bluuebunny/crossref_metadata_2025 huggingface dataset:
Caspofungin versus liposomal amphotericin B for treatment of invasive fungal infections or febrile neutropenia
Authors: Zhang Jinyu , Gong Yizhen , Wang Ke , Kong Jinliang , Chen Yiqiang
Published: January 2024

Background

Nowadays, there are published trials in regards to the comparison of caspofungin with liposomal amphotericin B (L-AmB). However, these studies have a modest sample size and convey inconclusive results. The aim of this study was to review the efficacy and safety of caspofungin for the treatment of invasive fungal infections (IFIs), compared with L-AmB.

Methods

Electronic databases (up to July 31, 2013) PubMed and Embase databases, the Cochrane Library, and Google Scholar were searched to identify relevant trials of caspofungin and L-AmB. Analyses of efficacy and adverse outcomes were performed by relative risks (RRs) and 95% confidence intervals (CIs). Heterogeneity was assessed by χ
2-test and the I2
-statistic.

Results

Three trials were included in this meta-analysis with 1249 modified intention-to-treat (MITT) patients. The results showed that caspofungin produced equal efficacy in favorable overall response (RR=1.02, 95% CI 0.88-1.18; P=0.81) and mortality rate (RR=1.53, 95% CI 0.38-6.27, P=0.55), safer in clinical adverse events (RR=0.20, 95% CI 0.08-0.54; P=0.001), laboratory adverse events (RR=0.69, 95% CI 0. 57-0.84; P=0.0002), and discontinuation rate (RR=0.26, 95% CI 0.08-0.83, P=0.02), compared with L-AmB in the treatment of patients with IFIs.

Conclusion

Based on the results of this meta-analysis, it would appear that caspofungin was measured to have equal efficacy in clinical outcomes and safer in terms of adverse events.
Kinetics of serum HBsAg in Chinese patients with chronic HBV infection with long-term adefovir dipivoxil treatment
Authors: Li Minran , Xi Hongli , Wang Qinhuan , Hou Fengqin , Huo Na , Zhang Xiaxia , Li Fang , Xu Xiaoyuan
Published: January 2024

Background

Knowledge on Hepatitis B surface antigen (HBsAg) kinetics in chronic hepatitis B (CHB) patients with long-term adefovir dipivoxil (ADV) treatment is limited. The aims of this study were to investigate HBsAg kinetics in patients with chronic hepatitis B virus (HBV) infection treated with long-term ADV and to evaluate different characteristics between patients with and without HBsAg loss.

Methods

We retrospectively evaluated HBsAg kinetics in 24 Chinese patients with chronic HBV infection who achieved continuous virologic suppression during ADV therapy. HBV genotype was determined at baseline. Liver biochemistry, hepatitis B e antigen status, serum HBV DNA, and HBsAg levels were measured at baseline, 6 months, and once every year thereafter.

Results

Of these 24 patients, 3, 1, and 20 patients were followed up for 3, 5, and 6 years, respectively. Baseline serum HBsAg level had a moderate correlation with baseline HBV DNA level (r=0.52, P=0.01). The median rate of HBsAg reduction during the therapy period was 0.08 lg IU·ml-1·y-1. Baseline serum HBsAg level was significantly higher than other time points (P ranges from 0.046 to 0.002). The HBsAg reduction rate during the first year was similar to that in other years (P>0.05). The HBsAg reduction rate during the first year in patients with eventual HBsAg loss was significantly faster than that in patients without HBsAg loss (P=0.005).

Conclusions

Serum HBsAg levels in Chinese CHB patients receiving long-term ADV demonstrated a gradual reduction. Patients with eventual HBsAg loss had a significantly faster HBsAg reduction rate during the first year than those without HBsAg loss.
An experimental study on thymus immune tolerance to treat surgical brain injury
Authors: Zheng Yongtao , Kang Jianmin , Liu Baolong , Fan Weijia , Wu Qiaoli , Luo Kai , Yan Hua
Published: January 2024

Background

Many researches demonstrate that the secondary brain injury which is caused by autoimmune attack toward brain antigens plays an important role in surgical brain injury (SBI). Although traditional immunosuppression can reduce autoimmune attack, it will lower the body immunity. Immune tolerance, by contrast, not only does not lower the body immunity, but also could lighten autoimmunity. This study used thymus tolerance to develop an immune system that is tolerant to autologous cerebrospinal fluid (CSF) and autologous brain tissue so that autoimmune injury can be suppressed following the disruption of the blood-brain barrier, thereby reducing brain damage.

Methods

Eighty experimental rabbits were divided into five groups by random number table method: 16 in SBI group (group A), 16 in SBI+CSF drainage group (group B), 16 in SBI+CSF drainage+PBS injection group (group C), 16 in SBI+CSF drainage+CSF intrathymic injection group (group D), and 16 in SBI+brain homogenate intrathymic injection group (group E). Rabbits’ CSF was drained in group B; was drained and injected PBS into thymus in group C; was drained and injected CSF into thymus in group D; and was injected brain homogenate in group E. Half of the rabbits in each group were phlebotomized on 1st, 3rd, 7th, and 14th days to observe the changes in IL-l, TGF-β by ELISA test, and CD4CD25 regulatory T cells ratio by flow cytometry, and in other animals brain tissues were taken on 7th day for exploring FasL expression by RT-PCR. The least significant difference (LSD) test was used to make paired comparisons; P <0.05 was considered statistically significant.

Results

The levels of FasL, TGF-β, and the ratios of CD4CD25 regulatory T cells in groups D and E were apparently higher than those in other three groups (P <0.05). Likewise, the levels of IL-1 in these two groups were lower than the other three groups (P <0.05). Moreover, the ratios of CD4CD25 regulatory T cells and the levels of TGF-β in groups B and C were higher than those in group A, but the level of IL-1 was lower than that in group A (P <0.05). There was no significant difference between groups B and C, and groups D and E.

