bluuebunny/crossref_metadata_2025 huggingface dataset:
Vitamin D status and the risk of pancreatic cancer: a meta-analysis
Authors: LIU Shang-long , ZHAO Yu-pei , DAI Meng-hua , YOU Lei , WEN Zhang , XU Jian-wei
Published: January 2024

Background

Vitamin D status in relation to pancreatic cancer risks is still inconsistent. This study was performed to evaluate the association between vitamin D status and risk of pancreatic cancer using a meta-analysis approach.

Methods

A systemic review of all relevant literature in English was performed by searching Pubmed, Web of Science and Embase to identify eligible studies from the earliest available date to April 1, 2012. The search terms “vitamin D”, “25-hydroxyvitamin D”, “pancreatic cancer” or “pancreatic neoplasms” were used to retrieve relevant papers. Inclusion criteria were: (1) the exposure of interest was intake of vitamin D or blood levels of vitamin D; (2) the outcome of interest was pancreatic cancer; (3) data on high and low intake or blood vitamin D in cases and controls were available; (4) odds ratio (OR) estimates with 95% confidence interval (CI) were provided; (5) primary epidemiological data were provided reporting pancreatic cancer incidence. The combined OR values and their 95% CIs were calculated via a meta-analysis. The potential presence of publication bias was estimated using Egger's regression asymmetry test.

Results

Nine studies with a total of 1 206 011 participants met the inclusion criteria. The test for heterogeneity showed there were significant differences among the included studies (
2
=70.9%, P=0.001), so a randomized-effects model was used in the meta-analysis. The pooled OR of pancreatic cancer for the highest versus the lowest categories of vitamin D level was 1.14 (95% CI 0.896-1.451), and the Z-score for the overall effect was 1.06 (P=0.288), showing that there was no significant association between vitamin D levels and the risk of pancreatic cancer. Egger's test indicated there was a low possibility of publication bias in this study (P=0.348).

Conclusion

Dietary vitamin D or circulating concentrations of 25-hydroxyvitamin D are not associated with the risk of pancreatic cancer based on evidence from currently published studies.
Histopathological classification and location of consecutively operated meningiomas at a single institution in China from 2001 to 2010
Authors: WANG Dai-jun , XIE Qing , GONG Ye , MAO Ying , WANG Yin , CHENG Hai-xia , ZHONG Ping , CHE Xiao-ming , JIANG Cheng-chuan , HUANG Feng-ping , ZHENG Kang , LI Shi-qi , GU Yu-xiang , BAO Wei-min , YANG Bo-jie , WU Jing-song , XIE Li-qian , ZHENG Ming-zhe , TANG Hai-liang , ZHU Hong-da , CHEN Xian-cheng , ZHOU Liang-fu
Published: January 2024

Background

Meningioma is one of the most common primary tumors of the central nervous system, but there are not many detailed studies on the sex, age, subtypes and locations of large series. This study was a retrospective analysis of the characteristics of meningioma cases consecutively operated on at a single institution in China from 2001 to 2010.

Methods

This study investigated the demographic background of 7084 meningioma cases, and the subtypes and locations of the tumors. Sex and age distributions were analyzed, and the pathological subtypes were classified according to the World Health Organization (WHO) classification. The location of the meningiomas was also categorized.

Results

The female:male ratio of the 7084 cases was 2.34:1. The mean age was 51.4 years (range, 11 months-86 years). The mean age of cases of WHO grade I meningioma was significantly older than that of grade II or III meningiomas (P <0.001, Fisher's Least Significant Digit test). There was a significantly higher female:male ratio in WHO grade I meningiomas than in grade II or grade III meningiomas (2.57, 1.03 and 0.76, respectively; P <0.001, χ2 test). Meningothelial (n=2061) and fibrous meningiomas (n=3556) were the most common subtypes, comprising 79.3% of all meningiomas. All meningioma cases were classified into 23 locations in this study, with the cerebral convexity the most common site (38.33%, n=2722). Cases with uncommon locations such as extra-cranial and sylvian fissure meningiomas were also present in this series.

Conclusions

Female predominance was found for benign meningiomas, while malignant subtypes showed male predominance. The mean age of patients with WHO grade I meningiomas was older than that of patients with higher-grade tumors. Meningothelial and fibrous meningiomas were the most common subtypes. The cerebral convexity was the most common meningioma location.
MicroRNAs are implicated in the initiation and progression of gastric cancer
Authors: Jianning Song , Zhigang Bai , Zhongtao Zhang
Published: January 2024

Objective

Gastric cancer is a genetically heterogeneous disease that progresses via different oncogenes. MicroRNA (miRNA) can regulate oncogene expression at the post-translational level. In this review, we summarize the most commonly altered miRNAs and their possible roles in cancer initiation and progression in gastric cancer.

Data sources

Most articles were identified by searching PubMed online resources using the key terms of microRNA and gastric cancer.

Study selection

Mainly original milestone articles and critical reviews written by major pioneer investigators in the field were selected, and the 69 most important articles were cited finally.

Results

A set of miRNAs are consistently deregulated in gastric cancer, although there is no clear miRNA expression profiles, such as miR-21 and miR-17 (˜92 clusters). These deregulated miRNAs play important roles in promoting cell proliferation, tumor metastasis, and chemotherapeutic resistance in gastric cancer by targeting different oncogenes. Clinical relevance of these deregulated miRNAs is proved to be associated with TNM stages, metastasis, and prognosis of gastric cancer patients. In addition, circulating miRNAs are promising noninvasive biomarkers for gastric cancer.

