bluuebunny/crossref_metadata_2025 huggingface dataset:
Removal versus preservation of the posterior longitudinal ligament in Bryan cervical disc arthroplasty
Authors: YANG Da-long , DING Wen-yuan , ZHANG Ying-ze , ZHANG Wei , XU Jia-xin , SHEN Yong
Published: January 2024

Background

Bryan cervical disc arthroplasty can be used to restore and maintain the mobility and function of the involved cervical spinal segments. The efficiency of posterior longitudinal ligament (PLL) resection in anterior cervical decompression and fusion has been demonstrated. However, no clinical reports have compared PLL removal with preservation in Bryan cervical disc arthroplasty. This study aimed to assess the role of removal of PLL in Bryan cervical disc arthroplasty at an 18-month follow-up.

Methods

We performed a prospective investigation of clinical and radiological outcomes in patients after Bryan cervical disc arthroplasty. Sixty patients who underwent Bryan cervical disc arthroplasty were included. The PLL was removed in 35 patients (investigational group) and preserved in 25 patients (control group). All of the patients were followed up for more than 18 months. Clinical (Japanese Orthopedic Association score and Visual Analogue Scale pain score) and radiological (functional spinal unit (FSU) angle, range of movement (ROM), and diameter of the spinal cord) parameters were compared between the two groups before and after surgery (18 months).

Results

Clinical outcomes in the investigational group were significantly superior to those in the control group. There were no significant differences in the FSU angle and ROM (P=0.41 and 0.16, respectively) between the two groups. However, the increase in diameter of the spinal cord in the investigational group was significantly greater than that in the control group (P <0.01).

Conclusions

Removal of the PLL can improve the clinical outcomes of Bryan cervical disc arthroplasty. This procedure does not have a large effect on imbalance and motion of the cervical spine.
Reoperation on aortic disease in patients with previous aortic valve surgery
Authors: SUN Xiao-gang , ZHANG Liang , YU Cun-tao , QIAN Xiang-yang , CHANG Qian
Published: January 2024

Background

Aortic valve replacement (AVR) is a safe and effective method in the treatment of aortic valve diseases. This study aimed to increase the understanding on re-treatment of aortic diseases after aortic valve surgery through a retrospective analysis of 47 related cases.

Methods

Forty-seven patients (38 males and 9 females) with previous aortic valve surgery have received reoperation on aorta from January 2003 to June 2012, and the mean interval time of re-intervention to aortic disease was 6 years ((6.0± 3.8) years). The secondary aortic surgery included aortic root replacement (14 cases), ascending aorta replacement (10 cases), aortic root/ascending aorta plus total arch replacement with stented elephant trunk implantation (21 cases), and total thoracoabdominal aorta replacement (2 cases). All these patients have received outpatient re-exams or follow-up by phone calls.

Results

After the initial aortic valve replacement, patients suffered from aortic dissection (25 cases, 53%), ascending aortic aneurysm (12 cases, 26%) or aortic root aneurysm (10 cases, 21%). Diameter in ascending aorta increased (5.2±7.1) mm per year and aortic sinus (3.3±3.1) mm per year. The annual growth value of diameter in ascending aorta was higher in patients with rheumatic heart disease than that in Marfan syndrome (P<0.05). All 47 patients have received reoperation on aorta. One patient died in operating room because aortic dissection seriously involved right coronary artery. Seven patients had renal insufficiency after operation; neurological complications occurred in 14 patients including 7 patients with stroke and the others with transient brain dysfunction. All patients were followed up, the mean survival time was (97.25±17.63) months, 95% confidence interval was 55.24–73.33 months. Eight cases were died during follow-up and five-year survival rate was 83%.

Conclusion

To reduce the aortic adverse events after first aortic valve surgery, it is necessary to actively treat and strictly follow-up patients with previous aortic operation especially patients with Marfan syndrome and rheumatic heart disease.
Structured lipid emulsion as nutritional therapy for the elderly patients with severe sepsis
Authors: CHEN Jin , YAN Jing , CAI Guo-long , XU Qiang-hong , GONG Shi-jin , DAI Hai-wen , YU Yi-hua , LI Li
Published: January 2024

Background

The nutritional support is one of the important therapeutic strategies for the elderly patients with severe sepsis, but there is controversial in choosing a parenteral nutrition formulation. This study was designed to compare the therapeutic effects of structured lipid emulsion, physically mixed medium, and long-chain fat emulsion in the treatment of severe sepsis in elderly patients.

Methods

A total number of 64 elder patients with severe sepsis were enrolled in the study. After a week of enteral nutritional support, the patients were randomly divided into research (structured lipid emulsion as parenteral alimentation) and control groups (physically mixed medium and long-chain fat emulsion as parenteral alimentation). The alterations of plasma albumin, lipid metabolism, and blood glucose level were recorded after parenteral alimentation and were compared between the two groups.

Results

The plasma levels of albumin, prealbumin, cholesterol, and triglyceride were decreased in all the patients after one week of enteral nutritional support treatment (t=7.78, P=0.000; t=10.21, P=0.000; t=7.99, P=0.000; and t=10.99, P=0.000). Further parenteral alimentation with different lipid emulsions had significant effects on the serum prealbumin and albumin (t=3.316, P=0.002; t=3.200, P=0.002), whilst had no effects on the blood glucose and triglyceride level (t=7.78, P=0.000; t=4.228, P=0.000). In addition, the two groups had a significantly different Apache II score, ventilator time, and hospital stay time (t= -2.213, P=0.031; t=2.317, P=0.024; t=2.514, P=0.015).

