bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of acute kidney injury as defined by the risk, injury, failure, loss, and end-stage criteria in critically ill patients undergoing abdominal aortic aneurysm repair
Authors: YUE Jia-ning , LUO Zhe , GUO Da-qiao , XU Xin , CHEN Bin , JIANG Jun-hao , YANG Jue , SHI Zhen-yu , ZHU Ting , JU Min-jie , TU Guo-wei , WANG Yu-qi , ZHU Du-ming , FU Wei-guo
Published: January 2024

Background

Acute kidney injury (AKI) is considered as a common and significant complication following abdominal aortic aneurysm (AAA) repair. This study aimed to assess the associated risk factors of AKI in the critically ill patients undergoing AAA repair and to evaluate the appropriate AKI management in the specific population.

Methods

We retrospectively examined data from all critically ill patients undergoing AAA repairs at our institution from April 2007 to March 2012. Multivariable analysis was used to identify factors associated with postoperative AKI, which was defined by risk, injury, failure, loss and end-stage (RIFLE) kidney disease criteria. The goal-directed hemodynamic optimization (maintenance of optimal hemodynamics and neutral or negative fluid balance) and renal outcomes were also reviewed.

Results

Of the 71 patients enrolled, 32 (45.1%) developed AKI, with 30 (93.8%) cases diagnosed on admission to surgical intensive care unit (SICU). Risk factors for AKI were ruptured AAA (odds ratio (OR)=5.846, 95% confidence interval (CI): 1.346-25.390), intraoperative hypotension (OR=6.008, 95% CI: 1.176 to 30.683), and perioperative blood transfusion (OR=4.611, 95% CI: 1.307-16.276). Goal-directed hemodynamic optimization resulted in 75.0% complete and 18.8% partial renal recovery. Overall in-hospital mortality was 2.8%. AKI was associated with significantly increased length of stay ((136.9±24.5) hours vs. (70.4±11.3) hours) in Surgical Intensive Care Unit.

Conclusions

Critically ill patients undergoing AAA repair have a high incidence of AKI, which can be early recognized by RIFLE criteria. Rupture, hypotension, and blood transfusion are the significant associated risk factors. Application of goal-directed hemodynamic optimization in this cohort appeared to be effective in improving renal outcome.
Blood lead levels among children aged 0 to 6 years in 16 cities of China, 2004-2008
Authors: XIE Xiao-hua , TAN Zang-wen , JIA Ni , FAN Zhao-yang , ZHANG Shuai-ming , LÜ Yan-yu , CHEN Li , DAI Yao-hua
Published: January 2024

Background

The adverse health effects of lead for children under 6 years are well known. Studies to assess the lead exposure among children in China are small in sample size and lack of national representative data. The aim of this study therefore was to describe blood lead levels and identify risk factors for lead exposure among children aged 0 to 6 years living in 16 cities in China.

Methods

We analyzed data from blood lead levels surveillance in China carried out in 16 large cities between 2004 and 2008. A stratified clustered random sampling strategy was used. A total of 69 968 children aged 0 to 6 years were included. We conducted multiple Logistic regression analyses to explore risk factors to high blood lead level.

Results

The geometric mean blood lead level of the children was 4.50 μg/dl (median: 4.90 μg/dl; IQR: 3.20-7.00 μg/dl). Overall prevalence of blood lead level ≥10.00 μg/dl among 0- to 6-year-old children was 7.57%. But the proportion of blood lead level ≥5.00 but <10.00 μg/dl was 42.12%. Blood lead levels were significantly higher in boys (4.63 μg/dl) than in girls (4.35 μg/dl) (P <0.0001). The geometric mean blood lead levels and prevalence of blood lead level ≥10.00 μg/dl increased with age (P <0.0001 for the two trends). After controlling for sociodemographic, dietary and behavior factors, multivariable analysis indicated that lower maternal education, male gender, younger age, often biting pencil or/and toys, walking or playing for long time on the street, not washing hands before eating are major risk factors for higher lead levels.

Conclusions

The blood lead levels among Chinese children in urban areas are lower than previous studies but close to those of developed countries. However, children with low lead exposure account for almost half and the sociodemographic factors (age, male sex, and low mother education level) continue to be associated with higher blood lead levels.
Transplantation of human umbilical cord-derived endothelial progenitor cells promotes re-endothelialization of the injured carotid artery after balloon injury in New Zealand white rabbits
Authors: HU Cheng-heng , KE Xiao , CHEN Kui , YANG Da-ya , DU Zhi-min , WU Gui-fu
Published: January 2024

Background

Cell transplantation has great potential for promoting endothelial repair and reducing the complications of percutaneous coronary intervention (PCI). The aim of this study was to investigate the effect of transplantation of human umbilical cord blood endothelial progenitor cells (EPCs) on injured arteries.

Methods

Umbilical cord blood mononuclear cells were obtained from post-partum lying-in women, and EPCs were isolated, cultured, expanded and identified by immunofluorescence. The carotid arterial endothelium of New Zealand white rabbits was injured by dilatation with a 3F balloon, and the EPCs were injected into the lumen of the injured artery in the transplanted group (n=16), while an equal volume of phosphated buffered saline (PBS) was injected into the control group after balloon injury (n=16). The animals were sacrificed after either 2 or 4 weeks, and the grafted cells were identified by double immunofluorescence staining with human nuclear antigen (HNA) and CD31 antibodies. Arterial cross sections were analyzed by pathology, immunohistochemisty and morphometry to evaluate the reparative effects of EPCs. Proliferating cell nuclear antigen (PCNA) and transforming growth factor (TGF)-β1 mRNA expression were detected by reverse transcription-polymerase chain reaction (RT-PCR).

