bluuebunny/crossref_metadata_2025 huggingface dataset:
Prognostic significance of metastatic lymph nodes ratio in patients with gastric adenocarcinoma after curative gastrectomy
Authors: Zhang Meiling , Wang Jian , Shi Wei , Chen Wenjiao , Li Wei , Shu Yongqian , Liu Ping , Lu Kaihua
Published: January 2024

Background

We evaluated the impact of the number of metastatic lymph nodes and the metastatic lymph nodes ratio (the ratio between metastatic lymph nodes and total dissected lymph nodes, MLNR) in patients with gastric adenocarcinoma following curative gastrectomy and also analyzed the relationship between the number of removed lymph nodes and prognosis in node-negative gastric cancer.

Methods

From January 2005 to December 2010, 1 390 patients who were diagnosed with gastric adenocarcinoma and underwent curative gastrectomy were included. In particular, lymph node metastasis was not present in 515 patients. The number of metastatic lymph nodes and the metastatic lymph nodes ratio were selected for univariate and multivariate analyses to evaluate their influences on the disease outcome. The survival curve was presented according to the number of removed lymph nodes in node-negative gastric cancer using Kaplan-Meier plots.

Results

The overall 5-year survival rate was 54% in this group. Univariate analysis revealed that age category, macroscopic appearance, histological grade, tumor size, depth of primary tumor invasion, number of metastatic lymph nodes, metastatic lymph nodes ratio, tumor, nodes, metastasis-classification (TNM) stage and status of lymphovascular, and vessel invasion have significant impact on survival. The number of metastatic lymph nodes and the metastatic lymph nodes ratio both have significant impact on survival (P <0.001). However, in multivariate analyses, only the metastatic lymph nodes ratio was identified to be an independent prognostic factor (P <0.001). The number of removed lymph nodes in node-negative was a strong prognostic factor of survival, the more lymph nodes dissected, the better the survival.

Conclusions

The metastatic lymph nodes ratio has more significant prognostic value for survival in patients with gastric cancer following curative gastrectomy than the number of metastatic lymph nodes. The number of removed lymph nodes might be an important prognostic factor for gastric cancer without lymph node metastasis.
Re-epithelializaiton by epithelial inoculation with recipient phenotype in heterotopically transplanted rat allografts
Authors: Zheng Hui , Hu Xuefei , Li Chao , Xie Huikang , Gao Wen , Chen Chang
Published: January 2024

Background

Re-epithelialization has remained a major obstacle in both tracheal and lung transplantations. This study examines the realization of re-epithelialization by epithelial inoculation in a rat heterotopic tracheal transplantation model.

Methods

The original epithelia of tracheas from donor Wistar rats were removed and the tracheas were then inoculated with 106/ml in vitro cultured epithelial cells of the Spraque-Dawley (SD) rat phenotype. These allo-tracheas were then heterotopically transplanted into SD rats. After 28 days, the allo-trachea tissues were recovered and assessed for epithelial morphology and cellular differentiation using immunohistochemical analysis. An additional experimental group was used to compare the outcomes of re-epithelialization in immunosuppressed animals.

Results

Histological examination showed that allografts with epithelial inoculation maintained patent tracheal lumens, which were obliterated in controls. Recipient immunosuppression facilitated the formation of an integrated ciliated epithelial layer, further demonstrated by the presence of a dense cilia population, a well-developed plasma membrane, and readily recognizable intercellular junctions. Epithelial cellular differentiation markers such as cytokeratin 14 and 18, and cystic fibrosis transmembrane conductance regulator (CFTR) were all positive in allografts under immunosuppression.

Conclusion

Concurrent recipient-derived epithelial inoculation with immunosuppression can result in complete re-epithelialization with the recipient phenotype and suppress the luminal obliteration process in heterotopic transplantations.
Clinical and microbiological characterization of Clostridium difficile infection in a tertiary care hospital in Shanghai, China
Authors: Dong Danfeng , Peng Yibing , Zhang Lihua , Jiang Cen , Wang Xuefeng , Mao Enqiang
Published: January 2024

Background

Over the last decade, Clostridium difficile infection (CDI) has emerged as a significant nosocomial infection, yet little has been reported from China. This study aimed to characterize the clinical and microbiological features of CDI from a hospital in Shanghai.

Methods

Patients with CDI seen between December 2010 and March 2013 were included in this study, of which clinical data were retrospectively collected. The microbiological features of corresponding isolates were analyzed including genotype by multi-locus sequence typing (MLST), antimicrobial susceptibility, toxin production, sporulation capacity, biofilm formation, and motility.

Results

Ninety-four cases of CDI were included during this study period, 12 of whom were severe cases. By reviewing the clinical data, all patients were treated empirically with proton pump inhibitor or antibiotics or both, and they were distributed widely across various wards, most frequently to the digestive ward (28/94, 29.79%). Comparing the severe with mild cases, no significant differences were found in the basic epidemiological data or the microbiological features. Among the 94 isolates, 31 were toxin A-negative toxin B-positive all genotyped as ST37. They generated fewer toxins and spores, as well as similar amounts of biofilm and motility percentages, but exhibited highest drug resistance to cephalosporins, quinolones, macrolide-lincosamide and streptogramin (MLSB), and tetracycline.

Conclusions

No specific clinical genotype or microbiological features were found in severe cases; antimicrobial resistance could be the primary reason for epidemic strains leading to the dissemination and persistence of CDI.
Experimental study on new self and mutual-aiding occlusive dressing for wound
Authors: Liang Xiangdang , Chen Wen , Sun Geng , Liu Shiluan , Cai Hongfei , Zhou Lin
Published: January 2024

Background

Self and mutual-aiding occlusive dressing is a novel method to treat with the wounds in special circumstances. This study aims to prepare a new antimicrobial adhesive for the dressing and evaluate the application effects of the adhesive.