Conclusions

miRNAs have produced a novel paradigm in research in gastric cancer. These small molecules play macroroles in gastric cancer initiation and progression. These results will help us improve management of gastric cancer in future.
Serological and molecular capsular typing, antibiotic susceptibility and multilocus sequence typing of Streptococcus pneumoniae isolates from invasive and non-invasive infections
Authors: ZHANG Yi-jie , CHEN Yu-shen , WANG Zhan-wei , LI Yu-qian , WANG Da-xuan , SHANG Ying , FU Rong-rong , HU Ying-hui , GENG Rong , WEI Li-ping , YANG Jing-ping , LI Jia-shu , YU Qin , DU Juan , GAO Zhan-cheng
Published: January 2024

Background

Streptococcus pneumoniae (S. pneumoniae) is a major causative agent of severe infections, including sepsis, pneumonia, meningitis, and otitis media, and has become a major public health concern. We report the pneumococcal serotype and sequence type (ST) distribution, and antimicrobial resistance of 39 S. pneumoniae strains from seven hospitals in China.

Methods

Blood/cerebrospinal fluid (CSF) and sputum isolates from patients were analyzed to determine S. pneumoniae serotypes by polymerase chain reaction (PCR) and the Neufeld Quellung reaction, the multilocus sequence types (MLST) by PCR and sequencing, and susceptibility to antimicrobial agents by the VITEK Gram Positive Susceptibility Card.

Results

A total of 39 isolates were collected including 21 blood/CSF and 18 sputum isolates. Conventional serotyping by the Quellung reaction required 749 reactions. In contrast, PCR based typing needed only 106 PCR reactions. The most frequent serotypes from the blood/CSF isolates were 14 (38.1%), 19A (14.3%), 23F (9.5%), and 18C (9.5%). In the sputum isolates the most frequent serotypes were 19F (33.3%), 23F (16.7%), 19A (11.1%), and 3 (11.1%). The incidence of penicillin resistance in the blood/CSF and sputum isolates was 66.7% and 55.6%, respectively. Statistical analysis showed that patients ≤5 years old had a higher resistance to penicillin when they compared with the patients ≥65 years old (P=0.011). Serotypes 14, 19A and 19F were significantly associated with penicillin resistance (P <0.001). ST320, ST271, and ST876 isolates showed high resistant rates to several antibiotics including penicillin (P=0.006). All of the isolates of serotype 19A were resistant to both penicillin and erythromycin, and they were all multi-drug resistant (MDR) isolates.

Conclusions

The specificity and sensitivity of multiplex-PCR are good, and this method represents a substantial savings of time and money, and can be widely used in the laboratory and clinical practice. Data from this research showed an extremely high prevalence of penicillin resistance and an increasing prevalence of multi-drug resistant (MDR) rate in S. pneumoniae. A distinctive emergence of serotype 19A was observed which was also associated with the increasing prevalence of antimicrobial resistance. Therefore, nationwide surveillance of pneumococcal resistance and serotypes is strongly warranted.
Altered miR-143 and miR-150 expressions in peripheral blood mononuclear cells for diagnosis of non-small cell lung cancer
Authors: ZENG Xiao-li , ZHANG Shao-yan , ZHENG Jun-fang , YUAN Hui , WANG Yan
Published: January 2024

Background

Sensitive and specific biomarkers for identifying early stage of non-small cell lung cancer (NSCLC) are urgently needed to improve the therapeutic outcome and reduce the mortality. Small non-coding microRNAs (miRNAs) are key components of cancer development and are considered as potential biomarkers for cancer diagnosis and for monitoring treatment. The aim of this study was to determine whether aberrant miRNA expression can be used as a marker in peripheral blood mononuclear cells (PBMC) for the diagnosis of NSCLC.

Methods

The levels of two mature miRNAs (miR-143 and miR-150) were detected by probe-based stem-loop quantitative reverse-transcriptase PCR (RT-qPCR) in PBMC of 64 patients with NSCLC and 26 healthy individuals, and the relationship between miR-143 and miR-150 levels and clinical and pathological factors was explored.

Results

All endogenous miRNAs were present in peripheral blood in a remarkably stable form and detected by RT-qPCR. MiR-143 expression in the PBMC specimens was significantly lower in NSCLC patients than in healthy individuals (P <0.0001). MiR-150 expression in the PBMC specimens was not significantly different between NSCLC patients and healthy individuals (P=0.260). MiR-150 expression was significantly higher in lung adenocarcinoma patients than in healthy individuals (P=0.001). There was a very strong difference in the expression level of miR-150 between lung adenocarcinoma patients and lung squamous cell carcinoma patients (P <0.0001). In receiver operating characteristic curve (ROC) analysis, low expression of miR-143 showed the area under the ROC (AUC) of 0.885 for distinguishing cancer patients from healthy subjects. High expression of miR-150 had an AUC of 0.834 for distinguishing lung adenocarcinoma patients from healthy subjects. High expression of miR-150 had an AUC of 0.951 for distinguishing lung adenocarcinoma from lung squamous cell carcinoma. The miR-150 level was significantly associated with distant metastasis (P=0.014).

Conclusions

It is indicated that there is a potential for using miR-143 as a novel diagnostic biomarker for NSCLC. Moreover, miR-150 can be a highly accurate marker for differentiating adenocarcinoma from squamous cell carcinoma.
Magnetic resonance diffusion tensor imaging with fluorescein sodium dyeing for surgery of gliomas in brain motor functional areas
Authors: LIU Jia-gang , YANG Shuai-feng , LIU Yan-hui , WANG Xiang , MAO Qing
Published: January 2024

Background

Tumor surgery in brain motor functional areas remains challenging. Novel techniques are being developed to gain maximal and safe resection for brain tumor surgery. Herein, we assessed the magnetic resonance diffusion tensor imaging (MR-DTI) and fluorescein sodium dyeing (FLS) guiding technique for surgery of glioma located in brain motor functional areas.