Results

Fluorescence-labeled EPCs were found in the neointima. The neointimal area and the neointimal/medial area ratio were significantly lower in the transplanted group than in the control group (P <0.05). von Willebrand factor (vWF) immunohistostaining showed more VWF-positive cells in the transplanted animals than in the controls (8.75±2.92 vs. 4.50±1.77, P <0.05). Compared with the control group, the transplanted group had lower expression of PCNA mRNA (0.67±0.11 vs. 1.25±0.40, P <0.01) and higher expression of TGF-β1 mRNA (1.10±0.21 vs. 0.82±0.07, P <0.05).

Conclusions

EPCs derived from human umbilical cord blood were successfully transplanted into injured vessels. The transplanted EPCs inhibited neointimal hyperplasia and promoted vascular re-endothelialization.
Acortatarin A inhibits high glucose-induced extracellular matrix production in mesangial cells
Authors: ZHAO Zhi-fang , ZHOU Li-li , CHEN Xia , CHENG Yong-xian , HOU Fan-fan , NIE Jing
Published: January 2024

Background

Diabetic nephropathy (DN) is the leading cause of end-stage renal disease. Various treatment regimens and combinations of therapies provide only partial renoprotection. Therefore new approaches are needed to retard the progression of DN. The aim of the present study was to evaluate the role of a novel spiroalkaloid from Acorus tatarinowii named acortatarin A (AcorA) in inhibiting high glucose-induced extracellular matrix accumulation in mesangial cells (MCs).

Methods

The cytotoxity of AcorA on MCs was examined by 3-(4,5-dimethylthiazol-2-yl)-2.5-diphenyltetrazolium bromide (MTT) assay. The expression of fibronectin and collagen IV was examined by real time PCR and western blotting. The expression of p22phox and p47phox was detected by western blot. The interaction between p22phox and p47phox was examined by co-immunoprecipitation. The phosphorylation of p47phox was examined by immunoprecipitation. The phosphorylation of protein kinase C (PKC) α, PKCβ, phospholiase C gamma (PLCγ1), and the p85 subunit of PI3K was determined by Western blotting.

Results

AcorA significantly inhibited high glucose-induced activation of NADPH oxidase, a ROS-generating enzyme, by increasing phosphorylation of p47phox and enhancing interaction between p22phox and p47phox. Preincubation of AcorA with MCs inhibited high glucose-induced collagen IV and fibronectin production in a dose-dependent manner. Moreover, AcorA attenuated high glucose enhanced phosphorylation of PKCα, PKCβ, PLCγ1, and the p85 subunit of PI3K.

Conclusion

AcorA inhibits high glucose-induced extracellular matrix production via blocking NADPH oxidase activation.
Clinical characteristics of 4355 patients with anterior cruciate ligament injury
Authors: MEI Yu , AO Ying-fang , WANG Jian-quan , MA Yong , ZHANG Xin , WANG Jia-ning , ZHU Jing-xian
Published: January 2024

Background

Clinical features of anterior cruciate ligament (ACL) injury are important for its prevention, diagnosis and treatment. However, few studies have reported such data, especially in China. The purpose of this study was to describe the clinical characteristics of ACL injury on a large cohort.

Methods

Between 1993 and 2007, a total of 4355 ACL deficient inpatients (612 athletes and 3743 non-athletes) were registered. Data were collected using a special database system. And the distributions of characteristics in different groups were compared and analyzed statistically.

Results

All subjects were confirmed with ACL tear during surgery. Statistical analysis revealed that the percentage of females in Athlete Group was significantly higher than that in Non-athlete Group (56.05% vs. 24.95%, P<0.001). This study also found that sports trauma was the main cause of ACL tears. Soccer, basketball, judo, wrestling and track and field were the five most responsible activities for athletes. The average injury time for athletes was significantly shorter than that for non-athletes (413.3 days vs. 717.5 days, P<0.001). Three thousand nine hundred and eight cases were ordered ACL reconstruction (76.04% single-bundle, 18.30% double-bundle). Three hundred and forty-five patients (7.92%) were combined with other ligaments injuries, 2667 (61.24%) were found with various grades of cartilage lesions, and 3377 (77.54%) were found with meniscal injury.

Conclusions

Sports trauma was the main cause of ACL tears in China, and reconstruction had become the principal surgical choice. In order to restore knee joint stability and reduce the incidence of cartilage and meniscal injury, patienttailored ACL reconstruction should be suggested at the right moment.
Impact of diabetes on the prognosis of hip fracture: a cohort study in the Chinese population
Authors: WANG Hong , Yan-wei LÜ , LAN Ling , ZHANG Quan , CHEN Hai-ling , ZHANG Guo-ying , DENG Li-li , LI Ju-fen
Published: January 2024

Background

Diabetes has been associated with increased risk of fracture and impaired fracture healing. The aim of this study was to examine the influence of diabetes on perioperative complications, length of stay and ambulatory ability recovery in individuals with hip fracture, and to determine whether changes could be made to improve treatment outcome.

Methods

The study included 707 hip fracture patients treated at Beijing Jishuitan Hospital between July 2009 and December 2010. The medical history and perioperative complications were compared between non-diabetic and diabetic groups. Length of stay, days awaiting surgery, and days of hospitalization after surgery were also analyzed. Ambulatory ability was compared at 1-year follow-up using the Chi-square test and Fisher's exact test. An independent Student's t-test was used to compare normally distributed continuous data.

