bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of epinephrine and Shen-Fu injection on resuscitation outcomes in a porcine model of prolonged cardiac arrest
Authors: Yin Wenpeng , Guo Zhijun , Li Chunsheng
Published: January 2024

Background

Epinephrine has been used as a first-choice vasopressor drug for cardiac arrest (CA) since 1974. However, the administration of epinephrine is controversial. This study aims to compare the effects of Shen-Fu injection (SFI) and epinephrine on resuscitation outcomes in a porcine model of prolonged CA.

Methods

Ventricular fibrillation (VF) was electrically induced. After 8 minutes of untreated VF and 2 minutes of chest compressions, 24 pigs were randomly divided into 3 groups (n=8 per group): central venous injection of SFI (SFI group), epinephrine (EPI group), or saline solution (SA group). The haemodynamic status and oxygen metabolism parameters, including cardiac output, mean arterial pressure, left ventricular dp/dtmax and negative dp/dtmax, oxygen delivery (DO2), and oxygen consumption (VO2), were calculated.

Results

SFI shortened the time to restoration of spontaneous circulation (ROSC) and decreased the number of shocks, similar to epinephrine. However, the mean arterial pressure, cardiac output, left ventricular dp/dtmax and negative dp/dtmax were significantly higher in the SFI group than in the EPI group at 4 and 6 hours after ROSC. VO2 and ERO2 decreased after ROSC and then increased. VO2 and ERO2 were significantly higher in the SFI group than in the EPI and SA groups after ROSC, while those were lowest in the EPI group among all groups.

Conclusions

SFI shortened the time to ROSC and decreased the number of shocks, similar to epinephrine. However, SFI improved oxygen metabolism, and produced a better hemodynamic status compared with epinephrine. SFI might be a potentially vasopressor drug for the treatment of CA.
Correlation between magnetic resonance T2 image signal intensity ratio and cell apoptosis in a rabbit spinal cord cervical myelopathy model
Authors: Ma Lei , Zhang Di , Chen Wei , Shen Yong , Zhang Yingze , Ding Wenyuan , Zhang Wei , Wang Linfeng , Yang Dalong
Published: January 2024

Background

Cervical spondylotic myelopathy (CSM) is a common cause of disability in elderly patients. Previous studies have shown that spinal cord cell apoptosis due to spinal cord compression plays an important role in the pathology of myelopathy. Although changes in magnetic resonance imaging (MRI) T2 signal intensity ratio (SIR) are considered to be an indicator of CSM, little information is published supporting the correlation between changes in MRI signal and pathological changes. This study aims to testify the correlation between MRI T2 SIR changes and cell apoptosis using a CSM animal model.

Methods

Forty-eight rabbits were randomly assigned to four groups: one control group and three experimental chronic compression groups, with each group containing 12 animals. Chronic compression of the cervical spinal cord was implemented in the experimental groups by implanting a screw in the C3 vertebra. The control group underwent sham surgery. Experimental groups were observed for 3, 6, or 9 months after surgery. MRI T2-weighted SIR Tarlov motor scores and cortical somatosensory-evoked potentials (CSEPs) were periodically monitored. At each time point, rabbits from one group were sacrificed to determine the level of apoptosis by histology (n=6) and Western blotting (n=6).

Results

Tarlov motor scores in the compression groups were lower at all time points than the control group scores, with the lowest score at 9 months (P <0.001). Electrophysiological testing showed a significantly prolonged latency in CSEP in the compression groups compared with the control group. All rabbits in the compression groups showed higher MRI T2 SIR in the injury epicenter compared with controls, and higher SIR was also found at 9 months compared with 3 or 6 months. Histological analysis showed significant apoptosis in the spinal cord tissue in the compression groups, but not in the control group. There were significant differences in apoptosis degree over time (P <0.001), with the 9-month group displaying the most severe spinal cord apoptosis. Spearman's rank correlation test showed that there was close relation between MRI SIR and degree of caspase-3 expression in Western blotting (r=0.824. P <0.001).

Conclusions

Clear apoptosis of spinal cord tissue was observed during chronic focal spinal compression. Changes in MRI T2 SIR may be related to the severity of the apoptosis in cervical spinal cord.
Construction of the Chinese Veteran Clinical Research (CVCR) Platform for the assessment of non-communicable diseases
Authors: Jiping Tan , Nan Li , Jing Gao , Yuhe Guo , Wei Hu , Jinsheng Yang , Baocheng Yu , Jianmin Yu , Wei Du , Wenjun Zhang , Lianqi Cui , Qingsong Wang , Xiangnan Xia , Jianjun Li , Peiyi Zhou , Baohe Zhang , Zhiying Liu , Shaogang Zhang , Lanying Sun , Nan Liu , Ruixiang Deng , Wenguang Dai , Fang Yi , Wenjun Chen , Yongqing Zhang , Shenwu Xue , Bo Cui , Yiming Zhao , Luning Wang
Published: January 2024

Background

Based on the excellent medical care and management system for Chinese veterans, as well as the detailed medical documentation available, we aim to construct a Chinese Veteran Clinical Research (CVCR) platform on non-communicable diseases (NCDs) and carry out studies of the primary disabling NCDs.

Methods

The Geriatric Neurology Department of Chinese People's Liberation Army General Hospital and veterans' hospitals serve as the leading and participating units in the platform construction. The fundamental constituents of the platform are veteran communities. Stratified typical cluster sampling is adopted to recruit veteran communities. A cross-sectional study of mental, neurological, and substance use (MNS) disorders are performed in two stages using screening scale such as the Mini-Mental State Examination and Montreal cognitive assessment, followed by systematic neuropsychological assessments to make clinical diagnoses, evaluated disease awareness and care situation.

