bluuebunny/crossref_metadata_2025 huggingface dataset:
A Mathematical Model to Estimate the Risk of Microalbuminuria in an Overweight Adult Male Population
Authors: Chen B , Xu W , Chen RJ , Li X , Ye B , Chen Y
Published: February 2013

Being overweight or obese promotes microalbuminuria and increases the risk of chronic kidney disease. This study aimed to develop a mathematical model to estimate the risk of microalbuminuria in overweight Chinese men. Urine albumin/creatinine ratio and metabolic variables were assessed in 1179 subjects, randomly divided into estimation and validation groups that were comparable with respect to all variables. Regression analysis identified body mass index, systolic blood pressure, fasting plasma glucose and blood uric acid as significant variables; these were used to develop a mathematical model for estimating the risk of microalbuminuria. The model generated a receiver-operating characteristic curve indicative of strong predictive accuracy for microalbuminuria (area under the curve, 0.81). A probability cut-off point of 0.50 resulted in global predictive values for microalbuminuria of 86.4% and 84.1% in the validation group ( n = 354) and in all subjects, respectively. This model provides a beneficial tool for identifying overweight Chinese men at risk of microalbuminuria; additional studies are required to examine the predictive ability of the model further.
Effects of Predistention with Normal Saline Containing Adrenaline on Blood-Vessel Injury during Epidural Catheter Placement
Authors: Han C-B , Yu L , Qian Y-N , Ding Z-N , Jiang J-D , Zhou Q-H , Sun J
Published: February 2013

This study investigated the effects of predistention with normal saline containing adrenaline on vascular plexus injury during epidural catheter placement. Three hundred parturients undergoing caesarean sections were randomly divided into three groups. Group I ( n = 102) received an epidural injection with 5 ml normal saline; group II ( n = 93) received 5 ml normal saline containing adrenaline (5 μg/ml); group III ( n = 100) received direct epidural catheter placement. Five women were excluded from the analysis for technical reasons. The incidence of bloody fluid in the epidural needle was significantly lower in groups I and II compared with group III (eight [7.8%] and seven [7.5%] versus 17 [17.0%], respectively). There were no significant differences in the incidence of bloody fluid in the epidural catheter or in the incidence of intravascular epidural catheter placement between the three groups. Predistention with 5 ml normal saline before catheter insertion reduced the incidence of blood-vessel injury during epidural catheter placement, but adrenaline provided no additional protective effects.
Effects of Rosuvastatin versus Atorvastatin on Rho-Associated Coiled-Coil Containing Protein Kinase Activity and Endothelial Function in Patients with Atherosclerosis
Authors: Liu B , Cao HM , Li GY , Liu M , Feng J , Li J , Wang Q
Published: February 2013

This randomized, double-blind, parallel-design study compared the short-term effects of rosuvastatin and atorvastatin on serum lipids and markers of inflammation and endothelial function in patients with stable atherosclerosis. Patients received either 10 mg/day rosuvastatin ( n = 18) or 20 mg/day atorvastatin ( n = 18), orally, for 4 weeks. Serum lipids, high-sensitivity C-reactive protein (hsCRP), Rho-associated coiled-coil containing protein kinase (ROCK) activity and flow-mediated dilation (FMD) of the brachial artery were assessed before and after therapy. Both statins produced significant reductions in total cholesterol, low-density lipoprotein cholesterol (LDL-C), triglyceride and hsCRP levels, and significant increases in FMD. Both statins significantly reduced ROCK activity and inhibition was significantly greater with rosuvastatin. There was no correlation between ROCK activity and LDL-C level in either group. There was a significant correlation between ROCK activity and FMD for both statins, but no correlations between FMD and LDL-C or hsCRP levels. Short-term treatment with either rosuvastatin or atorvastatin inhibits ROCK activity independent of cholesterol reduction, and improves endothelium dysfunction in patients with atherosclerosis.
Effects of a Priming Dose of Fentanyl during Anaesthesia on the Incidence and Severity of Fentanyl-Induced Cough in Current, Former and Non-Smokers
Authors: Jung HJ , Kim JB , Im KS , Cho HJ , Kim JW , Lee JM
Published: February 2013

Fentanyl is commonly used during anaesthesia and can cause fentanyl-induced cough (FIC). This study investigated whether a priming dose of fentanyl reduced FIC, and determined the factors associated with increased risk of FIC. Subjects undergoing elective surgery under general anaesthesia ( n = 800) were randomized into four groups: group 1 received 2 μg/kg fentanyl bolus; groups 2, 3 and 4 received a priming dose of fentanyl 0.5 μg/kg followed by 1.5 μg/kg after 1, 2 or 3 min, respectively. The incidence of FIC was 17.0%, 10.0%, 12.5% and 11.5% for groups 1, 2, 3 and 4, respectively, with no significant between-group differences in FIC incidence or severity. The mean FIC onset time was 22 s. Former smokers were 2.91 times more likely than current smokers to experience cough. A fentanyl priming dose did not reduce the incidence and severity of FIC. Former smokers were hyper-reactive to fentanyl compared with current smokers.
Angioplasty with Stenting for Intracranial Atherosclerosis: A Systematic Review
Authors: Zhou Y , Yang Q-W , Xiong H-Y
Published: February 2013

