bluuebunny/crossref_metadata_2025 huggingface dataset:
Varied response of the pulmonary arterial endothelium in a novel rat model of venous thromboembolism
Authors: JI Ying-qun , FENG Min , ZHANG Zhong-he , LU Wei-xuan , WANG Chen
Published: January 2024

Background

The experimental studies of venous thromboembolism (VTE) as an entity and the response of the pulmonary arterial endothelium after VTE are still rare. The objective of this study was to observe changes in the pulmonary arterial endothelium using a novel rat model of VTE.

Methods

Rats were allocated to the VTE (n=54) or control groups (n=9). The left femoral vein was blocked using a microvessel clip to form deep vein thrombosis (DVT). One, four or seven-day-old thrombi were injected into the right femoral vein to induce DVT-pulmonary thromboembolism (DVT-PTE). The rats were sacrificed 1, 4 or 7 days later (Dn (1,4,7) Pn(1,4,7) subgroups (n=6)), and the lungs were examined using light and electron microscopy.

Results

On gross dissection, the rate of DVT formation was higher on day 1 (D1Pn: 100%, 18/18) than day 4 (D4Pn: 83%, 15/18; χ2=5.900, P=0.015) or day 7 (D7Pn: 44%, 8/18; χ2=13.846, P=0.000). On gross dissection, the positive emboli residue rate in the pulmonary arteries was lower in the D1Pn subgroup (39%, 7/18) than the D4Pn (73%, 11/15; χ2=3.915, P=0.048) and D7Pn subgroups (100%, 8/8; χ2=8.474, P=0.004); however, light microscopy indicated the residual emboli rate was similar in all subgroups. Hyperplasia of the pulmonary arterial endothelium was observed 4 and 7 days after the injection of one-day-old or four-day-old thrombi. However, regions without pulmonary arterial endothelial cells and intra-elastic layers were observed one day after injection of seven-day-old thrombi.

Conclusions

This novel model closely simulates the clinical situations of thrombus formation and is ideal to study pulmonary endothelial cell activation. The outcome of emboli and pulmonary arterial endothelial alterations are related to the age and nature of the thrombi.
Inhibition of Notch1 increases paclitaxel sensitivity to human breast cancer
Authors: Li Zhao , Yongjie Ma , Feng Gu , Li Fu
Published: January 2024

Background

Paclitaxel (PAC) is the first-line chemotherapy drug for most breast cancer patients, but clinical studies showed that some breast cancer patients were insensitive to PAC, which led to chemotherapy failure. It was reported that Notch1 signaling participated in drug resistance of breast cancer. Here, we show whether Notch1 expression is related to PAC sensitivity of breast cancer.

Methods

We employed Notch1 siRNA and Notch1 inhibitor, N-[N-(3,5-difluorophenacetyl)-1-alanyl]-S-phenylglycine t-butylester (DAPT), to down regulate Notch1 expression in human breast cancer cells MDA-MB-231, and detected the inhibition effect by Western blotting and reverse trans cription-polymerase chain reaction, respectively. After 24 hours exposure to different concentration of PAC (0, 1, 5, 10, 15, 20, and 25 μg/ml), the viability of the control group and experimental group cells was tested by MTT. We also examined the expression of Notch1 in PAC sensitive and nonsensitive breast cancer patients, respectively by immunohistochemistry (IHC). The PAC sensitivity of breast cancer patients were identified by collagen gel droplet embedded culture-drug sensitivity test (CD-DST).

Results

Down regulation of Notch1 expression by Notch1siRNA interference or Notch1 inhibitor increased the PAC sensitivity in MDA-MB-231 cells (P<0.05). Also, the expression of Notch1 in PAC sensitive patients was much lower than that of PAC non-sensitive patients (P<0.01).

Conclusion

Notch1 expression has an effect on PAC sensitivity in breast cancer patients, and the inhibition of Notch1 increases paclitaxel sensitivity to human breast cancer.
Benefits of intra-operative systemic chemotherapy during curative surgery in patients with locally advanced gastric cancer
Authors: MENG Qing-bin , YU Jian-chun , MA Zhi-qiang , KANG Wei-ming , ZHOU Li , YE Xin
Published: January 2024

Background

There is little information on the impact of intra-operative systemic chemotherapy on gastric cancer. The aim of this study was to identify prognostic factors in patients with locally advanced gastric cancer and undergoing curative resection, with a focus on evaluating survival benefits and tolerance of intra-operative systemic chemotherapy.

Methods

We retrospectively analyzed clinicopathological data for 264 consecutive patients who underwent curative resection for gastric cancer at Peking Union Medical College Hospital from January 2002 to January 2007. Survival curves were plotted using the Kaplan-Meier method and compared using log-rank tests. Univariate and multivariate analyses were performed with the Cox proportional hazard model.

Results

Patients who received intra-operative systemic chemotherapy had higher 5-year overall survival and 5-year disease-free survival rates (P=0.019 and 0.010, respectively) than patients who did not receive intra-operative systemic chemotherapy. In the subgroup analysis, systemic intra-operative chemotherapy benefited the 5-year overall survival and disease-free survival rates for patients with cancer of stage pTNM IB-IIIB, but not stage pTNM IIIC. Patients who received intra-operative systemic chemotherapy in combination with post-operative chemotherapy had higher 5-year overall survival and 5-year disease-free survival rates (P=0.046 and 0.021, respectively) than patients who only received postoperative chemotherapy. However, the difference in these rates between patients who received only intra-operative systemic chemotherapy and patients who only received curative surgery was not statistically significant (P=0.150 and 0.170, respectively). Multivariate analyses showed that intra-operative systemic chemotherapy was a favorable prognostic factor for the overall survival and disease-free survival rates (P =0.048 and 0.023, respectively). No grade 4 toxicities related to intra-operative systemic chemotherapy were recorded within the 4 weeks after surgery.