Methods

The main component of the new antimicrobial adhesive was 5% triclosan / cyanoacrylate (CA) antimicrobial adhesive. The adhesive was modified with carboxylic multi-walled carbon nanotubes (MWCNTs-COOH), multi-walled carbon nanotubes (MWCNTs), hydrophobic nano-silica, nitrile rubber, epoxy resin and polymethyl methacrylate (PMMA) respectively. The bond strength, toughness and viscosity of the modified adhesive in different concentrations were examined to select the optimal modifying material and the best ratio to prepare the new antimicrobial adhesive according to the results. After that, the antimicrobial property of the new antimicrobial adhesive was tested by filter paper method. At last, we disposed the injury models in rats using the new antimicrobial adhesive to examine the application effects.

Results

In individual tests, the bond strength modification performance of 0.064% MWCNTS-COOH is the best, the bond strength is (14.71±1.48) Mpa. 8% nano-silica shows the best toughness modification performance, the Tg is (1.10±0.24)°C. The viscosity modification performance of 8% nano-silica is the best, the viscosity is (15 536.68±28.4) cP. However, consolidating three test results, 6% nano-silica / antimicrobial adhesive has the balanced bond strength, toughness and viscosity. Its bond strength is (14.03±1.92) Mpa, the Tg is (3.60±0.68)°C, and the viscosity is (5 278.87±31.68) cP. The inhibition zone diameter of 6% nano-silica / antimicrobial adhesive and antimicrobial adhesive group in Day 5 is (28.61±0.91) mm versus (28.24±2.69) mm (P >0.05). In animal studies, both in blood routine test and pathological section, 6% nano-silica / antimicrobial adhesive group shows lower white blood cells count than gauze bandage group (P <0.05).

Conclusions

6% nano-silica has the optimal effect of bond strength modification, toughness modification and viscosity modification, and the antimicrobial adhesive modified with it has a good antimicrobial property (resistant staphylococcus aureus).
Postablation neutrophil/lymphocyte ratio correlates with arrhythmia recurrence after catheter ablation of lone atrial fibrillation
Authors: Guo Xueyuan , Zhang Sen , Yan Xianliang , Chen Yingwei , Yu Ronghui , Long Deyong , Sang Caihua , Du Xin , Dong Jianzeng , Ma Changsheng
Published: January 2024

Background

Neutrophil/lymphocyte ratio (NLR) has been proposed as a novel marker of systemic inflammation and oxidative stress. The objective of this study was to ascertain the relationship between levels of NLR and recurrence of lone atrial fibrillation (AF) after catheter ablation.

Methods

A total of 379 lone AF patients who underwent catheter ablation were enrolled in the study. The NLR before and after catheter ablation was determined. Cox regression analyses were used to estimate the relationship between NLR and the recurrence of lone AF.

Results

After a mean follow-up of (30.5±5.3) months, 124 (32.7%) patients had AF recurrences. The patients who developed AF recurrence had a higher postablation NLR (post-NLR) than patients with no recurrence (5.74±1.55 vs. 4.66±1.27,P<0.001). Multivariate Cox regression analysis revealed that post-NLR (hazard ratio (HR) 1.514, 95% confidence interval (CI) 1.364–1.680,P<0.001), left atrium diameter (HR1.035, 95%CI1.001–1.071,P=0.04) and body mass index (HR1.028, 95%CI1.002–1.054,P=0.03) were independent predictors of AF recurrence. Using a cut-off level of 5.15, post-NLR predicted AF recurrence with a sensitivity of 73% and specificity of 67%.

Conclusions

Our results indicate that an elevated post-NLR is associated with a high rate of lone AF recurrence. A simple measurement of NLR may help us to identify high-risk patients who need pharmacologic intervention to prevent recurrence.
Correlation between balloon release pressure and no-reflow in patients with acute myocardial infarction undergoing direct percutaneous coronary intervention
Authors: Wang Yanfei , Yao Min , Liu Haibo , Yang Yuejin , Xie Junmin , Jia Xinwei , Pan Huanjun , Wang Chunyan
Published: January 2024

Background

Balloon release pressure may increase the incidence of no reflow after direct percutaneous coronary intervention (PCI). This randomized controlled study was designed to analyze the correlation between balloon release pressure and no-reflow in patients with acute myocardial infarction (AMI) undergoing direct PCI.

Methods

There were 156 AMI patients who underwent PCI from January 1, 2010 to December 31, 2012, and were divided into two groups according to the stent inflation pressure: a conventional pressure group and a high pressure group. After PCI, angiography was conducted to assess the thrombolysis in myocardial infarction (TIMI) grade with related artery. Examinations were undertaken on all patients before and after the operation including cardiac enzymes, total cholesterol, low-density lipoprotein, blood glucose, homocysteine, â-thromboglobulin (β-TG), Hamilton depression scale (HAMD) and self-rating anxiety scale (SAS). After interventional therapy, the afore-mentioned parameters in both the conventional pressure group and high pressure group were again analyzed.

Results

The results showed that CK-MB, HAMD, SAS were significantly different (P<0.05) in all patients after PCI, especially the CK-MB in the high pressure group ((25.7±7.6) U/L vs. (76.7±11.8) U/L). CK-MB, HAMD, SAS, and β-TG were comparative before PCI but they were significantly changed (P<0.05) after intervention. No-reflow phenomenon occurred in 13 patients in the high pressure group, which was significantly higher than in the conventional pressure group (17.11% vs. 6.25%,P<0.05).