Conclusion

Thymic injection of CSF and brain homogenate may be able to reduce inflammation after SBI, so thymus immune tolerance may be a useful therapy to treat SBI.
Analysis of clinical efficacy of different initial antimicrobial treatment in healthcare associated pneumonia patients in emergency department
Authors: Cao Guohui , Chen Xuyan , Wu Sheng
Published: January 2024

Background

Community acquired pneumonia (CAP) is one of the most common infectious disease in emergency department. In 2005 the concept of healthcare associated pneumonia (HCAP) was proposed by the ATS/IDSA guidelines. The clinical features and microbiology of HCAP are different from CAP, however, the initial antimicrobial treatment is still controversial. We aimed to compare the clinical efficacy between HCAP patients treated initially with HCAP guideline-concordant antimicrobial agents and those with CAP guideline-concordant antimicrobial agents.

Methods

We conducted a retrospective observational study on HCAP patients who were admitted to emergency department between December 2011 and December 2012. Patients were divided into 2 groups according to their different initial antimicrobial treatment. We compared clinical features, distribution of pathogen, severity, days and spending on intravenous antimicrobial, length and charge of hospitalization and clinical outcomes, and meanwhile analyzed the clinical efficacy as well.

Results

Of the 125 HCAP patients, 55 patients received CAP guideline-concordant antimicrobial agents and 70 received HCAP agents. The major pathogens were Klebsiella pneumoniae, methicillin-resistant staphylococcus aureus (MRSA), Pseudomonas aeruginosa and Escherichia coli. The 2 groups were similar at baseline, including old age, comorbidities, Pneumonia Severity Index scores, APACHE scores, and length of intravenous antimicrobial use and hospitalization duration, and in-hospital mortality. Overall efficacy rate occurred in 70.0% of HCAP agent patients and 50.9% of CAP agent patients (P=0.029). Antimicrobial charge and total hospital charge for HCAP agent patients were significantly higher than that for CAP agent patients.

Conclusions

Initial treatment of HCAP patients in emergency department with HCAP guideline-concordant antimicrobial could increase clinical efficacy rate, as well as antimicrobial charge and total hospital charge, but was not associated with shortening the length of stay, or lowering in-hospital mortality.
Rapid resolution of subdural hematoma after targeted epidural blood patch treatment in patients with spontaneous intracranial hypotension
Authors: Wang Jin , Zhang Dan , Gong Xiangyang , Ding Meiping
Published: January 2024

Background

Subdural hematoma (SDH) is a common complication of spontaneous intracranial hypotension (SIH). To date, the management of SDH caused by SIH remains controversial. In this paper, we reviewed the clinical course of SDH in patients with SIH, and discuss the underlying mechanism and attributing factors for rapid resolution of subdural hematomas after epidural blood patch (EBP) surgery.

Methods

We retrospectively reviewed a cohort of seventy-eight SIH patients diagnosed and treated with targeted EBP in our neurology center. Patients who received early CT/MRI follow-up after EBP operation were included.

Results

A series of four cases of SIH complicated with SDHs were evaluated. Early follow-up neuroimages of these patients revealed that SDHs could be partially or totally absorbed just two to four days after targeted epidural blood patch treatment.

Conclusion

Targeted epidural blood patch can result in rapid hematoma regression and good recovery in some patients with a combination of SDH and SIH.
A comparative study of calcium sulfate artificial bone graft versus allograft in the reconstruction of bone defect after tumor curettage
Authors: Yongkun Yang , Xiaohui Niu , Qing Zhang , Lin Hao , Yi Ding , Hairong Xu
Published: January 2024

Background

Cavity reconstruction after benign bone tumor removal is varied and controversial. Allograft is widely used but is associated with complications. New bone substitutes, such as calcium sulfate artificial bone, have been introduced for bone tumor operation. However, the bone healing response of artificial bone has not been compared with allograft bone. We therefore compared calcium sulfate grafts (study group) with bone allografts (control group) for the treatment of benign bone tumors.

Methods

We retrospectively reviewed 50 patients who underwent calcium sulfate reconstruction and 50 patients who underwent allograft cancellous bone reconstruction. The two groups were well matched. The mean follow-up time of the study group was 19.9 (12–55) months. We investigated bone healing response, complications, and factors affecting bone healing.

Results

At the last follow-up, 84% (42/50) of cases in the study group and 62% (31/50) of cases in the control group had achieved clinical healing (P=0.013). The initial healing rate showed no significant difference between the two groups (100% vs. 96%,P=0.153). The mean healing times for calcium sulfate and allograft bone were 9.6 (3–42) months and 13.8 (3–36) months, respectively (P<0.01). Complications in the study group were minor and resolved. Implant volume was a significant factor affecting bone healing.

Conclusion

The calcium sulfate bone substitute showed a satisfactory healing outcome and safety profile in reconstruction of bone defects after benign bone tumor curettage, especially in smaller cavities.
One-year outcomes of percutaneous renal denervation for the treatment of resistant hypertension: the first Chinese experience
Authors: Dong Hui , Jiang Xiongjing , Liang Tuo , Zou Yubao , Guan Ting , Meng Peng , Song Lei , Zhang Huimin , Wu Haiying , Xu Bo , Yang Yuejin , Gao Runlin
Published: January 2024

Background

As a novel device-based approach targeting the renal sympathetic nerves, percutaneous renal denervation (RDN) has been shown to be effective and safe for reducing blood pressure. However, while considerable data on RDN have been obtained from Western populations, there is limited findings from East Asian populations. The purpose of this study was to evaluate one-year outcomes of RDN for the treatment of resistant hypertension in Chinese patients.