Methods

Totally 83 patients were enrolled according to our inclusion and exclusion criteria (56 patients in experimental group, 27 patients in control group). In the experimental group, the surgical approach was designed by DTI imaging, which showed the relationship between the tumor and motor tract. The range of resection in the operation was determined using the FLS-stained area, which recognized the tumor and its infiltrated tissue. The traditional routine method was used in the control group. Postoperatively, all patients underwent enhanced brain MRI within 72 hours to ascertain the extent of resection. Patients were followed in our outpatient clinic over 6-24 months. Neurological deficits and Karnofsky scoring (KPS) were evaluated.

Results

There were no significant differences in balance test indexes of preoperative data (sex, age, lesion location and volume, and neurological deficits before operation) and diagnosis of histopathology between the two groups. There was a trend in the experimental group for greater rates of gross total resection (80.4% vs. 40.7%), and the paralysis rate caused by surgery was lower in experimental (25.0%) vs. control (66.7%) groups (P <0.05). The 6-month KPS in the low-grade and high-grade gliomas was 91±11 and 73±26, respectively, in the experimental group vs. 82±9 and 43±27, respectively, in the control group (P <0.05 for both).

Conclusions

MR-DTI and FLS dye guiding for surgery of glioma located in brain motor functional areas can increase the gross total resection rate, decrease the paralysis rate caused by surgery, and improve patient quality of life compared with traditional glioma surgery.
Equity of health service utilization of urban residents: data from a western Chinese city
Authors: MAO Ying , XU Fei , ZHANG Ming-jun , LIU Jin-lin , YANG Jie , WANG Mei-juan , ZHANG Si-feng , ZHANG Yue-lin , YAN Jian-qun
Published: January 2024

Background

Getting medical treatment is still difficult and expensive in western China. Improving the equity of basic health services is one of the tasks of the new healthcare reform in China. This study aimed to analyze the parallel and vertical equity of health service utilization of urban residents and then find its influencing factors.

Methods

In August 2011, a household survey was conducted at 18 communities of Baoji City by multi-stage stratified random sampling. Based on the survey data, we calculated a concentration index of health service utilization for different income residents and a difference index of different ages. We then investigated the influencing factors of health service utilization by employing the Logistic regression model and log-linear regression model.

Results

The two-week morbidity rate of sampled residents was 19.43%, the morbidity rate of chronic diseases was 21.68%, and the required hospitalization rate after medical diagnosis was 11.36%. Among out-patient service utilization, the two-week out-patient rate, number of two-week out-patients, and out-patient expense had good parallel and vertical equity, while out-patient compensation expense had poor parallel and vertical equity. The inpatient service utilization, hospitalization rate, number of inpatients, days stayed in the hospital, and inpatient expense had good parallel equity, while inpatient compensation expense had poor parallel equity. While the hospitalization rate and number of inpatients had vertical equity, the days stayed in hospital, inpatient expense, and inpatient compensation expense had vertical inequity.

Conclusions

Urban residents' health was at a low level and there was not good health service utilization. There existed rather poor equity of out-patient compensation expense. The equity of inpatient service utilization was quite poor. Income difference and the type of medical insurance had great effects on the equity of health service utilization.
Transcatheter aortic valve implantation versus surgical aortic valve replacement for severe aortic stenosis: a meta analysis
Authors: Wu Yi-cheng , Zhang Jian-feng , Shen Wei-feng , Zhao Qiang
Published: January 2024

Background

Transcatheter aortic valve implantation (TAVI) has emerged as the treatment choice for non-operable patients with severe symptomatic aortic stenosis (AS) and may be a good alternative to surgery for those at very high or prohibitive surgical risk. We performed a meta-analysis to evaluate the comparative benefits of TAVI versus surgical aortic valve replacement (SAVR) in patients with severe AS.

Methods

A comprehensive literature search of PubMed, Embase, ScienceDirect and Cochrane Central Register of Controlled trials was performed, and randomized trials as well as cohort studies with propensity score analysis were included.

Results

One randomized trial (n=699) and six retrospective cohort studies (n=781) were selected for meta-analysis. Mortality at 30-day and 1-year follow-up was comparable between TAVI and SAVR. Despite similar incidences of stroke, myocardial infarction, re-operation for bleeding, and renal failure requiring dialysis, TAVI was associated with a lower occurrence rate of new-onset atrial fibrillation (OR 0.51, 95% CI 0.33-0.78) and shorter procedural time (mean difference —67.50 minutes, 95% CI —87.20 to —47.81 minutes). Post-operative aortic regurgitation and permanent pacemaker implantation were more common in patients after TAVI than in those with SAVR (OR 5.53, 95% CI 3.41-8.97; OR 1.71, 95% CI 1.02-2.84, respectively).

