bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of poly(DL-lactide-co-glycolide) on scar formation after glaucoma filtration surgery
Authors: DU Li-qun , YANG Hong-ling , WU Xin-yi , WANG Shen-guo , LI Yun
Published: January 2024

Background

Glaucoma filtering surgery (GFS) is the most common procedure performed in the treatment of glaucoma. Although antiscarring agents help prevent postsurgical scarring and improve glaucoma surgical outcomes, they may be associated with an increased incidence of severe and potentially blinding complications. Poly(DL-lactide-co-glycolide) (PDLLA/GA) is a bioresorbable polymer, which can be prepared with a large range of physical, mechanical, and biological properties and has been widely used in medicine, including as an absorbable suture and a drug carrier and especially as a scaffold in tissue engineering. This study aimed to evaluate the effect of PDLLA/GA on scar formation after glaucoma filtration surgery (GFS).

Methods

Forty-eight New Zealand white rabbits were divided into two groups randomly and GFS was performed on the right eye of each. PDLLA/GA membranes were put under the sclera flap for evaluation. GFS with no membrane inserted served as control. Clinical evaluations of intraocular pressure (IOP) and the presence of a filtration bleb were performed at intervals (3 days, 1, 2, 4, 8, 12, 20, and 24 weeks) postoperatively. At each time point, three eyes per group were excised to observe histological changes such as inflammation and scar formation and the expression of collagen type IV, proliferating cell nuclear antigen (PCNA), matrix metalloproteinase-9 (MMP-9), and tissue inhibitor of metalloproteinase-1 (TIMP-1). The expression of connective tissue growth factor (CTGF) mRNA was determined by reverse transcription-polymerase chain reaction.

Results

The lower IOP level and an effective bleb were maintained for a long time after GFS in the PDLLA/GA group. The histological analysis showed less inflammation and scar formation, weaker expression of collagen type IV and PCNA, more intense MMP-9 and TIMP-1, slightly elevated ratio of MMP-9 and TIMP-1, and a smaller increase in CTGF mRNA postoperatively in the PDLLA/GA group but less than the control group (P <0.05).

Conclusion

PDLLA/GA membranes may be promising for preventing fibrosis after GFS.
Prediction of H7N9 epidemic in China
Authors: Zhang Zhaojie , Xia Yao , Lu Yi , Yang Jingchao , Zhang Luwen , Su Hui , Lin Lili , Wang Guoling , Wang Tongmei , Lin Shao , Guo Zhongmin , Lu Jiahai
Published: January 2024

Background

In March 2013, human cases of infection with a novel A (H7N9) influenza virus emerged in China. The epidemic spread quickly and as of 6 May 2013, there were 129 confirmed cases. The purpose of this study was to analyze the epidemiology of the confirmed cases, determine the impacts of bird migration and temperature changes on the H7N9 epidemic, predict the future trends of the epidemic, explore the response patterns of the government and propose preventive suggestions.

Methods

The geographic, temporal and population distribution of all cases reported up to 6 May 2013 were described from available records. Risk assessment standard was established by analysing the temperature and relative humidity records during the period of extensive outbreak in three epidemic regions in eastern China, including Shanghai, Zhejiang and Jiangsu provinces. Risk assessment maps were created by combining the bird migration routes in eastern China with the monthly average temperatures from May 1993 to December 2012 nationwide.

Results

Among the confirmed cases, there were more men than women, and 50.4% were elderly adults (age >61 years). The major demographic groups were retirees and farmers. The temperature on the days of disease onset was concentrated in the range of 9°C-19°C; we defined 9°C-19°C as the high-risk temperature range, 0°C-9°C or 19°C-25°C as medium risk and <0°C or >25°C as low risk. The relative humidity on the days of disease onset ranged widely from 25% to 99%, but did not correlate with the incidence of infection. Based on the temperature analysis and the eastern bird migration routes, we predicted that after May, the high-risk region would move to the northeast and inland, while after September, it would move back to north China.

Conclusions

Temperature and bird migration strongly influence the spread of the H7N9 virus. In order to control the H7N9 epidemic effectively, Chinese authorities should strengthen the surveillance of migrating birds, increase poultry and environmental sampling, improve live poultry selling and husbandry patterns and move from a “passive response pattern” to an “active response pattern” in focused preventive measures.
Association of N-terminal pro-brain natriuretic peptide with the severity of coronary artery disease in patients with normal left ventricular ejection fraction
Authors: Wu Naqiong , Ma Fenglian , Guo Yuanlin , Li Xiaoling , Liu Jun , Qing Ping , Xu Ruixia , Zhu Chenggang , Jia Yanjun , Liu Geng , Dong Qian , Jiang Lixin , Li Jianjun
Published: January 2024

Backround

N-terminal pro-brain natriuretic peptide (NT-proBNP) is a reliable predictor in acute coronary artery disease (CAD). Little is known about patients with stable CAD, especially Chinese patients with CAD. The aim of the present study was to investigate the association of NT-proBNP levels with the severity of CAD in patients with normal left ventricular ejection fraction.

Methods

A total of 658 consecutive patients were divided into two groups based on angiograms: CAD group (n=484) and angiographic normal control group (n=174). The severity of CAD was evaluated by modified Gensini score, and its relationship with NT-proBNP was analyzed.

