bluuebunny/crossref_metadata_2025 huggingface dataset:
Hypermethylation of testis derived transcript gene promoter significantly correlates with worse outcomes in glioblastoma patients
Authors: WANG Li-jia , BAI Yu , BAO Zhao-shi , CHEN Yan , YAN Zhuo-hong , ZHANG Wei , ZHANG Quan-geng
Published: January 2024

Background

Glioblastoma is the most common and lethal cancer of the central nervous system. Global genomic hypomethylation and some CpG island hypermethylation are common hallmarks of these malignancies, but the effects of these methylation abnormalities on glioblastomas are still largely unclear. Methylation of the 06-methylguanine-DNA methyltransferase promoter is currently an only confirmed molecular predictor of better outcome in temozolomide treatment. To better understand the relationship between CpG island methylation status and patient outcome, this study launched DNA methylation profiles for thirty-three primary glioblastomas (pGBMs) and nine secondary glioblastomas (sGBMs) with the expectation to identify valuable prognostic and therapeutic targets.

Methods

We evaluated the methylation status of testis derived transcript (TES) gene promoter by microarray analysis of glioblastomas and the prognostic value for TES methylation in the clinical outcome of pGBM patients. Significance analysis of microarrays was used for genes significantly differently methylated between 33 pGBM and nine sGBM. Survival curves were calculated according to the Kaplan-Meier method, and differences between curves were assessed using the log-rank test. Then, we treated glioblastoma cell lines (U87 and U251) with 5-aza-2-deoxycytidines (5-aza-dC) and detected cell biological behaviors.

Results

Microarray data analysis identified TES promoter was hypermethylated in pGBMs compared with sGBMs (P <0.05). Survival curves from the Kaplan-Meier method analysis revealed that the patients with TES hypermethylation had a short overall survival (P<0.05). This abnormality is also confirmed in glioblastoma cell lines (U87 and U251). Treating these cells with 5-aza-dC released TES protein expression resulted in significant inhibition of cell growth (P=0.013). Conclusions Hypermethylation of TES gene promoter highly correlated with worse outcome in pGBM patients. TES might represent a valuable prognostic marker for glioblastoma.
Towards prenatal biomonitoring in Nanjing, China: lead and cadmium levels in the duration of pregnancy
Authors: LIU Kang-sheng , MAO Xiao-dong , HAO Jia-hu , SHI Juan , DAI Chun-fang , CHEN Wen-jun
Published: January 2024

Background

Prenatal lead and cadmium exposure will not only influence the mother's organ systems, but also will provide an environment that may influence the fetus and neonate in a harmful way.In the present study, we detected the blood lead levels (BLLS) and cadmium levels for the duration of pregnancy and 6-12 weeks after delivery and to analyze the influencing factors of BLLs in healthy pregnant women.

Methods

A cohort study survey was carried out. We recruited 174 healthy pregnant women without pregnancy or obstetric complications or abnormal pregnancy outcomes as the gravida group, and 120 healthy non-pregnant women as the control group.

Results

The lead concentrations in the three pregnancy trimesters and in the postpartum period were: (5.98±2.43), (5.54±2.01), (5.59±1.97), and (6.76±1.74) μg/dl; and (6.75±2.13) μg/dl in the control group. The cadmium concentrations in the three pregnancy trimesters and postpartum period were 1.61±0.45, 1.63±0.46, 1.64±0.49, and 1.67±0.57. We found that the BLLs in the gravida group were lower than in the control group during all three trimesters. Occupations, supplement nutritional elements (dietary supplements and nutritional (food) elements), and the time of house painting could affect BLLs in pregnant women. Lead-related occupations, using cosmetics, and living in a house painted more recently than one year previously are risk factors of high BLLs among pregnant women, while calcium, iron, zinc, and milk supplements are protective factors.

Conclusions

These findings may help people, especially pregnant women, to reduce lead exposure via supplements of calcium, iron, zinc, and milk or avoiding contacting risk factors.
Adjunctive with versus without intravitreal bevacizumab injection before Ahmed glaucoma valve implantation in the treatment of neovascular glaucoma
Authors: ZHOU Min-wen , WANG Wei , HUANG Wen-bin , CHEN Shi-da , LI Xing-yi , GAO Xin-bao , ZHANG Xiu-lan
Published: January 2024

Background

Neovascular glaucoma (NVG) is a refractory disease which is difficult to manage. This study aimed at evaluating the efficacy and safety of adjunctive intravitreal bevacizumab (IVB) injection in conjunction with Ahmed glaucoma valve implantation (AGVI) in the management of NVG.

Methods

This was a retrospective study of patients with NVG in whom AGVI was performed between October 2008 and May 2012. The sample was divided into two groups according to the pretreatment: with adjunctive IVB injection (the IVB group, n=25 eyes) and without adjunctive IVB injection (the control group, n=28 eyes). The surgical success rate, number of antiglaucoma medications used, best-corrected visual acuity (BCVA), postoperative complications, regression, and recurrence of iris neovascularization (NVI) were analyzed between the groups.

Results

The surgical outcomes of the two groups were compared. The complete success rates in the IVB and control groups were 84.0% and 64.3% at 12 months and 80.0% and 53.6% at 18 months, respectively. There was a significant difference between the two groups (P=0.041). Mean postoperative intraocular pressures, mean number of postoperative antiglaucoma medications, and BCVA were not significant between the two groups. The NVI in 22 (88.0%) eyes had completely regressed within 2-8 days after IVB. However, NVI recurred in 10 eyes (40.0%) 2-9 months later after IVB. The IVB group had only 1 case (4.0%) of hyphema out of 25 eyes, while there were 8 (28.6%) cases of hyphema out of 28 eyes in the control group (P=0.026).

