bluuebunny/crossref_metadata_2025 huggingface dataset:
Robotic stereotactic irradiation and reirradiation for spinal metastases: safety and efficacy assessment
Authors: Wang Qi , Song Yongchun , Zhuang Hongqing , Wang Xiaoguang , Li Fengtong , Dong Yang , Wang Jingsheng , Yuan Zhiyong
Published: January 2024

Background

Spine is the most common site of bone metastases in patients with cancer. Conventional external beam radiotherapy lacks precision to allow delivery of large fraction radiation but simultaneously limit the dose to spinal cord. The purpose of this study was to evaluate the safety and efficacy of CyberKnife® radiation therapy for spinal metastases.

Methods

Seventy-three lesions in 62 patients treated with CyberKnife radiotherapy from September 2006 to June 2010 for spinal metastases were retrospectively reviewed. Thirteen tumors in 12 patients had received prior radiation. Patients were followed clinically and radiographically for at least 12 months or until death. In all patients, the spinal cord and thecal sac were contoured for dose-volume constraints, and maximum doses to 0.1, 0.5, 1, 2, and 5-ml volumes were analyzed.

Results

Using the CyberKnife System, 20-48 Gy in one to five fractions for unirradiated patients, and 21-38 Gy in one to five fractions for the previously irradiatied patients, were delivered. Median 2-Gy normalized Biological Equvalent Dose (nBED) of unirradiated targets and irradiated targets were 49.6 Gy10/2 (range, 31.25-74.8 Gy10/2) and 46.9 Gy10/2 (range, 29.8-66 Gy10/2), respectively. With a median follow-up of 9.4 months (range, 2.5-45 months), twenty-nine patients (46.7%) were alive, whereas the others died of progressive disease. Fifty-six patients (93.3%) reported complete or partial reduction of pain after CyberKnife radiotherapy at one-month follow-up, 17 patients (28.3%) reported some degree of pain relief after first fraction of the treatment course. Two patients experienced local recurrence at fifth and ninth months postradiotherapy. Median maximum nBED for spinal cord and thecal sac of naive targets were 68.6 Gy2/2 (range, 8.3-154.5 Gy2/2) and 83.5 Gy2/2 (range, 10.5-180.5 Gy2/2), respectively. Median maximum nBED for spinal cord and thecal sac for the re-irradiated targets were 58.6 Gy2/2 (range, 17.7-140 Gy2/2) and 70.5 Gy2/2 (range, 21.7-141.3 Gy2/2), respectively. No patient developed radiation related myelopathy during the follow-up period.

Conclusion

Cyberknife radiotherapy is clinically effective and safe for spinal metastases, even in previously irradiated patients.
Co-transplantation of neural stem cells and Schwann cells within poly (L-lactic-co-glycolic acid) scaffolds facilitates axonal regeneration in hemisected rat spinal cord
Authors: XIA Lei , WAN Hong , HAO Shu-yu , LI De-zhi , CHEN Gang , GAO Chuan-chuan , LI Jun-hua , YANG Fei , WANG Shen-guo , LIU Song
Published: January 2024

Background

Various tissue engineering strategies have been developed to facilitate axonal regeneration after spinal cord injury. This study aimed to investigate whether neural stem cells (NSCs) could survive in poly(L-lactic-co-glycolic acid) (PLGA) scaffolds and, when cografted with Schwann cells (SCs), could be induced to differentiate towards neurons which form synaptic connection and eventually facilitate axonal regeneration and myelination and motor function.

Methods

NSCs and SCs which were seeded within the directional PLGA scaffolds were implanted in hemisected adult rat spinal cord. Control rats were similarly injured and implanted of scaffolds with or without NSCs. Survival, migration, differentiation, synaptic formation of NSCs, axonal regeneration and myelination and motor function were analyzed. Student's t test was used to determine differences in surviving percentage of NSCs. One-way analysis of variance (ANOVA) was used to determine the differences in the number of axons myelinated in the scaffolds, the mean latency and amplitude of cortical motor evoked potentials (CMEPs) and Basso, Beattie & Bresnahan locomotor rating scale (BBB) score. The χ
2 test was used to determine the differences in recovery percentage of CMEPs.

Results

NSCs survived, but the majority migrated into adjacent host cord and died mostly. Survival rate of NSCs with SCs was higher than that of NSCs without SCs ((1.7831±0.0402)% vs. (1.4911±0.0313)%, P <0.001). Cografted with SCs, NSCs were induced to differentiate towards neurons and might form synaptic connection. The mean number of myelinated axons in PLGA+NSCs+SCs group was more than that in PLGA+NSCs group and in PLGA group ((110.25±30.46) vs. (18.25±3.30) and (11.25±5.54), P <0.01). The percentage of CMEPs recovery in PLGA+NSCs+SCs group was higher than in the other groups (84.8% vs. 50.0% and 37.5%, P <0.05). The amplitude of CMEPs in PLGA+NSCs+SCs group was higher than in the other groups ((1452.63±331.70) μV vs. (428.84±193.01) μV and (117.33±14.40) μV, P <0.05). Ipsilateral retransection resulted in disappearance again and functional loss of CMEPs for a few days. But contralateral retransection completely damaged the bilateral motor function.

Conclusions

NSCs can survive in PLGA scaffolds, and SCs promote NSCs to survive and differentiate towards neurons in vivo which even might form synaptic connection. The scaffolds seeded with cells facilitate axonal regeneration and myelination and motor function recovery. But regenerating axons have limited contribution to motor function recovery.
Major risk-stratification models fail to predict outcomes in patients with multivessel coronary artery disease undergoing simultaneous hybrid procedure
Authors: WANG Hao-ran , ZHENG Zhe , XIONG Hui , XU Bo , LI Li-huan , GAO Run-lin , HU Sheng-shou
Published: January 2024

Background

The hybrid procedure for coronary heart disease combines minimally invasive coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) and is an alternative to revascularization treatment. We sought to assess the predictive value of four risk-stratification models for risk assessment of major adverse cardiac and cerebrovascular events (MACCE) in patients with multivessel disease undergoing hybrid coronary revascularization.