Results

The prevalence of risk factors such as age, male gender, diabetes mellitus (DM), dyslipidemia, smoking, and family history of CAD in the CAD group were higher than that in the control group. In multivariate regression model analysis, age, gender, and DM were determinants of the presence of CAD. NT-pro BNP was found to be an independent predictor for CAD (OR:1.66 (95% CI: 1.06-2.61), P <0.05). In a receiver operating characteristic (ROC) curve analysis, an NT-proBNP value of 641.15 pmol/L was identified as a cut-off value in the diagnosis or exclusion of CAD (area under curve (AUC)=0.56, 95% CI: 0.51-0.61). Furthermore, NT-proBNP was positively correlated with Gensini score (r=0.14, P <0.001) in patients with CAD.

Conclusion

NT-proBNP was an independent predictor for Chinese patients with CAD, suggesting that the NT-proBNP level might be associated with the presence and the severity of CAD.
Pioglitazone inhibits the expression of nicotinamide adenine dinucleotide phosphate oxidase and p38 mitogen-activated protein kinase in rat mesangial cells
Authors: WANG Shan , YE Shan-dong , SUN Wen-jia , HU Yuan-yuan
Published: January 2024

Background

Oxidative Stress and p38 mitogen-activated protein kinase (p38MAPK) play a vital role in renal fibrosis. Pioglitazone can protect kidney but the underlying mechanisms are less clear. The purpose of this study was to investigate the effect of pioglitazone on oxidative stress and whether the severity of oxidative stress was associated with the phosphorylation level of p38MAPK.

Methods

Rat mesangial cells were cultured and randomly assigned to control group, high glucose group and pioglitazone group. After 48-hour exposure, the supernatants and cells were collected. The protein levels of p22phox, p47phox, phosphorylated p38MAPK, total p38MAPK were measured by Western blotting. The gene expressions of p22phox, p47phox were detected by RT-PCR. The levels of intracellular reactive oxygen species (ROS) were determined by flow cytometry. The levels of superoxide dismutase (SOD) and maleic dialdehyde (MDA) in the supernatant were determined respectively.

Results

Compared with the control group, the expression levels of p22phox, p47phox, phospho-p38 and ROS significantly increased, activity of SOD decreased in high glucose group, while the level of MDA greatly increased (P <0.01). Pioglitazone significantly suppressed p22phox, p47phox expressions and oxidative stress induced by high glucose. The expressions of p22phox, p47phox, phospho-p38MAPK and ROS generation were markedly reduced after pioglitazone treatment (P <0.05). The activity of SOD in the the supernatant increased (P <0.05), while the level of MDA decreased greatly by pioglitazone (P <0.05). The level of oxidative stress was associated with the phosphorylation level of p38MAPK (P <0.01).

Conclusion

Pioglitazone can inhibit oxidative stress through suppressing NADPH oxidase expression and p38MAPK phosphorylation.
Inhibition of peroxisome proliferator-activated receptor-γ in steroidinduced adipogenic differentiation of the bone marrow mesenchymal stem cells of rabbit using small interference RNA
Authors: Wang Yisheng , Li Jinfeng , Liu Ming , Zhao Guoqiang , Hao Lanyu , Li Yuebai
Published: January 2024

Background

Steroids inhibit osteogenic differentiation and decrease bone formation while concomitantly inducing adipose deposition in osteocytes. This leads to the fatty degeneration and necrosis of bone cells commonly seen in osteonecrosis of the femoral head. The peroxisome proliferator-activated receptor-γ (PPARγ) is an adipogenic transcription factor linked to the development of this disease and responsible for inducing adipogenesis over osteogenesis in bone marrow mesenchymal stem cells (BMSCs). The aim of this study was to assess whether adipogenic differentiation could be suppressed, and thus osteogenic potential retained, by inhibiting PPARγ expression in BMSCs.

Methods

Cells from the bone marrow of New Zealand rabbits were treated with 10-7mol/L dexamethasone and infected with one of three small interference RNA (siRNA) adenovirus vectors (S1, S2, and S3) or non-targeting control siRNA (Con) and compared with dexamethasone-treated (model) and untreated (normal) cells. Cells were grown for 21 days and stained with Sudan III for adipocyte formation. At various time points, cells were also assessed for changes in PPARγ, osteocalcin (OC), Runx2, alkaline phosphatase (ALP) activity, and triglyceride (TG) content.

Results

Dexamethasone-treated model and control groups showed a significant increase in fatty acid-positive staining, which was inhibited in cells treated with PPARγ siRNA-treated, similar to normal untreated cells. All three siRNA groups significantly inhibited PPARγ mRNA and protein, adipocyte number, and TG content compared with the dexamethasonetreated model and control groups, matching that seen in normal cells. OC and Runx2 mRNA and protein, as well as ALP activity, were significantly higher in cells treated with siRNA against PPARγ, similar to that seen in the normal cells. These osteogenic markers were significantly lower in the dexamethasone-treated cell cultures.

Conclusions

The siRNA adenovirus vector targeting PPARγ can efficiently inhibit steroid-induced adipogenic differentiation in rabbit BMSCs and retain their osteogenic differentiation potential.
Prognostic value of lymph node ratio in hypopharyngeal squamous cell carcinoma after chemoradiotherapy
Authors: YU Yue , WANG Xiao-lei , XU Zhen-gang , FAN Cheng-cheng , LI Qing
Published: January 2024

Background

Lymph node ratio (LNR) has recently been reported as a potential prognostic marker in many malignant diseases. We aimed to analyze the potential prognostic effect of LNR on hypopharyngeal squamous cell carcinoma (HPSCC) after neoadjuvant therapy in our institution.

