bluuebunny/crossref_metadata_2025 huggingface dataset:
Endovascular treatment of central venous stenosis and obstruction in hemodialysis patients
Authors: SHI Ya-xue , YE Meng , LIANG Wei , ZHANG Hao , ZHAO Yi-ping , ZHANG Ji-wei
Published: January 2024

Background

Central venous stenosis and obstruction (CVD) is a serious and prevalent challenge to both resolve the venous hypertension symptoms and maintain the pantency of the ipsilateral hemodialysis access in hemodialysis patients. This study aimed to summarize our experience of the endovascular management of the central venous stenosis or obstruction in hemodialysis patients.

Methods

Twenty-four haemodialysis cases of central vein stenosis or obstruction with ipsilateral functional vascular access in our hospital between July 2006 and February 2012 were treated by interventional therapy and the data were analyzed retrospectively.

Results

Eighteen males and six females with mean age of (66.4±13.8) years and manifesting with arm swelling and venous hypertension were enrolled; 62.5% of them had a history of catheterization. Venography showed stenotic lesion in 10 cases including eight cases of brachiocephalic vein stenosis and two cases of subclavian vein stenosis and 14 cases of obstruction lesions including seven cases of short brachiocephalic obstruction and seven cases of long segment obstruction. Interventional therapy was performed and the technique success rate was 83.3%. Percutaneous transluminal angioplasty (PTA) was performed in nine cases and stent was performed in 11 cases firstly. The symptoms of venous hypertension were resolved after intervention in all the cases. There was no major complication and death perioperatively. During follow-up, reintervention was done, the primary patency rates were (88.9±10.5)%, (64.8±10.5)% and (48.6±18.7)% at 3 months, 6 months and 1 year after treatment in the PTA group; (90.0±9.5)% and (77.1±14.4)% at 6 months and 1 year after treatment in the stent group, respectively. The secondary patency rates were (48.6±18.7)% in the PTA group and (83.3±15.2)% in the stent group 1 year after treatment, respectively. There was no significant difference between the two groups (primary patency, P=0.20; secondary patency, P=0.10).

Conclusions

The endovascular intervention is a safe and effective method for CVD in short term; enhanced follow-up and repeated interventions are required to maintain patency for long term. The prevention is most important. Avoiding and minimizing the placement of the central venous catheter may be the key point for the prevention.
Progress of radiation oncology: known and unknown
Authors: Liu Jing , Yu Jinming
Published: January 2024

Objective

To elaborate known and unknown aspects of radiation oncology.

Data sources

Data cited in this review were obtained mainly from PubMed and Medline in English from 1999 to 2013, with keywords “individualized medicine”, “personalized medicine”, “radiation dose”, “radiation target”, “molecular targeted therapy”, “molecular imaging” and “functional imaging”.

Study selection

Articles regarding radiation target delineation, radiation doses, new technology and equipment, combination of radiotherapy and molecular targeted therapy as well as other aspects were identified, retrieved and reviewed.

Results

A larger radiation field and a higher radiation dose are not always better. New equipment and technology are also not always better than conventional equipment and technologies. Effectiveness of radiotherapy combined with molecular targeted therapy needs more data to verify.

Conclusion

Personalized radiotherapy is the direction for the future.
Atrial natriuretic peptide attenuates inflammatory responses on oleic acid-induced acute lung injury model in rats
Authors: ZHU Yao-bin , ZHANG Yan-bo , LIU Dong-hai , LI Xiao-feng , LIU Ai-jun , FAN Xiang-ming , QIAO Chen-hui , LING Feng , LIU Ying-long
Published: January 2024

Background

An inflammatory response leading to organ dysfunction and failure continues to be a major problem after injury in many clinical conditions such as sepsis, severe burns, and trauma. It is increasingly recognized that atrial natriuretic peptide (ANP) possesses a broad range of biological activities, including effects on endothelial function and inflammation. A recent study has revealed that ANP exerts anti-inflammatory effects. In this study we tested the effects of human ANP (hANP) on lung injury in a model of oleic acid (OA)-induced acute lung injury (ALI) in rats.

Methods

Rats were randomly assigned to three groups (n=6 in each group). Rats in the control group received a 0.9% solution of NaCl (1 ml·kg-1·h-1) by continuous intravenous infusion, after 30 minutes a 0.9% solution of NaCl (1 ml/kg) was injected intravenously, and then the 0.9% NaCl infusion was restarted. Rats in the ALI group received a 0.9% NaCl solution (1 ml·kg-1·h-1) intravenous infusion, after 30 minutes OA was injected intravenously (0.1 ml/kg), and then the 0.9% NaCl infusion was restarted. Rats in the hANP-treated ALI group received a hANP (0.1 μg·kg-1·min-1) infusion, after 30 minutes OA was injected intravenously (0.1 ml/kg), and then the hANP infusion was restarted. The anti-inflammation effects of hANP were evaluated by histological examination and determination of serum cytokine levels.

Results

Serum interleukin (IL)-1β, IL-6, IL-10 and tumor necrosis factor (TNF) α were increased in the ALI group at six hours. The levels of all factors were significantly lower in the hANP treated rats (P <0.005). Similarly, levels of IL-1β, IL-6, IL-10 and TNF-α were higher in the lung tissue in the ALI group at six hours. hANP treatment significantly reduced the levels of these factors in the lungs (P <0.005). Histological examination revealed marked reduction in interstitial congestion, edema, and inflammation.