Methods

The data of 120 patients were retrospectively collected and the SYNTAX score, EuroSCORE, SinoSCORE and the Global Risk Classification (GRC) calculated for each patient. The outcomes of interest were 2.7-year incidences of MACCE, including death, myocardial infarction, stroke, and any-vessel revascularization.

Results

During a mean of 2.7-year follow-up, actuarial survival was 99.17%, and no myocardial infarctions occurred. The discriminatory power (area under curve (AUC)) of the SYNTAX score, EuroSCORE, SinoSCORE and GRC for 2.7-year MACCE was 0.60 (95% confidence interval 0.42-0.77), 0.65 (0.47-0.82), 0.57 (0.39-0.75) and 0.65 (0.46-0.83), respectively. The calibration characteristics of the SYNTAX score, EuroSCORE, SinoSCORE and GRC were 3.92 (P=0.86), 5.39 (P=0.37), 13.81 (P=0.32) and 0.02 (P=0.89), respectively.

Conclusions

In patients with multivessel disease undergoing a hybrid procedure, the SYNTAX score, EuroSCORE, SinoSCORE and GRC were inaccurate in predicting MACCE. Modifying risk-stratification models to improve the predictive value for a hybrid procedure is needed.
Idiopathic inflammatory demyelinating diseases of the central nervous system in patients following allogeneic hematopoietic stem cell transplantation: a retrospective analysis of incidence, risk factors and survival
Authors: Zhang Xiao-hui , Huang Xiao-jun , Liu Kai-yan , Xu Lan-ping , Liu Dai-hong , Chen Huan , Han Wei , Chen Yu-hong , Wang Feng-rong , Wang Jing-zhi , Wang Yu , Zhao Ting , Chen Yao , Fu Hai-xia , Wang Min
Published: January 2024

Background

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a curative therapy for many hematological diseases, but there are many complications following allo-HSCT, among which neurological complications (NC) are one of the most commonly described ones. However, little is known about idiopathic inflammatory demyelinating diseases (IIDDs) of the central nervous system (CNS) in patients following allo-HSCT.

Methods

A nested case-control study was conducted in a large cohort of 1365 patients, who underwent allo-HSCT at the Institute of Hematology and Peking University People's Hospital, between January 2004 and December 2009, 36 patients of whom developed CNS IIDDs. Kaplan-Meier method, univariate and multivariate Cox regression were applied in our statistical analysis using SPSS 16.0.

Results

The cumulative incidence of all cases of IIDDs at 6 years posttransplantation was 3.6%. Thirty-five patients (97.2%) suffered IIDDs after transplantation, 16 patients (44.4%) between day 0 to day 100 post-transplantation, 10 patients (27.8%) between day 100 to 1 year post-transplantation, and 9 patients (25.0%) 1 year post-transplantation. Multivariate regression analysis identified donor type (P=0.031), infection (P=0.009), and acute lymphatic leukemia (P=0.017) as independent risk factors for posttransplantation IIDDs. The median survival time of patients with IIDDs was 514 days after transplantation (95% CI: 223:805). Survival at 6 years was significantly lower in patients who developed the diseases compared to those who did not (26.6% vs. 73.5%, P <0.001). Of the 36 patients experiencing IIDDs, 58.3% (n=21) died. The causes of death were graft-versus-host disease (GVHD) (n=4), underlying disease relapse (n=3), infections (n=12), and other causes (n=2).

Conclusions

IIDDs is an uncommon but serious complication of allo-HSCT, especially in patients with a primary diagnosis of acute lymphatic leukemia, mismatched transplants, and infections. Our study results indicate that patients with IIDDs tend toward a poor prognosis following allo-HSCT.
Robotic anterior resection of rectal cancer: technique and early outcome
Authors: DU Xiao-hui , SHEN Di , LI Rong , LI Song-yan , NING Ning , ZHAO Yun-shan , ZOU Zhen-yu , LIU Na
Published: January 2024

Background

The Da Vinci system is a newly developed device for colorectal surgery. With advanced stereoscopic vision, lack of tremor, and the ability to rotate the instruments surgeons find that robotic systems are ideal laparoscopic tools. Since conventional laparoscopic total mesorectal excision is a challenging procedure, we have sought to assess the utility of the Da Vinci robotic system in anterior resections for rectal cancer.

Methods

Between November 2010 and December 2011, a total of 22 patients affected by rectal cancer were operated on with robotic technique, using the Da Vinci robot. Data regarding the outcome and pathology reports were prospectively collected in a dedicated database.

Results

There were no conversions to open surgery and no postoperative mortality of any patient. Mean operative time was (220±46) minutes (range, 152-286 minutes). The median number of lymph nodes harvested was (14.6±6.5) (range, 8-32), and the circumferential margin was negative in all cases. The distal margin was (2.6±1.2) cm (range, 1.0-5.5 cm). The mean length of hospital stay was (7.8±2.6) days (range, 7.0-13.0 days). Macroscopic grading of the specimen was complete in 19 cases and nearly complete in three patients.

Conclusions

Robotic anterior resection for rectal surgery is safe and feasible in experienced hands. Outcome and pathology findings are comparable with those observed in open and laparoscopy procedures. This technique may facilitate minimally invasive radical rectal surgery.
Dynesys dynamic stabilization system for the lumbar degenerative disease: a preliminary report from China
Authors: LI Hai-Peng , LI Fang , GUAN Kai , ZHAO Guang-Ming , SHAN Jian-Lin , SUN Tian-Sheng
Published: January 2024

Background

Dynesys dynamic stabilization system was first implanted in patients in 1994, and introduced to China in 2007. Therefore, it was a new technique for Chinese orthopedics and hence necessary to collect clinical data about Dynesys in China. The objective of this study was to report the preliminary results of Dynesys for the lumbar degenerative disease in China.