Methods

We performed a retrospective study of 279 patients with HPSCC who underwent radiotherapy with or without chemotherapy followed by neck dissection between November 1965 and December 2008. Patients were divided into four groups according to quartiles based on LNR.

Results

The mean LNR was 10.4% (range 0-100%, median 4.3%). Males and advanced clinical N classification significantly increased the LNR (P=0.014 and P <0.001, respectively). Compared with those with LNR <0.14, LNR ≥0.14 was associated with reduced overall, disease-specific and disease-free survival (all at P <0.001). Multivariate analysis revealed that LNR is an independent predictor of prognosis.

Conclusion

Our results suggest that LNR is a strong predictor of HPSCC after chemoradiotherapy.
Predictive value of different scoring systems for early postoperative mortality in patients with a second coronary artery bypass grafting
Authors: Zhang Benqing , Sun Hansong , Hu Shengshou , Xu Jianping , Wang Wei , Song Yunhu , Lyu Feng , Wu Hengchao
Published: January 2024

Background

Coronary artery bypass graft (CABG) has been developed over many years. Recently, an increasing number of patients need a second surgery for relapse of symptoms. In consideration of the high surgical risk, accurate preoperative evaluation is needed. The aim of the study was to assess the predictive value of three different risk scoring system for early postoperative mortality rate in patients with redo-CABG.

Methods

Seventy-seven patients who underwent redo-CABG in Fu Wai Hospital from January 1997 to June 2013 were enrolled. All patients were retrospectively scored for early postoperative mortality rate using EuroSCORE, STS score and SinoSCORE. Overall expected mortality rates were compared with observed mortality rates. Discrimination was evaluated using receiver operating characteristic (ROC) curves and area under a ROC curve (AUC).

Results

Four patients died after a redo-CABG 5%. The mortality rates predicted by EuroSCORE, STS score and SinoSCORE were 5.0%, 2.2% and 1.4%, respectively. The AUC of the three kinds of score were 0.465, 0.543 and 0.528, respectively, indicating a poor correlation between the observed and predicted mortality rates.

Conclusion

The predictive value of EuroSCORE, STS score and SinoSCORE is poor for early postoperative mortality rate in patients with redo-CABG.
Clinical relevance of angiographic coronary collaterals during primary coronary intervention for acute ST-elevation myocardial infarction
Authors: Shen Ying , Wu Feng , Pan Chunzang , Zhu Tianqi , Zhang Qi , Zhang Ruiyan , Ding Fenghua , Lu Lin , Hu Jian , Yang Zhenkun , Shen Weifeng , Wu Zonggui
Published: January 2024

Background

Collaterals to occluded infarct-related coronary arteries (IRA) have been observed after the onset of acute ST-elevation myocardial infarction (STEMI). We sought to investigate the impact of early coronary collateralization, as evidenced by angiography, on myocardial reperfusion and outcomes after primary percutaneous coronary intervention (PCI).

Methods

Acute procedural results, ST-segment resolution (STR), enzymatic infarct size, echocardiographic left ventricular function, and major adverse cardiac events (MACE) at 6-month follow-up were assessed in 389 patients with STEMI undergoing primary PCI for occluded IRA (TIMI flow grade 0 or 1) within 12 hours of symptom-onset. Angiographic coronary collateralization to the occluded IRA at first contrast injection was graded according to the Rentrop scoring system.

Results

Low (Rentrop score of 0 or 1) and high (Rentrop score of 2 or 3) coronary collateralization was detected in 329 and 60 patients, respectively. Patients with high collateralization more commonly had prior stable angina and right coronary artery occlusion, but less often had left anterior descending artery occlusion. At baseline, these patients presented with less extent of ST-segment elevation and lower serum levels of creatine kinase myocardial band (CK-MB) and cardiac troponin I (cTnI). Procedural success rate, STR, corrected TIMI flame count, and area under the curve of CKMB and cTnI measurements after the procedure were similar between patients with high collateralization and those with low collateralization (for all comparisonsP>0.05). There were no differences in left ventricular ejection fraction and rates of MACE at 6 months according to baseline angiographic collaterals to occluded IRA.

Conclusions

In patients with acute STEMI undergoing primary PCI within 12 hours of symptom-onset, coronary collateralization to the occluded IRA was influenced by clinical and angiographic features. Early recruitment of collaterals limits infarct size at baseline, but has no significant impact on myocardial reperfusion after the procedure and subsequent left ventricular function and clinical outcomes.
Matrix metalloproteinase-8 inhibitors mitigate sepsis-induced myocardial injury in rats
Authors: Xiaorui Zhou , Jiakai Lu , Dong Chen , Wei Wang , Qing Cai , Tongxun Li , Jinglan Zhang
Published: January 2024

Background

Sepsis-induced myocardial injury (SIMI) is caused by a variety of mechanisms. The aim of the study is to investigate the effects of metalloproteinase-8 (MMP-8) on SIMI and its mechanisms in rats.

Methods

Forty male Sprague Dawley rats were randomly divided into four groups: MMP-8 inhibitor (M8I), dexamethasone (DEX), sepsis, and sham groups. The sepsis model was established by cecal ligation and puncture (CLP). Rats in the M8I group immediately received an intraperitoneal injection of M8I (0.1 mg/kg) after CLP. Rats in the DEX group immediately received an intraperitoneal (IP) injection of DEX (2 mg/kg). Rats in the sepsis and sham groups received intraperitoneal injections of normal saline. Rats were sacrificed 12 hours after CLP. Paraffin sections were stained with hematoxylin and eosin to observe the myocardium. The myocardial ultrastructure was observed with transmission electron microscopy. MMP-8, tumor necrosis factor-α (TNF-α), and interleukin-1β (IL-1β) were detected by immunohistochemistry. The expression of MMP-8 was measured by Western blotting. TNF-α and IL-1β levels in serum and myocardial tissue were determined by enzyme-linked immunosorbent assay.