Conclusions

This study showed that preoperative IVB injection reduced NVI remarkably, decreased hyphema, and led to higher surgical success rates. Pre-operative IVB injection may be an effective adjunct to AGVI in the management of NVG.
Inhibition of the reinstatement of morphine-induced place preference in rats by high-frequency stimulation of the bilateral nucleus accumbens
Authors: Ma Yu , Chen Ning , Wang Hui-min , Fan-gang Meng , Zhang Jian-guo
Published: January 2024

Background

Opiate addiction remains intractable in a large percentage of patients, and relapse is the biggest hurdle to recovery. Many studies have identified a central role of the nucleus accumbens (NAc) in addiction. Deep brain stimulation (DBS) has the advantages of being reversible, adjustable, and minimally invasive, and it has become a potential neurobiological intervention for addiction. The purpose of our study was to investigate whether high-frequency DBS in the NAc effectively attenuates the reinstatement of morphine seeking in morphine-primed rats.

Methods

A morphine-dependent group of rats was given increasing doses of morphine during conditioned place preference training. A control group of rats was given equal volumes of saline. After the establishment of this model, withdrawal syndromes were precipitated in these two groups by administering naloxone, and the differences in withdrawal symptoms between the groups were analyzed. Electrodes for DBS were implanted in the bilateral shell of the NAc in the experimental group. The rats were stimulated daily in the NAc for 5 hours per day over 30 days. Changes in the conditioned place preference test and withdrawal symptoms in the rats were investigated and place navigation studies were performed using the Morris water maze. The data were assessed statistically with one-way analysis of variance (ANOVA) followed by Tukey's tests for multiple post hoc comparisons.

Results

High-frequency stimulation of the bilateral NAc prevented the morphine-induced reinstatement of morphine seeking in the conditioned place preference test. The time spent in the white compartment by rats following 30 days of DBS ((268.25±25.07) seconds) was not significantly different compared with the time spent in the white compartment after relapse was induced by morphine administration ((303.29±34.22) seconds). High-frequency stimulation of the bilateral NAc accelerated the innate decay of drug craving in morphine-dependent rats without significantly influencing learning and memory.

Conclusion

Bilateral high-frequency stimulation of the shell of the NAc may be useful as a novel therapeutic modality for the treatment of severe morphine addiction.
Effect of endoscopic retrograde cholangiopancreatography combined with laparoscopy and choledochoscopy on the treatment of Mirizzi syndrome
Authors: LI Bo , LI Xun , ZHOU Wen-ce , HE Ming-yan , MENG Wen-bo , ZHANG Lei , LI Yu-min
Published: January 2024

Background

Mirizzi syndrome is often difficult to diagnose before surgery, and is often accompanied by extensive adhesions in the cystohepatic (Calot's) triangle and the difficulty of separating tissue can lead to bile duct injury and other intraoperative and postoperative complications. The aim of this study is to investigate minimally invasive means of treating different types of Mirizzi syndrome.

Methods

Fifty-four patients diagnosed with Mirizzi syndrome were enrolled between July 2004 and May 2012. The diagnosis was further refined according to the Csendes classification. Twenty-seven patients were treated with a combination of endoscopic retrograde cholangiopancreatography (ERCP), laparoscopy, and choledochoscopy (tripartite approach group); type I in 16 cases, type II five cases, and type III in six cases. Twenty-seven patients were treated with laparotomy (routine approach group); type I in 19 cases, type II in six cases, and type III in two cases. The operation time, blood loss during operation, initiation of intake time of food, postoperative complications, and hospital stays were compared between two groups.

Results

All patients were successfully cured in surgical operation. The operation time was (49.7±27.5) minutes, blood loss during operation was (21.1±15.9) ml, initiation of intake time of food was (6.3±2.7) hours, postoperative complications were with two cases (7%, 2/27), and hospital stay was (6.7±1.8) days in the tripartite approach group. In the routine approach group, the operation time was (85.1±20.3) minutes, blood loss during operation was (150.3±20.5) ml, initiation of intake time of food was (36.6±10.3) hours, postoperative complications were with three cases (11%, 3/27), and hospital stay was (10.9±3.4) days. Except for postoperative complications, there were significant differences in the operation time, blood loss during operation, initiation of intake time of food, and hospital stays between two groups (P <0.05).

Conclusions

ERCP combined with laparoscopy and choledochoscopy is a safe and effective means of treating Mirizzi syndrome. The approach is minimally invasive and patients recover quickly requiring only brief hospitalization.
Long-term outcome of native artery versus bypass graft intervention in prior coronary artery bypass graft patients with ST-segment elevation myocardial infarction
Authors: LIU Wei , LIU Yu-yang , Mukku Venkata K. , SHI Dong-mei , Lü Shu-zheng , ZHOU Yu-jie
Published: January 2024

Background

Patients with prior coronary artery bypass graft (CABG) have a poor outcome after acute myocardial infarction (AMI). Little is known about the treatment strategy and outcome of percutaneous coronary intervention (PCI) in these patients. The purpose of this study was to investigate the impact of graft versus native artery PCI on the outcomes of prior CABG patients with AMI.

Methods

Between September 2005 and October 2011, a total of 140 consecutive patients with previous CABG undergoing PCI for the treatment of AMI were included. Clinical/procedural characteristics and long-term clinical outcomes were compared between graft and native artery PCI patients.