Conclusion

Intra-operative systemic chemotherapy during curative surgery may benefit patients with stage pTNM IB-IIIB gastric cancer in terms of both overall survival and disease-free survival.
In vitro study of safety and co-efficiency of the transbronchial coagulation techniques
Authors: BAI Chong , DONG Yu-chao , SONG Xiao-lian , HUANG Yi , SHI Hui , HU Zhen-li , LI Qiang
Published: January 2024

Background

The usual transbronchial coagulation techniques include microwave, argon plasma coagulation (APC), electrocautery and cryotherapy. However, there are serious clinical problems in the safety of each. By analyzing the experimental data and clinical observations, we observed the variable effects of different coagulation techniques via bronchofibroscopy, to look for an optimal interventional management of luminal bronchus diseases, and evaluate the safety and the equivalent point.

Methods

Four kinds of coagulation techniques under bronchoscopy were performed on the fresh bronchus of healthy sheep, and the pathologic changes in all groups were observed under the microscope. The different treatment parameters were as follows: microwave 60 W×1 second, 3 seconds, 5 seconds and 40 W×1 second, 3 seconds, 5 seconds; APC 40 W×1 second, 3 seconds, 5 seconds; electrocautery 40 W×1 second, 3 seconds, 5 seconds; cryotherapy 100 Ω×60 seconds, 120 seconds.

Results

After treatment, ovine bronchial mucosa in all groups showed pathologic changes such as local necrosis and amotio of the mucosa lining epithelium, local submucosa coagulative necrosis or tissue defects, while inflammation in the surrounding tissue was not obvious. Under the same output power and action time, different methods had different outcomes. The damage by APC was the most superficial, microwave was the second, and electrocautery caused the worst damage. The study also found that effects of electrocautery at 40 W×3 seconds, microwave at 40 W×5 seconds or 60 W×3 seconds, APC at 40 W×5 seconds and cryotherapy at 100 Ω×120 seconds were the equivalent point conditions. The appearance included mucosa absence, partial submucosa absence, and collagen fiber coagulation in treatment areas.

Conclusions

Each coagulation technique has its own characteristic. It is very important to choose the appropriate power and action time of the suitable method according to the therapy requirement.
Etiological and clinical analysis of osteonecrosis of the femoral head in Chinese patients
Authors: WANG Xing-shan , ZHUANG Qian-yu , WENG Xi-sheng , LIN Jin , JIN Jin , QIAN Wen-wei
Published: January 2024

Background

Many potential causative factors are related to the initiation and progression of osteonecrosis of the femoral head. The aim of this research was to investigate the etiology and clinical features of osteonecrosis of the femoral head in Chinese patients.

Methods

From January 1990 to July 2011, 643 cases of osteonecrosis of the femoral head were investigated retrospectively to analyze the potential causative factors, age, gender, latency period, time from the onset of pain to diagnosis, and Association Research Circulation Osseous stage.

Results

Of 643 cases, 315 cases were bilateral and 328 cases were unilateral, with an average age of (47.55±15.27) years. In the steroid-induced group, the average age at symptom onset was (41.80±15.47) years, and the median duration from taking steroid to the onset of pain was 36 months. The underlying diseases in the steroid-induced osteonecrosis of the femoral head group consisted of autoimmune and other diseases, of which systemic lupus erythematosus was the most common. In the alcohol-induced group, the average age at onset of symptoms was (48.06±11.90) years and the median time of habitual alcohol use was 240 months. In the traumatic group, the average age was (51.43±14.23) years and the median time from trauma to the onset of pain was 20 months. In the idiopathic group, the average age was (50.33±15.88) years. Of the total of 958 hips, 647 were at stage III or IV. The stage at diagnosis was earlier in the steroid-induced group than in the alcohol-induced, traumatic, or idiopathic groups.

Conclusions

Steroid use is the most common cause for osteonecrosis of the femoral head in this study. The age at diagnosis, time from the onset of pain to diagnosis, and stage were significantly earlier in the steroid-induced group.
Wnt3a enhances bone morphogenetic protein 9-induced osteogenic differentiation of C3H10T1/2 cells
Authors: ZHANG Xiao , LIN Liang-bo , XU Dao-jing , CHEN Rong-fu , TAN Ji-xiang , LIANG Xi , HU Ning , HUANG Wei
Published: January 2024

Background

Bone morphogenetic protein 9 (BMP9) and Wnt/β-catenin signaling pathways are able to induce osteogenic differentiation of mesenchymal stem cells (MSCs), but the role of Wnt/β-catenin signaling pathway in BMP9-induced osteogenic differentiation is not well understood. Thus, our experiment was undertaken to investigate the interaction between BMP9 and Wnt/β-catenin pathway in inducing osteogenic differentiation of MSCs.

Methods

C3H10T1/2 cells were infected with recombinant adenovirus expressing BMP9, Wnt3a, and BMP9+Wnt3a. ALP, the early osteogenic marker, was detected by quantitative and staining assay. Later osteogenic marker, mineral calcium deposition, was determined by Alizarin Red S staining. The expression of osteopotin (OPN), osteocalcin (OC), and Runx2 was analyzed by Real time PCR and Western blotting. In vivo animal experiment was carried out to further confirm the role of Wnt3a in ectopic bone formation induced by BMP9.

Results

The results showed that Wnt3a enhanced the ALP activity induced by BMP9 and increased the expressions of OC and OPN, with increase of mineral calcium deposition in vitro and ectopic bone formation in vivo. Furthermore, we also found that Wnt3a increased the level of Runx2, an important nuclear transcription factor of BMP9.