Methods

Between February and August 2012, 14 patients (mean age 39±8 years, 10 males) with resistant hypertension underwent successful RDN at the Fuwai Hospital. All 14 patients were followed up at 1, 3, 6 and 12 months postprocedure. Blood pressure, use of antihypertensive agents, renal function, and complications were investigated.

Results

Baseline values included mean office blood pressure of 164/103±14/10 mmHg, mean 3.9±0.6 anti-hypertensive agents, and an estimated glomerular filtration rate of (79±19) ml·min-1·1.73 m-2. Office blood pressure after the procedure was reduced by -14/-10, -17/-11, -21/-12, and -24/-14 mmHg at 1, 3, 6, and 12 months respectively, and the reduction of the number of antihypertensive agents at the above corresponding time points was -1.3, -1.5, -1.7 and -1.8 respectively (allP<0.001). The mean reduction of 24-hour ambulatory blood pressure was similar to the reduction of office blood pressure at the four corresponding time points. Renal function did not significantly change at any time point (allP>0.05). No clinical complications were observed at 12-month follow-up.

Conclusion

This study showed that RDN seems to be effective in reducing blood pressure of Chinese patients with resistant hypertension, with minimal adverse events at 12-month follow-up.
Transoral endoscopic thyroidectomy with central neck dissection: experimental studies on human cadavers
Authors: Guo Peiyi , Tang Zhiping , Ding Zihai , Chu Guoliang , Yao Huosheng , Pan Tao , Wang Huaqiao
Published: January 2024

Background

With the development of natural orifice trans-luminal endoscopic surgery, studies on transoral video-assisted thyroidectomy in preclinical experiments (e.g., human anatomy and animal trials) were progressing gradually. From 2009 to 2011, embalmed human cadavers were dissected to define the anatomical location, surgical planes, and related neural and vascular structures to create a safe transoral access to the front cervical spaces. Recently, experimental transoral endoscopic thyroidectomy was performed to verify the feasibility of this approach on 15 fresh specimens.

Methods

Fifteen specimens were placed in the supine position with slight neck extension. Endoscopic incision was made on the midline between the Wharton's duct papillae and two other incisions were made on mandibular first premolar buccal mucosa. Sublingual combined bilateral vestibular tunnels were created from oral cavity to the cervical region. The neck subplatysmal working space was insufflated with CO2 at 6–8 mmHg. The bilateral thyroid lobes and central lymph nodes were dissected under craniocaudal view.

Results

Three incisions were made in the oral cavity without any incisions on the body surfaces. The distance from the oral cavity to front neck region was the shortest. Bilateral thyroid lobes and central neck region were fully resected via transoral approach. This approach provided a craniocaudal view, in which retrosternal thyroid gland and lymph nodes were easily accessible. The recurrent laryngeal nerve could be identified safely on the inferior cornu of the thyroid cartilage. The only structure at risk was the mental nerve. Camera motion was somewhat limited by the maxillary dentition. The volume of harvested thyroid nodule through sublingual tunnel in the fifteen human cadavers was (40±15) cm3.

Conclusion

The transoral procedure is progressive and innovative which not only gives the best cosmetic result and minimal access trauma but also provides a craniocaudal view.
Prostasin gene polymorphism at rs12597511 is associated with severe preeclampsia in Chinese Han women
Authors: Luo Dong , Zhang Yanyan , Bai Yi , Liu Xijing , Gong Yunhui , Zhou Bin , Zhang Lin , Luo Linli , Zhou Rong
Published: January 2024

Background

Preeclampsia, characterized by hypertension and proteinuria, is a multifactorial disease associated with shallow invasion of trophoblast cells and inadequate spiral artery remodeling. Trophoblast and tumor cells have similar invasion mechanism. Prostasin is closely related to tumor development, invasion and metastasis and influences blood pressure through activating epithelial sodium channel. The effect of prostasin on the pathogenesis of preeclampsia remains unclear. This study investigated the association of prostasin gene at rs12597511 with severe preeclampsia.

Methods

A single nucleotide polymorphism, rs12597511, was tested with polymerase chain reaction and restriction-fragment length polymorphism analyses in 179 severe preeclampsia patients and 222 normal pregnant women.

Results

The frequencies of TC + CC genotypes were significantly higher in severe preeclampsia group compared with in control group (the adjusted odds ratio was 2.030, 95% confidence interval 1.195–3.449, P=0.009). The C allele of rs12597511 was present significantly more often among women with severe preeclampsia (P=0.001). Genotyping analysis showed that the C allele of rs12597511 could confer a risk for severe preeclampsia.

Conclusion

The higher frequency of C allele of prostasin gene at rs12597511 is associated with severe preeclampsia.
Distinct characteristics and new prognostic scoring system for Chinese patients with Waldenström macroglobulinemia
Authors: Yi Shuhua , Cui Rui , Li Zengjun , An Gang , Qi Junyuan , Zou Dehui , Zhang Peihong , Chen Huishu , Wang Jianxiang , Chang Hong , Qiu Lugui
Published: January 2024

Background

Waldenström macroglobulinemia (WM) is an uncommon lymphoid malignancy. The characteristics and prognosis of WM have never been systematically studied in the East.

Methods

We analyzed the clinical characteristics and the prognostic factors of 90 Chinese WM patients, and compared them with the Western reports.