Results

Patients with diabetes were more likely than non-diabetic patients to develop cardiac perioperative complications (8.9% vs. 3.0%, P=0.021), urinary tract infections (12.0% vs. 2.8%, P <0.001), and gastrointestinal symptoms (15.0% vs. 6.8%, P=0.003). No difference in perioperative complications was observed between the groups. Days awaiting surgery and length of hospital stay were both longer in the diabetic group ((8.0±5.1) vs. (6.2±3.7) days and (16.5±3.8) vs. (13.3±3.8) days, P <0.001, respectively). Before the occurrence of fracture, patients with diabetes were less likely to be ambulatory outdoors (71.9% vs. 85.9%, P <0.001) and had more restricted walking ability. After at least 1-year follow-up, similar proportions of patients in the non-diabetic and diabetic groups (16.1% and 15.9%, respectively), who were able to ambulate outdoors before the fracture, became housebound till the final follow-up.

Conclusions

Diabetics are at increased risk of specific complications and have a longer time to surgery and longer in-hospital stay, but generally have similar recovery to non-diabetics thereafter.
Reprogramming of adult human neural stem cells into induced pluripotent stem cells
Authors: Xie Li-qian , Sun Hua-ping , Wang Tian , Tang Hai-liang , Wang Pu , Zhu Jian-hong , Yao Zheng-wei , Feng Xiao-yuan
Published: January 2024

Background

Since an effective method for generating induced pluripotent stem cells (iPSCs) from human neural stem cells (hNSCs) can offer us a promising tool for studying brain diseases, here we reported direct reprogramming of adult hNSCs into iPSCs by retroviral transduction of four defined factors.

Methods

NSCs were successfully isolated and cultured from the hippocampus tissue of epilepsy patients. When combined with four factors (OCT3/4, SOX2, KLF4, and c-MYC), iPSCs colonies were successfully obtained.

Results

Morphological characterization and specific genetic expression confirmed that these hNSCs-derived iPSCs showed embryonic stem cells-like properties, which include the ability to differentiate into all three germ layers both in vitro and in vivo.

Conclusion

Our method would be useful for generating human iPSCs from NSCs and provide an important tool for studying neurological diseases.
Multimodality imaging assessments of response to metformin therapy for breast cancer in nude mice
Authors: Mao Yi , Xia Rui , Wang Lei , Wang Yu-qing , Gao Fa-bao
Published: January 2024

Background

Metformin is the most widely used anti-diabetic drug in the world. An increasing body of evidence shows metformin also blocks cell cycle progression and selectively induces apoptosis via caspase activation in some breast tumor cells. Diffusion-weighted imaging (DWI) and bioluminescence imaging (BLI) have great potential in the evaluation of the early response to cancer therapies. We used DWI and BLI in evaluating the response of breast cancer to metformin.

Methods

The luciferase-engineered human breast cancer cell line MDA-MB-231 was inoculated into the mammary fat pad of nude mice. Twelve female nude mice bearing tumors were divided into two groups. The mice in the treatment group received metformin (2 mg/ml in drinking water daily) after tumor inoculation, and the mice in the control group were offered drinking water without any drug added. We performed 7T magnetic resonance imaging and optical imaging every week. Imaging included T1- and T2-weighted imaging, DWI, and BLI. After imaging. The tumors were collected and subjected to histological analysis.

Results

The mean photons/second of tumors in the treatment group was (3.00±0.43)×106 at day one, (1.01±0.14)×107 at 2 weeks, (5.79±1.42)×107 at 4 weeks, and (2.33±0.70)×107 at 8 weeks. The mean photons/second of tumors in the control group was (3.29±0.59)×106 at day one, (3.59±0.63)×107 at 2 weeks, (3.87±0.56)×108 at 4 weeks, and (4.12±1.72)×108 at 8 weeks. Compared to the control group, the treatment group showed an obvious decrease in the mean bioluminescence (photons/s) of the tumors and fewer metastases. Histological examination confirmed the presence of fewer metastases. DWI showed the apparent diffusion coefficient (ADC) value of the tumors; the mean ADC value was (0.9287±0.04346)×10-3 mm2/s in the treated tumors and (0.7553±0.01804)×10-3 mm2/s in the untreated tumors. The ADC value of tumors in the treatment group was significantly higher than the control tumors (P=0.0013).

Conclusions

The growth and metastasis of MDA-MB-231 breast cancer may be inhibited by metformin. DWI and BLI have great potentials in the evaluation of the early response to metformin treatment. BLI has a high degree of sensitivity and is able to detect micrometastasis, thus can be used for identifying tumor metastasis in vivo.
Axonal loss and blood flow disturbances in the natural course of indirect traumatic optic neuropathy
Authors: SHI Wei , WANG Huai-zhou , SONG Wei-xian , YANG Wen-li , LI Wei-ye , WANG Ning-li
Published: January 2024

Background

Indirect traumatic optic neuropathy (TON) is an acute injury of the optic nerve associated with severe visual dysfunction, which may be a result of secondary mechanical injury and vascular disorder of the optic nerve due to trauma. We analyzed the natural course of axonal loss and blood flow disturbances in patients with indirect TON to find a possible therapeutic window.

Methods

A cohort of 54 patients with indirect TON recruited between October 2008 and October 2010 at Beijing Tongren Hospital was retrospectively analyzed. The patients were divided into no light perception group (NLP) and better than NLP (btNLP) group. Specifically, the thickness of the retinal nerve fiber layer (RNFL) measured by spectral domain optical coherence tomography (SD-OCT), and hemodynamic parameters of the ophthalmic artery (OA), central retinal artery (CRA) and posterior ciliary artery (PCA) were determined.

