bluuebunny/crossref_metadata_2025 huggingface dataset:
Combination Therapy with Metformin and Fenofibrate for Insulin Resistance in Obesity
Authors: Li X-M , Li Y , Zhang N-N , Xie Y-H , Shi Y-Q
Published: February 2013

This randomized controlled study investigated metformin and fenofibrate, compared with metformin alone, for the treatment of peripheral insulin resistance in patients with simple obesity with hyperinsulinaemia but not diabetes. Participants were randomized to receive metformin (500 mg orally three times daily) plus either fenofibrate (200 mg orally once daily; n = 44) or placebo ( n = 43) for 6 months. Blood pressure, free fatty acids (FFA), body mass index (BMI), lipid and insulin levels were recorded pre- and post-treatment. β-Cell function and insulin resistance were measured by the homeostasis model assessment for insulin resistance (HOMA-IR) index. Both groups showed significant decreases in blood pressure, FFA, BMI and HOMA-IR relative to baseline. In addition, combined metformin and fenofibrate therapy showed significantly decreased fasting and postmeal insulin levels relative to baseline and relative to the placebo group. Both treatments were well tolerated. Metformin and fenofibrate can increase insulin sensitivity and recover β-cell function in patients with simple obesity accompanied by insulin resistance.
Clinical Factors Associated with Sodium Removal in Peritoneal Dialysis Patients
Authors: Shan YS , Ding XQ , Ji J , Lv WL , Cao XS , Zhong YH
Published: February 2013

A cross-sectional study was conducted in 156 clinically-stable peritoneal dialysis patients to identify the factors associated with sodium removal. Serum biochemistry, peritoneal function (modified peritoneal equilibration test [PET]) and the adequacy of dialysis were analysed in relation to sodium removal using multivariate linear regression. Factors significantly affecting peritoneal sodium removal included infusion volume and ultrafiltration volume per 24 h, sodium dip in the first hour of PET and sodium difference between serum and fresh dialysate. Factors significantly affecting total sodium removal included ultrafiltration and urine volume per 24 h, sodium dip in the first hour of PET and sodium difference between serum and fresh dialysate. With traditional dialysate, adequate fluid removal is required to ensure sufficient sodium removal, but a low-sodium dialysate may prevent sodium retention. Sodium removal should be included in evaluation of the adequacy of dialysis.
Oxidative Stress Levels in Myelodysplastic Syndrome Patients: Their Relationship to Serum Ferritin and Haemoglobin Values
Authors: Saigo K , Takenokuchi M , Hiramatsu Y , Tada H , Hishita T , Takata M , Misawa M , Imoto S , Imashuku S
Published: February 2013

Reactive oxygen species (ROS) and serum ferritin levels are both considered to be important biological factors in the pathogenesis of myelodysplastic syndrome (MDS). This study evaluated the levels of ROS in 40 patients with MDS (19 males and 21 females) using the Free Radical Analytical System, FRAS4, and derivatives of reactive oxygen metabolite kits. The patients' mean age was 67.3 years (range 58–86 years). The sera of 34 (85%) patients exhibited higher levels of oxidative stress than the reference range. There was a positive correlation between ROS levels and serum ferritin levels, and a negative correlation between ROS levels and haemoglobin levels. There was a negative relationship between serum haemoglobin and ferritin levels. The results indicated that iron accumulation or severe anaemia could contribute to oxidative stress in MDS patients. Iron chelation and antioxidant therapy may be suitable for the management of MDS.
Bortezomib-Dexamethasone or Vincristine-Doxorubicin-Dexamethasone as Induction Therapy Followed by Thalidomide as Maintenance Therapy in Untreated Multiple Myeloma Patients
Authors: Chen RA , Tu Y , Cao Y , Liu L , Liang Y
Published: February 2013

This randomized, retrospective study evaluated the effect of thalidomide combined with bortezomib-dexamethasone (TBD) or vincristine-doxorubicin-dexamethasone (T-VAD) on 46 patients with multiple myeloma. Newly diagnosed patients were randomly allocated to receive TBD ( n = 24) or T-VAD ( n = 22). The high-quality response rate (complete response plus very good partial response) was 62.5% in the TBD group and 45.4% for T-VAD. The complete response rate was 29.2% for TBD and 13.6% for T-VAD. Overall survival at 2 and 3 years, respectively, was 91.7% and 62.5% for TBD versus 86.4% and 54.5% for T-VAD. Most of the toxic effects of treatment were well tolerated. Both regimens were effective in the treatment of newly diagnosed multiple myeloma patients. Further studies are required to determine the role of thalidomide in these two regimens.
Diagnosis and Treatment of Acquired Aplastic Anaemia in Adults: 142 Cases from a Multicentre, Prospective Cohort Study in Shanghai, China
Authors: Wang W , Wang X , Xu X , Lin G
Published: February 2013

To improve diagnosis and therapy for aplastic anaemia (AA) in Shanghai, clinical and laboratory data for patients with AA ( n = 142) and hypocellular myelodysplastic syndrome (MDS; n = 22) were comparatively analysed (follow-up 2–6 years). Red blood cell distribution width and absolute lymphocyte and reticulocyte counts were significantly different between the two groups. AA was diagnosed in 54.2% of patients using a single bone marrow aspirate smear plus peripheral haemogram results, and in 95.1% using an additional bone marrow biopsy; 4.9% required multiple-site bone marrow examination. Clonal chromosomal abnormalities occurred in 3.9% and 31.8% of patients with AA and MDS, respectively. In patients with severe AA, 12.0% received antithymocyte globulin (ATG) + cyclosporin A (CSA; effectiveness rate 77.8%; 5-year survival 74.1%), 45.3% received CSA + androgen therapy (effectiveness rate 58.8%; 5-year survival 76.5%) and 26.7% received androgen monotherapy (effectiveness rate 25.0%). Multivariate analysis of prognostic factors indicated that therapy regimen and blood platelet count affected survival. Peripheral blood smears, bone marrow spicule classification and biopsy are important diagnostic factors. Standardization of evidence-based therapy and promotion of ATG + CSA would improve general therapeutic effects in AA.
Diffuse Large B-Cell Lymphoma with Concurrent Gastric Adenocarcinoma: Case Report and Literature Review
Authors: Hu XR , Hu YX , Fu HR , Sheng LX , Huang WJ , Hu KY , Huang H , Xie WZ
Published: February 2013