Results

The median age was 62 years old with a male-to-female ratio of 3.74. The most common symptoms at diagnosis were fatigue (77.8%) and bleeding (20%), while only 6 patients (6.7%) were asymptomatic. In the univariate analysis, age >62 years, thrombocytopenia, leucopenia, cytopenias ≥2, and high risk on the international prognostic scoring system for WM were the adverse risk factors, but only age >62 years and ≥2 cytopenias were the independent prognostic factors in the multivariate analysis. Using age <62 years and ≥2 cytopenias, three significantly different prognostic groups could been distinguished, with 5-year overall survival of 71.6%, 48.6%, and 17.0% (P <0.001).

Conclusion

Distinct characteristics exist in WM in China compared to the West and we describe a new simple prognostic model for newly diagnosed WM patients.
Clinical features and management of postural tachycardia syndrome in children: a single-center experience
Authors: Li Jiawei , Zhang Qingyou , Hao Hongjun , Jin Hongfang , Du Junbao
Published: January 2024

Background

The incidence of postural tachycardia syndrome (POTS) has been increasing in children and adolescents, while clinical characteristics of POTS in the pediatric population are not fully understood.

Methods

An observational study was performed in 150 pediatric patients aged between 5 and 18 years who underwent head-up tilt test (HUTT) with the diagnosis of POTS at Peking University First Hospital from March 2008 to August 2013. Demographic data, clinical presentation, autonomic parameters, laboratory findings, and treatments were recorded.

Results

POTS in children commonly occurred in the age of 7–14 years. Dizziness (84.00%) was the most common symptom, followed by weakness (72.00%) and orthostatic syncope (62.67%). Positive family history of orthostatic intolerance (OI) was found in 24.64% of children with POTS. And 33.09% of them had preceding infection history as precipitating events. Ten percent of them suffered from orthostatic hypertension. Hyperadrenergic status was documented in 51.28% of 39 patients who were tested for the standing norepinephrine levels. More than half of POTS patients, with 24-hour urinary sodium level <124 mmol/24 hours, were suitable for treatment of salt supplementation. At least 25.74% of POTS patients were of positive acetylcholine receptor (AChR) antibody. Low iron storage in children with POTS was relatively rare. Most patients responded well to treatments, 43.51% of patients recovered, while 7.63% of them had relapse after symptoms disappeared.

Conclusions

POTS is a relatively common condition with complex pathophysiology and heterogeneous clinical manifestation. A comprehensive therapeutic regimen is recommended for the treatment.
Urinary albumin excretion rate: a risk factor for retinal hard exudates in macular region in type 2 diabetic patients
Authors: Wang Shaocheng , Lin Siyong , Cao Xi , Zheng Yuezhong , Wang Jinyang , Lu Na , Yang Jinkui
Published: January 2024

Background

The various risk factors for retinal hard exudates are still poorly understood in type 2 diabetic patients. The aim of this study was to determine the association between urinary albumin excretion rate (UAER) and hard exudates in macular region in north Chinese patients.

Methods

A total of 272 patients (272 eyes) were enrolled for this study, including 154 subjects from group 1 (mild hard exudates), 91 subjects from group 2 (moderate hard exudates) and 27 subjects from group 3 (severe hard exudates) confirmed using colour fundus photography, optical coherence tomography (OCT) as well as slit-lamp biomicroscopy with 78 diopter (D) lens. Each participant underwent a comprehensive assessment that included biochemical, clinical characteristics test and detailed ophthalmic evaluation. One-way analysis of variance (ANOVA) test and chi-square test were performed to analyze the fasting blood glucose (FBG), glycated hemoglobin (HbA1c), total cholesterol (TC), low density lipoprotein (LDL), high density lipoprotein (HDL), triglycerides (TG), full blood counts, urinary albumin excretion rate (UAER), blood creatinine (CREA), duration of diabetes, body mass index (BMI), systolic blood pressures (SBP) and diastolic blood pressures (DBP) between groups. Ordinal logistic regression analysis was further performed in order to eliminating the possible confounding factors.

Results

Three groups were matched in terms of age and gender. Risk factors which showed significant difference between groups include FBG (P <0.001), HbA1c (P <0.001), LDL (P <0.001), UAER (P <0.001), duration of diabetes (P=0.001), TC (P=0.005), SBP (P=0.026), CREA (P=0.004) and haemoglobin (Hb) (P=0.012). There was no significant difference between groups for the TG, HDL, DBP, platelet, total white blood cells and BMI. Using ordinal Logistic regression analyses, of all the variables, HbA1c, LDL and UAER which were independent risk factor for hard exudates showed a significantly odds ratio of 1.25, 3.07, and 1.39, respectively. There were also significant differences in UAER level between patients with mild, moderate, severe hard exudates groups (P <0.001).

Conclusions

UAER was an independent risk factor associated with retinal hard exudates in macular region in type 2 diabetic patients. This study highlights the need for close monitoring and fundus examination for hard exudates in patients with elevated UAER to prevent irreversible visual loss.
Initial study of biexponential model of intravoxel incoherent motion magnetic resonance imaging in evaluation of the liver fibrosis
Authors: Cuiyun Chen , Bin Wang , Dapeng Shi , Fangfang Fu , Jiliang Zhang , Zejun Wen , Shaocheng Zhu , Junling Xu , Qing Lin , Jing Li , Shewei Dou
Published: January 2024

Background

The diagnosis of liver fibrosis is a difficult task at any time using conventional clinical imaging. Intravoxel incoherent motion (IVIM) can be used to investigate both diffusion and perfusion changes in tissues. This study was designed to determine the value of IVIM in the diagnosis and staging of liver fibrosis.