Results

Compared with the sham group, the myocardium in the sepsis group was seriously injured. MMP-8, TNF-α and IL-1β expression was higher in the sepsis group than in the sham group. Treatment with M8I or DEX, however, attenuated sepsis induced histopathological changes in the heart, and was associated with significant reductions in serum and myocardial levels of TNF-α and IL-1β (P<0.05). M8I significantly inhibited MMP-8 expression in myocardial tissue (P<0.05). In addition, treatment with DEX was not associated with a change in myocardial levels of MMP-8 (P>0.05).

Conclusion

MMP-8 inhibitor attenuated myocardial injury in septic rats, which might be related to reduced expression of TNF-α and IL-1β.
Bronchiectasis: still a problem
Authors: Wang Zengli
Published: January 2024

Objective

The purpose of this descriptive review was to delineate the current knowledge of bronchiectasis in terms of prevalence, burden of disease, pathophysiology, and management.

Data sources

The National Library of Medicines MEDLINE and PubMed database (2005—2013) were used to conduct a search using the keyword term “bronchiectasis”. The references for articles being considered for inclusion were searched from additional sources such as conference proceedings.

Study selection

Criteria for inclusion of articles included data outlining epidemiology, pathogenesis, diagnosis, and evidence-based guidelines for management of bronchiectasis. In assessing the quality of the articles, factors such as size of the population studied, clinical setting of the study, and whether or not the studies were prospective or retrospective were taken into consideration. Review articles were also included in our data collection.

Results

Despite many advances in modern medicine, bronchiectasis still remains a significant public health problem in developed countries and the developing world. It carries a significant burden worldwide in terms of morbidity and mortality, as well as financially to the affected population. In addition, bronchiectasis may associate with chronic airflow obstruction, regardless of smoking status.

Conclusions

Bronchiectasis is a debilitating illness responsible for significant morbidity with a poor health-related quality of life. The condition has a substantial socioeconomic cost because both primary and secondary healthcare resources are frequently used and periods of sick leave are common.
Proliferating cell nuclear antigen involved in the repair process of ouabain-induced brain damage independent of hypertension in rats
Authors: You Beian , Shen Lin , Qiu Jie , Liu Xiangju , Zhao Shaohua , Ji Xiang , Wang Yan , Gao Haiqing
Published: January 2024

Background

Ouabain is a mammalian adrenocortical hormone that is involved in the pathogenesis of hypertension by inhibiting Na-K ATPase activity. It also participates in a variety of kinase-mediated signaling pathways associated with Na-K ATPase. Previous studies have shown that ouabain can cause cardiac remodeling independent of elevated blood pressure and that proliferating cell nuclear antigen (PCNA) plays a coordinating role for numerous proteins involved in multiple processes associated with DNA synthesis. Therefore, we hypothesized that ouabain might play a role in the cerebral cortex through signaling pathways independent of hypertension. And PCNA might be involved in this process.

Methods

Male Sprague-Dawley rats were treated with ouabain or with 0.9% nitric sodium as the control group. Systolic blood pressure was recorded weekly. After four weeks of treatment, morphological changes in the cerebral cortex were analyzed using light and transmission electron microscopy. The expression of PCNA in the cerebral cortex was evaluated by immunohistochemistry, real time quantitative PCR, and Western blotting.

Results

After 4-week treatment, there was no significant difference in systolic blood pressure compared with the control group, but both structural deterioration and up-regulated expression of PCNA in the brain was induced by ouabain treatment.

Conclusions

These results suggest that ouabain induces alterations in the brain structure, and this effect is independent of blood pressure. PCNA might be involved in the repair process of ouabain-induced brain damage.
Transplantation of bone marrow stromal cells overexpressing human vascular endothelial growth factor 165 enhances tissue repair in a rat model of radiation-induced injury
Authors: Wang Tao , Liao Tian'an , Wang Hong , Deng Wei , Yu Dahai
Published: January 2024

Background

The multilineage differentiation potential ability of bone marrow stromal cells (BMSCs) showed great potential in tissue engineering, while vascular endothelial growth factor 165 (VEGF165) promotes vasculogenesis and further promotes tissue regeneration. This study aimed to assess the ability of rat BMSCs expressing humanVEGF A165(hVEGF165) to promote tissue repair in rat model of radiation-induced injury.

Methods

Rat BMSCs were isolated from the tibia. Plasmid DNA expressinghVEGF165was stably transfected into BMSCs using liposomes. The right hindlimb muscle of 40 rats was irradiated using a60Co Y source (total dose 30 Gy). The animals were divided into four groups (n=10): not injected with BMSCs (control; group 1) or intramuscularly injected two times (once in 2 weeks) with pcDNATM3.1-transfected BMSCs (group 2), untransfected BMSCs (group 3), orhVEGF165- transfected BMSCs (group 4). Angiography was performed 1 week after the last injection of BMSCs; samples of the hindlimb muscle were subjected to transmission electron microscopy, ultrastructural analysis, reverse transcription-PCR (RT-PCR), Western blotting, and immunohistochemistry.

