bluuebunny/crossref_metadata_2025 huggingface dataset:
Catestatin could ameliorate proliferating changes of target organs in spontaneously hypertensive rats
Authors: LIU Ran , SUN Ning-ling , YANG Song-na , GUO Jian-qiang
Published: January 2024

Background

Catestatin, a chromogranin A-derived peptide, is a potent antagonist of nicotine-evoked catecholamine release. We know that catecholamine plays an important role in cardiovascular remodeling induced by hypertension, therefore we hypothesized that catestatin would affect target-organ structure during hypertension.

Methods

Twelve spontaneously hypertensive rats (SHRs) were randomized to SHR control group and catestatin group, the normal control group was comprised of six healthy Wistar-Kyoto rats of the same age. Tail-cuff blood pressure and pulse rate were obtained at weeks 1, 4 and 8. At the end of the eight-week period, the heart, abdominal aorta and left kidney were excised and weighed, VG staining was done and the intima-media thickness of vessels and the collagen volume fraction were assessed by an image acquisition and analysis system. The proliferating cell nuclear antigen (PCNA) was observed by immunohistochemistry, and real time reverse transcription-polymerase chain reaction (RT-PCR) was used to detect the mRNA levels of proliferative genes including cyclin A, ki67 and PCNA in the abdominal aorta.

Results

All the parameters in SHR observed in the present study increased significantly compared to Wistar Kyoto rats (P <0.01). With intervention with catestatin, the systolic blood pressure decreased slightly but it was not significantly different from the SHR control, the cardiac mass index and left ventricular mass index both decreased significantly, the collagen volume fraction decreased by nearly 30% in the heart, by 25% in vessels and by 10% in the kidney, and the intima-media thickness and expression of proliferative genes, including cyclin A, ki67 and PCNA, in the abdominal aorta also decreased significantly.

Conclusions

The present study indicated that catestatin could ameliorate proliferating changes of heart, kidney and vessels during hypertension, especially to the deposition of interstitial collagen. Blood pressure was not the main factor to mediate this effect, which suggested that catestatin could become a novel protective factor for hypertensive target organs.
Perioperative and long-term outcome of thymectomy for myasthenia gravis: comparison of surgical approaches and prognostic analysis
Authors: LIU Cheng-wu , LUO Meng , MEI Jian-dong , ZHU Yun-ke , PU Qiang , MA Lin , CHE Guo-wei , LIN Yi-dan , WU Zhu , WANG Yun , KOU Ying-li , LIU Lun-xu
Published: January 2024

Background

Thymectomy is an established treatment for myasthenia gravis (MG), and video-assisted thoracoscopic surgery (VATS) thymectomy has become an acceptable surgical procedure. This study aimed to compare the results of VATS thymectomy and open thymectomy and to identify the prognostic factors after thymectomy.

Methods

The clinical data of 187 consecutive thymectomies performed between July 2000 and December 2009 were retrospectively reviewed; 75 open thymectomies and 112 VATS thymectomies. Clinical efficacy and variables influencing outcome were assessed by Kaplan-Meier survival curves and Cox proportional hazards regression analysis.

Results

The operative blood loss in the VATS group was significantly less than that in the open group ((62.14±55.43) ml vs. (137.87±165.25) ml, P <0.05). The postoperative crisis rate increased with the severity of preoperative MG and the prescription dose of anticholinesterase. Complete follow-up information of patients more than 12 months after the thymectomy was obtained on 151 cases, 89 cases from the VATS group and 62 cases from the open group, with a mean follow-up period of 59.3 months, range from 12 to 117 months. Complete stable remission (CSR) was the end point for evaluation of the treatment results. The overall five-year CSR rate was 57.5%. Two good prognostic factors were identified; preoperative prescription of anticholinesterase alone (P=0.035) and non-thymomatous MG (P=0.003). The five-year CSR rate of the ocular type of MG reached a high level of 67.4%.