Conclusion

hANP can attenuate inflammation in an OA-induced lung injury in rat model.
Programmed cell death 5 correlates with disease activity and interleukin-17 in serum and synovial fluid of rheumatoid arthritis patients
Authors: WANG Jun-feng , GUAN Zhen-peng , ZHANG Shao-long , PEI Zheng , CHEN Ying-yu , PAN Huan
Published: January 2024

Background

Programmed cell death 5 (PDCD5) is a novel apoptotic regulatory gene that promotes apoptosis in various tumor cells. Studies have shown that PDCD5 accelerates the apoptosis of synoviocytes in vitro, implying a potential role in rheumatoid arthritis (RA) pathogenesis. This study examined the expression of PDCD5 in serum and synovial fluid of RA patients, its effect on the expression of inflammatory cytokine, interleukin-17 (IL-17), and the assessment of disease activity in RA.

Methods

PDCD5 and IL-17 levels in serum and synovial fluid from 18 patients with RA and 22 patients with osteoarthritis (OA) were detected using enzyme-linked immunosorbent assay (ELISA). Concentrations of serum PDCD5 in 40 healthy people were also detected as controls. As disease activity indices, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), rheumatoid factor (RF), and X-ray grading scale were also evaluated.

Results

Serum and synovial fluid PDCD5 levels in RA patients were significantly higher than those in OA and healthy controls. Serum PDCD5 level was inversely correlated to CRP and ESR, and was significantly higher in the RF negative group than in the positive group. PDCD5 level was also negatively correlated with IL-17 levels both in serum and synovial fluid of RA patients. However, differences in synovial fluid PDCD5 level from RA patients at different Larsen stages were not detectable.

Conclusions

PDCD5 affects RA pathogenesis. Insufficient apoptosis of fibroblast-like synoviocytes and inflammatory cells in RA could increase the expression of PDCD5 protein. As PDCD5 levels correlated negatively with disease activity indices and IL-17 level, PDCD5 could become a target in the diagnosis and treatment of RA.
Risk factors for perioperative major cardiac events in Chinese elderly patients with coronary heart disease undergoing noncardiac surgery
Authors: LIU Zi-jia , YU Chun-hua , XU Li , HAN Wei , JIANG Jing-mei , HUANG Yu-guang
Published: January 2024

Background

Few studies have investigated perioperative major adverse cardiac events (MACEs) in elderly Chinese patients with coronary heart disease (CHD) undergoing noncardiac surgery. This study examined the incidence and risk factors for perioperative MACE in elderly patients who underwent noncardiac surgery, and established a risk stratification system.

Methods

This retrospective observational clinical study included 482 patients aged ≥60 years with CHD who underwent elective major noncardiac surgery at the Peking Union Medical College Hospital. The primary outcome was MACE within 30 days after surgery. Risk factors were evaluated using multivariate Logistic regression analysis.

Results

Perioperative MACE occurred in 61(12.66%) of the study patients. Five independent risk factors for perioperative MACE were identified: history of heart failure, preoperative arrhythmia, preoperative diastolic blood pressure ≤75 mmHg, American Society of Anesthesiologists grade 3 or higher, and intraoperative blood transfusion. The area under the receiver operating characteristic curve for the risk-index score was 0.710±0.037. Analysis of the risk stratification system showed that the incidence of perioperative MACE increased significantly with increasing levels of risk.

Conclusions

Elderly Chinese patients with CHD who undergo noncardiac surgery have a high risk of perioperative MACE. Five independent risk factors for perioperative MACE were identified. Our risk stratification system may be useful for assessing perioperative cardiac risk in elderly patients undergoing noncardiac surgery.
Factors associated with low adherence to head-of-bed elevation during mechanical ventilation in Chinese intensive care units
Authors: LIU Jing-tao , SONG Hai-jing , WANG Yu , KANG Yan , JIANG Li , LIN Si-han , DU Bin , MA Peng-lin
Published: January 2024

Background

Elevating the head of bed (HOB) 30°-45° has been widely supported as a means of ventilator associated pneumonia (VAP) prevention. However, it was poorly adhered in clinical practice. This observational study aimed to investigate the factors impeding this simple practice at the bedside.

Methods

This prospective study was conducted in 33 Chinese academic hospital intensive care units (ICUs). HOB angle was measured four times daily at 5l7 hour intervals. The predefined HOB elevation goal was an angle ≥30°.

Results

The overall rate of achieving the HOB goal was 27.8% of the 8647 measurements in 314 patients during 2842 ventilation days. The HOB goal of ≥3 times/d was consistently achieved only in 15.9% of the cases. Almost 60% of patients had at least one 24 hours period during which the HOB goal was never documented. This low rate of protocol compliance was not associated with acute physiology and chronic health evaluation (APACHE) II score or dependence on vasopressors. In a survey, “nurse workload” was identified as the most important factor for non-compliance with the HOB goal. In addition, the rates of compliance were significantly different (P <0.001) between physicians self-reporting that they either did or did not know the Institutes of Healthcare Improvement (IHI) ventilator bundle.

Conclusions

Low adherence to a HOB angle of L303 was found in this nationwide survey. Nursing workload and lack of knowledge on VAP prevention were important barriers to changing this practice.
Efficacy and safety of triple-antiplatelet therapy after percutaneous coronary intervention: a meta-analysis
Authors: ZHANG Yong , TANG Hai-qin , LI Jin , FU Zhao-xin
Published: January 2024

Background

The combination of cilostazol, aspirin and clopidogrel (triple antiplatelet therapy, TAT) after a percutaneous coronary intervention has been used as an alternative therapy. We performed a meta-analysis to evaluate the efficacy and safety of TAT for patients after percutaneous coronary intervention (PCI).

Methods

We systematically searched Pubmed, Embase and Web of Science databases to identify all randomized controlled trials (RCTs) that compared dual antiplatelet therapy (DAT) with and without cilostazol after PCI. All analyses were conducted using Review Manager 5.0.

