bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of prosthesis-patient mismatch on survival after mitral valve replacement: a systematic review
Authors: Zhang Jian-feng , Wu Yi-cheng , Shen Wei-feng , Kong Ye
Published: January 2024

Objective

To determine whether the prosthesis-patient mismatch has a deleterious impact on survival after mitral valve replacement.

Data sources

A comprehensive literature search of PubMed, Embase, and ScienceDirect was carried out. References and cited papers of relevant articles were also checked.

Study selection

All articles published after January 1980 was initially considered. Non-English and non-human studies, case reports, and reviews were excluded from the initial search. References and cited papers of relevant articles were also checked.

Results

A total of 8 retrospective cohort studies were identified for this review. The overall incidence of prosthesis-patient mismatch (<1.3 to <1.2 cm2/m2) after mitral valve replacement ranged from 3.7% to 85.9% (moderate prosthesis-patient mismatch (0.9 to 1.2 cm2/m2) in 37.4% to 69.5%, severe prosthesis-patient mismatch (<0.9 cm2/m2) in 8.7% to 16.4%). Four studies demonstrated an association of prosthesis-patient mismatch with reduced long-term survival, but the other four studies found no significant deleterious impact of prosthesis-patient mismatch after mitral valve replacement. No definite conclusion could be derived from these conflicting results.

Conclusions

Current evidence is insufficient to derive a definite conclusion whether mitral prosthesis-patient mismatch affects long-term survival because of the biases and confounding factors that interfere with late clinical outcomes. Good-quality prospective studies are warranted to evaluate the impact of mitral prosthesis-patient mismatch after mitral valve replacement in the future.
Age-related differences in the biological parameters of vertebral cancellous bone from Chinese women
Authors: JIANG Rui , LIU Guo-min , BAI Hao-tian , WANG Tian-bin , WU Han , JIA Yun-yan , LUO Yun-gang
Published: January 2024

Background

With aging, the human fracture risk gradually increase. This is mainly due to the corresponding changes of the biomechanical parameters of human bone presents with aging. We measured the microstructural parameters of lumbar bone from women in several age groups by micro-computed tomography and scanning electron microscopy. We observed changes in lumbar cancellous bone mineral density and in biomechanical parameters with aging to elucidate the relationship between age and risk of fracture. We provide theoretical support for human pathology, fracture risk increased with age and the individualized of each age group.

Methods

Thirty-two fresh L3 vertebral bodies were donated from 32 women, aged 20-59 years and were divided into four age groups: 20 to 29 years (group A); 30 to 39 years (group B); 40 to 49 years (group C); and 50 to 59 years (group D). Conventional lumbar separation was performed by removing soft tissue and subsidiary structures, leaving only the vertebral body. The vertebral body was cut into halves along the median sagittal plane, maintaining the upper and lower end-plates of each half, and used for biomechanical, morphological, and density measurements.

Results

Comparing group A to B, the rod-like trabecular thickness (Tb.Th) decreased; the trabecular spacing (Tb.Sp) increased; the plate-like Tb.Th decreased; bone mineral density, tissue mineral density, bone volume fraction, and bone surface fraction decreased, and the elastic modulus and the ultimate stress decreased (all changes P <0.05). Similar significant (P < 0.05) trends were obtained when comparing group C to D. With aging, the collagen cross-linking capacity declined, the thickness of the collagen fibrils was variable (ranging from almost the same to loose, sparse, or disordered), and the finer collagen fibrils between the thick filaments were disorganized.

Conclusions

In women aged 20 to 59 years, the rod-like and plate-like Tb.Th of the vertebral body decreased, while Tb.Sp increased. Additionally, the density, elastic modulus, and ultimate stress of the cancellous bone decreased with age. These associated changes in bone microstructure, density, and biomechanics with age may lead to an increasing risk of osteoporosis and fracture.
Biphasic insulin aspart 30 improved glycemic control in Chinese patients with type 2 diabetes poorly controlled on oral glucose-lowering drugs: a subgroup analysis of the A1chieve study
Authors: Chen Liming , Xing Xiaoyan , Lei Minxiang , Liu Jie , Shi Yongquan , Li Pengqiu , Qin Guijun , Li Chengjiang , Li Yukun , Wang Qing , Gao Tianshu , Hu Ling , Wang Yangwei , Yang Wenying
Published: January 2024

Background

The effectiveness and safety of initiating biphasic insulin aspart 30 in patients who were poorly controlled on oral glucose-lowering drugs were studied in randomized controlled trials, while results from clinical practice remain limited. This subgroup analysis was to provide such findings from a large-scale non-interventional study.

Methods

A1chieve was a multinational, prospective, open-label, non-interventional, 24-week study in patients with type 2 diabetes initiating insulin analogues in 28 countries across Asia, Africa, Europe, and Latin America. After physician had taken the decision to use this insulin, any patient with type 2 diabetes who was not treated with or who had started the study insulin within 4 weeks before inclusion was eligible. Patients were treated with study insulin alone or in combination with oral glucose-lowering drugs. Data on adverse drug reactions, hypoglycemia and glycemic control were collected at baseline, week 12 and 24. This is a report of a Chinese subgroup analysis from the A1chieve study.

Results

Totally, 4 100 patients constituted this subgroup. No serious adverse drug reactions were reported. Rates of total, major, nocturnal hypoglycemic events (events/patient per year) were 1.47, 0.10, 0.31 at baseline and 1.35, 0.00, 0.22 at week 24, respectively. Glycemic control was improved as measured by hemoglobin A1c (mean 9.3% to 7.0%, reduction -2.3%), fasting plasma glucose (mean 10.2 to 6.8 mmol/L, reduction -3.5 mmol/L) and postprandial plasma glucose (mean 14.4 to 8.8 mmol/L, reduction -5.6 mmol/L), all P <0.001. Change in mean body weight was +0.3 kg (P <0.001).