Conclusions

Thymectomy can achieve good long-term CSR in MG, and VATS is an ideal alternative method. High-dose prescription of anticholinesterase and the advanced stage by Myasthenia Gravis Foundation of America (MGFA) classification have higher risks of postoperative crisis. Preoperative prescription of anticholinesterase alone and non-thymomatous MG are good prognostic factors. Thymectomy should also be considered for the ocular type of MG.
Perioperative factors related to prognosis of regular hepatectomy in comparison with irregular hepatectomy
Authors: Feng Zhiqiang , Li Hongqi , Zhang Jinqian , Xu Lining , Xiao Mei , Huang Zhiqiang , Zhang Hongyi
Published: January 2024

Background

The aim of this research was to analyze the perioperative factors of regular hepatectomy and irregular hepatectomy. The superiority of the clinical application of the two methods was compared in the perioperative period.

Methods

From 1986 to 2011, 1798 patients underwent consecutive liver resections with regular hepatectomy and irregular hepatectomy at the Air Force General Hospital of People's Liberation Army and the General Hospital of Chinese People's Liberation Army. Their medical documentation was investigated retrospectively.

Results

In patients on whom regular hepatectomy and irregular hepatectomy were performed, there was no significant difference in perioperative blood loss, complications, in-hospital mortality, hospital stay, and so on. But in regular hepatectomy, operating time was an independent risk factor (P <0.001, OR=1.004).

Conclusions

There was no significant difference between the perioperative risk of regular hepatectomy and that of irregular hepatectomy.
Dual-energy computed tomography angiography for evaluating the renal vascular variants
Authors: TAO Xiao-feng , ZHU Jing-qi , WU Ying-wei , TANG Guang-yu , SHI Yu-zhen , ZHANG Lei , LIN Yi , WANG Zhong-qiu
Published: January 2024

Background

Recognizing renal vascular variants preoperatively is important in order to avoid vascular complications during surgery. This study aimed to investigate the renal vascular variants with dual-energy computed tomography (DECT) angiography to provide valuable information for surgery.

Methods

A total of 378 patients underwent DECT. The number, size, course and relationships of the renal vessels were retrospectively observed from the scans. Anomalies of renal arteries and veins were recorded and classified. Multiplanar reformations (MPR), maximum intensity projections (MIP), and volume renderings (VR) were used for analysis.

Results

In 378 patients (756 kidneys), renal artery variations were discovered and recorded in 123 kidneys (16.3%, 123/756) of 106 patients (28.0%, 106/378). Type IB (early branches of the only one main renal artery) and IC (accessory renal artery with only one main renal artery) were found most frequently with an incidence of 11.4% (43/378) and 14.5% (55/378). The incidence of renal artery variations in the left kidney was not statistically different than in the right kidney (12.4% vs. 11.1%). The incidence of renal vein variations was detected in 104 patients (27.5%, 104/378). The incidence of venous variants in the right kidney was higher than in the left kidney (20.1% vs. 7.4%), but left renal vein variations were more complex. Variants of the left renal vein were detected in 28 patients including type 1 (circumaortic left renal vein) in eight cases, type 2 (retroaortic left renal vein) in seven cases, type 3 (abnormal reflux) in six cases, type 4 (late venous confluence of left renal vein) in five cases, and type 5 (rare type) in two cases. The frequency of left renal vein variation associated with the left renal accessory artery was significantly higher than with early branches of the left renal artery (P=0.037).

Conclusions

The renal vascular variants are rather common and complex. DECT angiography can demonstrate the precise anatomy of the renal vessels, which is a benefit for renal transplantation or other renal operations
Screening for Parkinson syndrome in a Chinese rural population: re-examination of a historic questionnaire
Authors: LIU Ying , FAN Jin-hu , CHEN Wen , NIE Zhi-yu , QIAO You-lin , ZHANG Lin
Published: January 2024

Background

Standardized screening tools for Parkinson syndrome have not been developed for non-western populations. This study aimed to validate the Copiah County questionnaire (CCQ) as a screening instrument in a Chinese rural population.

Methods

All participants of a previously reported prevalent study were interviewed using CCQ. The participants who answered yes to at least one item on CCQ were defined as positive. The Parkinson's disease (PD) diagnosis was established using United Kingdom Parkinson's disease Brain Bank Clinical diagnosis criteria (UKPDBBC) and served as a gold standard to determine the sensitivity, specificity, and positive and negative predictive values (PPV, NPV) for the questionnaire.