The simultaneous occurrence of diffuse large B-cell lymphoma (DLBCL) and gastric carcinoma is rare. The present case report describes a 61-year-old man with DLBCL at the ileocaecal junction with several metastatic lymph nodes and concurrent gastric intramucosal adenocarcinoma. Both tumours, together with the enlarged lymph nodes, were successfully removed by surgery. At 1 month postoperatively, the patient received chemotherapy consisting of rituximab, cyclophosphamide, vindesine, epirubicin hydrochloride and dexamethasone; he responded well to treatment. Reports published in the literature between January 2006 and March 2011 of other cases of DLBCL combined with concurrent non-haematological malignancies in immunocompetent patients were reviewed. The identification of common factors is important for clarification of the mechanisms of lymphomagenesis and carcinogenesis, as well as the creation of preventive and therapeutic strategies. Such cases highlight the need routinely to perform preoperative imaging studies to exclude other synchronous tumours and, if possible, to biopsy any such masses in order to offer timely and appropriate therapy.
Reduced Lymph Node Harvest after Neoadjuvant Chemotherapy in Gastric Cancer
Authors: Wu Z-M , Teng R-Y , Shen J-G , Xie S-D , Xu C-Y , Wang L-B
Published: February 2013

This retrospective study investigated the impact of neoadjuvant chemotherapy on the number of lymph nodes harvested in patients with T3/T4 gastric cancer. Lymph node counts in 58 patients who received preoperative neoadjuvant chemotherapy were compared with those in 168 patients who received surgery alone. Significantly more patients ( n = 14, 24.1%) treated with neoadjuvant chemotherapy had < 15 lymph nodes harvested compared with patients ( n = 13, 7.7%) treated with surgery alone. A significant correlation between the total number of harvested lymph nodes and the number of metastatic lymph nodes (mLNs) existed in both groups. Neoadjuvant chemotherapy was the only factor associated with the retrieval of < 15 lymph nodes. The number of mLNs was an independent predictive factor for overall survival. Although neoadjuvant chemotherapy decreased the number of lymph nodes harvested, the number of mLNs may still be an acceptable prognostic factor in patients with gastric cancer, following neoadjuvant chemotherapy.
Post-Transcriptional Regulation by MicroRNA-21 and let-7a MicroRNA in Paediatric Cholesteatoma
Authors: Chen X , Qin Z
Published: February 2013

This study investigated the role of microRNA-21 (miR-21) and let-7a microRNA in paediatric and adult cholesteatoma. Total RNA and protein were isolated from the cholesteatoma specimens and normal skin of 10 adults and 10 children. Levels of miR-21 and let-7a microRNA were assessed by real-time reverse transcription-polymerase chain reaction, and levels of phosphatase and tensin homologue (PTEN), programmed cell death 4 (PDCD4) and high mobility group AT-hook 2 (HMGA2) protein were assessed by Western blot analysis. Levels of miR-21 and let-7a microRNA were significantly higher in cholesteatoma tissue compared with normal skin, especially in paediatric patients. PTEN, PDCD4 and HMGA2 protein levels were significantly lower in paediatric versus adult cholesteatoma patients. It is possible that upregulation of miR-21 leads to higher tumour cell proliferation and invasion of cholesteatoma in children than adults, and the benign nature of cholesteatoma may be due to a balance between let-7a microRNA and miR-21. These data may help to identify targets for miRNA- and protein-based therapeutic interventions for the non-surgical or adjunctive treatment of cholesteatoma.
Angiotensin-(1–7) Inhibits Vascular Remodelling in Rat Jugular Vein Grafts via Reduced ERK1/2 and p38 MAPK Activity
Authors: Wu J-G , Tang H , Liu Z-J , Ma Z-F , Tang A-L , Zhang X-J , Gao X-R , Ma H
Published: February 2013

This study evaluated the effect of angiotensin (Ang)-(1–7) on vascular remodelling in a rat autologous jugular vein graft model in which rats underwent autologous jugular vein graft transplantation (Ang-[1–7] and control groups) or sham surgery (sham group). The animals received continuous jugular infusion of Ang-(1–7) at 25 μg/kg per h (Ang-[1–7] group) or normal saline (control and sham groups) starting 3 days after surgery. Ang-(1–7) infusion reduced venous graft hyperplasia, vascular remodelling, extracellular signal-regulated kinase 1/2 (ERK1/2) activation, p38 mitogen-activated protein kinase (MAPK) activation and levels of proliferating cell nuclear antigen and α-smooth muscle actin compared with control animals. The vascular tissue Ang II level was higher in Ang-(1–7) and control rats than in sham animals. These findings suggest that Ang-(1–7) acts by inhibiting the activation of ERK1/2 and p38 MAPK in vascular tissue. The use of exogenous Ang-(1–7) could improve the outcome of vein grafting through the attenuation of vascular remodelling.
Clinical Outcome of Patients Treated with an Early Invasive Strategy after Out-of-Hospital Cardiac Arrest
Authors: Möllmann H , Szardien S , Liebetrau C , Elsässer A , Rixe J , Rolf A , Nef H , Weber M , Hamm C
Published: February 2013

