bluuebunny/crossref_metadata_2025 huggingface dataset:
ERK signaling mediates enhanced angiotensin II-induced rat aortic constriction following chronic intermittent hypoxia
Authors: GUO Xue-ling , DENG Yan , SHANG Jin , LIU Kui , XU Yong-jian , LIU Hui-guo
Published: January 2024

Background

Obstructive sleep apnea (OSA) has been recognized as an independent risk factor for systemic hypertension. The study investigated the functional consequences of chronic intermittent hypoxia (CIH) on aortic constriction induced by angiotensin II (Ang II) and the possible signaling involving ERK1/2 and contractile proteins such as myosin light chain kinase (MLCK), myosin phosphatase targeting subunit (MYPT1) and myosin light chain (MLC).

Methods

Male Wistar rats were randomly divided into CIH group and normoxia group and exposed to either CIH procedure or air-air cycles. Phosphorylation of ERK1/2, MYPT1 and MLC was assessed by Western blotting following constrictor studies in the presence or absence of PD98059 (10 μmol/L).

Results

CIH-exposure resulted in more body weight gain and elevated blood pressure, which could be attenuated by pretreatment with PD98059. Endothelium-removed aortic rings from CIH rats exhibited higher constrictor sensitivity to Ang II (Emax: (138.56±5.78)% versus (98.45±5.31)% of KCl; pD2: 7.98±0.14 versus 8.14±0.05, respectively). CIH procedure exerted complex effects on ERK expressions (total ERK1/2 decreased whereas the ratio of phosphorylated to total ERK1/2 increased). CIH aortas had higher MLCK mRNA and basal phosphorylation of MYPT1 and MLC. In parallel to greater increases in phosphorylation of ERK1/2, MYPT1 and MLC, Ang II-induced aortic constriction was significantly enhanced in CIH rats, which was largely reversed by PD98059. However vascular constriction of normoxia rats remained unchanged despite similar but smaller changing tendency of proteins phosphorylation.

Conclusion

These data suggest that CIH exposure results in aortic hyperresponsiveness to Ang II, presumably owing to more activated ERK1/2 signaling pathway.
Prognosis and weaning of elderly multiple organ dysfunction syndrome patients with invasive mechanical ventilation
Authors: Xiao Kun , Su Longxiang , Han Bingchao , Guo Chao , Feng Lin , Jiang Zhaoxu , Wang Huijuan , Lin Yong , Jia Yanhong , She Danyang , Xie Lixin
Published: January 2024

Background

Elderly multiple organ dysfunction syndrome (MODS) patients receiving invasive mechanical ventilation have poor prognosis in intensive care units (ICUs). We studied the usefulness of four commonly used severity scores and extrapulmonary factors that affected weaning to predict outcome of such patients.

Methods

Clinical data of 197 patients on admission to ICUs (from January 2009 to June 2012) were used retrospectively. The Acute Physiology and Chronic Health Evaluation (APACHE) II, APACHE III, Sample Acute Physiological Score (SAPS) II and MODS scores were calculated. All the patients were grouped into survivors and nonsurvivors according to the prognosis. Patients, who weaned from ventilator (n=154), were subdivided into a successful weaning group and a failed weaning group. The receiver operating characteristic (ROC) curves and Logistic regression was used for prognostic and weaning assessment.

Results

Based on the outcomes, the areas under the ROC of APACHE II, APACHE III, SAPS II, and MODS were 0.837, 0.833, 0.824, and 0.837, respectively. The Logistic regression analysis revealed that the odds ratio (OR) of underlying lung diseases, serum albumin and creatinine, and the number of organ failures was 2.374, 0.920, 1.003, and 1.547. APACHE II scores on admission performed excellent (ROC: 0.921) on the weaning assessments.

Conclusions

APACHE II and MODS systems were marginally better for evaluating the prognosis of elderly MODS patients who received invasive mechanical ventilation. Underlying lung diseases, serum albumin, serum creatinine and the number of organ failures were independent prognostic factors. Using the APACHE II scores on admission before weaning may increase the likelihood of successful weaning. (ClinicalTrial.gov identifier NCT01802983).
Chemotherapy with or without irinotecan in patients with advanced or recurrent gastric cancer: a meta-analysis of randomized controlled trials
Authors: Zeng Chao , Zhou Hang , Wei Yang , Wang Liyang , Xie Hua , Yao Wenxiu
Published: January 2024

Background

Studies have shown that irinotecan can improve survival in patients with advanced or recurrent gastric cancer, but the overall benefit of irinotecan in the treatment of advanced or recurrent gastric cancer remains controversial. The aim of this study was to evaluate the benefits and risks of irinotecan for survival in patients with advanced or recurrent gastric cancer.

Method

We searched PubMed, EmBase, the Cochrane Central Register of Controlled Trials, reference lists of articles, and proceedings of major conferences for relevant clinical trials. We included randomized controlled trials that reported on the efficacy and safety of irinotecan in patients with advanced or recurrent gastric cancer. Outcomes were analyzed by survival rate, objective response rate (ORR), and toxicity. Furthermore, the analysis was further stratified by factors that could affect the treatment effects.

Results

Eight trials recruiting 1 546 patients with advanced or recurrent gastric cancer were included in the analysis. Overall, irinotecan therapy was associated with a 6% improvement in survival rate, but this difference was not statistically significant (odds ratio (OR) 0.94; 95% confidence interval (95% CI) 0.70-1.27; P=0.69). However, irinotecan therapy had more frequent ORR than irinotecan-free arm (OR 1.70; 95% CI 1.34-2.17; P<0.001). Furthermore, irinotecan therapy was associated with a clinically and statistically significant increase in the risk for declined hemoglobin, hyponatremia, and diarrhea, but it also protected against thrombocytopenia risk when compared with irinotecan-free therapy.