Conclusion

In this subgroup analysis of the A1chieve study, biphasic insulin aspart 30 improved glycemic control with low risk of hypoglycemia.
Influence of sinomenine on protein profiles of peripheral blood mononuclear cells from ankylosing spondylitis patients: a pharmacoproteomics study
Authors: Huang Zhi-xiang , Tan Jin-hui , Li Tian-wang , Deng Wei-ming , Qiu Ke-wei , Liao Ze-tao , Zeng Zhao-qiu
Published: January 2024

Background

Ankylosing spondylitis (AS) is a common inflammatory rheumatic disease which lacks satisfactory treatment so far. Sinomenine (SIN) is an alkaloid and has recently been utilized in treating multiple rheumatic diseases including AS in China, but its exact mechanism remains to be explored. This study investigated the alteration of proteome in peripheral blood mononuclear cells (PBMCs) from AS patients.

Methods

Thirty AS patients were enrolled in this study. PBMCs from each AS patient were cultured in medium with or without SIN respectively. Then PBMCs proteins from both groups were separated by two-dimensional electrophoresis (2-DE) and analyzed by mass spectrometry (MS). Two differentially expressed proteins were then chosen to be verified using Western blotting.

Results

Seven proteins, including α-synuclein (SNCA), calmodulin (CALM), acidic leucine-rich nuclear phosphoprotein 32 family member A (ANP32A), chloride intracellular channel protein 1 (CLIC1), guanine nucleotide-binding protein G(I)/G(S)/G(T) subunit beta-1 (GNB1), gelsolin (GSN) and histone H2B type 1-M (HISTH2BM) were over-expressed, while coronin-1A (CORO1A) was under-expressed in the SIN-treated PBMCs. Further bioinformatics search indicated that the changes of SNCA, ANP32A and CLIC1 pertained to apoptosis, while changes of GSN and CORO1A were associated with both apoptosis and inhibition of immunological function. Subsequently GSN and CORO1A were selected to validate by Western blotting and the results were consistent with those of 2-DE.

Conclusion

There were 8 differentially expressed proteins in the SIN-treated PBMCs, which might shed some light on the mechanism of SIN in the treatment of AS.
Effect of long intermittent hemodialysis on improving dialysis adequacy of maintenance hemodialysis patients
Authors: DAI Wen-di , ZHANG Dong-liang , CUI Wen-ying , LIU Wen-hu
Published: January 2024

Background

With the increase in hemodialysis (HD) patients, the blood dialysis patient’s quality of life (QoL) and long-term survival are still a challenge for clinicians. Recent studies have found that most of the HD patients have sleep disorders, which have a certain correlation with long-term survival and QoL. But there are few studies of Chinese in this field. This study aimed to investigate whether increasing the dialysis dose can improve sleep quality, so we treated HD patients on long intermittent hemodialysis (LIHD).

Methods

Forty patients who were treated by conventional HD at the Beijing Friendship Hospital Blood Purification Center were offered the option of LIHD. The patients’ laboratory data, medication use, and questionnaire answers were analyzed. Conventional HD was delivered thrice weekly with 4 hours per treatment, and LIHD was delivered thrice weekly with 8 hours per treatment. The study lasted 6 months. Questionnaires included sleep quality survey and QoL SF-36; the former includes the Athens Insomnia Scale, Pittsburgh Sleep Quality Index (PSQI), and Epworth Sleepiness Scale (ESS).

Results

After conversion to LIHD the dialysis efficiency (K
t/V) significantly increased than before (P <0.05) and clearance rate of urea nitrogen also increased from 67 to 78% (P <0.01). After conversion, median values for Hb increased from 108.95 to 126.55 g/L (P <0.01); albumin increased from 38.85 to 40.05 g/L (P <0.01). Phosphorus decreased from 2.69 to 1.54 mmol/L (P <0.01), but there was no alteration in blood calcium; phosphorus and calcium-phosphate product levels were under more control, but parathyroid hormone (iPTH) level did not change after conversion to LIHD. After conversion, blood pressure (BP) was better controlled than before and the mean number of antihypertensive drugs prescribed declined from 2.9 to 0.5 (P <0.01). There was a significant reduction in the use of erythropoietin-stimulating agent of 5250 U/w (P <0.01). Sleep quality significantly improved in the 2 months after conversion to LIHD, and the PSQI score decreased from 10.80 to 5.45 and the ESS score decreased from 12.05 to 5.30 (P <0.01). However, sleep quality started to decline after 2 months on LIHD. QoL SF-36 score increased from 410.92 to 592.53 (P <0.01).

Conclusion

LIHD offers an effective improvement in dialysis adequacy for Chinese maintenance HD patients, but it improves sleep quality only briefly which may be related to loss of serum calcium and parathyroid dysfunction.
High expression of follicle stimulating hormone receptor in testicular tissue of idiopathic azoospermic patients with severe spermatogenic defects
Authors: Liquan Wang , Hefeng Huang , Fan Jin , Caiyun Zhou , Yuli Qian , Jianhua Chen
Published: January 2024

Background

Follicle stimulating hormone is necessary for normal reproduction in men. The biochemical actions of follicle stimulating hormone result from binding to the follicle stimulating hormone receptor in the plasma membrane of Sertoli cells. Here, we investigated the expression of the follicle stimulating hormone receptor in different testicular histological phenotypes of patients with idiopathic azoospermia.