Little is known about the impact of early invasive treatment in patients following out-of-hospital cardiac arrest (OHCA). The present study investigated the clinical characteristics and long-term prognosis of 1254 patients with suspected acute coronary syndrome, including 65 with OHCA who underwent successful cardiopulmonary resuscitation (CPR) and 1189 patients who did not require CRP. All patients underwent immediate coronary angiography even if clear signs of myocardial infarction (MI) were absent. The incidence of ST-elevation and non-ST-elevation MI did not differ between the two groups. Cardiac biomarkers were significantly higher in CPR patients despite a shorter period from symptom onset to admission. The 6-month mortality rate was 29% in the CPR group and 4% in the non-CPR group, with > 90% of fatalities occurring ≤ 3 weeks after admission. In summary, early invasive treatment leads to a considerably reduced mortality and improved prognosis in patients after OHCA.
The Association between Left Ventricular Diastolic Function and a Mild-to-Moderate Decrease in Glomerular Filtration Rate in Patients with Type 2 Diabetes Mellitus
Authors: Pecková M , Charvat J , Schuck O , Hill M , Svab P , Horackova M
Published: February 2013

This prospective study evaluated the relationship between echocardiography parameters of left ventricular (LV) diastolic function and mild-to-moderate renal function impairment in 82 patients with type 2 diabetes mellitus. The mean age of the patients was 61.1 years. A significant correlation was found between estimated glomerular filtration rate (eGFR) and the ratio of peak velocity of early transmitral flow (E) to peak velocity of early diastolic mitral annular motion (E′). Cluster analysis revealed two subgroups of patients with different E′ values but comparable eGFRs. The correlation between eGFR and E/E′ was significant in 38 patients with E′ ≤ 7.1 cm/s, but not significant in 44 patients with E′ > 7.1 cm/s. The results suggest that the deterioration of LV relaxation (E′) represents the underlying condition for the association between mild-to-moderate renal function impairment and the non-invasive parameter of LV end-diastolic pressure (E/E′), in patients with type 2 diabetes without any previous cardiovascular event and with well-controlled blood pressure.
Gemcitabine Adsorbed onto Carbon Particles Increases Drug Concentrations at the Injection Site and in the Regional Lymph Nodes in an Animal Experiment and a Clinical Study
Authors: Guo F , Mao X , Wang J , Luo F , Wang Z
Published: February 2013

This study investigated whether gemcitabine, adsorbed onto activated carbon particles (GEM-AC), increased the concentration of gemcitabine at the injection site and in the regional lymph nodes in an experimental animal model and a clinical study. The adsorption isotherm for GEM-AC was defined, and the concentration and distribution of gemcitabine in rats ( n = 50) and in patients with pancreatic cancer ( n = 8) was investigated. Drug concentrations in plasma, tumour samples, lymph nodes and at the injection site were measured after GEM-AC or gemcitabine solution (GEM-Sol) were subcutaneously injected into the left hind foot pad in rats, or into pancreatic tumours in patients. These experiments showed that GEM-AC was selectively delivered to the regional lymph nodes and the injection site, from which it slowly released greater amounts of gemcitabine to maintain the free concentration of gemcitabine at a relatively high level for a long period of time. The administration of GEM-AC might enhance the anticancer effects of gemcitabine.
Obstructive Sleep Apnoea and Its Association with Left Ventricular Function and Aortic Root Parameters in Newly Diagnosed, Untreated Patients: A Prospective Study
Authors: Cicek D , Lakadamyali H , Yağbasan BD , Sapmaz İ , Müderrisoğlu H
Published: February 2013

This prospective study investigated whether untreated obstructive sleep apnoea-hypopnoea syndrome (OSAHS), which is strongly associated with cardiovascular disease, is a risk factor for left ventricular (LV) systolic and diastolic dysfunction and aortic root dilatation. Ninety consecutive patients with breathing and snoring problems, including 64 with newly diagnosed, untreated OSAHS, were classified into four groups based on their apnoea-hypopnoea index (AHI). All participants underwent overnight polysomnographic and complete echocardiographic examinations, and LV systolic, diastolic and aortic measurements were compared. Body mass index was the only demographic characteristic that significantly increased as the severity of OSAHS (AHI) increased and it significantly correlated with AHI. Patients with a higher AHI had a significantly higher aortic root diameter and aortic stiffness index, and significantly lower aortic strain. The LV diastolic parameters were least favourable in patients with more severe OSAHS. The LV ejection fraction did not differ significantly between groups. It was concluded that LV diastolic function and aortic elastic parameters deteriorate with OSAHS.
The Effect of Ketamine with Remifentanil for Improving the Quality of Anaesthesia and Recovery in Paediatric Patients Undergoing Middle-Ear Ventilation Tube Insertion
Authors: Lee J-A , Jeon Y-S , Noh H-I , Choi J-W , In J-H , Kim Y-M , Joo J-D
Published: February 2013

This prospective randomized study evaluated the effects of ketamine with remifentanil to improve the quality of anaesthesia and postoperative recovery, following brief procedures, in 60 paediatric patients undergoing middle-ear ventilation tube insertion (MEVTI). Patients were randomly assigned to either ketamine 2 mg/kg intravenous [i.v.] bolus plus normal saline by i.v. infusion (K group, n = 30) or ketamine 2 mg/kg i.v. bolus, plus remifentanil 0.15 μg/kg per min i.v. infusion (KR group, n = 30). Parameters that were assessed included intraoperative patient movement, surgeon satisfaction, anaesthesia time, total ketamine dose, postoperative recovery time, agitation and side-effects. Intraoperative patient movement scores were significantly lower, and surgeon satisfaction scores were significantly higher, in the KR group than in the K group. Time to recovery was significantly shorter in the KR group than in the K group. In conclusion, remifentanil was a good adjuvant to ketamine, improving the quality of anaesthesia and postoperative recovery in children undergoing MEVTI.
Characteristics of Infradian and Circadian Rhythms in the Persistent Vegetative State
Authors: Guan J , You C , Liu Y , Liu Y , Zhang R , Wang Z
Published: February 2013