Results

The final analysis consisted of 4474 patients from ten studies. The combined results suggested that there was a lower risk of cardiac death (relative risk (RR)=0.55, 95% confidence interval (CI): 0.31-0.98, P <0.05) and major adverse cardiac events (MACEs) (RR=0.63, 95% CI: 0.54-0.74, P <0.05) in patients treated with TAT as compared to those with DAT follow-ups after six months to one year; no significant difference was observed in bleeding and non-fatal myocardial infarction (MI) (RR=1.14, 95% CI: 0.80-1.64, P >0.05; RR=0.87, 95% CI: 0.42-1.83, P >0.05). However, the rate of adverse drug reaction was higher in patients receiving TAT than in patients receiving DAT (RR=2.21, 95% CI: 1.84-2.66, P <0.05). Moreover, there was a lower risk of stent thrombosis in patients treated with TAT as compared to those treated with DAT (RR=0.44, 95% CI: 0.21-0.94, P <0.05). The TAT group had a reduced risk of target lesion revascularization (TLR) (RR=0.60, 95% CI: 0.43-0.82, P=0.001) and target vessel revascularization (TVR) than the DAT group (RR=0.56, 95% CI: 0.45-0.71, P <0.05). The number of MACEs was lower for patients in the TAT group than in the DAT group with diabetes mellitus sub-analysis (RR=0.41, 95% CI: 0.28-0.61, P <0.05). But no significant difference was observed between the two groups regarding MACEs in patients with drug-eluting stent implantations (RR=0.82, 95% CI: 0.65-1.03, P >0.05).

Conclusion

TAT could significantly reduce the rates of MACEs and cardiac death in comparison to DAT, but more attention should be paid to adverse side effects of the drugs.
Telmisartan promotes proliferation and differentiation of endothelial progenitor cells via activation of Akt
Authors: Cao Zheng , Yang Yong , Hua Xianping , Wu Ruixia , Wang Junfeng , Zhou Ming , Zhan Zhongqun , Chen Pingying
Published: January 2024

Background

Numerous studies have demonstrated that the peroxisome proliferator-activated receptor-γ (PPARγ) plays an important role in regulating endothelial progenitor cells (EPC) function. Telmisartan, as a partial agonist of PPARγ, may have an effect on the regulation of EPC functions. The purpose of this study was to investigate the effects of telmisartan on EPC proliferation and differentiation.

Methods

Peripheral blood derived mononuclear cells containing EPC were isolated from healthy volunteers and then cultured on fibronectin-coated dishes in the presence or absence of telmisartan. The proliferative activity of EPC was determined by colony forming units (CFU) and MTT assay. The migratory activity of EPC was assessed by transwell assay. The expression of endothelial cells (EC) markers, including vascular endothelial cadherin (VE-cadherin), von Willebrand factor (vWF) and endothelial nitric oxide synthase (eNOS), were measured by Western blotting analysis.

Results

Morphological analysis revealed that telmisartan significantly increased the proliferation of EPC and the number of endothelial cell colony forming units. Telmisartan could enhance the expression of the makers of mature EC, including VE-cadherin, vWF, and eNOS, which indicated telmisartan could stimulate EPC to differentiate into mature EC. Telmisartan increased the phosphorylation of Akt in EPC. The inhibition of Akt activation significantly attenuated the effect of telmisartan on EPC functions, suggesting that Akt is involved in the stimulatory effect of telmisartan on EPC differentiation.

Conclusions

The results of this study demonstrate that telmisartan promotes EPC functions via activation of Akt.
Change in cholesterol absorption and synthesis markers in patients with coronary heart disease after combination therapy with simvastatin plus ezetimibe
Authors: ZHANG Tao , WU Wen-feng , LIU Yang , WANG Qi-hui , WANG Lü-ya , MI Shu-hua
Published: January 2024

Background

Statins and ezetimibe have been reported to change the balance of cholesterol metabolism, but few studies have been performed on Chinese patients. The aim of this study was to evaluate changes in cholesterol metabolism markers in patients with coronary heart disease.

Methods

Forty-five patients with coronary heart disease were treated with 20 mg/d of simvastatin for four weeks. Subjects were then divided into two different therapy groups according to whether they reached the target values for total cholesterol and low density lipoprotein cholesterol level. Patients who reached the target values remained on simvastatin and those who did not reach the target values took a combination of simvastatin plus 10 mg/d ezetimibe until the 12th week. The concentrations of cholesterol synthesis markers (lathosterol and desmosterol) and absorption markers (campesterol and sitosterol) were measured on the 1st, 4th, and 12th week of the study by gas chromatography.

Results

After treatment with simvastatin for four weeks, the levels of total cholesterol and low density lipoprotein cholesterol decreased significantly compared to levels measured during the 1st week (P <0.05). On the 12th week the levels of total cholesterol and low density lipoprotein cholesterol had decreased significantly (P <0.001) compared to levels during the 4th week. By the 12th week the levels of campesterol and sitosterol in the combination group had decreased significantly (P <0.05) compared with levels measured during the 4th week.

Conclusions

Coronary heart disease patients with high cholesterol synthesis at baseline might gain a greater benefit from simvastatin treatment. Combination therapy with simvastatin plus ezetimibe in patients with low cholesterol synthesis at baseline might increase the success rate of lipid-lowering through decreasing the absorption of cholesterol.
Changes in main causes of death in Macao residents from 1986-2006
Authors: CHAN Man-si , CHEN Qing , LAM Christopher Wai-kei
Published: January 2024

Background

Since Macao's return of sovereignty to China in December 1999, the life style of Macao residents has changed. The aim of this study was to investigate changes of death patterns in Macao residents from 1986 to 2006 in order to identify the trends and patterns of major public health problems, which could provide the guidance for developing public health policies.