Results

Two weeks after injury, there was a statistically significant decrease in the thickness of RNFL in the btNLP group as compared with the fellow control eyes (P <0.05). In contrast, in the NLP group, RNFL thickness slightly increased for 2 weeks following injury, then overtly reduced after 4 weeks (P <0.05). Peak systolic velocity (PSV) of CRA was significantly decreased 4 weeks after injury (P<0.05) in both the NLP group and btNLP group (P <0.05). The thickness of RNFL in the NLP group was negatively correlated with PSV of CRA after 1 week of injury (P <0.05, r=-0.962).

Conclusions

SD-OCT is a useful supplement in detecting the axonal loss in TON. The dynamic change of the thickness of RNFL appears to correlate with the hemodynamic disturbances in the natural course of TON. The first 2 weeks following an injury is critical and should be considered as the therapeutic window for TON patients.
Evaluation of neuro-intensive care unit performance in China: predicting outcomes of Simplified Acute Physiology Score II or Glasgow Coma Scale
Authors: Zhao Xiao-xia , Su Ying-ying , Wang Miao , Zhang Yan , Ye Hong , Feng Huan-huan , Zhang Yun-zhou , Gao Dai-quan , Chen Wei-bi
Published: January 2024

Background

Severity scoring systems are useful tools for measuring the severity of the disease and its outcome. This pilot study was to verify and compare the prognostic performance of the Simplified Acute Physiology Score II (SAPS II) and Glasgow Coma Scale (GCS) in neuro-intensive care unit (N-ICU) patients.

Methods

A total of 1684 patients consecutively admitted to the N-ICU at Xuanwu Hospital between January 1, 2005 and December 31, 2011 were enrolled in this study. The data-base included admission data, at 24-, 48-, and 72-hour SAPS II and GCS. Repeated measure data analysis of variance, Logistic regression analysis, the Hosmer-Lemeshow goodness-of-fit statistic, and the area under the receiver operating characteristic were used to evaluate the performance.

Results

There was a significant difference between the SAPS II or GCS score at four time points (F=16.110, P=0.000 or F=8.108, P=0.000). The SAPS II scores or GCS score at four time points interacted with the outcomes with significant difference (F=116.771, P=0.000 or F=65.316, P=0.000). Calibration of the SAPS II or GCS score at each time point on all patients was good. The percentage of a risk estimate prediction corresponding to observed mortality was also good. The 72-hour score have the greatest consistency. Discriminations of the SAPS II or GCS score at each time were all satisfactory. The 72-hour score had the greatest discriminative power. The cut-off value was 33 (sensitivity of 85.2% and specificity of 74.3%) and 6 (sensitivity of 70.6% and specificity of 65.0%). The SAPS II at each time point on all patients showed better calibration, consistency and discrimination than GCS. The binary Logistic regression analysis identified physiological variables, GCS, age, and disease category as significant independent risk factors of death. After the two variables including underlying disease and type of admission were excluded, we built the simplified SAPS II model. A correlation was suggested between the simplified SAPS II score at each time point and outcome, regardless of the diagnosis.

Conclusions

The GCS scoring system tends to be a little weaker in the predictive power than the SAPS II scoring system in this Chinese cohort of N-ICU patients. The advantage of SAPS II scoring system still exists that it dose not need to take into account the diagnosis or diseases categories, even in the special N-ICU. The simplified SAPS II scoring system is considered a new idea for the estimation of effectiveness.
Spectrum and antimicrobial resistance of common pathogenic bacteria isolated from patients with acute exacerbation of chronic obstructive pulmonary disease in mainland of China
Authors: YE Feng , HE Li-xian , CAI Bo-qiang , WEN Fu-qiang , CHEN Bai-yi , Mangunnegoro Hadiarto , CHEN Rong-chang , YUAN Jin-ping , SUN Hong-li
Published: January 2024

Background

Bacteria-induced respiratory infection has been long considered to be the major cause of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Therefore, a clear picture about the distribution and drug-resistance of pathogenic bacteria in the lower airways should be helpful for treatment of the disease. So far, data on this topic among Chinese are lacking.

Methods

A surveillance study was performed in consecutive patients with AECOPD at five areas in China between October 2006 and April 2008. The sputum from these patients was cultured and isolated for bacteria. Agar dilution method was used to determine the minimal inhibitory concentrations (MICs) of levofloxacin and other 15 antibiotics against these strains.

Results

Three hundred and fifty-nine pathogenic bacterial strains were isolated among 884 patients with AECOPD. The predominant bacteria were Pseudomonas aeruginosa (21.7%), Klebsiella pneumoniae (12.3%), Haemophilus influenzae (14.2%) and Streptococcus pneumoniae (11.7%), followed by Haemophilus parainfluenzae (9.5%), Acinetobacter baumannii (7.8%), Moraxella catarrhalis (6.4%) and Escherichia coli (3.6%). The majority of bacterial pathogens isolated in this study were susceptible to fluoroquinolones, ceftazidime, cefepime and imipenem.