Results

The mean time interval to prior CABG was (5.6±4.2) years. Thirty patients received graft PCI, success rate being 90%. One hundred and ten patients received native artery PCI, success rate being 90.7% (P>0.05). There were no significant differences in the basic characteristics between the two groups. All patients received drug eluting stents (DESs). Three patients died during hospitalization in the graft-PCI group (10% vs. native PCI 0, P<0.05). After a median follow-up of two years, major adverse cardiac events (MACE) (myocardial infarction, target vessel revascularization, total death) were 20% with no significant difference between the two groups. Cox regression analysis showed that both diabetes mellitus (DM, HR 3.57, 95% CI 1.03-5.75, P <0.05) and primary PCI (HR 5.932, 95% CI 1.91-18.4, P <0.05) were independent predictors of MACE.

Conclusions

More patients with prior CABG underwent native artery PCI for AMI. PCI to culprit graft vessels had higher in-hospital mortality. DM and primary PCI, but not graft PCI, were predictors for adverse long-term outcome.
Diagnostic value of endobronchial ultrasound guided transbronchial needle aspiration in superior vena cava syndrome
Authors: ZHOU Zu-li , ZHAO Hui , LI Yun , SUI Xi-zhao , XIE Zhen , CHEN Ke-zhong , YANG Feng , LI Feng-wei , LIU Jun , ZHENG Hong-fang , WANG Jun
Published: January 2024

Background

The pathological diagnosis is of critical importance to the subsequent treatment for the pathients with superior vena cava syndrome (SVCS). The aim of this study is to report our experience in the diagnosis of SVCS by endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA).

Methods

The data of 520 patients who underwent EBUS-TBNA from September 2009 to May 2012 at our institution were reviewed. Of these, there were 14 males and 6 females (mean age of 59.1 years) with SVCS who received EBUS-TBNA that were included in the analysis.

Results

The mean short axis diameter of the paratracheal lesions was (3.32±1.79) cm (range, 1.69 to 9.50 cm) and 6 cases also had subcarinal lymph node enlargement with a mean short axis diameter of (2.14±0.49) cm (range, 1.73 to 3.01 cm). An average of 4.3 punctures was performed per lesion. Malignancy was confirmed in 16 cases (10 small cell carcinomas, 4 adenocarcinomas, 1 squamous cell carcinoma and 1 Hodgkin lymphoma). In two patients, pathological examination of tissue revealed no evidence of malignancy and for 13 to 24 months of follow-up. One patient from whom adequate tissue was not obtained refused further surgical biopsy since he had undergone endovascular stenting of the SVC. One patient in whom a diagnosis was not obtained by EBUS-TBNA underwent thoracoscopic biopsy and the final diagnosis was B cell non-Hodgkin's lymphoma. The diagnosis accuracy of EBUS-TBNA in SVCS was 18/20 patients.

Conclusion

EBUS-TBNA is a highly effective and safe procedure for the diagnosis of SVCS.
Tolerability and toxicity of adjuvant cisplatin and gemcitabine for treating non-small cell lung cancer
Authors: YANG Fan , LI Xiao , CHEN Ke-zhong , JIANG Guan-chao , WANG Jun
Published: January 2024

Background

The combination of cisplatin and vinorelbine is an evidence-supported regimen for adjuvant chemotherapy for treating non-small cell lung cancer (NSCLC). But this doublet has considerable toxicity and unfavorable tolerability, and results in poor compliance. The cisplatin and gemcitabine regimen is one of the most active and well-tolerated regimens against advanced NSCLC, but its toxicity and tolerability has not been adequately evaluated in the adjuvant setting. Methods From a lung cancer database we retrospectively reviewed NSCLC patients receiving adjuvant chemotherapy of cisplatin (75 mg/m2) and gemcitabine (1250 mg/m2) between January 2005 and December 2011. Postoperative demographics, compliance to adjuvant therapy and toxicity were retrieved from medical records.

Results

A total of 132 patients met the criteria and were included in the study, 96 were male (72.7%) and 36 were female (27.3%). Median age was 60.5 years old, range 29-75 years, and 41.7% of patients were ≥65 years old. Overall, 68.2% patients received all four planned cycles, and the cumulative dose delivered for gemcitabine was 8333 mg (83.3% of the planned dose) and cisplatin 248 mg (82.7% of the planned dose). There were no treatment-related deaths. Grade 3/4 neutropenia developed in 47 patients (35.6%) and was the predominant hematologic toxicity. Common grade 3/4 non-hematologic toxicities were nausea/vomiting (22.0%), infection (12.3%), and febrile neutropenia (11.4%).

Conclusion

Cisplatin and gemcitabine are feasible for use in the adjuvant setting with a favorable toxicity profile and superior tolerability compared with published data on cisplatin and vinorelbine.
Aliskiren ameliorates sympathetic nerve sprouting and suppresses the inducibility of ventricular tachyarrhythmia in postinfarcted rat heart
Authors: JIA Yin-yu , BAO Zhi-wei , WEI Mei-fang , ZHU Jian-hua , GUI Le
Published: January 2024

Background

Aliskiren is an oral renin inhibitor, which inhibits the first rate limiting step in the renin angiotensin aldosterone system. In this study, sympathetic nerve sprouting and the inducibility of ventricular fibrillation after aliskiren treatment in myocardial infarction were investigated.

Methods

Male Sprague Dawley rats after coronary artery ligation were randomly allocated to four groups: angiotensin converting enzyme inhibitor enalapril, angiotensin receptor blocker valsartan, β adrenergic receptor blocker carvedilol and rennin inhibitor aliskiren treatment for six weeks. Electrophysiological study, histological examination and Western blotting were performed.