Conclusion

In stent implantation, using a pressure less than 1823.4 kPa balloon to release pressure may be the better choice to reduce the occurrence of no-reflow following direct PCI.
Research approaches to mass casualty incidents response: development from routine perspectives to complexity science
Authors: Weifeng Shen , Libing Jiang , Mao Zhang , Yuefeng Ma , Guanyu Jiang , Xiaojun He
Published: January 2024

Objective

To review the research methods of mass casualty incident (MCI) systematically and introduce the concept and characteristics of complexity science and artificial system, computational experiments and parallel execution (ACP) method.

Data sources

We searched PubMed, Web of Knowledge, China Wanfang and China Biology Medicine (CBM) databases for relevant studies. Searches were performed without year or language restrictions and used the combinations of the following key words: “mass casualty incident”, “MCI”, “research method”, “complexity science”, “ACP”, “approach”, “science”, “model”, “system” and “response”.

Study selection

Articles were searched using the above keywords and only those involving the research methods of mass casualty incident (MCI) were enrolled.

Results

Research methods of MCI have increased markedly over the past few decades. For now, dominating research methods of MCI are theory-based approach, empirical approach, evidence-based science, mathematical modeling and computer simulation, simulation experiment, experimental methods, scenario approach and complexity science.

Conclusions

This article provides an overview of the development of research methodology for MCI. The progresses of routine research approaches and complexity science are briefly presented in this paper. Furthermore, the authors conclude that the reductionism underlying the exact science is not suitable for MCI complex systems. And the only feasible alternative is complexity science. Finally, this summary is followed by a review that ACP method combining artificial systems, computational experiments and parallel execution provides a new idea to address researches for complex MCI.
Effect of continuous hypothermic machine perfusion transport system (AirdriveTM) on canine kidney preservation
Authors: Hu Xiaopeng , Xue Wenrui , Zhang Qiang , Wang Wei , Zhang Jiqing , Zhang Xiaodong
Published: January 2024

Background

Organ preservation keeps the quality of the organs under prolonged ischemia. Continuous machine perfusions are gaining an important position in clinical research and practice. The aim of this study was to evaluate the protective effect of continuous hypothermic machine perfusion transport system (AirdriveTM) on cold ischemic injury of canine kidney.

Methods

Ten kidneys of five healthy preserving canines were taken out after general anesthesia. Five kidneys were stored using common cold preservation (CCP group) by immersing it in the organ preservation solution, mixed with water and ice, and kept in a cold room at 4°C. The other five kidneys were stored using continuous machine perfusion preservation (CMP group) and were placed into the AirdriveTM continuous machine perfusion device at room temperature. The renal tissues were examined by histopathology, electron microscopy, and mitochondrial activity check at different time points.

Results

Histologic sections showed that the structures of the ten renal tissues were similar during the first 24 hours. After 48 hours, the CCP group showed more pronounced changes, as the renal tubular epithelial cells were more obvious than those in the glomeruli. Oxygen consumption rate of state III and IV respiration in the CCP group decreased after 12–48 hours and increased at 48 hours, respectively, when compared to the CMP group (P <0.05). Cortex respiratory control ratio and phosphorus oxygen ratio were significantly higher in the CMP group at 48 hours.

Conclusion

With prolonged storage time, the effect of continuous hypothermic machine perfusion transport system is better than that of common cold preservation on canine kidney.
Exploration of approaches to adjusting brand-name drug prices in Mainland of China: based on comparison and analysis of some brand-name drug prices of Mainland and Taiwan, China
Authors: Weng Geng , Han Sheng , Pu Run , Pan Wynn HT , Shi Luwen
Published: January 2024

Background

Under the circumstance of the New Medical Reform in Mainland of China, lowering drug prices has become an approach to relieving increase of medical expenses, and lowering brand-name medication price is a key strategy. This study, by comparing and analyzing brand-name medication prices between Mainland of China and Taiwan, explores how to adjust brand-name medication prices in Mainland of China in the consideration of the drug administrative strategies in Taiwan.

Methods

By selecting brand-name drug with generic name and dose types matched in Mainland and Taiwan, calculate the average unit price and standard deviation and test it with the paired t-test. In the mean time, drug administrative strategies between Mainland and Taiwan are also compared systematically.

Results

Among the 70 brand-name medications with generic names and matched dose types, 54 are at higher prices in Mainland of China than Taiwan, which is statistically significant in t-test. Also, among the 47 medications with all of matched generic names, dose types, and manufacturing enterprises, 38 are at higher prices in Mainland than Taiwan, and the gap is also statistically significant in t-test. In Mainland of China, brand-name medication took cost-plus pricing and price-based price adjustment, while in Taiwan, brand-name medication took internal and external reference pricing and market-based price adjustment.

Conclusions

Brand-name drug prices were higher in Mainland of China than in Taiwan. The adjustment strategies of drug prices are scientific in Taiwan and are worth reference by Mainland of China.
Retinoschisis and intravitreal ranibizumab treatment for myopic choroidal neovascularization
Authors: Huang Jianfeng , Chen Tong , Lu Yingyi , Long Li , Dai Hong
Published: January 2024

Background

Intravitreal ranibizumab injection is effecitve on treating myopic CNVs, but it could be a risk factor for developing more severe retinoschisis in eyes with preexisted retinoschisis and epiretinal membrane. This study aimed to explore the incidence and features of retinoschisis after intravitreal ranibizumab injection for myopic choroidal neovascularization.