OBJECTIVE: Intracranial artery stenosis can be fatal, requiring fast, safe and effective intervention. The introduction of the Wingspan™ stent system with Gateway™ percutaneous transluminal angioplasty balloon catheter has made intracranial intervention possible in a clinical trial setting. This systematic review planned to identify and review all randomized controlled trials comparing angioplasty and stenting of intracranial arteries with standard medical care. METHODS: Electronic databases and relevant records were examined for possible trials using predefined inclusion and exclusion criteria. RESULTS: A total of 3661 records were identified by searching several English language databases and other sources including Chinese academic journals. The recently discontinued Stenting and Aggressive Medical Management for Preventing Recurrent stroke in Intracranial Stenosis (SAMMPRIS) trial was the single qualifying study and showed clear advantage of medical management over percutaneous transluminal angioplasty and stenting (PTAS). CONCLUSIONS: The SAMPRASS trial indicated that PTAS is associated with high complication and morbidity rates. Definitive recommendations cannot be made until convincing results from additional robustly designed randomized trials become available.
Selective Neurogenic Blockade and Perioperative Immune Reactivity in Patients Undergoing Lung Resection
Authors: Viviano E , Renius M , Rückert J-C , Bloch A , Meisel C , Harbeck-Seu A , Boemke W , Hensel M , Wernecke K-D , Spies C
Published: February 2013

OBJECTIVE: This double-blind, prospective, randomized, controlled trial examined the effects of thoracic epidural block and intravenous clonidine and opioid treatment on the postoperative Th1/Th2 cytokine ratio after lung surgery. The primary endpoint was the interferon γ (IFN-γ; Th1 cytokine)/interleukin 4 (IL-4; Th2 cytokine) ratio. Secondary endpoints were reductions in pain and incidence of pneumonia. METHODS: Sixty patients were randomized into three groups to receive remifentanil intravenously (remifentanil group, n = 20), remifentanil and clonidine intravenously (clonidine group, n = 20), or ropivacaine epidurally (ropivacaine group, n = 20). Pain was assessed using a numerical rating scale (NRS). Cytokines were measured using a cytometric bead array. RESULTS: Patients in the ropivacaine group (thoracic epidural block) had a significantly lower IFN-γ/IL-4 ratio at the end of surgery than those in the remifentanil group and clonidine group. There were no significant between-group differences in the IFN-γ/IL-4 ratio at other time-points. There were no differences in NRS scores at any time-point. No patient developed pneumonia. CONCLUSION: Intraoperative thoracic epidural block decreased the IFN-γ/IL-4 ratio immediately after lung surgery, indicating less inflammatory stimulation during surgery.
Detection and Clinical Significance of Lymph Node Micrometastasis in Gastric Cardia Adenocarcinoma
Authors: Ru Y , Zhang L , Chen Q , Gao SG , Wang GP , Qu ZF , Shan TY , Qian N , Feng XS
Published: February 2013

OBJECTIVES: Lymph node micro metastasis was investigated in gastric cardia adenocarcinoma (GCA) patients without lymph node metastasis on routine pathological examination. The relationship between micrometastasis and clinicopathological features was also evaluated. METHODS: A total of 349 lymph nodes were obtained from 45 patients with GCA. Micrometastases were detected by immunohistochemical staining for the markers cytokeratin 19 (CK19) and CD44 variant 6 (CD44v6). RESULTS: A total of 33 lymph nodes (9.5%) from 15 patients (33.3%) were positive for CK19. Of these, 27 lymph nodes (7.7%) from 12 patients (26.7%) were also positive for CD44v6. Micrometastasis was significantly related to depth of tumour invasion and Lauren classification (intestinal or diffuse). The recurrence rate was significantly higher and 2-year survival rate significantly lower in patients with than in those without lymph node micrometastasis, showing the necessity of detecting micrometastasis in GCA patients who test negative for lymph node metastasis on routine examination. CONCLUSION: CK19 and CD44v6 were shown to be good markers for micrometastasis detection.
Therapeutic and Preventive Effects of an Epidermal Growth Factor Receptor Inhibitor on Oral Squamous Cell Carcinoma
Authors: Ge H , Liu H , Fu Z , Sun Z
Published: February 2013

OBJECTIVE: Oral squamous cell carcinoma (OSCC) is the sixth most common human neoplasm worldwide. Epidermal growth factor receptor (EGFR) is a receptor tyrosine kinase that is highly expressed in human OSCC and is a target for cancer therapy and prevention. This study investigated the therapeutic and preventive effects of an inhibitor of EGFR (PD153035) on OSCC. METHODS: The effects of PD153035 were examined in human cancer cell lines in vitro, in an athymic nude mouse xenograft model in vivo, and in the 7,12-dimethylbenz[ a]anthracene (DMBA)-induced hamster cheek pouch tumour model in vivo. RESULTS: PD153035 significantly inhibited cell growth, delayed cell cycle progression and induced apoptosis in human OSCC cells in vitro. In vivo, PD153035 inhibited xenograft tumour growth in nude mice in a dose-dependent manner and prevented the development of OSCC at the postinitiation stage in the DMBA-induced hamster cheek pouch tumour model. PD153035 inhibited the DMBA-induced increases in cell proliferation and in levels of phosphorylated EGFR and phosphorylated signal transducer and activator of transcription 3 (STAT3) protein in the hamster cheek pouch. CONCLUSIONS: Inhibitors of EGFR, such as PD153035, have potential value in the treatment and prevention of OSCC.
Evaluation of Plasma and Tissue S100A4 Protein and mRNA Levels as Potential Markers of Metastasis and Prognosis in Clear Cell Renal Cell Carcinoma
Authors: Yang H , Zhao K , Yu Q , Wang X , Song Y , Li R
Published: February 2013