Methods

A retrospective study was conducted for this investigation. Research data were collected from official websites and statistical yearbooks and classified by the International Classification of Diseases (ICD)-9.

Results

It was observed that mortality from the three major causes of (1) infectious, maternal and childhood diseases, (2) chronic non-communicable diseases, and (3) injury and poisoning were 17.7, 298.2 and 26.0 per 100 000, respectively. The largest decrease in death rate over the 21-year study-period was from infectious, maternal and childhood diseases (62.5%). The highest mortality rate was ischemic heart diseases (37.0%). The largest increase in mortality rate was lung cancer (46.9%).

Conclusions

Mortality rate of Macao residents progressively decreased, but the constituent ratio of death from chronic non-communicable diseases was increasing. The mortality rate of lung cancer was clearly ascending, so emphasis should be put on tertiary prevention in future.
Indication of lower neck irradiation in nasopharyngeal carcinoma without nodal metastasis: the potential impact of tumor volume
Authors: FU Jie , ZHOU Jia-yin , CHONG Vincent FH , Khoo James BK
Published: January 2024

Background

Elective radiation of lower neck is controversial for nasopharyngeal carcinoma (NPC) without lymph node metastasis (NO disease). Tumor volume is an important prognostic indicator. The objective of this study is to explore the potential impact of tumor volume on the indication of the lower neck irradiation for NO-NPC, by a qualitative evaluation of the relationship between tumor volume and nodal metastasis.

Methods

Magnetic resonance (MR) images of 99 consecutive patients with NPC who underwent treatment were retrospectively reviewed. Primary tumor volumes of NPC were semi-automatically measured, nodal metastases were N-classified and neck level involvements were examined. Distributions of tumor volumes among N-category-based groups and distributions of N-categories among tumor volume-based groups were analyzed, respectively.

Results

The numbers of patients with NO to N3 disease were 12, 39, 32, and 16, respectively. The volumes of primary tumor were from 3.3 to 89.6 ml, with a median of 17.1 ml. For patients with nodal metastasis, tumor volume did not increase significantly with the advancing of N-category (P >0.05). No significant difference was found for the distribution of N1, N2, and N3 categories among tumor volume-based groups (P>0.05). Nevertheless patients with nodal metastasis had significantly larger tumor volumes than those without metastasis (P <0.05). Patients with larger tumor volumes were associated with an increased incidence of nodal metastasis.

Conclusions

Certain positive correlations existed between tumor volume and the presence of nodal metastasis. The tumor volume (>10 ml) is a potential indicator for the lower neck irradiation for NO-NPC.
Finite element analysis of neodymium: yttrium-aluminum-garnet incisions for the prevention of anterior capsule contraction syndrome
Authors: WANG Yan-ling , WANG Zhen-ze , ZHAO Lu , XIONG Shi-hong , LI Qian , WANG Ning-li , SUN An-qiang
Published: January 2024

Background

Anterior capsular contraction syndrome is a potential complication of continuous curvilinear capsulorhexis (CCC). Three neodymium: yttrium-aluminum-garnet (Nd:YAG) laser relaxing incisions decrease anterior capsular contraction but the mechanism is unknown. The present study analyzed the biomechanical mechanism of three Nd:YAG laser relaxing incisions made to reduce anterior capsular contraction.

Methods

A three-dimensional control model and a three-dimensional Nd:YAG model of the anterior capsule with an opening diameter of 6 mm were created. Three incisions of 1 mm in length were made centrifugally at intervals of 120° around the opening circle. The stress alterations of the anterior capsule after CCC with and without Nd:YAG relaxation were numerically simulated and compared.

Results

In the control model, the stress was axially uniform in the inner area and relatively high near the inner rim of the opening. Meanwhile, in the Nd:YAG model, the stress level was very low in the inner opening areas, especially near the three incisions. The relaxing incisions in the Nd:YAG model significantly released the relatively high stress on the anterior capsule. Additionally, there was a high stress gradient near the relaxing incisions.

Conclusion

Biomechanical effects of stress release may be the preventive mechanism of Nd:YAG incision against anterior capsular contraction syndrome.
Quantitative assessment of late lumen loss after biodegradable polymer and permanent polymer sirolimus-eluting stents implantation
Authors: Kan Jing , Chen Feng , Liu Li-ya , Xu Hai-mei , Lin Ling , Liu Yan , Zhao Ying-ying , Cheng Jiu-pei , Chen Shao-liang
Published: January 2024

Background Sirolimus-eluting stents (SES) are reported to be associated with reduced late lumen loss (LLL), resulting in less frequent restenosis when compared to bare-metal stent. The current study aimed to assess the difference in LLL between SES with biodegradable and with permanent polymer.

Methods From March 2010 to June 2011, 300 consecutive patients having only biodegradable polymers or permanent polymer SES for all diseased vessels were included. Serial quantitative coronary analysis was performed on both the “in-stent” and “segment” area, including the stented segment, as well as both five mm margins proximal and distal to the stent. The primary endpoint was the LLL defined as the minimal lumen diameter (MLD) post-stenting minus the MLD at nine-month after the indexed procedure.

Results LLL was comparable between the two stents. Importantly, LLL for the distal segment (median 0.05 mm, interquartile 0 to 0.09 mm) was less severe compared with in-stent (median 0.13 mm, interquartile 0.08 to 0.18 mm) and proximal segment LLL (median 0.12 mm, interquartile 0.06 to 0.14 mm, all P <0.001). In general, the LLL was associated with the post-procedure MLD (b=0.28, P=0.002), hyperlipidemia (b=0.14, P=0.021), and calcified lesions (b=0.58, P=0.001). The R
2 and R
adj of the multiple regression model were 0.651 and 0.625, respectively.