Results

The plasma norepinephrine level and sympathetic nerve innervation significantly increased in treated infarcted rats compared to untreated rats. Aliskiren treatment reduced the sympathetic nerve innervations after myocardial infarction. There is no significant difference in sympathetic nerve innervations after myocardial infarction among the enalapril, valsartan, carvediloand or aliskiren treated groups. Programmed electrical stimulation study showed that inducible ventricular arrhythmia was reduced, ventricular fibrillation threshold was increased and ventricular effective refractory period was prolonged in enalapril, valsartan, carvedilol and aliskiren treated infarcted rats compared to untreated infarcted rats. Cardiomyocytic apoptosis in infarcted region was significantly decreased in enalapril, valsartan, carvedilol and aliskiren treated infarcted rats.

Conclusions

Aliskiren ameliorated cardiomyocytic apoptosis, attenuated the sympathetic nerve innervations and reduced the vulnerability of ventricular arrhythmias after myocardial infarction. Enalapril, valsartan and carvedilol have similar effects as aliskiren on cardiomyocytic apoptosis, sympathetic nerve innervations and vulnerability of ventricular arrhythmias after myocardial infarction.
Effect of two intensive insulin therapy regimens on perioperative glycemic control in bone fracture patients with type 2 diabetes mellitus
Authors: DENG Wei , HUO Li-li , LAN Ling , LÜ Yan-wei , WANG Man-yi
Published: January 2024

Background

Currently, there are no uniform standards and methods for perioperative glycemic control in bone fracture patients with Type 2 diabetes mellitus (T2DM). We retrospectively analyzed the efficacy and safety of two intensive insulin therapy regimens administered to bone fracture patients with T2DM in the perioperative period, to explore the best method of achieving perioperative glycemic control.

Methods

A number of 159 bone fracture patients with T2DM were divided into two groups. One group (n=81) received multiple subcutaneous insulin injections (MSII group) and the other (n=78) received continuous subcutaneous insulin infusion (CSII group). Blood glucose (BG) levels, time to achieve glycemic target, insulin dosage, and the incidence of hypoglycemia and complications were compared between groups.

Results

Both regimens reduced BG to desired levels before surgery. The time to reach glycemic target in CSII group (2.5 days) was significantly shorter than that in the MSII group (7.3 days; P<0.001). Mean insulin dosage in the CSII group (0.66 IUkg-1d-1) was significantly lower than that in the MSII group (0.74 IUkg-1d-1; P=0.005), as were the incidences of hypoglycemia (15.4% vs 32.1%) and infection (6.4% vs. 23.5%). Multiple regression analysis showed that the time to reach glycemia target was associated with the insulin therapy regimen and dosage. The insulin dosage on reaching glycemia target was positively associated with body mass index (BMI), diabetes mellitus course, glycated hemoglobin A1c (HbA1c), and β-hydroxybutyric acid, and was negatively associated with age.

Conclusion

The efficacy and safety of CSII was superior to that achieved with MSII, suggesting that CSII should be considered as initial therapy to control perioperative BG in bone fracture patients with T2DM.
Association between change of health care providers and pregnancy exposure to FDA category C, D and X drugs
Authors: Yang Jianzhou , Xie Rihua , Daniel Krewski , Wang Yongjin , Mark Walker , Cao Wenjun , Shi Wu Wen
Published: January 2024

Background

Changing health care providers frequently breaks the continuity of care, which is associated with many health care problems. The purpose of this study was to examine the association between a change of health care providers and pregnancy exposure to FDA category C, D and X drugs.

Methods

A 50% random sample of women who gave a birth in Saskatchewan between January 1, 1997 and December 31, 2000 were chosen for this study. The association between the number of changes in health care providers and with pregnancy exposure to category C, D, and X drugs for those women with and without chronic diseases were evaluated using multiple logistical regression, with adjusted odds ratios (ORs) and its 95% confidence intervals (CIs) as the association measures.

Results

A total of 18 568 women were included in this study. Rates of FDA C, D, and X drug uses were 14.35%, 17.07%, 21.72%, and 31.14%, in women with no change of provider, 1-2 changes, 3-5 changes, and more than 5 changes of health care providers. An association between the number of changes of health care providers and pregnancy exposure to FDA C, D, and X drugs existed in women without chronic diseases but not in women with chronic disease.

Conclusion

Change of health care providers is associated with pregnancy exposure to FDA category C, D and X drugs in women without chronic diseases.

Chin Med J 2014;127(4): 702-706
Lung microRNA profile in chronic cyanotic piglets with decreased pulmonary blood flow
Authors: WANG Dong , LIU Ying-long , Lü Xiao-dong , LING Feng , LIU Ai-jun , DU Jie , HAN Ling
Published: January 2024

Background

Cyanotic congenital heart defects with decreased pulmonary blood flow due to lung ischemia, hypoxia, and others lead to infant morbidity and mortality more than acyanotic heart disease does. Despite the great effort of medical research, their genetic link and underlying microRNAs molecular mechanisms remain obscure. In this study, we aimed to investigate microRNAs regulation during cyanotic defects in lung of immature piglets.

Methods

Cyanotic piglet model was induced by main pulmonary artery-left atrium shunt with distal pulmonary artery banding. Four weeks later, hemodynamic parameters confirmed the development of cyanotic defects and pulmonary lobe RNA was extracted from all animals. We studied the repertoire of porcine lung microRNAs by Solexa deep sequencing technology and quantified highly expressed microRNAs by microarray hybridization. Furthermore, we quantitated selected microRNAs from cyanotic and control piglets by quantitative RT-PCR.