Results

Among 16 130 participants, 2872 (17.8%) were screened positive for CCQ and 13 258 negative (82.2%). Among the 697 participants diagnosed as having Parkinson syndrome, 605 were positive for CCQ, and 92 were negative, leading to a sensitivity of 86.8%. Out of the 15 433 non-Parkinson syndrome participants, 13 166 were negative to CCQ, giving a specificity of 85.3%. Among the 2872 participants screened positive, 605 were diagnosed with Parkinson syndrome, and their PPV was 21.1%. For the 13 258 participants screened negative on CCQ, 92 were diagnosed with Parkinson syndrome and 13 166 did not have Parkinson syndrome, leading to a NPV of 99.3%.

Conclusions

CCQ appeared to have satisfactory statistical parameters to serve as a screening instrument for Parkinson syndrome in this rural Chinese population. Further studies may prove the utility of this short questionnaire in Parkinson syndrome screening among Chinese populations including those residing in rural areas.
An increased ratio of Th2/Treg cells in patients with moderate to severe asthma
Authors: SHI Yu-heng , SHI Guo-chao , WAN Huan-ying , AI Xiang-yan , ZHU Hai-xing , TANG Wei , MA Jia-yun , JIN Xiao-yan , ZHANG Bo-ying
Published: January 2024

Background

Recent studies have shown that T helper type-2 (Th2) cells can induce the apoptosis of CD4+CD25+ Treg cells or resist the immunosuppressive effect of Treg cells. We hypothesize that an imbalance of Th2/Treg is present in patients with allergic asthma.

Methods

Twenty-two patients with mild asthma, 17 patients with moderate to severe asthma, and 20 healthy donors were enrolled. All patients were allergic to house dust mites. The proportion of peripheral blood CD4+CD25+ Treg cells and Th2 cells were determined by flow cytometry. The concentration of interleukin (IL)-10, transforming growth factor (TGF)-β and IL-4 in plasma was determined by enzyme linked immunosorbent assay. In these subjects, peripheral blood mononuclear cells from 17 mild asthmatic patients, 13 moderate to severe asthmatic patients and 14 healthy donors were acquired and expression of forkhead box P3 (Foxp3) and GATA-3 mRNA was detected by reverse-transcriptase polymerase chain reaction.

Results

Compared with healthy donors and patients with mild asthma, the percent of CD4+CD25+ Treg cells and plasma IL-10 levels were decreased in patients with moderate to severe asthma. There were no significant differences in Foxp3 mRNA expression among three groups, but a downward trend seen among patients with asthma. However, the percent of Th2 cells, IL-4 levels and expression of GATA-3 mRNA was markedly higher in patients with mild and moderate to severe asthma than in the control group. The ratio of Th2/Treg and their cytokines was increased in allergic asthma, especially for moderate to severe asthma. The ratio of GATA-3/Foxp3 mRNA was also increased in allergic asthma. In patients with moderate to severe asthma, the percentage of peripheral blood Treg cells was negatively correlated to the percentage of Th2 cells and IL-4 levels.

Conclusions

The decline of CD4+CD25+ Treg cells in patients with moderate to severe asthma may play an important role in progress of the disease. Furthermore, the deficiency of CD4+CD25+ Treg cells was associated with the over-expression of Th2 response.
Epidemiology of opportunistic invasive fungal infections in China: review of literature
Authors: LIAO Yong , CHEN Min , Hartmann Thomas , YANG Rong-ya , LIAO Wan-qing
Published: January 2024

Objective

To summarize the recent findings on the epidemiology of medically important, opportunistic invasive fungal infections (IFIs) in China and discuss the relevant social, economical reasons and medical factors.

Data sources

We performed a comprehensive search of both English and Chinese literatures of opportunistic IFIs from China up to April 2012.

Study selection

Relevant literatures involving researches and cases/case series were identified, retrieved and reviewed.

Results The incidence of opportunistic IFIs in China was steadily increasing. The incidence and mortality of IFIs were different in patients with various underlying conditions/diseases, from 4.12% to 41.18% and 9.8% to 60.0%, respectively. Candida species, Aspergillus species and Cryptococcus neoformans species complex were the most frequent isolated pathogens. Other uncommon opportunistic IFIs were also been reported, including trichosporonosis, mucormycosis, hyalohyphomycosis (hyaline hyphomycetes) and phaeohyphomycosis (dematiaceous hyphomycetes). Reports of Chinese patients differed from those of many other countries as there were a higher number of patients without identifiable underlying diseases/conditions.