OBJECTIVES: To investigate levels of S100A4 protein in plasma and S100A4 mRNA in tumours from patients with clear cell renal cell carcinoma (CCRCC), and correlate these with metastasis, survival and levels of vascular endothelial growth factor (VEGF). METHODS: Plasma S100A4 and VEGF protein concentrations were measured using enzyme-linked immunosorbent assays in 39 healthy subjects and 68 consecutive patients with untreated CCRCC. Levels of S100A4 and VEGF mRNA in tumour and matched control (healthy) tissue samples were measured using real-time quantitative reverse transcription—polymerase chain reaction. Findings were analysed with respect to clinicopathological characteristics. RESULTS: Plasma VEGF concentrations were higher in patients with CCRCC than in healthy subjects. S100A4 and VEGF mRNA levels were up-regulated in CCRCC tumour tissue compared with control tissue samples. Logistic regression analysis revealed that up-regulated tumour S100A4 and VEGF mRNA levels were independent risk factors for the presence of invasion and/or metastasis. CONCLUSIONS: S100A4 and VEGF are associated with tumour invasion and metastasis, and may be useful prognostic markers in patients with CCRCC. S100A4 and VEGF may represent potential targets for therapeutic intervention.
Enhanced T Cell Immunity by B7-H4 Downregulation in Nonsmall-Cell Lung Cancer Cell Lines
Authors: Sun S-Q , Jiang C-G , Lin Y , Jin Y-L , Huang P-L
Published: February 2013

OBJECTIVES: T cell immunity plays a critical role in host immune surveillance of tumour cell growth and metastatic spread. This study used small hairpin (sh)RNA-mediated gene silencing to target VTCN1 (B7-H4) expression in a nonsmall-cell lung cancer (NSCLC) cell line (A549) and evaluated the effects on T cell immune activity using an in vitro coculture system. METHODS: VTCN1-specific shRNA-expressing plasmid was transfected into A549 cells. Mock transfected and empty plasmid-transfected A549 cells served as controls. VTCN1 expression in A549 cells was determined by reverse transcription– polymerase chain reaction (RT—PCR) for VTCN1 mRNA and Western blotting for B7-H4 protein. Transfected A549 cells were cocultured with Jurkat cells. Jurkat cells were examined for proliferation, apoptosis, cell cycle distribution and intracellular cytokine mRNA and protein levels. RESULTS: VTCN1-specific shRNA efficiently knocked down VTCN1 mRNA and B7-H4 protein levels in A549 cells. This downregulation led to enhanced Jurkat cell proliferation, decreased apoptosis, stimulated cell cycle progression and elevated production of interferon-γ, interleukin (IL)-10 and IL-2. CONCLUSIONS: B7-H4 negatively regulates T cell-mediated antitumour immunity in NSCLC.
The Effects of Intrathecal Morphine on Patient-Controlled Analgesia, Morphine Consumption, Postoperative Pain and Satisfaction Scores in Patients Undergoing Gynaecological Oncological Surgery
Authors: Kara I , Apiliogullari S , Oc B , Celik JB , Duman A , Celik C , Dogan NU
Published: February 2013

OBJECTIVE: Gynaecological oncological surgery (GOS) includes a wide variety of surgical procedures and postoperative pain is a major concern. This study compared the impact of intrathecal morphine (ITM) plus patient-controlled analgesia (PCA) with PCA alone on morphine consumption, pain relief and patient satisfaction after GOS. METHODS: Sixty women undergoing GOS under general anaesthesia were randomized to receive either 0.3 mg ITM or placebo. On arrival at the postanaesthesia care unit each patient received a morphine PCA pump. The three primary outcome measures were pain, patient satisfaction scores evaluated using a 100-mm visual analogue scale and cumulative PCA morphine consumption. RESULTS: No significant differences were observed in the demographic data. Cumulative PCA morphine consumption was significantly lower in the ITM group compared with the control group. Fatigue scores were lower in the ITM group compared with the control group but did not reach statistical significance. Pain, sedation and patient satisfaction scores, and the rate of side-effects were similar for the two groups. CONCLUSIONS: Administering ITM in GOS could improve postoperative analgesia and reduce morphine consumption without serious side-effects.
Increase in Total Antioxidant Capacity of Plasma despite High Levels of Oxidative Stress in Uncomplicated Type 2 Diabetes Mellitus
Authors: Savu O , Ionescu-Tirgoviste C , Atanasiu V , Gaman L , Papacocea R , Stoian I
Published: February 2013

OBJECTIVE: Oxidative stress is implicated in the pathophysiology of diabetes mellitus and its chronic complications. The aim of this study was to evaluate plasma antioxidant status in patients with uncomplicated type 2 diabetes, in order to understand the interactions between its components and the diabetic milieu. METHODS: Plasma samples were collected from 15 patients with type 2 diabetes receiving oral antidiabetic agents and from 18 healthy control subjects without diabetes. Glycosylated haemoglobin was measured as an indicator of blood glucose control. Total and residual antioxidant activities were measured. Lipid peroxides were measured as indicators of plasma oxidative stress. Copper and caeruloplasmin were also assayed as possible pro-oxidants. RESULTS: Antioxidant activities, lipid peroxide level, copper concentration and caeruloplasmin activity were significantly increased in the plasma of patients with diabetes compared with control subjects. CONCLUSIONS: The total antioxidant capacity of plasma was increased, despite high levels of oxidative stress, in patients with uncomplicated type 2 diabetes. Increased levels of copper and caeruloplasmin characterized the diabetic milieu, despite an absence of chronic complications.
Comparison of Hippocampal Volume Measured Using Magnetic Resonance Imaging in Alzheimer's Disease, Vascular Dementia, Mild Cognitive Impairment and Pseudodementia
Authors: Dolek N , Saylisoy S , Ozbabalik D , Adapinar B
Published: February 2013