Results

A total of 9 676 among 277 veteran communities from 18 cities are recruited into this platform, yielding a response rate of 83.86%. 8 812 subjects complete the MNS subproject screening and total response rate is 91.70%. The average participant age is (82.01±4.61) years, 69.47% of veterans are 80 years or older. Most participants are male (94.01%), 83.36% of subjects have at least a junior high school degree. The overall health status of veterans is good and stable. The most common NCD are cardiovascular disorders (86.44%), urinary and genital diseases (73.14%), eye and ear problems (66.25%), endocrine (56.56%) and neuro-psychiatric disturbances (50.78%).

Conclusion

We first construct a veterans' comprehensive clinical research platform for the study of NCDs that is primarily composed of highly educated Chinese males of advanced age and utilize this platform to complete a cross-sectional national investigation of MNS disorders among veterans. The good and stable health condition of the veterans could facilitate the long-term follow-up studies of NCDs and provide prospective data to the prevention and management of NCDs.
Sleep disorders and its related risk factors in patients undergoing chronic peritoneal dialysis
Authors: Li Han , Li Xiaobei , Feng Sujuan , Zhang Guizhi , Wang Wei , Wang Shixiang
Published: January 2024

Background

The prevalence of sleep disorders has been shown to be high in patients with chronic dialysis patients and may contribute to impaired quality of life and higher mortality in this population. However, there are few data on the relationship of sleep disorders and their risk factors in chronic dialysis patients. The aim of this study was to evaluate the relationship of sleep disorders and their risk factors in chronic dialysis patients.

Methods

A total of 42 continuous ambulatory peritoneal dialysis (CAPD) patients were involved in this cross-sectional study. Sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI). Restless legs syndrome (RLS) was diagnosed according to the criteria of the International Restless Legs Syndrome Study Group. And depression was assessed by Hamilton depression scale. General information and laboratory data were collected.

Results

The prevalence of sleep disorders was 47.6% in the CAPD patients. According to the PSQI, the 42 CAPD patients were divided into sleep disturbance group and non-sleep disorders group. There were no significant differences in age, gender, dialysis duration, hemoglobin, serum creatinine, urea nitrogen, β2-microglobulin, parathyroid hormone, calcium, and phosphorus between CAPD patients with sleep disorders and those without sleep disorders. But the level of serum albumin (Alb) in CAPD patients with sleep disorders was significantly lower than that in CAPD patients without sleep disorders (31.3±1.4 vs. 34.3±3.7, t=3.603, P=0.001). And the prevalence of RLS and depression was significantly higher than that in CAPD patients without sleep disorders (RLS: 11/22 vs. 1/20, χ2=10.395, P=0.001; depression: 7/22 vs. 1/20, χ2=4.886, P=0.027). In CAPD patients with RLS, the prevalence of sleep disorders was significantly higher than that in CAPD patients without RLS (11/22 vs. 11/30, χ2=10.395, P=0.001). And in CAPD patients with depression, the prevalence of sleep disorders was significantly higher than that in CAPD patients without depression (7/8 vs. 15/34, χ2=4.886, P=0.027). In CAPD patients, bivariate correlation analysis showed that sleep disorders was negatively correlated with serum Alb (r= -0.606, P=0.000) and positively correlated with RLS (r=0.497, P=0.001) and depression (r=0.341, P=0.029). Multivariate regression analysis revealed that the odds ratio of RLS, depression, and low serum Alb was 22.900, 42.209, and 0.597, respectively.

Conclusions

The prevalence of sleep disorders was relatively high in CAPD patients. RLS, depression, and low serum Alb were the risk factors for CAPD patients with sleep disorders.
T8590C polymorphism of CYP4A11 is a risk factor for hypertension: a meta-analysis
Authors: Jiang Yuan , Hou Jing , Zhang Qiang , Tang Wenru , Luo Ying
Published: January 2024

Background

T8590C polymorphism of CYP4A11 has been associated with hypertension, though with conflicting results. The aim of this study was to quantitatively summarize the evidence for CYP4A11 T8590C polymorphism and hypertension risk.

Methods

Electronic search of PubMed and the Chinese Biomedicine database was conducted to select studies. Case-control studies containing available genotype frequencies of T8590C were chosen, and odds ratio (OR) with 95% confidence interval (CI) was used to assess the strength of this association.

Results

Seven case-control studies, including 3 295 cases and 3 192 controls, were identified. The meta-analysis, stratified by ethnicity, showed that individuals with the C allele carriers (CC+CT) had increased risk of hypertension in over all (OR=1.184, 95% CI: 1.063–1.319, P=0.002) and in others (OR=1.217, 95% CI: 1.045–1.419, P=0.012). The results among Asians did not suggest an association (OR=1.152, 95% CI: 0.990–1.342, P=0.068). A symmetric funnel plot, the Egger's test (P=0.863), and the Begg test (P=0.393) were all suggestive of the lack of publication bias.

Conclusions

This meta-analysis suggests the CYP4A11 T8590C polymorphism may be a risk factor for hypertension. Future well-designed large studies might be necessary to validate this association in different populations incorporated with environmental factors in the susceptibility of hypertension.
Observation and management of retinal changes related to diving in professional divers
Authors: Zhou Dan , Wei Wenbin , Tian Bei , Wang Cong , Shi Xuehui , Jiao Xuan
Published: January 2024

Background

It is very common for professional divers to have damage on the retinas. Severe retinal lesions can profoundly affect athletes' training efficacy and their daily lives. At present, it is not clear if there is effective preventive action. Thus, in our study, we continuously tracked the ocular changes in athletes and closely monitored the risk factors associated with retinal detachment. Also, we analyzed possible interventions, their associated factors, and efficacies for timely preventions to protect the retina from damage in professional divers.

