bluuebunny/crossref_metadata_2025 huggingface dataset:
Endoscopic full-thickness resection of gastric stromal tumor arising from the muscularis propria
Authors: ZHANG Bo , HUANG Liu-ye , WU Cheng-rong , CUI Jun , JIANG Li-xin , ZHENG Hai-tao
Published: January 2024

Background

Gastric stromal tumors are the most common type of tumor originating from mesenchymal tissue. The traditional method for the treatment of gastric stromal tumor is surgical operation or therapeutic laparoscopy. More recently, endoscopic micro-traumatic surgery has become possible for gastric stromal tumors, with any perforation caused by endoscopic therapy mended endoscopically. We assessed the effectiveness of endoscopic full-thickness resection (EFR) in the treatment of gastric stromal tumors arising from the muscularis propria.

Methods

Of the 42 gastric stromal tumors, each >2.0 cm in diameter, arising from the muscularis propria, 22 were removed by EFR and 20 by laparoscopic surgery. Tumor expression of CD34, CD117, Dog-1, S-100, and smooth muscle actin (SMA) was assessed immunohistochemically. Operating time, complete resection rate, length of hospital stay, incidence of complications, and recurrence rates were compared between the two groups. Continuous data were compared by using independent samples t-tests and categorical data by using χ2 tests.

Results

Comparisons of the 22 gastric stromal tumors treated with EFR and the 20 treated with laparoscopic surgery showed similar operation times (60-155 minutes (mean, (90±17) minutes) vs. 50-210 minutes (mean, (95±21) minutes), P >0.05), complete resection rates (100% vs. 95%, P >0.05), and length of hospital stay (4-10 days (mean, (6.0±1.8) days) vs. 4-12 days (mean, (7.3±1.7) days), P >0.05). None of the patients treated with EFR experienced complications, whereas one patient treated with laparoscopy required a conversion to laparotomy and one experienced postoperative gastroparesis. No recurrences were observed in either group. Immunohistochemical staining showed that of the 42 gastric stromal tumors diagnosed by gastroscopy and endoscopic ultrasound, six were leiomyomas (SMA-positive) and the remaining 36 were stromal tumors.

Conclusions

Gastric stromal tumors arising from the muscularis propria can be completely removed by EFR. EFR may replace surgical or laparoscopic procedures for the removal of gastric stromal tumors.
Comparison of the flaps made by femtosecond laser and automated keratomes for sub-bowman keratomileusis
Authors: ZHAI Chang-bin , TIAN Lei , ZHOU Yue-hua , ZHANG Qing-wei , ZHANG Jing
Published: January 2024

Background

Thin-flap laserin situkeratomileusis (LASIK) is the new trend of refractive error correction surgery, the formation of corneal flap is crucial for a success of LASIK surgery. This study aimed to assess and compare the variations of LASIK flap created by the IntraLase femtosecond laser, Moria One Use-Plus SBK and Moria M2 Single-Use 90 μm-head microkeratome using Anterior segment optical coherence tomography (Visante OCT).

Methods

One hundred and sixty-one eyes of 81 consecutive patients were enrolled in this prospective study and randomly divided into three groups depending on the flap creation method: flap creation with the the IntraLase femtosecond laser (IntraLase group, 59 eyes), flap creation with the Moria One Use-Plus SBK (SBK group, 44 eyes), and flap creation with the Moria M2 Single-Use 90 μm-head microkeratome (M2SU90 group, 58 eyes). The nominal flap thickness was 110 μm for all patients and for the three devices. One month after surgery, Visante OCT was used to measure the flap thickness at 20 locations on each cornea and the results were assessed for uniformity, regularity, and accuracy.

Results

At 1 month after surgery, the mean central flap thickness was (111±3) μm in the IntraLase group, (114±8) μm in the SBK group, and (118±13) μm in the M2SU90 group respectively. The flaps in the IntraLase group and the SBK group were more regular, showing an almost planar configuration, than the meniscus-shaped flaps in the M2SU90 group. The maximum deviation from the intended flap thickness (110 μm) was 6 μm in the IntraLase group, 10 μm in the SBK group, and 20 μm in the M2SU90 group respectively. A difference greater than 20 μm was observed in 0.42% of measurements in the IntraLase group; 2.95% of the measurements in the SBK group and 21.12% of measurements in the M2SU90 group.

Conclusions

The flaps created by the IntraLase femtosecond laser and Moria One Use-Plus SBK are more uniform; more regular, and more accurate than those created by the Moria M2 Single-Use 90 μm-head microkeratome. The first two methods can make precise flaps for Sub-Bowman Keratomileusis.
Clinical features of retinal diseases masquerading as retrobulbar optic neuritis
Authors: JIANG Li-bin , SHEN Ce-ying , CHEN Fei , YAN Wei-yu , LAI Timothy Y. Y. , WANG Ning-li
Published: January 2024

Background

Managements of optic neuritis (ON) included high-dose corticosteroids or combined with systemic immunomodulatory agents. It was important to make a correct diagnosis of ON before initiation of treatment. The purpose of the study was to report and analyze the clinical features of retinal diseases in patients who were misdiagnosed as having retrobulbar ON.

Methods

Retrospective review of 26 patients (38 eyes) initially diagnosed with retrobulbar ON but were ultimately diagnosed with retinal or macular diseases. Data obtained from fundus examination, fluorescence fundus angiography (FFA), automated static perimetry, full-field electroretinogram (ffERG), multifocal electroretinogram (mfERG), and optical coherence tomography (OCT) were evaluated.