Conclusions

Gram-negative bacilli are the leading pathogens in patients with AECOPD in China. Haemophilus parainfluenzae may be one of the most important pathogens in AECOPD. This study provides evidence for local surveillance of AECOPD pathogens and appropriate choice of antimicrobials in China.
Aquaporin 8 expression is reduced and regulated by microRNAs in patients with ulcerative colitis
Authors: MIN Min , PENG Li-hua , SUN Gang , GUO Ming-zhou , QIU Ze-wu , YANG Yun-sheng
Published: January 2024

Background

Ulcerative colitis (UC) is associated with differential expression of genes involved in inflammation and tissue remodeling. MicroRNA (miRNA) plays an important role in the pathogenesis of UC by regulating the gene expression at the post-transcriptional level and control crucial physiological processes. This study aimed to identify aquaporin 8 (AQP8) expression and its relationship with miRNA in UC patients.

Methods

Human colon samples, in this study, were obtained from 20 patients with UC and 16 healthy subjects undergoing diagnostic colonoscopy at the Chinese People's Liberation Army General Hospital between December 2009 and June 2010. We screened different genes from UC tissues and healthy subjects using genome-wide microarray, quantitative reverse transcription-polymerase chain reaction (qRT-PCR) and Western blotting. Regulation of gene expression by miRNAs was assessed by luciferase reporter construct assays and transfection of specific miRNA mimics and inhibitor.

Results

We identified that 1596 genes were increased and 1301 genes were decreased in UC patients compared to healthy subjects. Among them, we focused on the analysis of AQP8 which was decreased three folds in UC tissues (P <0.01). The expression of AQP8 mRNA and protein were decreased in UC tissue and tumor necrosis factor (TNF)-α treated HT29 cells compared with controls (P <0.05). We searched candidate target miRNAs of AQP8 through bioformatics and the luciferase report assay analysis indicated that miR-424, miR-195, miR-330, miR-612, and miR-16 which has complementary site in the 3-untranslated region (3′UTR) of AQP8 could decrease the relative luciferase activities by 10%-45%.

Conclusion

AQP8 and its relationship with miRNAs may be involved in the pathogenesis of UC.
Remnant-preserving posterior cruciate ligament reconstruction with graft tension-relieving: a comparative study with conventional technique
Authors: Gong Xi , Yu Jia-kuo , Ao Ying-fang
Published: January 2024

Background

Posterior cruciate ligament (PCL) tear is a severe injury to the knee joint and often requires surgical reconstruction. A number of PCL reconstruction techniques have been reported. However, the problem of residual laxity after surgery is not unusual with conventional techniques. This study aims to introduce a modified PCL reconstruction with remnant preservation and graft tension relieving.

Methods

Between December 2008 and June 2011, 36 cases of PCL reconstruction were performed in our institute, 20 with conventional technique (Group I) and 16 with modified technique (Group II). Pre- and post-operative results of the international knee documentation committee knee evaluation form (IKDC), Lysholm, Tegner, and KT2000 side-to-side difference were obtained.

Results

Significant improvements of IKDC, Lysholm, Tegner, and KT2000 results after surgery were found in both groups. Group II showed better improvement in all subjective examinations and significantly more decrease of KT 2000 side-to-side difference.

Conclusion

Modified PCL reconstruction with remnant preservation and graft tension relieving showed better results in restoration of posterior stability compared to conventional technique.
Age-related white matter degradation rule of normal human brain: the evidence from diffusion tensor magnetic resonance imaging
Authors: Xiang Zhang , Baoqing Li , Baoci Shan
Published: January 2024

Background

Diffusion tensor imaging can evaluate white matter function in human brain. Fractional anisotropy is the most important parameter. This study aimed to find regional reduction of fractional anisotropy (FA) with aging in the whole brain and the changing rules of anisotropy with aging.

Methods

Fifty volunteers from 20 to 75 years old were divided into five consecutive age groups; a young group and four senior groups. FA values were calculated with diffusion tensor imaging (DTI) studio software. The difference of FA between the young group and the four senior groups were analyzed by analysis of voxel-level height threshold in Statistic Parametric Mapping (SPM), and the regions with decreased FA were obtained. The FA values of these regions were then extracted using an in-house developed program, and a multiple linear regression model was built to assess the influence of age and sex on the FA values of these regions.

Results

Eight regions, including frontal lobe, postcentral gyrus, optic radiation, hippocampus, cerebella hemisphere, corona radiate, corpus callosum and internal capsule, were found to have decreased FA. There was a strong negative correlation between age and the FA in the frontal lobe, postcentral gyrus, optic radiation, hippocampus, and cerebella hemisphere, while a weaker negative correlation in the corona radiate, corpus callosum, and internal capsule was found. The FA reduction in the frontal lobe, postcentral gyrus, optic radiation, hippocampus and cerebella hemisphere were found earlier than in the corona radiate, corpus callosum and internal capsule. There was no correlation between sex and FA in these regions.

Conclusions

The FA in the subcortical white matter area reduces earlier than that in deep white matter. The areas with decreased FA continuously enlarge with aging. The FAs in these regions have a strong negative correlation with age.
Ninety-day administration of dl-3-n-butylphthalide for acute ischemic stroke: a randomized, double-blind trial
Authors: CUI Li-ying , ZHU Yi-cheng , GAO Shan , WANG Jian-ming , PENG Bing , NI Jun , ZHOU Li-xin , HE Jia , MA Xiu-qiang
Published: January 2024

Background

Dl-3-n-butylphthalide (NBP), first isolated from the seeds of celery, showed efficacy in animal models of stroke. This study was a clinical trial to assess the efficacy and safety of NBP with a continuous dose regimen among patients with acute ischemic stroke.