Methods

Between 2009 and 2012, a total of 39 professional divers enrolled in follow-up management. The conducted examinations included ocular examination, record screening on retinal lesion, monitoring best-corrected visual acuity, and checking intraocular pressure (IOP) and the scope of retinal lesion. The management included optimizing training methods, taking customized follow-up based on different retinal lesions, laser treatments for definite cases of retinal tear, retinal degeneration caused by retinal layer thinning or vitreous traction, and observing the changes in the scope of retinopathy.

Results

Every year, the percentage of divers who have various degrees of retinal lesions is between 43.3% and 56.2%. During the 4 years, there were no statistically significant differences in divers' best-corrected visual acuity and retinal lesions. There were also no statistically significant differences between male and female athletes. However, there were statistically significant differences in IOP during these years. Moreover there were statistically significant differences in IOP and the scope of retinal lesions between platform divers and springboard divers.

Conclusions

Our management of retinal lesions could be effective to prevent severe retinopathy in professional divers. At the same time, platform divers are more likely to have retinal lesions than springboard divers.
Granulocyte colony-stimulating factor ameliorates coronary artery elastin breakdown in a mouse model of Kawasaki disease
Authors: Liu Junfeng , Chen Zhi , Du Zhongdong , Lu Dunxiang
Published: January 2024

Background

Coronary artery damage from Kawasaki disease (KD) is closely linked to the dysfunction of the endothelial progenitor cells (EPCs). The aim of the present study was to evaluate the modulatory effect of granulocyte colony-stimulating factor (G-CSF) on EPCs and elastin breakdown of coronary arteries in a KD mouse model.

Methods

A Lactobacillus casei cell wall extract (LCWE)-induced KD model was established in C57BL/6 mice that were subsequently administrated with recombinant human G-CSF (rhG-CSF). Nù-nitro-L-arginine methyl ester (L-NAME) was administrated for the negative intervention. Evaluations included coronary artery lesions, EPC number and functions, and the plasma concentration of nitric oxide (NO).

Results

Elastin breakdown was found in the coronary arteries of model mice 56 days after injection of LCWE. The number of circulating EPCs, plasma concentration of NO, and functions of bone marrow EPCs, including proliferation, adhesion, and migration abilities, were all lower in the KD model group compared with those in the control group. After administration of rhG-CSF, the number of circulating EPCs and plasma concentration of NO were increased significantly compared with those in the KD model group. There were also increases in the functional indexes of EPCs. Furthermore, rhG-CSF administration improved the elastin breakdown effectively. However, these protective effects of rhG-CSF on coronary arteries were attenuated by L-NAME.

Conclusion

The present study indicated that the administration of G-CSF prevents elastin breakdown of the coronary arteries by enhancing the number and functions of EPCs via the NO system, and then accelerates the repair of coronary artery lesions in the KD.
Combined treatment with erythropoietin and granulocyte colony-stimulating factor enhances neovascularization and improves cardiac function after myocardial infarction
Authors: Xue Jingyi , Du Guoqing , Shi Jing , Li Yue , Masahiro Yasutake , Liu Lei , Li Jianqiang , Kong Yihui , Wang Shuxian , Yun Fengxiang , Li Weimin
Published: January 2024

Background

Erythropoietin (EPO) and granulocyte colony-stimulating factor (G-CSF) are both potential novel therapeutics for use after myocardial infarction (MI). However, their underlying mechanisms remain unclear and the efficacy of monotherapy with EPO or G-CSF is also controversial. Therefore, we investigated the effects of combined treatment with EPO and G-CSF on neovascularization and cardiac function in post-infarction rats and explored the potential mechanisms.

Methods

Four groups of rats were used: control (saline injection after MI, i.h.), EPO (a single dose of 5 000 IU/kg after MI, i.h.), G-CSF (a dose of 50 μg· kg-1· d-1 for 5 days after MI, i.h.), and both EPO and G-CSF (EPO+G-CSF, using the same regiment as above). Cardiac function was assessed by echocardiography before and 1 day, 7 days, 14 days and 21 days after MI. CD34+/Flk-1
+
cells in the peripheral blood were evaluated by flow cytometry before and 3 days, 5 days and 7 days after MI. The infarct area and angiogenesis in the peri-infarct area were analyzed. The mRNA and protein expression of vascular endothelial growth factor (VEGF) and stromal-derived factor-1α (SDF-1α) in the peri-infarct area were detected by real-time quantitative RT-PCR and Western blotting.

Results

Compared with the control and monotherapy groups, the EPO+G-CSF group had significantly increased CD34+/Flk-1+ endothelial progenitor cells (EPCs) in the peripheral blood (P <0.05), up-regulated VEGF and SDF-1α levels in the peri-infarct region (P <0.05), enhanced capillary density (P <0.05), reduced infarct size (P <0.05) and improved cardiac structure and function (P <0.05). G-CSF alone did not dramatically increase EPCs in the peripheral blood, enhance capillary density in the peri-infarct area or reduce infarct size compared with the control group.