Results

Thirty-eight eyes of 26 patients were found to have misdiagnosis of retrobulbar ON, based on normal or slight abnormal fundus findings and abnormal visual evoked potentials (VEP). The mean age of the patients was 34 years and the correct diagnosis of the patients included acute zonal occult outer retinopathy (AZOOR, 15 eyes, 14 patients), occult macular dystrophy (OMD, 8 eyes, 4 patients), cone or cone-rod dystrophy (10 eyes, 5 patients), acute macular neuroretinopathy (AMNR, 3 eyes, 2 patients), and cancer-associated retinopathy (CAR, 2 eyes, 1 patient).

Conclusion

When attempting to diagnose retrobulbar ON in clinical practice, it is crucial to carry out necessary examinations of the retinal function and morphology to decrease misdiagnosis.
Recombinant human thrombopoietin in combination with cyclosporin A as a novel therapy in corticosteroid-resistant primary immune thrombocytopenia
Authors: CUI Zhong-guang , LIU Xin-guang , QIN Ping , HOU Ming , WU Shao-ling , PENG Jun , ZHAO Hong-guo , WANG Hong-yi , ZHAO Chun-ting
Published: January 2024

Background

The management of patients with refractory immune thrombocytopenia (ITP) is challenging, as there is no standard treatment option. The aim of this study was to investigate the efficacy of recombinant human thrombopoietin (rhTPO) in combination with cyclosporin A (CsA) for the management of patients with corticosteroid-resistant primary ITP. Methods Thirty-six patients with corticosteroid-resistant ITP were randomly divided into an observation group and control group. In the observation group, 19 patients received subcutaneous injection of rhTPO at a dose of 1 μg/kg (300 U/kg) once daily up to day 14. Simultaneously they also received oral CsA at a dose of 1.5-2.0 mg/kg twice daily for three months. In the control group, rhTPO alone was administered subcutaneously at 1 μg/kg once daily in the other 17 ITP patients for 14 consecutive days and then the treatment was withdrawn.

Results

There was no significant difference in the response rate at the end of the first week after treatment initiation between the observation group and the control group (63.2% vs. 58.8%, P >0.05), neither was there at the end of the second week (89.5% vs. 94.1%, P >0.05). However, the relapse rate in the observation group was significantly lower than that in control group at the end of the first (17.7% vs. 50.0%, P <0.05), second (29.4% vs. 68.8%, P <0.05) and the third month (29.4% vs. 87.5%, P <0.01). In addition, rhTPO plus CsA were well tolerated and adverse events recorded were mild.

Conclusions

Combination therapy with rhTPO and CsA was effective in the management of patients with corticosteroid-resistant ITP, with a relatively short time to response and low recurrence rate. It might be considered as a potential second-line treatment regimen for ITP.
Efficacy and safety of insulin treatment in type 2 diabetes using a new index called glucose safety control index
Authors: CAI Xiao-ling , LUO Ying-ying , HAN Xue-yao , JI Li-nong
Published: January 2024

Objective

To recommend an index named glucose safety control index (GSCI) to evaluate the efficacy and safety for insulin regimens.

Data sources

We searched databases for primary studies published in English. The main search concepts were type 2 diabetes, insulin treatment, premixed insulin, premixed insulin analogs, basal inuslin, basal inuslin analogs, bolus insulin, bolus insulin analogs, safety and efficacy.

Study selection

Studies were eligible for inclusion if they met all of the following criteria: (1) type 2 diabetic patients aged >18 years were included; (2) random control studies with at least 12 weeks of follow-up; (3) different insulin regimens were evaluated.

Results

When long-acting basal insulin therapy compared with neutral protamine Hagedorn (NPH) insulin therapy, the proportion of GSCI%A1c ratio more than 1 was 100%, the proportion of GSCIΔA1c ratio more than 1 was 94.44%. When premixed insulin therapy compared with oral hypoglycemic agents plus basal insulin therapy, the proportion of GSCI%A1c ratio more than 1 was 45.5%, the proportion of GSCIΔA1c ratio more than 1 was 38.9%. When premixed insulin therapy compared with oral hypoglycemic agents, the proportion of GSCI%A1c ratio less than 1 was 100%, the proportion of GSCIΔA1c ratio more than 1 was 50%. When premixed insulin therapy compared with basal-bolus insulin therapy, the proportion of GSCI%A1c ratio more than 1 was 37.5%, the proportion of GSCIΔA1c ratio more than 1 was 50%.

Conclusion

According to the GSCI ratio, long-acting basal insulin therapy tended to be superior to NPH therapy, oral hypoglycemic agents plus basal insulin therapy tended to be superior to premixed insulin therapy, noninsulin antidiabetic agents and premixed insulin therapy was comparable, and basal-bolus insulin therapy tended to be superior to premixed insulin therapy in type 2 diabetes.
Clinical outcome of ileal pouch-anal anastomosis for chronic ulcerative colitis in China
Authors: Gang Liu , Hongqiu Han , Tong Liu , Qiang Fu , Yongcheng Lyu
Published: January 2024

Background

The incidence of chronic ulcerative colitis (CUC) in China is remarkably increasing, while little information on surgical treatment has been reported. This study aimed to completely describe and analyze the clinical outcome of restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) for CUC in China.

Methods

Ninety-five consecutive patients, who suffered CUC and had surgical indications, were carefully selected. All patients underwent IPAA. Data on patient characteristics, surgical indications, surgical details, postoperative complications, functional outcome, and quality of life were collected.