Methods

A randomized, double-blind, double-dummy trial enrolled 573 patients within 48 hours of onset of ischemic stroke in China. Patients were randomly assigned to receive a 14-day infusion of NBP followed by an NBP capsule, a 14- day infusion of NBP followed by aspirin, or a 14-day infusion of ozagrel followed by aspirin. The efficacy measures were Barthel index score and the modified Rankin scale (mRS) at day 90. Differences among the three groups on mRS were compared using χ2 test of proportions (with two-sided α=0.05) and Logistic regression analysis was conducted to take the baseline National Institutes of Health Stroke Scale (NIHSS) score into consideration.

Results

Among the 535 subjects included in the efficacy analysis, 90-day treatment with NBP was associated with a significantly favorable outcome than 14-day treatment with ozagrel as measured by mRS (P <0.001). No significant difference was found among the three groups on Barthel index at day 90. The rate of adverse events was similar among the three groups.

Conclusions

The 90-day treatment with NBP could improve outcomes at the third month after stroke. The NBP treatment (both intravenous and oral) is safe (ChiCTR-TRC-09000483).
Gene polymorphisms of interleukin-28, p21-activated protein kinases 4, and response to interferon-α based therapy in Chinese patients with chronic hepatitis B
Authors: YU Feng-xue , ZHANG Xiao-lin , WANG Yan-ping , MA Ning , DU Hong , MA Jian-min , LIU Dian-wu
Published: January 2024

Background

Peg-Interferon-α treatment is expensive and associated with considerable adverse effects, selection of patients with the highest probability of response is essential for clinical practice. The objective of this study was to assess the relationship between the gene polymorphisms of interleukin-28 (IL-28), p21-activated protein kinase 4 (PAK4) and the response to interferon treatment in chronic hepatitis B patients.

Methods

Two hundred and forty interferon-naive treatment HBeAg seropositive chronic hepatitis B patients were enrolled in the present prospective nested case-control study. Peripheral blood samples were collected, including 92 with favorable response and 148 without response to the interferon treatment. Rs8099917, rs12980602, and rs9676717 SNP was genotyped using matrix assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF MS).

Results

IL-28 genotype was not associated with response to interferon treatment (OR for GT/GG vs. TT, 0.881 (95% CI 0.388−2.002); P=0.762; OR for CT/CC vs. TT, 0.902 (95% CI 0.458-1.778); P=0.766). Rs9676717 in PAK4 genotype was independently associated with the response (OR for CT/CC vs. TT, 0.524 (95% CI 0.310-0.888); P=0.016). When adjusting for age, gender, smoking, drinking, levels of hepatitis B virus DNA, and alanine aminotransferase (ALT), rs9676717 genotype TT appeared to be associated with a higher probability of response for interferon treatment (OR, 0.155 (95% CI 0.034−0.700); P=0.015).

Conclusion

Genotype TT for rs9676717 in PAK4 gene and no drinking may be predictive of the interferon-α treatment success.
Neovascularization in the carotid atherosclerotic plaque is not associated with inflammatory cell aggregation
Authors: GAI Jing-jing , LIU Hong-bin , LI Juan , XIE Lei-xing , ZHAO Xi-hai , CHENG Liu-quan , CHEN Hui-jun , WANG Yong , YIN Da-yi , LIU Jia-jin , ZHANG Xiong-wei
Published: January 2024

Background

Monocytes and macrophages in atherosclerotic plaque lead to plaque instability. The aim of the study was to determine if plaque neovascularization led to inflammation.

Methods

Patients were consecutively enrolled if their carotid intimal media thickness was >2 mm, as revealed by duplex ultrasound. The patients then underwent dynamic contrast enhanced magnetic resonance imaging (DCE MRI) and fluorine-18 fluorodeoxyglucose (18F-FDG) positron emission tomography combined with computed tomography (PET CT). A target to background ratio (TBR) of ≥1.25 or <1.25 served as the cutoff point for the presence and absence of inflammation, respectively.

Results

Twenty-six patients underwent bilateral carotid DCE MRI and 24 patients also underwent PET CT. One hundred and fifty-five plaques were evaluated by both DCE MRI and PET CT. There was no significant difference in plaque morphology between the TBR ≥1.25 (n=61) and TBR <1.25 (n=94) groups. No significant differences were found in plasma volume and transfer constant between the TBR ≥1.25 and TBR <1.25 groups.

Conclusion

Our study did not find a significant correlation between plaque neovascularization and the aggregation of inflammatory cells.
Four-year clinical outcome in asymptomatic patients undergoing coronary computed tomography angiography
Authors: ZHANG Kai-yi , GAI Lu-yue , GAI Jing-jing , HE Bin , GUAN Zhi-wei
Published: January 2024

Background

Percutaneous coronary intervention (PCI) is indicated for angina with coronary stenosis. However, PCI for asymptomatic coronary stenosis remains controversial. We prospectively followed a group of patients for four years who underwent coronary computed tomography angiography (CCTA) for major adverse cardiac events (MACE). We hypothesized that the results of this trial would reliably reflect the natural outcome of the coronary disease.

Methods

Consecutive patients who underwent CCTA from June 2008 to May 2009 were selected. Those who could not be reached by telephone, had significant angina, had CT images that were not interpretable, or poor kidney and left ventricular (LV) function were excluded. The patients were divided into five groups: group A normal CCTA without stenosis, group B mild stenosis (1%-49%), group C moderate stenosis (50%-74%), group D severe stenosis (≥75%) and they were treated with optimal medical therapy (OMT) or PCI. The group E had PCI before the CCTA examination. The patients were then followed for MACE after different treatments. MACE included acute myocardial infarction (MI), heart failure (HF) and death.