Methods

Eighty-three eyes of 81 patients with choroidal neovascularization secondary to pathologic myopia were treated with intravitreal ranibizumab injection. The best corrected visual acuity and optical coherence tomography (OCT) images were recorded at baseline and every month thereafter. Central retina thickness and maximal retina thickness were measured. The subjects were divided into three groups. Eleven eyes that had retinoschisis and epiretinal membrane were in group 1, six eyes that had simple epiretinal membrane were in group 2, and 66 eyes that had neither retinoschisis nor epiretinal membrane were in group 3. Six contralateral eyes in group 1 which had retinoschisis and epiretinal membrane but were not treated with intravitreal ranibizumab injection were set as the control group.

Results

Seven of the 11 eyes in group 1 developed more severe retinoschisis, the mean maximal retinal thickness increased from (380.28±90.13) to (467.00±70.20) μm (P <0.05). The retinoschisis of all 6 eyes of the control group did not aggravate. Compared with the control group, the aggravation ratio of retinoschisis increased significantly (P <0.05). No new onset of retinoschisis took place in group 2 and group 3.

Conclusion

Intravitreal ranibizumab injection may be a risk factor for aggravation of retinoschisis in eyes with preexisted retinoschisis and epiretinal membrane.
Profile of pediatric glaucoma patients in Shanghai Eye, Ear, Nose and Throat Hospital
Authors: Yuan Fang , Qingqing Long , Wenyi Guo , Xinghuai Sun
Published: January 2024

Background

The extent of our knowledge of the epidemiology of pediatric glaucoma in China is limited. To better characterize the epidemiology of pediatric glaucoma in eastern China, we report the clinical profile, etiologies, and treatment modalities in patients <18 years of age in Shanghai Eye, Ear, Nose and Throat Hospital.

Methods

The medical records of patients presenting glaucoma between January 2003 and December 2010 were retrospectively reviewed. The demographic characteristics, the proportion of different glaucoma subtypes and surgical precedures were collected and analyzed.

Results

A total of 1 142 eyes of 734 pediatric patients (500 males) were included. Congenital glaucoma was the leading subtype, accounting for 47.55% of all patients. The ratio of boys to girls was 2.5:1. Patients with congenital glaucoma affecting both eyes accounted for 72.5% of all patients examined. Patients with primary juvenile glaucoma were the second most common group (n=125, 17.03%). Traumatic glaucoma was the third most common subtype (n=81, 11.03%). The type of surgery was related to the subtype of glaucoma.

Conclusions

Congenital glaucoma, primary juvenile glaucoma, and traumatic glaucoma are the most prevalent subtypes in pediatric glaucoma patients in Shanghai Eye, Ear, Nose and Throat Hospital. The characteristics of congenital glaucoma in China are similar to those in Western countries.
Comparison of two and three dimensional quantitative coronary angiography to intravascular ultrasound in the assessment of left main coronary artery bifurcation lesions
Authors: Kan Jing , Gao Xiaofei , Sandeep Kumar Gami , Xu Haimei , Zhao Yingying , Chen Shaoliang , Chen Feng
Published: January 2024

Background

Angiographic evaluation of left main coronary artery (LMCA) bifurcation lesions is often limited. two dimensional (2D) quantitative coronary angiography (QCA) with segmental analysis provides accuracy for quantification of the degree of stenosis in the main vessel and side branch ostium but can be affected by foreshortening and variable magnification. The accuracy of three dimensional (3D) QCA has recently developed to overcome 2D QCA limitations, however, accuracy and precision of 3D bifurcation QCA measurements in LMCA bifurcation lesions has not been established.

Methods

We investigated whether such 3D and 2D bifurcation QCA measurements differ in their accuracy in assessing significant LMCA bifurcation lesions defined by intravascular ultrasound (IVUS) as a minimum luminal area (MLA) <6 mm2of LMCA and MLA <4 mm2of proximal left anterior descending (LAD) and/or proximal left circumflex (LCX)

Results

LMCA bifurcation lesions were assessed in 44 patients undergoing elective percutaneous coronary intervention. From 2D QCA measurements, MLA correlated moderately with threshold intravascular ultrasound MLA for LMCA (r=0.81,P<0.000 1), LAD (r=0.54,P=0.000 1) and LCX (r=0.58,P<0.000 1). Severity of lesion as MLA by derived 3D QCA, correlated moderately with threshold intravascular ultrasound MLA for LMCA (r=0.84,P<0.000 1), LAD (r=0.53,P=0.000 2); LCX (r=0.66,P<0.000 1). Overall, the C statistics tended to be slightly higher for 3D QCA and 2D QCA measurements in LMCA segment compared with proximal LAD and LCX segments, and there were no significant predictive power of percent diameter stenosis and percent area stenosis on 3D QCA for LCX IVUS MLA <4 mm2 (percent diameter stenosis: area under curve 0.55, cutoff 23%, sensitivity 88%, specificity 37%,P=0.618 6; percent arer stenosis: area under curve 0.56, cutoff 41%, sensitivity 83%, specificity 38%,P=0.518 4, respectively).

Conclusions

The accuracy of 3D bifurcation QCA in detecting significant LMCA bifurcation lesions is limited, especially the proximal LCX ostium. When IVUS is not available or contraindicated, 3D QCA may assist in the evaluation of intermediate LMCA lesions with MLA.
Long-term follow-up for Shang Ring male circumcision
Authors: Cheng Yue , Wu Kerong , Yan Zejun , Yang Shuwei , Li Fang , Su Xinjun
Published: January 2024

Background

Shang Ring male circumcision (MC) is a safe surgery with good short-term effects. This retrospective study was performed to investigate the long-term result of patients who had undergone Shang Ring MC.