Conclusions

The structured lipid emulsion was safe as parenteral nutrition for elderly patients with severe sepsis. It was demonstrated to be superior to the physically mixed medium and long-chain fat emulsion with respect to the protein synthesis and prognosis.
Risk factors associated with postoperative hospital stay after pancreaticoduodenectomy: a retrospective study
Authors: Xie Yi-bin , Wang Cheng-feng , Zhao Dong-bing , Shan Yi , Bai Xiao-feng , Sun Yue-min , Chen Ying-tai , Zhao Ping , Tian Yan-tao
Published: January 2024

Background

Postoperative hospital stay after pancreaticoduodenectomy (PD) is relatively longer than after other gastrointestinal operations. The aim of the current study was to investigate the risk factors associated with prolonged hospital stay after PD.

Methods

Patients who had PD at the Cancer Hospital of Chinese Academy of Medical Sciences between December 2008 and November 2012 were selected for this retrospective study. Clinical and pathological data were collected and analyzed. The primary outcome was postoperative length of stay. Normal discharge or recovery was defined as a postoperative hospital stay of no more than 10 days; otherwise it was defined as delayed discharge or recovery (including hospital death).

Results

A total of 152 patients were enrolled in the present study. Postoperative hospital stay was (19.7±7.7) days (range 7-57). Of the 152 patients, 67 were discharged within the normal time and 85 had delayed discharge. Postoperative complications occurred in 62.5% (95/152), and the mortality rate was 3.29% (5/152). Multiple regression analysis showed that delayed discharge was significantly associated with postoperative complications (adjusted odds ratio (OR) 10.40, 95% confidence interval (CI) 3.58-30.22), age (adjusted OR 4.09, 95% CI 1.16-14.39), body mass index (BMI) (adjusted OR 4.40, 95% CI 1.19-16.23), surgical procedure (adjusted OR 26.14, 95% CI 4.94-153.19), blood transfusion (adjusted OR 7.68, 95% CI 2.09-28.27), and fluid input (adjusted OR 3.47, 95% CI 1.24-11.57).

Conclusions

Postoperative complications increase the time to postoperative hospital discharge. The length of hospital stay after PD is also associated with age, BMI, blood transfusion, surgical procedure, and fluid input. Further studies with more patients are needed in future.
Prevalence, awareness, treatment, and control of hypertension in the non-dialysis chronic kidney disease patients
Authors: ZHENG Ying , CAI Guang-yan , CHEN Xiang-mei , FU Ping , CHEN Jiang-hua , DING Xiao-qiang , YU Xue-qing , LIN Hong-li , LIU Jian , XIE Ru-juan , WANG Li-ning , NI Zhao-hui , LIU Fu-you , YIN Ai-ping , XING Chang-ying , WANG Li , SHI Wei , LIU Jian-she , HE Ya-ni , DING Guo-hua , LI Wen-ge , WU Guang-li , MIAO Li-ning , CHEN Nan , SU Zhen , MEI Chang-lin , ZHAO Jiu-yang , GU Yong , BAI Yun-kai , LUO Hui-min , LIN Shan , CHEN Meng-hua , GONG Li , YANG Yi-bin , YANG Xiao-ping , LI Ying , WAN Jian-xin , WANG Nian-song , LI Hai-ying , XI Chun-sheng , HAO Li , XU Yan , FANG Jing-ai , LIU Bi-cheng , LI Rong-shan , WANG Rong , ZHANG Jing-hong , WANG Jian-qin , LOU Tan-qi , SHAO Feng-min , MEI Feng , LIU Zhi-hong , YUAN Wei-jie , SUN Shi-ren , ZHANG Ling , ZHOU Chun-hua , CHEN Qin-kai , JIA Shun-lian , GONG Zhi-feng , GUAN Guang-ju , XIA Tian , ZHONG Liang-bao
Published: January 2024

Background

Data on the epidemiology of hypertension in Chinese non-dialysis chronic kidney disease (CKD) patients are limited. The aim of the present study was to investigate the prevalence, awareness, treatment, and control of hypertension in the non-dialysis CKD patients through a nationwide, multicenter study in China.

Methods

The survey was performed in 61 tertiary hospitals in 31 provinces, municipalities, and autonomous regions in China (except Hong Kong, Macao, and Taiwan). Trained physicians collected demographic and clinical data and measured blood pressure (BP) using a standardized protocol. Hypertension was defned as systolic BP ≥140 mmHg and/or diastolic BP ≥90 mmHg, and/or use of antihypertensive medications. BP <140/90 mmHg and <130/80 mmHg were used as the 2 thresholds of hypertension control. In multivariate logistic regression with adjustment for sex and age, we analyzed the association between CKD stages and uncontrolled hypertension in non-dialysis CKD patients.

Results

The analysis included 8927 non-dialysis CKD patients. The prevalence, awareness, and treatment of hypertension in non-dialysis CKD patients were 67.3%, 85.8%, and 81.0%, respectively. Of hypertensive CKD patients, 33.1% and 14.1% had controlled BP to <140/90 mmHg and <130/80 mmHg, respectively. With successive CKD stages, the prevalence of hypertension in non-dialysis CKD patients increased, but the control of hypertension decreased (P<0.001). When the threshold of BP <130/80 mmHg was considered, the risk of uncontrolled hypertension in CKD 2, 3a, 3b, 4, and 5 stages increased 1.3, 1.4, 1.4, 2.5, and 4.0 times compared with CKD 1 stage, respectively (P<0.05). Using the threshold of <140/90 mmHg, the risk of uncontrolled hypertension increased in advanced stages (P<0.05).