This retrospective study investigated the circadian and infradian characteristics of blood pressure and heart rate in 26 patients with traumatic head injury in a persistent vegetative state (PVS). Systolic and diastolic blood pressures and heart rate were measured every hour for the first 240 h (10 days) following hospital admission. These data were analysed for the presence of circadian and infradian rhythms using the least-squares fit of the cosine function with the single cosinor method. Infradian rhythms were defined as biological rhythms with a period of approximately 7 days (circaseptan rhythms). All the patients studied had circadian and circaseptan rhythms of systolic and diastolic blood pressures and heart rate. The amplitudes of all the circaseptan rhythms were significantly greater than those of the corresponding circadian rhythms. It was concluded that there was an altered association between circadian and infradian blood pressure and heart rate rhythms in patients in a PVS. Circadian and infradian rhythms were present, but the infradian rhythm had a greater amplitude than the circadian rhythm.
Long-Term, High Intake of Vitamin C Decreases Size and Increases Quantity of Liver Mitochondria in Guinea-Pigs
Authors: Feuring M , Schultz A , Hersemeyer K
Published: February 2013

Microsomal cytochrome P450 is an important enzyme involved in drug metabolism and bioactivation in the liver. In guinea-pigs, the specific amount of cytochrome P450 depends on dietary vitamin C intake. Short-term vitamin C treatment can induce non-genomic effects on hepatocytes, such as activating mitochondrial respiration without changing cytochrome concentration. The aim of this investigation was to elucidate the long-term effects of a low or high vitamin C diet on the quantity and size of mitochondria in the hepatocytes of guinea-pigs. After 6 – 8 weeks of vitamin C feeding, the group receiving a low vitamin C content in their food (10 mg/100 g food) had significantly less mitochondria, but of a larger size, than the group receiving a high vitamin C content (680 mg/100 g food). This animal model investigation demonstrated that treatment with long-term vitamin C can induce morphological changes in the mitochondria of hepatocytes.
Immediate Repair Compared with Delayed Repair of Congenital Omphalocele: Short-Term Neonatal Outcomes in China
Authors: Na Q , Liu C , Cui H , Zhang Z , Yin S , Li Q
Published: February 2013

This prospective study evaluated the short-term outcomes of 16 neonates undergoing single congenital omphalocele repair. Parents made informed choices for their baby to receive either immediate repair (IR group, n = 8) or repair ≥ 3 h after delivery (control group, n = 8). All babies were delivered by elective caesarian section. Babies in the two groups were matched one-to-one according to their birth weight, bulging volume and gestational age. Short-term outcomes included the incidence of infection and the lengths of stay in the neonatal intensive care unit (NICU) and in the hospital. Compared with the control group, the IR group showed a significantly lower incidence of infection, shorter surgical duration, shorter NICU stay, less time on total parenteral nutrition, less time to total enteral nutrition and shorter length of hospital stay. Immediate repair significantly improved the short-term neonatal outcomes of congenital omphalocele in China.
Nodule or Pseudonodule? Differentiation in Hashimoto's Thyroiditis with Sonoelastography
Authors: Yildirim D , Gurses B , Gurpinar B , Ekci B , Colakoglu B , Kaur A
Published: February 2013

Fine needle aspiration biopsy (FNAB) is the gold standard for the diagnosis of lymphoma in Hashimoto's thyroiditis and is able to differentiate between benign, inflammatory or malignant nodules, classifying them as either true nodules or pseudonodules. This technique is, however, invasive. The present study aimed to differentiate pseudonodules from true nodules by sonoelastography, a noninvasive technique, in 54 patients with Hashimoto's thyroiditis. The accuracy of sonoelastography to differentiate between true or pseudonodules was compared with the gold standard FNAB and with grey scale ultrasonography. The nodules were categorized into three groups: non-demarcated hypoechogenic, demarcated hyperechogenic, and demarcated hypoechogenic. Sonoelastography findings were concordant with the cytopathological results and demonstrated that sonoelastography was able to detect true thyroid nodules often misdiagnosed by conventional grey scale ultrasonography. Sonoelastography was found to have increased sensitivity for true nodule diagnosis compared with conventional grey scale ultrasonography and may eliminate unnecessary FNABs being carried out.
N-Acetylcysteine Ameliorates γ-Radiation-Induced Deterioration of Bone Quality in the Rat Femur
Authors: Demirel C , Kilciksiz S , Gurgul S , Erdal N , Yildiz A
Published: February 2013

This animal study evaluated the radioprotective effects of N-acetylcysteine (NAC) and amifostine on the biomechanical properties of bone in Wistar albino rats of both genders. The rats were randomly divided into four groups of eight: A control group (C); a group given a single dose of 40 Gy of g-irradiation (R); a group given γ-irradiation plus 200 mg/kg amifostine (R + amifostine); and a group given γ-irradiation plus 1000 mg/kg NAC (R + NAC). Extrinsic and intrinsic properties of bone, bone mineral density (BMD) and the cross-sectional area of the femoral shaft were determined. The cross-sectional area was significantly higher in the R + NAC and R + amifostine groups compared with the R and C groups. The BMD, maximum load and stiffness were also significantly higher in the R + NAC and R + amifostine groups than in the R group, and energy absorption capacity was higher in the R + NAC group than in the R group. These findings indicate that NAC and amifostine preserve bone quality in rats exposed to γ-irradiation.
Cerebrospinal Fluid Levels of Soluble Amyloid Precursor Protein and β-Amyloid 42 in Patients with Multiple Sclerosis, Neuromyelitis Optica and Clinically Isolated Syndrome
Authors: Mai W , Hu X , Lu Z , Peng F , Wang Y
Published: February 2013