Methods

IVIM examinations were performed on a GE 3.0T MR scanner in 25 patients with liver fibrosis and 25 healthy volunteers as the control group. Patients with liver fibrosis diagnosis were confirmed by pathology and staged on a scale of F0–4. The standard ADC values and the values of a biexponential model (slow ADC (Dslow), fast ADC (Dfast) and fraction of fast ADC (FF)) were measured in three liver regions per person. The mean standard ADC values, Dslow values, Dfast values and FF values from the study group were compared among the right posterior hepatic lobe, right anterior hepatic lobe and medial segment of the left lobe. Receiver Operating Characteristic (ROC) curves and independent-samples t-tests were used to calculate the mean standard ADC values, Dslow values, Dfast values and FF values from the study group and the control group. Spearman rho correlation analysis was used for the stage of liver fibrosis. The liver fibrosis stages between the groups F0–1 and F2–4, the groups F0–2 and F3–4 were compared.

Results

Among the liver fibrosis, there was no significant difference in the mean standard ADC values, Dslow values, Dfast values, and FF values obtained from the right posterior hepatic lobe, right anterior hepatic lobe and medial segment of the left lobe. Using ROC analysis, the Area Under the Curve (AUC) values of standard ADC, Dslow, Dfast, FF were all between 0.7 to 0.9. The mean standard ADC values, Dslow values, Dfast values and FF values of the liver in the study group were significantly lower than the values in the control group (P <0.05). As the stage of the fibrosis increased, the values decreased by Spearman rho correlation analysis. The mean values (standard ADC, Dslow, Dfast, and FF) of liver fibrosis stages between the groups F0–1 and F2–4, the groups F0–2 and F3–4 showed significant differences (P<0.05).

Conclusions

IVIM can reflect the conditions of perfusion and diffusion in liver fibrosis and thus distinguish between normal liver and liver fibrosis. The IVIM technique may serve as a valuable tool for detecting and characterizing liver fibrosis, and monitoring its progression in a noninvasive manner.
High prevalence of obstructive sleep apnea in Marfan's syndrome
Authors: Li Mo , Quanying He , Yinna Wang , Birong Dong , Jinhan He
Published: January 2024

Objective

To review the current evidence about the prevalence of obstructive sleep apnea in patients with Marfan's syndrome, and discuss some proposed potential mechanisms for this relationship.

Data sources

The data in this review were mainly from Medline and PubMed articles published in English from 1990 to 2013. The search term was “Marfan's syndrome and sleep apnea”.

Study selection

Clinical evidence about the epidemiology of obstructive sleep apnea in patients with Marfan's syndrome; the mechanism that causes obstructive sleep apnea; interventional therapy for patients with Marfan's syndrome, and coexisting obstructive sleep apnea.

Results

A high prevalence of obstructive sleep apnea exists in patients with Marfan's syndrome. The potential reasons are craniofacial abnormalities and lax upper airway muscles, which lead to high nasal airway resistance and upper airway collapse. Obstructive sleep apnea mechanically deteriorates aortic dilatation and accelerates progression of aortic aneurysms. The condition is reversible and rapid maxillary expansion and adequate continuous positive airway pressure therapy are possible effective therapies to delay the expansion of aortic diameter in patients with Marfan's syndrome.

Conclusions

Obstructive sleep apnea is strongly associated with Marfan's syndrome. Craniofacial abnormalities and lax upper airway are the main mechanisms. Untreated obstructive sleep apnea accelerates progression of aortic dissection and rupture. Effective therapies for obstructive sleep apnea could postpone the aortic dilatation in patients with Marfan's syndrome.
Impact of vitamin D supplementation on the outcome of tuberculosis treatment: a systematic review and meta-analysis of randomized controlled trials
Authors: Jingyan Xia , Liyun Shi , Lifang Zhao , Feng Xu
Published: January 2024

Background

Vitamin D supplementation is believed to be beneficial in the treatment of patients with tuberculosis (TB), however, results from clinical trials have been inconclusive.

Methods

We performed a systematic literature search across MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, Springer, EBSCO, ProQuest, HighWire Press, and Web of Science, published as of December 2013. We individually inspected citations and extracted data independently. We estimated pooled risk ratios (RR) and 95% confidence intervals (CI) using random-effect models. We also assessed risk of bias using the Jadad scale and the quality of the evidence using GRADE. We included all randomized controlled trials comparing vitamin D with or without standard TB therapy or placebo.

Results

A total of five studies were analyzed in our meta analysis covering 841 newly-diagnosed TB cases. Patients receiving vitamin D supplementation had a 39% reduced risk of sputum smear or culture positive after six weeks of anti-TB treatment than those in the control group, although this is not statistically significant (pooled RR 0.61, 95% CI 0.24 to 1.56, P=0.30). Apart from an increased serum vitamin D level in the supplement group after eight weeks of treatment there was no evidence of any additional adverse effects related to vitamin D.

Conclusions

The meta analysis results indicate that vitamin D supplementation does not seem to have any beneficial effect in the treatment of TB. Future rigorous randomized controlled trials are needed to explore whether the supplementation of vitamin D could shorten treatment duration and to confirm whether the polymorphisms of vitamin D receptor have any potentially beneficial effect.
Molecular mechanisms of FK506-induced hypertension in solid organ transplantation patients
Authors: Jianglin Wang , Ren Guo , Shikun Liu , Qingjie Chen , Shanru Zuo , Meng Yang , Xiaocong Zuo
Published: January 2024

Objective

Tacrolimus (FK506) is an immunosuppressive drug, which is widely used to prevent rejection of transplanted organs. However, chronic administration of FK506 leads to hypertension in solid organ transplantation patients, and its molecular mechanisms are much more complicated. In this review, we will discuss the above-mentioned molecular mechanisms of FK506-induced hypertension in solid organ transplantation subjects.