Methods

A total of 103 patients who underwent the surgery were recruited in the study. Before and after the surgery, a questionnaire inquiring sexual function and sexual satisfaction was filled up. Face-to-face interview was executed. Physical examination of the external genitals was performed and complications were evaluated.

Results

The median follow-up duration was 19.1 months (range from 9 to 28 months). The mean width of penile mucosa was (9.3±2.5) mm. The mean width of scar was (3.7±1.6) mm. No tender pain was found in participants when palpating the penis. No significant or functional complication was observed except of mucosa asymmetry in one case and scar hyperplasia in two cases. The postoperative sexual function did not differ from the preoperative one, although partners showed better satisfaction toward sexual life.

Conclusion

Shang Ring MC represents a good long-term cosmetic result with no significant complication or adverse effects on sexual function.
Age, estimated glomerular filtration rate and ejection fraction score predicts contrast-induced acute kidney injury in patients with diabetes and chronic kidney disease: insight from the TRACK-D study
Authors: Li Jing , Li Yi , Wang Xiaozeng , Yang Shuguang , Gao Chuanyu , Zhang Zheng , Yang Chengming , Jing Quanming , Wang Shouli , Ma Yingyan , Wang Zulu , Liang Yanchun , Han Yaling
Published: January 2024

Background

The occurrence of contrast induced acute kidney injury (CIAKI) has a pronounced impact on morbidity and mortality. The aim of the present study was to appraise the diagnostic efficacy of age, estimated glomerular filtration rate (eGFR) and ejection fraction (AGEF) score (age/EF(%)+1 (if eGFR was <60 ml·min-1·1.73 m-2)) as an predictor of CIAKI in patients with diabetes mellitus (DM) and concomitant chronic kidney disease (CKD).

Methods

The AGEF score was calculated for 2 998 patients with type 2 DM and concomitant CKD who had undergone coronary/peripheral arterial angiography. CIAKI was defined as an increase in sCr concentration of 0.5 mg/dl (44.2 mmol/L) or 25% above baseline at 72 hours after exposure to the contrast medium. Post hoc analysis was performed by stratifying the rate of CIAKI according to AGEF score tertiles. The diagnostic efficacy of the AGEF score for predicting CIAKI was evaluated with receiver operating characteristic (ROC) analysis.

Results

The AGEF score ranged from 0.49 to 3.09. The AGEF score tertiles were defined as follows: AGEFlow ≤0.92 (n=1 006); 0.92 1.16 (n=992). The incidence of CIAKI was significantly different in patients with low, middle and high AGEF scores (AGEFlow=1.1%, AGEFmid=2.3% and AGEFhigh=5.8%, P <0.001). By multivariate analysis, AGEF score was an independent predictor of CIAKI (odds ratio=4.96, 95% CI: 2.32–10.58, P <0.01). ROC analysis showed that the area under the curve was 0.70 (95% CI: 0.648–0.753, P <0.001).

Conclusion

The AGEF score is effective for stratifying risk of CIAKI in patients with DM and CKD undergoing coronary/peripheral arterial angiography. (Clinical Trial identifier: NCT00786136).
Safety and efficacy of a novel abluminal groove-filled biodegradable polymer sirolimus-eluting stent for the treatment of de novo coronary lesions: 12-month results from the TARGET II trial
Authors: Xu Bo , Zhao Yelin , Yang Yuejin , Zhang Ruiyan , Li Hui , Ma Changsheng , Chen Shaoliang , Wang Jianan , Huo Yong , Leon Martin B. , Gao Runlin
Published: January 2024

Background

In the TARGET I randomized controlled trial, the novel abluminal groove-filled biodegradable polymer sirolimus-eluting stent FIREHAWK proved non-inferior to the everolimus-eluting stent in nine-month in-stent late loss in singlede novocoronary lesions. This study was aimed at evaluating clinical safety and effectiveness of FIREHAWK in a moderately complex population (including patients with small vessels, long lesions and multi-vessels), and at validating the ability of the SYNTAX score (SS) to predict clinical outcomes in patients treated with this latest generation drug-eluting stent.

Methods

TARGET II was a prospective, multicenter, single-arm study with primary outcome of 12-month target lesion failure (TLF), including cardiac death, target vessel myocardial infarction (TV-MI) and ischemia-driven target lesion revascularization (TLR). Stent thrombosis was defined according to the Academic Research Consortium (ARC) definition. Patients were grouped by tertiles of SS (≤6, >6 to ≤12, and >12). All patients were exclusively treated with the FIREHAWK stent and were followed up at 1, 6, and 12 months, and annually thereafter up to five years.

Results

A total of 730 patients were included in this registry study. The 12-month incidence of TLF was 4.4% and the incidence of TLF components were, cardiac death 0.5%, TV-MI 3.2%, and TLR 2.2%. One definite/probable stent thrombosis was observed at 12-month follow-up. Mean SS was 10.87±6.87. Patients in the SS >12 tertile had significantly higher TLF (P=0.02) and TLR (P<0.01) rates than those in lower SS groups. In COX proportional-hazards regression analyses, TLF incidence was strongly related to lesion length (long lesion vs. non-long lesion patients;HR3.416, 95%CI, 1.622–7.195), but unrelated to diabetic, small vessel, and multivessel subgroups.