Conclusion

Canonical Wnt/β-catenin signal pathway may play an important role in BMP9-induced osteogenic differentiation of MSCs, and Runx2 may be a linkage between the two signal pathways.
Validation and target gene screening of hsa-miR-205 in lung squamous cell carcinoma
Authors: Huang Wei , Jin Yi , Yuan Yunfeng , Bai Chunxue , Wu Ying , Zhu Hongguang , Lu Shaohua
Published: January 2024

Background

Lung cancers are classified as squamous cell carcinoma (SQ), adenocarcinoma (AC) and small cell lung carcinoma (SCLC). SQ is the major subtype of lung cancer. Currently, there are no targeted therapies for SQ due to lack of understanding its driving oncogenes. In this study, we validated an SQ specific biomarker hsa-miR-205 in Chinese patients with lung cancer and screened its candidate target genes for further functional studies to enrich knowledge in SQ target therapies.

Methods

Quantitative reverse-transcription PCR (quantitative RT-PCR) was performed on 197 macro-dissected (cancerous cells >75%) surgical lung tissues (45 SQ, 44 AC, 54 SCLC and 54 adjacent normal tissues) to validate the expression profiles of miR-205. Furthermore, the targets of this microRNA were predicted through the gateway miRecords and mapped to lung cancer-associated pathways using the KEGG (Kyoto Encyclopedia of Genes and Genomes) database. Then quantitative RT-PCR was performed on an independent cohort of 44 snap-frozen surgical lung tissues to concurrently assess the expression profiles of miR-205 and its 52 putative targeted genes.

Results

MicroRNA-205 yielded high diagnostic accuracy in discriminating SQ from AC with an area under the curve (AUC) of 0.985, and discriminating SQ from SCLC with an AUC of 0.978 in formalin-fixed paraffin-embedded (FFPE) surgical lung tissues. Predicted targets of miR-205 were associated with 52 key members of lung cancer signaling pathways. Ten target genes (ACSL1, AXIN2, CACNA2D2, FOXO3, PPP1R3A, PRKAG3, RUNX1, SMAD4, STK3andTBL1XR1) were significantly down-regulated in SQ and had a strong negative correlation with miR-205, while one target gene (CDH3) was up-regulated in SQ and exhibited a strong positive correlation with miR-205.

Conclusions

We confirmed the high diagnostic accuracy of miR-205 in discriminating SQ from AC and SCLC in Chinese patients. Moreover, we identified 11 significant target genes of miR-205 which could be used for further functional studies as the basis for the development of SQ targeted therapies.
Effects of hyperbaric oxygen preconditioning on ischemia-reperfusion inflammation and skin flap survival
Authors: QI Zheng , GAO Chun-jin , WANG You-bin , MA Xue-mei , ZHAO Ling , LIU Fu-jia , LIU Xue-hua , SUN Xue-jun , WANG Xiao-jun
Published: January 2024

Background

Hyperbaric oxygen preconditioning (HBO) is a new method of ischemia preconditioning. In this study, we examined its effects on skin flap survival and the mechanisms involved.

Methods

Thirty-six rats were divided into three groups: HBO preconditioning, control, and sham groups. An extended epigastric adipocutaneous flap based on the right superficial epigastric artery and vein was raised. A 3-hour period of flap ischemia was induced by clamping the pedicle vessels with a microvascular clamp. At the end of ischemia induction, the clamp was removed and the flap was resutured. Rats in the HBO preconditioning group were treated with HBO four times before surgery. Microcirculation in the skin flap was measured on postoperative days 1, 3 and 5. The size of the flap was measured on postoperative day 5, before the animals were sacrificed. Samples of the skin flap were prepared and stained with hematoxylin and eosin. The levels of tumor necrosis factor (TNF)-α, interleukin (IL)-1β, and IL-6 in the flap samples were measured.

Results

Surviving flap size was significantly higher in the HBO preconditioning group compared with controls, with a reduced inflammatory response and increased perfusion. IL-1, TNF-α, and IL-6 levels in the HBO preconditioning group were lower than in controls.

Conclusions

HBO preconditioning improved flap survival in this ischemia-reperfusion rat model. The mechanisms responsible for this effect may relate to attenuation of the inflammatory response and increased flap perfusion following HBO preconditioning.
Citrate versus unfractionated heparin for anticoagulation in continuous renal replacement therapy
Authors: LIAO Yu-jie , ZHANG Ling , ZENG Xiao-xi , FU Ping
Published: January 2024

Background

Unfractionated heparin is the most commonly used anticoagulant in continuous renal replacement therapy (CRRT), but it can increase the risk of bleeding. Citrate is a promising substitute. Our study was to assess the efficacy and safety of citrate versus unfractionated heparin in CRRT.

Methods

We searched the MEDLINE, the EMBASE, the Cochrane Central Register of Controlled Trials, and the China National Knowledge Infrastructure Database until up to November 2011 for randomized controlled trials comparing citrate with unfractionated heparin in adult patients with acute kidney injury prescribed CRRT. The primary outcome was mortality and the secondary outcomes included circuit survival, control of uremia, risk of bleeding, transfusion rates, acid-base statuses, and disturbance of sodium and calcium homeostasis.

Results

Four trials met the inclusion criteria. Meta-analysis found no significant difference between two anticoagulants on mortality. Less bleeding and more hypocalcemic episodes were with citrate. Citrate was superior or comparable to unfractionated heparin in circuit life.