Data sources

The data analyzed in this review were mainly from relevant articles without restriction on the publication date reported in PubMed. The terms “FK506” or “tacrolimus” and “hypertension”were used for the literature search.

Study selection

Original articles with no limitation of research design and critical reviews containing data relevant to FK506-induced hypertension and its molecular mechanisms were retrieved, reviewed and analyzed.

Results

There are several molecular mechanisms attributed to FK506-induced hypertension in solid organ transplantation subjects. First, FK506 binds FK506 binding protein 12 and its related isoform 12.6 (FKBP12/12.6) and removes them from intracellular ryanodine receptors that induce a calcium ion leakage from the endoplasmic/sarcoplasmic reticulum. The conventional protein kinase C beta II (cPKCβII)-mediated phosphorylation of endothelial nitric oxide (NO) synthase at Thr495, which reduces the production of NO, was activated by calcium ion leakage. Second, transforming growth factor receptor/SMAD2/3 signaling activation plays an important role in Treg/Th17 cell imbalance in T cells which toget converge to cause inflammation, endothelial dysfunction, and hypertension following tacrolimus treatment. Third, the activation of with-no-K(Lys) kinases/STE20/SPS1-related proline/alanine-rich kinase/thiazide-sensitive sodium chloride co-transporter (WNKs/SPAK/NCC) pathway has a central role in tacrolimus-induced hypertension. Finally, the enhanced activity of renal renin-angiotensin-aldosterone system seems to play a crucial role in the pathophysiology of FK506-induced hypertension.

Conclusion

FK506 plays a predominant role in the pathophysiology of hypertension in solid organ transplantation subjects.
Effect of short-term high-dose atorvastatin on systemic inflammatory response and myocardial ischemic injury in patients with unstable angina pectoris undergoing percutaneous coronary intervention
Authors: Sun Fei , Yin Zhao , Shi Quanxing , Zhao Bei , Wang Shouli
Published: January 2024

Background

Percutaneous coronary intervention (PCI) could develop periprocedural myocardial infarction and inflammatory response and statins can modify inflammatory responses property. The aim of this study was to evaluate whether short-term high-dose atorvastatin therapy can reduce inflammatory response and myocardial ischemic injury elicited by PCI.

Methods

From March 2012 to May 2014, one hundred and sixty-five statin-naive patients with unstable angina referred for PCI at Department of Cardiology of the 306th Hospital, were enrolled and randomized to 7-day pretreatment with atorvastatin 80 mg/d as high dose group (HD group, n=56) or 20 mg/d as normal dose group (ND group, n=57) or an additional single high loading dose (80 mg) followed 6-day atorvastatin 20 mg/d as loading dose group (LD group, n=52). Plasma C-reactive protein (CRP) and interleukin-6 (IL-6) levels were determined before intervention and at 5 minutes, 24 hours, 48 hours, 72 hours, and 7 days after intervention. Creatine kinase-myocardial isoenzyme (CK-MB) and cardiac troponin I (cTnI) were measured at baseline and then 24 hours following PCI.

Results

Plasma CRP and IL-6 levels increased from baseline after PCI in all groups. CRP reached a maximum at 48 hours and IL-6 level reached a maximum at 24 hours after PCI. Plasma CRP levels at 24 hours after PCI were significantly lower in the HD group ((9.14±3.02) mg/L) than in the LD group ((11.06±3.06) mg/L) and ND group ((12.36±3.08) mg/L, P <0.01); this effect persisted for 72 hours. IL-6 levels at 24 hours and 48 hours showed a statistically significant decrease in the HD group ((16.19±5.39) ng/L and (14.26±4.12) ng/L, respectively)) than in the LD group ((19.26±6.34) ng/L and (16.03±4.08) ng/L, respectively, both P <0.05) and ND group ((22.24±6.98) ng/L and (17.24±4.84) ng/L, respectively). IL-6 levels at 72 hours and 7 days showed no statistically significant difference among the study groups. Although PCI caused a significant increase in CK-MB and cTnI at 24 hours after the procedure in all groups, the elevated CK-MB and cTnI values were lower in the HD group ((4.71±4.34) ng/ml and (0.086±0.081) ng/ml, respectively) than in the ND group ((7.24±6.03) ng/ml and (0.138±0.103) ng/ml, respectively, both P <0.01) and LD group ((6.80±5.53) ng/ml and (0.126±0.101) ng/ml, respectively, both P <0.01).

Conclusion

Short-term high-dose atorvastatin treatment before PCI significantly reduced systemic inflammatory response and myocardial ischemic injury elicited by PCI.
Association between arterial stiffness and risk of coronary artery disease in a community-based population
Authors: Zhang Yun , Ye Ping , Luo Leiming , Bai Yongyi , Xu Ruyi , Xiao Wenkai , Liu Dejun , Wu Hongmei
Published: January 2024

Background

Arterial stiffness is well known as an important risk factor for coronary artery disease. In this study, we aimed to investigate the association between carotid-ankle pulse wave velocity (caPWV) and risk of coronary artery disease (CAD), and the interaction between pulse wave velocity (PWV) and other potential risk factors of CAD.

Methods

A community-based cross-sectional study was conducted for subjects living in Beijing, China. We collected 213 subjects with coronary artery disease and 1 266 subjects without CAD between September 2007 and January 2009 in a community center of Beijing. A multivariate Logistic regression analysis was carried out to assess the odds ratios of factors related to CAD.