Methods

Fifty-seven cases of idiopathic azoospermia were classified into three groups according to the results of testicular biopsy: patients with hypospermatogenesis, patients with maturation arrest, and patients with Sertoli cell-only syndrome. Thirteen azoospermic patients identified by testicular biopsy as being capable of completing spermatogenesis acted as the control group. Immunohistochemistry and real-time quantitative reverse-transcriptase polymerase chain reaction were performed in each case, and the serum hormone level was also measured in all patients.

Results

The serum follicle stimulating hormone level in patients with Sertoli cell-only syndrome was significantly higher than in patients with hypospermatogenesis, maturation arrest, and complete spermatogenesis (P<0.01). The serum follicle stimulating hormone level in patients with maturation arrest was significantly higher than in patients with hypospermatogenesis and complete spermatogenesis (P<0.05). There was no difference in serum follicle stimulating hormone levels in patients with hypospermatogenesis and complete spermatogenesis. The follicle stimulating hormone receptor expression level of testicular samples with Sertoli cell-only syndrome was significantly higher than in those with hypospermatogenesis, maturation arrest, and complete spermatogenesis (P<0.05), but no significant difference was observed among hypospermatogenesis, maturation arrest, and complete spermatogenesis testicular samples.

Conclusions

Different serum follicle stimulating hormone levels and follicle stimulating hormone receptor expression were found in the different testicular histology phenotypes in azoospermic patients. Differential follicle stimulating hormone receptor expression in testicular tissue of patients with idiopathic azoospermia may be associated with the degree of spermatogenesis.
Central tendon splitting combined with SutureBridge double-row technique as a surgical treatment for insertional Achilles tendinopathy
Authors: LIN Yuan , WANG Zhi-wei , ZHANG Bo , PAN Jiang , QU Tie-bing , HAI Yong
Published: January 2024

Background

Surgical treatment of insertional Achilles tendinopathy should be considered when a variety of conservative measures fail. To achieve a satisfactory outcome, thorough debridement of the Achilles tendon is critical, besides excision of the bursitis and the calcaneal exostosis. Central tendon-splitting provides straightforward access to the calcified or degenerative tissue within the Achilles tendon. For Achilles tendon reconstruction if detachment is present, several surgical techniques have been reported. Controversy surrounds the technique can provide maximum security for reattachment of the Achilles tendon. The SutureBridge double-row construct, initially used in rotator cuff repair, is probably a good choice.

Methods

Ten consecutive patients with insertional Achilles tendinopathy underwent tendon reattachment using the SutureBridge technique through a central tendon-splitting approach. We retrospectively evaluated the surgical outcomes, which included pre- and postoperative visual analog scale (VAS), postoperative Maryland Foot Score (MFS), postoperative range of motion of the affected ankle, and related complications. Follow-up was performed in the outpatient department.

Results

One patient was lost to follow-up. Nine patients (two male and seven female; 12 feet) were reviewed with a minimum follow-up of six months (range 6-30 months). The postoperative VAS pain scores were markedly lower than the preoperative scores. Postoperative MFS was 92.1±8.0 (range 74-100). No intra- or postoperative complications were found, except for one case of delayed healing incision. At last follow-up, all affected ankles achieved their normal range of motion, and patients were able to resume daily activities without any assistive device.

Conclusions

Although a randomized control trial with a larger sample may be necessary to compare the central tendonsplitting combined with the SutureBridge technique with other techniques, our results confirmed that it was a promising alternative for treatment of insertional Achilles tendinopathy.
Spontaneous brain activity in chronic smokers revealed by fractional amplitude of low frequency fluctuation analysis: a resting state functional magnetic resonance imaging study
Authors: Shuilian Chu , Dan Xiao , Shuangkun Wang , Peng Peng , Teng Xie , Yong He , Chen Wang
Published: January 2024

Background

Nicotine is primarily rsponsible for the highly addictive properties of cigarettes. Similar to other substances, nicotine dependence is related to many important brain regions, particular in mesolimbic reward circuit. This study was to further reveal the alteration of brain function activity during resting state in chronic smokers by fractional amplitude of low frequency fluctuation (fALFF) based on functional magnetic resonance imaging (fMRI), in order to provide the evidence of neurobiological mechanism of smoking.

Methods

This case control study involved twenty healthy smokers and nineteen healthy nonsmokers recruited by advertisement. Sociodemographic, smoking related characteristics and fMRI images were collected and the data analyzed.

Results

Compared with nonsmokers, smokers showed fALFF increased significantly in the left middle occipital gyrus, left limbic lobe and left cerebellum posterior lobe but decreases in the right middle frontal gyrus, right superior temporal gyrus, right extra nuclear, left postcentral gyrus and left cerebellum anterior lobe (cluster size >100 voxels). Compared with light smokers (pack years ≤20), heavy smokers (pack years >20) showed fALFF increased significantly in the right superior temporal gyrus, right precentral gyrus, and right occipital lobe/cuneus but decreased in the right/left limbic lobe/cingulate gyrus, right/left frontal lobe/sub gyral, right/left cerebellum posterior lobe (cluster size >50 voxels). Compared with nonsevere nicotine dependent smokers (Fagerström test for nicotine dependence, score ≤6), severe nicotine dependent smokers (score >6) showed fALFF increased significantly in the right/left middle frontal gyrus, right superior frontal gyrus and left inferior parietal lobule but decreased in the left limbic lobe/cingulate gyrus (cluster size >25 voxels).