Results

The mean patient age at the time of the operation was 32 years. Twenty-nine (31%) patients underwent an emergency operation, and 66 (69%) underwent elective procedures. Four patients with severe dysplasia underwent operations, but no carcinoma was histologically confirmed. A two-stage operation was performed in 87 (92%) patients, and a hand-sewn technique was applied in 88 (93%) patients. Sixteen patients (17.0%) experienced early complications, and there was a significant difference between the emergency surgery group and the elective group (31.0% vs. 10.6%, respectively;P<0.01). Five (5.3%) patients developed pouchitis as a late complication. The mean stool frequency after the operation was 4.6 (2-11) during the first 24 hours and 1.5 (0-4) overnight. According to the Kirwan grading scale, 87 (91.8%) patients showed satisfactory anal continence function. The quality of life improved significantly from a preoperative mean value of 0.28-0.61 before ileostomy closure to 0.78 after ileostomy closure (P<0.01) according to the Cleveland Global Quality of Life index.

Conclusions

IPAA is an effective and safe surgical procedure for patients with CUC in China. However, some characteristics, such as the low incidence of pouchitis, require further study.
HIV and syphilis infections among street-based female sex workers in China, 2010-2012
Authors: Li Dongmin , Wang Lu , Lin Wen , Li Peilong , Wang Lan , Guo Wei , Ge Lin , Ding Zhengwei , Cui Yan , Wang Ning
Published: January 2024

Background

Female sex workers (FSW) were high-risk population for HIV and other sexually transmitted diseases (STD) earlier, and now are an important driver of the HIV/AIDS epidemic in China. Sentinel surveillance for FSW was set up to monitor the trend of HIV prevalence and risk behavior-related HIV infection. This study collected the data on street-based FSW from HIV sentinel surveillance system to understand HIV and syphilis infections, risk behaviors, and intervention in China from 2010 to 2012.

Methods

The study population was the street-based FSW who were recruited for the national HIV integrated biological and behavioral surveillance between 2010 and 2012. Demographic information, HIV-related risk behaviors, and HIV and syphilis testing results were described and trend analysis was performed.

Results

Between 2010 and 2012, the number of street-based FSW surveyed was 3725, 3425, and 3335, respectively. HIV knowledge awareness rate significantly increased from 74.6% in 2010 to 76.8% in 2011 and 82.2% in 2012 (P <0.01). More FSW consistently used condom in the last month (49.0% in 2010; 51.0% in 2011; and 59.0% in 2012) and in the last commercial sex (72.0% in 2010; 78.5% in 2011; and 80.0% in 2012) over time. The proportions of individuals who received HIV testing in the last year were 31.2% (2010), 37.0% (2011), and 36.9% (2012) (P-trend <0.01). HIV prevalence rate changed from 1.5% in 2010 to 1.4% in 2011 and 2.3% in 2012 (P-trend=0.01). Syphilis prevalence rate was 6.9%, 7.2%, and 7.1% in the same period. The top three provinces with the highest average HIV prevalence rates over the 3 years were Guangxi (5.9%), Yunnan (4.2%), and Sichuan (1.2%).

Conclusions

Street-based FSW are at high risk of HIV and syphilis infections. Intervention efforts need to target street-based FSW who are of old age and minority, who use illicit drugs and have syphilis infection.
A novel, recovery, and reproducible minimally invasive cardiopulmonary bypass model with lung injury in rats
Authors: LI Ling-ke , CHENG Wei , LIU Dong-hai , ZHANG Jing , ZHU Yao-bin , QIAO Chen-hui , ZHANG Yan-bo
Published: January 2024

Background

Cardiopulmonary bypass (CPB) has been shown to be associated with a systemic inflammatory response leading to postoperative organ dysfunction. Elucidating the underlying mechanisms and developing protective strategies for the pathophysiological consequences of CPB have been hampered due to the absence of a satisfactory recovery animal model. The purpose of this study was to establish a good rat model of CPB to study the pathophysiology of potential complications.

Methods

Twenty adult male Sprague-Dawley rats weighing 450-560 g were randomly divided into a CPB group (n=10) and a control group (n=10). All rats were anaesthetized and mechanically ventilated. The carotid artery and jugular vein were cannulated. The blood was drained from the right atrium via the right jugular and transferred by a miniaturized roller pump to a hollow fiber oxygenator and back to the rat via the left carotid artery. Priming consisted of 8 ml of homologous blood and 8 ml of colloid. The surface of the hollow fiber oxygenator was 0.075 m2. CPB was conducted for 60 minutes at a flow rate of 100-120 ml• kg-1· min-1 in the CPB group. Oxygen flow/perfusion flow was 0.8 to 1.0, and the mean arterial pressure remained 60-80 mmHg. Blood gas analysis, hemodynamic investigations, and lung histology were subsequently examined.

Results

All CPB rats recovered from the operative process without incident. Normal cardiac function after successful weaning was confirmed by electrocardiography and blood pressure measurements. Mean arterial pressure remained stable. The results of blood gas analysis at different times were within the normal range. Levels of IL-1β and TNF-α were higher in the lung tissue in the CPB group (P <0.005). Histological examination revealed marked increases in interstitial congestion, edema, and inflammation in the CPB group.

Conclusion

This novel, recovery, and reproducible minimally invasive CPB model may open the field for various studies on the pathophysiological process of CPB and systemic ischemia-reperfusion injury in vivo.
Balloon dilation versus Amplatz dilation during ultrasound-guided percutaneous nephrolithotomy for staghorn stones
Authors: Ren Minghua , Zhang Cheng , Fu Weijun , Fu Yiming , Ma Li , Zhao Weiming , Xu Wanhai , Ni Shaobin
Published: January 2024

Background

Amplatz dilation and balloon dilation are different methods in creating the accesses during percutaneous nephrolithotomy (PCNL). The aim of this study was to review the surgical experiences of managing staghorn calculi by Amplatz dilation and balloon dilation for 3 years.