Conclusion

In patients with severe symptomatic AS, TAVI and SAVR did not differ with respect to short- and mid-term survival, but the incidence of permanent pacemaker implantation and post-procedural aortic regurgitation remain relatively high after TAVI.
Biodistribution and preparation of technetium-99m-labeled D-D3 monoclonal antibody against pro-gastrin-releasing peptide(31-98) in mice
Authors: HAO Li-jun , HONG Zhi-hui , SHI Yi-zhen , LIU Zeng-li , ZHOU Xiao-lin
Published: January 2024

Background

We previously reported that iodine-131(131I)-labeled anti-progastrin-releasing peptide (ProGRP(31-98)) monoclonal antibody D-D3 could selectively accumulate in the tumor sites of nude mice bearing small cell lung cancer (SCLC) xenografts. However, 131I-D-D3 was cleared slowly from the body, and the best radioimmunoimaging time for SCLC was 72-96 hours after injection. The aims of this study were to radiolabel anti-ProGRP(31-98) D-D3 monoclonal antibody with technetium-99m (99mTc) and to investigate the biodistribution of this antibody in healthy ICR mice. Methods D-D3 was labeled with 99mTc via the 2-mercaptoethanol reduction method. 99mTc-D-D3 was purified by the gel column separation method. The labeling efficiency and radiochemical purity were measured by thin-layer chromatography. The immunological activity of 99mTc-D-D3 was determined with cell conjugation assays. 99mTc-D-D3 was injected into healthy ICR mice via a tail vein, and all the healthy ICR mice were sacrificed by cervical dislocation at a designated time. Then, the blood and major organs were removed and weighed, and counted in a gamma scintillation counter to determine the percentage of the injected dose per gram (%ID/g).

Results

The labeling rate and the radiochemical purity of 99mTc-D-D3 were (73.87±2.89)% and (94.13±4.49)%, respectively. The immunobinding rates of 99mTc-D-D3 to the human small cell lung cancer NCI-H446 cell line and lung adenocarcinoma A549 cell line were (81.2±2.37)% and (24.3±1.46)%, respectively. The distribution data of normal ICR mice demonstrated that 99mTc-D-D3 was mainly distributed in the liver, kidney and lung, and less in the brain tissue and muscle.

Conclusions

99mTc-D-D3 antibody not only had high radiochemical purity, but also had good stability both in vitro and in vivo, and maintained good immunological activity. 99mTc-D-D3 was metabolized mainly in the kidney and liver, and the blood radioactivity decreased rapidly. Thus, 99mTc-D-D3 is conducive to the radioimmunoimaging of SCLC.
miRNA expression profile during fluid shear stress-induced osteogenic differentiation in MC3T3-E1 cells
Authors: MAI Zhi-hui , PENG Zhu-li , ZHANG Jing-lan , CHEN Lin , LIANG Huan-you , CAI Bin , AI Hong
Published: January 2024

Background

Mechanical stress plays an important role in the maintenance of bone homeostasis. Current hypotheses suggest that interstitial fluid flow is an important component of the system by which tissue level strains are amplified in bone. This study aimed to test the hypothesis that the short-term and appropriate fluid shear stress (FSS) is expected to promote the terminal differentiation of pre-osteoblasts and detect the expression profile of microRNAs in the FSS-induced osteogenic differentiation in MC3T3-E1 cells.

Methods

MC3T3-E1 cells were subjected to 1 hour of FSS at 12 dyn/cm2 using a parallel plate flow system. After FSS treatment, cytoskeleton immunohistochemical staining and microRNAs (miRNAs) were detected immediately. Osteogenic gene expression and immunohistochemical staining for collagen type I were tested at the 24th hour after treatment, alkaline phosphatase (ALP) activity assay was performed at 24th, 48th, and 72th hours after FSS treatment, and Alizarin Red Staining was checked at day 12.

Results

One hour of FSS at 12 dyn/cm2 induced actin stress fiber formation and rearrangement, up-regulated osteogenic gene expression, increased ALP activity, promoted synthesis and secretion of type I collagen, enhanced nodule formation, and promoted terminal differentiation in MC3T3-E1 cells. During osteogenic differentiation, expression levels of miR-20a, -21, -19b, -34a, -34c, -140, and -200b in FSS-induced cells were significantly down-regulated.

Conclusion

The short-term and appropriate FSS is sufficient to promote terminal differentiation of pre-osteoblasts and a group of miRNAs may be invovled in FSS-induced pre-osteoblast differentiation.
Efficacy and safety of FIREHAWK® abluminal groove filled biodegradable polymer sirolimus-eluting stents for the treatment of long coronary lesions: nine-month angiographic and one-year clinical results from TARGET I trial long cohort
Authors: Xu Bo , Gao Run-lin , Zhang Rui-yan , Wang Hai-chang , Li Zhan-quan , Yang Yue-jin , Ma Chang-sheng , Han Ya-ling , Lansky Alexandra J. , Huo Yong , Li Wei , Leon Martin B.
Published: January 2024

Background Previous studies indicated that long coronary lesions are one of the key predictors of drug-eluting stent (DES) failure. The purpose of this study was to evaluate the efficacy and the safety of the long length FIREHAWK® stent in long coronary artery disease.

Methods The long cohort of TARGET I was a prospective, multicenter, single arm trial. It was planned to enroll 50 patients undergoing percutaneous coronary intervention (PCI) for the treatment of de novo long lesions in a native coronary artery. The major inclusion criteria of the trial was that patients were intended to undergo the treatment of a long target lesion(s) with diameter stenosis ≥70% and reference vessel diameter 2.5 mm to 4.0 mm by visual estimate, that needed to be covered by at least one 33 mm or 38 mm stent or multiple long stents overlapped. The angiographic follow-up was planned at 9-month and the clinical follow-up will be up to 5 years. The primary end point was in-stent late lumen loss at 9-month.

Results Fifty patients (mean age (57.6±10.2) years) with 59 de novo long lesions (reference vessel diameter (2.85±0.44) mm, lesion length (35.2±9.4) mm, and stent length (41.8±11.3) mm) were enrolled. The angiographic follow-up rate was 92% at 9-month. The in-stent late loss was (0.16±0.16) mm. Proximal edge, distal edge and in-segment late loss (mm) were 0.21±0.35, 0.03±0.33, and 0.07±0.26, respectively. No in-segment binary restenosis was observed. At 1-year no death, Q wave myocardial infarction (MI), or stent thrombosis occurred. Non-Q-wave MI occurred in two patients (4%) due to procedural complications.