Conclusions SES with either biodegradable or permanent polymer had lower value of LLL. The small amount of LLL at the distal segment possibly contributed to the less distal edge stenosis.
Outcome of catheter ablation of atrial fibrillation in patients with prior ischemic stroke
Authors: Li Song-nan , Kang Jun-ping , Du Xin , He Xiao-nan , Long De-yong , Yu Rong-hui , Tang Ri-bo , Sang Cai-hua , Jiang Chen-xi , Ning Man , Dong Jian-zeng , Ma Chang-sheng
Published: January 2024

Background Catheter ablation for atrial fibrillation (AF) has been demonstrated to be effective in a subsets of patients with AF. However, very few data are available in regard to patients with prior history of stroke undergoing catheter ablation. This study aimed to investigate the outcome of catheter ablation in AF patients with prior ischemic stroke.

Methods Between January 2008 and December 2011, of 1897 consecutive patients who presented at Beijing An Zhen Hospital for treatment of drug-refractory AF, 172 (9.1%) patients in the study population had a history of ischemic stroke. All patients underwent catheter ablation and were followed up to assess maintenance of sinus rhythm and recurrence of symptomatic stroke.

Results Among these 1897 patients, 1768 (93.2%) who had complete follow-up information for a minimum of six months were included in the final analysis. Patients in the stroke group (group I) and the no-stroke group (group II) were similar in regards to gender, body mass index (BMI), history of diabetes, type of AF, and left atrial size. The patients in group I were older than those in group II, and had a higher incidence of hypertension, chronic heart failure, lower left ventricular ejection fraction (LVEF), and higher CHADS2 scores. Six months after ablation, 107 (68.6%) patients in group I and 1403 (87.1%) in group II had discontinued warfarin treatment (P <0.001). During a median follow-up of (633±415) days, 65 patients in the group I and 638 in group II experienced AF recurrence, and five patients in group I and 28 in group II developed symptomatic stroke. The rates of AF recurrence and recurrent stroke were similar between group I and group II (41.7% vs. 39.6%, P=0.611; 3.2% vs. 1.7%, P=0.219; respectively).

Conclusion Catheter ablation of AF in patients with prior stroke is feasible and efficient.
Effect of CO2 pneumoperitoneum on the expression of the chemokine receptors CXCR4 and CCR7 in colorectal carcinoma cells in vitro
Authors: YANG Chun-kang , LI Guo-dong , YING Min-gang , XU Ke
Published: January 2024

Background

The ability of pneumoperitoneum in laparoscopic surgery to promote proliferation and metastasis of colorectal cancer has become a focus of research in the field of minimally invasive surgery. The aim of this research was to investigate the effect of CO2 pneumoperitoneum under different pressures and exposed times on the expression of chemokine receptors in colorectal carcinoma cells.

Methods

We constructed an in vitro pneumoperitoneum model. SW480 colon carcinoma cells were exposed to CO2 pneumoperitoneum under different pressures (6, 9, 12, and 15 mmHg) for 1, 2, and 4 hours. These cells were then cultivated under the same conditions as normal SW480 colon carcinoma cells without CO2 pneumoperitoneum (control group), treated at 37°C, and 5% CO2. The expression of the chemokine receptors CXC receptor 4 (CXCR4) and chemokine C receptor 7 (CCR7) was detected by immunocytochemistry and reverse transcriptase polymerase chain reaction after being cultivated for 0, 24, 48, and 72 hours.

Results

Immunocytochemistry showed that CXCR4 expression in SW480 cells was significantly decreased in the 6, 9, 12, and 15 mmHg CO2 pneumoperitoneum-treated groups for the same exposure times compared with controls (P <0.05). CCR7 expression in SW480 cells was significantly decreased in the 12 and 15 mmHg CO2 pneumoperitoneum-treated groups compared with controls (P <0.05). CXCR4 and CCR7 expression increased up to the level of the control group after 24 and 48 hours (P >0.05). If the CO2 pneumoperitoneum pressure increased, CXCR4 and CCR7 expression decreased at all exposure times. If the CO2 pneumoperitoneum exposure time prolonged, there were no significant differences in CXCR4 and CCR7 expression under the same pressure. Under all exposure times, CXCR4 and CCR7 mRNA expression was significantly decreased in the 6, 9, 12, and 15 mmHg CO2 pneumoperitoneum-treated groups (P <0.05) compared with controls, and it increased up to the level of controls after being cultivated for 48 hours (P >0.05). If the CO2 pneumoperitoneum pressure increased (with all exposure times) and exposure time prolonged (under the same pressure), there were no significant differences in CXCR4 and CCR7 expression.

Conclusions

CXCR4 and CCR7 expression is temporarily affected after continuous CO2 pneumoperitoneum treatment. The high pressure of CO2 pneumoperitoneum plays an important role in suppressing the expression of these chemokine receptors. Different lengths of time of exposure to a CO2 pneumoperitoneum-like environment do not change CXCR4 and CCR7 expression.
Expressions of CLDN1 and insulin-like growth factor 2 are associated with poor prognosis in stage N2 non-small cell lung cancer
Authors: Zhang Zhen-fa , Pei Bao-xiang , Wang An-lei , Zhang Lian-min , Sun Bing-sheng , Jiang Ri-cheng , Wang Chang-li
Published: January 2024

Background

Patients with single station mediastinal lymph node (N2) non-small cell lung cancer (NSCLC) have a better prognosis than those with multilevel N2. The molecular factors which are involved in disease progression remain largely unknown. The purpose of this study was to investigate gene expression differences between single station and multilevel N2 NSCLC and to identify the crucial molecular factors which are associated with progress and prognosis of stage N2 NSCLC.