Conclusions

The prevalence of hypertension Chinese non-dialysis CKD patients was high, and the hypertension control was suboptimal. With successive CKD stages, the risk of uncontrolled hypertension increased.
Adiponectin alleviates contractile dysfunction of genioglossus in rats exposed to chronic intermittent hypoxia
Authors: WANG Wen-jing , LU Gan , DING Ning , HUANG Han-peng , DING Wen-xiao , ZHANG Xi-long
Published: January 2024

Background

Genioglossal dysfuntion takes an important role in pathogenesis of obstructive sleep apnea hypopnea syndrome (OSAHS) in which chronic intermittent hypoxia (CIH) is the major pathological origin. Recent studies have suggested genioglossal injury induced by CIH might be improved by adiponectin. The aim of this study was to investigate the effects of adiponectin on genioglossus contractile properties in rats exposed to CIH.

Methods

Thirty-nine healthy male Wistar rats were randomly divided into three groups: normal control (NC), CIH and adiponectin supplement (CIH+Ad) with 13 rats in each. Rats in NC were kept breathing normal air, while rats in CIH and CIH+Ad experienced the same CIH environment eight hours per day for 35 successive days. Rats in CIH+Ad were given intravenous adiponectin of 10 μg twice a week for 30 successive days. Rats in the NC and CIH were injected with normal saline as a control. After 35 days' CIH exposure, the levels of serum adiponectin and genioglossus contractile properties were compared.

Results

Serum adiponectin level was significantly lower in CIH than in NC (1210 ng/ml vs. 2236 ng/ml). Serum adiponectin level in CIH+Ad (1844 ng/ml) was significantly higher than CIH but lower than NC. Twitch tension, time to peak tension, half relaxation time and tetanic tension were significantly lower in CIH than NC and improved in CIH+Ad. All mean tetanic fatigue indices decreased more rapidly in the first 20 seconds than during the subsequent 100 seconds. Tetanic fatigue indices in NC and CIH+Ad were significantly higher compared to CIH.

Conclusions

CIH could lead to hypoadiponectinaemia, impaired genioglossus contractile properties and decreased fatigue resistance in rats. Such changes could be partially offset by supplementation of adiponectin.
Effect of epidural analgesia with 0.075% ropivacaine versus 0.1% ropivacaine on the maternal temperature during labor: a randomized controlled study
Authors: YUE Hong-Li , SHAO Liu-Jiazi , LI Jin , WANG Ya-Nan , WANG Lei , HAN Ru-Quan
Published: January 2024

Background

A wealth of evidence has indicated that labor epidural analgesia is associated with an increased risk of hyperthermia and overt clinical fever. Recently, evidence is emerging that the epidural analgesia-induced fever is associated with the types of the epidural analgesia and the variations in the epidural analgesia will affect the incidence of fever. The aim of the present study was to investigate the effects of epidural analgesia with 0.075% or 0.1% ropivacaine on the maternal temperature during labor.

Methods

Two hundred healthy term nulliparas were randomly assigned to receive epidural analgesia with either 0.1% ropivacaine or 0.075% ropivacaine. Epidural analgesia was initiated with 10 ml increment of the randomized solution and 0.5 μg/ml sufentanyl after a negative test dose of 5 ml of 1.5% lidocaine, and maintained with 7 ml bolus doses of the abovementioned mixed analgesics every 30 minutes by the patient-controlled epidural analgesia. The measurements included the maternal oral temperature, visual analog scale pain scores, labor events and neonatal outcomes.

Results

Epidural analgesia with 0.075% ropivacaine could significantly lower the mean maternal temperature at 4 hours after the initiation of analgesia and the oxytocin administration during labor compared with the one with 0.1% ropivacaine. Moreover, 0.075% ropivacaine treatment could provide satisfactory pain relief during labor and had no significant adverse effects on the labor events and neonatal outcomes.

Conclusion

Epidural analgesia with 0.075% ropivacaine may be a good choice for the epidural analgesia during labor.
Comparison study of two diagnostic and grading systems for conjunctivochalasis
Authors: ZHANG Xing-ru , ZOU Hai-dong , LI Qing-song , ZHOU Huan-ming , LIU Bin , HAN Zhu-mei , XIANG Min-hong , ZHANG Zheng-yong , WANG Han-min
Published: January 2024

Background

Different diagnostic and grading systems of conjunctivochalasis have resulted in apparent disparity between the prevalence rates of recent population-based studies. This study aimed to investigate the disparity between 4-level system cited from Meller and Tseng in 1998 (abbreviated here as Meller's system) and 5-level system modified from Meller's system cited from Zhang and associates (abbreviated here as Zhang's system) regarding the diagnosis and the patients' preferences for the treatment of conjunctivochalasis in the general population.

Methods

A total of 546 senile residents living in the Guiyangyuan community of Shanghai, China, participated in the study. The diagnostic criteria for conjunctivochalasis were based on two diagnostic grading systems: Meller's system and Zhang's system, which was modified from Meller's system. The participants' preference regarding medical treatment for conjunctivochalasis was determined according to the response to a question. One year later, a follow-up interview determines whether the patient had undergone surgery for conjunctivochalasis.

Results

With Meller's system, 398 participants were confirmed as having conjunctivochalasis, and the prevalence rate was 72.89%. According to Zhang's system, only 213 participants were diagnosed as having conjunctivochalasis, and the prevalence rate was 39.01%. A total of 109 eyes underwent medical treatment or surgery for conjunctivochalasis in the following year, including eight eyes that were diagnosed as grade II and 101 eyes that were diagnosed as grade III according to Meller's system and five eyes that were diagnosed as grade I, 55 eyes that were diagnosed as grade II, 31 eyes that were diagnosed as grade III, and 18 eyes that were diagnosed as grade IV according to Zhang's system.