Conclusions Treatment of long coronary lesions with the FIREHAWK® stent is able to produce similar results as observed in the FIREHAWK® FIM clinical trial. Based on this result, we are confident in the treatment prospect of the FIREHAWK® for long coronary lesions.
Heterosexual transmission of HIV and related risk factors among serodiscordant couples in Henan province, China
Authors: Wang Lan , Wang Lu , Smith Kumi M. , Li Li-ming , Ming Shuai , Lü Jun , Cao Wei-hua , He Wen-sheng , Zhou Jian-ping , Wang Ning
Published: January 2024

Background

HIV transmission between discordant couples has become an important source of new infections in China. To describe the seroconversion rate among serodiscordant couples and to identify salient behavioral and clinical risk factors including ART that affect heterosexual HIV transmission risk among couples in rural China.

Methods

Longitudinal follow-up of an open cohort of HIV serodiscordant couples took place between 2007 and 2011 in Zhumadian, a city in southern Henan province in China, where blood plasma selling in 1990s led to a regional HIV epidemic. Annual follow-up included separate face-to-face interviews of husbands and wives, and HIV antibody testing for non-index partners. Cox proportional-hazard modeling was used to assess the relationship between HIV seroconversion and covariates of interest.

Results

By the end of 2011, 4499 HIV serodiscordant couples had been enrolled in at least two follow-up interviews; 100 non-index partners seroconverted during the entire observation period for an incidence rate of 0.82 per 100 person-years (95% CI: 0.66-0.99). The incidence rates by the end of 2008, 2009, and 2010 were 2.14, 1.51, and 0.90 per 100 person-years respectively. Always using condoms in the past year of sex, gender of the index partner, frequency of sex, and ART exposure were all significant predictors of HIV seroconversion in the negative spouse. ART was highly protective against seroconversion whether the index partner was actively receiving treatment at the last follow-up (RR=0.05, 95% CI, 0.01-0.16) or if the index partner had ever received ART (RR=0.01, 95% CI, 0.00, 0.12). The risk of seroconversion in the non-index spouse also decreased the longer the duration of the index partner's exposure to ART.

Conclusions

ART exposure and always using condom were highly protective against HIV seroconversion in the negative spouse. HIV incidence in serodiscordant couples has been decreasing over time, associated with ART treatment time within 7 years in the index partner. Gender of the index spouse and frequency of sex were also important predictors. Treatment as part of a combination prevention package may be a feasible method of HIV control in this population.
Initial experience of occluding special type patent ductus arterioses using the Amplatzer vascular plug
Authors: ZHANG Po , ZHU Xian-yang , WANG Qi-guang , ZHANG Duan-zhen , HAN Xiu-min
Published: January 2024

Background

Occluders licensed for clinical use are not fit for some special Krichenko E patent ductus arterioses. The Amplatzer vascular plug I (AVP1) has not been licensed for use for closure of patent ductus arteriose. We report our initial experience to occluding special type patent ductus arterioses with the AVP1-a single lobe device of single layer Nitinol mesh for short vessel landing zones.

Methods

Patients referred with small and long Krichenko E patent ductus arterioses 1 mm to 3 mm in diameter underwent occlusion using AVP1. All cases underwent pre-, intra- and post-procedural echocardiography and chest X-ray at the completion of the procedure, the next day and at a 30-day, 3-month and 6-month follow-up visits. Device sizing for device waist diameter and length was based on aortography.

Results

From April 2008 to June 2012, 26 patients with a mean age of (7.6±8.0) years (range 6 months-32 years) and a mean weight of (23.8±14.8) kg (range 7–67 kg) underwent successful patent ductus arteriose closure. The mean ductus diameter was (2.1±0.7) mm (range 1–3 mm). Transpulmonary (22/26) and transaortic approaches (4/26) were used. No persistent patency was observed after 24 hours and after one month. No device displacement, residual flow and iatrogenic coarctation of the aorta were observed after three months and six months.

Conclusions

The AVP1 makes it easy to close some Krichenko E patent ductus arterioses. Smaller delivery catheter profile and symmetric cylindrical device shape allow for use for small and long Krichenko E patent ductus arterioses 1 mm to 3 mm in diameter and small patients through transaortic approaches. Broader experience is required to further delineate device and patient selection as well as to document its long-term efficacy and safety.
Efficacy and tolerability of a single-pill combination of telmisartan/ hydrochlorothiazide 80/25 mg in Chinese and Korean patients with moderate to severe hypertension: a subgroup analysis of a randomized, double-blind, active-controlled trial
Authors: ZHU Ding-liang , GAO Ping-jin , LIU Shao-wen , Ho Jeong Myung , Mattheus Michaela , Voelker Birgit
Published: January 2024

Background

Hypertension is an important issue in Asia, responsible for up to 66% of cardiovascular disease cases. This randomized controlled trial subgroup analysis compared telmisartan 80 mg (T80)/hydrochlorothiazide 25 mg (H25) single-pill combination with T80 monotherapy, specifically in Chinese and Korean patients.

Methods

Patients with grade 2/3 hypertension were randomized to receive telmisartan 40 mg (T40)/hydrochlorothiazide 12.5 mg (H12.5) combination or T40 monotherapy for one week, before uptitrating the dose to T80/H25 or T80, respectively, for the remaining 6 weeks. The primary endpoint was systolic blood pressure (SBP) mean change from baseline. Secondary endpoints included mean diastolic blood pressure (DBP) change from baseline, and blood pressure (BP) goal achievement. Adverse events were recorded.