Conclusions

In smokers during rest, the activity of addiction related regions were increased and the activity of smoking feeling, memory, related regions were also changed. The resting state activity changes in many regions were associated with the cumulative amount of nicotine intake and the severity of nicotine dependence.
Microarray analysis of gene expression after electrical stimulation of the dura mater surrounding the superior sagittal sinus in conscious adult rats
Authors: Jiang Lei , Dong Zhao , Li Fengpeng , Liu Ruozhuo , Qiu Enchao , Wang Xiaolin , Yu Shengyuan
Published: January 2024

Background

The molecular and cellular origins of migraine headache are among the most complex problems in contemporary neurology. Up to now the pathogenesis of migraine still remains unclearly defined. The objective of this study was to explore new factors that may be related to the mechanism of migraine.

Methods

The present study performed a comprehensive analysis of gene expression in the trigeminal nucleus caudalis induced by electrical stimulation of dura mater surrounding the superior sagittal sinus in conscious rats using microarray analysis followed by quantitative real-time reverse-transcribed polymerase chain reaction (qRT-PCR) verification. Student’s two sample t-test was employed when two groups were compared. A P value <0.05 was considered to be statistically significant.

Results

Comparing the placebo and the electrical stimulation groups, 40 genes were determined to be significantly differentially expressed. These significantly differentially expressed genes were involved in many pathways, including transporter activity, tryptophan metabolism, G protein signaling, kinase activity, actin binding, signal transducer activity, anion transport, protein folding, enzyme inhibitor activity, coenzyme metabolism, binding, ion transport, cell adhesion, metal ion transport, oxidoreductase activity, mitochondrion function, and others. Most of the genes were involved in more than 2 pathways. Of particular interest is the up-regulation of Phactr3 and Akap5 and the down-regulation of Kdr.

Conclusion

These findings may provide important clues for a better understanding of the molecular mechanism of migraine.
Combined incisional ropivacaine infiltration and pulmonary recruitment manoeuvre for postoperative pain relief after diagnostic hysteroscopy and laparoscopy
Authors: Liu Huili , Ma Caihong , Zhang Xiaoqing , Yu Chen , Yang Yan , Song Xueling , Tang Yi , Guo Xiangyang
Published: January 2024

Background

Preoperative incisional local anaesthesia with ropivacaine is a common method of providing post-laparoscopy pain relief. The pulmonary recruitment manoeuvre also provides pain relief, but the combined effect of these two methods on pain following laparoscopic procedures has not been reported. We investigated the efficacy of combining local anaesthetic infiltration of ropivacaine with pulmonary recruitment manoeuvre on postoperative pain following diagnostic hysteroscopy and laparoscopy.

Methods

This prospective, randomized, controlled study involved 60 patients divided into two groups (n=30, each). Group 1 received 20 ml of 0.5% ropivacaine injected peri-incisionally preoperatively, with intra-abdominal carbon dioxide removed by passive deflation. Group 2 received 20 ml of 0.5% ropivacaine injected peri-incisionally with five manual inflations of the lungs with a positive-pressure ventilation of 40 cmH2O at the end of surgery. The last inflation was held for 5 seconds. The intensity of postoperative incisional and shoulder pain was evaluated using a numerical rating scale at 0, 2, 4, 8, 12, 24 and 48 hours postoperatively by an independent blinded anaesthesiologist. Tramadol was given postoperatively for analgesia.

Results

Compared with group 1, incisional ropivacaine infiltration combined with pulmonary recruitment manoeuvre significantly reduced dynamic pain at 0 hour, 4 hours, and 24 hours postoperatively (4.1 ± 2.2 vs. 2.1 ± 1.9, P=0.002; 2.7 ± 2.7 vs. 1.2 ± 1.3, P=0.035; and 3.5 ± 2.1 vs. 2.1 ± 1.8, P=0.03, respectively). Static incisional pain was significantly relieved at 0 hour, 2 hours, and 24 hours postoperatively (3.1 ± 1.7 vs. 1.6 ± 1.3, P=0.001; 1.4 ± 1.3 vs. 0.5 ± 0.8, P=0.012; and 2.3 ± 1.9 vs. 1.0 ± 1.5, P=0.038, respectively). Group 2 had more patients without shoulder pain (P<0.05) and fewer requiring tramadol (P<0.05).

Conclusion

Ropivacaine with pulmonary recruitment manoeuvre provided simple and effective pain relief after diagnostic hysteroscopy and laparoscopy.
Famitinib in metastatic renal cell carcinoma: a single center study
Authors: ZHANG Wen , ZHOU Ai-Ping , QIN Qiong , CHANG Chun-Xiao , JIANG Hao-Yuan , MA Jian-Hui , WANG Jin-Wan
Published: January 2024

Background

Famitinib is a novel and potent multitargeting receptor tyrosine kinase inhibitor. The phase I clinical study showed that famitinib was well tolerated and had a broad anti-tumor spectrum. The purpose of this study was to examine the efficacy and safety of famitinib for the treatment of metastatic renal cell carcinoma (mRCC).

Methods

The data of famitinib in treating patients with mRCC from the single-center phases I and II clinical trials were analyzed. Famitinib was administered orally at the dose of 13-30 mg once daily until tumor progression, occurrence of intolerable adverse reactions or withdrawal of the informed consent.