Methods

Twenty-seven patients were treated with the Dynesys between July 2007 and January 2009. The diagnosis included degenerative spondylolisthesis (12 cases), degenerative spinal stenosis (nine cases), and lumbar intervertebral disc herniation (six cases). Back pain and leg pain were evaluated using 100-mm visual analog scales (VAS). The Oswestry Disability Index (ODI) was used to evaluate the patients' function. The intervertebral disc height and range of motion at the operative level were taken on radiographs.

Results

All the patients were followed-up, with an average of (22.40±4.23) months (range 15-32 months). VAS of back pain and leg pain were improved significantly (P <0.05) at follow-up. The ODI scores were reduced from (62.58±12.01)% preoperatively to (15.01±5.71)% at follow-up (P <0.05). The preoperative mean height of the intervertebral disc was (11.21±1.58) mm (range 8.5-13.8 mm) and mean was (10.10±1.78) mm (range 7.0-13.4 mm) at follow-up (P <0.05). The mean range of motion of the implanted segment was (6.00±1.79)° (range 2.5-9.3°) preoperatively and (5.47±1.27)° (range 2.9-7.8°) at follow-up (P=0.11).

Conclusions

The preliminary results of Dynesys for the lumbar degenerative disease in China are similar to the published results of other countries. It can significantly improve the clinic symptoms and preserved motion at the level of implantation. However, the long-term follow-up data need to be collected.
Changes in microRNAs expression are involved in age-related atrial structural remodeling and atrial fibrillation
Authors: XU Guo-jun , GAN Tian-yi , TANG Bao-peng , CHEN Zu-heng , Mahemuti Ailiman , ZHOU Xian-hui , JIANG Tao , SONG Jian-guo , GUO Xia , LI Yao-dong , MIAO Hai-jun , ZHANG Yu , LI Jin-xin
Published: January 2024

Background

Small noncoding microRNAs regulate gene expression in cardiac development and disease and have been implicated in the aging process and in the regulation of extracellular matrix proteins. However, their role in age-related cardiac remodeling and atrial fibrillation (AF) was not well understood. The present study was designed to decipher molecular mechanisms underlying age-related atrial structural remodeling and AF.

Methods

Three groups of dogs were studied: adult and aged dogs in sinus rhythm and with persistent AF induced by rapid atrial pacing. The expressions of microRNAs were measured by quantitative real-time polymerase chain reaction. Pathohistological and ultrastructural changes were tested by light and electron microscopy. Apoptosis index of myocytes was detected by TUNEL.

Results

Samples of atrial tissue showed the abnormal pathohistological and ultrastructural changes, the accelerated fibrosis, and apoptosis with aging and/or in AF dogs. Compared to the adult group, the expressions of microRNAs-21 and -29 were significantly increased, whereas the expressions of microRNAs-1 and -133 showed obvious downregulation tendency in the aged group. Compared to the aged group, the expressions of microRNAs-1, -21, and -29 was significantly increased in the old group in AF; contrastingly, the expressions of microRNA-133 showed obvious downregulation tendency.

Conclusion

These multiple aberrantly expressed microRNAs may be responsible for modulating the transition from adaptation to pathological atrial remodeling with aging and/or in AF.
Association between chronic obstructive pulmonary disease and lung cancer: the missing link
Authors: WANG Zeng-li
Published: January 2024

Objective

This review focuses on current knowledge of specific processes that drive chronic airway inflammation which are important in the pathogenesis of both chronic obstructive pulmonary disease (COPD) and lung cancer.

Data sources

The data used in this review were obtained mainly from studies reported in the PubMed database (1997-2012) using the terms of COPD and lung cancer.

Study selection

Data from published articles about prevalence of COPD-lung cancer overlap and mechanism involved in lung cancer development in COPD were identified, retrieved and reviewed.

Results

COPD prevalence, morbidity and mortality vary and are directly related to the prevalence of tobacco smoking except in developing countries where air pollution resulting from the burning of biomass fuels is also important. COPD is characterized by a chronic inflammation of lower airway and, importantly, the presence of COPD increases the risk of lung cancer up to 4.5 fold among long-term smokers. COPD is by far the greatest risk factor for lung cancer amongst smokers and is found in 50%-90% of patients with lung cancer.

Conclusions

Both COPD and lung cancer are tobacco smoking-associated chronic diseases that cluster in families and aggravate with age, and 50%-70% of patients diagnosed with lung cancer have declined spirometric evidence of COPD. Understanding and targeting common pathogenic mechanisms for lung cancer and COPD would have potential diagnostic and therapeutic implications for patients with these lung diseases and for people at risk.
Value of a virtual hepatic segment model in assisting in the ultrasonic localization of intrahepatic lesions
Authors: CHENG Guo , GUO Yan-li , ZHONG Chun-yan , TAN Li-wen , ZHANG Shao-xiang
Published: January 2024

Background

During scanning of the right hypochondrium and right intercostal regions with an ultrasonic transducer, several ultrasonic images of oblique sections are obtained. It is still a challenge for ultrasonography to divide these non-conventional sections into an accurate hepatic segmentation pattern. The aim of this research was to investigate the value of the virtual hepatic segment model (VHSM) in assisting the ultrasonic localization of space-occupying hepatic lesions.

Methods

VHSM was constructed via 3D reconstruction according to the first Chinese visible human dataset. Preoperative ultrasonography, contrast-enhanced CT scan and VHSM techniques were performed in 100 patients with space-occupying focal lesions in the liver parenchyma for segmental localization. The results of these three techniques were compared with the operative findings.