Conclusions

There is no evidence to support the use of irinotecan therapy in patients with advanced or recurrent gastric cancer; however, given the significant advantage in ORR irinotecan therapy using combination regimens may be considered for further evaluation in subsets of patients who may benefit from this treatment.
An alternative therapy for drug-resistant epilepsy: transcutaneous auricular vagus nerve stimulation
Authors: Rong Peijing , Liu Aihua , Zhang Jianguo , Wang Yuping , Yang Anchao , Li Liang , Ben Hui , Li Liping , Liu Rupeng , He Wei , Liu Huanguang , Huang Feng , Li Xia , Wu Peng , Zhu Bing
Published: January 2024

Background

Previous studies demonstrated that vagus nerve stimulation (VNS) is an effective therapy for drug-resistant epilepsy. Acupuncture is also used to treat epilepsy. This study was designed to examine the safety and effectiveness of transcutaneous auricular vagus nerve stimulation (ta-VNS) for patients with drug-resistant epilepsy.

Methods

A total of 50 volunteer patients with drug-resistant epilepsy were selected for a random clinical trial to observe the therapeutic effect of ta-VNS. The seizure frequency, quality of life, and severity were assessed in weeks 8, 16, and 24 of the treatment according to the percentage of seizure frequency reduction.

Results

In the pilot study, 47 of the 50 epilepsy patients completed the 24-week treatment; three dropped off. After 8-week treatment, six of the 47 patients (12%) were seizure free and 12 (24%) had a reduction in seizure frequency. In week 16 of the continuous treatment, six of the 47 patients (12%) were seizure free; 17 (34%) had a reduction in seizure frequency. After 24 weeks' treatment, eight patients (16%) were seizure free; 19 (38%) had reduced seizure frequency.

Conclusion

Similar to the therapeutic effect of VNS, ta-VNS can suppress epileptic seizures and is a safe, effective, economical, and widely applicable treatment option for drug-resistant epilepsy. (ChiCTR-TRC-10001023)
Comparing minimally invasive and open transforaminal lumbar interbody fusion for treatment of degenerative lumbar disease: a meta-analysis
Authors: SUN Zhi-jian , LI Wen-jing , ZHAO Yu , QIU Gui-xing
Published: January 2024

Background

Transforaminal lumbar interbody fusion (TLIF) through a minimally invasive approach (mTLIF) was introduced to reduce soft tissue injury and speed recovery. Studies with small numbers of patients have been carried out, comparing mTLIF with traditional open TLIF (oTLIF), but inconsistent outcomes were reported.

Methods

We conducted a meta-analysis to evaluate the effectiveness of mTLIF and oTLIF in the treatment of degenerative lumbar disease. We searched PubMed, Embase and Cochrane Database of Systematic Reviews in March 2013 for studies directly comparing mTLIF and oTLIF. Patient characteristics, interventions, surgical-related messages, early recovery parameters, long-term clinical outcomes, and complications were extracted and relevant results were pooled.

Results

Twelve cohort studies with a total of 830 patients were identified. No significant difference regarding average operating time was observed when comparing mTLIF group with oTLIF group (-0.35 minute, 95% confidence interval (CI): -20.82 to 20.13 minutes). Intraoperative blood loss (-232.91 ml, 95% CI: -322.48 to -143.33 ml) and postoperative drainage (-111.24.ml, 95% CI: -177.43 to -45.05 ml) were significantly lower in the mTLIF group. A shorter hospital stay by about two days was observed in patients who underwent mTLIF (-2.11 days, 95% CI: -2.76 to -1.45 days). With regard to long-term clinical outcomes, no significant difference in visual analog scale score (-0.25, 95% CI: -0.63 to 0.13) was observed; however, there was a slight improvement in Oswestry Disability Index (-1.42, 95% CI: -2.79 to -0.04) during a minimum of 1-year follow-up between the two groups. The incidence of complications did not differ significantly between the procedures (RR=1.06, 95% CI: 0.7 to 1.59). Reoperation was more common in patients in mTLIF group than in oTLIF group (5% vs. 2.9%), but this difference was not significant (RR=1.62, 95% CI: 0.75 to 3.51).

Conclusion

Current evidence suggests that, compared with traditional open surgery, mTLIF reduces blood loss and allows early postoperative recovery, while achieving comparable or slightly better long-term outcomes, and with a comparable risk of complications.
Effect of simvastatin on the expression of farnesoid X receptor in diabetic animal models of altered glucose homeostasis
Authors: Wang Lulu , Huang Xianping , Hu Su , Ma Xiaoli , Wang Shaolian , Pang Shuguang
Published: January 2024

Background

Statin therapy has affected glucose homoeostasis of type 2 diabetes patients, which could be related with bile acids metabolism. Whether bile acid metabolism and the expression of farnesoid X receptor (FXR), liver X receptor-α (LXR-α) and sterol regulatory element-binding protein (Srebp)-1c is regulated by hyperglycemia, or whether simvastatin therapy led to higher glucose is related with down-regulated expression of FXR in diabetic rats remained unclear.

Methods

Forty male Wistar rats were randomly divided into four groups: normal control rats, insulin resistance rats, diabetic model rats, and the late simvastatin induced diabetic rats. Normal control rats were fed with standard diet, others were fed with high-fat diet. Diabetic model rats were induced by a single intraperitoneal injection of streptozotocin (STZ). The late simvastatin induced diabetic rats started simvastatin administration after STZ induced diabetic model rats. Characteristics of fasting blood glucose (FPG), lipid files and total bile acids (TBAs) were measured and the oral glucose tolerance test (OGTT) was performed after overnight fasting at the eighth weekend. RNA and protein levels of FXR, LXR-α and Srebp-1c were tested by Western blotting and reverse transcription polymerase chain reaction (RT-PCR).