Amyloid precursor protein (APP) accumulation in axonal ovoids is a sensitive marker for acute axonal injury in multiple sclerosis (MS) lesions. This study measured levels of α-cleaved soluble APP (αsAPP) and β-amyloid 42 (Aβ42) in the cerebrospinal fluid (CSF) of 42 MS, 10 neuromyelitis optica and 25 clinically isolated syndrome patients and 21 healthy controls, and analysed the correlation between αsAPP and Aβ42 levels and relevant clinical parameters. The CSF concentrations of αsAPP and Aβ42 in patients and controls were not significantly different. There was a significant inverse correlation in patients between CSF asAPP concentration and the Expanded Disability Status Scale (EDSS), but no significant correlation between CSF Aβ42 concentration and EDSS. The concentration of αsAPP in the CSF of statin-treated patients was significantly higher than in those not treated with statins, suggesting that statins may have a neuroprotective effect. In conclusion, αsAPP was present at similar levels in the CSF of patients with neuromyelitis optica, MS and clinically isolated syndrome and healthy controls, and an inverse correlation existed between CSF αsAPP concentration and neurological disability.
The Relationship between Bioimpedance Analysis, Haemodynamic Parameters of Haemodialysis, Biochemical Parameters and Dry Weight
Authors: Çelik G , Kara I , Yilmaz M , Apiliogullari S
Published: February 2013

Adequate fluid management plays an important role in the treatment of haemodialysis patients and the assessment of dry weight is important for efficient therapy. Fluid volume parameters were assessed in adults undergoing haemodialysis for end-stage renal disease, using whole-body multifrequency bioimpedance analysis (BIA), and their relationship to haemodynamic and biochemical parameters of haemodialysis was evaluated. Ultrafiltration volume was correlated with age, sodium, haemoglobin, extracellular water (ECW)/total body water (TBW) ratio and ECW/intracellular water (ICW) ratio. The ECW/TBW ratio was correlated with age, body mass index, dry weight, predialysis systolic and diastolic blood pressure, and ECW/total body weight ratio. The ECW/ICW ratio correlated with age, dry weight, TBW, albumin, adequacy of dialysis and urea removal ratio. The study demonstrated a close relationship between bioimpedance-derived fluid volume parameters and the haemodynamic and biochemical parameters of haemodialysis. It is concluded that multifrequency whole-body BIA may have clinical value in the estimation of dry weight and other haemodynamic parameters of haemodialysis and so may protect patients from the risks associated with under- or over-hydration.
Targeted Drug Regulation on Methylation of p53—BAX Mitochondrial Apoptosis Pathway Affects the Growth of Cholangiocarcinoma Cells
Authors: Liu X-F , Jiang H , Zhang C-S , Yu S-P , Wang Z-Q , Su H-L
Published: February 2013

OBJECTIVE: To study the mechanism of 5-aza-2-deoxycytidine (DAC; a methylation inhibitor) on growth of the human cholangiocarcinoma QBC939 cell line. METHODS: A colourimetric assay was used to detect growth of QBC939 cells treated with DAC (0.1 – 100 μmol/l) over 24 h, 48 h and 72 h. Cell morphology was observed by transmission electron microscopy (TEM). The cell cycle and apoptosis were analysed by flow cytometry. Hypermethylation of the promoters of the p53–BAX mitochondrial apoptosis genes cyclin-dependent kinase inhibitor 2A ( CDKN2A), death-associated protein kinase 1 ( DAPK1) and PYD and CARD domain containing ( PYCARD) was detected by methylation-specific polymerase chain reaction, with and without DAC treatment. RESULTS: DAC inhibited QBC939 cell growth with a half maximal inhibitory concentration of 5 μmol/l at 72 h. After DAC treatment, apoptosis was observed by TEM. Flow cytometric analysis of propidium iodide-positive cells demonstrated increased apoptosis of DAC-treated QBC939 cells (43.04%) compared with untreated cells (4.31%). DAC treatment resulted in demethylation of the gene promoters of CDKN2A and DAPK1 in QBC939 cells. CONCLUSIONS: DAC induces apoptosis of QBC939 cells by reactivation of hypermethylated p53–BAX mitchondrial apoptosis genes in cholangiocarcinoma cells.
Noninvasive Evaluation of Cerebral Glioma Grade by Using Diffusion-Weighted Imaging-Guided Single-Voxel Proton Magnetic Resonance Spectroscopy
Authors: Liu Z-L , Zhou Q , Zeng Q-S , Li C-F , Zhang K
Published: February 2013

OBJECTIVE: To investigate the usefulness of diffusion-weighted imaging (DWI)-guided, single-voxel proton magnetic resonance spectroscopy (SVS) for preoperative evaluation of cerebral glioma grade. METHODS: For SVS, placement of volume-of-interest was guided by the minimal apparent diffusion coefficient value obtained from DWI. Spectral data for N-acetylaspartate (NAA), choline (Cho), and phosphocreatine (Cr) were analysed in 33 patients with primary gliomas. RESULTS: Cho/Cr and Cho/NAA ratios were significantly higher in high-grade than in low-grade gliomas; NAA/Cr ratios were significantly lower in high-grade than in low-grade gliomas. Receiver operating characteristic curve analysis demonstrated a threshold value of 2.01 for Cho/Cr for sensitivity, specificity, positive predictive and negative predictive values of 86.36%, 90.00%, 95.00% and 75.00%, respectively. Threshold values of 2.49 and 0.97 were obtained for Cho/NAA and NAA/Cr, respectively. Despite no significant difference in diagnostic accuracy between the metabolite ratios, diagnostic accuracy using the Cho/Cr ratio was slightly better than that of Cho/NAA or NAA/Cr. CONCLUSION: DWI-guided SVS has potential value for the preoperative prediction of glioma grade.
Association between Cardiac Function and Pulmonary Function in Hypertensive Patients
Authors: Masugata H , Senda S , Okada H , Murao K , Inukai M , Himoto T , Hosomi N , Murakami K , Noma T , Kohno M , Goda F
Published: February 2013