Methods

Gene expression analysis was performed using Agilent 4×44K Whole Human Genome Oligo Microarray on 10 freshfrozen lymph node tissue samples from single station N2 and paired multilevel N2 NSCLC patients. Real-time reverse transcription (RT)-PCR was used to validate the differential expression of 14 genes selected by cDNA microarray of which four were confirmed. Immunohistochemical staining for these validated genes was performed on formalin-fixed, paraffin-embedded tissue samples from 130 cases of stage N2 NSCLC arranged in a high-density tissue microarray.

Results

We identified a 14 gene expression signature by comparative analysis of gene expression. Expression of these genes strongly differed between single station and multilevel N2 NSCLC. Four genes (ADAM28, MUC4, CLDN1, and IGF2) correlated with the results of microarray and real-time RT-PCR analysis for the gene-expression data in samples from 56 NSCLC patients. Immunohistochemical staining for these genes in samples from 130 cases of stage N2 NSCLC demonstrated the expression of IGF2 and CLDN1 was negatively correlated with overall survival of stage N2 NSCLC.

Conclusions

Our results suggest that the expression of CLDN1 and IGF2 indicate a poor prognosis in stage N2 NSCLC. Further, CLDN1 and IGF2 may provide potential targeting opportunities in future therapies.
Retinal nerve fiber layer in primary open-angle glaucoma with high myopia determined by optical coherence tomography and scanning laser polarimetry
Authors: WANG Xiao-en , WANG Xiao-yu , GU Yang-shun , HUANG Zhu
Published: January 2024

Background

Fundus changes associated with high myopia (HM) may mask those associated with primary open-angle glaucoma (POAG). This study aim to determine the characteristics of RNFL thickness changes in patients with both POAG and HM and compare these to changes in patients with only HM. The diagnostic capabilities of both OCT and GDxVCC in this subset of patients are also evaluated.

Methods

Twenty-two eyes with POAG and HM (spherical equivalent (SE) between −6.0 and −12.0 D) were evaluated, and 22 eyes with HM were used for comparison. Characteristic retinal nerve fiber layer (RNFL) thickness profiles in patients with POAG and HM were examined using optical coherence tomography (OCT) and scanning laser polarimetry with variable corneal compensation (GDxVCC), and the diagnostic capabilities of these imaging modalities were compared. RNFL parameters evaluated included superior average (Savg-GDx), inferior average (Iavg-GDx), temporal-superior-nasal- inferior-temporal (TSNIT) average, and nerve fiber indicator (NFI) on GDxVCC and superior average (Savg-OCT), inferior average (Iavg-OCT), nasal average (Navg-OCT), temporal average (Tavg-OCT), and average thickness (AvgThick-OCT) on OCT (fast RNFL scan). Visual field testing was performed and defects were evaluated using mean defect (MD) and pattern standard deviation (PSD).

Results

The RNFL parameters (P <0.05) significantly different between groups included Savg-GDx, Iavg-GDx, TSNIT average, NFI, Savg-OCT, Iavg-OCT, Tavg-OCT, and AvgThick-OCT. Significant correlations existed between TSNIT average and AvgThick-OCT (r=0.778), TSNIT average and MD (r=0.749), AvgThick-OCT and MD (r=0.647), TSNIT average and PSD (r=−0.756), and AvgThick-OCT and PSD (r=−0.784). The area under the receiver operating characteristic curve (AUROC) values of TSNIT average, Savg-GDx, Iavg-GDx, NFI, Savg-OCT, Iavg-OCT, Navg-OCT, Tavg-OCT, and AvgThick-OCT were 0.947, 0.962, 0.973, 0.994, 0.909, 0.917, 0.511, 0.906, and 0.913, respectively. The NFI AUROC was the highest value.

Conclusions

RNFL thickness was significantly lower in all but the nasal quadrant in patients with POAG and HM, compared to patients with only HM. Measurements with OCT and GDxVCC were well-correlated, and both modalities detected RNFL thickness changes. However, GDxVCC was better than OCT in detecting POAG in HM patients.
Comparison of the reaction time of wrist flexion and extension between patients with stroke and age-matched healthy subjects and correlation with clinical measures
Authors: BI Sheng , WAN Chun-xiao
Published: January 2024

Background

Brain injury had an effect on reaction time (RT) and brain-injured patients were normally significantly slower than normal controls. The RT of the paretic upper limb (UL) in patients with stroke was slower than in a control group. The present study was designed to compare the RTs of the unaffected and affected sides in stroke survivors and those of normal subjects. This study also explores the relationships among wrist flexion and extension RTs in the affected side and the motor deficits of the UL as measured by clinical Composite Spasticity Index (CSI), Associated Reaction Rating Score (ARRS), and Wolf Motor Function Test (WMFT) scores.

Methods

Ninety-eight hemiparetic stroke survivors and 20 normal subjects participated in the study. Abnormal muscle tone was measured by CSI. Associated reaction was measured by ARRS. Motor function was measured by WMFT. The subject was asked to flex or extend the affected and non-affected wrists as fast as possible, following an auditory “go” signal. An electrogoniometer attached to the wrist measured wrist flexion and extension angle. RT was defined as the time from the “go” signal to a change in wrist angle denoting movement onset. Clinical assessments and RT were conducted within one day. Differences in the variables between normal subjects and the unaffected sides of the stroke patients were analyzed using analysis of variance. Correlations were assessed by computing Spearman's correlation coefficient. The significance level was set at 5%.