Methods

We retrospectively analyzed clinical data from 125 patients (129 kidneys) with staghorn kidney stones who underwent PCNL from January 2010 to December 2012, of whom 60 patients underwent Amplatz dilation (AD group) and 65 underwent balloon dilation (BD group) during PCNL.

Results

The AD and BD groups were similar in age, male-female ratio, stone burden, stone type, hydronephrosis, and proportion of patients who had undergone extracorporeal lithotripsy. However, these two groups showed significant differences in terms of duration of percutaneous access (15.1±3.6) minutes vs. (10.0±3.3) minutes, one-attempt success rate of dilation via a single access 88.9% (72/81) vs. 97.8% (91/93), hemoglobin drop after surgery (3.5±0.9) g/dl vs. (1.7±0.9) g/dl, number of cases requiring intraoperative and postoperative blood transfusion 27.9% (n=17) vs. 13.2% (n=9), changes of central venous pressure before and after surgery (2.3±1.2) cmH2O vs. (1.2±0.7) cmH2O, number of patients who experienced postoperative fever >37.5°C 21 (34.4%) vs. 13 (19.1%) (allP<0.05). No injury of adjacent organs, including pleura, liver, spleen, or bowel, was noted in patients.

Conclusions

During ultrasound-guided PCNL for staghorn stones, balloon dilation and Amplatz dilation are all effective and safe. Compared with Amplatz dilation, balloon dilation is a better choice, as it has a higher access creation success rate, shorter access creation time less blood loss, and lower proportions of circulatory overload and postoperative fever.
A two-year follow-up for Chinese patients with abdominal aortic aneurysm undergoing open/endovascular repair
Authors: Tao Sun , Hongju Zhang , Yutong Cheng , Su Wang , Ying Tao , Donghua Zhang , Ji Huang , Jingmei Zhang , Zhizhong Li , Mouyue Wang
Published: January 2024

Background

A number of studies have demonstrated the rates of overall and aneurysm-related mortality and morbidity in Western populations. The cardiovascular risk factors influencing postoperative outcome have been also reported. Until recently, little has been known about the prognosis in this patient cohort in the Chinese population. We evaluated the independent predictors of mortality and morbidity in abdominal aortic aneurysm (AAA) patients undergoing elective surgical treatment and emphasized whether the coronary artery revascularization could have any effect on the overall mortality and morbidity in patients following the current guideline recommendation.

Methods

A total of 386 patients (174 women) undergoing surgery in Beijing Anzhen Hospital from January 2008 to June 2010 were enrolled (mean age (70.6±10.5) years). Kaplan-Meier curves were constructed to compare the mortality and morbidity of AAA patients with coronary artery revascularization and those without. A Cox proportional hazards model was constructed to identify clinical factors associated with two-year outcomes. The primary outcomes were death from any cause, the pre-specified morbidity was re-hospitalization for pulmonary conditions, congestive heart failure, angina, ischemic/hemorrhagic stroke.

Results

During the two-year follow-up, 34 patients died and 65 experienced re-hospitalization with pulmonary conditions, congestive heart failure, angina, or ischemic/hemorrhagic stroke. Kaplan-Meier survival analysis showed that the AAA patients with cardiac revascularization had no higher incidence of overall mortality and major morbidity than those without (log-rank test P=0.35 and P=0.40, respectively). Cox proportional hazards regression analysis showed that level of lowdensity lipoprotein (HR, 4.06; 95% CI: 1.19-18.7, P=0.027) and AAA size (HR, 2.18; 95% CI: 1.28-11.65, P=0.036) were independently associated with the incidence of overall mortality. Long-term use of angiotensin converting enzyme inhibitors, statins, AAA size and systolic blood pressure were independent predictors of the secondary pre-specified outcomes.

Conclusions

Coronary artery revascularization following the guideline recommendations did not increase the mortality and morbidity of Chinese with AAA who were undergoing repair. Absence of angiotensin converting enzyme inhibitors and statins, AAA size, and systolic blood pressure were powerful predictors of the clinical events.
Normal blood D-dimer concentrations: do they exclude pulmonary embolism?
Authors: Guo Zhiguo , Ma Qingbian , Zheng Yaan , Zhang Yumei , Ge Hongxia
Published: January 2024

Background

Although pulmonary embolism (PE) with normal blood D-dimer (DD) concentrations is considered rare, in practice the incidence may be greater than is generally believed. Overlooking PE is potentially dangerous. The aim of this study was to explore the incidence and clinical features of PE with normal DD concentrations.

Methods

We retrospectively analyzed the records of 29 patients with PE and normal DD concentrations from the past seven years. We here compare relevant clinical characteristics of these patients with those of patients with PE and abnormal DD concentrations. We evaluated the probabilities of differences by computing pretest probability scores (Wells score and revised Geneva score).

Results

The frequency of normal DD concentrations in patients with PE was 4%. Previous episode(s) of PE were more common in patients with normal DD concentrations than in those with abnormal DD concentrations (P=0.001). Fever, tachycardia, and tachypnea occurred less frequently in the former group (P<0.05) and time between onset of symptoms and DD testing was longer (P=0.001). The diagnosis of PE was delayed in 22 of the 29 cases. Nineteen and seven cases with normal DD concentrations were classified according to pretest scores as intermediate and low risk, respectively.