Results

The insulin resistance rats showed higher glucose, lipid files and lower expression of FXR compared with normal control rats (P >0.05). The diabetic model rats showed significantly higher glucose, lipid files, TBA and lower expression of FXR compared with insulin resistance rats (P <0.05). The late simvastatin induced diabetic rats displayed higher glucose and TBA and lower expression of FXR compared with diabetic model rats (P <0.05).

Conclusions

Changes in bile acid homeostasis, including the alterations of bile acid levels and bile acid receptors, are either a cause or a consequence of the metabolic disturbances observed during diabetic models. Statin therapy induced hyperglycemia may be related with FXR, SHP, LXR-α and Srebp-1 pathways.
Changes in anterior chamber depth following vitrectomy
Authors: Li Yang , Yang Cheng-xun , Qing Guo-ping , Wei Wen-bin
Published: January 2024

Background

Anterior segment morphometry is crucial for ophthalmologists to understand the visual outcomes of cataract surgery, keratorefractive surgery, as well as some other anterior segment disorders. Previous reports in literature have shown that anterior chamber depth (ACD) may shift slightly after vitrectomy. This study aimed to characterize the short-term changes in ACD in eyes after vitrectomy by means of A-scan ultrasound.

Methods

A prospective case series study was carried out on 29 eyes of 29 patients who underwent vitrectomy as the sole procedure. ACD was measured using A-scan ultrasound biometry shortly before vitrectomy and 1 week, 1 month, and 3 months after the surgery. Postoperative ACDs were compared with baseline.

Results

Twenty-nine patients (16 males and 13 females) were enrolled in the study, with mean age of (50±11) (25-65) years. Twenty-three eyes of 23 patients were vitrectomized for vitreous hemorrhage (VH) and the other six were operated for idiopathic epiretinal membrane (ERM). The mean preoperative ACD of the VH eyes was (2.98±0.38) mm. No significant difference was found between the ACD of the VH eyes and their fellow eyes (P=0.058). The average preoperative ACD in the ERM eyes was (2.94±0.31) mm, which was statistically deeper than that of their fellow eyes ((2.85±0.28) mm, P=0.008). No statistical difference was found in the postoperative average ACD of the VH eyes compared with baseline. In the ERM group, the postoperative ACD in the surgical eyes was still statistically deeper than the fellow eyes 1 week after surgery (P=0.034). However, such statistical difference disappeared at 1 or 3 months postoperative (P=0.186 and 0.682).

Conclusions

ERM may induce deepening of the ACD, which can be recovered by uneventful vitrectomy. VH does not cause shift of ACD, neither does vitrectomy.
Phosphorylation of PTEN increase in pathological right ventricular hypertrophy in rats with chronic hypoxia induced pulmonary hypertension
Authors: Nie Xin , Shi Yiwei , Yu Wenyan , Xu Jianying , Hu Xiaoyun , Du Yongcheng
Published: January 2024

Background

Phosphatase and tensin homologue on chromosome ten (PTEN) acts as a convergent nodal signalling point for cardiomyocyte hypertrophy, growth and survival. However, the role of PTEN in cardiac conditions such as right ventricular hypertrophy caused by chronic hypoxic pulmonary, hypertension remains unclear. This study preliminarily discussed the role of PTEN in the cardiac response to increased pulmonary vascular resistance using the hypoxia-induced PH rats.

Methods

Male Sprague Dawley rats were exposed to 10% oxygen for 1, 3, 7, 14 or 21 days to induce hypertension and right ventricular hypertrophy. Right ventricular systolic pressure was measured via catheterization. Hypertrophy index was calculated as the ratio of right ventricular mass to left ventricle plus septum mass. Tissue morphology and fibrosis were measured using hematoxylin, eosin and picrosirius red staining. The expression and phosphorylation levels of PTEN in ventricles were determined by real time PCR and Western blotting.

Results

Hypoxic exposure of rats resulted in pathological hypertrophy, interstitial fibrosis and remodelling of the right ventricle. The phosphorylation of PTEN increased significantly in the hypertrophic right ventricle compared to the normoxic control group. There were no changes in protein expression in either ventricle.

Conclusion

Hypoxia induced pulmonary hypertension developed pathological right ventricular hypertrophy and remodelling probably related to an increased phosphorylation of PTEN.
Clinical efficacy and safety of moxifloxacin versus levofloxacin plus metronidazole for community-acquired pneumonia with aspiration factors
Authors: Sun Tieying , Sun Li , Wang Rongmei , Ren Xiaoping , Sui Dong-jiang , Pu Chun , Ren Yajuan , Liu Ying , Yang Zhuo , Li Fengzhi
Published: January 2024

Background

Community-acquired pneumonia (CAP) is a common infectious disease throughout the world and the incidence continues to grow as the population ages. Aspiration is an important pathogenic mechanism for pneumonia in the elderly and the management of patients with community-acquired pneumonia with aspiration factors is a major medical problem. Our study aimed to assess whether moxifloxacin in comparison to levofloxacin plus metronidazole are effective and safe in the treatment of community-acquired pneumonia with aspiration factors.

Methods

In this prospective, multicenter, open-label, randomized controlled trial, 77 patients with mild-to-moderate community-acquired pneumonia with aspiration factors were enrolled and randomly assigned to receive moxifloxacin or levofloxacin plus metronidazole. The primary efficacy variables were clinical outcomes in evaluable patients at a follow-up visit 7 to 14 days after the end of therapy.