Conclusions

Combined treatment with EPO and G-CSF increased EPCs mobilization, up-regulated VEGF and SDF-1α levels in the post-infarction microenvironment, subsequently enhanced neovascularization in the peri-infarct region and reduced infarct size. All factors contributed to its beneficial effects on cardiac function in post-infarction rats.
Analysis of Pathological data of renal biopsy at one single center in China from 1987 to 2012
Authors: Zhang Xueguang , Liu Shuwen , Tang Li , Wu Jie , Chen Pu , Yin Zhong , Li Minxia , Xie Yuansheng , Cai Guangyan , Wei Ribao , Qiu Qiang , Wang Yuanda , Shi Suozhu , Chen Xiangmei
Published: January 2024

Background

In China, the prevalence of chronic kidney disease has increased significantly. Many studies shows that the spectrum of kidney disease had changed in recent years. We retrospectively analyzed the pathological types of renal biopsy and its spectrum change at the General Hospital of the Chinese People’s Liberation Army from December 1987 to December 2012, in order to offer new supporting evidences for further specifying the distribution of renal pathological types in China.

Methods

According to the “Revised Protocol for the Histological Typing of Glomerulopathy” (WHO, 1995), pathological diagnosis of renal biopsy was classified, detection rate of each pathological type was summarized (i.e., percentage of total renal biopsy cases), study period was divided at an interval of 5 years, and age-stratified distribution change of main pathological types was analyzed.

Results

The proportion of pathological types in 11 618 cases of renal biopsy was as follows: primary glomerulonephritis (PGN, 70.7%), secondary glomerulonephritis (SGN, 20.7%), tubular-interstitial nephropathy (4.0%), hereditary/rare nephropathy (0.3%), end-stage renal disease (0.9%), and unclassified renal disease (3.3%). Among PGN, there was IgA nephropathy (IgAN, 37.0%), membranous nephropathy (MN, 11.8%), mesangial proliferative glomerulonephritis (MsPGN, 8.9%), minimal change disease (MCD, 6.6%), and focal segmental glomerulosclerosis (3.9%). Among SGN there was lupus nephritis (LN, 5.5%), Henoch-Schönlein purpura glomerulonephritis (5.3%), hepatitis B virus-associated nephritis (HBVAN, 3.03%), diabetic nephropathy (2.2%), and hypertension/malignant hypertension-associated renal damage (1.9%). Pathological data were analyzed from 1987-1992 to 2008-2012 (after age adjustment). Detection rate of IgAN tended to rise (P <0.001). Detection rates of MN and MCD rose significantly (P <0.001), but detection rate of MsPGN dropped significantly (P <0.001). Among SGN, detection rate of HBVAN tended to drop (P <0.001).

Conclusion

In China, PGN was the most common glomerulopathy (mostly IgAN), LN was the most common SGN, and detection rate of MN and MCD rose significantly.
Clinical and serological characterization of autoimmune hemolytic anemia after allogeneic hematopoietic stem cell transplantation
Authors: Yang Zhen , Wu Bangzhao , Zhou Youning , Wang Wenjuan , Chen Suning , Sun Aining , Wu Depei , Xu Yang
Published: January 2024

Background

Autoimmune hemolytic anemia (AIHA) is an uncommon complication of allogeneic hematopoietic stem cell transplantation (allo-HSCT) which has only been reported in a few cases. We here aimed to explore its mechanism.

Methods

We retrospectively analyzed 296 patients who underwent allo-HSCT in our center from July 2010 to July 2012. Clinical manifestations were carefully reviewed and the response to currently available treatment approaches were evaluated. The survival and risk factors of AIHA patients after allo-HSCT were further analyzed.

Results

Twelve patients were diagnosed with AIHA at a median time of 100 days (15–720 days) after allo-HSCT. The incidence of AIHA after allo-HSCT was 4.1%. IgG antibody were detected in ten patients and IgM antibody in two patients. The two cold antibody AIHA patients had a better response to steroid corticoid only treatment and the ten warm antibody AIHA patients responded to corticosteroid treatment and adjustment of immunosuppressant therapy. Rituximab was shown to be effective for AIHA patients who failed conventional therapy. Survival analysis showed that the combination of AIHA in allo-HSCT patients hinted at poor survival. Cytomegalovirus (CMV) infection, graft-versus-host disease (GVHD) and histocompatibility leukocyte antigen (HLA) mismatch seemed to increase the risk of developing AIHA.

Conclusions

Patients who develop AIHA after allo-HSCT have poor survival compared to non-AIHA patients. Possible risk factors of AIHA are CMV infection, GVHD, and HLA mismatch. Rituximab is likely to be the effective treatment choice for the refractory patients.
Detection of abnormalities in dyspneic patients using a new lung imaging modality
Authors: Wang Zhen , Xiong Yingxia
Published: January 2024

Background

Although chest radiography is a useful examination tool, it has limitations. Because not all chest conditions can be detected on a radiograph, radiography cannot necessarily rule out all irregularities in the chest. Therefore, further imaging studies may be required to clarify the results of a chest radiograph, or to identify abnormalities that are not readily visible. The aim of this study was to compare traditional chest radiography with acoustic-based imaging (vibration response imaging) for the detection of lung abnormalities in patients with acute dyspnea.

Methods

The current investigation was a pilot study. Respiratory sounds throughout the respiratory cycle were captured using an acoustic-based imaging technique. Consecutive patients who presented to the emergency department with acute dyspnea and a normal chest radiograph on admission were enrolled and underwent imaging at the time of presentation. Dynamic and static images of vibration (breath sounds) and a dynamic image score were generated, and assessments were made using an evaluation form.

Results

In healthy volunteer controls (n=61), the mean dynamic image score was 6.3±1.9. In dyspneic patients with normal chest radiographs (n=51) and abnormal chest radiographs (n=48), the dynamic image scores were 4.7±2.7 and 5.1±2.5, respectively (P <0.05). The final assessment of the vibration images indicated abnormal findings in 15%, 86% and 90% of the participants in the above groups, respectively (P <0.05).