OBJECTIVE: To examine the relationship between different types of dementia and hippocampal volume. METHODS: Hippocampal volume was measured by magnetic resonance imaging in patients with Alzheimer's disease ( n = 22), vascular dementia ( n = 14), mild cognitive impairment ( n = 12) or pseudodementia ( n = 16), and in healthy control subjects ( n = 11). The Mini Mental State Examination was used to stratify subjects according to cognitive function. RESULTS: Hippocampal volume was reduced by 42% in Alzheimer's disease, 21% in vascular dementia, 15% in mild cognitive impairment and 13% in pseudodementia compared with controls. The severity of dementia increased in line with decreasing hippocampal volume. CONCLUSIONS: Measurement of hippocampal volume may facilitate differentiation between dementia subtypes. There was a relationship between reduced hippocampal volume and the degree of cognitive impairment.
Climatic Factors Correlate with Innate Immune Response in Children with Dermatophagoides farinae-Induced Allergic Asthma
Authors: Tan Y-Q , Cao LF , Shen J , Yu Y
Published: February 2013

OBJECTIVE: To determine the effect of climatic factors on immune markers in children with Dermatophagoides farinae-induced asthma. METHODS: Serum concentrations of macrophage migration inhibitory factor (MIF), eosinophil cationic protein (ECP) and D. farinae-specific immunoglobulin E (DF-sIgE), together with peripheral blood eosinophil counts, were measured in children with D. farinae-induced ( n = 75) or non- D. farinae-induced asthma ( n = 17), and in healthy controls ( n< = 30). Mean temperature and relative humidity in the month before enrolment were calculated from meteorological data. RESULTS: MIF, ECP and eosinophil counts were significantly higher in children with D. farinae-induced asthma than in controls, but comparable with non- D. farinae-induced asthma. Children with D. farinae-induced asthma in a low temperature (< 16°C) or low relative humidity (< 70%) climate had significantly lower DF-sIgE, MIF, ECP and eosinophil counts than those in a high temperature or high humidity climate. DF-sIgE correlated positively with MIF, ECP and eosinophil count in D. farinae-induced asthma. CONCLUSIONS: Temperature and humidity influenced MIF, ECP, eosinophil count and DF-sIgE in D. farinae-induced asthma. Understanding this relationship may provide new strategies for asthma prevention and treatment.
Prevalence of the Association of Subacromial Impingement with Subcoracoid Impingement and Their Clinical Effects
Authors: Misirlioglu M , Aydin A , Yildiz V , Dostbil A , Kilic M , Aydin P
Published: February 2013

OBJECTIVES: A prospective study to determine how commonly chronic subacromial impingement is associated with subcoracoid impingement and to evaluate clinical outcome after arthroscopic subacromial decompression (ASD). METHODS: Subacromial and coracohumeral distances were evaluated in patients with chronic shoulder pain before and after ASD, using magnetic resonance imaging and the University of California at Los Angeles (UCLA) shoulder scale and Constant—Murley shoulder assessment. RESULTS: A total of 40 patients were included in the study; patients were followed up for a mean of 27.3 months. Before ASD, 14 (35%) patients with chronic subacromial impingement also had subcoracoid impingement. In these patients, the mean coracohumeral distance was 7.18 mm (range 5.00 – 11.00 mm). After ASD, no patient had subcoracoid impingement, and the mean coracohumeral distance was significantly longer than pre-ASD, 12.85 mm (range 11.00 – 15.00 mm). The Constant—Murley shoulder assessment and UCLA shoulder scale both showed improvement after ASD. CONCLUSIONS: Chronic subacromial impingement occurred together with subcoracoid impingement in 35% of patients presenting with chronic shoulder pain. Following ASD, the coracohumeral distance increased with remission from pain.
Malignant Fibrous Histiocytoma of the Spermatic Cord: Case Report and Literature Review
Authors: Xu LW , Yu YL , Li G-H
Published: February 2013

This case study reports on a rare case of malignant fibrous histiocytoma arising in the right spermatic cord. An 80-year-old male presented with a 2-week history of a right inguinal mass, with mild pain in the same region. Ultrasonography and computed tomography showed a mass arising from the right spermatic cord. A right radical orchiectomy was performed with wide dissection of the mass; the right testicle and epididymis were found not to be grossly involved. The patient had an uneventful postoperative course and recovered well. The patient and his family refused further adjuvant radiotherapy. There was no evidence of recurrence or metastasis during 20 months of regular follow-up. The diagnosis, histological classification, treatment and prognosis of this case are presented, together with a review of the literature.
Serum Overexpression of MicroRNA-10b in Patients with Bone Metastatic Primary Breast Cancer
Authors: Zhao F-L , Hu G-D , Wang X-F , Zhang X-H , Zhang Y-K , Yu Z-S
Published: February 2013

OBJECTIVE: Bone metastasis is a major complication of advanced breast cancer. The present prospective case—control study investigated the involvement of microRNA (miR)-10b in the development of bone metastasis arising from primary breast carcinoma. METHODS: Serum miR-10b concentrations were determined by quantitative real-time reverse transcription—polymerase chain reaction in 122 patients with breast cancer, with or without bone metastases, and 59 age-matched healthy control subjects. RESULTS: Serum miR-10b concentrations were significantly higher in patients with bone metastases than in patients without bone metastases or control subjects. Serum miR-10b had an area under the receiver operating characteristic curve for the presence of bone metastases of 0.769, with 64.8% sensitivity and 69.5% specificity. CONCLUSION: These results suggest that serum miR-10b may be a useful biomarker for the identification of bone metastatic breast cancer.
Value of Abdominal Susceptibility-Weighted Magnetic Resonance Imaging for Quantitative Assessment of Hepatic Iron Deposition in Patients with Chronic Hepatitis B: Comparison with Serum Iron Markers
Authors: Lv W , Yan F , Zeng M , Zhang J , Yuan Y , Ma J
Published: February 2013