Results

After surgical procedure 4 weeks later, the cyanotic model produced lower arterial oxygen tension, arterial oxygen saturation, and higher arterial carbon dioxide tension, hematocrit and hemoglobin concentration than controls (all P<0.05). In 1273 miRNAs expressed in the immature piglets lungs, 2 most abundant microRNAs (miR-370 and miR-320) demonstrated significant difference between cyanotic and control group (all P<0.05).

Conclusion

Our results extended lung microRNA profile in immature piglets and suggested that miR-370 and miR-320 are significantly up-regulated in cyanotic lung tissues.
Basal insulin therapy strategy is superior to premixed insulin therapy in the perioperative period blood glucose management
Authors: HUANG Qing-xian , LOU Fu-chen , WANG Ping , LIU Qian , WANG Kun , ZHANG Li , ZHU Lei , YU Shan , XU Hua , WANG Qian , ZHANG Ying , HOU Wei-kai
Published: January 2024

Background

The probability and risk of operations increase in patients with type 2 diabetes mellitus. For diabetic patients, blood glucose control is a key factor to improving the prognosis of surgery. During perioperative period, insulin therapy is usually advised to be used for surgical patients with type 2 diabetes. However, the insulin regimen which one is better remains controversial. In this study, we estimated the efficacy, safety and advantage of different insulin therapy strategy during perioperative period.

Methods

A total of 1086 cases of surgical patients with type 2 diabetes mellitus enrolled in the present study. According to the glucose level at admission, all patients were divided into relatively high glucose group (group A, fasting blood glucose (FBG) ≤13.9 mmol/L) and higher glucose group (group B, FBG >13.9 mmol/L). Patients in group A randomly accepted premixed insulin twice a day, or basal insulin plus oral medications, and were divided into group A1 and A2 respectively. Patients in group B randomly received premixed insulin twice daily, basal insulin plus oral hypoglycemic agents, or basal insulin plus preprandial insulin, and were divided into group B1, B2 and B3 respectively. The data of the preoperative preparation time, the daily doses of insulin used in different periods, postoperative incision healed installments, hypoglycemic events, the total hospitalization time, postoperative complications were all collected and statistically analyzed.

Results

Compared the main outcome measures in groups treated by premixed insulin therapy, both in preoperative preparation and postoperative period, the daily insulin dosage and the frequency of hypoglycemic events were decreased in groups treated by basal insulin therapy (P <0.05). The preoperative preparation time and the total hospitalization time in groups with basal insulin therapy were shorter than that in groups with premixed insulin therapy (P <0.05). The incision healing rate of stage I, II and III among different therapy protocols were significantly different (P<0.05).

Conclusions

Basal insulin therapy could be used in diabetic patients undergoing elective major and medium surgery during whole perioperative period. Basal insulin therapy strategy, including a single injection of basal insulin and basal insulin plus preprandial insulin injection subcutaneously, is superior to premixed insulin therapy in the perioperative blood glucose management, and it could be viewed as the best choice in glucose control during perioperative period.
National survey of doctor-reported secondary preventive treatment for patients with acute coronary syndrome in China
Authors: LI Jing , LI Xi , Chen Yiping , Chen Zhengming , ZHANG Li-hua , FENG Fang , ZHANG Hai-bo , LIU Jia-min , GAO Yan , HUNDEI Wuhan-bilige , LI Li , JIANG Li-xin
Published: January 2024

Background

Long-term use of antiplatelet agents, statins, beta-blockers and angiotensin-converting enzyme inhibitors are proven therapies for secondary prevention in acute coronary syndrome. However, little is known of physicians’ opinion about their use in China.

Methods

In 2010, standard questionnaires were posted to chief cardiologists in 1397 geographically diverse and representative sample of tertiary and secondary hospitals in China, collecting information about their opinions on the recommended treatments for acute coronary syndrome.

Results

A total of 1009 (72%) cardiologists responded with a valid questionnaire. Of them, 77% reported routine use of all the four main secondary preventive treatments, with little difference between secondary and tertiary hospitals (75% vs. 79%, P=0.16). Of the cardiologists reporting routine or selective use of aspirin, beta-blockers, statins and angiotensin-converting enzyme inhibitors, 94%, 85%, 73% and 86% would recommend indefinite use respectively. For all the 4 treatments combined, only 63.5% reported indefinite use at the same time, with no significant difference between secondary and tertiary hospitals (62% vs. 65%, P=0.17), nor between hospitals with or without fast track for primary percutaneous coronary intervention (66% vs. 61%, P=0.50).

Conclusions

Although Chinese cardiologists seem well informed about the value of main secondary preventive treatments for acute coronary syndrome, there is still gap in their understanding of the need for combined and prolonged use of these treatments.
Molecular typing and resistance mechanisms of carbapenem resistant Pseudomonas aeruginosa isolated from a Chinese surgical intensive care unit
Authors: Yi Meiying , Wang Pengyuan , Liu Yucun
Published: January 2024

Background

Carbapenems are an important class of drugs for the treatment of Pseudomonas aeruginosa (P. aeruginosa) infections. However, carbapenem resistance has been commonly observed in nonfermenter species of bacteria. The purpose of this study was to investigate the molecular epidemiology and carbapenem resistant mechanisms of P. aeruginosa isolated from a surgical intensive care unit (SICU) in China.