Results

VHSM was successfully detected on 2D sectional images by 3D reconstruction through surface rendering and volume rendering. The model could simulate ultrasonic directions to conduct a virtual dissection on any section plane, and fine liver segmentation could be displayed in any virtual plane. In 100 patients, there were 112 liver space-occupying focal lesions distributed in 148 liver segmentations. Regarding the positioning accuracies for lesions of different sizes and the lesion segmental distribution accuracies estimated using the three methods mentioned above, ultrasonography exhibited a significantly lower accuracy than VHSM for the segmental localization of lesions (P <0.05), and contrast-enhanced CT was not significantly different from ultrasonography plus VHSM (P >0.05).

Conclusion

VHSM increased the accuracy of ultrasonic localization of space-occupying hepatic lesions, particularly in hepatic hypovascular regions.
Role of paxillin in colorectal carcinoma and its relationship to clinicopathological features
Authors: Hongfang Yin , Quanwen Zhang , Xin Wang , Ting Li , Yuanlian Wan , Yucun Liu , Jing Zhu
Published: January 2024

Background

Colorectal carcinoma is one of the most common malignant tumors. Despite advances in therapy, mortality is still very high. The aim of this study was to evaluate the expression of paxillin in the human colon adenocarcinoma cell line SW480 and its role in cell cycle and apoptosis. We also investigated the expression of paxillin in colorectal carcinoma tissues and its relationship to clinicopathological features and survival.

Methods

Paxillin short hairpin RNA (shRNA) was constructed and transfected into the colon adenocarcinoma cell line SW480. The influence of paxillin shRNA on the cell cycle and cell apoptosis was analyzed by flow cytometry. Immunohistochemistry staining was used to assess the expression of paxillin and its association with the expression of carcinoembryonic antigen (CEA), carbohydrate antigen (CA) 19-9, p53 and Bcl-2 in 102 patients with primary colorectal carcinoma. Western blotting was also used to investigate the expression of paxillin. Medical records were reviewed and a clinicopathological analysis was performed.

Results

In vitro, the percentage of cells in S phase was (45.23±1.05)%, (43.53±1.23)%, and (36.13±0.57)% in the blank control group, negative control group, and paxillin shRNA group respectively. It was significantly decreased in the paxillin shRNA group (P=0.000). The early apoptosis index of the paxillin shRNA group (17.2±1.18%) was significantly increased compared to the control shRNA group ((13.17±1.15)%, P=0.013). Paxillin was positive in 71 (69.6%) patients, and it was found to be overexpressed in tumor tissues compared with normal adjacent tissues. Paxillin positive rate was higher in patients who are less than 50-years old (100.0% vs. 65.6%, P=0.016). Paxillin expression was associated with a high histologic grade of carcinoma (81.4% vs. 61.0%, P=0.031), a high rate of regional lymph node metastasis (22.5% vs. 13.0%, P=0.031), mesenteric artery lymph node metastasis (100.0% vs. 64.8%, P=0.008), distant metastasis (94.1% vs. 64.7%, P=0.016) and a high Tumor Node Metastasis (TNM) stage (94.1%, 73.2%, 60.0%, and 50%, P=0.030). Multivariate analyses revealed that recurrence was associated with the rate of regional lymph node metastasis (P=0.001) and paxillin expression (P=0.024). Multivariate analysis indicated that the overall survival is related to the TNM stage (P=0.000).

Conclusions

In vitro, paxillin may promote cell proliferation and inhibit apoptosis in SW480 cells. Paxillin may be a potential metastasis predictor, and an independent prognosis factor of recurrence. It may also be related to poor patient outcomes, but was not an independent predictor of survival.
Impact of primary percutaneous coronary intervention on blood perfusion in nonculprit artery in patients with anterior ST elevation myocardial infarction
Authors: WANG Jian , LIU Jing-hua , ZHENG Bin , ZHANG Ming , WANG Shao-ping , ZHENG Ze
Published: January 2024

Background

Recent studies have demonstrated that epicardial flow in nonculprit arteries, which has been assumed to be normal, was slowed in the setting of ST-elevation myocardial infarction (STEMI). However, the impact of primary percutaneous coronary intervention (PCI) on blood perfusion in nonculprit arteries in patients with STEMI has not been clarified. The purpose of this study was to investigate the impact of primary PCI on blood perfusion in nonculprit arteries in patients with STEMI and correlated clinical factors.

Methods

A total of 117 patients with anterior wall STEMI, the culprit artery being the left anterior descending artery (LAD), undergoing primary PCI (the study group) and 100 patients with normal coronary angiography (the control group) were enrolled. To observe the differences of corrected TIMI frame count (cTFC) and myocardial blush grade (MBG) before and after primary PCI in both culprit and nonculprit arteries, the left circumflex coronary artery (LCX), cTFC and MBG in the LAD and LCX were measured in the study group and control group. The study group was divided into three groups; reflow in the culprit artery group (the R group), no reflow in culprit artery group (the NR group), and no reflow in both the culprit artery and nonculprit artery group (the NRB group) according to MBG grade. The level of serum C-reactive protein (CRP), catecholamine, and fibroblast growth factor-21 (FGF21) were assayed. The clinical and angiographic characteristics were also analyzed.

Results

cTFC (28.1±24.3 vs. 20.3±19.3, P <0.05) and MBG in the LCX were different in the study group compared to the control group before primary PCI. cTFC (25.2±22.3 vs. 28.1±24.3, P <0.05) and the MBG level in the LCX were improved after successful primary PCI, but were not recovered to the normal level. Patients with no reflow in the culprit artery had a higher incidence of no-reflow in the nonculprit artery (78% vs. 19%, P <0.0001), and the levels of CRP ((3.29±1.31) mg/dl vs. (2.51±1.14) mg/dl vs. (2.93±1.07) mg/dl, P <0.05, respectively), catecholamine ((epinephrine (693.48±89.78) pg/ml vs. (398.12±93.28) pg/ml vs. (562.54±96.22) pg/ml, P <0.0001, respectively), and norepinephrine ((7012.43±932.47) pg/ml vs. (4012.34±814.16) pg/ml vs. (5549.03±912.65) pg/ml, P <0.0001, respectively)) in the NRB group were higher than those in the R group and NR group. The level of FGF21 ((0.299±0.093) ng/ml vs. (0.612±0.071) ng/ml vs. (0.428±0.074) ng/ml, P <0.0001 respectively) in the NRB group was lower than that in the R group and NR group.