Results

The patient population consisted of 419 patients. The follow-up time was (51±5) months. The age was (60±31) years. Male made up 67.78% of the population (n=284). A total of 51 cases of MACE occurred including 25 MI, eight HF and 18 all-cause deaths. There was no MACE in group A. Although MACE occurred in two patients in group B, they were not attributed to cardiac death. We further compared the MACE in groups C-E and no significant difference was found (P >0.05). However, a difference was detected among patients with unstable angina pectoris (UAP), stable angina pectoris (SAP), re-hospitalization, and cerebrovascular events from groups A-E (P <0.05). The plaque scores were used to predict MACE. The scores progressively increased significantly with lesion severity (P <0.05). Receiver operating curve (ROC) was performed to determine the sensitivity and specificity in predicting MACE. Our scores predicted MI with area of 0.76, predicted HF with area of 0.77, and predicted death with area of 0.70.

Conclusions

Normal and mild lesions had very few events. With increased stenosis the MACE rate increased progressively. PCI did not significantly reduce the MACE in comparison with OMT in asymptomatic patients. Furthermore, UAP, re-hospitalization, and re-PCI were significantly increased in patients who were treated with PCI.
Long-term clinical outcomes of patients with unprotected left main bifurcation lesions treated with 2-stent techniques
Authors: PEI Han-jun , SUI Yong-gang , WU Yong-jian , YANG Yue-jin , XU Bo , CHEN Ji-lin , QIAO Shu-bin , LI Jian-jun , QIN Xue-wen , YAO Min , YUAN Jin-qing , CHEN Jue , LIU Hai-bo , YOU Shi-jie , GAO Run-lin
Published: January 2024

Background

Currently available evidence suggests that outcomes are less favorable when left main (LM) bifurcation lesions are treated with 2-stent techniques compared with a single-stent technique. We aimed to evaluate the long-term outcomes of the 2-stent techniques for treating unprotected LM bifurcation lesions in Chinese patients.

Methods

We enrolled 301 consecutive patients treated with drug-eluting stents (DES) implantation using 2-stent techniques for unprotected LM bifurcation lesions (MEDINA 1, 1, 1, 70.5%). The 2-stent techniques included crush technique, V stenting, T stenting, and Culottes stenting. After stenting, both vessels were redilated at a high pressure before final kissing balloon (FKB). Clinical and angiographic data were analyzed. The primary endpoints were major adverse cardiac events (MACE), which included death, myocardial infarction, and target lesion revascularization.

Results

Immediate procedural success was obtained in all cases with a FKB success rate of 95.3%. Follow-up data were available for all patients. The overall incidence of angiographic in-stent restenosis (ISR) rate was 20.3% and most ISRs were of the focal type. During long-term follow-up (mean duration, (54±22) months), the cumulative incidence of MACE was 11.0%, with 8 (2.7%) deaths, 7 (2.3%) myocardial infarctions, and 18 (6.0%) repeated lesion revascularization. MACEs in high SYNTAX score terciles were significantly higher compared with those in low and intermediate SYNTAX score terciles (P=0.001).

Conclusions

Although percutaneous coronary intervention (PCI) with 2-stent technique for unprotected LM bifurcation lesions was accompanied with a slightly high incidence of ISR, the long-term clinical follow-up is acceptable. Technical modifications and stent innovations may further improve both the angiographic and clinical outcomes for patients with LM bifurcation disease treated by PCI.
Combined detections of interleukin 27, interferon-γ, and adenosine deaminase in pleural effusion for diagnosis of tuberculous pleurisy
Authors: WU Yan-bin , YE Zhi-jian , QIN Sou-ming , WU Cong , CHEN Yi-qiang , SHI Huan-zhong
Published: January 2024

Background

Previous studies reported interleukin-27 (IL-27), interferon-γ (IFN-γ), or adenosine deaminase (ADA) alone plays a helpful role in diagnosing tuberculous pleural effusion (TPE). The present study aims at comparing the diagnostic accuracy of pleural IL-27, IFN-γ, and ADA, and investigate the diagnostic accuracy of the combination of IL-27, IFN-γ, or/ and ADA for differentiating TPE from pleural effusions with the other etiologies.

Methods

The concentrations of IL-27, IFN-γ and ADA were simultaneously determined in pleural fluids and sera from 40 patients with TPE; 26 with malignant pleural effusion, seven with infectious pleural effusion, and eight with transudative pleural effusion by enzyme linked immunosorbent assay and colorimetric method. The corresponding biochemical indexs were also simultaneously determined.

Results

The concentrations of pleural IL-27 and IFN-γ in the tuberculous group were significantly higher than those in the malignant, infectious, and transudative groups. The concentrations of ADA in TPE were significantly higher than those in MPE or transudative effusions, while much lower than those in infectious effusions. Among these three biomarkers, IL-27 was the most effective for TPE diagnosis, with the cut off value of 900.8 ng/L. IL-27 had a high sensitivity of 95% and specificity of 97.6% for differential diagnosis of TPE from non-TPEs. Combinations of IL-27, IFN-γ and ADA measurements further increased the sensitivity or specificity up to 100%.