Methods

The molecular typing was analyzed by REP-PCR. Enzyme activity was measured with a 260 nm wavelength spectrophotometer. The levels of outer membrane proteins OprD and OprN were measured by Western blotting. The levels of mexA gene transcriptional expression were measured by quantitative real-time PCR. The metallo-beta-lactamase genes IMP, VIM, SPM, GES, and GIM were amplified by PCR. DNA fragments were sequenced by an automated ABI PRISM 3700.

Results

Forty-two strains resistant to carbapenems isolated from a SICU were analyzed. REP-PCR revealed 34 belonging to type A, a predominant strain in this SICU. But we did not find metallo-beta-lactamases IMP, VIM, SPM, GES, or GIM genes by PCR. With a three-dimensional extract test, we found 34 strains producing high levels of AmpC enzymes. We also observed the activity of beta-lactamases enzymes in the imipenem resistant group, which was statistically different from the sensitive group. Western blotting revealed that 23 strains showed loss of OprD, 18 strains had decreased OprD expression, and 14 strains expressed OprN. We discovered 27 strains that overexpressed mexA by quantitative real-time PCR, and the resistance rate to meropenem was statistically different between the overexpressing group and the lowexpressing group. Nucleotide sequences and deduced amino acid sequence analysis revealed that eight strains carried mutations in the mexR gene operon down regulating MexAB-OprM. The nucleotide sequences of mexR genes from PA36, PA41 and PA48 were submitted to the Genebank with accession numbers of AY899299, AY899300, and AY899301.

Conclusions

There was a predominant strain in the SICU of our hospital. Imipenem resistance is mainly mediated by OprD deficiency or loss, and high activity AmpC enzymes. Overexpression of MexAB-OprM is one of the mechanisms of meropenem resistance, which are partly upregulated by mutations in the mexR gene. The expression of MexEF-OprN also plays an important role in the carbapenem resistance.
Limited value of recovery phase-limited ST segment depression of treadmill exercise test
Authors: Yang Hongbo , Huang Zheyong , Lou Yi , Shen Yunli , Qian Juying , Ge Junbo
Published: January 2024

Background

Clinical meaning of recovery phase limited ST segment depression of a treadmill exercise test is controversial. The aim of this study was to re-assess the diagnostic and prognostic value of ST segment depression during the recovery phase with the active phase of a treadmill exercise test in suspected coronary artery disease patients.

Methods

Clinical, exercise and angiographic data were retrospectively collected from 602 patients in the study. Five hundred and seventy-six patients developed ST segment depression during the active phase of the treadmill exercise test (group 1) and 26 patients developed ST segment depression only during the recovery phase (group 2).

Results

With similar major clinical features, the prevalence of significant coronary artery stenosis and average Gensini scores were lower in the recovery phase-limited depression patients (group 2 vs. group 1, 50.0% vs. 66.9%, P=0.031 and group 2 vs. group 1, 1.5 vs. 8.5, P=0.04). At a median follow up of 50.9 months for 22 group 2 and 34.8 months for 438 group 1 patients, the prevalence of total cardiac events was higher in group 1 than in group 2 patients (RR 1.60, 95% CI 1.00-2.54, P=0.049).

Conclusion

The present study provides preliminary evidence that the diagnostic and prognostic value of recovery phase-limited ST segment depression of treadmill exercise test is limited.

Chin Med J 2014;127 (4): 742-746
A new method for rating dyspnea during exercise in patients with chronic obstructive pulmonary disease
Authors: Wang Hao-yan , Xu Qiu-fen , Yuan Wei , Nie Shan , He Xin , Zhang Jian , Kong Yuan-yuan , Sperry Al , Guan David
Published: January 2024

Background

The Borg scale is most commonly used to measure dyspnea in China. However, many patients that find it is difficult to distinguish the labeled numbers corresponding to different dyspnea scores. We developed a new method to rate dyspnea, which we call the count scale (CS). It includes the count scale number (CSN) and count scale time (CST). The aims of the present study were to determine the reproducibility and sensitivity of the CS during exercise in patients with chronic obstructive pulmonary disease (COPD).

Methods

Fourteen male patients with COPD (aged 58.00±7.72 years) participated in this study. A progressive incremental exercise and a 6-minute constant work exercise test were performed every 2 to 3 days for a total of 3 times. The CS results were evaluated at rest and at 30% and 70% of maximal workload (Wmax) and Wmax. The Borg scales were obtained during exercise.

Results

No significant differences occurred across the three trials during exercise for the CS and Borg scores. The CSN and CST were more varied at Wmax (coefficient of variation (CV)=(22.28±16.96)% for CSN, CV=(23.08±19.11)% for CST) compared to 30% of Wmax (CV=(11.92±8.78)% for CSN, CV=(11.16±9.96)% for CST) and 70% of Wmax (CV=(9.08±7.09)% for CSN, CV=(12.19±12.32)% for CST). Dyspnea ratings with either CSN or CST tended to decrease at the higher workload compared to the lower workload. CSN and CST scores were highly correlated (r=0.861, P <0.001). CSN was negatively correlated with Borg scores (r=-0.363, P=0.001). Similar results were obtained for the relationship between CST and Borg scores (r=-0.345, P=0.003).

Conclusion

We concluded that the CS is simple and reproducible when measuring dyspnea during exercise in patients with COPD.
Positive end expiratory pressure titrated by transpulmonary pressure improved oxygenation and respiratory mechanics in acute respiratory distress syndrome patients with intra-abdominal hypertension
Authors: YANG Yi , LI Yang , LIU Song-qiao , LIU Ling , HUANG Ying-zi , GUO Feng-mei , QIU Hai-bo
Published: January 2024

Background

Intra-abdominal hypertension (IAH) is common in acute respiratory distress syndrome (ARDS) patients and when resulting in decrease of chest wall compliance will weaken the effect of positive end expiratory pressure (PEEP). We investigated the effect of PEEP titrated by transpulmonary pressure (Ptp) on oxygenation and respiratory mechanics in ARDS patients with IAH compared with PEEP titrated by ARDSnet protocol.