Results

A total of 24 patients with mRCC were treated including 17 patients at a dose of 25 mg once daily, 4 patients at a dose of 27 mg and 1 patient each at a dose of 13 mg, 20 mg and 30 mg, respectively. Twelve (50.0%) patients achieved partial response (PR) and 9 patients achieved stable disease (SD). Progressive disease was found in 3 (12.5%) patients. The disease control rate was 87.5%. The median follow-up time was 17.6 months; the median progression free survival (PFS) was 10.7 (95% CI 7.0-14.4) months; and the estimated median overall survival (OS) time was 33.0 (95% CI 8.7-57.3) months. The adverse drug reactions mainly included hypertension (54.1%), hand-foot skin reactions (45.8%), diarrhea (33.3%), mucositis (29.2%), neutropenia (45.8%), thrombocytopenia (29.2%), hyperlipidemia (41.7%) and proteinuria (41.7%). The incidence rate of grades 3 and 4 adverse events was low, mainly including hypertension 12.5%, hand-foot skin reactions 4.2%, neutropenia 4.2%, thrombocytopenia 4.2%, hyperlipidemia 4.2% and proteinuria 12.5%.

Conclusions

Famitinib has significant anti-tumor activity in mRCC. The common adverse reactions are generally manageable.
Plasma levels of tissue inhibitor of matrix metalloproteinase-1 correlate with diagnosis and prognosis of glioma patients
Authors: LIN Yi , WANG Jiang-Fei , GAO Guang-Zu , ZHANG Guo-Zhen , WANG Fei-Long , WANG Yun-Jie
Published: January 2024

Background

There is no validated blood biomarker available for glioma management. Invasive growth is the key feature of glioma. We assessed the clinical usefulness of plasma tissue inhibitor of metalloproteinase 1 (TIMP-1), which has less molecular weight than metalloproteinases, as a potential blood biomarker for glioma.

Methods

A total of 285 patients and 59 normal subjects were studied. Plasma concentration of TIMP-1 was measured with enzyme-linked immunosorbent assay. Plasma TIMP-1 was compared between normal and glioma patients, between patients with different pathological grades, and between patients with different prognoses. Longitudinal changes in plasma TIMP-1 during treatment were also evaluated. Plasma matrix metalloproteinase (MMP)-9 level was also assayed and its clinical usefulness was compared with that of TIMP-1.

Results

Plasma TIMP-1 and MMP-9 were both increased in glioma patients compared with normal controls (TIMP-1: P <0.001; MMP-9: P=0.007). Plasma TIMP-1 increases with increased tumor grade. In Grade IV gliomas, plasma TIMP-1 significantly increased after “successful removal” of the tumor (paired samples t-test, before operation vs. during chemotherapy without recurrence, t = -2.131, P=0.038), but did not change significantly at the time of tumor recurrence (during chemotherapy without recurrence vs. after tumor recurrence, t = -0.652, P=0.632). High plasma TIMP-1 level correlated with better survival in Grade IV glioma patients (hazard ratio: 0.550, 95% CI: 0.101-1.000, P=0.036). In Grade IV gliomas, patients with higher plasma TIMP-1 had significantly longer survival time than those with lower plasma TIMP-1 level (25.23 vs. 18.95 months, log-rank P=0.045). Plasma MMP-9 did not show significant association with either the pathological grade or the prognosis of glioma patients.

Conclusions

Plasma TIMP-1 is associated with the diagnosis and prognosis of glioma patients. It appears to have better usefulness for guiding clinical decision making than plasma MMP-9. Further studies in an expanded patient population are needed to better define its clinical usefulness.
Ertapenem versus ceftriaxone for the treatment of complicated infections: a meta-analysis of randomized controlled trials
Authors: Bai Nan , Sun Chunguang , Wang Jin , Cai Yun , Liang Beibei , Zhang Lei , Liu Youning , Wang Rui
Published: January 2024

Background

Ertapenem has been demonstrated to be highly effective for the treatment of complicated infections. The aim of this study was to compare the efficacy and safety of ertapenem with ceftriaxone.

Methods

We searched the PubMed, EMBASE, and the Cochrane Library for published randomized controlled trials (RCTs) that compared the efficacy and safety of ertapenem with ceftriaxone for the treatment of complicated infections including community-acquired pneumonia (CAP), complicated urinary tract infections (cUTIs), and complicated intraabdominal infections (cIAIs). Meta-analysis was performed by RevMan 5.0.

Results

Eight RCTs, involving 2 883 patients, were included in our meta-analysis. Ertapenem was associated with similar clinical treatment success with ceftriaxone for complicated infections (1 326 patients, fixed-effect model, OR: 1.13, 95% CI: 0.75–1.71). There was no difference between the compared treatment groups with regard to the microbiological treatment success, and no difference was found with regard to the incidence of clinical and laboratory drug-related adverse events between ertapenem and ceftriaxone groups. As to local tolerability, overall, there was no difference between the compared groups; however, in the subgroup analysis, local reaction was significantly less in the ertapenem subgroup than the ceftriaxone plus ceftriaxone subgroup.

Conclusions

Ertapenem can be used as effectively and safely as ceftriaxone for the treatment of complicated infections. It is an appealing option for the treatment of these complicated infections.
Clinical characteristics of patients with congenital long QT syndrome and bigenic mutations
Authors: Jimmy Juang Jyh-Ming , Ching-Yu Chen , Huei-Ming Yeh , Wei-Yih Chiu , Chih-Chieh Yu , Yen-Bin Liu , Chia-Ti Tsai , Li-Wei Lo , Sherri Yeh Shih-Fan , Ling-Ping Lai
Published: January 2024

Background

Congenital long QT syndrome (LQTS) is an ion channelopathy associated with genetic mutations. It is well known that most LQTS patients (91%) have a single mutation. The purpose of this study was to investigate the clinical characteristics of congenital LQTS patients with bigenic mutations in Taiwan, China.