Conclusions

Compared to non-TPEs, IL-27, IFN-γ and ADA all simultaneously increased in TPE; and among these three rapid detection methods, IL-27 appeared to be the best for distinguishing tuberculous from non-TPEs, especially from MPE. Combinations of the three markers (IL-27, IFN-γ and ADA) yielded the highest sensitivity and specificity. These findings suggest that the applications of a new biomarker, IL-27, alone or with IFN-γ and ADA, may contribute to more efficient diagnosis strategies in the management of tuberculous pleurisy.
Molecular subtypes identified by gene expression profiling in early stage endometrioid endometrial adenocarcinoma
Authors: Gao Bao-rong , Chen Yong-hua , Yao Yuan-yang , Li Xiao-ping , Wang jian-liu , Wei Li-hui
Published: January 2024

Background

Early stage (FIGO stage I-II) endometrioid endometrial adenocarcinoma (EEA) is very common in clinical practice. However, patients with the early stage EEA show various clinical behaviors due to biological heterogeneity. Hence, we aimed to discover distinct classes of tumors based on gene expression profiling, and analyze whether the molecular classification correlated with the histopathological stages or other clinical parameters.

Methods

Hierarchical clustering was performed for class discovery in 28 early stage EEA samples using a special cDNA microarray chip containing 492 genes designed for endometrial cancer. Correlations between clinicopathologic parameters and our classification were analyzed. And the significance analysis of microarrays (SAM) array was used to identify the signature genes according to the tumor grade and myometrial invasion.

Results

Three tumor subtypes (subtypes I, II and III) were identified by hierarchical clustering, each subtype had different clinicopathological factors, such as tumor grade, myometrial invasion status, and FIGO stage. Moreover, SAM analysis showed 34 up-regulated genes in high grade tumors, and 38 up-regulated genes and 1 down-regulated in deep myometrial invasive tumors. The overlap genes between these two high-risk factors were markedly up-regulated in subtype I, but down-regulated in subtype III.

Conclusion

We have identified novel molecular subtypes in early stage EEA. Differential gene signatures characterize each tumor subtype, which could be used for recognizing the tumor risk and providing a basis for further treatment stratification.
Reduction of atrial fibrillation in remotely monitored pacemaker patients: results from a Chinese multicentre registry
Authors: CHEN Ke-Ping , DAI Yan , HUA Wei , YANG Jie-Fu , LI Kang , LIANG Zhao-Guang , SHEN Fa-Rong , CHEN Si-Lin , SU Yan-Gang , DING Yan-Sheng , ZHANG Shu
Published: January 2024

Background

Many recipients of implantable cardiac electronic devices have atrial fibrillation (AF) occurrences after device implantation, even if there is no previous history of AF, and some of the episodes are asymptomatic. The purpose of this study was to evaluate trends in AF burden following early AF detection in patients treated with pacemakers equipped with automatic, daily Home Monitoring function.

Methods

Between February 2009 and December 2010, the registry recruited 701 pacemaker patients (628 dual-chamber, 73 biventricular devices) at 97 clinical centers in China. Daily Home Monitoring data transmissions were analyzed to screen for the AF burden. In-office follow-ups were scheduled for 3 and 6 months after implantation. Upon first AF (i.e., mode-switch) detection in a patient, screening of AF burden by Home Monitoring was extended for the next 180 days.

Results

At least one episode of AF was observed in 22.9% of patients with dual-chamber pacemakers and in 28.8% of patients with biventricular pacemakers. The first AF detection in a patient occurred, on average, about 2 months before scheduled follow-up visits. In both pacemaker groups, mean AF burden decreased significantly (P<0.05) over 180 days following first AF detection: from 12.0% to 2.5% in dual-chamber and from 12.2% to 0.5% in biventricular pacemaker recipients. The number of patients with an AF burden >10% per month was significantly reduced over 6 months of implantation in both dual chamber (38 patients in the first month vs. 21 patients in month 6, P<0.05) and biventricular (7 patients in the first month vs. 0 patient in months 4-6, P<0.05) pacemaker recipients.

Conclusions

Automatic, daily Home Monitoring of patients treated with cardiac pacemakers allows early detection of AF, and there is a gradual and significant decrease in AF burden.
Effects of chest compressions on cardiorespiratory function in a non-arrested porcine model
Authors: CONG Lu-hong , LI Chun-sheng , GUO Zhi-jun , WANG Shuo , WU Jun-yuan , YUAN Wei
Published: January 2024

Background

The effects of chest compressions to hemodynamic and respiratory parameters during hands-only cardiopulmonary resuscitation (CPR) in a non-arrested patient who suddenly collapses are confusing. In this research, we investigated the effects of chest compressions in a non-arrested porcine model.

Methods

Fourteen male domestic pigs were randomized into sham control group (SHAM group, only anesthetized and instrumented without chest compression, n=6) or chest compression group (CC group, 2 minutes of chest compressions, n=8). Continuous hemodynamic parameters, dynamic lung compliance (Cdyn), and blood gas analysis outcomes were recorded. Serum levels of catecholamine were measured at baseline and 2 minutes, 30 minutes, 4 hours, and 24 hours after chest compressions. Chest computed tomography (CT) was performed at 30 minutes and 24 hours. Conventional histopathology evaluation was performed.

Results

After two minutes of chest compressions in the CC group, heart rate and extravascular lung water increased significantly; mean arterial pressure, stroke volume, and global ejection fraction significantly decreased. Cdyn significantly decreased to valley levels at 30 minutes and slowly recovered. Compared with the baseline, serum levels of catecholamine significantly increased at 2 minutes and rapidly decreased 24 hours later. At 30 minutes after chest compressions, chest CT showed local exudation, which was absorbed 24 hours later.

Conclusions

This research showed that 2 minutes of chest compressions causes various heart and lung tissue damage in the normal a normal porcine model. It also impacts the hemodynamic and Cdyn.