Results

Rat BMSCs with multipotent differentiation capacity were isolated.hVEGF165-transfected BMSCs overexpressed hVEGF165mRNA and protein. Injection of BMSCs (groups 2–4) increased the average vessel number, density, diameter, and cross-sectional area; mRNA expression of the myogenic markers including myoblast determination protein, myogenin, and α-smooth muscle actin; and CD31 protein expression; and promoted the repair of blood vessels and myofibers after radiation-induced injury compared to group 1; each of these parameters andhVEGF165mRNA or protein expression were markedly improved in rats injected withhVEGF165-transfected BMSCs compared to groups 2 and 3.

Conclusions

BMSCs expressinghVEGF165enhanced the repair of radiation-induced tissue injury by promoting vasculogenesis and muscle fiber regeneration. BMSCs expressinghVEGF165may have potential clinical applications.
Efficacy of sunitinib in patients with metastatic renal cell carcinoma: initial experience in two Chinese centers
Authors: Zhisong He , Gang Guo , Cuijian Zhang , Xuesong Li , Weijun Fu , Jie Jin , Xu Zhang , Liqun Zhou
Published: January 2024

Background

The advent of targeted therapy has proved a milestone in the history of metastatic renal cell carcinoma treatment, and several guidelines now recommend sunitinib as first- or second-line treatment. But little is known about its efficacy in Asian patients. The aim of this article was to evaluate the efficacy of sunitinib monotherapy in patients with metastatic renal cell carcinoma treated at two Chinese centers.

Methods

One hundred and forty-one patients with metastatic renal cell carcinoma were included in the study. Of them, 119 patients received single-agent sunitinib as first-line therapy and the remaining 22 patients received it as second-line therapy. One hundred and twenty patients received sunitinib in a dosage of 50 mg orally once daily on a 4-2 schedule (4 weeks on treatment, 2 weeks off), while 21 patients received 37.5 mg/day continuously until either disease progression or unacceptable toxicity occurred. The overall response rate, survival outcomes, and safety were evaluated. Results Over a median follow-up time of 23 months (16 cycles; range 2-45 months), complete responses, partial responses, and stable disease lasting two cycles or longer were achieved in 2.8%, 24.1%, and 60.3% of patients respectively (objective response rate 26.9%; overall benefit 87.2%). The median progression-free survival was 14.2 months (range 3-39 months). During the study, 53 patients died and the median survival time was 13.5 months (range 7-25 months). Dose modification or treatment interruption due to adverse events was required in 36.9% of the patients. The most common adverse events were hand-foot syndrome (71.4%), thrombocytopenia (68.8%), hypertension (47.1%), and fatigue (46.3%).

Conclusion

Sunitinib had a favorable efficacy/tolerability profile in Chinese patients with metastatic renal cell carcinoma.
Clinical characteristics and prognostic factors of patients with gastric neuroendocrine carcinoma treated with radical surgery
Authors: Xuefeng Xu , Jian’ang Li , Xu Han , Chenye Shi , Dayong Jin , Wenhui Lou
Published: January 2024

Background

Gastric neuroendocrine carcinomas (g-NECs) are rare tumors that have aggressive biological behaviors and poor prognosis, but the prognostic factors of postoperative patients with g-NEC are still unclear. Our aim was to study and explore the clinical characteristics and prognostic factors of patients with g-NEC treated with radical surgery.

Methods

The clinical data of 43 g-NEC patients who underwent surgery from January 2002 to January 2011 at the Zhongshan Hospital of Fudan University were analyzed. Follow-up was conducted by telephone, mail, or returning visit survey.

Results

The sizes of the 43 neuroendocrine carcinomas (G3) were 1.5 cm × 1.5 cm × 0.5 cm to 7 cm × 8 cm × 1.5 cm. Eight NECs were localized, and 35 had lymph node involvement, of which 1 also had hepatic metastasis. At the end of the follow-up, the follow-up rate was 97.7% (42/43), and the median follow-up time was 22.2 months. The median overall survival of g-NEC patients was 36.5 months, and the 1-, 3-, and 5-year overall survival rates were 86.0%, 51.6%, and 36.7%, respectively. Sex (P <0.05) and lymph node involvement (P <0.05) were prognostic factors of postoperative g-NEC patients, among which sex was an independent prognostic factor (P <0.05), as a survival advantage of female patients over male was observed.

Conclusions

Most of the g-NECs were diagnosed at an advanced stage. The prognosis of g-NECs was related with sex and lymph node involvement, of which sex was an independent prognostic factor, with female patients having a survival advantage.
Retroperitoneal laparoendoscopic single-site ureterolithotomy versus conventional laparoscopic ureterolithotomy
Authors: Qiao Peng , Zhang Junhui , Wang Jianwen , Tian Xiquan , Niu Yinong , Xing Nianzeng
Published: January 2024

Background

Laparoendoscopic single-site (LESS) surgery through the retroperitoneal approach has been seldom reported. We aimed to evaluate the outcomes of LESS and conventional laparoscopic surgery via the retroperitoneal approach in the management of large, impacted ureteral calculi.

Methods

Between November 2011 and July 2013, retroperitoneal LESS ureterolithotomy was performed in 12 patients using a homemade single-port device comprising a surgical glove and several strips of tape. Another 16 patients underwent conventional retroperitoneal laparoscopic ureterolithotomy. We compared the operative time, complications, and surgical outcomes, retrospectively.