Conclusions

The blood perfusion in the nonculprit artery may be impaired in patients with STEMI. Although nonculprit artery perfusion may be improved after successful primary PCI, it is still lower than that in the control group, and may be involved in inflammation and spasms.
Cyclooxygenase 2 1195G>A polymorphism is associated with chronic obstructive pulmonary disease in Japanese and Chinese patients
Authors: CHEN Li-jun , XU Wang , Yasuyuki Taooka , Miki Ohe , Hitoshi Takahashi , Akihisa Sutani , Takashige Kuraki , Takeshi Isobe
Published: January 2024

Background

Cyclooxygenase-2 (COX-2) is overexpressed during airway inflammation in chronic obstructive pulmonary disease (COPD) patients. Single nucleotide polymorphisms (SNPs) in the COX-2 promoter might contribute to differential COX-2 expression and subsequent interindividual variability in susceptibility to COPD. We investigated the association between COX-2 (-765G>C, -1195G>A) polymorphisms and COPD susceptibility in Japanese and Chinese patients.

Methods

COX-2 genotypes were determined by polymerase chain reaction, restriction fragment length polymorphism in 230 COPD patients (103 Japanese and 127 Chinese) and 273 healthy controls (129 Japanese and 144 Chinese).

Results

The frequency of -1195AA homozygote was significantly higher than the controls in Chinese COPD (adjusted OR=2.43, 95% CI 1.14-4.19), Japanese COPD (adjusted OR=2.25, 95% CI 1.06-4.76) and combined COPD groups (adjusted OR=2.26, 95% CI 1.34-3.99). There was no difference in COX-2-765G>C polymorphism between COPD and control groups in either Japanese or Chinese, while more Chinese individuals carried the -765C allele than Japanese in both groups (15.3% vs. 2.9% in COPD, 18.8% vs. 5.5% in control). Chinese individuals with the haplotype -765G:-1195A were at higher risk for COPD (adjusted OR=1.93, 95% CI 1.05-3.55).

Conclusions

The COX-2-1195AA genotype is associated with increased risk for COPD in both Japanese and Chinese individuals. Although COX-2-765G>C polymorphism was not associated with COPD in either ethnic group, the -765C allele frequency was higher in Chinese than Japanese and haplotype -765G-1195A may confer susceptibility to COPD in Chinese.
Structural, densitometric and biomechanical evaluations of Chinese patients with long-term bisphosphonate treatment
Authors: LEUNG Kwok-sui , TANG Ning , James Griffith , CHOY Tak-Kee , HUNG Vivian Wing-Yin , MOK Hoi-Wa , SHI Lin , LEUNG Ping-Chung , CHEUNG Wing-Hoi
Published: January 2024

Background

The association of long-term bisphosphonate treatment for osteoporosis and related safety problems such as atypical fractures were not clearly defined. This study was to evaluate the structural, densitometric and biomechanical properties of the prolonged bisphosphonate-loaded bones.

Methods

Bone mineral density (BMD) at hip and femoral midshaft, bone cross-sectional area, moment of inertia of both femurs, bone formation and resorption biochemical markers were compared between 28 elderly with at least 4 years of bisphosphonate treatment from 2002 through 2006 and age-matched group of 37 elderly.

Results

The total hip BMD and t-score were found not different between two groups. However, bisphosphonate treated patients were found to have significantly lower bone mineral content in the femoral shaft (P <0.05); morphological study showed lower cross-sectional area in subtrochanteric and mid-diaphyseal region and thus significantly lower moment of inertia (P <0.01). High resolution-peripheral quantitative computed tomography showed significantly decreased trabecular density, bone volume ratio, trabecular number but increased trabecular spacing in tibia and distal radius. Finite element analysis further confirmed significantly lower stiffness and failure load in tibia. Biochemical studies also showed lower bone resorption and severely suppressed bone formation activity (P <0.001).

Conclusions

The unchanged total hip BMD between two groups confirmed the beneficial effects of bisphosphonate on trabecular bone, thus preventing osteoporotic fractures at large in previous studies. However, the inferior structural, densitometric and biomechanical properties at cortical bones, especially femur midshaft, need a special attention to look into the association between long-term bisphosphonate intake and the occurrence of stress fractures. When patients taking bisphosphonate complain of proximal thigh pain or discomfort, plain X-ray film can be the first line screening. All patients prescribed with bisphosphonate should be informed of such a complication though we must stress its rarity.
Stress-induced growth-differentiation factor 15 plays an intriguing role in cardiovascular diseases
Authors: LIU Hai-tao , WANG Hai-chang , TAO Ling , LI Cheng-xiang , LI Fei , ZHANG Yu-yang , LIU Bo-wu
Published: January 2024

Objective

To provide an overview of the current knowledge of growth-differentiation factor 15 (GDF-15) in heart disease.

Data sources

To identify relevant publications, we searched PubMED database combining the textual terms of heart, cardiac, cardiovascular disease with GDF-15.

Study selection

Well-controlled, relatively large-scale, retrospective studies as well as meaningful individual cases were all selected as materials.