Conclusions

In patients with acute dyspnea who present with normal chest radiographs, respiratory sound analyses often showed abnormal values. Hence, the ability of acoustic-based recordings to offer objective and noninvasive measurements of abnormal sound transmission may be useful in the clinical setting for patients presenting with acute dyspnea.
Magnetic resonance study of the structure and function of the hippocampus and amygdala in patients with depression
Authors: Yuefeng Li , Jinchuan Yan , Dongqing Wang , Meifang Sun , Yan Zhu , Xiaolan Zhu , Ping Jiang , Ruigen Yin , Liang Zhao
Published: January 2024

Background

The hippocampus and amygdala exhibit structural and functional alterations in patients with depression. The objective of this study was to investigate the structural and functional relationships between these core regions.

Methods

Based on the severity of their condition, 60 patients and 20 healthy controls were equally divided into four groups (mild group, moderate group, major group and health controls group), scanned by T1-MR, functional magnetic resonance imaging (fMRI), and susceptibility weighted imaging (SWI). Structural image, BOLD image, and SWI image were collected for processing and analysis. The characteristics of the depression and controls were checked by analysis of variance test, and the difference between groups was checked by Dunnett's test.

Results

The volume of hippocampus and amygdala varied with the severity of the condition. The signal obtained under the stimulation of negative events was linearly decreased in the mild, moderate and major groups revealed by fMRI. The length and diameter of the lateral ventricle vein was reduced in the mild group, whereas the number of branches increased. In the moderate and major groups, the reduction in the length, diameter and increase in the number of branches of the lateral ventricle vein were greater.

Conclusion

The alterations of the volume, fMRI, and cerebral veins in these core regions may account for the causal relationship between structure and function.
Extrahepatic manifestations of chronic hepatitis C virus infection: 297 cases from a tertiary medical center in Beijing, China
Authors: Cheng Zhaojing , Zhou Baotong , Shi Xiaochun , Zhang Yao , Zhang Lifan , Chen Limeng , Liu Xiaoqing
Published: January 2024

Background

Chronic hepatitis C virus (HCV) infection can affect multiple organ systems and cause a variety of extrahepatic manifestations (EMs). We sought to assess the constituent ratio of EMs in Chinese patients with chronic HCV infection and identify the clinical and biological factors associated with EM.

Methods

The medical records of 297 patients with chronic HCV infection were analyzed and demographic and epidemiological information was collected. The diagnosis of chronic HCV infection was based on positive anti-HCV combined with a positive HCV-RNA or at least two times of elevated aminotransferases attributable to HCV infection. Patients with HBV and/or HIV coinfection, autoimmune hepatitis, and history of alcohol abuse were excluded.

Results

Sixty-two percent (184/297) of the patients had at least one EM, including fatigue (29.4%), type 2 diabetes mellitus (28.2%), renal involvement (12.5%), lymphadenopathy (9.6%), fever (9.4%), thyroid dysfunction (8.1%), and arthralgia (7.4%). Neuropathy, sicca syndrome, B-cell lymphoma, Raynaud's phenomenon, and lichen planus were rare. The mean age of patients with EM was older compared with those without EM.

Conclusions

EMs were common in Chinese patients with chronic HCV infection, particularly fatigue, type 2 diabetes, renal impairment, lymphadenophy, fever, and thyroid dysfunction. Older age was associated with EMs.
Value of STOP-Bang questionnaire in screening patients with obstructive sleep apnea hypopnea syndrome in sleep disordered breathing clinic
Authors: Luo Jinmei , Huang Rong , Zhong Xu , Xiao Yi , Zhou Jiong
Published: January 2024

Background

Obstructive sleep apnea hypopnea syndrome (OSAHS) is the most common sleep-disordered breathing and is still underdiagnosed. This study was designed to evaluate the value of the STOP-Bang questionnaire (SBQ) in screening OSAHS in sleep-disordered breathing clinics in order to extend it into the general Chinese population.

Methods

Two hundred and twelve patients undergoing overnight polysomnography (PSG) in the sleep-disordered breathing clinic of Pecking Union Medical College Hospital between May 2011 and January 2012 were prospectively included and were asked to fill in the SBQ. A score of 3 or more of the SBQ indicated a high risk of OSAHS. We analyzed the sensitivities and specificities of SBQ in screening OSAHS. Logistic regression analysis was used to evaluate the probabilities of the severity of OSAHS based upon the apnea hypopnea index (AHI).

Results

The patients at high risk of OSAHS had higher AHI, higher oxygen desaturation index (ODI), lower pulse oxygen saturation (LSpO2) during sleep time and less sleep time in stage N3. SBQ scores were positively correlated with AHI, ODI and the ratio of SpO2 lower than 90%, and negatively correlated with LSpO2 during sleep. The sensitivities of the SBQ with AHI ≥5/h, AHI ≥15/h, AHI ≥30/h as cut-offs were 94.9%, 96.5%, and 97.7%, respectively, and the specificities were 50.0%, 28.6%, and 17.9%, respectively. The Logistic regression analysis showed the probability of severe OSAHS increased and the probability of normal subjects decreased with increasing SBQ score.