Conclusions

Because of the rapid economic development, changing population structure and a growing number of immunocompromised hosts with risk factors, today opportunistic IFIs in China have a significant impact on public health, associated with high morbidity/mortality and higher care costs. Now information related to the epidemiology of opportunistic IFIs in China is still sparse, so we need more organized groups of clinical scientists performing related researches to help the clinicians to obtain more accurate epidemiological characteristics.

Chin Med J 2013;126 (2): 361-368
Assessment of a five-color flow cytometric assay for verifying automated white blood cell differentials
Authors: HUANG Chun-mei , YU Lian-hui , PU Cheng-wei , WANG Xin , WANG Geng , SHEN Li-song , WANG Jian-zhong , CUI Wei
Published: January 2024

Background

White blood cell (WBC) counts and differentials performed using an automated cell counter typically require manual microscopic review. However, this last step is time consuming and requires experienced personnel. We evaluated the clinical efficiency of using flow cytometry (FCM) employing a six-antibody/five-color reagent for verifying automated WBC differentials.

Methods

A total of 56 apparently healthy samples were assessed using a five-color flow cytometer to verify the normal reference ranges of WBC differentials. WBC differentials of 622 samples were also determined using both a cell counter and FCM. These results were then confirmed using manual microscopic methods.

Results

The probabilities for all of the parameters of WBC differentials exceeded the corresponding normal reference ranges by no more than 7.5%. The resulting WBC differentials were well correlated between FCM and the cell counter (r >0.88, P <0.001), except in the case of basophils. Neutrophils, lymphocytes, and eosinophils were well correlated between FCM and standard microscopic cytology assessment (r >0.80, P <0.001). The sensitivities of FCM for identification of immature granulocytes and blast cells (72.03% and 22.22%, respectively) were higher than those of the cell counter method (44.92% and 11.11%, respectively). The specificities of FCM were all above 85%, substantially better than those of the cell counter method.

Conclusion

These five-color FCM assays could be applied to accurately verify abnormal results of automated assessment of WBC differentials.
Effect of topotecan on retinocytoma cell apoptosis and expression of Livin and PTEN
Authors: ZHANG Meng , SHAN Bao-en , YUAN Nai-fen , LIU Wei
Published: January 2024

Background

Retinocytoma (RB) is a very common intraocular malignant tumor during infancy. Chemotherapy has gradually been used as the first-line treatment for intraocular RB in recent years. In this study, Livin and PTEN expressions were observed in the RB tissue, along with the growth-inhibiting and apoptosis-induced effects of topotecan (TPT) on RB HXO-Rb44 cell strain. This study aimed to investigate the antigrowth effects of TPT on RB cell strain HXO-Rb44.

Methods

Max-Vision™ rapid immunohistochemistry was adopted to detect Livin and PTEN expressions in the normal retina and in RB, and their relationship with RB clinicopathologic features was analyzed. Human RB cell strain HXO-Rb44 was cultivated and passaged. MTT method was used to measure the survival rates of HXO-Rb44 cell strains under various TPT concentrations. IC50 values were calculated. Flow cytometry was used to detect the effects of various TPT concentrations on HXO-Rb44 cell apoptosis. Western blotting was used to detect the differences of Livin and PTEN protein expressions during cell apoptosis.

Results

The positive expressions of Livin and PTEN in the RB group were obviously different from those in the normal control group. In RB tissue, Livin expression was relevant to PTEN expression. TPT could significantly induce the occurrence of cell apoptosis and had a dependent relationship with drug concentration. Livin and PTEN expression levels varied with the extension of the effect time of TPT based on Western blotting analysis.

Conclusions

Livin and PTEN have high and low expression levels in the RB tissue, respectively. Both of them have key roles in RB occurrence and development. TPT could induce human RB cell strain HXO-Rb44 cell apoptosis, and its mechanism is associated with the inhibition of Livin and PTEN expressions.
Use of real-time polymerase chain reaction for the diagnosis of Pneumocystis pneumonia in immunocompromised patients: a meta-analysis
Authors: Summah Hanssa , Zhu Ying-gang , Falagas Matthew E , Vouloumanou Evridiki K , Qu Jie-ming
Published: January 2024

Background

The diagnosis of Pneumocystis pneumonia (PCP) in immunocompromised patients is still challenging today due to the absence of an in vitro culture system and the low diagnostic accuracy of microscopic examinations. Herein, we performed a meta-analysis to evaluate the accuracy of real-time polymerase chain reaction (PCR) in the diagnosis of PCP.