Methods

ARDS patients admitted to the intensive care unit (ICU) of the Zhongda Hospital were enrolled. Patients were ventilated with volume control mode with tidal volume of 6 ml/kg under two different PEEP levels titrated by Ptp method and ARDSnet protocol. Respiratory mechanics, gas exchange and haemodynamics were measured after 30 minutes of ventilation in each round. IAH was defined as intra-abdominal pressure of 12 mmHg or more.

Results

Seven ARDS patients with IAH and 8 ARDS patients without IAH were enrolled. PEEP titrated by Ptp were significant higher than PEEP titrated by ARDSnet protocol in both ARDS patients with IAH ((17.3±2.6) cmH2O vs. (6.3±1.6) cmH2O and without IAH ((9.5±2.1) cmH2O vs. (7.8±1.9) cmH2O). Arterial pressure of O2/fraction of inspired oxygen (PaO2/FiO2) was much higher under PEEP titrated by Ptp when compared with PEEP titrated by ARDSnet protocol in ARDS patients with IAH ((27.2±4.0) cmHg vs. (20.9± 5.0) cmHg. But no significant difference of PaO2/FiO2 between the two methods was found in ARDS patients without IAH. In ARDS patients with IAH, static compliance of lung and respiratory system were higher under PEEP titrated by Ptp than by ARDSnet protocol. In ARDS patients with IAH, central venous pressure (CVP) was higher during PEEP titrated by Ptp than by ARDSnet protocol.

Conclusion

Positive end expiratory pressure titrated by transpulmonary pressure was higher than PEEP titrated by ARDSnet protocol and improved oxygenation and respiratory mechanics in ARDS patients with IAH.
Protectin D1 promotes resolution of inflammation in a murine model of lipopolysaccharide-induced acute lung injury via enhancing neutrophil apoptosis
Authors: Li Xingwang , Li Chunlai , Liang Wandong , Bi Yuntian , Chen Maohua , Dong Sheng
Published: January 2024

Background

Protectin D1 (PD1), derived from docosahexaenoic acid, has been shown to control and resolve inflammation in some experimental models of inflammatory disorders. We investigated the protective roles of protectin D1 in pulmonary inflammation and lung injury induced by lipopolysaccharide (LPS).

Methods

Mice were randomly assigned to six groups (n=6 per group): sham-vehicle group, sham-PD1 group, sham-zVAD-fmk group, LPS-vehicle group, LPS-PD1 group, and LPS-PD1-zVAD-fmk group. Mice were injected intratracheally with 3 mg/kg LPS or saline, followed 24 hours later by intravenous injection of 200 μg/mouse PD1 or vehicle. At the same time, some mice were also injected intraperitoneally with the pan-caspase inhibitor zVAD-fmk. Seventy-two hours after LPS challenge, samples of pulmonary tissue and bronchoalveolar lavage fluid were collected. Optical microscopy was used to examine pathological changes in lungs. Cellularity and protein concentration in bronchoalveolar lavage fluid were analyzed. Lung wet/dry ratios and myeloperoxidase activity were measured. Apoptosis of neutrophils in bronchoalveolar lavage fluid (BALF) was also evaluated by flow cytometry.

Results

Intratracheal instillation of LPS increased neutrophil counts, protein concentration in bronchoalveolar lavage fluid and myeloperoxidase activity, it induced lung histological injury and edema, and also suppressed apoptosis of neutrophils in BALF. Posttreatment with PD1 inhibited LPS-evoked changes in BALF neutrophil counts and protein concentration and lung myeloperoxidase activity, with the outcome of decreased pulmonary edema and histological injury. In addition, PD1 promoted apoptosis of neutrophils in BALF. The beneficial effects of PD1 were blocked by zVAD-fmk.

Conclusion

Posttreatment with PD1 enhances resolution of lung inflammation during LPS-induced acute lung injury by enhancing apoptosis in emigrated neutrophils, which is, at least in part, caspase-dependent.
Antiviral therapy for “difficult-to-treat” hepatitis C virus-infected patients
Authors: Tatsuo Kanda , Osamu Yokosuka , Masao Omata
Published: January 2024

Objective

To review the updated research on direct antiviral agents (DAAs)-including regimens for hepatitis C virus (HCV), and focus on “difficult-to-treat” HCV-infected patients.

Data sources

The literature concerning DAAs and hepatitis C cited in this review was collected from PubMed and Google Scholar databases published in English up to July 2013.

Study selection

Data from published articles regarding HCV and DAAs in clinical trials and in clinical use were identified and reviewed.

Results

It was recognized that some “difficult-to-treat” patients would still exist, even though stronger treatments using such as DAAs, including telaprevir and boceprevir, which lead to higher sustained virological response rates, are available. Such patients include those with advanced fibrosis/cirrhosis, elderly persons, children, HCV-human immunodeficiency virus co-infected patients, HCV-infected recipients, and so on.