Conclusion

Diagnoses of conjunctivochalasis using Zhang's system are more consistent with patient requests and the medical treatment strategies used than diagnoses made using Meller's system.
Uncoupling protein and nonalcoholic fatty liver disease
Authors: JIN Xi , XIANG Zun , CHEN Yi-peng , MA Kui-fen , YE Yue-fang , LI You-ming
Published: January 2024

Objective

To review the current advances on the role of uncoupling protein (UCP) in the pathogenesis and progress of nonalcoholic fatty liver disease (NAFLD).

Data sources

A comprehensive search of the PubMed literature without restriction on the publication date was carried out using keywords such as UCP and NAFLD.

Study selection

Articles containing information related to NAFLD and UCP were selected and carefully analyzed.

Results

The typical concepts, up-to-date findings, and existing controversies of UCP2 in NAFLD were summarized. Besides, the effect of a novel subtype of UCP (hepatocellular down regulated mitochondrial carrier protein, HDMCP) in NAFLD was also analyzed. Finally, the concept that any mitochondrial inner membrane carrier protein may have, more or less, the uncoupling ability was reinforced.

Conclusions

Considering the importance of NAFLD in clinics and UCP in energy metabolism, we believe that this review may raise research enthusiasm on the effect of UCP in NAFLD and provide a novel mechanism and therapeutic target for NAFLD.
Neuropsychiatric disorders and cognitive dysfunction in patients with Cushing's disease
Authors: CHEN Yu-fan , LI Yun-feng , CHEN Xiao , SUN Qing-fang
Published: January 2024

Objective

To review the main neuropsychiatric disorders and cognitive deficits in patients with Cushing's disease (CD) and the associated pathophysiological mechanisms underlying CD. These mechanistic details may provide recommendations for preventing or treating the cognitive impairments and mood disorders in patients with CD.

Data sources

Data were obtained from papers on psychiatric and cognitive complications in CD published in English within the last 20 years. To perform the PubMed literature search, the following keywords were input: cushing's disease, cognitive, hippocampal, or glucocorticoids.

Study selection

Studies were selected if they contained data relevant to the topic addressed in the particular section. Because of the limited length of this article, we have frequently referenced recent reviews that contain a comprehensive amalgamation of literature rather than the actual source papers.

Results

Patients with active CD not only suffer from many characteristic clinical features, but also show some neuropsychiatric disorders and cognitive impairments. Among the psychiatric manifestations, the common ones are emotional instability, depressive disorder, anxious symptoms, impulsivity, and cognitive impairment. Irreversible effects of previous glucocorticoid (GC) excess on the central nervous system, such as hippocampal and the basal ganglia, is the most reasonable reason. Excess secretion of cortisol brings much structural and functional changes in hippocampal, such as changes in neurogenesis and morphology, signaling pathway, gene expression, and glutamate accumulation. Hippocampal volume loss can be found in most patients with CD, and decreased glucose utilization caused by GCs may lead to brain atrophy, neurogenesis impairment, inhibition of long-term potentiation, and decreased neurotrophic factors; these may also explain the mechanisms of GC-induced brain atrophy and hippocampal changes.

Conclusions

Brain atrophy and hippocampal changes caused by excess secretion of cortisol are thought to play a significant pathophysiological role in the etiology of changes in cognitive function and psychiatric disturbances. The exact mechanisms by which GCs induce hippocampal volume loss are not very clear till now. So, further investigations into the mechanisms by which GCs affect the brain and the effective coping strategy are essential.
Muscle mass loss and intermuscular lipid accumulation were associated with insulin resistance in patients receiving hemodialysis
Authors: WANG Hui-ling , DING Ting-ting , LU Shi , XU Ye , TIAN Jun , HU Wei-feng , ZHANG Jin-yuan
Published: January 2024

Background

An accelerated muscle wasting was the pivotal factor for protein-energy wasting in end stage renal disease. However, very few researches have examined the skeletal muscle quantity and quality in clinical patients. This study investigated the muscle morphologic changes by magnetic resonance imaging (MRI) and analyzed the related factors in hemodialysis patients.

Methods

Fifty-eight patients receiving maintenance hemodialysis (HD) were investigated and 28 healthy adults with gender and age matched were used as controls (Control). Anthropometry, cytokine factors, and laboratory data were measured. The muscle and intermuscular adipose tissues (IMAT) were analyzed via a Thigh MRI. The bicep samples were observed after HE staining. Homeostatic model assessment of insulin resistance (HOMA-IR) was measured and their association with muscle wasting was analyzed.

Results

HD patients tended to have a lower protein diet, anthropometry data, and serum albumin, but the C reactive protein and interleukin-6 increased significantly. The MRI showed that HD patients had less muscle mass and a lower muscle/total ratio, but the fat/muscle and IMAT was higher when compared to the Control group. The muscle fiber showed atrophy and fat accumulation in the biceps samples come from the HD patients. Moreover, we found that the HD patients presented with a high level of plasma fasting insulin and increased HOMA-IR which negatively correlated with the muscle/total ratio, but positively with the fat/muscle ratio.

Conclusions

Muscle wasting presented early before an obvious malnutrition condition emerged in HD patients. The main morphological change was muscle atrophy along with intermuscular lipid accumulation. Insulin resistance was associated with muscle wasting in dialysis patients.
Insulin enhances apoptosis induced by cisplatin in human esophageal squamous cell carcinoma EC9706 cells related to inhibition of autophagy
Authors: Yang Yang , Wen Fengbiao , Dang Lifeng , Fan Yuxia , Liu Donglei , Wu Kai , Zhao Song
Published: January 2024

Background

Chemoresistance is common among patients with esophageal squamous cell carcinoma (ESCC). We investigated the effect and mechanism of insulin on enhancing anticancer functions of cisplatin in human esophageal cancer cell line EC9706.