OBJECTIVE: This study examined the association between cardiac function and pulmonary function in hypertensive patients. METHODS: Hypertensive patients without overt cardiovascular disease were enrolled ( n = 43; mean ± SD age 71 ± 9 years). Pulmonary function was measured by the percentage of predicted forced vital capacity (%FVC) and the ratio of 1 s forced expiratory volume (FEV1) to FVC (FEV1/FVC ratio). Left ventricular ejection fraction (LVEF) and the ratio of peak early diastolic transmitral flow (E) to peak early diastolic mitral annular velocity (e′) (E/e′ ratio) were assessed using echocardiography. RESULTS: Multiple linear regression analysis revealed that E/e′ was independently associated with %FVC and that LVEF was independently associated with FEV1/FVC ratio. Both LVEF and FEV1/FVC ratio were significantly lower in hypertensive former or current smokers than in hypertensive never smokers. CONCLUSIONS: Subclinical cardiac dysfunction was independently associated with reduced pulmonary function in hypertensive patients. Hypertensive patients with decreased pulmonary function may need preventive care to prevent the progression of heart failure.
Diffusion Tensor Imaging for Predicting Hand Motor Outcome in Chronic Stroke Patients
Authors: Song F , Zhang F , Yin D-Z , Hu Y-S , Fan M-X , Ni H-H , Nan X-L , Cui X , Zhou C-X , Huang C-S , Zhao Q , Ma L-H , Xu Y-M , Xia Q-J
Published: February 2013

OBJECTIVE: Previous studies have indicated that diffusion tensor imaging (DTI) values are related to clinical outcome in stroke patients. This prospective study explored whether DTI values were predictive for hand function outcome in chronic stroke patients. METHODS: The DTI parameters (rλ1, rλ23, fractional anisotropy [rFA] and mean diffusivity [rMD]) were investigated in patients with completely paralysed hands (CPH; n = 10) or partially paralysed hands (PPH; n = 10), by two methods of analysis: segment of the corticospinal tract [sCST] analysis; pure region of interest [ROI] analysis. Spearman's correlation coefficient was used to assess the correlation between the DTI parameters and the following clinical measures: Fugl—Meyer Assessment [FMA]; National Institutes of Health Stroke Scale [NIHSS]. RESULTS: Significant differences were found between CPH and PPH for rFA and rλ23 (sCST analysis) and for rMD and rλ23 (ROI analysis). The rλ23 (sCST analysis) correlated with the NIHSS; the rMD (sCST analysis) correlated with the FMA (hand). CONCLUSION: The three parameters, rFA, rλ23 and rMD may have predictive value for evaluating hand function outcome in chronic stroke patients.
Impact of a Resistant Dextrin on Intestinal Ecology: How Altering the Digestive Ecosystem with NUTRIOSE®, a Soluble Fibre with Prebiotic Properties, May Be Beneficial for Health
Authors: Lefranc-Millot C , Guérin-Deremaux L , Wils D , Neut C , Miller LE , Saniez-Degrave MH
Published: February 2013

OBJECTIVES: The prebiotic potential of NUTRIOSE® – a sugar-free, digestion-resistant dextrin — was evaluated in two randomized, placebo-controlled trials that included 48 and 40 healthy volunteers, respectively. METHODS: In study 1, the effect on colonic bacteria of NUTRIOSE® 10, 15 or 20 g/day administered for 14 days was examined; in study 2, gut microbial changes in response to NUTRIOSE® 8 g/day for 14 days were monitored using real-time polymerase chain reaction analysis. RESULTS: NUTRIOSE® increased proliferation of Bacteroides and inhibited Clostridum perfringens in both studies, increased β-glucosidase activity (at 10 and 15 g/day) and decreased colonic pH (at 20 g/day). The increase in short-chain fatty acid production with NUTRIOSE® consumption was not statistically significant. There were no indications of gastrointestinal intolerance at any dose. CONCLUSIONS: According to commonly accepted definitions, NUTRIOSE® is a prebiotic soluble fibre that provides a beneficial effect on colonic ecology while preserving digestive comfort.
Perioperative Assessment of Terlipressin Infusion during Living Donor Liver Transplantation
Authors: Hong SH , Lee JM , Choi JH , Chung HS , Park JH , Park CS
Published: February 2013

OBJECTIVE: To investigate the safety and efficacy of infusion of terlipressin during living donor liver transplantation (LDLT). METHODS: Patients undergoing LDLT with low systemic vascular resistance index (SVRI) and pulmonary vascular resistance index (PVRI) ( n = 41) were randomly allocated into control ( n = 20) and terlipressin groups ( n = 21). Terlipressin was infused at 1.0 – 4.0 μg/kg per h in the terlipressin group during surgery. Controls received generally accepted inotropic and vasopressor agents. RESULTS: Terlipressin infusion induced significantly higher SVRI and PVRI at 60 min after drug infusion, produced significantly greater hourly urine output during the anhepatic phase, and was related to significantly shorter stays in the postoperative intensive care unit (ICU) compared with control treatment (mean ± SD ICU stay 5.7 ± 1.5 versus 6.9 ± 1.5 days, respectively). Patients given a terlipressin infusion > 2.0 μg/kg per h during the preanhepatic phase had a median ICU stay of < 6 days (sensitivity 90.0%; specificity 89.0%). CONCLUSIONS: Terlipressin infusion improved low SVRI and PVRI during LDLT and may have contributed to better renal function and shorter ICU stays.
Alleviation of Ferric Chloride-Induced Seizures and Retarded Behaviour in Epileptic Rats by Cortical Electrical Stimulation Treatment
Authors: Wang C , Wu H , He F , Jing X , Liang Q , Heng G , Wang L , Gao G , Zhang H
Published: February 2013