Results

We found CAD subjects were more likely to have a higher body massindex (BMI), fasting glucose, uric acid, low-density lipoprotein (LDL) cholesterol, high-sensitivity Creactive protein (hs-CRP), carotic-femoral pulse wave velocity (cfPWV) and caPWV (P <0.05), and CAD subjects had a significantly lower HDL cholesterol levels (P <0.05). Moreover, the proportion of hypertension in CAD subjects was significantly higher than non-CAD subjects. The multiple Logistic regression analysis showed that hypertension, higher uric acid, hs-CRP, cfPWV and caPWV levels significantly increased the risk of CAD, with ORs (CI) of 1.47 (1.25–1.74), 1.17 (1.01–1.26), 1.35 (1.10–1.67), 1.15 (1.09–1.19) and 1.07 (1.01–1.15), respectively. Higher HDL cholesterol was significantly associated with reduced risk of CAD, with ORs (CI) of 0.58 (0.40–0.83). In addition, cfPWV had significant association with age, hypertension, LDL cholesterol, with Pearson's coefficients of 0.166, 0.074, and 0.030, respectively.

Conclusions

cfPWV and caPWV are independently associated with significant CAD, and cfPWV has significant correlation with age and hypertension. cfPWV and caPWV may be used as a practical tool for predicting the risk of CAD.
Influence of developmental cervical stenosis on dural sac space
Authors: Tang Yanchao , Yu Miao , Liu Zhongjun , Sun Yu , Liu Xiaoguang
Published: January 2024

Background

This retrospective study aimed to investigate the difference of the intra-dural reserving space for spinal cord in magnetic resonance imaging (MRI) between patients with and without developmental cervical stenosis and its clinical significance.

Methods

A total of 264 patients with cervical spondylotic myelopathy who had decompression surgeries were recruited. The average follow-up was 29 months. Based on their lateral radiographs, they were divided into stenosis group and non-stenosis group. On the magnetic resonance images, the ratio of the sagittal diameter of the dural sac to that of the vertebral body was measured and calculated as MRI Pavlov ratio at the mid-vertebral level on T2-weighted sagittal images from C3 to C7. The ratio of the transverse area of the spinal cord to that of the dural sac was measured and calculated as occupation ratio on T2-weighted axial images at the same levels. The MRI Pavlov ratio and occupation ratio were compared between the two groups. The stenosis group was further divided into space-reserving and non-space-reserving subgroups based on the occupation ratios; then clinical parameters were compared between the two subgroups to determine the clinical significance of the reserving space.

Results

The MRI Pavlov ratio of the stenosis group was significantly smaller than that of the non-stenosis group at C3-C7 (P <0.01), while the occupation ratio was significantly larger only at C7 (P <0.05). For the space-reserving subgroup, the postoperative recovery rate was lower (P <0.05). The postoperative recovery rate was (23±6)% in anterior approach, larger than (-23±15)% in posterior approach (P <0.05).

Conclusions

Developmental cervical stenosis is associated with a smaller sagittal diameter of the dural sac, but does not lead to a significant decrease in intra-dural space available for the cord. For patients with normal intra-dural space, the recovery after anterior decompression surgery was better than posterior approach.
Closed reduction external fixator fixation versus open reduction internal fixation in the patients with Bennett fracture dislocation
Authors: Li Zhongzhe , Guo Yang , Tian Wen , Tian Guanglei
Published: January 2024

Background

The Bennett fracture is either a common or a challenging problem to hand surgeons. It is still debated whether closed or open reduction gives optimal results. This study aimed to describe and assess a closed reduction and mini-external fixator fixation technique for the treatment of Bennett's fracture dislocation and to compare this technique versus open reduction and internal fixation.

Methods

From October 2002 to December 2012, 56 patients with Bennett's fracture dislocation were treated by closed reduction and mini-external fixator fixation and 32 patients were treated by open reduction and internal fixation in Jishuitan Hospital. Patients with an articular step-off of more than 1 mm were excluded. All patients were assessed at a mean follow-up of 7 years (range 2–10 years) and the two groups were compared with pain levels, active range of trapeziometacarpal motion, grip strength and pinch strength, arthritic changes, and adduction deformity.

Results

Based on primary closed reduction maintained, the rate of anatomic reduction is 63.6%. Radiographic fracture union was achieved in all patients at a mean time of 5 weeks. At the final follow-up, there was no difference between the two groups in mean union time and pain levels (P=0.2). There was also no difference between the two groups regarding the active range of trapeziometacarpal motion (P=0.3), grip stength (P=0.6), pinch strength (P=0.2), arthritic change and loss of reduction (P=0.2). There was a significant correlation between adduction deformity and the development of arthritis (P=0.02).

Conclusion

Closed reduction mini-external fixator fixation should be first tried to apply in the treatment of Bennett's fracture dislocation, and open reduction internal fixation should only be performed for irreducible fractures.
Yeni Nesil Bilgi Merkezleri: Veri Yönetimi
Authors: Alav Orhan
Published: January 2024

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Mesleki Tükenmişlik ve İş Tatmini
Authors: Bölümcü İhsan
Published: January 2024

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New application of bimetallic Ag/Pt nanoplates in a colorimetric biosensor for specific detection of E. coli in water
Authors: Pebdeni Azam Bagheri , AL-Baiati Mohammad N , Hosseini Morteza
Published: January 2024