Methods

Congenital LQTS patients were recruited consecutively at Taiwan University Hospital in Taiwan from 2003 to 2009. The diagnosis of LQTS was defined by an LQTS Schwartz score greater than 4. Mutation screening in KCNQ1, KCNH2, KCNE1, and SCN5A was performed using direct sequencing.

Results

Three of 16 LQTS patients (18.7%) were identified with bigenic mutations. One patient had missense mutations in KCNQ1 and KCNH2, the second in KCNQ1 and KCNE1, and the third in KCNH2 and SCN5A. The mean age at onset of LQTS for patients with bigenic mutations was (17±3) years, and all of these patients were female. Two of them experienced seizure and one presented with syncope, although one of them had a family history of syncope. The mean QTc interval was (515±17) ms, similar to those with single mutation or SNPs ((536±74) ms, P=0.63). Compared to those LQTS patients with single mutation or SNPs, a significantly higher percentage of LQTS patients with bigenic mutations presented with seizure and were younger at onset of the first index event (P=0.03 and 0.001, respectively), but lower percentage of them presented with sudden cardiac death (P=0.03).

Conclusions

Although the percentage of bigenic mutations in LQTS is less than 10% in Caucasian populations, we identified 3 of 16 LQTS patients (18.7%, 95% confidence interval: 0.04-0.46) with bigenic mutations in Taiwan. However, the severity of their clinical presentations was not higher than those patients with single mutation or SNPs.
Correlation between blood glucose fluctuations and activation of oxidative stress in type 1 diabetic children during the acute metabolic disturbance period
Authors: WU Di , GONG Chun-xiu , MENG Xi , YANG Qiu-lan
Published: January 2024

Background

Studies have shown that complications in type 1 diabetes mellitus (T1DM) in children are mainly due to oxidative stress (OS). Lipid peroxidation is the main marker of OS and iso-prostaglandin is a reliable biomarker of lipid peroxidation in type 2 diabetes mellitus (T2DM). However, there have been few studies on OS in T1DM children with hyperglycemia and glucose fluctuations.

Methods

We prospectively enrolled 23 newly diagnosed T1DM patients and 23 age and sex matched healthy controls in Beijing Children's Hospital from May 2010 to January 2011. They were treated with continuous subcutaneous insulin injection (CSII) and monitored by continuous glucose monitoring system (CGMS). Twenty-four-hour urine samples were collected to measure the concentration of 8-iso prostaglandin F2α (8-isoPGF2α). Samples taken from diabetic children were collected at days 8 to 10 after insulin treatment. Intraday glucose fluctuations were assessed by mean amplitude of glucose excursions (MAGE), largest amplitude of glycemic excursions (LAGE), standard deviation of blood glucose (SDBG) and number of glycemic excursions (NGE). The correlations between glucose parameters and the index of oxidative stress were analyzed.

Results

Urine 8-isoPGF2α in the T1DM group was higher than that in the control group ((967.70±412.68) ng vs. (675.23±354.59) ng, P=0.019). There was a correlation between urine 8-isoPGF2α level and MAGE (r=0.321, P=0.039), a significant correlation between low-density lipoprotein and urine 8-isoPGF2α level (r=0.419, P=0.03). There was no significant correlation between urine 8-isoPGF2α level and blood pressure, glycosylated hemoglobin (HbA1c), fasting C-peptide or other lipid indices.

Conclusion

A correlation between urine 8-isoPGF2α levels and MAGE and low-density lipoprotein was found in children newly diagnosed with T1DM.
Gene expression profiles and phosphorylation patterns of AMP-activated protein kinase subunits in various mesenchymal cell types
Authors: Yugang Wang , Qiming Fan , Rui Ma , Wentao Lin , Tingting Tang
Published: January 2024

Background

Recent studies on bone have shown an endocrine role of the skeleton, which could be impaired in various human diseases, including osteoporosis, obesity, and diabetes-associated bone diseases. As a sensor and regulator of energy metabolism, AMP-activated protein kinase (AMPK) may also play an important role in the regulation of bone metabolism. The current study aimed to establish the expression profiles and phosphorylation patterns of AMPK subunits in several mesenchymal cell types.

Methods

Reverse transcription-polymerase chain reaction (PCR) for relative quantification, real-time PCR for absolute quantification, and Western blotting were used to investigate the gene expression profiles and phosphorylation patterns of AMPK subunits in several mesenchymal cell types, including primary human mesenchymal stem cells (hMSCs) and hFOB, Saos-2, C3H/10T1/2, MC3T3-E1, 3T3-L1, and C2C12 cells.

Results

AMPKα1 and AMPKβ1 mRNAs were abundantly expressed in all cell types. AMPKγ1 mRNA was abundantly expressed in C3H/10T1/2, MC3T3-E1, 3T3-L1, and C2C12 but not detected in human-derived cell types. AMPKγ2 mRNA was mildly expressed in all cell types. AMPKα1 protein was highly expressed in all cell types and AMPKα2 protein was highly expressed only in hFOB and Saos-2 cells. AMPKβ1 protein was abundantly expressed in all cell types except for Saos-2, in which AMPKβ2 protein overwhelmed AMPKβ1 expression. AMPKγ1 and AMPKγ2 proteins were expressed in C3H/10T1/2, MC3T3-E1, 3T3-L1, and C2C12 cells and only AMPKγ2 protein was expressed in hMSCs, hFOB and Saos-2 cells. AMPKα was phosphorylated at Thr172 and Ser485 and AMPKβ1 was phosphorylated at Ser108 and Ser182 in all cell types with a specific pattern in each cell type.