Methods

The viability of EC9706 cells exposed to cisplatin was assessed using MTT assay. The times T1, when the number of living cells reached a plateau and T2, when the number of living cells reached a new plateau after the addition of insulin were found. T1 and T2 plateau cells were stained by Annexin V-FITC/PI and monodansylcadaverin (MDC). Fluorescent microscopy was used to observe the expression of apoptosis and autophagy intuitively. Apoptotic ratio and fluorescent intensity were analysed by flow cytometry (FCM) quantitatively. Western blotting analysis was used to estimate the protein expression levels of AKT, mTOR, PI3K, PTEN, autophage related indicator LC3-II and autophage related protein Beclin1 changes that occurred in the course of treatment.

Results

A larger number of typical autophagosomes were detected in EC9706 cells exposed to cisplatin. Insulin can increase the apoptosis induced by cisplatin. Apoptotic ratio of T1 plateau cells ((32.6±4.3)%) is significantly less than T2 plateau ((47.5±5.6)%). MDC fluorescent intensity at T1 plateau (104.9±13.2) was significantly higher than intensity at T2 plateau (82.6±10.3). After cotreatment with insulin, the expression level of LC3-II, Beclin1 and PTEN in T2 plateau cells were significantly downregulated, but AKT, mTOR and PI3K expressions significantly upregulated compared with T1 plateau.

Conclusions

Insulin could enhance cisplatin-induced apoptosis in human esophageal squamous cell carcinoma EC9706 cells related to inhibition of autophagy. The activation of PI3K/Akt/mTOR signaling pathway induced by insulin resulted in the suppression of autophagy in EC9706 cells, which may be attributed to the anticancer effects of cisplatin.
Low-intensity pulsed ultrasound prompts tissue-engineered bone formation after implantation surgery
Authors: Wang Juyong , Wang Juqiang , Asou Yoshinori , Paul Fu , Shen Huiliang , Chen Jiani , Sotome Shinichi , Liu Zhao , Shinomiya Kenichi
Published: January 2024

Background

A practical problem impeding clinical translation is the limited bone formation seen in artificial bone grafts. Low-pressure/vacuum seeding and dynamic culturing in bioreactors have led to a greater penetration into the scaffolds, enhanced production of bone marrow cells, and improved tissue-engineered bone formation. The goal of this study was to promote more extensive bone formation in the composites of porous ceramics and bone marrow stromal cells (BMSCs).

Methods

BMSCs/β-tricalcium phosphate (β-TCP) composites were subcultured for 2 weeks and then subcutaneously implanted into syngeneic rats that were split into a low-intensity pulsed ultrasound (LIPUS) treatment group and a control group. These implants were harvested at 5, 10, 25, and 50 days after implantation. The samples were then biomechanically tested and analyzed for alkaline phosphate (ALP) activity and osteocalcin (OCN) content and were also observed by light microscopy.

Results

The levels of ALP activity and OCN content in the composites were significantly higher in the LIPUS group than in the control group. Histomorphometric analysis revealed a greater degree of soft tissue repair, increased blood flow, better angiogenesis, and more extensive bone formation in the LIPUS groups than in the controls. No significant difference in the compressive strength was found between the two groups.

Conclusion

LIPUS treatment appears to enhance bone formation and angiogenesis in the BMSCs/β-TCP composites.

Chin Med J 2014;127 (4): 669-674
A phase II trial of oxaliplatin plus S-1 as a first-line chemotherapy for patients with advanced gastric cancer
Authors: YANG Lin , SONG Yan , ZHOU Ai-ping , QIN Qiong , CHI Yihebali , HUANG Jing , WANG Jin-wan
Published: January 2024

Background

Palliative chemotherapy has been shown to have a survival benefit for patients with recurrent or metastatic gastric cancer. We conducted a Phase II trial to determine the efficacy and safety of S-1 plus oxaliplatin (SOX regimen) as first-line chemotherapy for patients with unresectable locally advanced or metastatic gastric cancer.

Methods

Eligible patients had measurable lesions and no previous history of chemotherapy (except adjuvant chemotherapy). Oxaliplatin was administered intravenously at a dose of 130 mg/m2 on day 1. S-1 was administered orally in doses of 80, 100, or 120 mg/d according to body surface areas of <1.25 m2, 1.25–1.5 m2, or >1.5 m2 respectively; the total dose was divided into two daily doses on days 1–14. Treatments were repeated every 3 weeks until disease progression or intolerable toxicity occurred.

Results

Forty-three patients were enrolled in the study. All were assessable for efficacy and adverse events. The objective response and disease control rates were 55.8% and 76.7% respectively. The median follow-up time was 16.5 months. The median progression-free survival time was 7 months (95% CI, 5.8–8.2 months) and the median overall survival time was 16.5 months (95% CI, 9.7–23.3 months). The one-year survival rate was 54.2%. Major adverse reactions were grade 3/4 neutropenia (9.3%) and thrombocytopenia (20.9%).

Conclusion

The SOX regimen with oxaliplatin at a dose of 130 mg/m2 was found to be effective and safe as a first-line chemotherapy in Chinese patients with advanced gastric cancer.
Association between high-sensitivity cardiac troponin T and N-terminal pro-brain natriuretic peptide in a community based population
Authors: Xu Ruyi , Ye Ping , Luo Leiming , Sheng Li , Wu Hongmei , Xiao Wenkai , Zheng Jin , Wang Fan , Xiao Tiehui
Published: January 2024

Background

N-terminal pro-B-type natriuretic peptide (NT-proBNP) and high-sensitivity cardiac troponin T (hs-cTnT) are excellent biomarkers for detecting heart failure and subclinical myocardial injury. However, it remains unclear whether subclinical myocardial injury is associated with NT-proBNP elevation in a community based population.

