: January 2024

Background

Neural stem cells (NSCs) not only are essential to cell replacement therapy and transplantation in clinical settings, but also provide a unique model for the research into neurogenesis and epigenesis. However, little attention has been paid to the electrophysiological characterization of NSC development. This work aimed to identify whether the morphological neuronal differentiation process in NSCs included changes in the electrophysiological properties of transient A-type K+ currents (IA).

Methods

NSCs were isolated from early postnatal rat hippocampus and were multiplied in basic serum-free medium containing basic fibroblast growth factor. Potassium currents were investigated and compared using whole-cell patch-clamp techniques and one-way analysis of variance (ANOVA), respectively.

Results

Compared with NSC-derived neurons, cloned NSCs (cNSCs) had a more positive resting membrane potential, a higher input resistance, and a lower membrane capacitance. Part of cNSCs and NSC-derived neurons possessed both delayed-rectifier K+ currents (IDR) and IA, steady-state activation of IA in cNSCs (half-maximal activation at (21.34±4.37) mV) occurred at a more positive voltage than in NSC-derived neurons at 1–6 days in vitro (half-maximal activation at (12.85±4.19) mV).

Conclusions

Our research revealed a developmental up-regulation of the IA component during differentiation of postnatal NSCs. Together with the marked developmental up-regulation of IDR in vitro neuronal differentiation we have previously found, the voltage-gated potassium channels may participate in neuronal maturation process.

Chin Med J 2010;123(13):1731–1735
Current role of surgery for the treatment of fulminant Clostridium difficile colitis
Authors: WANG Ming-fei , DING Zhao , ZHAO Jian , JIANG Cong-qing , LIU Zhi-su , QIAN Qun
Published: January 2024

Objective

This review discusses the current status and progress in studies on fulminant Clostridium difficile colitis (FCDC), including the definition, risk factor, diagnostic role of CT, surgical treatment, postoperative mortality, and new therapeutic strategy.

Data sources

A literature search was conducted mainly in Medline and PubMed published in English between January 2000 and May 2011. The search terms were “fulminant Clostridium difficile colitis”, “treatment””, “surgery” and “mortality”.

Results

Recent studies show that the overall mortality rate for FCDC remains high despite early surgical intervention. It has been difficult to identify the real value for surgical intervention in patients with FCDC due to the absence of prospective, randomized studies. Early recognition of patients with FCDC will help a clinician decide the need for treatment in an intensive care setting, multi-disciplinary consultation, and appropriate therapeutic selection. Some studies emphasize the importance of early recognition and emergent surgery at a less severe stage. Monoclonal antibody therapy and intravenous immunoglobulin treatment may be useful for the treatment of FCDC.

Conclusions

Present studies do not provide strong evidence for guiding the surgical treatment of FCDC; hence, creation of collaborative research networks is crucial in order to undertake large prospective multi-center studies for improvement in overall survival.
Spine surgery may cause more spinal epidural hematomas than spinal puncture
Authors: Jian-xiong AN , FANG Qi-wu , Sullivan Erin A. , Williams John P.
Published: January 2024

Background

Spinal epidural hematoma (SEH) is a rare but acute and possibly devastating clinical event. The purpose of this study is to assess the multiple etiologies of SEH seen in an academic medical center over a 15-year span. We have examined the etiologies of SEH occurring in a single institution, the University of Pittsburgh Medical Center (UPMC) over the last fifteen years using an electronic record keeping system and database: the Medical Archive Retrieval System (MARS).

Methods

We screened MARS from 1986-2001 using key words: epidural, hematoma and spinal. All potential SEH cases were reviewed and only those confirmed by surgical intervention were identified as positive SEH and reported in this study.

Results

There were 17 cases of confirmed SEH. Among them, seven cases were from spontaneous bleeding, seven cases following spinal surgery, and three cases from traumatic spinal fracture. There were no findings of SEH that were related to spinal or epidural anesthesia. Among the seven patients with spontaneous SEH; two were receiving anti-coagulants for deep venous thrombosis (DVT) and had elevated prothrombin time (PT) and activated partial thromboplastine time (APTT), one had hemophilia (type B), four had hypertension, and three out of seven had chronic renal or liver disease. Among postoperative SEH patients, two of the seven patients were receiving chemotherapy and radiation therapy and one had ongoing hemodialysis for renal failure. Among three patients with traumatic SEH, two had ankylosing spondylitis. Six patients had a history of alcohol abuse.

Conclusions

Spontaneous bleeding is by far the leading cause of SEH with spinal surgery being the second leading cause. Patients with multiple co-morbidities that result in coagulopathy from a variety of causes include liver or renal disease, alcohol abuse, radiation therapy, or chemotherapy. Neuraxial anesthesia is an extremely rare cause of SEH.
Antagonism between gene therapy and epigenetic therapy on human laryngeal carcinoma tumor-bearing mice
Authors: LIAN Meng , WANG Qi , FANG Ju-gao , WANG Hong , FAN Er-zhong
Published: January 2024

Background

Gene therapy and epigenetic therapy have gained more attention in cancer treatment. However, the effect of a combined treatment of gene therapy and epigenetic therapy on head and neck squamous cell carcinoma have not been studied yet. To study the mechanism and clinical application, human laryngeal carcinoma cell (Hep-2) tumor-bearing mice were used.

Methods

A xenograft tumor model was established by the subcutaneous inoculation of Hep-2 cells in the right armpit of BALB/c nu/nu mice. The mice with well-formed tumor were randomly divided into six groups. Multisite injections of rAd-p53 and/or 5-aza-dC were used to treat tumor. Tumor growth was monitored by measuring tumor volume and growth rate. p53 and E-cadherin protein levels in tumor tissues were detected by immunohistochemical staining. The mRNA levels were monitored with FQ-PCR.

Results

Gene therapy was much more effective than single epigenetic therapy and combined therapy. The gene therapy group has the lowest tumor growth rate and the highest expression levels of p53 and E-cadherin.

Conclusions

The combined treatment of gene and epigenetic therapy is not suggested for treating head and neck carcinoma, because gene therapy shows an antagonistic effect to epigenetic therapy. However, the mechanisms of action are still unclear.