Conclusion

The combination of AMPK α β, and γ subunits and phosphorylation of AMPKα (Thr172 and Ser485) and AMPKβ1 (Ser108 and Ser182) showed a specific pattern in each cell type.
ImmunoCyt™ and cytology for diagnosis of bladder carcinoma: a meta analysis
Authors: Yang Minggen , Zheng Zhouda , Zhuang Zhiming , Zhao Xiaokun , Xu Zhenqiang , Lin Haili
Published: January 2024

Background

Currently, cystoscopy and urine cytology are standard modalities in therapy monitoring and follow-up of bladder carcinoma (BC). Cystoscopy is an invasive and uncomfortable procedure while cytology has a limited value because it is operator-dependent and has low sensitivity. This study was to assess the accuracy of ImmunoCyt in detecting BC by comparing it with cytology using systemic analyses of studies published in both English and Chinese.

Methods

Cochrane systematic evaluation was used to search through MEDLINE, EMBASE, Cochrane Library, CMCC, and CNKI for studies regarding ImmunoCyt and cytology for detection of BC. Data were extracted and analyzed by the software MetaDiSc 1.4.

Results

In total 42 relevant studies were searched, of which 15 were enrolled and 12 491 patients were included. Heterogeneity, except for threshold effects, was found within these studies. A meta-analysis was performed using the random effect model. Pooled accuracy indicators like sensitivity, specificity, and diagnostic odds ratio of ImmunoCyt™ and cytology were 0.75 (0.73-0.77) vs. 0.45 (0.43-0.48), 0.73 (0.72-0.74) vs. 0.97 (0.96-0.97), and 10.97 (7.53-15.99) vs. 16.40 (10.57-25.46), respectively. The sensitivity of both was increased with the increase of tumor grade and stage. The area under summary receiver operating characteristics curve was 0.834 4 and 0.853 4 and the Q index 0.766 7 and 0.785 3 for ImmunoCyt and cytology, respectively. Combination of both can obviously improve the accuracy of diagnosis.

Conclusions

ImmunoCyt has a high sensitivity in detecting BC, but its specificity is low. As an important adjunct, ImmunoCyt™ can not replace cytology, but combined with cytology it could improve sensitivity with high specificity in the detection and postoperative monitoring of BC.
Mitochondrial apoptosis of lymphocyte is induced in type 2 diabetes
Authors: Xu Hui , Chen Yanbo , Li Yanxiang , Xia Fangzhen , Han Bing , Zhang Huixin , Zhai Hualing , Wu Hui , Li Ying , Lu Yingli
Published: January 2024

Background

Lymphocyte function and homeostasis is associated with immune defence to infection. Apoptosis of lymphocytes might be a considerably important component which has an impact on immunity to infections in people with hyperglycemia. The aim of this study was to explore the mitochondrial apoptosis pathway of lymphocyte in diabetic patients.

Methods

Sixty patients with type 2 diabetes mellitus and fifty healthy volunteers were included in this study. Annexin V and propidiumiodide (PI) were joined in the isolated lymphocytes and the rate of lymphocyte apoptosis was calculated with flow cytometry. Observation of the lymphocytes was done using transmission electron microscopy; mitochondria had been extracted and then mitochondrial membrane potential (MMP) was detected to assess mitochondrial function; the mRNA level of Bcl-2, cytochrome c (Cyt-C), caspase-9 and caspase-3 were analyzed by real-time reverse transcription-polymerase chain reaction (RT-PCR).

Results

Apoptosis rate of lymphocyte was significantly higher in diabetic group than that in normal control group (P <0.05). Transmission electron microscopy showed lymphocyte shrinkage and breakage, chromatin condensation and less mitochondria; a fall in MMP levels was also evident; Bcl-2 concentration was reduced and the expressions of caspase-9, caspase-3 and Cyt-C were elevated (P <0.05) in diabetic patients.

Conclusions

The rate of lymphocyte apoptosis was significantly higher in type 2 diabetic patients than that in normal population. Mitochondrial apoptosis pathway may play a very important role in decreasing function of lymphocyte in diabetes.
An in vivo model of in situ implantation using pulmonary valved conduit in large animals under off-pump condition
Authors: WU Hao , XU Zhi-wei , LIU Xian-min , GONG Da , WAN Ju-yi , XU Xiu-fang , ZHOU Zi-fan , LI Wen-bin
Published: January 2024

Background

The application of pulmonary valved conduit to reconstruct the continuity between right ventricles and pulmonary artery is one of the major surgeries. This study aimed to establish an in vivo model of in situ implantation using pulmonary valved conduit in large animals under off-pump condition to validate the long-term effects of artificial pulmonary valved conduit.

Methods

Domesticate juvenile male sheep and tissue-engineered porcine pulmonary valved conduit were used for the experiment: 30 sheep, weighing (15±3) kg (range 13 to 17 kg) were randomly divided into two groups which were all operated under general anesthesia by off-pump surgery (group 1) and left thoracotomy (group 2). Two different off-pump surgical methods were used to perform cannulation in sheep pulmonary artery to replace part of sheep pulmonary artery with pulmonary valved conduit which will work together with sheep pulmonary artery and valves. During the experiments, animal survival, complication rates, operating time and blood loss were recorded to compare the results between groups and to establish a surgical method with minimal invasion, simplicity, safety, and high success rates.

Results

In group 1, a total of 15 cases of surgeries were performed, in which two sheep died; the operative mortality was 13.3% (2/15). In group 2, a total of 15 cases of surgeries were performed, and the surgical mortality rate was 0 (0/15). The operation time and blood loss in group 2 was significantly better than that in group 1. The postoperative echocardiograms showed that, after the surgeries by these two methods, the blood flows were normal, and the valves can open and close freely. Autopsy after 6 months showed that the inner wall and the valves of pulmonary valved conduit were smooth with no thrombus formation.