Conclusions

Citrate anticoagulation in CRRT seems to be superior in reducing bleeding risk and with a longer or similar circuit life, although there is more metabolic derangement. Mortality superiority has not been approved.
Common underlying diseases do not contribute in determining the causes of sudden unexplained death
Authors: TIAN Zhao-xing , Yan-yu LÜ , Nugessur Chetan Rai , YAN Wei , ZHAO Wen-kui , KONG Li-li , ZHENG Ya-an
Published: January 2024

Background

Underlying diseases have a statistically significant positive correlation to sudden death. However, sudden unexplained death (SUD) is different from sudden death, as there is no clinical evidence to support the sudden death due to the original underlying disease, nor a lethal pathological basis to be found during autopsy. In addition, SUD are more common in young, previously healthy individuals, usually without any signs of disease, with no positive lesions found after autopsy. Therefore, a causal relationship between SUD and the underlying disease needs to be further explored. This study aimed to explore the role that common underlying diseases play in patients with SUD and to reveal the correlation between them.

Methods

The medical records, history and case information of 208 patients with SUD were collected for the survey. All these SUD occurred in the emergency room of Peking University Third Hospital from January 2006 to December 2009. The patients were stratified by with and without common underlying diseases. To examine possible associations between the underlying diseases and the cause of unexplained sudden death, the chi-squared and Fisher's exact tests were used.

Results

Among the 208 patients, 65 were diagnosed with common underlying diseases while 143 were not. Within these two groups, there were 45 patients for whom the clear cause of death was determined. However, there were no statistically significant differences or strong associations (x
2=1.238, P >0.05) between the 11 patients with (16.90%) and 34 without (23.78%) common underlying disease among these 45 patients. We also found that occurrence of the common underlying diseases, such as neurological system, cardiovascular and pulmonary system diseases, are not statistically significant (P >0.05) in the diagnosis of the SUD.

Conclusion

Common underlying diseases make no obvious contributions to SUD and are not useful in diagnosing the underlying reasons for death.
Brain metabolism in patients with vegetative state after post-resuscitated hypoxic-ischemic brain injury: statistical parametric mapping analysis of F-18 fluorodeoxyglucose positron emission tomography
Authors: Kim Yong Wook , Kim Hyoung Seop , An Young-Sil
Published: January 2024

Background

Hypoxic-ischemic brain injury (HIBI) after cardiopulmonary resuscitation is one of the most devastating neurological conditions that causing the impaired consciousness. However, there were few studies investigated the changes of brain metabolism in patients with vegetative state (VS) after post-resuscitated HIBI. This study aimed to analyze the change of overall brain metabolism and elucidated the brain area correlated with the level of consciousness (LOC) in patients with VS after post-resuscitated HIBI.

Methods

We consecutively enrolled 17 patients with VS after HIBI, who experienced cardiopulmonary resuscitation. Overall brain metabolism was measured by F-18 fluorodeoxyglucose positron emission tomography (F-18 FDG PET) and we compared regional brain metabolic patterns from 17 patients with those from 15 normal controls using voxel-by-voxel based statistical parametric mapping analysis. Additionally, we correlated the LOC measured by the JFK-coma recovery scale-revised of each patient with brain metabolism by covariance analysis.

Results

Compared with normal controls, the patients with VS after post-resuscitated HIBI revealed significantly decreased brain metabolism in bilateral precuneus, bilateral posterior cingulate gyrus, bilateral middle frontal gyri, bilateral superior parietal gyri, bilateral middle occipital gyri, bilateral precentral gyri (P
FEW correctecd <0.0001), and increased brain metabolism in bilateral insula, bilateral cerebella, and the brainstem (P
FEW correctecd <0.0001). In covariance analysis, the LOC was significantly correlated with brain metabolism in bilateral fusiform and superior temporal gyri (P
uncorrected <0.005).

Conclusions

Our study demonstrated that the precuneus, the posterior cingulate area and the frontoparietal cortex, which is a component of neural correlate for consciousness, may be relevant structure for impaired consciousness in patient with VS after post-resuscitated HIBI. In post-resuscitated HIBI, measurement of brain metabolism using PET images may be helpful for investigating the brain function that cannot be obtained by morphological imaging and can be used to assess the brain area responsible for consciousness.
Serum HBV DNA level at week 12 is superior to viral response at week 24 in predicting long-term treatment outcome of telbivudine for chronic hepatitis B patients
Authors: LÜ Wei , YANG Hai-hong , FAN Yun-ming , LI Takming , ZHANG Li-fan , MUI Chongseong , FAN Hong-wei , ZHOU Bao-tong , LIU Zheng-yin , NG Hou , LIU Xiao-qing
Published: January 2024

Background

Telbivudine, one of the five nucleos(t)ide antiviral drugs, was reported to be superior to lamivudine in a better biochemical, virological, and histological response for treatment-naive patients in the GLOBE trial. The aim of this study was to determine the antiviral potency, viral resistance, and the significance of early response for long-term telbivudine treatment.

Methods

We recruited 161 patients of chronic hepatitis B (CHB) on telbivudine between January 2009 and September 2011 in Macau, China. The serum hepatitis B virus DNA levels, hepatitis B e antigen (HBeAg) seroconversion, alanine aminotransferase (ALT) normalization, and viral resistance were analyzed.

Results

The median age and follow-up duration were 48 years and 16.9 months. All patients were followed up for at least 6 months, while data were collected for 132, 120, 95, and 53 patients at 12, 24, 48, and 96 weeks respectively. The cumulative HBeAg seroconversion rate was 20.8% and only three patients (1.9%) presented with telbivudine low level resistance. The ALT normalization rates were 76.9% at 48 weeks and 77.6% at 96 weeks. Undetectable HBV DNA was achieved by 1.8%, 31.6%, 60%, and 74.1% in HBeAg positive patients and 29.3%, 60.3%, 84%, and 84.6% in HBeAg negative patients at each time point. Week 12 HBV DNA level <1000 copies/ml (<200 IU/ml) was a better predictor of viral suppression at 2-year follow-up (P=0.001, OR=27.00) than undetectable HBV DNA level at week 24 (P=0.120, OR=4.81).