Results

Of a total 888 patients who were treated, efficacy analyses for Chinese and Korean patients included 127 patients treated with T80/H25 and 54 patients treated with T80. At week 7, mean SBP reductions from baseline were −37.5 mmHg (1 mmHg=0.133 kPa) and −26.9 mmHg in the T80/H25 and T80 groups (adjusted mean difference, −10.6 mmHg; 95% confidence interval (CI), −15.6 to −5.7). Mean DBP reductions were −19.0 and −14.1 mmHg in the T80/H25 and T80 groups (adjusted mean difference, −4.9 mmHg; 95% CI, −8.0 to −1.8). In total, 56.7% of patients receiving T80/ H25 achieved BP goal (<140/90 mmHg) compared with 35.2% receiving T80. SBP goal attainment (<140 mmHg) and DBP goal attainment (<90 mmHg) were also higher in the T80/H25 group compared with the T80 group (SBP: 69.3% vs. 48.1%; DBP: 62.2% vs. 46.3%). A small number of treatment-related adverse events were observed in both T80/H25 (nine patients, 6.9%) and T80 monotherapy (two patients, 3.6%) groups.

Conclusions

In Chinese and Korean patients with moderate-to-severe hypertension, treatment with T80/H25 provided large reductions in mean SBP and DBP, and high BP goal attainment rates. This once-daily combination is effective and well tolerated in this patient group. (ClinicalTrials.gov identifier NCT00926289)
Clinicopathological classification and individualized treatment of breast cancer
Authors: HU Hui , LIU Yin-hua , XU Ling , ZHAO Jian-xin , DUAN Xue-ning , YE Jing-ming , LI Ting , ZHANG Hong , ZHANG Shuang , XIONG Yan
Published: January 2024

Background

The clinicopathological classification was proposed in the St. Gallen Consensus Report 2011. We conducted a retrospective analysis of breast cancer subtypes, tumor-nodal-metastatic (TNM) staging, and histopathological grade to investigate the value of these parameters in the treatment strategies of invasive breast cancer.

Methods

A retrospective analysis of breast cancer subtypes, TNM staging, and histopathological grading of 213 cases has been performed by the methods recommended in the St. Gallen International Expert Consensus Report 2011. The estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor-2 (HER2), and Ki-67 of 213 tumor samples have been investigated by immunohistochemistry according to methods for classifying breast cancer subtypes proposed in the St. Gallen Consensus Report 2011.

Results

The luminal A subtype was found in 53 patients (24.9%), the luminal B subtype was found in 112 patients (52.6%), the HER2-positive subtype was found in 22 patients (10.3%), and the triple-negative subtype was found in 26 patients (12%). Histopathological grade and TNM staging differed significantly among the four subtypes of breast cancer (P <0.001).

Conclusion

It is important to consider TNM staging and histopathological grading in the treatment strategies of breast cancer based on the current clinicopathological classification methods.
Chemoradiotherapy followed by surgery could improve the efficacy of treatments in patients with resectable esophageal carcinoma
Authors: WANG Feng , WANG Ya-mei , HE Wei , LI Xiang-ke , PENG Fang-hui , YANG Xiao-li , FAN Qing-xia
Published: January 2024

Background

The effectiveness of chemoradiotherapy followed by surgery (CRTS) in patients with resectable esophageal carcinoma remains controversial. We performed a systematic review of the literature with meta-analysis.

Methods

Electronic databases were used to identify published studies between January 1992 and April 2012. Pooled relative risk(RR)with 95% confidence interval (95%CI) was utilized to estimate the strength of the association between CRTS and surgery alone (SA) survival of the resectable esophageal carcinoma patients. Heterogeneity and publication bias were also assessed in the present study.

Results

The final analysis of 2755 resectable esophageal carcinoma cases from 21 randomized controlled trials (RCTs) are presented. Compared to the SA group, the 1, 3- and 5-year survival rates were significantly higher in the CRTS group (allP<0.05); the 3- and 5-year survival rates for the Eastern patients, Western patients, patients undergoing concurrent chemoradiotherapy, patients with squamous cell carcinoma, patients undergoing High-dose radiotherapy ( ≥40 Gy), and patients given either “cisplatin + Fluorouracil” or “cisplatin + paclitaxel” chemotherapy were significantly higher in the CRTS group (allP<0.05). There were no statistical significances in the 3- and 5-year survival rates for patients undergoing sequential chemoradiotherapy or patients with adenocarcinoma between the two groups (allP>0.05). Compared to the RCTS group, the surgery rate in the SA group was higher (P<0.05), while the CRTS group had significantly higher radical resection rate, R0 resection rate and lower postoperative local recurrence rate (allP<0.05). The differences in postoperative complication incidence, post-operative distant metastasis and postoperative mortality rate were not statistically significant between the two groups (allP>0.05).

Conclusion

CRTS can significantly improve the survival and surgical conditions of patients with resectable esophageal carcinoma.
Effect of the regimen of Gaoshan Hongjingtian on the mechanism of poly(ADP-ribose) polymerase regulation of nuclear factor kappa B in the experimental diabetic retinopathy
Authors: ZHAO Hong-shu , SHI Xiang-yu , WEI Wen-bin , WANG Ning-li
Published: January 2024

Background

Poly(ADP-ribose) polymerase (PARP) plays an important role in the death of retinal capillary cells in diabetic retinopathy (DR) partly via its regulation of nuclear factor kappa B (NF-κB). The current study investigated the effect of the regimen of Gaoshan Hongjingtian (RG) on the mechanism of PARP regulation of NF-κB, and demonstrated the possible impact of the RG and Gaoshan Hongjingtian (Rhodiola sachalinensis, RS) on diabetic retinopathy.