Results

All patients were completed without conversion to conventional laparoscopic or open surgery. The operative time of the LESS group and of the conventional laparoscopic group were (125.3±12.8) minutes and (116.9±14.4) minutes, respectively (P=0.119). The intraoperative blood loss was (42.9±8.9) and (43.4±14.7) ml, respectively (P=0.914). Postoperative radiologic evaluation revealed that the stones had been removed completely. Cosmetic results were superior in the LESS group (P=0.001).

Conclusion

Retroperitoneal LESS ureterolithotomy using a homemade single-port device can be considered a feasible and safe alternative to conventional laparoscopic ureterolithotomy.
Retrospective epidemiological study of thyroid nodules by ultrasound in asymptomatic subjects
Authors: Sharen Gaowa , Zhang Bo , Zhao Ruina , Sun Jie , Gai Xiaorong , Lou Huiping
Published: January 2024

Background

The purpose of this study was to conduct thyroid ultrasound examinations on a large sample of subjects and explore the occurrence, distribution, and characteristics of thyroid nodules and thyroid cancer to provide some information on the epidemic trend of thyroid nodules and cancer.

Methods

The thyroid ultrasonic examination results of 19 895 healthy physical examinees who visited the Department of Health Management, Peking Union Medical College Hospital from January 2009 to December 2011 were analyzed retrospectively to determine the detection rate and characteristics of thyroid nodules. Fine needle aspiration or surgical resection was suggested to subjects suspected of having thyroid cancer.

Results

The detection rate of thyroid nodules was 42.6% (8 480/19 895), 40.0% (4 661/11 678) in men and 46.5% (3 819/8 217) in women. The detection rate noticeably increased with increasing age. The detection rate of thyroid nodules by palpation was obviously lower than by ultrasonic examination in various age groups. Among those with thyroid nodules, 61.3% were multiple and 38.7% were solitary; multiple nodule was the major type both in men and women. Twenty-nine cases of malignant nodules were solitary, and 30 cases of malignant nodules were multiple. There was no significant difference. The detection rate of thyroid cancer was 0.30% for the entire group of examinees, and 0.15% in men and 0.50% in women. Among all sex and age groups, 30- to 40-year-old women had the highest detection rate (0.76%). The detection rate of thyroid nodules correlated with age, systolic blood pressure, height, and weight. Increasing age and/or higher systolic blood pressure correlated with a higher detection rate, while smaller height and weight also correlated with a higher detection rate with significant differences. However, there were no significant correlations between the detection rate and diastolic blood pressure or body mass index.

Conclusions

The detection of thyroid cancer increased significantly, especially in women. Thus, precautions needed to be taken. Regular physical examination and timely intervention after detection of malignant nodules are critical to improve the prognosis in thyroid cancer patients.
Dynamic changes in hair cell ribbon synapse induced by loss of spiral ganglion neurons in mice
Authors: Yuan Yasheng , Chi Fanglu
Published: January 2024

Background

Previous studies have suggested that primary degeneration of hair cells causes secondary degeneration of spiral ganglion neurons (SGNs), but the effect of SGN degeneration on hair cells has not been studied. In the adult mouse inner ear ouabain can selectively and permanently induce the degeneration of type 1 SGNs while leaving type 2 SGNs, efferent fibers, and sensory hair cells relatively intact. This study aimed to investigate the dynamic changes in hair cell ribbon synapse induced by loss of SGNs using ouabain application to the round window niche of adult mice.

Methods

In the analysis, 24 CBA/CAJ mice aged 8-10 weeks, were used, of which 6 normal mice were used as the control group. After ouabain application in the round window niche 6 times in an hour, ABR threshold shifts at least 30 dB in the three experimental groups which had six mice for 1-week group, six for 1-month group, and six for 3-month group. All 24 animals underwent function test at 1 week and then immunostaining at 1 week, 1 month, and 3 months.

Results

The loss of neurons was followed by degeneration of postsynaptic specializations at the afferent synapse with hair cells. One week after ouabain treatment, the nerve endings of type 1 SGNs and postsynaptic densities, as measured by Na/K ATPase and PSD-95, were affected but not entirely missing, but their partial loss had consequences for synaptic ribbons that form the presynaptic specialization at the synapse between hair cells and primary afferent neurons. Ribbon numbers in inner hair cells decreased (some of them broken and the ribbon number much decreased), and the arrangement of the synaptic ribbons had undergone a dynamic reorganization: ribbons with or without associated postsynaptic densities moved from their normal location in the basal membrane of the cell to a more apical location and the neural endings alone were also found at more apical locations without associated ribbons. After 1 month, when the neural postsynaptic densities had completed their degeneration, most ribbons were lost and the remaining ribbons had no contact with postsynaptic densities; after 3 months, the ribbon synapses were gone except for an occasional remnant of a CtBP2-positive vesicle. Hair cells were intact other than the loss of ribbons (based on immunohistochemistry and DPOAE).

Conclusion

These findings define the effect of SGN loss on the precise spatiotemporal size and location of ribbons and the time course of synaptic degeneration and provide a model for studying plasticity and regeneration.
Genetic analysis of a congenital nephrogenic diabetes insipidus pedigree
Authors: Shen Yunfeng , Lai Xiaoyang , Xiao Xinlan , Li Jing , Yu Rong , Gao Hui , Zhang Meiying
Published: January 2024

Background

As an X-linked recessive way, arginine vasopressin receptor 2 (AVPR2) gene mutation resulted in a hereditary disease — congenital nephrogenic diabetes insipidus (CNDI). We found a suspect clinical CNDI pedigree. In order to identify the genetic etiology, we performed the genetic analysis.