OBJECTIVE: To assess hepatic iron deposition quantitatively in patients with chronic hepatitis B (HBV) infection, using abdominal susceptibility-weighted magnetic resonance imaging (SWI). METHODS: Patients with HBV infection and healthy controls underwent abdominal SWI and were assessed for serum iron markers. Phase values were measured and five grades of hepatic iron deposition were described by SWI. RESULTS: Patients with HBV infection ( n = 327) and healthy controls ( n = 50) were prospectively enrolled. In total, 77 (25.4%) patients with HBV infection had hepatic iron deposition as determined by SWI. Phase values were significantly different between patients with hepatic iron deposition compared with patients without hepatic iron deposition or controls, and were significantly different across different grades of hepatic iron deposition. Serum iron, ferritin, transferrin and transferrin saturation were significantly higher in patients with, versus those without, hepatic iron deposition. Only serum ferritin was significantly different across different grades of hepatic iron deposition, and there was a low inverse correlation between serum ferritin and phase values. CONCLUSIONS: Compared with serum iron markers, abdominal SWI may represent a powerful tool to assess hepatic iron deposition quantitatively in patients with chronic HBV infection.
Myocardial Protection by Salvia Miltiorrhiza Injection in Streptozotocin-Induced Diabetic Rats through Attenuation of Expression of Thrombospondin-1 and Transforming Growth Factor-β1
Authors: Yu J , Fei J , Azad J , Gong M , Lan Y , Chen G
Published: February 2013

OBJECTIVES: To investigate the myocardially protective effects of Salvia miltiorrhiza injection in streptozotocin-induced diabetic rats and the possible mechanisms involved. METHODS: Adult male Sprague—Dawley rats were randomized into three groups ( n = 10 per group): diabetes, no treatment (Sm-); diabetes, S. miltiorrhiza injection (Sm+); control (no diabetes; saline treatment). After model induction and 4 weeks' treatment, heart function of five rats from each group was tested by Langendorff isolated in vivo heart perfusion. In the remaining rats, pathological changes of the myocardium were observed by haematoxylin and eosin staining, and protein levels of thrombospondin-1 (TSP-1) and transforming growth factor-β1 (TGF-β1) were assessed by immunohistochemistry. RESULTS: Left ventricular systolic end pressure and left ventricular developed pressure were significantly improved in the Sm+ group compared with the Sm- group. Pathological changes were ameliorated through significantly reduced TSP-1 and TGF-β1 protein levels. CONCLUSIONS: S. miltiorrhiza injection may improve the heart function of diabetic rats and protect against cardiomyopathy by downregulating TSP-1 and TGF-β1 in myocardial tissue.
Evaluation of the Significance of Circulating Insulin-Like Growth Factor-1 and C-Reactive Protein in Patients with Chronic Obstructive Pulmonary Disease
Authors: Ye M , Yu H , Yu W , Zhang G , Xiao L , Zheng X , Wu J
Published: February 2013

OBJECTIVES: This study in patients with chronic obstructive pulmonary disease (COPD) investigated whether acute exacerbation of COPD (AECOPD) and clinically stable COPD (CSCOPD) are associated with changes in circulating insulin-like growth factor-1 (IGF-1) and C-reactive protein (CRP) concentrations, and whether changes in IGF-1 and CRP levels are related to changes in the indicators of malnutrition and muscle wasting. METHODS: A total of 61 patients with AECOPD, 43 patients with CSCOPD and 20 healthy age-matched controls were included in the study. Circulating IGF-1 and CRP levels, together with erythrocyte sedimentation rate and indicators of malnutrition and muscle wasting, were measured in all the study participants. RESULTS: Circulating IGF-1 levels were significantly lower and CRP levels significantly higher in COPD patients than in controls. In addition, IGF-1 levels were significantly lower and CRP levels significantly higher in AECOPD patients than in CSCOPD patients. In COPD patients, indicators of malnutrition and muscle wasting (weight, body mass index, thigh circumference and albumin level) were significantly positively correlated with logIGF-1; thigh circumference and albumin level were significantly inversely correlated with logCRP. CONCLUSION: Circulating IGF-1 and CRP levels may have potential as indicators of exacerbation, malnutrition and muscle wasting in patients with COPD.
Extracellular Matrix Metalloproteinase Inducer is Associated with Severity of Brain Oedema following Experimental Subarachnoid Haemorrhage in Rats
Authors: Tu Y , Fu J , Wang J , Fu G , Wang L , Zhang Y
Published: February 2013

OBJECTIVE: Brain oedema is a major cause of clinical deterioration and death following brain trauma; cellular mechanisms involved in its development remain elusive. This study investigated the role of extracellular matrix metalloproteinase inducer (EMMPRIN) in brain oedema. METHODS: The monofilament puncture model was used to induce subarachnoid haemorrhage. Adult male Sprague—Dawley rats were divided into five groups ( n = 20 per group): sham-operated, sacrificed immediately after surgery (sham group); sacrificed 12, 24 or 72 h after subarachnoid haemorrhage induction (SAH-12, SAH-24 and SAH-72 groups, respectively); treated with EMMPRIN inhibitor immediately after subarachnoid haemorrhage, sacrificed at 24 h (SAH-inhibition group). Mean brain water content, and EMMPRIN mRNA and protein levels, were determined. RESULTS: Compared with the sham group, mean brain water content, EMMPRIN mRNA and protein levels in the SAH-12, SAH-24 and SAH-72 groups increased rapidly and significantly (maximal at 24 h). EMMPRIN inhibition significantly reduced mean brain water content and EMMPRIN mRNA and protein levels in the SAH-inhibition group, compared with the SAH-24 group. CONCLUSIONS: EMMPRIN upregulation may be important in the formation of brain oedema; inhibition of EMMPRIN activity may provide a potential approach to reduce oedema after subarachnoid haemorrhage.
The Role of Telomeres in Musculoskeletal Diseases
Authors: Li D , Yuan Q , Wang W
Published: February 2013