Conclusions

Two-year telbivudine treatment yielded high rates of viral suppression and ALT normalization. Serum HBV DNA level at week 12 is a superior predictor for long-term viral suppression.
Inhaled unfractionated heparin improves abnormalities of alveolar coagulation, fibrinolysis and inflammation in endotoxemia-induced lung injury rats
Authors: WANG Zong-yu , WU Sheng-nan , ZHU Zhao-zhong , YANG Ba-xian , ZHU Xi
Published: January 2024

Background

Acute lung injury/acute respiratory distress syndrome presents with not only local inflammation, but also pulmonary coagulopathy which is characterized by an alveolar procoagulant response, anticoagulant inhibition, fibrinolytic supression and fibrin deposition. We thus had hypothesized that if aerosolized unfractionated heparin was inhaled into alveolar spaces, it could block the procoagulant tendency, lessen depletion of coagulation factors, and even influence the inflammatory response. We also assessed the effects of different administration regimens of heparin.

Methods

Male Wistar rats were given inhaled heparin starting 30 minutes before (prophylactic heparin) or 2 hours after (therapeutic heparin) intravenous lipopolysaccharide (LPS) was administered at 6-hour intervals; control groups received inhaled normal saline with or without being exposed to LPS. Thrombin-antithrombin complexes, activated protein C, tissue type and urokinase type plasminogen activators (t-PA/u-PA), plasminogen activator inhibitor-1 (PAI-1), tumor necrosis factor-α, interleukin-6 in bronchoalveolar lavage, and lung tissue myeloperoxidase activity, and histology score were measured at three time-points. PAI-1/(t-PA + u-PA) was calculated based on the before-mentioned parameters. Statistical analysis was made using one-way analysis of variance (ANOVA) with post hoc test or Student's t test in the case of heterogeneity of variance.

Results

An alveolar procoagulant reaction, depressed fibrinolysis, and inflammatory response occurred in endotoxemia-induced lung injury. Local prophylactic application of heparin attenuated coagulation and early inflammation, promoted fibrinolysis, and reduced the histology score. Therapeutic application of heparin had similar, but weaker effects.

Conclusions

Intrapulmonary application of unfractionated heparin by inhalation might inhibit alveolar procoagulant reaction and the early inflammatory response, promote fibrinolysis, and alleviate pulmonary pathology in endotoxemia-induced lung injury rats. Administration of heparin before LPS challenge was more efficacious.

Chin Med J 2013;126 (2): 318-324
Cord blood transplantation for the treatment of acute leukemia
Authors: Park Meerim , Lee Young-ho
Published: January 2024

Objective

This review discussed the available data on treatment outcomes of cord blood transplantation (CBT) for acute leukemia.

Data sources

The data cited in this review were obtained from articles listed in Medline and Pubmed.

Study selection

We reviewed the articles of clinical results from various registries and institutions, as well as our experiences with CBT in children, adolescents and adults.

Results

This research has clearly shown that cord blood (CB) has several unique characteristics resulting in distinct advantage and disadvantages when compared to transplantation with unrelated donor bone marrow or peripheral blood stem cells. The field of CBT has advanced from investigating its safety and feasibility to addressing more specific issues such as accelerating engraftment, extending access, and examining outcomes in specific subgroups of patients. Many approaches have been investigated in the attempt to improve engraftment and survival. Variable factors have been identified, such as factors related to donor choice (human leukocyte antigen (HLA) compatibility, cell dose, and others) and transplantation (conditioning and graft-versus-host disease prophylaxis regimen). Data support that CB should be considered a reasonable option in those that do not have HLA matched sibling donor and for those in whom the time to transplant is critical.

Conclusions

CB is a reasonable alternative to unrelated donor bone marrow or peripheral blood progenitor cells for transplantation. Recently developed strategies aimed at improving hematopoietic recovery and reducing early transplantation-related mortality could further improve treatment outcomes of CBT for patients with acute leukemia.
Evaluation of neointimal coverage in patients with coronary artery aneurysm formation after drug-eluting stent implantation by optical coherence tomography
Authors: TIAN Feng , CHEN Yun-dai , CHEN Lian , SUN Zhi-jun , GUO Jun , JIN Qin-hua , LIU Chang-fu , WANG Jin-da , LIU Hong-bin
Published: January 2024

Background

The vessel healing in patients with coronary artery aneurysms (CAA) that form after drug-eluting stent (DES) implantation is not clear. This study aims to assess the vessel healing in patients with CAA formation after DES implanation.

Methods

From June 2008 to August 2011, follow-up coronary angiography was conducted on 1160 patients who underwent percutaneous coronary intervention (PCI). The average period of follow-up was about (18.95±13.05) months. A total of 175 patients who underwent DES implantation into de novo lesions and who underwent coronary angiography and optical coherence tomography (OCT) examination during follow-up were identified. Patients were divided into the CAA group (n=31) and non-CAA group (n=144) based on the results of the coronary angiography. The cardiac events including angina and acute myocardial infarction were noted; in addition, the neointimal thickness and the frequency of strut malapposition and strut uncoverage were also noted.