Results

Seven days after the end of therapy a clinical cure was achieved for 76.7% (23 of 37) of efficacy-evaluable patients in the moxifloxacin group and 51.7% (15 of 40) of patients in the levofloxacin plus metronidazole group. There was a significant difference between the two groups (○2=4.002, P <0.05). Bacteriological success rates were similar in the moxifloxacin group (93.3%) and levofloxacin plus metronidazole group (96.4%), there was no significant difference between the two groups (P >0.05). The overall adverse event rate was 10.8% (4/37) in the moxifloxacin group versus 17.5% (7/40) in the levofloxacin plus metronidazole group, there was no significant difference between the two groups (P >0.05). No serious adverse events were observed.

Conclusions

Moxifloxacin is effective and safe for treatment of community-acquired pneumonia with aspiration factors. And the regimen of moxifloxacin monotherapy is more convenient compared with levofloxacin plus metronidazole.
Surveillance of Mycoplasma pneumoniae infection among children in Beijing from 2007 to 2012
Authors: Zhao Hanqing , Li Shaoli , Cao Ling , Yuan Yi , Xue Guanhua , Feng Yanling , Yan Chao , Wang Liqiong , Fan Zhaoyang , Sun Hongmei
Published: January 2024

Background

Mycoplasma pneumonia (M. pneumoniae) is one of the key pathogens of community-acquired pneumonia. A global pandemic of M. pneumoniae has occurred since 2010. The aim of this study was to survey the prevalence of M. pneumoniae in children in Beijing from 2007–2012.

Methods

A total of 3 073 clinical specimens were obtained from pediatric patients with respiratory tract infections from January 2007 to December 2012, and examined by nested polymerase chain reaction. PCR products were visualized by 2% agarose gel electrophoresis, positive products sequenced, and compared with reference sequences in GenBank. Macrolide resistance-associated mutations were also detected for some positive samples.

Results

Of the 3 073 specimens, 588 (19.13%) were positive for M. pneumoniae, 12.4% of which were accompanied by viral infections. Positive rates for M. pneumoniae were highest in 2007 and 2012, showing a significant difference when compared with other years. Infections tended to occur in autumn and winter and positive rates were significantly higher for children aged 3–16. The rate of macrolide resistance-associated mutations was 90.7%, and the predominant mutation was an A→G transition (89.92%) at position 2063 in domain V of the 23S rRNA gene.

Conclusions

M. pneumoniae outbreaks occurred in 2007 and 2012 in pediatric patients in Beijing, which is consistent with the global prevalence of M. pneumoniae. M. pneumoniae can cause multi-system infections in children, and may be accompanied with viral infections. We determined that school-age children are more susceptible to this disease, particularly in autumn and winter. Gene mutations associated with macrolide resistance were very common in M. pneumoniae-positive specimens during this period in Beijing.
Cigarette smoking contributes to idiopathic pulmonary fibrosis associated with emphysema
Authors: Qiao Ye , Kewu Huang , Yi Ding , Baohui Lou , Ziliang Hou , Huaping Dai , Chen Wang , Mouyue Wang
Published: January 2024

Background

Combined emphysema and pulmonary fibrosis, including idiopathic pulmonary fibrosis (IPF), is a distinct disorder described with upper-lobe emphysema and lower-lobe fibrosis on chest computed tomography. Smoking appears to be the predominant risk factor for this disorder. We aimed to compare clinical features, smoking history, physiological and radiological findings between IPF with and without emphysema.

Methods

A sample of 125 IPF patients over a period of 48 months were evaluated. High resolution CT scans were reviewed blinded to clinical data. The IPF patients with or without emphysema were classified accordingly.

Results

The prevalence of emphysema in this IPF sample was 70/125. IPF with emphysema was significantly associated with smoking status (OR 63; 95% CI 4.4 to 915; P=0.002) and smoking pack year (OR 1.1; 95% CI 1.05 to 1.13; P=0.000). The patients with IPF and emphysema had a higher decrease in carbon monoxide diffusing capacity adjusted for alveolar volume ((58±19)% pred vs. (66±21)% pred; P=0.021) and a higher prevalence of pulmonary hypertension (24/70 vs. 7/55; P=0.006). The two groups of patients had similar forced and residual volumes. No significant differences were found in cell differentials of bronchoalveolar lavage or the scores of fibrosis on chest CT. Survival of the patients with emphysema was significantly less than that of patients with IPF alone.

Conclusions

Cigarette smoking induces IPF combined with emphysema. Emphysema further impairs physiological function and increases the prevalence of pulmonary hypertension that leads to poor prognosis. The inclusion of the patients with combined pulmonary fibrosis and emphysema in IPF clinical trials may lead to under evaluation of the effect of treatment in patients.
Factors influencing the feasibility of laparoscopy colectomy
Authors: He Zhiyun , Zhang Zhongtao
Published: January 2024

Objective

The objective was to review the factors affecting the feasibility of performing successful laparoscopic colectomy.

Data sources

The literatures about the risk factors closely related to the ability to perform laparoscopic colectomy on different surgical diseases of the colon cited in this review were obtained from PubMed published in English from 2006 to 2012.

Study selection

Original articles regarding the risk factors that affect the ability to perform laparoscopic colectomy were selected.