The telomeric region of repetitive DNA sequences at the end of chromosomes prevents end-to-end fusion of chromosome terminals and deterioration of the doublestrand free ends. Because of the ‘end-replication problem’, telomeres shorten with each round of cell division, resulting in cell senescence. The enzyme telomerase compensates for telomere shortening by elongating telomeric sequences, thereby prolonging the lifespan of the cell. Studies of articular cartilage and bone tissues have indicated that telomere shortening limits normal cell function and proliferation, while the telomere maintenance mechanisms of osteosarcoma cells facilitate escape from cell death and promote immortality. This article reviews the literature on this topic and provides an extensive discussion of the basic molecular biology and roles of telomeres and telomerase in musculoskeletal diseases such as osteoarthritis, osteoporosis and osteosarcoma. Findings to date suggest that telomeres and telomerase may become novel therapeutic targets for the diagnosis, treatment and prevention of musculoskeletal disorders.
Thrombospondin-1 and Transforming Growth Factor-β1 Levels in Prolactinoma and their Clinical Significance
Authors: Jiang M , Mou Cz , Han T , Wang M , Yang W
Published: February 2013

OBJECTIVE: To investigate the roles of angiogenesis, thrombospondin-1 (TSP-1) and transforming growth factor-β1 (TGF-β1) in invasive and noninvasive prolactinoma. METHODS: TSP-1 and TGF-β1 protein were examined using immunohistochemistry and Western blotting in 81 prolactinomas. Angiogenesis was assessed by measuring microvessel density via CD34 immunostaining. RESULTS: Microvessel density was significantly higher in invasive prolactinomas than in noninvasive prolactinomas. Immunohistochemistry demonstrated that significantly fewer invasive prolactinomas were positive for TSP-1 compared with noninvasive prolactinomas (17.9% versus 50.0%, respectively), and significantly higher numbers of invasive prolactinomas were positive for TGF-β1 compared with noninvasive prolactinomas (82.1% versus 42.9%, respectively). Microvessel density was significantly lower in TSP-1-positive prolactinomas than in TSP-1-negative prolactinomas, and significantly higher in TGF-β1-positive prolactinomas than in TGF-β1-negative prolactinomas. CONCLUSIONS: These results suggest a close relationship between angiogenesis and tumour invasiveness in prolactinoma. TSP-1 and TGF-β1 may play important roles in the progression of prolactinoma, by affecting angiogenesis.
Higher Serum Retinol Binding Protein 4 May be a Predictor of Weak Metabolic Control in Chinese Patients with Type 2 Diabetes Mellitus
Authors: Wang Mn , Han Yb , Li Q , Guo L , Yang Ym , Wang W , Zhang Jc
Published: February 2013

OBJECTIVE: To investigate relationships between serum levels of retinol binding protein 4 (RBP4) and clinical and metabolic variables in Chinese patients with type 2 diabetes mellitus. METHODS: A total of 513 patients (286 males/227 females) provided clinical and lifestyle data and blood and urine samples for analysis. Patients were stratified into four quartile groups according to serum RBP4 concentrations. RESULTS: RBP4 concentration was independently associated with gender, systolic blood pressure, serum triglyceride and creatinine levels, and estimated glomerular filtration rate (eGFR). Hypertension, dyslipidaemia, microalbuminuria and impaired eGFR (< 60 ml/min per 1.73 m2) were significantly more prevalent in patients with the highest RBP4 levels than in those with the lowest levels. Increased serum RBP4 was associated with increased risk of hypertension, dyslipidaemia, microalbuminuria and impaired eGFR after adjusting for gender, age, body mass index and duration of diabetes. CONCLUSION: Serum RBP4 may be a useful marker of overall metabolic control in Chinese patients with type 2 diabetes mellitus.
Altered Aggrecan Synthesis and Collagen Expression Profiles in Chondrocytes from Patients with Kashin—Beck Disease and Osteoarthritis
Authors: Gao Zq , Guo X , Duan C , Ma W , Xu P , Wang W , Chen Jc
Published: February 2013

OBJECTIVES: To investigate cell morphology, aggrecan expression, and type I, II, III and X collagen expression in chondrocytes from adults with Kashin—Beck disease or osteoarthritis (OA). METHODS: Samples of knee articular cartilage were taken during surgery; cartilage samples obtained from fresh cadavers without arthritic disease were used as controls. Samples were digested with collagenase; isolated chondrocytes were cultured in monolayers. Aggrecan was detected by toluidine blue staining; collagen and aggrecan protein levels were evaluated by immuno cytochemistry and immunofluorescence staining. RESULTS: Samples were obtained from six participants per group. Aggrecan and type II collagen levels in chondrocytes from patients were significantly lower than those from controls, but levels of type I, III and X collagen were enhanced in patients compared with controls. Production of type III and X collagen was higher in chondrocytes from patients with Kashin—Beck disease than in those from OA patients. CONCLUSIONS: Biochemical and morphological mechanisms underlying Kashin—Beck disease and OA include enhanced dedifferentiation and hypertrophy of chondrocytes, increased type I, III and X collagen levels, and suppressed type II collagen and aggrecan production compared with control samples.
Bilateral Superficial Cervical Plexus Block Reduces Postoperative Nausea and Vomiting and Early Postoperative Pain after Thyroidectomy
Authors: Cai H-D , Lin C-Z , Yu C-X , Lin X-Z
Published: February 2013