Methods

In a community based study, levels of hs-cTnT and of NT-proBNP were determined in 1 497 participants older than 45 years. The lower detection limit of the hs-cTnT assay used in the present study was 0.003 ng/ml. The association of hs-cTnT levels and NT-proBNP levels was analyzed.

Results

When the subjects with undetectable (<0.003 ng/ml), intermediate (0.003-0.014 ng/ml), and elevated (≥0.014 ng/ml) levels of hs-cTnT were compared (r=0.175, P <0.001), a strong association between the hs-cTnT levels and NT-proBNP levels was observed (β=-0.206, P <0.001; β=-0.118, P <0.001, respectively). In multivariable analyses, older age and hs-cTnT were positively and independently associated with NT-proBNP levels (β=0.341, P <0.001; β=0.143, P <0.001, respectively), and male gender and the levels of eGFR were inversely and independently associated with NT-proBNP levels. When the subjects with normal or elevated NT-proBNP were analyzed separately, the hs-cTnT level was not an independent predictor for the NT-proBNP level in the normal NT-proBNP group, whereas the hs-cTnT level was the only independent predictor for NT-proBNP level in the elevated NT-proBNP group (β=0.399, P <0.01).

Conclusions

In this community based population, NT-proBNP elevation was common. In addition to female gender and older age, subclinical myocardial injury indicated by the hs-cTnT level was another important factor in NT-proBNP elevation.

Chin Med J 2014;127 (4): 638-644
Efficacy and feasibility of gemcitabine and carboplatin as first-line chemotherapy in elderly patients with advanced non-small cell lung cancer
Authors: Lim Kyu-Hyoung , Lee Hui-Young , Song Seo-Young
Published: January 2024

Background

Although platinum-based chemotherapy is a standard first-line treatment in advanced non-small cell lung cancer (NSCLC), further research for the safety and efficacy of combination chemotherapy in elderly patients has been required. The purpose of this study was to evaluate the efficacy and safety of gemcitabine and carboplatin as first-line treatment in elderly patients with advanced NSCLC and to evaluate the prognostic factors.

Methods

Eligibility included: (1) age of 70 years or more, (2) histologically confirmed NSCLC, (3) chemotherapy-naïve, (4) advanced disease with stage IIIB or IV, (5) Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0-2, (6) adequate organ function. Patients received intravenous carboplatin (area under curve (AUC)=5) on day 1 and gemcitabine (1000 mg/m2) on days 1 and 8, every 3 weeks.

Results

The medical records of forty patients were reviewed retrospectively. Median age was 73.9 years (range, 70-84.6), and there were 27 men (67.5%). Thirty-seven patients (92.5%) had ECOG PS 0-1. Adenocarcinoma was found in 57.5%. Median cycles were administrated with 4.5 per person (range: 1-6). Best responses were partial response in 22 (55.0%) patients and stable disease (SD) in 13 (32.5%). The median progression free survival (PFS) and overall survival (OS) were 5.9 months (95% CI: 4.5-7.3 months) and 9.6 months (95% CI: 8.2-11.0 months), respectively. Grade 4 hematologic toxicities for neutropenia (7.5%), thrombocytopenia (7.5%) and anemia (5.0%) were observed. Histology was significant prognostic factor for PFS (P=0.024).

Conclusion

Gemcitabine and carboplatin combination chemotherapy is an effective and manageable treatment option in elderly advanced NSCLC patients with good performance status.
Glycation of high-density lipoprotein in type 2 diabetes mellitus
Authors: SUN Jia-teng , SHEN Ying , LÜ An-kang , LÜ Lin , SHEN Wei-feng
Published: January 2024

Objective

To evaluate whether glycation of high-density lipoprotein (HDL) increases cardiovascular risk in patients with type 2 diabetes mellitus by altering its anti-atherogenic property.

Data sources

Data cited in this review were obtained mainly from Pubmed and Medline in English from 2000 to 2013, with keywords “glycation”, “HDL”, and “atherosclerosis”.

Study selection

Articles regarding glycation of HDL and its role in atherogenesis in both humans and experimental animal models were identified, retrieved and reviewed.

Results

Glycation alters the structure of HDL and its associated enzymes, resulting in an impairment of atheroprotective functionality and increased risks for cardiovascular events in type 2 diabetic patients.

Conclusion

Glycation of HDL exerts a deleterious effect on the development of cardiovascular complications in diabetes.
Genome-wide study reveals an important role of spontaneous autoimmunity, cardiomyocyte differentiation defect and antiangiogenic activities in gender-specific gene expression in Keshan disease
Authors: He Shulan , Tan Wuhong , Wang Sen , Wu Cuiyan , Wang Pan , Wang Bin , Su Xiaohui , Zhao Junjie , Guo Xiong , Xiang Youzhang
Published: January 2024

Background

Keshan disease (KD) is an endemic cardiomyopathy in China. The etiology of KD is still under debate and there is no effective approach to preventing and curing this disease. Young women of child-bearing age are the most frequent victims in rural areas. The aim of this study was to determine the differences between molecular pathogenic mechanisms in male and female KD sufferers.

Methods

We extracted RNA from the peripheral blood mononuclear cells of KD patients (12 women and 4 men) and controls (12 women and 4 men). Then the isolated RNA was amplified, labeled and hybridized to Agilent human 4×44k whole genome microarrays. Gene expression was examined using oligonucleotide microarray analysis. A quantitative polymerase chain reaction assay was also performed to validate our microarray results.