Conclusions

The STOP-Bang questionnaire has excellent sensitivity in screening OSAHS patients and can predict the severity of OSAHS. More studies will be required to determine the value of SBQ in the general Chinese population.
Clinical diagnostic performance of the simultaneous amplification and testing methods for detection of the Mycobacterium tuberculosis complex for smear-negative or sputum-scarce pulmonary tuberculosis in China
Authors: Fan Lin , Zhang Qing , Cheng Liping , Liu Zhibing , Ji Xiaobing , Cui Zhenling , Ju Jingliang , Xiao Heping
Published: January 2024

Background

Early detection of pulmonary tuberculosis (PTB) is a big challenge in smear negative and sputum scarce patients in China. Simultaneous amplification and testing methods for detection of the Mycobacterium tuberculosis (MTB) complex (SAT-TB assay) is a novel molecular technique established in our hospital. This method has a high sensitivity and specificity in the lab. In this study, the clinical diagnostic performance of this method in smear-negative or sputum-scarce PTB suspects was investigated and evaluated.

Methods

Two hundred smear negative and 80 sputum-scarce patients were recruited in this study. Samples that included sputum or bronchial washing fluid were collected and sent for both bacteria culture and SAT-TB assay. Diagnosis for these patients was based on the comprehensive evaluation of chestX- ray/CT study, histology examination, lab results, and treatment response. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for each diagnostic test were investigated and calculated using confirmed tuberculosis (TB) and non-TB cases. The time required for detection of MTB was also measured for each method.

Results

Ninety-two patients (33%) were diagnosed as definitive TB, 112 patients (40%) were probable PTB, and 76 (27%) were non-TB. The sensitivity, specificity, PPV, and NPV of SAT-TB in smear-negative PTB suspects were 93% (95% CI, 84%-98%), 98% (95% CI, 90%-100%), 98% (95% CI, 91%-100%), and 93% (95% CI, 83%-98%). In sputum scarce PTB suspects, the sensitivity, specificity, PPV, and NPV of the SAT-TB assay on bronchial washing fluids were 90% (95% CI, 74%-98%), 100% (95% CI, 85%-100%), 100% (95% CI, 88%-100%), and 88% (95% CI, 69%-97%). The accuracy of the SAT-TB assay is consistent with the bacteria culture assay. The median time required for detecting MTB in the SAT-TB assay was 0.5 day, which was much faster than bacteria culture (28 days).

Conclusions

The SAT-TB assay is a fast and accurate method for the detection of MTB. It can be widely applied in the clinic and be an asset in early detection and management of PTB suspects, especially in those patients who are smear negative or sputum scarce.
Advances in the study on endogenous sulfur dioxide in the cardiovascular system
Authors: Tian Hong
Published: January 2024

Objective

This review summarized the current advances in understanding the role of the novel gasotransmitter, sulfur dioxide (SO2), in the cardiovascular system.

Data sources

Articles on the advances in the study of the role of endogenous sulfur dioxide in the cardiovascular system were accessed from PubMed and CNKI from 2003 to 2013, using keywords such as “endogenous sulfur dioxide” and “cardiovascular system”.

Study selection

Articles with regard to the role of SO2 in the regulation of cardiovascular system were selected.

Results

Recently, scientists discovered that an endogenous SO2 pathway is present in the cardiovascular system and exerts physiologically significant effects, such as regulation of the cardiac function and the pathogenesis of various cardiopulmonary diseases such as hypoxic pulmonary hypertension, hypertension, coronary atherosclerosis, and cardiac ischemia-reperfusion (I/R) injury, in the cardiovascular system.

Conclusions

Endogenous SO2 is a novel member of the gasotransmitter family in addition to the nitric oxide (NO), carbon monoxide (CO), and hydrogen sulfide (H2S). Studies indicated that it has a role in regulating the cardiovascular disease.
Immune system modifications and feto-maternal immune tolerance
Authors: Dan Song , Yichao Shi
Published: January 2024

Objective

This review aimed at understanding pregnancy-induced changes in the maternal immune response and mechanisms for the establishment of feto-maternal tolerance.

Data sources

Articles cited in this review were obtained from PubMed in English from 2000 to 2014, and the search string included keywords such as feto-maternal tolerance, dendritic cells, macrophage, T regulatory cells, natural killer cells, cytokines and hormone.

Study selection

Articles regarding altered maternal immune response, including the proliferation and differentiation of the altered cells, and the production of cytokines and regulation of hormones in the feto-maternal interface were retrieved, reviewed and analyzed.

Results

The changes in immune cells and cytokines in the local uterine microenvironment and peripheral blood are correlated with the establishment of feto-maternal tolerance. The endocrine system regulates the maternal immune system, promoting modifications during pregnancy. In these regulatory networks, every factor is indispensible for others.

Conclusions

The integration and balance of these immune factors during pregnancy give rise to an environment that enables the fetus to escape rejection by the maternal immune system. This progress is complicated, and needs more comprehensive exploration and explanation.
Genetic polymorphism of the phospholipase C epsilon 1 gene and risk of gastric cancer
Authors: Xinyang Liu , Xiaowei Zhang , Zhichao Wang , Jinjia Chang , Zheng Wu , Zhe Zhang , Shanshan Wang , Jin Li
Published: January 2024

Background

The pathogenesis of gastric cancer (GC) involves environmental and genetic factors. Recently, two genome-wide association studies found that phospholipase C epsilon 1 (PLCE1) polymorphisms might be related to GC risk, and several studies further validated this finding. However, these studies yielded inconsistent results.

Methods

A comprehensive database search was performed to identify eligible studies. Odds ratios with 95% confidence intervals were calculated to assess the strength of the association between PLCE1 rs2274223, rs753724, and rs11187842 and risk of GC. Subgroup analyses, publication bias, and sensitivity analyses were also conducted.

Results

Eleven studies (12 cohorts) were included in the meta-analysis. Based on 13 676 cases and 23 569 controls, a significant association between PLCE1 rs2274223 and GC risk was detected under various genotypic models. In the subgroup analyses, the association was significant for cardia GC, but weak for non-cardia GC. The association under the heterozygote model was detected for PLCE1 rs753724 and rs11187842 based on three studies involving 2768 cases and 3890 controls.