Conclusions

The low TLF incidence in this study indicates that FIREHAWK is safe and effective in the treatment of moderately complex coronary disease. SS is also able to predict adverse clinical outcomes in FIREHAWK treated patients. (Clinical Trial.gov identifier: NCT0141264)
Study of preferred background luminance in watching computer screen in children
Authors: Shen Yang , Kuai Shuguang , Zhou Weixi , Peng Sheng , Tian Mi , Liu Kangjun , Zhou Xingtao
Published: January 2024

Background

In recent years, computers have been intensively used at home. In contrast to paper-based books and documents, computer screen is self-illuminated with larger screen-background luminance difference, which greatly induces visual discomfort. To compensate for that, one effective solution is to offer an additional background luminance. In this study, we investigated whether and to what extent additional background lighting is needed in looking at a computer display comfortably.

Methods

In this study, 60 healthy children aged from 9 to 12 years and 58 adults aged from 21 to 39 years participated in the experiments. They were asked to choose their most preferred background luminance intensities at three screen luminance levels. The data were analyzed by Matlab (R2012b) and SPSS 20.0.

Results

Both children and adult participants selected a non-dark background as their comfortable lighting condition when watching a computer display (children: t (59)=22.0, P <0.01, adults: t (57)=15.5, P <0.01). Comparatively, children preferred brighter background in general (F (1,116)=7.0, P <0.01). More importantly, participants’ preferred background luminance levels were linearly correlated with screen luminance intensities (children: slope=0.97, R2
=0.98; adults: slope=0.38, R2
=1.00).

Conclusion

These results indicate that varying background luminance to maintain screen-background luminance ratio is beneficial to human visual comfort.
Application of immunosuppressant facilitates the therapy of optic neuritis combined with Sjögren's syndrome
Authors: Hongyang Li , Zihao Liu , Yan Gong , Zhaocai Jiang , Yixin Zhang , Yanli Dai , Yan Zhang , Shihui Wei
Published: January 2024

Background

Optic neuritis (ON) is often the first symptom of multiple sclerosis (MS) and neuromyelitis optica (NMO) while there has been very little research reported on ON combined with Sjögren's syndrome (SS). The aim of this study is to provide different treatments and services for and NMO patients combined with SS.

Methods

Twenty-seven patients with ON combined SS were divided into two groups: corticosteroid group (C group, methylprednisolone sodium succinate, 14 patients) and corticosteroid+ immunosuppressant group (C+I group, leflunomide, 13 patients). ON relapse times in 1 year after treatment, number of patients who relapsed to NMO/MS in 1 years, visual acuity and retina nerve fiber layer (RNFL) thickness were measured. Mann Whitney-Wilcoxon test was used to compare continuous variables and Chi-square test or Fisher's exact test was to compare proportions.

Results

ON combined with SS patients had higher incidence rates in middle-aged women who have binocular damage and heavier visual function damage or when there is an easy relapse, and the patients are often hormone dependent. The patients are more likely anti-aquaporin-4 IgG seropositive (70.4%). They are liable to form a centrocecal scotoma and tubular vision. The times of relapse decreased in patients who used immunosuppressant, and a significant difference was found between immunosuppressant and non-immunosuppressant groups in visual acuity recovery during 6-month followup period (P <0.05); however, the RNFL thickness at the four quadrants was not significantly different.

Conclusions

The effect of immunosuppressant plus corticosteroid on the early onset of ON combined with SS was to provide ON remedy and to prevent recurrence in clinics. This study provides a significant reference for the prevention and treatment of ON on the basis of immunosuppressant and corticosteroid.
Preliminary radioimmunoimaging and biodistribution of 131iodinelabeled single-chain antibody fragment against progastrin-releasing peptide(31–98) in small cell lung cancer xenografts
Authors: Hong Zhihui , Shi Yizhen , Liu Zengli , Zhou Xiaolin , Yang Yi , Tang Jun
Published: January 2024

Background

Monoclonal antibodies (mAbs) such as DD3, raised against progastrin-releasing peptide(31–98) (ProGRP(31–98)) antigen, have been used to target small cell lung cancer (SCLC). However, as an intact mAb, DD3 is cleared slowly from the body, with an optimal radioimmunoimaging time of 72 hours. More recently, a single-chain antibody fragment has demonstrated reduced excretion time in blood and normal tissues and is increasingly used in diagnostic cancer research. Thereby, it potentially increases the radioimmunoimaging efficacy. However, there have been few studies with this antibody fragment. The aim of this study was to characterize the preliminary radioimmunoimaging and biodistribution of 131I-anti-ProGRP(31–98) scFv in nude mice bearing SCLC xenografts.

Methods

Anti-ProGRP(31–98) scFv was used to detect ProGRP expression by flow cytometry analysis and immunohistochemistry. 131I-anti-ProGRP(31–98) scFv was injected intravenously into healthy Kunming mice and the percentage injected dose per gram (%ID/g) in various organs was calculated. Similarly, the %ID/g and tumor/non-tumor ratio in xenograft-bearing mice was calculated. After injection of 131I-anti-ProGRP(31–98) scFv, treated mice were imaged at 1, 24, and 30 hours. Then the tumor/base ratios were calculated.

Results

ProGRP was highly expressed in NCI-H446 cells and xenograft tissue. The metabolism of 131I-anti-ProGRP(31–98) scFv in healthy mice was consistent with a first-order and two-compartment model; T1/2α
and T1/2β
were 10.2 minutes and 5 hours 18 minutes, respectively. The %ID/g of 131I-anti-ProGRP(31–98) scFv in xenografts was much higher than in healthy tissues at 12 hours after injection, reaching a maximum of (5.38±0.92) %ID/g at 24 hours. Successful imaging of xenograft tissue was achieved as early as 1 hour post-injection and persisted until 30 hours, with 24 hours proving optimal.