Results

RTs of wrist flexion and extension in the stroke survivors' affected hands were significantly longer than those in normal subjects and their unaffected hands (P <0.01 for both). The wrist flexion RT moderately correlated with CSI (ρ=0.412, P<0.001) and ARRS (ρ=0.341, P <0.001) and with WMFT functional ability (negatively; ρ=-0.531, P <0.001) and time score (ρ=0.504, P <0.001). Similarly, the wrist extension RT moderately correlated with CSI (ρ=0.429, P<0.001), ARRS (ρ=0.374, P<0.001), and with WMFT functional ability (negatively; ρ=−0.531, P <0.001) and time score (ρ=0.486, P <0.001).

Conclusions

RTs of wrist flexion and extension on the stroke survivors' affected sides were significantly longer than those on the unaffected sides and those of normal subjects. The wrist flexion and extension RTs moderately correlated with CSI and ARRS and inversely with motor functional performance of the UL in patients with stroke.
Twenty-year trends in major cardiovascular risk factors in hospitalized patients with acute myocardial infarction in Beijing
Authors: CAO Cheng-Fu , REN Jing-Yi , ZHOU Xiang-Hai , LI Su-Fang , CHEN Hong
Published: January 2024

Background

Hypertension, diabetes mellitus, hypercholesterolaemia and current smoking are the strongest modifiable cardiovascular risk factors for acute myocardial infarction (AMI). We examined their changing trends over the last 20 years.

Methods

The clinical data of 3498 patients hospitalized in Peking University People's Hospital with AMI from 1991 to 2010 were used. Information was collected regarding to patients' demographic data, cardiovascular risk factors (hypertension, diabetes mellitus, hypercholesterolemia and current smoking). To assess trends over time in the prevalence of risk factors, we categorized patients into four groups (1991 to 1995, 1996 to 2000, 2001 to 2005 and 2006 to 2010).

Results

Highly significant increases were observed in the prevalence of hypertension from 40.8% to 55.6% for males and from 58.0% to 69.0% for females; and diabetes mellitus from 12.9% to 30.8% for males and from 23.0% to 42.3% for females. Similarly, the prevalence of hypercholesterolaemia decreased from 53.1% to 30.7% for males and from 57.0% to 44.0% for females. The prevalence of current smoking decreased in females from 29.0% to 11.1%, but remained unchanged in males. In addition, the proportion of patients with more than three modifiable risk factors increased from 19.0% to 27.1% and the age at onset of AMI extended to younger as well as older individuals.

Conclusions

The prevalence of hypertension and diabetes mellitus are still increasing in patients with AMI in Beijing and although the prevalence of hypercholesterolaemia and current smoking decreased, high clustering of risk factors were commonly present. These adverse trends show a compelling need for more effective management of cardiovascular risk factors.
Predicting value of serum soluble ST2 and interleukin-33 for risk stratification and prognosis in patients with acute myocardial infarction
Authors: Zhang Kun , Zhang Xin-chao , Mi Yu-hong , Liu Juan
Published: January 2024

Background

Acute myocardial infarction (AMI) is a common cardiac emergency with high mortality. Serum soluble ST2 (sST2) is a new emerging biomarker of cardiac diseases. The present study is to investigate the predictive value of sST2 and interleukin-33 (IL-33) for risk stratification and prognosis in patients with AMI.

Methods

Fifty-nine patients with AMI, whose chief complaint was chest pain or dyspnea, were selected for our study. Physical examination, chest radiograph, electrocardiograph (ECG), biomarkers of myocardial infarction, NT-proBNP, echocardiography and other relevant examinations were performed to confirm the diagnosis of AMI. Thirty-six healthy people were chosen as the control group. Serum samples from these subjects (patients within 24 hours after acute attack) were collected and the levels of sST2 and IL-33 were assayed by enzyme-linked immuno-sorbent assay (ELISA) kit. The follow-up was performed on the 7th day, 28th day, 3rd month and 6th month after acute attack. According to the follow-up results we defined the end of observation as recurrence of AMI or any causes of death.

Results

Median sST2 level of the control group was 9.38ng/ml and that of AMI patients was 29.06ng/ml. Compared with the control group, sST2 expression in the AMI group was significantly different (P<0.001). In contrast, the IL-33 level showed no significant difference between the two groups. Serum sST2 was a predictive factor independent of other variables and may provide complementary information to NT-proBNP or GRACE risk score. IL-33 had no relationship to recurrence of AMI. Both sST2 and the IL-33/sST2 ratio were correlated with the 6-month prognosis; areas under the ROC curve were 0.938 and 0.920 respectively.

Conclusions

Early in the course (<24 hours) of AMI, sST2 usually increases markedly. The increase of sST2 has an independent predictive value for the prognosis in AMI patients and provides complementary information to NT-proBNP or GRACE risk score. The IL-33/sST2 ratio correlates with the 6-month prognosis of AMI patients. However, there is no significant relationship between IL-33 and the prognosis of AMI patients.
Heme oxygenase-1 promotes Caco-2 cell proliferation and migration by targeting CTNND1
Authors: ZHANG Li , LIU Yu-lin , CHEN Guang-xiang , CUI Bin , WANG Jin-shen , SHI Yu-long , LI Le-ping , GUO Xiao-bo
Published: January 2024

Background

Heme oxygenase-1 (HO-1) can be induced by inflammatory cytokines, oxidation, ischemia, hypoxia, and endotoxins. As a “graft survival protective gene,” HO-1 is a hot spot in organ transplantation research. However, the role of HO-1 gene expression in the function of human colon adenocarcinoma cell line (Caco-2) cells has not been reported previously.