Conclusions

PE with normal DD concentrations is uncommon. Although most diagnoses of PE are ruled out by normal DD values, a small number of cases with PE are missed. A combination of pretest probability score and normal DD concentration increases the probability of making the correct diagnosis, but cannot completely exclude patients with suspected PE. When the clinical manifestations cannot be otherwise explained, clinicians should be alert to the possibility of PE with normal DD concentrations in patients with previous episode(s) of PE or a long interval between onset of symptoms and DD testing.
Safety and efficacy of early administration of tirofiban in patients with acute ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention: a meta-analysis
Authors: Liu Yangchun , Su Qiang , Li Lang
Published: January 2024

Background

Tirofiban has been widely used as an adjunctive pharmacologic agent for revascularization in patients undergoing percutaneous coronary intervention, and the outcomes appear attractive. However, the potential benefits from early administration of tirofiban in patients with acute ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI) remain unclear.

Methods

We conducted a search in MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials up to September 2012 without language restriction. A total of eight randomized trials (n=1 577 patients) comparing early (emergency department or ambulance) versus late (catheterization laboratory) administration of tirofiban in STEMI patients undergoing PPCI were included in this meta-analysis. Risk ratio (RR) was computed from individual studies and pooled with random- or fixed-effect models.

Results

There were no differences in post-procedural Thrombolysis In Myocardial Infarction (TIMI) flow grade 3 and Corrected TIMI Frame Count (RR=1.02, 95% confidence interval (CI): 0.99–1.05,P=0.18; weighted mean difference (WMD)=-0.93, 95%CI: -5.37–3.52,P=0.68, respectively) between the two groups. Similarly, there were no significant differences in the incidence of 30-day mortality (RR=1.69, 95%CI: 0.69–4.13,P=0.25) and re-myocardial infarction (RR=0.71, 95%CI: 0.21–2.35,P=0.57) between early and late administration of tirofiban. As to the safety end points, no significant difference was observed in hospital minor bleeding (RR=1.08, 95%CI: 0.54–2.14,P=0.83) and hospital and 30-day major bleeding between the two groups (RR=0.98, 95%CI: 0.46–2.10,P=0.96;RR=1.32, 95%CI: 0.59–2.97,P=0.49, respectively).

Conclusions

Early administration of tirofiban in patients undergoing PPCI for STEMI was safe, but no beneficial effects on post-procedural angiographic or clinical outcomes could be identified as compared with late administration. Besides the negative finding, more high-quality randomized clinical trials are still needed to explore the efficacy of adequate, earlier administration of tirofiban in patients undergoing PPCI.
Relationship with spatial memory in diabetic rats and protein kinase Cγ, caveolin-1 in the hippocampus and neuroprotective effect of catalpol
Authors: Zhou Haicheng , Liu Jing , Ren Liyuan , Liu Wei , Xing Qian , Men Lili , Song Guirong , Du Jianling
Published: January 2024

Background

The mechanisms underlying diabetic encephalopathy are largely unknown, and no effective treatments are available. Catalpol has received much attention due to its numerous biological effects, especially in neuroprotective studies. The aim of this study was to investigate the effects of catalpol on cognitive functions in diabetic rats and the underlying mechanisms.

Methods

A rat model of diabetes was established by streptozotocin injection, followed by intraperitoneal infusion of catalpol after 10 weeks. Two weeks later, the Morris water maze was used to test the spatial learning performance. Nissl staining was performed to evaluate the morphological changes in the hippocampus. Expression of protein kinase Cγ (PKCγ) and caveolin-1 (Cav-1) in the hippocampus were assessed by reverse transcription PCR and Western blotting. Activities of anti-oxidative enzymes such as glutathione (GSH), superoxide dismutase (SOD) and catalase (CAT) and levels of malonaldehyde (MDA) were measured using commercial kits.

Results

Significant hippocampal neuronal injury was observed in rats with streptozotocin-induced diabetes. Moreover, cognitive dysfunction was associated with markedly increased oxidative stress in the brain. Catalpol treatment significantly attenuated cognitive deficits, neuronal damage, and oxidative stress in the brain of diabetic rats. Biochemical analyses showed that catalpol reversed the down-regulation of PKCγ and Cav-1 expression in the diabetic rats.

Conclusions

Spatial memory in diabetic rats is associated with the expression of PKCγ and Cav-1. Catalpol treatment markedly attenuated oxidative stress, reversed the alteration of PKCγ, Cav-1 and spatial memory deficits.
Bedside chest radiography of novel influenza A (H7N9) virus infections and follow-up findings after short-time treatment
Authors: SONG Feng-xiang , ZHOU Jun , SHI Yu-xin , ZHANG Zhi-yong , FENG Feng , ZHOU Jian-jun , WANG Qing-le
Published: January 2024

Background

Influenza A (H7N9) virus infections were first observed in China in March 2013. This type virus can cause severe illness and deaths, the situation raises many urgent questions and global public health concerns. Our purpose was to investigate bedside chest radiography findings for patients with novel influenza A (H7N9) virus infections and the followup appearances after short-time treatment.

Methods

Eight hospitalized patients infected with the novel influenza A (H7N9) virus were included in our study. All of the patients underwent bedside chest radiography after admission, and all had follow-up bedside chest radiography during their first ten days, using AXIOM Aristos MX and/or AMX-IV portable X-ray units. The exposure dose was generally 90 kV and 5 mAs, and was slightly adjusted according to the weight of the patients. The initial radiography data were evaluated for radiological patterns (ground glass opacity, consolidation, and reticulation), distribution type (focal, multifocal, and diffuse), lung zones involved, and appearance at follow-up while the patients underwent therapy.