OBJECTIVE: To compare the incidence of postoperative nausea and vomiting (PONV) and postoperative pain in thyroidectomy patients undergoing general anaesthesia, with or without bilateral superficial cervical plexus block (BSCPB). METHODS: In this prospective, randomized, double-blind study, adult patients scheduled for thyroid surgery under general anaesthesia were randomized to receive BSCPB with 20 ml 0.5% ropivacaine (ropivacaine group) or placebo (20 ml saline; saline group) before surgery. The incidence of PONV and postoperative pain, and the need for rescue antiemetics were assessed at 0 – 24 h postoperatively. RESULTS: Data from 135 patients were evaluated and the incidence of PONV, the need for rescue antiemetics and the number of patients needing additional perioperative pain relief in the postanaesthetic care unit were significantly lower in the ropivacaine group compared with the saline group. Early postoperative (0 – 8 h) visual analogue scale pain scores were significantly lower in the ropivacaine group compared with the saline group. CONCLUSIONS: BSCPB with 0.5% ropivacaine administered before surgery can significantly reduce the incidence of PONV and early postoperative pain and also reduce perioperative opioid requirements in thyroidectomy patients undergoing general anaesthesia.
Changes in Spontaneous Dorsal Horn Potentials after Dorsal Root Entry Zone Lesioning in Patients with Pain after Brachial Plexus Avulsion
Authors: Dong S , Hu Ys , Du W , Tao W , Zhang Xh , Zhuang P , Li Yj
Published: February 2013

OBJECTIVES: This study investigated spontaneous dorsal horn potentials in patients with pain after brachial plexus avulsion and determined the effect of dorsal root entry zone (DREZ) lesioning on these potentials and on pain levels. METHODS: Electrospinography (ESG) recordings were undertaken in seven patients using a noninvasive electrocorticography strip electrode. Measurements were taken from the DREZ on the intact side of the spinal cord before lesioning of the injured DREZ and from the injured DREZ before and after lesioning. RESULTS: DREZ lesioning had a significant positive effect on pain at 12 months postoperatively. At 15.0 Hz, the mean ESG power from the injured DREZ before lesioning was significantly higher than that from the intact DREZ. In addition, the mean ESG power from the injured DREZ after successful DREZ lesioning was significantly lower than that from the intact DREZ and that from the injured DREZ before lesioning. CONCLUSIONS: The ESG power from the injured DREZ increases in patients with pain after brachial plexus avulsion compared with that of the intact DREZ; this increase is reduced by successful DREZ lesioning.
Paraoxonase-1 Gene Q192R Polymorphism and Reactive Oxygen Metabolites
Authors: Kotani K , Tsuzaki K , Sakane N
Published: February 2013

OBJECTIVE: Paraoxonase-1 (PON1) is a high-density lipoprotein-associated antioxidant enzyme. The Q192R polymorphism of the PON1 gene can protect against oxidative conditions, but the relationship between Q192R polymorphism and oxidative stress-related markers remains controversial. In this study, the diacron reactive oxygen metabolites (d-ROMs) test was used to investigate the relationship between Q192R polymorphism and oxidative stress-related markers in Japanese subjects. METHODS: Patients without a history of overt cardiovascular disease who were not receiving antioxidant medication were enrolled in a cross-sectional clinic-based study. An allele-specific polymerase chain reaction method was used to assess the PON1 Q192R polymorphism and compare the level of d-ROMs between genotypes. RESULTS: A total of 103 subjects were analysed. The RR genotype was associated with a significantly lower level of d-ROMs than the RQ and QQ genotypes. After multivariate analysis the relationship between the genotypes and level of d-ROMs remained independently significant. CONCLUSIONS: The RR genotype may be protective against oxidative stress in cardiovascular disease-free Japanese subjects. In addition, the d-ROMs test can be useful for examining the role of the PON1 Q192R polymorphism under oxidative conditions.
Continuous Subcutaneous Insulin Infusion in Adult Type 1 Diabetes Mellitus: Data from a Registry at the University Medical Centre Ljubljana, Slovenia
Authors: Janez A
Published: February 2013

OBJECTIVE: To evaluate the treatment indications, effectiveness and adverse events of continuous subcutaneous insulin infusion (CSII) in adults with type 1 diabetes mellitus using data from a registry at the University Medical Centre Ljubljana, Ljubljana, Slovenia. METHODS: The registry included patients with type 1 diabetes who had converted from multiple daily injection (MDI) to CSII. Patients with complete data sets covering a period of ≥ 3 years were included in the study ( n = 184). Complications, glycaemic control and insulin dose during CSII were compared with data obtained during MDI. RESULTS: CSII resulted in significant reductions in glycosyated haemoglobin level and total daily insulin dose. The mean number of severe hypoglycaemic episodes during CSII was 0.17 per patient per year. CONCLUSIONS: Treatment of adults with type 1 diabetes mellitus by CSII can improve glycaemic control and reduce insulin requirements compared with MDI, however patient selection, education and continuous care are important parts of this therapy.
Multifactor Analysis on the Outcomes of Cervical Spondylotic Myelopathy with Expansive Open-Door Laminoplasty
Authors: Zhang H , Zhu R , Yang H , Zhu X , Zhou F
Published: February 2013