Conclusions

Certain “difficult-to-treat” patients would still exist, even though stronger treatment is available. Although evidence from clinical trials is still lacking, interferon-sparing regimens could have stronger effects for eradicating HCV in such cases.
Total liquid ventilation reduces oleic acid-induced lung injury in piglets
Authors: ZHU Yao-Bin , LIU Dong-Hai , ZHANG Yan-Bo , LIU Ai-Jun , FAN Xiang-Ming , QIAO Chen-Hui , WANG Qiang , LIU Ying-Long
Published: January 2024

Background

Pediatric patients are susceptible to lung injury that does not respond to traditional therapies. Total liquid ventilation has been developed as an alternative ventilatory strategy for severe lung injury. The aim of this study is to investigate the effect of total liquid ventilation on oleic acid (OA)-induced lung injury in piglets.

Methods

Twelve Chinese immature piglets were induced acute lung injury by OA. Twelve piglets were randomly treated with conventional gas ventilation (control group) or total liquid ventilation (study group) for 240 minutes. Samples for blood gas analysis were collected before, and at 60-minute intervals after OA-induced lung injury. The degree of lung injury was quantified by histologic examination. The inflammatory cells and the levels of IL-1β, IL-6, IL-10 and TNF-α in plasma, tissue and bronchoalveolar lavage were analyzed.

Results

Neutrophil and macrophage counts in bronchoalveolar lavage were significantly decreased in the study group (P<0.05). The total lung injury score was also reduced in the study group (P<0.05). The concentrations of IL-1β, IL-6, IL-10 and TNF-α in plasma, tissue and bronchoalveolar lavage were significantly reduced in the study group (P<0.05).

Conclusions

Total liquid ventilation reduces biochemical and histologic OA-induced lung injury in piglets.
Serum interleukin-10 levels and adverse events in patients with acute coronary syndrome: a systematic review and meta-analysis
Authors: Liu Jun , Jia Yanjun , Li Xiaolin , Xu Ruixia , Zhu Chenggang , Guo Yuanlin , Wu Naqiong , Li Jianjun
Published: January 2024

Background

Several studies investigating the prognostic utility of interleukin-10 (IL-10) in patients with acute coronary syndrome (ACS) have provided conflicting findings. The aim of the study was to assess the existing evidence regarding association between serum IL-10 levels and adverse events.

Methods

Literature search was performed in PubMed, EMBASE, and Cochrane Trials Register databases from their inception to September 30, 2012. In addition, reference lists of the included articles and their related citations in PubMed were also reviewed for additional pertinent studies.

Results

A total of 12 eligible studies comprising a total of 5882 patients were identified. The pooled relative risks for both studies reporting the risk estimates by IL-10 categories and studies reporting the risk estimates by unit IL-10 indicated an association between high IL-10 levels and adverse events. Sensitivity and subgroup analysis indicated that the results obtained in IL-10 categories were not stable.

Conclusions

Data from our meta-analysis supported the existence of a relationship between high serum IL-10 levels and adverse events in patients with ACS. Large study with longer follow-up is needed to confirm the findings.
An experimental study of using Chai Lai Prescription to treat in vitro rabbit models of reflux esophagitis
Authors: WANG Xiao-hua , WEN Hao , YOU Si-hong , XU Xiao-fei , WEN Wei
Published: January 2024

Background

Chai Lai Prescription is a Chinese herbal compound which is used to sooth the liver, strengthen the spleen and harmonize the stomach for descending adverse Qi. We initiated the study to investigate its mechanism of treating in vitro rabbit reflux esophagitis models.

Methods

Adult male Japanese white rabbits, weighing 1.8–2.2 kg, were divided into five groups of three each, which were: normal control group (Krebs buffer, pH7.4), esophagitis model group (Krebs buffer, pH5.8), esophagitis model proup+low-dose Chinese herbal medicine protection group (0.6 mg·ml-1·kg-1), esophagitis model group+moderate-dose Chinese herbal medicine protection group (6 mg·ml-1·kg-1), esophagitis model group+high-dose Chinese herbal medicine protection group (60 mg·ml-1·kg-1). The RT-PCR method was used to test the influence of Chai Lai Prescription on IL-1 and IL-6 in in vitro rabbit models of esophagitis. We treated the in vitro models with different doses of Chinese herbal medicine.

Results

Esophageal mucosa were filled with various liquids. IL-6 and IL-1β mRNA expression was increased in rabbit esophageal mucosa stimulated with acid. Chinese herbal medicine significantly reduced the levels of IL-6 and IL-1β mRNA expression in the in vitro cultured rabbit esophageal mucosa. Using Chinese herbal medicine to treat in vitro models of RE, we found that the IL-6 and IL-1β mRNA expression levels went down, near to or lower than the normal control levels, compared with the group treated with acidified buffer solution.

Conclusions

Chai Lai Prescription lowered the IL-1β and IL-6 cytokine mRNA levels and protected the esophageal mucosa in the in vitro models of reflux esophagitis, suggesting that the traditional Chinese herbal compound may be able to treat reflux esophagitis by inhibiting the its inflammatory mediators.
A new gene ontology-based measure for the functional similarity of gene products
Authors: QI Guo-long , QIAN Shi-yu , FANG Ji-qian
Published: January 2024

Background

Although biomedical ontologies have standardized the representation of gene products across species and databases, a method for determining the functional similarities of gene products has not yet been developed.

Methods

We proposed a new semantic similarity measure based on Gene Ontology that considers the semantic influences from all of the ancestor terms in a graph. Our measure was compared with Resnik's measure in two applications, which were based on the association of the measure used with the gene co-expression and the protein-protein interactions.

Results

The results showed a considerable association between the semantic similarity and the expression correlation and between the semantic similarity and the protein-protein interactions, and our measure performed the best overall.

Conclusion

These results revealed the potential value of our newly proposed semantic similarity measure in studying the functional relevance of gene products.