Conclusions

Our findings demonstrate that the presence of the G allele at rs2274223 of the PLCE1 gene may contribute to susceptibility to GC, especially cardia GC. PLCE1 rs753724 and rs11187842 are associated with GC risk under the heterozygote model. Further well-designed large studies are warranted to validate these findings.
Nine-month angiographic and two-year clinical follow-up of polymer-free sirolimus-eluting stent versus durable-polymer sirolimus-eluting stent for coronary artery disease: the Nano randomized trial
Authors: Zhang Yaojun , Chen Fang , Muramatsu Takashi , Xu Bo , Li Zhanquan , Ge Junbo , He Qing , Yang Zhijian , Li Shumei , Wang Lefeng , Wang Haichang , He Ben , Li Kang , Qi Guoxian , Li Tianchang , Zeng Hesong , Peng Jianjun , Jiang Tieming , Zeng Qiutang , Zhu Jianhua , Fu Guosheng , Bourantas Christos V. , Serruys Patrick W. , Huo Yong
Published: January 2024

Background

First generation drug-eluting stents (DES) were associated with a high incidence of late stent thrombosis (ST), mainly due to delayed healing and re-endothelization by the durable polymer coating. This study sought to assess the safety and efficacy of the Nano polymer-free sirolimus-eluting stent (SES) in the treatment of patients with de novo coronary artery lesions.

Methods

The Nano trial is the first randomized trial designed to compare the safety and efficacy of the Nano polymer-free SES and Partner durable-polymer SES (Lepu Medical Technology, Beijing, China) in the treatment of patients with de novo native coronary lesions. The primary endpoint was in-stent late lumen loss (LLL) at 9-month follow-up. The secondary endpoint was major adverse cardiac events (MACE), a composite of cardiac death, myocardial infarction or target lesion revascularization.

Results

A total of 291 patients (Nano group: n=143, Partner group: n=148) were enrolled in this trial from 19 Chinese centers. The Nano polymer-free SES was non-inferior to the Partner durable-polymer DES at the primary endpoint of 9 months (P <0.001). The 9-month in-segment LLL of the polymer-free Nano SES was comparable to the Partner SES (0.34±0.42) mm vs. (0.30±0.48) mm, P=0.21). The incidence of MACE in the Nano group were 7.6% compared to the Partner group of 5.9% (P=0.75) at 2 years follow-up. The frequency of cardiac death and stent thrombosis was low for both Nano and Partner SES (0.8% vs. 0.7%, 0.8% vs. 1.5%, both P=1.00).

Conclusions

In this multicenter randomized Nano trial, the Nano polymer-free SES showed similar safety and efficacy compared with the Partner SES in the treatment of patients with de novo coronary artery lesions. Trials in patients with complex lesions and longer term follow-up are necessary to confirm the clinical performance of this novel Nano polymer-free SES.
Impact of biodegradable versus durable polymer drug-eluting stents on clinical outcomes in patients with coronary artery disease: a meta-analysis of 15 randomized trials
Authors: Zhang Yaojun , Tian Nailiang , Dong Shengjie , Ye Fei , Li Minghui , Bourantas Christos V. , Iqbal Javaid , Onuma Yoshinobu , Muramatsu Takashi , Diletti Roberto , Garcia-Garcia Hector M. , Xu Bo , Serruys Patrick W. , Chen Shaoliang
Published: January 2024

Background

Drug eluting stents (DESs) made with biodegradable polymer have been developed in an attempt to improve clinical outcomes. However, the impact of biodegradable polymers on clinical events and stent thrombosis (ST) remains controversial.

Methods

We searched Medline, the Cochrane Library and other internet sources, without language or date restrictions for articles comparing clinical outcomes between biodegradable polymer DES and durable polymer DES. Safety endpoints were ST (definite, definite/probable), mortality, and myocardial infarction (MI). Efficacy endpoints were major adverse cardiac event (MACE) and target lesion revascularization (TLR).

Results

We identified 15 randomized controlled trials (n=17 068) with a weighted mean follow-up of 20.6 months. There was no statistical difference in the incidence of definite/probable ST between durable polymer- and biodegradable polymer-DES; relative risk (RR) 0.83; 95% confidence interval (CI) 0.62–1.11; P=0.22. Biodegradable polymer DES had similar rates of definite ST (RR 0.94, 95% CI 0.66–1.33, P=0.72), mortality (RR 0.94, 95% CI 0.82–1.09, P=0.43), MI (RR 1.08, 95% CI 0.92–1.26. P=0.35), MACE (RR 0.99, 95% CI 0.91–1.09, P=0.85), and TLR (RR, 0.94, 95% CI 0.83–1.06, P=0.30) compared with durable polymer DES. Based on the stratified analysis of the included trials, the treatment effect on definite ST was different at different follow-up times: ≤1 year favoring durable polymer DES and >1 year favoring biodegradable polymer DES.

Conclusions

Biodegradable polymer DES has similar safety and efficacy for treating patients with coronary artery disease compared with durable polymer DES. Further data with longer term follow-up are warranted to confirm the potential benefits of biodegradable polymer DES.
Effect of cigarette smoke extraction on the expression of found in inflammatory zone 1 in rat lung epithelial L2 cells
Authors: Lin Chunyan , Chen Li , Huang Zhihong , Wu Yi , Liu Shengming
Published: January 2024

Background

Found in inflammatory zone 1 (FIZZ1) protein increased in pulmonary epithelial cells and in limited amounts of other lung cells. FIZZ1 increased in murine model of smoke induced chronic obstructive pulmonary disease. However, the direct role of FIZZ1 produced by pulmonary epithelium stimulated with cigarette smoke extraction has not been determined. We examined the expression and function of FIZZ1 in rat lung epithelial L2 cells.