Results

A greater proportion of incomplete neointimal coverage (17.17% vs. 1.90%, P <0.001) and strut malapposition (18.20% vs. 1.38%, P <0.001) were observed in the CAA group. The neointimal thickness in the CAA group was significantly thinner than that in the non-CAA group ((146.6±94.8) μm vs. (192.5±97.1) μm, P <0.001), as detected via OCT. Patients with CAA formation had a higher frequency of cardiac events including angina pectoris (25.81% vs. 6.25%, P=0.001) and acute myocardial infarction (9.68% vs. 0.13%, P=0.002) and thrombosis (16.13% vs. 0.69%, P <0.001). The longitudinal length of the CAA in the cardiac event group was significantly longer than in the no cardiac event group (20.0±9.07) mm vs. (12.05±5.38) mm, P=0.005).

Conclusion

CAA formation after DES implantation is frequently associated with cardiac events as a result of stent malapposition and incomplete neointimal coverage.
Long-term effects of bone marrow-derived cells transplantation in patients with acute myocardial infarction: a meta-analysis
Authors: CHEN Long , TONG Jia-yi , JIN Hui , REN Xiao-mei , JIN Hong , WANG Qing-jie , MA Gen-shan
Published: January 2024

Background

The long-term effects of bone marrow-derived cells (BMC) transplantation in patients with acute myocardial infarction (AMI) have not been established. The present meta-analysis of randomized controlled trials with follow-up ≥2 years was performed to investigate the long-term effects of BMC therapy in patients after AMI.

Methods

Specific terms were used to conduct a systematic literature search of MEDLINE, EMBASE, the Cochrane Library and the Cochrane Central Register of Controlled Trials, and the China Biological Medicine Disk database from their inception to March 2012. A standardized protocol was used to extract information, and random effect model was used to analyze all data except major adverse events.

Results

Five trials comprising 510 patients were included. Compared with controls, BMC therapy significantly improved left ventricular ejection fraction (LVEF) (4.18%, 95% CI: 2.02% to 6.35%, P=0.0002), while mildly but not significantly reduced left ventricular end-systolic volume (-4.47 ml, 95% CI: -10.92 to 1.99, P=0.17) and left ventricular end-diastolic volume (-2.29 ml, 95% CI: -9.96 to 5.39, P =0.56). Subgroup analysis revealed that significant improvement of LVEF induced by BMC therapy could be observed in patients with baseline LVEF ≤42%, but disappeared in those with baseline LVEF >42%. There were trends in favor of BMC therapy for most major clinical adverse events, though most differences were not significant.

Conclusions

Intracoronary BMC infusion in patients with AMI seems to be safe and may further improve LVEF on top of standard therapy; especially the beneficial effects could last for long term. The findings need to be validated in the future.

Chin Med J 2013;126 (2): 353-360
Pulmonary oligemia maneuver can alleviate pulmonary artery injury during pulmonary thromboendarterectomy procedure
Authors: GAN Hui-li , ZHANG Jian-qun , LU Jia-kai , DONG Xiu-hua , HOU Xiao-tong , GAO Yuan-ming , ZHU Guang-fa
Published: January 2024

Background

Pulmonary thromboendarterectomy (PTE) has evolved as a treatment of choice for chronic thromboembolic pulmonary hypertension (CTEPH). This study aimed to characterize if pulmonary oligemia maneuver (POM) can alleviate pulmonary artery injury during PTE procedure.

Methods

A total of 112 cases of CTEPH admitted to Beijing Anzhen Hospital from March 2002 to August 2011 received PTE procedure. They were retrospectively classified as non-POM group (group A, n=55) or POM group (group B, n=57). Members from group B received POM during rewarming period, whereas members from group A did not.

Results

There were three (5.45%) early deaths in group A, no death in group B (0) (Fisher's exact test, P=0.118). Six patients in group A needed extracorporeal membrane oxygenation (ECMO) as life support after the PTE procedure, no patients in group B needed ECMO (Fisher's exact test, P=0.013). The patients in group B had a shorter intubation and ICU stay, lower mean pulmonary arterial pressure (mPAP) and pulmonary vascular resistance (PVR), higher partial pressure of oxygen in artery (PaO2) and arterial oxygen saturation (SaO2) and less medical expenditure than patients in group A. With a mean follow-up time of (58.3 ± 30.6) months, two patients in group A and one patient in group B died. The difference of the actuarial survival after the procedure between the two groups did not reach statistical significance. Three months post the PTE procedure, the difference of residual occluded pulmonary segment between the two groups did not reach statistical significance (P=0.393).

Conclusion

POM can alleviate pulmonary artery injury, shorten ICU stay and intubation time, and lower down the rate of ECMO after PTE procedure.
Comparative analysis of early and middle outcomes of the arterial switch operation in children with complete transposition of the great arteries with ventricular septal defect and severe pulmonary artery hypertension
Authors: LIU Cheng-hu , SU Jun-wu , LI Zhi-qiang , FAN Xiang-ming , CHEN Yan , HE Yan , LIU Ying-long
Published: January 2024

Background

The best age for the arterial switch operation (ASO) in complete transposition of great arteries with ventricular septal defect is usually considered to be within six months. This is because of severe pulmonary arterial hypertension and pulmonary arterial obstructive pathological changes. There are few reports on ASO surgery in children older than three years old.

Methods

We studied 41 children, including 24 males and 17 females, from January 2010 to December 2011. They were divided into three groups by operation age; 15 patients were <1 year old, 13 were 1-3 years old, and 13 were >3 years old. Associated cardiac abnormalities included patent ductus arteriosus in six cases, atrial septal defect in five cases, and mitral regurgitation in two cases. All the patients had echocardiography before the operation. Seventeen patients underwent a coronary computed tomography examination and five patients underwent right heart catheterization. All ASO surgeries were performed under inhalation anesthesia and hypothermic cardiopulmonary bypass.