Conclusion

131I-anti-ProGRP(31–98) scFv shows highly selective tumor uptake with low accumulation in normal tissues and rapid blood clearance, indicating that it could be a promising agent for SCLC radioimmunoimaging.
Progress on the M-type phospholipase A2 receptor in idiopathic membranous nephropathy
Authors: Wang Chao , Lu Huan , Yang Cui , Luo Yuezhong
Published: January 2024

Objective

To highlight current knowledge about M-type phospholipase A2 receptor (PLA2R) which is the first human autoantigen discovered in adult idiopathic membranous nephropathy.

Data sources

Relevant articles published in English from 2000 to present were selected from PubMed. Searches were made using the terms “idiopathic membranous nephropathy, M-type PLA2R and podocyte.”

Study selection

Articles studying the role of M-type PLA2R in idiopathic membranous nephropathy were reviewed. Articles focusing on the discovery, detection and clinical observation of anti-PLA2R antibodies were selected.

Results

M-type PLA2R is a member of the mannose receptor family of proteins, locating on normal human glomeruli as a transmembrane receptor. The anti-PLA2R in serum samples from MN were primarily IgG4 subclass. Technologies applied to detect anti-PLA2R autoantibody are mainly WB, IIFT, ELISA and so on. Studies from domestic and overseas have identified a strongly relationship between circulating anti-PLA2R levels and disease activity.

Conclusion

Recent discoveries corresponding to PLA2R facilitate a better understanding on IMN pathogenesis and may provide a new tool to its diagnosis, differential diagnosis, risk evaluation, response monitoring and patient-specific treatment.
Lysophosphatidic acid increases SLC26A3 expression in inflamed intestine and reduces diarrheal severity in C57BL/6 mice with dextran-sodium-sulfate-induced colitis
Authors: Xu Lihong , Xiao Fang , He Jiayi , Lan Xiaoqin , Ding Qiang , Li Junhua , Ursula Seidler , Zheng Yong , Tian Dean
Published: January 2024

Background

Diarrhea is a common clinical feature of ulcerative colitis resulting from unbalanced intestinal fluid and salt absorption and secretion. The Cl-/HCO3
- exchanger SLC26A3 is strongly expressed in the mid-distal colon and plays an essential role in colonic Cl- absorption and HCO3
- secretion. Slc26a3 expression is up-regulated by lysophosphatidic acid (LPA)in vitro. Our study was designed to investigate the effects of LPA on SLC26A3 expression and the diarrheal phenotype in a mouse colitis model.

Methods

Colitis was induced in C57BL/6 mice by adding 4% of dextran sodium sulfate (DSS) to the drinking water. The mice were assigned to LPA treatment DSS group, phosphate-buffered saline (PBS) treatment DSS group, DSS only group and untreated mice with a completely randomized design. Diarrhea severity was evaluated by measuring mice weight, disease activity index (DAI), stool water content and macroscopic evaluation of colonic damage. The effect of LPA treatment on Slc26a3 mRNA level and protein expression in the different groups of mice was investigated by quantitative PCR and Western blotting.

Results

All mice treated with DSS lost weight, but the onset and severity of weight loss was attenuated in the LPA treatment DSS group. The increases in stool water content and the macroscopic inflammation score in LPA treatment DSS group were significantly lower compared to DSS control group or PBS treatment DSS group ((18.89±8.67)% vs. (28.97±6.95)% or (29.48±6.71)%, P=0.049, P=0.041, respectively and 2.67±0.81 vs. 4.5±0.83 or 4.5±0.54, P=0.020, P=0.006, respectively), as well as the increase in DAI (P=0.004, P=0.008, respectively). LPA enema resulted in higher Slc26a3 mRNA and protein expression levels compared to PBS-treated and untreated DSS colitis mice.

Conclusion

LPA increases Slc26a3 expression in the inflamed intestine and reduces diarrhea severity in DSS-induced colitis, suggesting LPA might be a therapeutic strategy in the treatment of colitis associated diarrhea.
Uterine artery embolization in cesarean scar pregnancy: safe and effective intervention
Authors: Cao Shasha , Zhu Lihong , Jin Long , Gao Jian , Chen Chen
Published: January 2024

Background

Cesarean scar pregnancy (CSP) is a very rare but life-threatening entity and there is no optimal management strategy. Here we report a successfully conservative treatment of CSP.

Methods

We retrospectively analyzed the clinical data of 54 women with CSP, who underwent uterine artery embolization between January 2007 and September 2012 at the Peking University People's Hospital. We evaluated the clinical outcomes, the technique and the complications of uterine artery embolization.

Results

Of the 54 patients, 2 patients with hemorrhage after induced abortion received bilateral uterine artery embolization treatment alone, and 52 patients underwent suction curettage after bilateral uterine artery embolization. All 54 women were successfully cured, without any severe complications, and uterine function was restored. During the follow-up, one patient had accidental normal interuterine pregnancy and received induced abortion during the first trimester.

Conclution

Uterine artery embolization combined with suction curettage is an effective and safe conservative treatment for cesarean scar pregnancy.
Cardiorenal syndrome: pathophysiological mechanism, preclinical models, novel contributors and potential therapies
Authors: Qiang Fu , Longxing Cao , Huang Li , Binghui Wang , Zhiliang Li
Published: January 2024

Objective

To review the current knowledge about the pathophysiological mechanisms, preclinical models, novel contributors and potential therapies of cardiorenal syndrome.