Methods

Wistar rats were made diabetic by administering streptozotocin. They were then assigned to three groups at random. After 2 months, the three groups of these diabetic rats were treated with RS or RG, or untreated. Analyses of expression levels of PARP, NF-κB, and intercellular adhesion molecule-1 (ICAM-1) in the retinas of rats in different groups were performed by Western blotting and immunohistochemical assays, and mRNA levels of NF-κB and ICAM-1 were determined by real-time polymerase chain reaction (PCR). In addition, the basement membranes of capillaries in the rats' retinas were observed using electron microscopy, and diabetes-induced capillary degeneration (ghost pericytes and acellular capillaries) were quantitated.

Results

From the third month after the injection of streptozotocin, the diabetic rats were given daily RG, RS or tap water separately. The diabetic rats failed to gain weight compared with normal age-matched rats, whereas their glycated hemoglobin levels were significantly increased. After 5 months, the mRNA levels of NF-κB and ICAM-1 and the protein expression of PARP, NF-κB, and ICAM-1 were significantly increased in the retinas of diabetic rats in the untreated group compared with the nondiabetic controls. After 8 months, the number of degenerated retinal capillaries (ghost pericytes and acellular capillaries) was significantly increased in the diabetic rats in the untreated group compared with normal age-matched rats. RG and RS inhibited diabetes-induced over-expression of PARP, NF-κB, and ICAM-1 in the retinas of diabetic rats at the end of 5-month diabetic duration. Treatment using RG and RS significantly inhibited increases in the number of acellular capillaries and pericyte ghosts and suppressed the basement membrane thickening in the retinas of rats with diabetes for 8 months compared with the control diabetic rats.

Conclusions

These results indicate that PARP plays an important role in the pathogenesis of diabetic retinopathy. RS and RG may have acted on the mechanism of PARP regulation of NF-κB, which suppressed the expression of NF-κB and ICAM-1, and led to the inhibition of retinal capillary degeneration.
Neuroprotection in glaucoma: present and future
Authors: CHEN Shi-da , WANG Lu , ZHANG Xiu-lan
Published: January 2024

Objective

To review the updated research on neuroprotection in glaucoma, and summarize the potential agents investigated so far.

Data sources

The data in this review were collected from PubMed and Google Scholar databases published in English up to September 2012, with keywords including glaucoma, neuroprotection, and retinal ganglion cells, both alone and in combination. Publications from the past ten years were selected, but important older articles were not excluded.

Study selection

Articles about neuroprotection in glaucoma were selected and reviewed, and those that are cited in articles identified by this search strategy and judged relevant to this review were also included.

Results

Although lowering the intraocular pressure is the only therapy approved as being effective in the treatment of glaucoma, increasing numbers of studies have discovered various mechanisms of retinal ganglion cells death in the glaucoma and relevant neuroprotective strategies. These strategies target neurotrophic factor deprivation, excitotoxic damage, oxidative stress, mitochondrial dysfunction, inflammation, activation of intrinsic and extrinsic apoptotic signals, ischemia, and protein misfolding. Exploring the mechanism of axonal transport failure, synaptic dysfunction, the glial system in glaucoma, and stem cell used in glaucoma constitute promising research areas of the future.

Conclusions

Neuroprotective strategies continue to be refined, and future deep investment in researching the pathogenesis of glaucoma may provide novel and practical neuroprotection tactics. Establishing a system to assess the effects of neuroprotection treatments may further facilitate this research.
Quadrilobed superior gluteal artery perforator flap for sacrococcygeal defects
Authors: HAI Heng-lin , SHEN Chuan-an , CHAI Jia-ke , LI Hua-tao , YU Yong-ming , LI Da-wei
Published: January 2024

Background

Perforator flaps are used extensively in repairing soft tissue defects. Superior gluteal artery perforator flaps are used for repairing sacral defects, but the tension required for direct closure of the donor area after harvesting of relatively large flaps carries a risk of postoperative dehiscence. This research was to investigate a modified superior gluteal artery perforator flap for repairing sacrococcygeal soft tissue defects.

Methods

From June 2003 to April 2010, we used our newly designed superior gluteal artery perforator flap for repair of sacrococcygeal soft tissue defects in 10 patients (study group). The wound and donor areas were measured, and the flaps were designed accordingly. Wound healing was assessed over a follow-up period of 6-38 months. From January 1998 to February 2003, twelve patients with sacrococcygeal pressure sores were treated with traditional methods, VY advancement flaps or oblong flaps, as control group.

Results

After debridement, the soft tissue defects ranged from 12 cm × 10 cm to 26 cm × 22 cm (mean 16.3 cm × 13.5 cm). Four patients were treated using right-sided flaps ranging from 15 cm × 11 cm to 25 cm × 20 cm (mean 18.2 cm × 14 cm). Four patients were treated using left-sided flaps, and two were treated using both right- and left-sided flaps. Suction drains were removed on postoperative Days 3-21 (mean 5.9) and sutures were removed on postoperative Days 12-14. Each flap included 1-2 perforators for each of the donor and recipient sites. Donor sites were closed directly. All flaps survived. In eight patients, the wounds healed after single-stage surgery. After further debridement, the wounds of the remaining two patients were considered healed on postoperative Days 26 and 33, respectively. The rate of first intention in the study group (80%, 8/10) significantly increased than that of control group ((25%, 3/12), χ2=4.583, P=0.032). Follow-up examinations found that the flaps had a soft texture without ulceration. In the two patients without paraplegia, the range of motion of the hip joints was not affected.