OBJECTIVE: To study the effects of low-frequency cortical electrical stimulation (CES) on seizures and behaviour in a rat model of epilepsy induced by ferric chloride (FeCl3). METHODS: Rats were randomly assigned into four groups ( n = 8 per group): normal healthy rats; saline-treated control rats; FeCl3-induced epileptic rats; CES-treated FeCl3-induced epileptic rats. Behavioural tests, analysis of the levels of brain-derived neurotrophic factor (BDNF) protein in brain tissue, and ultrastructural studies using transmission electron microscopy (TEM) were undertaken. RESULTS: CES significantly decreased the number and grade of seizures, and improved rat behaviour, compared with untreated epileptic rats. CES reduced levels of BDNF protein in the forebrain and increased levels of BDNF protein in the hippocampus compared with untreated epileptic rats. TEM showed less damage and ultrastructural changes in the neurons of CES-treated epileptic rats. CONCLUSIONS: CES inhibited seizures in FeCl3-induced epileptic rats and improved their behaviour. These effects might be mediated by altering BDNF protein levels in the brain.
Aspirin Resistance: Clinical Significance and Genetic Polymorphism
Authors: Xu Z-H , Jiao J-R , Yang R , Luo B-Y , Wang X-F , Wu F
Published: February 2013

OBJECTIVE: To determine the prevalence, clinical implications and underlying mechanism of aspirin resistance in Chinese patients. METHODS: Platelet aggregation was determined by light transmission aggregometry (LTA) using four different inducers. Patients were divided into aspirin-resistant (AR), aspirin semi responder (ASR) and aspirin-sensitive (AS) groups, according to their LTA results. Aspirin resistance was assessed by thromboelastography (TEG, with arachidonic acid [AA] or adenosine diphosphate as inducers), serum/urinary 11-dehydrothromboxane B2 (11-DH-TXB2) assay, platelet function analyser-100 assay and P-selectin assay. Polymorphisms in the prostaglandin endoperoxide synthase 1 ( PTGS1) gene (A842G, C50T, C22T, G128A, C644A and C714A), the PTGS2 gene (G765C) and the integrin β3 ( ITGB3) gene (C196T) were examined. RESULTS: The study included 360 aspirin-treated patients and 314 healthy controls. AS patients had significantly lower levels of 11-DH-TXB2 than AR and ASR patients, and significantly lower levels of P-selectin than AR patients. TEG-AA was more sensitive, specific and consistent than P-selectin in detecting aspirin resistance. The frequency of the PTGS2 G765C mutation was significantly higher in the AR/ASR groups versus the AS group. CONCLUSIONS: TEG-AA was more sensitive, specific and consistent than the P-selectin assay for detecting aspirin resistance, and the PTGS2 G765C mutation may be related to aspirin resistance.
Evaluation of Biventricular Myocardial Performance Index in Patients with Behçet's Disease
Authors: Cobankara V , Guclu A , Kuru O , Senel S , Kuru DS , Evrengul H , Kaya A
Published: February 2013

OBJECTIVE: The global function of both left ventricular (LV) and right ventricular (RV) functions were compared in patients with Behçet's disease (BD) versus healthy controls. METHODS: Biventricular function was evaluated by measurement of the myocardial performance index (MPI) evaluated from tissue Doppler echo-cardiographic measurements in 24 BD patients and was compared with measurements in 24 age- and sex-matched healthy controls. RESULTS: Significantly higher MPI values were associated with ventricular dysfunction. The study demonstrated impaired RV function in patients with BD compared with healthy controls, whereas normal LV function was observed both in patients with BD and in healthy controls. CONCLUSION: Early noninvasive evaluation of the properties of BD during the asymptomatic phase of this inflammatory disease may have prognostic value in the management of patients.
Correlation between Thyroid Nodule Calcification Morphology on Ultrasound and Thyroid Carcinoma
Authors: Shi C , Li S , Shi T , Liu B , Ding C , Qin H
Published: February 2013

OBJECTIVE: This study investigated the detection of thyroid nodule calcifications on ultrasound and their relationship to thyroid carcinoma. METHODS: Microcalcifications (≤ 2 mm) and macrocalcifications (> 2 mm) on preoperative ultrasound examination of thyroid and lymph nodes were compared with postoperative pathological diagnoses in 4186 patients undergoing thyroid surgery. RESULTS: Higher incidences of micro- and macrocalcifications were found in patients with thyroid carcinoma than in those with benign disease. The incidence of malignant disease was significantly higher in patients with microcalcifications than those with macrocalcifications, suggesting that the presence of microcalcifications is a better predictor of malignant thyroid carcinoma than other calcification types. The specificity of microcalcifications for a diagnosis of malignant thyroid carcinoma was 96.5%. Microcalcifications were significantly more frequent in patients aged ≤ 45 years, but there was no difference between genders. The incidence of malignancy was significantly higher in patients with single nodule calcifications than in those with multiple nodule calcifications. Lymph node calcifications were seen in 12 patients, all of whom had papillary carcinoma. CONCLUSIONS: Thyroid microcalcifications are strongly associated with thyroid carcinoma, especially micropapillary carcinoma. When cervical lymph node calcification is present, immediate surgery is required.
Prognostic Value of a Mitochondrial Functional Score in Prostate Cancer
Authors: Sun X , Liao N-K , Yu J-J
Published: February 2013