Results

Obesity, diabetes, inflammatory bowel diseases, advanced age, emergency operation, and pelvic anatomy are all important risk factors that increase the risk of developing serious complications such as hemorrhage, anastomotic leak, and skin and soft tissue infections following laparoscopic colectomy. These factors also increase the likelihood of conversion to an open operation. In this study, we reviewed the recent original articles about the relationship of laparoscopic colectomy with these risk factors. We also describe some strategies that limit the likelihood of these complications and the likelihood of conversion to an open operation.

Conclusions

Obesity, diabetes, inflammatory bowel diseases, age, emergency operation, and pelvic anatomy are all important risk factors that increase the risk of either serious complications or conversion to open operation with laparoscopic colectomy. Evaluation of these risk factors preoperatively should influence the decision to perform colectomy using laparoscopic techniques.
Comparison of two different renorrhaphy techniques in retroperitoneal laparoscopic partial nephrectomy for complex tumor
Authors: SHANG Ji-wen , MA Xin , ZHANG Xu , LI Hong-zhao , SHI Tao-ping
Published: January 2024

Background

Partial nephrectomy is currently the standard treatment for clinical T1 renal neoplasms, as it can provide oncologic outcomes equivalent to radical nephrectomy. The aim was to evaluate the efficacy of self-retaining suture (SRS) in renorrhaphy technique in retroperitoneal laparoscopic partial nephrectomy (LPN) for a single renal mass of moderate or high complexity by assessing peri-operative outcomes.

Methods

A retrospective analysis was done of 64 patients between 2010 and 2012 for complex renal mass (RENAL score ≥7) in whom retroperitoneal LPN was performed with two layers using continuous knotless barbed suture (Quill PDO SRS group; n=34) and absorbable vicryl (non-SRS group; n=30), respectively. Cases were matched for RENAL score. All the surgical procedures were performed by the same surgeon with experience of more than 500 cases of LPN. Comparisons were made in patients and preoperative outcomes and peri-operative complications between SRS group and non-SRS group.

Results

Mean warm ischemia time (WIT) in SRS group was less than non-SRS group (18.0 vs. 24.8 minutes, P=0.021). Renorrhaphy suture cost in SRS group was lower than non-SRS group ($269.6 vs. $335.8, P=0.001). There were no significant differences between the two groups for postoperative changes in creatinine and estimated glomerular filtration rate and the rate of peri-operative complications.

Conclusion

SRS was safe for complex renal tumor with two layers, continuous and unknot suture, during LPN and would reduce the WIT and renorrhaphy suture cost significantly.
Expression of hepatocyte growth factor and its receptor c-Met in lensinduced myopia in guinea pigs
Authors: LI Xiu-juan , YANG Xiao-peng , WAN Guang-ming , WANG Yu-ying , ZHANG Jin-song
Published: January 2024

Background

Myopia is a common disorder and the incidence has increased yearly, but its pathogenesis remains unclear. The aim of this study was to investigate the possible role of hepatocyte growth factor (HGF) and its receptor c-Met in the development of lens-induced myopia in guinea pigs.

Methods

Sixty one-week-old guinea pigs were chosen. The right eyes were treated with -10.0 diopters (D) lenses as the lens-induced myopia group; the left eyes remained untreated as the control group. Six weeks later, refractive status and axial length were determined by streak retinoscopy and A-scan ultrasonography, respectively. The guinea pigs were killed and both eyes collected. Morphological changes were observed by hematoxylin and eosin staining. The expression levels of HGF, c-Met, and matrix metalloproteinase 2 (MMP-2) mRNA and protein in the posterior sclera were analyzed by RT-PCR and Western blotting, respectively.

Results

The lens-induced myopia group became myopic with a significant increase in axial length and a significant decrease in refraction. Compared with the control group, the posterior retina and sclera were thinner in the lens-induced myopia group. The expression levels of HGF and MMP-2 mRNA and protein and of phosphorylated c-Met protein were significantly higher in the posterior sclera of the lens-induced myopia group than in the control group (all P <0.05). In the lens-induced myopia group, the expression level of MMP-2 in the posterior sclera positively correlated with the expression level of HGF (r=0.902, P <0.05) and phosphorylated c-Met (r=0.885, P <0.05).

Conclusion

HGF/c-Met might play a role in the development of lens-induced myopia in guinea pigs by upregulating the expression of MMP-2.
Influence of extract of Ginkgo biloba leaves tablets on the aquaporin-1 expression in isolated lung ischemia reperfusion
Authors: LI Xiang-nan , YANG Ji-yao , PAN Xue , ZHAO Song , ZHANG Chun-yang , ZHU Deng-yan , WANG Peng
Published: January 2024

Background

The extract of Ginkgo biloba leaves tablets, ginaton, is widely used in treating ischemic cerebrovascular disease in the clinic. This study aimed to investigate the expression of aquaporin-1 (AQP-1) in rat lung with ischemia/ reperfusion injury after pretreatment with ginaton, and whether the pretreatment with ginaton reduces the acute lung injury caused by ischemia/reperfusion injury.

Methods

Adult Wistar rats were divided into two groups. Some rats were used as donors (n=20), the others as recipients (n=20). Left lungs of donor rats were used for the isolated lung reperfusion model, which perfused only with low potassium dextran (LPD) solution as group A (n=10); the others were pretreated with ginaton before reperfusion as group C (n=10). Right lung of donor rat without any treatment was used as a control group (group B and group D, n=10 for each group). After the model was established, the expression of AQP-1 in the lung tissues was examined by immunohistochemistry, Western blotting, and reverse transcriptase-polymerase chain reaction.

Results

Immunohistochemical examination revealed that AQP-1 was expressed in endothelia. Immunoblotting demonstrated that the relative gray values of AQP-1 protein in groups A and C were 0.65±0.06, 0.88±0.11, respectively. The relative gray values of the mRNA expression in groups A and C were 0.30±0.08, 0.49±0.11, respectively. The expression of AQP-1 protein and mRNA in group C was significantly higher than in group A (P <0. 05).