OBJECTIVES: To examine clinical outcomes following expansive open-door laminoplasty (EOLP) in the treatment of multilevel cervical spondylotic myelopathy (CSM) and the factors that influence these outcomes. METHODS: This retrospective analysis in CSM patients following EOLP investigated the relationship between recovery rate, based on the Japanese Orthopaedic Association (JOA) score, and the impact of age, duration of CSM, and axial symptoms, including the effect of EOLP on cervical curvature. RESULTS: In total, 79 CSM patients were included. Overall, the pre-and postoperative (1 year after surgery) mean ± SD JOA scores were 9.6 ± 1.4 and 14.7 ± 1.9, respectively, indicating an improvement of 68.9%. Factors that were significantly related to ‘excellent’ (≥ 75%) or ‘good’ (≥ 50% – < 75%) recovery rates included a high preoperative JOA score, short duration of CSM (≤ 12 months) and patient age < 50 years. Significant reductions in cervical curvature angle were only observed in patients with axial symptoms. CONCLUSIONS: These results indicate that CSM should be treated early. The severity of CSM, the patient's age, cervical curvature angle, operation technique and axial symptoms play important roles in clinical outcomes.
Does farm environment protect against type 1 diabetes mellitus?
Authors: Heikkinen Sanna MM , Pitkäniemi Janne M , Kilpeläinen Maritta L , Koskenvuo Markku J
Published: February 2013

Aims/Hypothesis:

Hygiene hypothesis has been shown valid in respect of allergies and asthma but has not been, however, sufficiently studied in relation to type 1 diabetes mellitus. This study investigates the effect of childhood farm environment on the prevalence of type 1 diabetes mellitus in Finnish children and young adults.

Methods:

Data come from a questionnaire study carried out in 2007 (N = 5805). Prevalence of type 1 diabetes mellitus was analysed according to the type of the rural exposure below the age of 18 years. Associations were estimated and tested using Bayesian methods.

Results:

Consistent suggestive evidence of the inverse association of childhood’s farm environment with the occurrence of type 1 diabetes mellitus was shown, even though conclusive results were not reached.

Conclusion/Interpretation:

Exposure to a broad variety of non-pathogenic environmental microorganisms during childhood might have a protective effect on type 1 diabetes mellitus. Results clearly suggest that further research is well grounded with larger samples.
“The Intelligence of Nations”
Authors: Sternberg Robert J.
Published: February 2013

I argue in this comment that Hunt’s analysis of the intelligence of nations is smarter than it is wise. It is based on too narrow a conception of intelligence. It also conflates correlation and causation with regard to the relation between IQ and socially defined success, both individual and familial. I suggest that a better approach might be to compare nations as well for their creativity and wisdom.
The Work of Making and the Work it Does: Cultural Sociology and ‘Bringing- Into-Being’ the Cultural Assemblage of the Olive Schreiner Letters
Authors: Stanley Liz , Salter Andrea , Dampier Helen
Published: February 2013

Programmatic ideas regarding cultural sociology and its inter-relationship with cultural production inspired by the work of Inglis et al., Mukerji and Bennett are explored. A particular cultural assemblage, the editorial practices arising in an interdisciplinary project concerned with researching and publishing the letters of South African feminist writer and social theorist Olive Schreiner, is detailed. Four key aspects of the particular ‘bringing-into-being’ which these working practices involve are interrogated, regarding the ‘moment of writing’, archive stories, the ‘editorial moment’ and the involvement of the later reader, with these examined in depth in relation to examples of Schreiner’s letters.
Cardiovascular Collapse in Anaphylaxis Successfully Treated With Vasopressin
Authors: Weott Patricia
Published: February 2013

In this report, we describe the case of a 52-year-old man who suffered a severe anaphylactic reaction in the operating room that was unresponsive to epinephrine. After an uneventful induction and intubation, he received antibiotics and was placed in the prone position. His blood pressure began to decline and despite escalating doses of phenylephrine, ephedrine, and then epinephrine, his pressure continued to deteriorate and became unobtainable. When all other resuscitative measures failed, a single dose of vasopressin 20 units was given intravenously; the patient had an immediate response with dramatic reversal of the cardiovascular collapse. He was then stabilized, transferred to the ICU, and subsequently discharged home without neurologic sequelae. In this article, we review the signs and symptoms of anaphylaxis seen in patients under anesthesia and consider the pathophysiologic mechanisms of the reaction that support the use of vasopressin.
Comparison of transhepatic and extrahepatic routes for EUS‐guided rendezvous procedure for distal CBD obstruction
Authors: Dhir Vinay , Bhandari Suryaprakash , Bapat Mukta , Joshi Nitin , Vivekanandarajah Suhirdan , Maydeo Amit
Published: February 2013

Background

EUS‐guided rendezvous procedure (EUS‐RV) can be done by the transhepatic (TH) or the extrahepatic (EH) route. There is no data on the preferred access route when both routes are available.

Study aim

To compare the success, complications, and duration of hospitalization for patients undergoing EUS‐RV by the TH or the EH route.

Patients and methods

Patients with distal common bile duct (CBD) obstruction, who failed selective cannulation, underwent EUS‐RV by the TH route through the stomach or the EH route through the duodenum.

Results

A total of 35 patients were analysed (17 TH, 18 EH). The mean procedure time was significantly longer for the TH group (34.4 vs. 25.7 min; p  = 0.0004). There was no difference in the technical success (94.1 vs. 100%). However, the TH group had a higher incidence of post‐procedure pain (44.1 vs. 5.5%; p  = 0.017), bile leak (11.7 vs. 0; p  = 0.228), and air under diaphragm (11.7 vs. 0; p  = 0.228). All bile leaks were small and managed conservatively. Duration of hospitalization was significantly higher for the TH group (2.52 vs. 0.17 days; p  = 0.015).

Conclusions

EUS‐RV has similar success rate by the TH or the EH route. However, the TH route has higher post‐procedure pain, longer procedure time, and longer duration of hospitalization. The EH route should be preferred for EUS‐RV in patients with distal CBD obstruction when both access routes are technically feasible.