Results

Three operative deaths occurred. Two were in the <1 year old group, who died from severe postoperative low cardiac output. The other was two years old and died of postoperative multiple organ failure. There was no significant difference in postoperative mortality and the recent mid-term survival rate among the three groups. Thirty-eight cases were followed up for an average of 11.2 months, ranging 6-20 months. One seven years old patient died of acute diarrhea and electrolyte disturbance arrhythmia caused by food poisoning. Three patients more than three years old still had residual pulmonary arterial hypertension.

Conclusion

Children older than three years old can still undergo the ASO procedure, but residual pulmonary hypertension is present.
Multimodal magnetic resonance imaging for assessing lacunar infarction after proximal middle cerebral artery occlusion in a canine model
Authors: LU Shan-shan , LIU Sheng , ZU Qing-quan , XU Xiao-quan , WANG Jian-wei , YU Jing , SUN Lei , SHI Hai-bin
Published: January 2024

Background

A new lacunar infarction model was recently established in beagle dogs through proximal middle cerebral artery (MCA) occlusion by thrombus. This study aimed to characterize the model by multimodal magnetic resonance imaging (MRI) and to investigate its potential role for the future stroke research.

Methods

The left proximal MCA was embolized with an autologous thrombus in six beagles. Diffusion-weighted imaging (DWI) and T2-weighted imaging (T2WI) were performed every half hour during the first six hours after occlusion, followed by three time points at 12 hours, 24 hours, and one week. Perfusion-weighted imaging (PWI) and magnetic resonance angiography (MRA) were carried out at six hours, 24 hours and one week. The PWI-DWI mismatch ratio was defined as (PWI-DWI)/DWI ischemic volume.

Results

Lacunar infarcts induced by MCA occlusion were located in the left caudate nucleus and internal capsule. All the lesions could be detected within two hours by DWI. Lesion volume on DWI increased in a time dependent manner, from (87.19±67.16) mm3 at one hour up to (368.98±217.05) mm3 at 24 hours (P=0.009), while that on PWI gradually decreased from (7315.00±2054.38) mm3 at six hours to (4900.33±1319.71) mm3 at 24 hours and (3334.33±1195.11) mm3 at one week (P=0.002). The mismatch ratio was 41.93±22.75 at six hours after ischemia, showing “extensive mismatch”, and decreased to 18.10±13.74 at 24 hours (P=0.002). No MCA recanalization was observed within 24 hours after MCA occlusion.

Conclusions

Lacunar infarction induced by proximal MCA occlusion could be detected early by DWI and was characterized by extensive PWI-DWI mismatch. Multimodal MRI is useful to demonstrate the natural evolution of PWI-DWI mismatch. This ischemic model could be further used for investigating early thrombolysis in lacunar stroke showing extensive mismatch.
Follow-up of children born after intracytoplasmic sperm injection with epididymal and testicular spermatozoa
Authors: GUO Yi-hong , DONG Rui-na , SU Ying-chun , LI Jing , ZHANG Ya-jie , SUN Ying-pu
Published: January 2024

Background

To evaluate the safety of intracytoplasmic sperm injection (ICSI) with epididymal or testicular sperm, this study compared children born after ICSI treatment with epididymal or testicular sperm with children conceived after ICSI with ejaculated sperm.

Methods

This retrospective study included 317 children born after ICSI with percutaneous epididymal sperm aspiration (PESA), 103 children born after ICSI with testicular sperm aspiration (TESA), and a control group of 1008 children born after ICSI with ejaculated sperm. All of the patients received their assisted reproductive treatment in the Reproductive Medicine Center of the First Affiliated Hospital of Zhengzhou University from January 2004 to December 2011. Data,such as the rate of stillbirths, perinatal mortality, gestational age, birth weight, and the rate of congenital malformations of the three groups, were compared.

Results

PESA and TESA children were not different from ICSI children in the rate of stillbirths, perinatal mortality infant mortality rate, gestational age, the rate of prematurity, and the rate of malformations (P>0.05). A slight increase in birth defects was reported in the TESA group compared with those in the control group, but there was no significant difference between the groups (P>0.05).

Conclusion

ICSI with epididymal or testicular sperm does not lead to more stillbirths or congenital malformations compared with ICSI using ejaculated sperm.
Effects of thioperamide on seizure development and memory impairment induced by pentylenetetrazole-kindling epilepsy in rats
Authors: ZHANG Li-san , CHEN Jie-fang , CHEN Guan-feng , HU Xing-yue , DING Mei-ping
Published: January 2024

Background

Histamine H3 receptor antagonists have been considered as potential drugs to treat central nervous system diseases. However, whether these drugs can inhibit epileptogenesis remains unclear. This study aimed to investigate the effects of thioperamide, a selective and potent histamine H3 receptor antagonist, on the seizure development and memory impairment induced by pentylenetetrazole (PTZ)-kindling epilepsy in rats.

Methods

Chemical kindling was elicited by repeated intraperitoneal (ip) injections of a subconvulsant dose of PTZ (35 mg/kg) once every 48 hours for 12 times, and seizure activity of kindling was recorded for 30 minutes. Control rats were ip injected with saline instead of PTZ. Morris water maze was used to evaluate the spatial memory. Phosphorylated cyclic adenosine monophosphate response element binding protein (p-CREB) was tested by Western blotting in hippocampus.

Results

Intracerebroventricular (icv) injections with thioperamide (10 μg, 20 μg) 30 minutes before every PTZ injections, significantly prolonged the onset of PTZ-kindling and inhibited the seizure stages. PTZ-kindling seizures led to the impairment of spatial memory in rats, and thioperamide ameliorated the impairment of spatial learning and memory. Compared to non-kindling rats, there was a significant decrease in p-CREB level in hippocampus of the PTZ-kindling rats, which was reversed by thioperamide.