Results

GDF-15 is a distant member of the transforming growth factor-β cytokine superfamily. In myocardium, GDF-15 is weakly expressed under physiological conditions. However, its expression level is increased in response to pathological stress. Growing evidence indicate that elevated levels of GDF-15 is a promising prognostic biomarker in cardiovascular diseases. Moreover, GDF-15 exhibits the properties of endogenous anti-hypertrophy of cardiomyocytes and protecting the heart suffering from ischemia and reperfusion insult.

Conclusion

Ve GDF-15 may be a promising biomarker for evaluation and management of patient with cardiovascular diseases, and have potential protective properties on myocardium.
Resection and repair of large abdominal wall lesions in gynecologic patients
Authors: LIU Zhu-feng , WANG Jin-hui , CUI Bing-qian , FAN Qing-bo , WANG Xiao-jun , ZHAO Ru , SONG Ke-xin
Published: January 2024

Background

The techniques of resection and repair of large lesions in the abdominal wall are very challenging in the area of gynecology. We explored the techniques of resection and plastic surgical repair of large abdominal wall lesions in gynecologic patients.

Methods

Twenty-six patients with large lesions in the abdominal wall underwent resection by the gynecologists and repair through abdominal plasty and V-Y plasty with or without fascia patch grafting by the gynecologists or plastic surgeons from March 2003 to October 2010.

Results

All patients had a history of cesarean section. One patient had an infected sinus tract after cesarean section, one patient had an inflammatory nodule, and the others had lesions of endometriosis, including one cancer. The average largest lesion diameter was (4.79 ± 4.18) cm according to the ultrasonography results. The lesions of all patients were completely resected with pretty abdominal contour. A polypropylene biological mesh was added to the fascia in 20 patients. One patient underwent groin flap repair, and one underwent V-Y advanced skin flap repair on the left of the incision to relieve the suture tension.

Conclusions

Multi-department cooperation involving the gynecology and plastic surgery departments, and even the general surgery department, is essential for patients with large lesions in the abdominal wall. This cooperative effort enabled surgeons to completely resect large lesions. Abdominal wall plastic surgical repair can ameliorate large wounds of the abdominal wall.
Comparison of parathyroid hormone (1-34) and elcatonin in postmenopausal women with osteoporosis: an 18-month randomized, multicenter controlled trial in China
Authors: LI Ying , XUAN Miao , WANG Bo , YANG Jun , ZHANG Hong , ZHANG Xiu-zhen , GUO Xiao-hui , Xiao-feng LÜ , XUE Qing-yun , YANG Gang-yi , JI Qiu-he , LIU Zhi-min , LI Cheng-jiang , WU Tian-feng , SHENG Zheng-yan , LI Peng-qiu , TONG Jiu-cui
Published: January 2024

Background

Recombinant human parathyroid hormone (1-34) (rhPTH (1-34)) is the first agent in a unique class of anabolic therapies acting on the skeleton. The efficacy and safety of long-term administration of rhPTH (1-34) in Chinese postmenopausal women had not been evaluated. This study compared the clinical efficacy and safety of rhPTH (1-34) with elcatonin for treating postmenopausal women with osteoporosis in 11 urban areas of China.

Methods

A total of 453 postmenopausal women with osteoporosis were enrolled in an 18-month, multi-center, randomized, controlled study. They were randomized to receive either rhPTH (1-34) 20 μg (200 U) daily for 18 months, or elcatonin 20 U weekly for 12 months. Lumbar spine (L1-4) and femoral neck bone mineral density (BMD), fracture rate, back pain as well as biochemical markers of bone turnover were measured. Adverse events were recorded.

Results

rhPTH (1-34) increased lumbar BMD significantly more than did elcatonin after 6, 12, and 18 months of treatment (4.3% vs. 1.9%, 6.8% vs. 2.7%, 9.5% vs. 2.9%, P <0.01). There was only a small but significant increase of femoral neck BMD after 18 months (2.6%, P <0.01) in rhPTH groups. There were larger increases in bone turnover markers in the rhPTH (1-34) group than those in the elcatonin group after 6, 12, and 18 months (serum bone-specific alkaline phosphatase (BSAP) 93.7% vs. -3.6%; 117.8% vs. -4.1%; 49.2% vs. -5.8%, P <0.01; urinary C-telopeptide/creatinine (CTX/Cr) 250.0% vs. -29.5%; 330.0% vs. -41.4%, 273.0% vs. -10.6%, P <0.01). rhPTH (1-34) showed similar effect of pain relief as elcatonin. The incidence of clinical fractures was 5.36% (6/112) in elcatonin group and 3.2% (11/341) in rhPTH (1-34) group (P=0.303). Both treatments were well tolerated. Hypercaluria (9.4%) and hypercalcemia (7.0%) in rhPTH (1-34) group were transient and caused no clinical symptoms. Pruritus (8.2% vs. 2.7%, P=0.044) and redness of injection site (4.4% vs. 0, P=0.024) were more frequent in rhPTH (1-34). Nausea/vomiting (16.1% vs. 6.2%, P=0.001) and hot flushes (7.1% vs. 0.6%, P <0.001) were more common in elcatonin group.

Conclusions

rhPTH (1-34) was associated with greater increases in lumbar spine BMD and bone formation markers. It could increase femoral BMD after 18 months of treatment. rhPTH could improve back pain effectively. The results of the present study indicate that rhPTH (1-34) is an effective, safe agent in treating Chinese postmenopausal women with osteoporosis. (ChiCTR-TRC-10000924)
Cytotoxic effects of mono-(2-ethylhexyl) phthalate on human embryonic stem cells
Authors: SHI Cheng , CHEN Xi , CAI Xiao-hui , YU Wei-dong , LIANG Rong , LU Qun , SHEN Huan
Published: January 2024

Background

Mono-(2-ethylhexyl) phthalate (MEHP), the metabolite of di-(2-ethylhexyl) phthalate (DEHP), was suspected to be toxic to human embryos. This study contributes to investigating its toxic effects by an embryonic stem cell test (EST) based on two human embryonic stem cell (hESCs) lines.