Results

All patients presented with bilateral multiple lung involvement. Two patients had bilateral diffuse lesions, three patients had unilateral diffuse lesions of the right lobe with multifocal lesions of the left lobe, and the remaining three had bilateral multifocal lung lesions. The lesions were present throughout bilateral lung zones in three patients, the whole right lung zone in three patients with additional involvement in the left middle and/or lower lung zone(s), both lower and middle lung zones in one patient, and the right middle and lower in combination with the left lower lung zones in one patient. The most common abnormal radiographic patterns were ground glass opacity (8/8), and consolidation (8/8). In three cases examined by CT we also found the pattern of reticulation in combination with CT images. Four patients had bilateral and four had unilateral pleural effusion. After a short period of treatment the pneumonia in one patient had significantly improved and three cases demonstrated disease progression. In four cases the severity of the pneumonia fluctuated.

Conclusions

In patients with influenza A (H7N9) virus infection, the distribution of the lung lesions are extensive, and the disease usually involves both lung zones. The most common imaging findings are a mixture of ground glass opacity and consolidation. Pleural effusion is common. Most cases have a poor short-time treatment response, and seem to have either rapid progressive radiographic deterioration or fluctuating radiographic changes. Chest radiography is helpful for evaluating patients with severe clinical symptoms and for follow-up evaluation.
Current status of pediatric kidney transplantation in China: data analysis of Chinese Scientific Registry of Kidney Transplantation
Authors: Longshan Liu , Huanxi Zhang , Qian Fu , Liping Chen , Chuanhou Sun , Yunyi Xiong , Bingyi Shi , Changxi Wang
Published: January 2024

Background

Kidney transplantation (KTx) is the primary therapy for children with renal failure. Unlike KTx in adult patients, it is commonly agreed that pediatric KTx in China is far behind that of America. There has been no systematic analysis of Chinese pediatric KTx reported. This study aimed to demonstrate the current status of pediatric KTx in China.

Methods

Registry data of pediatric KTx (1983-2012) from Chinese Scientific Registry of Kidney Transplantation (CSRKT) were retrospectively analyzed.

Results

There were 851 pediatric KTx from 102 transplant units. The recipients were (15.4±2.5) years of age, 93.9% of who were over 10 years old. Chronic glomerulonephritis and pyelonephritis accounted for 75.6% of recognized primary diseases. Allografts were from deceased donors (72.2%) or living donation (27.7%). The patient survival for 1, 3, 5, and 10 years was 96.9%, 94.2%, 92.3%, and 92.3% and the graft survival was 94.6%, 91.4%, 86.3%, and 79.2%, respectively. The majority of post-transplant complications were acute rejection and infections. Annual transplant reached the peak in 2008 (n=114), and decreased sharply in 2006 (n=41) and 2010 (n=57). The percentage of pediatric KTx in total KTx was highest in 2007 (1.95%) and decreased to trough level in 2010 (1.0%). Living donation increased by 32.5-folds from 2004 to 2008 and then decreased by 86.6% till 2010. The percentage of living donation in pediatric or total KTx dynamically changed in a similar manner, while living donation ratio in pediatric KTx was much higher.

Conclusions

Kidney transplant can provide long-term benefits to pediatric recipients. Rejection and infections are worthy of concern during follow-up. Pediatric kidney transplant in China is very much lagging behind that in developed countries. Living donation played an important role in its development in the past decades. New strategies for implementation are encouraged to increase the priority of uremic children in organ allocation so as to promote its progress in China.
Chest radiographic characteristics of community-acquired Legionella pneumonia in the elderly
Authors: Zhang Zhigang , Liu Xinmin , Chen Luzeng , Qiu Jianxing
Published: January 2024

Background

Legionella is an important community-acquired pneumonia pathogen. Although the elderly are especially susceptible to Legionella, few studies have looked at comparative radiographic features of Legionella pneumonia in this population. The aim of this study was to explore the chest radiographic characteristics of community-acquired Legionella pneumonia in the elderly.

Methods

Serial chest radiographs obtained in 34 patients hospitalized with serologically proven Legionella pneumonia were retrospectively reviewed. Chest X-ray features of an aged group of ≥65 years were assessed and compared with a non-aged group of <65 years old with regard to initial patterns and distributions of pulmonary abnormalities, accompanying signs, and progression.

Results

The most common initial presentation was a patchy alveolar infiltrate involving a single lobe, most often the lower lobe. There was no middle or lingular lobe involvement in the aged group patients, but bilateral pleural effusion was significantly more common in this group. In the aged group patients, radiographic progression following adequate therapy, despite a clinical response, was more often noted and the radiographs were less likely to have returned to the premorbid state at discharge, but the differences were not significant between the two groups.

Conclusion

The discrepancy between imaging findings and clinical symptoms seems more prominent in communityacquired Legionella pneumonia in the elderly.
Value of magnetic resonance imaging including dynamic contrast-enhanced magnetic resonance imaging in differentiation between inverted papilloma and malignant tumors in the nasal cavity
Authors: Wang Xinyan , Zhang Zhengyu , Chen Xiaoli , Li Jing , Xian Junfang
Published: January 2024

Background

Distinguishing inverted papilloma (IP) from malignant tumors in the nasal cavity is difficult in a substantial number of cases, thus hindering the administration of appropriate therapeutic strategies. This study aimed to evaluate whether magnetic resonance imaging (MRI), including dynamic contrast enhanced MRI (DCE-MRI), could improve differentiation between IP and malignant tumors, and to identify which MRI features were the best in discriminating IP from malignant tumors in the nasal cavity.

Methods

Non-enhanced, static, and dynamic contrast enhanced MRI was performed in 88 patients with an IP or a malignant tumor in the nasal cavity that had been confirmed by histological results. MRI features of IP and malignant tumors including side, margin, T1 signal intensity, T1 homogeneity, T2 signal intensity, T2 homogeneity, lobulation signs, convoluted cerebriform pattern, extra-sinonasal involvement, pattern of enhancement, Tpeak, Tmax, CImax, and TIC type were evaluated and correlated with histological findings.