Methods

The rat lung epithelial L2 cells (CCL 149) were exposed to cigarette smoke extraction, expression of FIZZ1 mRNA was investigated by RT-PCR. Levels of FIZZ1 protein were detected by Western blotting and laser confocal microscope. CCL 149 cells were treated with different concentrations and for different time of recombinant protein FIZZ1. After treatment, the expression levels of interleukin 8 (IL-8) were detected by enzyme-linked immunosorbent assay (ELISA).

Results

When CCL 149 cells were exposed to cigarette smoke extraction, FIZZ1 mRNA and protein levels expressed significantly higher than control group. Recombinant protein FIZZ1 promoted the expression of IL-8 in a dose and time dependent manner in a certain range.

Conclusions

Cigarette smoke extraction activates FIZZ1 at mRNA and protein levels in CCL 149 cells. Recombinant protein FIZZ1 induces the expression of IL-8 and may thus participate in the process of chronic obstructive pulmonary disease airway inflammation and airflow obstruction. Generally, immune cells such as macrophages, neutrophils and lymphocytes are unavoidably involved in airway inflammatory and immune responses to cigarette smoke, but it is still unclear whether their involvement in the pathogenesis of chronic obstructive pulmonary disease is based on the specific expression in lung epithelial cells of FIZZ1.
Fundus artery occlusion caused by cosmetic facial injections
Authors: Yanyun Chen , Wenying Wang , Jipeng Li , Yajie Yu , Lin Li , Ning Lu
Published: January 2024

Background

With the increasing popularity of cosmetic facial filler injections in recent years, more and more associated complications have been reported. However, the causative surgical procedures and preventative measures have not been studied well up to now. The aim of this stady was to investigate the clinical characteristics and visual prognosis of fundus artery occlusion resulting from cosmetic facial filler injections.

Methods

Thirteen consecutive patients with fundus artery occlusion caused by facial filler injections were included. Main outcome measures were filler materials, injection sites, best-corrected visual acuity (BCVA), fundus fluorescein angiography, and associated ocular and systemic manifestations.

Results

Eleven patients had ophthalmic artery occlusion (OAO) and one patient each had central retinal artery occlusion (CRAO) and anterior ischemic optic neuropathy (AION). Injected materials included autologous fat (seven cases), hyaluronic acid (five cases), and bone collagen (one case). Injection sites were the frontal area (five cases), periocular area (two cases), temple area (two cases), and nose area and nasal area (4 cases). Injected autologous fat was associated with worse final BCVA than hyaluronic acid. The BCVA of seven patients with autologous fat injection in frontal area and temple area was no light perception. Most of the patients with OAO had ocular pain, headache, ptosis, ophthalmoplegia, and no improvement in final BCVA.

Conclusions

Cosmetic facial injections can cause fundus artery occlusion. Autologous fat injection tends to be associated with painful blindness, ptosis, ophthalmoplegia, and poor visual outcomes. The prognosis is much worse with autologous fat injection than hyaluronic acid injection.
Characteristics of optic disc parameters and its association in normal Chinese population: the Handan Eye Study
Authors: Zhang Qing , Li Sizhen , Liang Yuanbo , Wang Fenghua , Chen Weiwei , Wang Ningli
Published: January 2024

Background

Assessment of the optic disc and retinal nerve fiber layer (RNFL) is essential for the diagnosis and monitoring of glaucoma. Knowledge of normal optic disc topography provides a benchmark for evaluating glaucomatous pathologic changes, especially in its early stages. The purpose of this study was to evaluate the characteristics and correlation factors of the optic disc parameters using the Heidelberg Retina Tomograph II (HRT II) in a large sample of normal eyes of adult Chinese subjects.

Methods

Disc data were obtained from 6 830 subjects aged >30 years from the Handan Eye Study. All participants underwent comprehensive eye examinations and physical examinations. The associations of gender, age, body mass index, blood pressure, waist-to-hip ratio; refractive error, intraocular pressure, axial length, and disc area were assessed using simple and multiple regression analysis. The correlation between HRT II parameters was evaluated.

Results

Of the 7 557 eligible subjects, 6 830 took part in the study (90.4% response rate) and 2 633 normal eyes with good-quality HRT II images were selected. The mean disc area was 2.28 mm2 (standard deviation (SD) 0.43) and mean neural rim area was 1.80 mm2 (SD 0.29). In multiple regression analysis, optic disc area significantly correlated with age, gender, and axial length (P <0.001). All optic disc parameters showed a significant correlation with disc area (0.054 <r <0.736, P <0.01). The association between mean RNFL thickness and rim area is statistically significant but not strong (regression linear equation: rim area = 1.42 × mean RNFL thickness + 1.32 mm2, P <0.001; R
2=0.070). The global RNFL cross-sectional area was significantly associated with global rim area (regression linear equation: rim area = 1.14× RNFL cross-sectional area + 0.44 mm2, P <0.001; R
2 =0.271).

Conclusions

The optic disc area in rural Chinese population is larger than reported in white and Japanese populations, similar to that of Indian population and urban Chinese population. Most optic disc measurements were moderately or weakly affected by disc area. In addition to the RNFL, there may be other factors affecting the rim area. The relationship between optic disc and axial length may suggest a link between larger disc area, thinning of the lamina cribrosa, and increased glaucoma susceptibility in myopic eyes.