Conclusion

These two off-pump methods are feasible and safe with fewer traumas; but the second method is better and particularly suitable for the establishment of a juvenile animal model.
Rotary self-locking intramedullary nail for long tubular bone fractures
Authors: HUANG Zhong-lian , YANG Hai-long , XU Jian-kun , XIA Xue , WANG Xin-jia , SONG Jian-xin , HU Jun
Published: January 2024

Background

Intramedullary nails had been widely used in the treatment of long-bone fractures because of less interference of fractures and center bearing biomechanical advantage. However, it had been also found many shortcomings such as broken nails, delayed healing and was modified in order to achieve better efficacy and reduce complications. The aim of the present study is to compare the efficacy of rotary self-locking intramedullary nails (RSIN) with that of interlocking intramedullary nails (IIN) in the treatment of long-bone fractures.

Methods

A retrospective study investigated 129 cases with long-bone fractures (36 with femoral fracture, 81 with tibial fracture, and 12 with humeral fracture). The fractures were fixed using either an RSIN or IIN. All patients underwent follow-up for 12-30 months.

Results

All patients in both groups achieved a clinical fracture healing standard and the postoperative affected limb muscle strength and joint function were well restored. The RSIN group required a shorter operative time and the fracture healed faster. There was no significant difference in the hospital stay, intraoperative blood loss or postoperative complications between the two groups.

Conclusions

RSIN is used to treat long-bone fractures. Its healing efficacy is equivalent to the IIN. Moreover, the RSIN method is simpler and causes less tissue damage than the IIN, therefore having the advantage of accelerated healing.
Morphometric measurement of the patella on 3D model reconstructed from CT scan images for the southern Chinese population
Authors: Shang Peng , Zhang Linan , Hou Zengtao , Bai Xueling , Ye Xin , Xu Zhaobin , Huang Xu
Published: January 2024

Background

Due to racial differences in the morphology of the knee joint and due to most prostheses available in the market being designed using measurements from Caucasians, the objective of this study was to provide the morphometric data of the patella for the southern Chinese population for total knee arthroplasty (TKA), patellar resurfacing, and prostheses design.

Methods

The CT slices of the knee joint were obtained from both knees of 40 Chinese volunteers (20 females, 20 males, and age from 20–25 years) by performing a computer tomographic scan. A 3D model was reconstructed by Mimics software based on the computed tomography images. Six metrical characteristics were measured by digital ruler. Statistical analysis was performed with the SPSS statistical program.

Results

The mean, standard deviation and P values of measurements and ratios were calculated using SPSS. All dimensions showed a significant gender difference with P<0.05, but the six variables of the left and right knees had no statistical significance with P>0.05. In addition, we studied the relationship between six couples (H-W, H-T, H-HAF, W-T, W-HAF, T-HAF) of the four variables (H: height, W: width, T: thickness and HAF: height of articulating facet) that were measured, which showed a significant correlation.

Conclusions

Examination of the southern Chinese population revealed that males have larger patellae than women. In both genders, comparing data between left and right knees shows no statistically significant difference. Compared with Westerners in previous studies, the patella in our study was thin and small. There was a good linear regression correlation between measurements of the patella. The indirect measurement method on 3D models makes it easy to obtain anatomical data, and the results can provide a region and gender specific database for morphometric measurements of the patella, and can be helpful for designing implants suited for southern Chinese patients.
Anterior herniation of lumbar disc induces persistent visceral pain: discogenic visceral pain
Authors: TANG Yuan-zhang , Shannon Moore-Langston , LAI Guang-hui , LI Xuan-ying , LI Na , NI Jia-xiang
Published: January 2024

Background

Visceral pain is a common cause for seeking medical attention. Afferent fibers innervating viscera project to the central nervous system via sympathetic nerves. The lumbar sympathetic nerve trunk lies in front of the lumbar spine. Thus, it is possible for patients to suffer visceral pain originating from sympathetic nerve irritation induced by anterior herniation of the lumbar disc. This study aimed to evaluate lumbar discogenic visceral pain and its treatment.

Methods

Twelve consecutive patients with a median age of 56.4 years were enrolled for investigation between June 2012 and December 2012. These patients suffered from long-term abdominal pain unresponsive to current treatment options. Apart from obvious anterior herniation of the lumbar discs and high signal intensity anterior to the herniated disc on magnetic resonance imaging, no significant pathology was noted on gastroscopy, vascular ultrasound, or abdominal computed tomography (CT). To prove that their visceral pain originated from the anteriorly protruding disc, we evaluated whether pain was relieved by sympathetic block at the level of the anteriorly protruding disc. If the block was effective, CT-guided continuous lumbar sympathetic nerve block was finally performed.

Results

All patients were positive for pain relief by sympathetic block. Furthermore, the average Visual Analog Scale of visceral pain significantly improved after treatment in all patients (P <0.05). Up to 11/12 patients had satisfactory pain relief at 1 week after discharge, 8/12 at 4 weeks, 7/12 at 8 weeks, 6/12 at 12 weeks, and 5/12 at 24 weeks.

Conclusions

It is important to consider the possibility of discogenic visceral pain secondary to anterior herniation of the lumbar disc when forming a differential diagnosis for seemingly idiopathic abdominal pain. Continuous lumbar sympathetic nerve block is an effective and safe therapy for patients with discogenic visceral pain.