OBJECTIVE: To evaluate the utility of a mitochondrial functional score in predicting the progress of prostate cancer. METHODS: This retrospective study included 72 patients (mean age 70.1 years) with prostate cancer who were treated by radical prostatectomy between October 2006 and March 2007. The epithelioglandular mitochondrial functional scores were assessed according to the Flameng grading. Patients were divided into six groups (groups 1 – 6) according to their Gleason score (Gleason score 2 – 7, respectively). The correlation between Gleason score and mitochondrial functional score was examined using Pearson's correlation coefficient. RESULTS: The mean mitochondrial functional score was significantly lower in group 6 compared with group 1. An inverse correlation was found between the Gleason and mitochondrial functional scores. At 1 year, significantly fewer patients in group 1 had died (0/15 patients) than in group 6 (2/10 patients); the deaths were cancer-related. CONCLUSIONS: Mitochondrial dysfunction exists in patients with prostate cancer, particularly in cases with a higher degree of malignancy. The mitochondrial functional score, combined with the Gleason score, is beneficial for predicting the progress of prostate cancer.
HLA-B*1502 Allele is Associated with a Cross-Reactivity Pattern of Cutaneous Adverse Reactions to Antiepileptic Drugs
Authors: Wang J , Zhang J , Wu X , Yu P , Hong Z
Published: February 2013

The US Food and Drug Administration has recommended genetic screening for the human leucocyte antigen-B ( HLA-B)* 1502 allele in patients of Asian ethnicity before starting carbamazepine therapy, to avoid the fatal adverse treatment-related events associated with this drug. The association between cross-reactivity to antiepileptic drugs (AEDs) and the HLA-B*1502 allele has been only rarely reported. Here, two cases of cross-reactivity to AEDs, where cutaneous adverse drug reactions (cADRs) developed in female Han Chinese patients with epilepsy who tested positive for the HLA-B*1502 allele, are described. If the genetic association could be confirmed in larger studies, the HLA-B*1502 allele should be tested for in any patient experiencing cADRs, to avoid cross-reactivity to AEDs.
Wegener's Granulomatosis with Pulmonary Fungal Infection: A Case Report and Brief Review
Authors: He Y , Liu J , Gao B
Published: February 2013

Wegener's granulomatosis (WG) is an autoimmune, necrotizing granulomatous disease of unknown aetiology that affects small and medium blood vessels, and is usually recurrent. Infection is the most frequent cause of death in patients with WG. A case of WG with pulmonary fungal infection in a 50-year-old man is reported. The patient was hospitalized following a 2-month history of haemoptysis and a 1-month history of intermittent fever. Examination and pathology results confirmed a diagnosis of WG with associated pulmonary fungal infection. The patient's condition was complicated by a septic pneumothorax and sinus formation after lung biopsy, and preexisting diabetes and hypertension, which worsened rapidly due to his critical condition. He was treated with glucocorticoids and cyclophosphamide therapy with the goal of controlling these complications, and had no recurrence within the 4-year follow-up period. This case demonstrated the utility of combined glucocorticoid and cyclophosphamide therapy for the treatment of infection in WG.
Imprisonment-Associated Sperm Clumping and Male Infertility
Authors: Al-Joudi FS , Jamil JAK
Published: February 2013

OBJECTIVE: This observational, retrospective study investigated infertility among Iraqi men who had been long-term prisoners of war. METHODS: Routine seminal fluid analyses were undertaken in former prisoners with suspected infertility attending the Ramadi Infertility Clinic, Ramadi, Iraq; semen samples were also microscopically evaluated in these patients. RESULTS: In 16 out of 38 patients (42%), male infertility was found to be associated with the formation of unusually large clumps of sperm. These sperm clumps contained large numbers of sperm; clumping led to sperm immobilization and infertility. CONCLUSIONS: The causes of sperm clumping are unclear. It is possible that the sperm clumping observed in the present study might be a result of developmental defects, possibly related to stress or other undiscovered factors, although this requires further investigation.
Surgery is an Effective and Reasonable Treatment for Degenerative Scoliosis: A Systematic Review
Authors: Liang C-Z , Li F-C , Li H , Tao Y , Zhou X , Chen Q-X
Published: February 2013

OBJECTIVE: A systematic review to evaluate the role of surgery for treating degenerative scoliosis (DS) in terms of improved function (Oswestry Disability Index [ODI]) and correction of deformity (Cobb angle); safety outcomes included complication and repeat surgery rates. METHODS: A search of the MEDLINE, ISI Web of Knowledge and Cochrane Library databases was performed. The methodological quality of each study was assessed according to standardized criteria and data were extracted. RESULTS: A total of 16 studies including 553 patients with DS met the eligibility criteria for inclusion. The mean ODI score at final follow-up was 36.0 ± 7.8 (304 patients) and the mean decrease in ODI was 23.3 ± 11.3 (302 patients). Mean reduction in curve angle (as a percentage of the original curve) was 48.5 ± 21.0% (527 patients). The overall incidence of complications was 49.0% (171 in 349 patients) and the rate of repeat surgery was 15.3% (61 in 398 patients). CONCLUSIONS: Despite a high incidence of complications and reoperations, surgery was an effective and reasonable treatment for DS, providing significant functional improvement and deformity correction.
Kümmell's Disease, an Uncommon and Complicated Spinal Disorder: A Review
Authors: Li H , Liang C-Z , Chen Q-X
Published: February 2013

Kümmell's disease is an uncommon and complicated spinal condition first described in 1891. Patients develop a kyphosis in the lower thoracolumbar spinal region months to years after sustaining an otherwise asymptomatic minor spinal trauma. The pathophysiology, clinical presentation, imaging and treatment options of this disease remain controversial. The most widely accepted hypothetical pathophysiology is avascular osteonecrosis. The intravertebral vacuum cleft phenomenon is considered a radiographic sign of avascular osteonecrosis of the vertebral body and is highly suggestive of Kümmell's disease. Treatment options include nonsurgical and surgical treatment, and percutaneous vertebral augmentation. The primary aims of surgical treatment of Kümmell's disease are neural decompression and stabilization of the spinal column. Surgery can involve an anterior, posterior, or combined anterior and posterior approach. Surgery and percutaneous vertebral augmentation provide significant symptomatic relief, functional improvement and deformity correction. Treatment of this disease must be individualized according to the stage of disease and the experience and preference of the surgeon.