Methods

CH1 established in our own lab and H1, a federally registered cell line were two human embryonic stem cell lines used in this test. Four endpoint measurements were performed consisting of cell viability, proliferation ability, apoptosis as well as changes of gene expression patterns after spontaneous differentiation were determined. For measuring effects on the first three endpoints, the cells were treated with various concentrations of MEHP dissolved in dimethyl sulfoxide (DMSO) and only with DMSO which served as control and harvested after 5 days. For measuring effects during spontaneous differentiation, the RNA of embryoid bodies (EBs) formed after 8 days' MEHP exposure was collected and changes in differentiation specific gene expression patterns were analyzed by quantitative real time RT-PCR.

Results

As a result the viability and proliferation ability of both cell lines decreased significantly at 1000 μmol/L MEHP, while there was no effect on apoptosis or cell morphology. In addition MEHP also changed the gene expression pattern in the EBs of both cell lines.

Conclusion

MEHP in a high dose was cytotoxic and affected the development of hESCs, which indicates its embryo toxicity in human embryos.
Interferon regulatory factor-1 mediates the release of high mobility group box-1 in endotoxemia in mice
Authors: PAN Pin-hua , Cardinal Jon , LI Mo-li , HU Cheng-ping , Tsung Allan
Published: January 2024

Background

The extracellular release of the danger signal high mobility group box-1 (HMGB1) has been implicated in the pathogenesis and outcomes of sepsis. Understanding the mechanisms responsible for HMGB1 release can lead to the identification of targets that may inhibit this process. The transcription factor interferon regulatory factor-1 (IRF-1) is an important mediator of innate immune responses and has been shown to participate in mortality associated with endotoxemia; however, its role in mediating the release of HMGB1 in these settings is unknown.

Methods

Male IRF-1 knockout (KO) and age matched C57BL/6 wild type (WT) mice were given intraperitoneal (IP) injections of lipopolysaccharide (LPS). In some experiments, 96 hours survival rates were observed. In other experiments, mice were sacrificed 12 hours after LPS administration and sera were harvested for future analysis. In in vitro study, RAW 264.7 murine monocyte/macrophage-like cells or primary peritoneal macrophage obtained from IRF-1 KO and WT mice were cultured for LPS mediated HMGB1 release analysis. And the mechanism for HMGB1 release was analyzed by immune-precipitation.

Results

IRF-1 KO mice experienced less mortality, and released less systemic HMGB1 compared to their WT counterparts. Exogenous administration of recombinant HMGB1 to IRF-1 KO mice returned the mortality rate to that seen originally in IRF-1 WT mice. Using cultures of peritoneal macrophages or RAW264.7 cells, in vitro LPS stimulation induced the release of HMGB1 in an IRF-1 dependent manner. And the janus associated kinase (JAK)-IRF-1 signal pathway appeared to participate in the signaling mechanisms of LPS-induced HMGB1 release by mediating acetylation of HMGB1.

Conclusion

IRF-1 plays a role in LPS induced release of HMGB1 and therefore may serve as a novel target in sepsis.
BRAFV600E mutation is not a positive predictor for distant metastasis in sporadic papillary thyroid carcinoma
Authors: JING Fan-jing , LIANG Jun , LIANG Zhi-yong , MENG Chao , LONG Wen , LI Xiao-yi , LIN Yan-song
Published: January 2024

Background

BRAFV600E mutation is correlated with local aggressive clinicopathological features in papillary thyroid carcinoma; yet the relationship between this genetic variation and distant papillary thyroid carcinoma metastasis was unclear. This study aimed to investigate whether BRAFV600E is predictive for distant metastasis in the Chinese population.

Methods

One hundred and seven patients with papillary thyroid carcinoma were enrolled in this study, including 43 patients with distant metastasis and 64 patients without. Quantitative real-time polymerase chain reaction was used to detect BRAFV600E mutation, while immunohistochemistry was performed to detect vascular endothelial growth factor (VEGF) expression. The associations between distant metastasis and BRAFV600E mutation, and VEGF expression as well as local clinicopathological factors were determined.

Results

A total of 28.6% of the patients in the distant metastasis group harbored BRAFV600E mutation, which was significantly lower than in the without distant metastasis group (68.8%, P <0.001). BRAFV600E mutation was negatively correlated with positive VEGF expression (P=0.001). Furthermore, 52.2% of the patients with distant metastasis exhibited VEGF expression, compared with 25.0% of those without. Higher levels of VEGF expression were also observed in the distant metastasis group. Tumor size, extra-thyroid invasion, and BRAFV600E mutation were independent predictors for distant metastasis according to multivariate analysis (odds ratios were 2.8, 12.4, and 0.3; 95% CI 1.483-5.334, and 2.950-52.407, 0.100-0.890; P=0.002, 0.001, and 0.030, respectively). BRAFV600E mutation was negatively correlated with distant metastasis in adult subgroup analysis (P=0.005) but was not an independent parameter.

Conclusions

BRAFV600E mutation is predictive for distant metastasis in papillary thyroid carcinoma but not positively. VEGF may be involved in the pathogenesis of distant metastasis.
Fenestrated endovascular aortic repair for juxtarenal abdominal aortic aneurysm
Authors: GUO Wei , ZHANG Hong-peng , LIU Xiao-ping , JIA Xin , XIONG Jiang , MA Xiao-hui
Published: January 2024

Background

Endovascular stent-graft with fenestration can improve proximal sealing in patients with juxtarenal abdominal aortic aneurysm (JAAA). The purpose of this study was to describe our primary experience and evaluate the safety and efficacy of fenestrated device for JAAA in high-risk patients.