Conclusion

The use of the quadrilobed superior gluteal artery perforator flap can overcome the disadvantages of traditional perforator flaps and represents an improved approach for repairing soft tissue defects in the sacrococcygeal region.
Old age security in rural China: there is a long way to go
Authors: DAI Bao-Zhen , ZHOU Lu-Lin , Mei John Y
Published: January 2024

Objective

We aimed to examine the current developments and challenges confronted by old age security in rural China.

Data sources

This study is based on the data from PubMed, Elsevier, Wiley, EBSCO, EMBASE, SCI Expanded, ProQuest, Google, and CNKI which is the most informative database in Chinese.

Study selection

Articles were selected with the search terms “rural”, “China”, “old”, “older”, or “elder”, “elderly”, or “aged”, “aging”, “security”, “culture”, “value”, “medical insurance” or “community based medical insurance” or “cooperative medical scheme”. Related websites and yearbooks were searched as well.

Results

The socio-economic development has made the burden of traditional care for the rural elderly heavier than ever, and new challenges are emerging in rural communities, such as poor economic, deteriorating natural environment and health crisis.

Conclusions

The governments should improve the scale and caliber of rural old age security and strengthen regulations with great efforts in developing the rural economy and protecting the natural environment of rural communities.
Thymoma: current diagnosis and treatment
Authors: Detterbeck Frank C. , Zeeshan Ahmad
Published: January 2024

Objective

To review the presentation, diagnosis, staging and treatment of thymoma.

Data sources

Data were obtained from papers on thymoma published in English within the last 30 years. No formal systematic review was conducted, but an effort was made to be comprehensive.

Study selection

Studies were selected if they contained data relevant to the topic addressed in the particular section. In particular, standards adopted by the International Thymic Malignancies Interest Group through a formal process of achieving worldwide consensus are featured. 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

Thymomas are rare malignant tumors. They account for about half (47%) of anterior mediastinal tumors. About one third of these are associated with myasthenia gravis. Computed tomography with intravenous contrast is the standard diagnostic modality. Thymomas appear as round or oval masses in early stages but irregular shapes with calcifications occurring in later stages. They can invade surrounding structures including mediastinal fat, pleura, major blood vessels and nerves. Fine needle aspiration, core needle biopsy or open biopsy is used to obtain tissue diagnosis. Masaoka-Koga classification is currently used to stage thymomas. All thymomas should be considered for resection due to their malignant potential. A complete resection is a major prognostic factor and every effort should be made to achieve this even if this means resection and reconstruction of a major thoracic structure. Median sternotomy is the standard approach for thymoma resection. A number of minimally invasive techniques are used in selective centers. While stage I and II tumors undergo primary surgery, preoperative chemotherapy appears to increase the chances of complete resection for stage III and IVa tumors. Postoperative radiation could be considered for patients with residual disease. Excellent 5 and 10-year survival rates are noted for completely resected early stage thymomas.

Conclusions

Thymic malignancies are rare tumors. Standards have recently been achieved to allow better communication and promote collaborative research. Surgical resection is the mainstay of treatment, but a multimodality approach is useful for many patients.
Early changes of procalcitonin predict bacteremia in patients with intensive care unit-acquired new fever
Authors: Shi Yan , Du Bin , Xu Ying-chun , Rui Xi , Du Wei , Wang Yao
Published: January 2024

Background

Rapid detection of bacteremia is important for critically ill patients. Procalcitonin (PCT) has emerged as a marker of sepsis, but its characterization for predicting bacteremia is still unclear. This study aimed to investigate the role of change of PCT within 6 to 12 hours after new fever in predicting bacteremia.

Methods

An observational study was conducted in the ICU of our hospital from January 2009 to March 2010. Adult patients with new fever were included and grouped as bacteremia and non bacteremia group. Serum PCT concentration was measured at admission and within 6 to12 hours after new fever (designated PCT0 and PCT1). Other results of laboratory tests and therapeutic interventions were recorded. Multivariate Logistic regression analysis was used to identify the risk factors of bacteremia. The area under the ROC curve (AUC) was constructed to evaluate the discriminative power of variables to predict bacteremia.

Results

Totally 106 patients were enrolled, 60 of whom had bacteremia and 46 did not have bacteremia,. The acute physiology and chronic health evaluation II (APACHE II) and sequential organ failure assessment (SOFA) scores were 13.1±7.8 and 5.0±2.2 at admission, respectively. There was no significant difference in PCT0 between the bacteremia group and nonbacteremia group; 1.27μg/L (range, 0.10-33.3) vs. 0.98μg/L (range, 0.08-25.7), (P=0.157). However, the PCT1 and the rate of change of PCT were significantly higher in bacteremia group; PCT1 was 6.73μg/L (1.13-120.10) vs. 1.17μg/L (0.10-12.10) (P=0.001), and the rate of change was 5.62 times (1.05-120.6) vs. 0.07 times (-0.03-0.18) (P<0.001). The area under the ROC curve (AUC; 95% confidence interval) of the rate of change of PCT was better for predicting bacteremia than that of PCT1; 0.864 (range, 0.801-0.927) vs. 0.715 (range, 0.628-0.801), (P<0.05). The AUCs of PCT0 and other parameters (such as WBC count, granulocyte percentage and temperature) were not significantly different (all P>0.05). The best cut-off value for the rate of change was 3.54 times, with a sensitivity of 88.5% and a specificity of 98.0%. It was also an independent predictor of bacteremia (odds ratio 29.7, P<0.0001) and wasn't correlated with the presence or absence of co-infection, neutropenia or immunodeficiency (P>0.05).

Conclusion

The rate of change of PCT is useful for early detection of bacteremia during new fever and superior to the PCT absolute value and other parameters in non-selected ICU patients.