Results

There were significant differences between IP and malignant tumors in T2 homogeneity, lobulation signs, convoluted cerebriform pattern, extra-sinonasal involvement, Tpeak, Tmax and TIC types. A convoluted cerebriform pattern had a higher sensitivity and specificity in diagnosis of IP while washout-type TIC had a higher sensitivity and specificity in diagnosis of malignant tumors in the nasal cavity. Non-enhanced combined with static and dynamic enhancement MRI was significantly superior to non-enhanced combined with static enhancement MRI in the differentiation of IP and malignant tumors in the nasal cavity. Multivariate logistic regression analysis identified that the best MRI features were a convoluted cerebriform pattern, extra-sinonasal involvement, and washout-type TIC for both observers (Wang XY and Zhang ZY).

Conclusion

Non-enhanced and static combined with dynamic contrast-enhanced MRI improves differentiation of IP and malignant tumors in the nasal cavity.
Kyphoplasty versus vertebroplasty for the treatment of malignant vertebral compression fractures caused by metastases: a retrospective study
Authors: Zhi Li , Caifang Ni , Long Chen , Zhiyong Sun , Chao Yang , Xin Zhao , Yanwei Wang
Published: January 2024

Background

There are few comparative studies regarding kyphoplasty (KP) and vertebroplasty (VP) for the treatment of painful vertebral compression fractures (VCF) in patients with cancer. The purpose of this study is to retrospectively compare KP with VP in pain improvement, cement leakage incidence, and the cost of treatment of malignant VCF.

Methods

We performed a retrospective study of clinical data for 80 patients with multiple spinal metastases, treated with KP in 42 cases and VP in 38. Visual analog scale (VAS) scores were collected pre-operatively, post-operatively, at 1 month, 6 months, and 1 year after treatment. Cement leakage was identified using fluoroscopy and CT scan. Total cost per patient was also collected.

Results

There was a significant difference between the pre- and post-operative VAS scores (7.4±2.0 to 3.8±1.6,P< 0.001 in the KP group; 6.7±2.4 to 3.7±1.4,P<0.001 in the VP group), and was maintained at 1-year follow-up (3.2±1.4 in the KP group, 3.1±1.3 in the VP group). However, the difference in VAS score between these two groups was insignificant at baseline and every follow-up assessment post-operatively (P>0.05). The incidence of cement leakage in the KP group was lower than that of the VP group (16.9% (14/83) vs 30.3% (23/76),P<0.05). However, none of the patients developed any symptoms. The length of postoperative hospital stay in the VP group was shorter than that of the KP group ((2.4±1.3) vs (5.3±1.9) days,P<0.05). Total hospital cost in the KP group was much higher than that of the VP group (RMB Yuan 8 492±3 332 vs RMB Yuan 3 173±1 341,P<0.01).

Conclusions

VP and KP are both effective in providing pain relief for patients with cancer-related VCF. KP provides no greater degree of pain improvement. KP is associated with a lower rate of cement leakage compared with VP. VP is associated with lower cost and shorter postoperative hospital stay in China.
Association between adiponectin concentrations and diabetic retinopathy in patients with type 2 diabetes: a meta analysis
Authors: Fan Xiaohong , Wu Qunhong , Li Yuan , Hao Yanhua , Ning Ning , Kang Zheng , Cui Yu , Liu Ruohong , Han Liyuan
Published: January 2024

Background

Numerous studies have investigated the association between adiponectin concentrations and diabetic retinopathy (DR) caused by type 2 diabetic mellitus. However, the results remain conflicting. We performed a metaanalysis to explore the relationship between adiponectin concentrations and risk of DR caused by type 2 diabetic mellitus from published articles.

Methods

A published literature search was performed through the PubMed, Cochrane Library, EMBASE, Science Citation Index Expanded database, Chinese CNKI, and Chinese Wan Fang databases for articles published in English and Chinese. Pooled standardized mean differences (SMDs) and 95% confidence intervals (95% CIs) were calculated using random or fixed effects model. Heterogeneity between studies was assessed using the Cochrane Q test and I
2 statistics.

Results

Nineteen studies with a total of 1 545 cases and 1 502 controls were retrieved. The original meta-analysis found a significant difference in the adiponectin concentrations between the DR and non-DR (NDR) groups. After excluding the high heterogeneity studies, the second meta-analysis also demonstrated the significant association (SMD (95% CI) =-0.62 (-0.80 to -0.44), P=0.0001). According to the available data, there was statistical significance in the adiponectin concentrations considering non-proliferative DR (NPDR) versus NDR, PDR versus NPDR in Chinese populations with high heterogeneity.

Conclusion

Adiponectin concentrations are correlated with DR; however, the relationship between adiponectin concentrations and DR needs more in-depth investigations with larger sample sizes.
Multicenter prospective study of magnetic resonance imaging prior to breast-conserving surgery for breast cancer
Authors: Qian Liu , Yinhua Liu , Ling Xu , Xuening Duan , Ting Li , Naishan Qin , Hua Kang , Hongchuan Jiang , Deqi Yang , Xiang Qu , Zefei Jiang , Chengze Yu
Published: January 2024

Background

This multicenter prospective study aimed to assess the utility of dynamic enhanced magnetic resonance imaging (MRI) prior to breast-conserving surgery for breast cancer.