Data sources

The literature concerning cardiorenal syndrome in this review was collected from PubMed published in English up to January 2014.

Study selection

Original articles and critical reviews related to cardiorenal syndrome were selected and carefully analyzed.

Results

Cardiorenal syndrome is a condition characterized by kidney and heart failure where failure of one organ worsens the function of the other thus further accelerating the progressive failure of both organs. The pathophysiology of cardiorenal syndrome is not fully understood, but may be caused by a complex combination of neurohormonal system activation, endothelial dysfunction, proteinuria, oxidative stress, uremic toxins and other factors. Managing cardiorenal syndrome is still a major therapeutic challenge in clinical practice because many of the drugs used to control heart failure can worsen renal function, and vice versa. Non-dialyzable uremic toxins, such as indoxyl sulfate, causing detrimental effects on the heart and kidney as well as stimulation of inflammatory responses, may be an effective therapeutic target for cardiorenal syndrome.

Conclusions

Suitable disease models of cardiorenal syndrome are urgently needed to investigate the pathophysiology and effective therapeutic approaches to the condition. Non-dialyzable protein-bound uremic toxins that may have cardiac and renal effects may provide therapeutic benefit to cardiorenal syndrome patients.
Microscopic examination of intracellular organisms in bronchoalveolar lavage fluid for the diagnosis of ventilator-associated pneumonia: a prospective multi-center study
Authors: Liu Chang , Du Zhaohui , Zhou Qing , Hu Bo , Li Zhifeng , Yu Li , Xu Tao , Fan Xuepeng , Yang Junhui , Li Jianguo
Published: January 2024

Background

The presence of intracellular organisms (ICOs) in polymorphonuclear leukocytes obtained from bronchoalveolar lavage fluid (BALF) is a possible method for rapid diagnosis of ventilator-associated pneumonia (VAP). However, the validity of this diagnostic method remains controversial and the diagnostic thresholds reported by investigators were different. Our objective was to evaluate the accuracy of quantification of ICOs in BALF for the diagnosis of VAP, and to detect the best cutoff percentage of PMNs containing ICOs (PIC) in the microscopic examination of BALF for the diagnosis of VAP.

Methods

This was a prospective multi-center study conducted in 4 ICUs in Wuhan, China, which involved 181 patients suspected of first episode of VAP. BALF was obtained from all enrolled patients. The BALF samples underwent quantitative culture, cytological and bacteriological analysis to detect the culture results, PIC values and the morphological features of microorganisms. Definite diagnosis of VAP was based on pre-set criteria. The receiver-operating characteristic curve was used to detect the best cutoff point for PIC to diagnose VAP, and the diagnostic accuracy was calculated. Moreover, quantitative culture and Gram's stain of BALF were adopted to diagnose VAP, and their diagnostic accuracy was evaluated as well.

Results

There were 102 patients definitely diagnosed with VAP (VAP group), and 60 patients definitely diagnosed without VAP (no VAP group). We found that ICOs were present in 96.08% (98 out of 102) of VAP patients and 20.00% (12 out of 60) of no VAP patients. The PICs were significantly higher ((9.53±6.65)% vs. (0.52±1.33)%, P<0.01) in VAP group. In our study, the best cutoff point for PIC to diagnose VAP was 1.5%,which had a sensitivity of 94.12%, a specificity of 88.33%, a positive predictive value (PPV) of 93.20% and a negative predictive value (NPV) of 89.83%.The area under the receiver-operating characteristic curve was 0.956 (95% confidence interval,0.925-0.986; P<0.01). When the positive quantitative culture results of BALF were used to diagnose VAP, the sensitivity, specificity, PPV and NPV were 65.69%, 95.00%, 95.71% and 61.96%, respectively. Whereas they were 70.59%, 76.67%, 83.72% and 60.53%, respectively, when the positive Gram's stain results of BALF were used to diagnose VAP. The concordance between the results of Gram's stain and quantitative cultures was poor, only 32.10% (52 out of 162) was totally right, and 17.28% (28 out of 162) was partially right.

Conclusions

PIC>1.5% has good diagnostic performance in the microscopic examination of BALF for the diagnosis of VAP. However, Gram's stain is not reliable for the early application of antibiotic therapy, due to the poor bacteriological predictive value.
Echocardiographic evaluation of right ventricular function in congenital heart disease
Authors: Yiu-fai Cheung
Published: January 2024

Objective

This review aims to provide an overview of conventional and novel indices used in clinical and research arenas for evaluation of right ventricular (RV) function in congenital heart diseases with a dual-chambered circulation.

Data sources

Articles cited in this review were selected using PubMed search of publications in English with no date limits. The search terms included “echocardiography”, “right ventricle”, “RV function”, “cardiac function”, and “congenital heart disease”. Key references were also searched for additional publications.

Study selection

Articles related to description of echocardiographic techniques in the evaluation of subpulmonary or systemic RV function and their applications in congenital cardiac malformations were retrieved and reviewed.

Results

Three approaches have been used to evaluate subpulmonary and systemic RV function: (1) assessment of changes in RV size in the cardiac cycle, (2) determination of Doppler-derived velocities and systolic and diastolic time intervals, and (3) quantification of myocardial velocities and deformation.

Conclusions

Conventional and novel echocardiographic techniques enable the evaluation of subpulmonary and systemic RV function. Novel echocardiographic techniques have further allowed quantification of RV volumes and direct interrogation of myocardial deformation. These new techniques show promise in a more comprehensive evaluation beyond “eye-balling” of RV function in the growing population of adolescent and adult congenital heart patients.