Results

Among the genes differentially expressed in female KD patients we identified: HLA-DOA, HLA-DRA, and HLA-DQA1 associated with spontaneous autoimmunity; BMP5 and BMP7, involved in cardiomyocyte differentiation defect; and ADAMTS 8, CCL23, and TNFSF15, implicated in anti-angiogenic activities. These genes are involved in the canonical pathways and networks recognized for the female KD sufferers and might be related to the pathogenic mechanism of KD.

Conclusion

Our results might help to explain the higher susceptibility of women to this disease.
Preliminary molecular analysis of bacterial composition in periapical lesions with primary endodontic infections of deciduous teeth
Authors: SHANG Jia-jian , YANG Qiu-bo , ZHAO Huan-ying , CAI Shuang , ZHOU Yan , SUN Zheng
Published: January 2024

Background

The bacterial composition of periapical lesions in deciduous teeth has not been well documented. This study was designed to explore the bacterial compositions, especially the dominant bacteria in periapical lesions using 16S rRNA sequencing.

Methods

Tissue samples were collected from 11 periapical lesions in deciduous teeth with primary endodontic infections. DNA was extracted from each sample and analyzed using 16S rRNA cloning and sequencing for the identification of bacteria.

Results

All DNA samples were positive for 16S rRNA gene PCR. One hundred and fifty-one phylotypes from 810 clones were identified to eight phyla, and each sample contained an average of 25.9 phylotypes. In addition, 59 phylotypes were detected in more than two samples, and Fusobacterium (F.) nucleatum (8/11), Dialister (D.) invisus (8/11), Campylobacter (C.) gracilis (7/11), Escherichia (E.) coli DH1 (6/11), Aggregatibacter (A.) segnis (6/11), and Streptococcus (S.) mitis (6/11) were the most prevalent species. Furthermore, 45 as-yet-uncultivated phylotypes were also identified.

Conclusions

Chronic periapical lesions in deciduous teeth contained polymicrobial infections. F. nucleatum, D. invisus, C. gracilis, E. coli DH1, A. segnis, and S. mitis were the most prevalent species detected by 16S rRNA sequencing.
Evaluation of the therapeutic efficiency of mandibular anterior implant-supported fixed bridges with cantilevers
Authors: WU Min-jie , WANG Xiao-jing , ZOU Li-dong , XU Wei-hua , ZHANG Xiang-hao
Published: January 2024

Background

Dental implant technology has developed rapidly in recent years. However, the use of implant-supported fixed bridges with cantilevers has been controversial. The purpose of this study was to evaluate the clinical results of the mandibular anterior implant-supported fixed bridges with a cantilever.

Method

Thirty-three patients (15 males, 18 females; mean age, 42.6 years; range 20-54 years) with two missing anterior mandibular teeth had single implant-supported fixed bridges with a cantilever. Clinical examination was recorded and radiographs were taken. The mean duration of follow-up was 30 months (15-44 months).

Results

All implants survived. Loosening or fracture of the prosthesis was not observed. All patients were satisfied with the treatment. The mean bone resorption values after 12, 24, and 36 months of implant loading were 0.94, 1.18 and 1.35 mm respectively. The changes of gingival papilla height ranged from 0 to 0.5 mm. There was significant difference between 1-year and 2 or 3 years restoration groups regarding the average gingival height changes (P <0.05).

Conclusion

After careful and precise selection of patients, restoration with a single implant-supported fixed bridge with a cantilever can be recommended if two anterior mandibular teeth are missing.
Oral fibrinogen-depleting agent lumbrokinase for secondary ischemic stroke prevention: results from a multicenter, randomized, parallel-group and controlled clinical trial
Authors: CAO Yong-jun , ZHANG Xia , WANG Wan-hua , ZHAI Wan-qing , QIAN Ju-fen , WANG Jian-sheng , CHEN Jun , YOU Nian-xing , ZHAO Zhong , WU Qiu-yi , XU Yuan , YUAN Lei , LI Rui-xia , LIU Chun-feng
Published: January 2024

Background

Elevated fibrinogen (Fg) level is a known risk factor for ischemic stroke. There are few clinical trials on oral fibrinogen-depleting therapies for secondary ischemic stroke prevention. We aimed to assess the effects of one-year therapy with oral lumbrokinase enteric-coated capsules on secondary ischemic stroke prevention.

Methods

This is a multicenter, randomized, parallel group and controlled study that began treatment in hospitalized patients with ischemic stroke and continued for 12 months. Patients were randomized to either the control group that received the standard stroke treatment or the fibrinogen-depleting group that received the standard stroke treatment plus enteric-coated lumbrokinase capsules. The NIH Stroke Scale scores (NIHSSs) and plasma Fg level were recorded. The carotid artery intima-media thickness (IMT) and status of plaques were examined through carotid ultrasound examination. Primary outcomes included all-cause mortality, any event of recurrent ischemic stroke/transient ischemic attack (TIA), hemorrhagic stroke, myocardial infarction and angina, and other noncerebral ischemia or hemorrhage. Kaplan-Meier survival analysis and the Long-rank test were used to compare total vascular end point incidence between the two groups. Comparison of median values between two groups was done by the Student t test, one-way analysis of variance (ANOVA), or non-parametric rank sum test.

Results

A total of 310 patients were enrolled, 192 patients in the treatment group and 118 patients in the control group. Compared to the control group, the treatment group showed favorable outcomes in the Fg level, carotid IMT, the detection rate of vulnerable plaques, the volume of carotid plaques, NIHSS scores, and incidence of total vascular (6.78% and 2.08%, respectively) and cerebral vascular events (5.93% and 1.04%, respectively) (P <0.05). In the treatment group, the volume of carotid plaques was significantly related to the carotid IMT, the plaque diameter, width and number (P=0.000, 0.000, 0.000, 0.022; F=13.51, 2.52, 11.33, −3.29, but there was a weak correlation with the Fg level (P=0.056). After 1-year therapy, the incidence of overall vascular end points was reduced by 4.7%.