Methods

The clinical features of the proband and his family members were recorded. The laboratory tests and imaging inspections were analyzed. The water deprivation and pituitrin loading test were performed in the proband and his brother. The genomic DNA of all the members of the pedigree was extracted and then PCR amplification on AVPR2 gene was carried out. Sequencing in both directions was performed to identify mutation on AVPR2 gene.

Results

Both the proband and his brother were diagnosed as CNDI, meanwhile the other members of this pedigree were normal. No severe biochemical abnormality was found in the two CNDI patients. Both the patients had moderate urinary retention, severe megaloureter and hydronephrosis, and mild renal insufficiency. Two mutations of AVPR2 gene were discovered in the 3rd exon in the patients, a silent mutation L309L and a nonsense mutation R337X. The AVPR2 gene R337X mutation was co-segregated with CNDI. R337X mutation was not a reported mutation in the mainland of China.

Conclusion

The AVPR2 gene R337X mutation was also a genetic etiology of CNDI patients in the mainland of China.
Perioperative outcomes of laparoscopic versus open splenectomy for nontraumatic diseases: a meta-analysis
Authors: Jiang Chen , Rui Ma , Shouzhang Yang , Shuang Lin , Shilin He , Xiujun Cai
Published: January 2024

Background

Surgical treatment has become the standard treatment for nontraumatic diseases of the spleen. This meta-analysis compared the relative merits of laparoscopic splenectomy (LS) with open splenectomy (OS) for nontraumatic splenic diseases.

Methods

A literature search was performed to identify studies comparing perioperative outcomes in patients who underwent LS or OS for nontraumatic diseases. Pooled odds ratios (ORs) and weighted mean differences (WMD) with 95% confidence intervals (CIs) were calculated using a fixed- or random-effects model.

Results

Thirty-five studies matched the selection criteria. Of the 7 269 patients included 3 981 underwent LS and 3 288 underwent OS for nontraumatic diseases. OS was associated with shorter operation time (WMD=42.65, 95%CI: 25.58-59.73), whereas LS was associated with reduced operative blood loss (WMD=-133.95, 95%CI: -229.02 to -38.88), need for blood transfusion requirement (OR=0.53, 95%CI: 0.39-0.72), overall postoperative morbidity rate (OR=0.44, 95%CI: 0.38-0.51), postoperative mortality rate (OR=0.38, 95%CI: 0.24-0.59), and length of hospital stay (WMD = -2.73, 95%CI: -3.34 to -2.12).

Conclusions

LS is superior to OS for nontraumatic diseases, with reduced operative blood loss, need for blood transfusion, postoperative morbidity and mortality rates, and length of hospital stay, although OS is associated with reduced operation time. LS may be a good alternative to OS for patients with nontraumatic splenic diseases.
Anti-inflammatory effects of a synthetic peptide derived from pigment epithelium-derived factor on H2O2-induced corneal injury in vitro
Authors: Yi Lu , Jia Feng , Lili Yang , Hongfeng Tang , Ji Jin , Xun Xu
Published: January 2024

Background

The common pathological characteristics of corneal injury include inflammatory factors activation, vascular endothelial cells or inflammatory cells infiltration into lesions, corneal edema, corneal neovascularization (CNV), and scar formation. PEDF-34 is the functional fragment of pigment epithelium-derived factor (PEDF) that has anti-angiogenic and anti-inflammatory properties and contains an N-terminal 34-amino acid peptide. This study was to investigate the antiinflammatory effects of PEDF-34 on H2O2-induced corneal injuryin vitro.

Methods

After cultured in H2O2(0.1 mmol/L) for 2 hours, human corneal fibroblasts (HCFs) and human umbilical vein endothelial cells (HUVECs) were treated with PEDF-34-nanoparticles (NPs) at different concentrations (0.1, 0.5, 1.0, 2.0 μg/ml) or 2.0 μg/ml control-NPs for 24 hours. The viable cells were quantified using the MTT assay. Western blotting or ELISA analysis was performed for measuring the human vascular endothelial growth factor (VEGF) and intercellular adhesion molecule-1 (ICAM-1) expression of both HCFs and HUVECs. VEGF and nuclear factor κB (NF-κB) mRNA levels of HCFs were semi-quantified by RT-PCR.

Results

The survival rates of HCFs or HUVECs stimulated by H2O2did not decrease significantly (P>0.05) compared to those in the normal conditions. As compared to control-NP group, PEDF-34-NPs had dose-dependent inhibitive effect on HUVECs with the MTT assay, but not HCFs. Western blotting analysis showed that the VEGF and ICAM-1 levels in the HCFs and HUVECs stimulated by H2O2were significantly higher than those in the normal conditions, which were decreased dramatically in those treated with PEDF-34-NPs. RT-PCR analysis revealed that the VEGF mRNA and NF-κB mRNA levels increased in H2O2-stimulated HCFs, while both of them decreased in PEDF-34-NP groups dose dependently.

Conclusions

PEDF-34-NPs may play an important role in regulating the NF-κB pathway, inhibiting inflammatory activity. PEDF-34-NPs may be a potential new drug for treating corneal injury in the future.
Interleukin-32, not reduced by salmeterol/fluticasone propionate in smokers with chronic obstructive pulmonary disease
Authors: Du Yipeng , Wang Wei , Yang Wei , He Bei
Published: January 2024

Background

The interleukin (IL)-32/tumor necrosis factor (TNF) α pathway is supposed to play a key role in the amplification of the immune response in chronic obstructive pulmonary disease (COPD) inflammation. Inhaled corticosteroids (ICS) in combination with long-acting β2-agonists (LABA) have shown airway anti-inflammatory effects in recent studies, but the mechanism is still uncertain.