Conclusion

The pretreatment with ginaton can reduce the acute lung injury caused by ischemia/reperfusion.
Staged microvascular anastomosis training program for novices: transplantation of both kidneys from one rat donor
Authors: Zhou Shoujun , Li Enchun , He Jun , Weng Guobin , Yuan Hexing , Hou Jianquan
Published: January 2024

Background

Rat renal transplantation is an essential experimental model and requires greater microsurgical skills. Thus, training novices to perform quick and reliable microvascular anastomosis is of vital importance for rat renal transplantation. In this study, we developed and evaluated a staged microvascular anastomosis training program for novices, harvesting and transplanting both kidneys from one rat donor.

Methods

Five trainees without any prior microsurgical experience underwent a training program in which the goals were staged according to difficulty. Each trainee had to achieve satisfactory results as evaluated by a mentor before entering the next stage. Rat renal transplantation was accomplished by end-to-end technique with a bladder patch. In the intensive rat renal transplantation stage, the trainees required an average of 20 independent attempts at isotransplantation as final training assessment.

Results

After 2 months of intensive practice, all trainees had achieved stable and reproducible rat renal transplantation, with a satisfactory survival rate of 85.9% at postoperative Day 7. The total mean operative time was 78.0 minutes and the mean hot ischemia time was 26.2 minutes. With experience increasing, the operative time for each trainee showed a decreasing trend, from 90-100 minutes to 60-70 minutes. After 20 cases, the mean operative time of the trainees was not statistically significantly different from that of the mentor.

Conclusion

Harvesting and transplanting both kidneys from one rat donor after a staged microvascular anastomosis training program is feasible for novices without any prior microsurgical skills.
Effects of exercises on knee cartilage volume in young healthy adults: a randomized controlled trial
Authors: Lu Liangyu , Wang Yubin
Published: January 2024

Background

Acute effects of physical exercise on the deformational behavior of knee articular cartilage and changes in cartilage volume are definite. However, conclusive effects of different exercises on the loss of articular cartilage volume have not been proved. In this parallel-group randomized controlled trial, we tested whether 12 weeks of swimming, powerstriding, cycling, and running exercises would decrease the cartilage volume significantly and whether there would be a difference in the loss of cartilage volume after different types of exercises.

Methods

From October 2012 to January 2013 we evaluated 120 healthy volunteer students in Biomechanics Laboratory of Tongji University. Body mass index (BMI), right lower limb strength, and right knee cartilage magnetic resonance imaging (MRI) were obtained before exercise. MRI were conducted in East Hospital. The study was approved by Tongji University Ethical Committee, all subjects were randomly assigned to the running, powerstriding, cycling, swimming, and control groups by a drawing of lots. Each group contained 24 samples. At the end of 12 weeks of regular exercises, the same measurement procedures were applied. Cartilage volume was calculated with OSIRIS software based on the quantitative-MRI. Pre- and post-exercise comparisons were carried out using paired t-tests and one-way analysis of variance (ANOVA) was used to compare differences of cartilage volume loss between groups with Student-Newman-Keuls procedure for multiple comparisons.

Results

Running, cycling, and swimming groups resulted in a significant decrease in BMI. The quadriceps peak torque increased significantly in the swimming and cycling groups. Total cartilage volume significantly decreased in the running and cycling groups after 12 weeks of training, without any significant change in the nonimpact swimming, low-impact powerstriding, and control groups. Loss of total cartilage volume in the running and cycling groups were 2.21% (3.03) and 1.50% (0.42).

Conclusions

Twelve weeks of regular physical exercises (i.e., running and cycling) decrease the total knee cartilage volume. Swimming and powerstriding are recommended for the healthy youth. This finding suggests that articular cartilage has the functional adaptation for exercises, and some sports could be the risk factors for the initiation of osteoarthritis (OA) in young healthy adults.
Pig islets for islet xenotransplantation: current status and future perspectives
Authors: Hu Qinghua , Liu Zhongwei , Zhu Haitao
Published: January 2024

Objective

To review the current status and progress on pig islet xenotransplantation.

Data sources

Data used in this review were mainly from English literature of Pubmed database. The search terms were “pig islet” and “xenotransplantation”.

Study selection

The original articles and critical reviews selected were relevant to this review's theme.

Results

Pigs are suggested to be an ideal candidate for obtaining available islet cells for transplantation. However, the potential clinical application of pig islet is still facing challenges including inadequate yield of high-quality functional islets and xenorejection of the transplants. The former can be overcome mainly by selection of a suitable pathogen-free source herd and the development of isolation and purification technology. While the feasibility of successful preclinical pig islet xenotranplantation provides insights in the possible mechanisms of xenogeneic immune recognition and rejection to overwhelm the latter. In addition, the achievement of long-term insulin independence in diabetic models by means of distinct islet products and novel immunotherapeutic strategies is promising.