Methods

The role of HO-1 in the proliferation and migration of Caco-2 cells was analyzed using a stable HO-1 expression plasmid. We constructed a recombinant adeno-associated virus plasmid containing the HO-1 gene, heme oxygenase 1 (HMOX1), which was transfected into Caco-2 intestinal cells. We identified a number of target genes by global microarray analysis combined with real-time polymerase chain reaction (PCR) and chromatin immunoprecipitation assay.

Results

Our results showed that significant HO-1 upregulation was demonstrated in the Caco-2 cells after HO-1 transfection. Restoration of HO-1 expression promoted proliferation and invasion in vitro. The CTNND1 gene, a member of the armadillo protein family, was identified as a direct HO-1 target gene.

Conclusion

Overexpression of HO-1 promotes Caco-2 cell proliferation and migration by targeting the CTNND1 gene.
Retinal blood flow velocity in patients with active uveitis using the retinal function imager
Authors: Feng Xing , Sanjay Kedhar , Chavakij Bhoomibunchoo
Published: January 2024

Background

Previous studies suggest a link between macular edema and retinal blood flow velocity (RBFV). The effects of inflammation in the retinal blood vessels are not clearly understood. We want to evaluate the differences in retinal blood flow velocities of patients with active uveitis and healthy controls using the retinal function imager (RFI) and determine the correlation between retinal blood flow velocity and central macular thickness in uveitis patients.

Methods

Twenty-eight eyes of 24 patients with active anterior uveitis and 51 eyes of 51 normal control subjects were enrolled. Retinal blood flow velocities evaluated by RFI and central macular thickness evaluated by optical coherence tomography (SLO-OCT) were obtained. Differences among the groups were assessed using Stata statistical software.

Results

Ten eyes had uveitic cystoid macular edema (CME). Median (first quartile, third quartile) venous velocity for uveitic eyes with CME, uveitic eyes without CME, and controls were 2.09 (1.92, 2.44), 2.64 (2.32, 2.86), and 2.82 (2.39, 3.53) mm/s respectively. Median (first and quartile) arterial velocity for uveitic eyes with CME, uveitic eyes without CME, and controls were 3.79 (3.61, 4.09), 3.46 (2.86, 4.12), and 3.93 (3.35, 4.65) mm/s. Uveitic eyes with CME had significantly lower venous velocity than controls (P=0.044). There was a strong linear relationship between venous velocity and central retinal thickness (P=0.007).

Conclusions

Retinal venous velocities were significantly decreased in eyes with uveitic CME relative to controls. Decreased venous velocity was correlated with increased central retinal thickness in uveitic eyes.
Long-term outcome of correction of tetralogy of Fallot in 56 adult patients
Authors: Zheng Da-wei , Shao Guo-feng , Feng Qiang , Ni Yi-ming
Published: January 2024

Background

Although most patients with tetralogy of Fallot undergo radical repair during infancy and childhood, patients that remain undiagnosed and untreated until adulthood can still be treated. This study aimed to evaluate long-term outcomes of adult patients with tetralogy of Fallot who were treated surgically, and to determine the predictors of postoperative pulmonary regurgitation.

Methods

Fifty-six adult patients underwent complete surgical repair. Forty-three patients (76.8%) required a transannular patch. Systolic, diastolic, and mean pressure in the main pulmonary artery were measured after repair.

Results

The early mortality rate was 3.6%. The 16-year survival rate was (84.4±11.5)%. Late echocardiography revealed 41 patients with transannular patch who had pulmonary regurgitation, consisting of mild pulmonary regurgitation in 28 patients, moderate in eight, and severe regurgitation in five patients. In addition, there was right ventricular outflow tract stenosis in nine patients, moderate/severe tricuspid valve regurgitation in seven, and residual ventricular septal defect in five. Logistic regression analysis demonstrated that the mean pulmonary pressure measured just after repair predicted late pulmonary regurgitation.

Conclusions

The long-term survival of surgically treated adult patients with tetralogy of Fallot is acceptable. The mean pressure >20 mmHg in the main pulmonary artery measured right after surgical repair may be a feasible reference to time the reconstruction of the pulmonary valve.
Association between folate intake, serum folate levels and the risk of lung cancer: a systematic review and meta-analysis
Authors: Dai Wei-min , Yang Bo , Chu Xiang-yang , Wang Yu-qi , Zhao Ming , Chen Li , Zhang Guo-qing
Published: January 2024

Background

Folate plays a critical role in nucleotide synthesis and DNA methylation, and was considered to be associated with anti-carcinogenesis. Results from studies that concern the relationship between the folate intake or serum folate levels and lung cancer risk showed no consistency, which requires our further comprehensive metaanalysis.

Methods

Systematic literature search was conducted to identify the relevant studies (published prior to February 2013) according to standard protocol. Estimated effects were calculated under both random-effects and fixed-effects models. Heterogeneity between studies and publication bias were also evaluated.

Results

A total of 4390 cases and 6138 controls from 6 case-control studies revealed a significant overall inverse association between folate intake and lung cancer risk (OR = 0.74, 95% CI = 0.65-0.84, P< 0.001). Summary of 1438 cases and 2582 controls from 4 case-control studies and 44 cases out of a cohort of 1988 participants suggested a marginal association without significance (OR = 0.78, 95% CI = 0.60-1.02, P = 0.075) between high serum folate levels and less lung cancer susceptibility; however, subgroup analysis about population-based case-control studies showed that high serum folate levels significantly associated with the reduced lung cancer risk (OR = 0.76, 95% CI = 0.58-1.00, P = 0.048).

Conclusion

Higher folate intake can be a protective factor against lung cancer risk, and higher serum folate level is probably associated with reduced lung cancer risk in marginal manner, though more studies are warranted to confirm these associations.