Methods

The research subjects were drawn from patients with primary early resectable breast cancer treated in the breast disease centers of six three-level hospitals in Beijing from 1 January 2010 to 31 December 2012. The participants were allocated to a breast-conserving surgery group (breast-conserving group) or a total mastectomy group (total mastectomy group). Enhanced MRI was used to measure breast volume, longest diameter of tumor and tumor volume. The correlations between these measurements and those derived from histopathologic findings were assessed. The relationships between the success rate of breast-conserving surgery and MRI- and pathology-based measurement results were statistically analyzed in the breast-conserving group.

Results

The study included 461 cases in the total mastectomy group and 195 in the breast-conserving group. Allocation to these groups was based on clinical indications and patient preferences. The cut-off for concurrence between MRI- and pathology-based measurements of the longest diameter of tumor was set at 0.3 cm. In the total mastectomy group, the confidence interval for 95% concurrence of these measurements was 35.41%-44.63%. Correlation coefficients for MRI and histopathology-based measurements of breast volume, tumor volume and tumor volume/breast volume ratio were r=0.861, 0.569, and 0.600, respectively (all P <0.001). In the breast-conserving group, with 0.30 cm taken as the cut-off for concurrence, the 95% confidence interval for MRI and pathology-based measurements of the longest diameter of tumor was 29.98%-44.01%. The subjective and objective success rates for breast-conserving surgery were 100% and 88.54%, respectively.

Conclusions

There were significant correlations between dynamic enhanced MRI- and histopathology-based measurements of the longest diameter of breast lesions, breast and tumor volumes, and breast volume/tumor volume ratios. Preoperative MRI examination improves the success rate of breast-conserving surgery.
Clinical features and outcomes of 210 patients with idiopathic pulmonary fibrosis
Authors: Cai Miaotian , Zhu Min , Ban Chengjun , Su Jin , Ye Qiao , Liu Yan , Zhao Wen , Wang Chen , Dai Huaping
Published: January 2024

Background

Idiopathic pulmonary fibrosis (IPF) is a lethal chronic interstitial lung disease (ILD) of unknown cause and having a variable and unpredictable course. This study aimed to summarize the clinical features and follow-up outcomes and to identify potential factors useful for the assessment of prognosis in IPF.

Methods

Two hundred and ten patients hospitalized and diagnosed as IPF in our unit from January 1999 to June 2007 were enrolled into this study. The baseline demographic, clinical, radiologic and physiologic characteristics were summarized. Clinical follow-up data until February 2010 were collected, and the median survival time and 1-, 2-, and 5-year survival rates, as well as the influences of the summarized baseline variables on the prognosis were analyzed.

Results

The age at diagnosis as IPF was (64±10) years, the duration before diagnosis of 106 patients (50%) was shorter than 2 years, and 73% were males. One hundred and forty-five patients (69%) had a history of smoking with a median pack-year of 18. Eighty-nine patients (42%) had emphysema and 62 patients (29%) pulmonary arterial hypertension (PAH). One hundred and twenty-four patients were followed up, of which 99 patients died from various causes including respiratory failure related to IPF (93%). The follow-up period was (21±23) months. The median survival time was 38 months. The 1-, 2-, and 5-year survival rates were 61%, 52%, and 39%, respectively. Multivariate analysis showed clubbing, PAH, duration from initial onset to diagnosis, and forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) were independent prognostic indicators of IPF.

Conclusion

IPF patients who have clubbing, PAH, a higher FEV1/FVC, and a short duration from initial onset to diagnosis have a poorer outcome.
A novel method of defective vascular reconstruction using 2-octyl-cyanoacrylate and homemade prosthetic component
Authors: Liang Xiangdang , Cai Hongfei , Sun Geng , Liu Zihao , Chen Wen , Tang Peifu
Published: January 2024

Background

Currently, adhesive technique is popular in vascular repair but not widely used for defective vessels. This study aimed to determine the feasibility and effectiveness of repairing defective vessels with 2-octyl-cyanoacrylate and a homemade prosthetic component.

Methods

Homemade prosthetic component consisting of expanded polytetrofluoroethylene (ePTFE), terylene film, and homemade soluble hollow stent mixed with adhesive can replace autologous graft and suture in repairing defective vessels, can fix vessels better using the stent without occlusive bleeding. Forty male mongrel dogs were used, 20 for biomechanical tests and 20 for animal experiments. In the biomechanical test, dogs were randomly divided into two groups (n=10 each), one group repaired on the two sides of the carotid arteries with 2-octyl-cyanoacrylate and homemade component and another group repaired with suture and ePTFE. Of the 40 specimens, 10 were used for adhesive and 10 for suture specimens for tension strength test, whereas the remaining specimens were used for bursting pressure test. In animal experiments, dogs were also divided into adhesive and suture groups (n=10), only of the left carotid artery. Recording the operational time, bleeding or not. Vessels were tested using color Doppler ultrasound, the inner diameter was measured, and the degree of stenosis at 8 weeks was evaluated digital subtraction angiography (DSA) were also performed. Specimens were then analyzed histologically.

Results

In the adhesive and suture groups, the specimens could afford atension strength of (23.80±1.51) N versus (24.60±1.08) N (P>0.05), the bursting pressure was (52.03±2.43) kPa versus (50.04±3.51) kPa (P>0.05), and the mean time of anastomosis was (15.20±0.55) minutes versus (25.97±0.58) minutes (P <0.05). One dog in the adhesive group was bleeding from the suture. One dog from each group presented with thrombosis at 1 week. After measuring using ultrasound, the stenosis degree of all dogs were no more than 30% except the two thromboses. DSA and histological observation showed no obvious difference between the two groups.

Conclusion

Defective vascular anastomosis with 2-octyl-cyanoacrylate and our homemade prosthetic component is feasible, effective, timesaving, and easy to master.