Methods

Patients were treated in a randomized, open-labeled, parallel group clinical trial with either a combination of salmeterol xinafoate/fluticasone propionate (SF; Seretide, GlaxoSmithKline) Diskus (50/500 μg twice daily) or ipratropium bromide/salbutamol (IS; Combivent, Boehringer Ingelheim) MDI (42 μg/240 μg quartic daily) for 12 weeks. At the start and the end of treatment, induced sputum was collected and the concentration of IL-32 and TNF-α, the number of neutrophils and eosinophils were measured.

Results

Following 12 weeks of treatment, a statistically significant fall from baseline in the concentration of TNF-α in sputum (P=0.004) was seen after treatment with SF but not with IS. However, neither treatment had significant effects on the concentration of IL-32 in sputum. There was a decrease from baseline in the number of sputum neutrophils with SF that approached statistical significance (P=0.028) but not with IS, while the number of sputum eosinophils did not change significantly from baseline in either treatment group. There was a statistically significant decline from baseline in the quality of life as assessed by the St George’s respiratory questionnaire in both the SF (P=0.004) and IS (P=0.030) treatment groups, but no evidence of improvement in lung function was observed in either group.

Conclusion

The sputum TNF-α and neutrophils, but not IL-32 and macrophages, could be reduced by ICS/LABA treatment, suggesting that IL-32 could be involved in the corticosteroid resistance of COPD inflammation.
Association of polymorphisms in the vascular endothelial growth factor gene and its serum levels with diabetic retinopathy in Chinese patients with type 2 diabetes: A cross-sectional study
Authors: Fan Xiaohong , Wu Qunhong , Li Yuan , Hao Yanhua , Ning Ning , Kang Zheng , Cui Yu , Liu Ruohong , Han Liyuan
Published: January 2024

Background

Vascular endothelial growth factor (VEGF) is a major mediator of angiogenesis, and plays a key role in the pathogenesis of diabetic retinopathy (DR). This study was designed to identify the possible role of VEGF gene polymorphisms in the development of DR in type 2 diabetic patients in Chinese and clarify the relationship between VEGF serum levels and the risk of DR.

Methods

This cross-sectional study included 1 040 Chinese subjects with type 2 diabetes mellitus. There were 372 patients diagnosed with DR in the case group and 668 patients without DR in the control group. DNA from each patient was analyzed for VEGF polymorphisms of -2578A/C (rs699947), -1154G/A (rs1570360), -460C/T (rs833061), +405C/G (rs2010963), and +936C/T (rs3025039) using MassARRAY compact analyzer. The VEGF serum levels were quantified by enzyme-linked immunosorbent assay (ELISA).

Results

No evidence of association was observed between -2578 A/C (rs699947), +405C/G (rs2010963), +936C/T (rs3025039), and DR risk under stringent Bonferroni's correction. However, VEGF serum levels were significantly higher in DR patients than those of control group. The genetic variation of VEGF polymorphisms influenced VEGF serum levels; subjects carrying the VEGF -2578 C/C (rs699947) genotype had greater VEGF serum levels than those carrying the C/A genotype and VEGF serum levels were significantly higher in CC genotype of the +405C/G (rs2010963) compared with those of the other genotypes.

Conclusions

The data did not suggest significant association between the VEGF polymorphisms and DR risk under stringent Bonferroni's correction. However, our study indicated that DR patients have higher VEGF levels than diabetic patients without retinopathy, and -2578A/C (rs699947) and +405C/G (rs2010963) may be important factors in determining serum VEGF levels.
Analysis of operation-related complications of totally laparoscopic aortoiliac surgery
Authors: Qi Lixing , Gu Yongquan , Guo Lianrui , Li Xuefeng , Wu Yingfeng , Cui Shijun , Tong Zhu , Wu Xin , Guo Jianming , Zhang Jian , Wang Zhonggao
Published: January 2024

Background

Totally laparoscopic aortoiliac surgery has been newly developed in China. It is known as the most complex laparoscopic technique to learn because of its high-risk procedures. Analysis of the operation-related complications of this surgery is supposed to be helpful for the early success of this technique.

Methods

Twelve male patients (56–70 years old) with aortoiliac occlusive disease underwent totally laparoscopic aortoiliac bypass surgery (TLABS) in our institute. Clinical data and operation-related complications were retrospectively analyzed.

Results

Of the 12 patients, TLABS succeeded in nine and conversion to open surgery occurred in three. One of the converted patients finally died of pulmonary infection. Operation-related complications included bleeding from arterial injury, perforation from colonic injury, graft embolism, residual aortic stenosis, and hydronephrosis. Bleeding in two patients and colonic perforation in one patient resulted in three conversions to open surgery. Intraoperative graft embolectomy and postoperative aortic stenting were performed to resolve the thrombus/embolus-referring complications. Left hydronephrosis, which was thought to result from intraoperative injury and treated with ureteric intubation drainage, recovered 6 months after TLABS.

Conclusions

Good understanding and avoidance of operation-related complications are important to guarantee the technical success of TLABS. Immediate conversion to open surgery is necessary for saving the patient's life in case of life-threatening complications.