Methods

Between March 2011 and May 2012, nine male patients (mean age, (79.6±8.6) years) with asymptomatic JAAAs underwent elective deployment of the Zenith fenestrated stent-grafts at a single institution. All patients were treated in the hybrid operating room under general anesthesia. Follow-up computed tomography angiography (CTA) was routinely performed before discharge, at 3, 6, and 12 months and annually thereafter.

Results

Procedural success was achieved in all cases. Total sixteen small fenestrations, two large fenestrations and eight scallops were used. Intra-operative complications occurred in four patients, which included one proximal type I endoleak, two type II endoleaks, and one renal artery dissection. The mean hospital stay was (8.9±1.4) days, mean blood loss was (360.5±46.8) ml, and mean iodinated contrast volume was (230.6±58.3) ml. The mean follow-up time was (7.6±4.2) months. The visceral graft patency was 100% until now. One patient had an increase of serum creatinine of more than 30%, but did not require dialysis. No patients died, no stent fractured, and migration were diagnosed during the follow-up.

Conclusions

The early results of fenestrated device for high-risk patients with complex JAAAs are satisfactory. However, long-term fenestrated graft durability and branch vessel patency remain to be determined.
Failed anterior cruciate ligament reconstruction: analysis of factors leading to instability after primary surgery
Authors: MA Yong , AO Ying-fang , YU Jia-kuo , DAI Ling-hui , SHAO Zhen-xing
Published: January 2024

Background

Revision anterior cruciate ligament (ACL) surgery can be expected to become more common as the number of primary reconstruction keeps increasing. This study aims to investigate the factors causing instability after primary ACL reconstruction, which may provide an essential scientific base to prevent surgical failure.

Methods

One hundred and ten revision ACL surgeries were performed at our institute between November 2001 and July 2012. There were 74 men and 36 women, and the mean age at the time of revision was 27.6 years (range 16-56 years). The factors leading to instability after primary ACL reconstruction were retrospectively reviewed.

Results

Fifty-one knees failed because of bone tunnel malposition, with too anterior femoral tunnels (20 knees), posterior wall blowout (1 knee), vertical femoral tunnels (7 knees), too posterior tibial tunnels (12 knees), and too anterior tibial tunnels (10 knees). There was another knee performed with open surgery, where the femoral tunnel was drilled through the medial condyle and the tibial tunnel was too anterior. Five knees were found with malposition of the fixation. One knee with allograft was suspected of rejection and a second surgery had been made to take out the graft. Three knees met recurrent instability after postoperative infection. The other factors included traumatic (48 knees) and unidentified (12 knees).

Conclusion

Technical errors were the main factors leading to instability after primary ACL reconstructions, while attention should also be paid to the risk factors of re-injury and failure of graft incorporation.
Multilayer stents, a new progress in the endovascular treatment of aneurysms
Authors: ZHANG Yong-xue , LU Qing-sheng , JING Zai-ping
Published: January 2024

Objective

To review the recent progress of multilayer stents in treating arterial aneurysms and to draw an initial conclusion about its paradigm.

Data sources

PubMed database and ELSEVIER database were searched with the keywords “cardiatis” or “multilayer stent” for relevant articles from January 2008 to September 2012. Relevant websites (provided by Cardiatis) were also involved in the review process.

Study selection

Well-controlled, relatively large-scale, retrospective studies as well as meaningful individual cases were all selected as materials.

Results

A total of 23 articles were involved in this review. The newly introduced Cardiatis multilayer stent aims at creating an active flow-modulating barrier between normal blood flow and aneurismal sac, which can induce thrombosis within aneurismal sac and preserve collateral circulation at the same time. Currently, it has been applied for complicated aneurysms located in different segments of the arterial system.

Conclusion

This new concept of multilayer uncovered stent offers a promising alterative in the treatment of arterial aneurysms. However, a further large-scale clinical and hemodynamic study is required to evaluate the long-term effects.
Efficacy of laser peripheral iridoplasty and iridotomy on medically refractory patients with acute primary angle closure: a three year outcome
Authors: FU Jing , QING Guo-ping , WANG Ning-li , WANG Huai-zhou
Published: January 2024

Background

Argon laser peripheral iridoplasty (ALPI) is proved to be effective in lowering intraocular pressure (IOP) of patients with mild acute primary angle closure (APAC). It is unclear whether this laser treatment is equally efficient in managing patients with severe APAC. This study aimed to evaluate the IOP-lowering efficacy of ALPI and laser peripheral iridotomy (LPI) on patients with refractory APAC, who have previously responded poorly to intensive medical therapy.

Methods

Thirty-six patients (8 men and 28 women) were identified as medically refractory APAC, who still had ocular pain, red eye, hazy cornea, closed anterior chamber (AC) angle, and IOP of not less than 21 mmHg after two days or more of anti-glaucoma medication. All enrolled patients underwent ophthalmologic examinations including measurement of visual acuity (VA), best corrected VA (BCVA), IOP, biomicroscopy, and gonioscopy followed by ALPI immediately in the APAC eye and LPI in both eyes.

Results

All patients were affected unilaterally, with average age of (54.6±11.7) (range, 37.0−75.0) years old. The mean IOP value of the affected eyes dropped from (31.6±7.7) (range, 21.0−39.0) mmHg at enrollment to (18.4±8.7) (range, 10.0−27.0) mmHg 2 hours after ALPI. At follow-up day 7, the mean IOP value maintained at (14.8±4.2) (range, 9.0−21.0) mmHg, which was significantly different (P=0.000) compared with baseline. The average decrease of IOP in the APAC eyes was (16.8±7.4) (range, 12.0−21.0) mmHg. At follow-up three years later, the mean IOP of the APAC eyes stabilized at (16.3±3.2) (range, 9.0−20.0) mmHg with at least 180° of AC angle opened.

Conclusion

ALPI and LPI lower the IOP of medically refractory cases of APAC though they have responded poorly to anti-glaucoma medication.