Conclusions

Thioperamide plays a protective role in seizure development and cognitive impairment of PTZ-induced kindling in rats. The protection of thioperamide in cognitive impairment is possibly associated with the enhancement of CREB-dependent transcription.
Biomechanical effects of pedicle screw adjustments on the thoracolumbar burst fractures
Authors: SHANG Jian , LING Xiao-dong , LIU Yuan-chao , LIU Wei , XIAO Xi-gang , YUAN Shao-hui
Published: January 2024

Background

Posterior pedicle screw device is widely used in treatment of thoracolumbar burst fractures. As the clinical operation is not based upon quantitative data of adjustments, the results are not optimal. At present, no study has assessed the associations between the device adjustments and the restoration of stiffness. We investigated the biomechanical effects that adjustments of a pedicle screw device had on the burst fracture, and explored an optimal adjustment.

Methods

Burst fractures were produced at L1 vertebra in 24 fresh calf spines (T12-L3). The specimens were divided into four groups at random. Pedicle screw devices were attached to T13 and L2. Four device adjustments, consisting of distraction and extension, were applied. Adjustment 1 was pure 6r extension, adjustment 2 was pure 5 mm distraction, adjustment 3 was 6° extension followed by 5 mm distraction, and adjustment 4 was 5 mm distraction followed by 6° extension. The effect of each adjustment on the stiffness restoration, anatomical reduction, and neural decompression for the burst fractures was analyzed and evaluated.

Results

Pure extension (Group 1) produced the closest segment height and the least restoration of the canal to the intact. Pure distraction (Group 2) restored stiffness most, but with only 60% stiffness of the intact value, and lost the segmental angle most to the intact. The combination of extension-distraction (Group 3 and Group 4) produced the maximum reduction of the anatomy and restoration of the canal in the burst fracture, and the least stiffness restoration. The sequence of extension and distraction did not affect stiffness restoration, anatomical reduction, and neural decompression.

Conclusions

The device adjustments affected stiffness restoration, anatomical reduction, and neural decompression. The combined extension-distraction adjustment may be the most suitable considering the anatomical reduction and neural decompression, but the stiffness decreased the most; it should be considered to reconstruct L1 vertebra.
Combined subfascial endoscopic perforator surgery and endovenous laser treatment without impact on the great saphenous vein for management of lower-extremity varicose veins
Authors: GAN Shu-jie , QIAN Shui-xian , ZHANG Ci , MAO Jie-qi , LI Ke , TANG Jing-dong
Published: January 2024

Background

Conventional high ligation and stripping of the great saphenous vein (GSV) has a good curative effect but is highly traumatic with a considerable relapse rate. Subfascial endoscopic perforator surgery (SEPS) plus endovenous laser treatment (EVLT) could be applied as individual therapy. This study aimed to evaluate the feasibility of performing combined SEPS and EVLT without impacting GSV in the management of valvular insufficiency of the lower-limb venous perforators.

Methods

Placement of lower-limb venous perforator insufficiency was marked by ascending phlebography in 83 affected limbs from September 2010 to June 2011. After randomization, SEPS was performed on 41 limbs to address the insufficiency of the venous perforators under the deep fascia, in combination with EVLT to close the superficial varicose veins without impacting the GSV. The remaining 42 limbs were treated using traditional GSV phlebectomy as controls.

Results

Postoperatively, all varicose veins were resolved, with lightening of the pigmentation and healing of the ulcer. Within a follow-up period of 5-11 months, no symptoms had recurred. Compared with the control group, the operation time, the number of incisions sutured, and the in-hospital time decreased on average by 1.5 hours, 4.7, and 6.8 days, respectively (P<0.01 in all cases).

Conclusion

Combined SEPS and EVLT for treatment of valvular insufficiency of the lower-limb venous perforators offer the advantages of microtrauma and rapid cure.
Endovenous laser ablation of great saphenous vein with ultrasound-guided perivenous tumescence: early and midterm results
Authors: CHEN Jia-quan , XIE Hui , DENG Hao-yu , YUAN Kai , ZHANG Ji-wei , ZHANG Hao , ZHANG Lan
Published: January 2024

Background

Endovenous laser ablation (EVLA) is an improved method to treat varicose great saphenous veins (GSV) with a high satisfactory rate. This study aimed to evaluate the efficiency and safety of treatment by EVLA procedures with ultrasound-guided perivenous tumescence.

Methods

Thirty-one patients (31 limbs) with symptomatic varicose vein primary to chronic venous insufficiency (CVI) treated with EVLA were prospectively studied. The entire procedure was performed under ultrasound-guided tumescent local anesthesia. The patients were evaluated with a 18 month follow-up postoperation using clinical examination and venous duplex ultrasonography. Pain scores and quality of life (QOL) were recorded using visual analog scale (VAS) and the chronic venous insufficiency questionnaire (CIVIQ) at 1 week, 1 month, and 12 months after operation.

Results

All patients tolerated EVLA procedure well. The overall success occlusion rates of GSV were 92%, 94%, and 94% at 1, 12, and 18 months follow-up, respectively. The score of CIVIQ one week preoperation was 69.14±11.44 while that of CIVIQ one month postoperation was 85.32±4.89. The life quality has significantly improved after the operation of EVLA (t=12.71, P <0.05). The VAS one month after treatment was lower than 1 week before therapy (t=8.048, P<0.05). Major complications such as deep vein thrombosis and skin burns were not found. Most of the complications were minor and improved quickly.

Conclusions

This refinement type of EVLA procedure is a safe and effective treatment with a high satisfaction rate; it displayed noteworthy features including shortening hospitalization, early ambulant activity, and preferable occlusion rates.