Conclusion

Long-term oral fibrinogen-depleting therapy may be beneficial for secondary ischemic stroke prevention.
Isolated laparoscopic resection of the hepatic caudate lobe
Authors: Xiujun Cai , Zheyong Li , Hong Yu , Kun Liu , Xiao Liang , Yifan Wang , Yuelong Liang
Published: January 2024

The caudate lobe (Couinaud's segment 1) is located at the posterior part of the liver. Isolated resection of caudate lobe is a major challenge1,2 especially when it is carried out laparoscopically. We report a case of successful total laparoscopic resection of caudate lobe using the technique of curettage and aspiration3 on a hepatic hemangioma which measured 7 cm ×5 cm. As far as we know, this is the first report from Asia on isolated laparoscopic resection of the hepatic caudate lobe.
Determinants of health-related quality of life worsening in patients with chronic obstructive pulmonary disease at one year
Authors: Liang Lirong , Lin Yingxiang , Yang Ting , Zhang Hong , Li Jie , Wang Chen
Published: January 2024

Background

Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality worldwide and has been the leading cause of death in China. Patients with COPD have significant decrements in their healthrelated quality of life (HRQL). It is necessary to identify the factors involved in worsening HRQL in order to improve the HRQL of COPD patients. However, evidence from longitudinal studies is limited. The aim of the study was to evaluate the determinants of the deterioration of HRQL in patients with COPD.

Methods

At baseline, a total of 491 patients with stable COPD received comprehensive assessments, including psychosocial and clinical variables, six minutes walk distance (6MWD), dyspnea grade measured by the 5-grade Medical Research Council (MRC) dyspnea scale, anxiety and depression measured by the hospital anxiety and depression scale and HRQL measured by St. George's Respiratory Questionnaire (SGRQ). Patients were then monitored monthly for 12 months to document COPD exacerbations. At the end of the study period, the SGRQ values were reassessed. A 1-year change in SGRQ total score ≥4 was defined as a deterioration of the HRQL and as the outcome. A total of 450 patients completed the 12-month follow-up and were analyzed in the present study.

Results

The age (mean±SD) was (65.0±10.6) years and 68.7% of subjects were men. The deterioration of the HRQL was 26.4%. In multivariate Logistic regression, independent and graded associations were found between the baseline MRC dyspnoea grade and the deterioration of HRQL (P=0.012), OR 3.03 (95% CI 1.11–8.24) for patients with MRC dyspnoea grade ≥4 versus patients with MRC dyspnoea grade =1. Similarly, the number of exacerbations during the follow-up was independently and gradually increased with the deterioration of HRQL (P <0.001), OR 3.03 (95% CI 1.9–5.6) for the participants with exacerbations ≥3 versus participants with no exacerbation. The 6MWD evaluated by quartiles was negatively associated with the deterioration of HRQL with borderline statistical significance.

Conclusion

MRC dyspnea grade and the number of exacerbations impair the HRQL of patients with COPD.
Combined therapy with methylprednisolone and ulinastatin in experimental autoimmune encephalomyelitis
Authors: SHU Ya-qing , YANG Yu , WANG Yu-ge , DAI Yong-qiang , XIAO Li , QIU Wei , LU Zheng-qi , WU Ai-ming , RUAN Heng-fang , HU Xue-qiang
Published: January 2024

Background

Our previous study had demonstrated that ulinastatin (UTI) had a neuroprotective effect in experimental autoimmune encephalomyelitis (EAE). Methylprednisolone has been recommended to be a standard drug in multiple sclerosis (MS) therapies. The present study was to investigate the protective effects of UTI combined methylprednisolone in EAE.

Methods

Mice were divided into a UTI treatment group, a methylprednisolone treatment group, a combined treatment group with UTI and methylprednisolone, a normal saline treatment group, and a normal control group. EAE mice were induced in groups receiving different combined treatments, or respective monotherapies. Demyelination was evaluated by Solochrome cyanin staining. 2′,3′-cyclic nucleotide 3′- phosphodiesterase (CNP)/ myelin basic protein (MBP)/ the precursor form of nerve growth factor (proNGF)/p75/ inducible nitric oxide synthase (iNOS) proteins in cerebral cortex of EAE were detected by Western blotting.

Results

The combined treatment group had a lower clinical score ( 0.61±0.06) and demyelinating score (1.33±0.33) than the groups with normal saline (clinical score: 1.39±0.08, P <0.001; demyelinating score: 2.75±0.49, P <0.05) or monotheraphies. Compared with the saline treated EAE group, UTI combined methylprednisolone significantly increased expressions of CNP (1.14±0.06 vs. 0.65±0.04, P <0.001), MBP (1.28±0.14 vs. 0.44±0.17, P <0.001), and decreased expressions of proNGF (1.08±0.10 vs. 2.32±0.12, P <0.001), p75 (1.13±0.13 vs. 2.33±0.17, P <0.001), and iNOS (1.05±0.31 vs. 2.17±0.13, P <0.001) proteins in EAE. Furthermore, UTI combined methylprednisolone could significantly upregulate MBP (1.28±0.14 vs. 1.01±0.15, P <0.05) expression and downregulate iNOS (1.05±0.31 vs. 1.35±0.14, P <0.05) expression compared to methylprednisolone treatment EAE group. And proNGF expression was significantly lower in combined treatment (1.08±0.10) than that in UTI (1.51±0.24, P <0.05) or methylprednisolone (1.31±0.04, P <0.05) treatment group.

Conclusion

Combination treatment of UTI with methylprednisolone was shown to protect EAE, suggesting that combination therapy is a potential novel treatment in MS.