Conclusions

Pig islet xenotransplantation is one of the prospective treatments to bridge the gap between the needs of transplantation in patients with diabetes and available islet cells. Nonetheless, further studies and efforts are needed to translate obtained findings into tangible applications.
Prevalence, risk factors, clinical course, and outcome of acute kidney injury in Chinese intensive care units: a prospective cohort study
Authors: WEN Ying , JIANG Li , XU Yuan , QIAN Chuan-yun , LI Shu-sheng , QIN Tie-he , CHEN Er-zhen , LIN Jian-dong , AI Yuhang , WU Da-wei , WANG Yu-shan , SUN Ren-hua , HU Zhen-jie , CAO Xiang-yuan , ZHOU Fa-chun , HE Zhen-yang , ZHOU Li-hua , AN You-zhong , KANG Yan , MA Xiao-chun , YU Xiang-you , ZHAO Ming-yan , XI Xiu-ming , DU Bin
Published: January 2024

Background

Acute kidney injury (AKI) has been recognized as a major healthcare problem affecting millions of patients worldwide. However, epidemiologic data concerning AKI in China are still lacking. The objectives of this study were to characterize AKI defined by RIFLE criteria, assess the association with hospital mortality, and evaluate the impact of AKI in the context of other risk factors.

Methods

This prospective multicenter observational study enrolled 3,063 consecutive patients from 1 July 2009 to 31 August 2009 in 22 ICUs across mainland China. We excluded patients who were admitted for less than 24 hours (n=1623), younger than 18 years (n=127), receiving chronic hemodialysis (n=29), receiving renal transplantation (n=1) and unknown reasons (n=28). There were 1255 patients in the final analysis. AKI was diagnosed and classified according to RIFLE criteria.

Results

There were 396 patients (31.6%) who had AKI, with RIFLE maximum class R, I, and F in 126 (10.0%), 91 (7.3%), and 179 (14.3%) patients, respectively. Renal function deteriorated in 206 patients (16.4%). In comparison with non AKI patients, patients in the risk class on ICU admission were more likely to progress to the injury class (odds ratio (OR) 3.564, 95% confidence interval (CI) 1.706 - 7.443, P = 0.001], while patients in the risk class (OR 5.215, 95% CI 2.798–9.719, P <0.001) and injury class (OR 13.316, 95% CI 7.507–23.622, P <0.001) had a significantly higher probability of deteriorating into failure class. The adjusted hazard ratios for 90-day mortality were 1.884 for the risk group, 3.401 for the injury group, and 5.306 for the failure group.

Conclusions

The prevalence of AKI was high among critically ill patients in Chinese ICUs. In comparison with non-AKI patients, patients with RIFLE class R or class I on ICU admission were more susceptibility to progression to class I or class F. The RIFLE criteria were robust and correlated well with clinical deterioration and mortality.
Analysis of risk factors affecting the prognosis of pancreatic neuroendocrine tumors
Authors: Ming Tao , Chunhui Yuan , Dianrong Xiu , Xueying Shi , Liyuan Tao , Zhaolai Ma , Bin Jiang , Zhipeng Zhang , Lingfu Zhang , Hangyan Wang
Published: January 2024

Background

Pancreatic neuroendocrine tumors (pNETs) are a type of tumors with the characteristics of easy metastasis and recurrence. Till date, the risk factors affecting the prognosis are still in the debate. In this study, several risk factors will be discussed combined with our cases and experience.

Methods

Thirty-three patients diagnosed as pNETs were enrolled and the clinical features, blood tests, pathological features, surgical treatment, and follow-up data of these patients were collected and analyzed.

Results

In this study, operation time of G3 cases was longer than G1/G2 cases (P=0.017). The elevated level of tumor markers such as AFP, CEA, Ca125, and Ca19-9 may predict easier metastasis, earlier recurrence, and poor prognosis (P=0.007). The presence of cancer embolus and nerve invasion increases along with the TNM stage (P=0.037 and P=0.040), and the incidence of positive surgical margin increased (P=0.007). When the presence of nerve invasion occurs, the chance of cancer embolus and lymph node metastasis also increases (P=0.016 and P=0.026).

Conclusions

pNETs were tumors with the features of easy recurrence and metastasis and many risk factors could affect its prognosis such as the elevated levels of tumor markers and the presence of nerve invasion, except some recognized risk factors. If one or more of these factors existed, postoperative treatments may be needed to improve prognosis.
Systematic reviews on reports of hip fractures in Web of Science: a bibliometric analysis of publication activity
Authors: Zhi Mao , Guoqi Wang , Xifan Mei , Shuo Chen , Xiaoxie Liu , Xiantao Zeng , Anhua Long , Licheng Zhang , Lihai Zhang , Peifu Tang
Published: January 2024

Background

The objective of this study was to analyze the trend in the publication of systematic reviews on hip fractures through a bibliometric approach.

Methods

Literature including systematic reviews or meta-analyses on hip fractures was searched from the ISI Web of Science citation database. The search results were analyzed in terms of geographical authorship and frequency of citation by country, institution, author, and periodical distribution.

Results

A total of 654 published systematic reviews from 1995 to 2013 in 48 countries or regions were retrieved. The United States (171) was the predominant country in terms of the number of total publications, followed by the United Kingdom (149), Canada (120), Australia (76), and China (54). The number of systematic reviews significantly increased during the last 6 years, especially in China. The production ranking changed in 2012, at which time the United States and China were the leaders in the yearly production of systematic reviews on hip fractures. The amount of literature (27 publications) from China contributed almost one-quarter of the total literature (109 publications) in 2012. However, the average number of citations of each article from China was still low (6.70), while the highest number of citations of each article was from Sweden (193.36). The references were published in 239 different journals, with 15 journals contributing to 41.3% of the systematic reviews on hip fractures. The two journals that contributed the most were Osteoporosis International (10.6%) and the Cochrane Database of Systematic Reviews (7.6%). The predominant institution in terms of the number of publications was McMaster University (36) in Canada.