A fast and sensitive aptasensor was developed using nanoplates with peroxidase activity as a novel approach. E. coli detection is described using a silver/platinum nanoplate (Ag/Pt NPL) that interacts with an oligonucleotide aptamer as a bioreceptor. The size of the Ag/Pt NPLs was about 42 nm according to the FE-SEM images. The EDS result indicates that a thin layer of Pt ions was coated on the surface of the Ag NPLs. This nanobiosensor has the ability to specifically bind to E. coli, increasing the peroxidase activity of the apt-Ag/Pt NPL. Finally, the blue color of the solution in the contaminated water samples was increased in the presence of 3,3′,5,5′-tetramethylbenzidine (TMB) as a substrate and H2O2. The assay can be completed in 30 min and the presence of E. coli levels can be distinguished with the naked eye. The absorbance at 652 nm is proportional to pathogen concentration from 10 to 108 CFU·mL−1, with a detection limit of 10 CFU·mL−1. The percent recovery for the water samples spiked with E. coli is 95%. The developed assay should serve as a general platform for detecting other pathogenic bacteria which affect water and food quality. The proposed E. coli detection strategy has appealing characteristics such as high sensitivity, simple operation, short testing time, and low cost.
Paralebeda prokopenkoi — new lappet moth species from southern Laos, Vietnam, and Cambodia (Lepidoptera: Lasiocampidae)
Authors: Spitsyn Vitaly M. , Kondakov Alexander V. , Soboleva Alena A. , Spitsyna Elizaveta A.
Published: January 2024

In this paper, we describe Paralebeda prokopenkoi sp. nov., a new species from southern Laos, Vietnam, and Cambodia. This species is a sister species to Paralebeda lucifuga (Swinhoe, 1892) which was described from Singapore. The new species differs externally by the more elongate forewings. Additionally, the uncorrected COI p-distance between P. prokopenkoi sp. nov. and P. lucifuga is 2.61–3.90%.
Hypoxic Epicardium Contribution to Myocardial Repair
Authors: Konstantin V Dergilev , Mikhail Yu Menshikov , Yelena V Parfyonova
Published: January 2024

Epicardium, the outer epithelial layer of the heart forming from extracardiac primordium, plays a fundamental role in myocardial embryogenesis by generating epicardial-derived cells (cardiac fibroblasts, mesenchymal cells, vascular smooth muscle cells). In the adult heart, epicardium occurs as a mesothelial layer, which, in injured heart, recalls its “embryonic program” and transforms into mesenchymal cells contributing, by such a way, to myocardial reparation. This process is facilitated by hypoxic conditions arising during injury. In general, regulation of this process may be a potential methodology for treatment of cardiovascular diseases.
Ultrastructural Changes in Brain Tissue in Drug-Resistant Mesial Temporal Lobe Epilepsy in Humans: A Mini-Review
Authors: Sitovskaya Darya , Zabrodskaya Yulia
Published: January 2024

Epilepsy is a group of chronic neurological diseases of the brain characterized by a persistent predisposition to epileptic seizures, affecting more than 70 million people worldwide. Drug-resistance is a key problem in the theory and practice of epileptology. The literature contains many publications devoted to ultrastructural changes in brain tissue in experimental animal models, but the features of ultrastructural changes in human brain tissue in drug-resistant mesial Temporal Lobe Epilepsy (TLE) remain unknown. This brief review presents the current state of the art of problems devoted to the study of the ultrastructure of neurons, glia, and blood vessels in patients with drug-resistant mesial TLE.
Knowledge and Utilization of Cervical Cancer Screening Services Among Female Undergraduates at FUTO
Authors: Nwachukwu Cynthia , Asuzu Nneka Eleanor , Innocent David Chinaecherem , Ogazirilem Emerole Chiagoziem , Godswill Ekeleme Uzochukwu , Dozie Ugonma Winnie , Ekenze John Chigozie , Innocent Rejoicing Chijindum , Dike Ihuoma Chimdimma , Iwuagwau Uchechukwu Olive , Akpevba Ejiro , Rabaan Ali A , Innocent Promise Chinemerem , Innocent Increase Praise
Published: January 2024

Background: Globally, cervical cancer is the fourth most common is a type of cancer in women. It that starts in the cervix. The cervix is a hollow cylinder that connects the lower part of a woman’s uterus to her vagina. Cervical cancer is a leading cause of mortality particularly in young women. The aim of this study is to assess the knowledge and utilization of cervical cancer screening services among female undergraduates at Federal University of Technology Owerri. Methods: A descriptive cross sectional research design was adopted for this study. A multi stage sampling technique was used in recruiting a total of 374 female students that participated in this study and a pretested questionnaire was used in the data collection of the study. Statistical Package for Social Sciences (SPSS) version 20 was used in the analysis of the study. Results: The study showed that, 46.3% (173) of the respondents aged 15-24. From the study, majority of the respondents 85.8% (321) had heard about cervical cancer screening. Most of the respondents 81.9% (306) affirmed they would utilize cervical cancer screening if offered a chance. A good number of the respondents 33.95% (127), mentioned that opined “distance to facility” as one of the factors that influenced the utilization of cervical cancer screening services. Further results from the study based on the relationship between Socio-demographic characteristics and level of knowledge of respondents towards cervical cancer screening services demonstrated that there was a statistically significant relationship between age (p = 0.0035), academic level (p = 0.0023), healthcare plan (p = 0.0327) and level of knowledge of cervical cancer. Conclusion: The study concluded that, while many female undergraduates had a good understanding of cervical cancer screening, this did not translate into a propensity to utilize screening services. From the study, it was recommended that, female undergraduates must have a thorough understanding of cervical cancer and how to prevent it.
A Case of Holothuroidea-like Erythrocytes
Authors: LN* Katiukhin , ER Nikitina
Published: January 2024

Ektacytometric examination of red blood cells with morphological anomaly is presented. Confocal microscopy of the blood from the patient N. shows the abundance of RBCs in the form of representatives of the Holothuroidea. RBCs from control patients exhibited an elliptical diffraction pattern whereas patient’s N. RBCs generated a diamond shaped diffraction pattern. Erythrocytes of the patient N. have sharply reduced deformability, plasticity and water permeability of membranes. For the first time, we propose to evaluate the plastic properties of the blood cell membrane itself based on the results of the analysis at low shear stress.