Conclusions

The best evidence in the field of hip fractures has attracted increasing attention. Systematic reviews on hip fractures from China have been increasingly more frequent during the past 6 years, particularly in 2012.
Outcomes of upper airway reconstructive surgery for obstructive sleep apnea syndrome based on polysomnography after nasopharyngeal tube insertion
Authors: LI Shu-hua , WU Da-hai , BAO Ji-min , SHI Hong-jin
Published: January 2024

Background

The most common obstruction sites for obstructive sleep apnea hypopnea syndrome (OSAHS) are the oropharynx and the glossopharyx. The diagnosis of glossopharyngeal airway obstruction is difficult. The study aimed to assess the effect of upper airway reconstructive surgery for OSAHS based on polysomnography (PSG) after nasopharyngeal tube insertion (NPT-PSG), and to evaluate the clinical value of NPT-PSG in localizing the obstructive sites.

Methods

Seventy-nine OSAHS patients diagnosed with PSG were included in the study. PSG was repeated with a nasopharyngeal tube in place (NPT-PSG). Results of the two PSGs were compared. A NPT-PSG apnea hypopnea index (AHI) greater than 15 times per hour was used as a threshold for glossopharyngeal surgery. The cause of glossopharyngeal airway obstruction was taken into consideration in planning glossopharyngeal surgery. Assessment of efficacy was followed-up.

Results

After NPT-PSG, patients’ AHI significantly decreased and lowest oxygen saturation (LaSO2) significantly increased. Of the 79 patients, 47 were treated with uvulopalatopharyngoplasty (UPPP) alone and 32 with UPPP + glossopharyngeal surgery. Thirty-two patients were considered cured, 33 markedly improved, and 14 failed. The overall surgery success rate was 82.3%.

Conclusions

NPT-PSG can be used as a diagnosis tool for localizing airway obstruction in OSAHS patients. Surgical treatment based on NPT-PSG results in good treatment efficacy.
Aspirin combined with mechanical measures to prevent venous thromboembolism after total knee arthroplasty: a randomized controlled trial
Authors: Jiang Yi , Du Hui , Liu Jian , Zhou Yixin
Published: January 2024

Background

Venous thromboembolism (VTE) is an important complication after major orthopedic surgery. Pharmaceutical methods represent the main strategy of VTE prevention. The use of aspirin in VTE prevention is still controversial worldwide, especially in China. The purpose of this study was to evaluate the role of aspirin combined with mechanical measures in the prevention of VTE after total knee arthroplasty (TKA).

Methods

Between January 2012 and May 2013 and in accordance with the inclusion criteria, 120 patients undergoing TKA were randomly allocated to two groups. To prevent VTE, patients in group A received aspirin combined with mechanical measures postoperatively, while patients in group B received low-molecular-weight heparin (LMWH) sodium and rivaroxaban sequentially in combination with mechanical measures postoperatively. All surgeries were performed by one surgeon using a posterior-stabilized cemented prosthesis. The two groups were followed up and compared for the incidence of deep vein thrombosis (DVT) by duplex ultrasound scan and clinical VTE events. The adverse events, the blood loss index, and the cost of VTE prevention were also compared.

Results

DVT was detected in 10 of 60 patients in group A (16.7%, 95% CI: 7.3%-26.1%) compared with 11 of 60 in group B (18.3%, 95% CI: 8.5%-27.8%) (P=0.500). There is no statistical evidence supporting the inferior effect of aspirin in preventing DVT as compared with the other medications. There were no cases of symptomatic VTE or death during the follow-up period. Area of ecchymosis was lower in group A than in group B, and the differences were statistically significant. Patients in group A had the lower blood loss index as compared with patients in group B. No transfusion cases were found in both groups. The differences were statistically significant. The cost of VTE prevention analysis indicated a cost reduction using aspirin in group A compared with using LMWH and rivaroxaban in group B.

Conclusion

Aspirin combined with mechanical measures had a good effect on prevention of VTE after TKA and resulted in lower cost, less blood loss, and less subcutaneous ecchymosis.
A recommended technique of renal vein anastomosis in rat kidney transplantation for trainee
Authors: Ye Dongming , Heng Baoli , Lai Caiyong , Guo Zexiong , Su Zexuan
Published: January 2024

Background

Various rat kidney transplantation models have been introduced over the decades and the study on the models seems to lack novelty and necessity. However, vascular anastomosis, especially renal vein, is still very difficult for trainees. The aim of this study was to provide the modified renal venous anastomosis of rat kidney transplantation to substitute the current method for trainees.

Methods

Male Wistar rats were used as donors and recipients, respectively. Left orthotopic transplantation was performed with a modified technique of renal vein anastomosis, combining the end-to-end sutures with epidural catheter. Meanwhile, the survival rate, warm ischemia time, renal venous anastomosis time, and complications were recorded to evaluate the merits of the modified technique compared with the current recommended technique of rat renal vein. Two trainees took part in the learning of the models in two methods for performing 30 operations, respectively.

Results

The difference in warm ischemia time (from (57.25±7.30) minutes in the first 10 operations to (30.05±1.85) minutes in the third 10 operations) and renal vein anastomosis time (from (32.80±3.80) minutes in the first 10 operations to (19.30±0.98) minutes in the third 10 operations) was significantly short (P<0.01) and the survival rate was statistically high (from (25±7)% in the first 10 operations to 70% in the third 10 operations) in equal number of operations (P<0.01) by comparing with the current recommended method ((47.60±7.19) minutes to (22.8±1.85) minutes, (22.40±3.10) minutes to (9.95±1.50) minutes, 45%±7% to 80%±0, respectively). The intraoperative complications and postoperative complications of renal venous anastomosis were also significantly decreased (P<0.01).

Conclusions

The technique with epidural catheter can shorten the learning curve of the trainee learning rat kidney transplantation. It may replace the currently recommended technique of rat renal vein for trainees.