Methods

We searched Web of Knowledge and Medline from 1990 to May 2010 for studies reporting diagnostic accuracy data regarding the use of real-time PCR in the diagnosis of PCP in immunocompromised patients.

Results

Ten individual studies were included. Overall, the sensitivity of real-time PCR was 97% (95% CI: 93%-99%); the specificity was 94% (95% CI: 90%-96%). The area under the HSROC curve (95% CI) for real-time PCR was 0.99 (0.97-0.99). In a subgroup analysis regarding studies involving HIV patients among the study population, the sensitivity and specificity were 97% (95% CI: 93%-99%) and 93% (95% CI: 89%-96%), respectively. Regarding studies using Bronchoalveolar lavage (BAL) samples only: sensitivity =98% (95% CI: 94%-99%); specificity =93% (95% CI: 89%-96%), respectively. Regarding studies using microscopy as a reference standard: sensitivity =97% (95% CI: 92%-99%); specificity =93% (95% CI: 88%-96%). However, high between-study statistical heterogeneity was observed in all analyses.

Conclusions

Real-time PCR has a good diagnostic accuracy and may provide a useful adjunctive tool for the diagnosis of PCP in immunocompromised patients. Further studies are needed in order to identify any differences in the diagnostic performance of real-time PCR in HIV and non-HIV immunocompromised patients.
Hypertonic saline resuscitation contributes to early accumulation of circulating myeloid-derived suppressor cells in a rat model of hemorrhagic shock
Authors: LU Yuan-qiang , GU Lin-hui , ZHANG Qin , JIANG Jiu-kun , MOU Han-zhou
Published: January 2024

Background

Hemorrhagic shock is usually associated with complicated immune and inflammatory responses, which are sometimes crucial for the prognosis. As regulators of the immune and inflammatory system; proliferation, migration, distribution and activation of myeloid-derived suppressor cells (MDSCs) are intimately linked to the inflammation cascade.

Methods

In a model of severe hemorrhagic shock, thirty-five rats were randomly divided into control, sham, normal saline resuscitation (NS), hypertonic saline resuscitation (HTS), and hydroxyethyl starch resuscitation (HES), with seven in each group. MDSCs were analyzed by flow cytometric staining of CD11b/c+Gra+ in peripheral blood mononuclear cells (PBMC), spleen cell suspensions, and bone marrow nucleated cells (BMNC). Simultaneously, the expressions of arginase-1 (ARG-1) and inducible nitric oxide synthase (iNOS) mRNA in MDSCs were evaluated by quantitative reverse transcription-polymerase chain reaction (qRT-PCR).

Results

In the early stage after hemorrhagic shock, fluid resuscitation and emergency treatment, the MDSCs in the PBMC of NS, HTS and HES groups markedly increased, and MDSCs in BMNC of these groups decreased accordingly, significantly different to the control group. In hemorrhagic shock rats infused with HTS at the early resuscitation stage, MDSCs in PBMC increased about 2 and 4 folds, and MDSCs in BMNC decreased about 1.3 and 1.6 folds, as compared to the sham group respectively, with statistically significant difference. Furthermore, compared to the NS and HES groups, the MDSCs in PBMC of HTS group increased 1.6 and 1.8 folds with statistically significant differences; the MDSCs decrease in BMNC was not significant. However, there was no statistically significant difference in MDSCs of spleen among the five groups. In addition, compared to the control, sham, NS and HES groups, the ARG-1 and iNOS mRNA of MDSCs in PBMC, spleen and BMNC in the HTS group had the highest level of expression, but no statistically significant differences were noted.

Conclusions

In this model of rat with severe and controlled hemorrhagic shock, small volume resuscitation with HTS contributes to dramatically early migration and redistribution of MDSCs from bone marrow to peripheral circulation, compared to resuscitation with NS or HES.
Tactics used by HIV-1 to evade host innate, adaptive, and intrinsic immunities
Authors: LU Lu , YU Fei , DU Lan-ying , XU Wei , JIANG Shi-bo
Published: January 2024

Objective

To review the mechanisms by which HIV evades different components of the host immune system.

Data sources

This review is based on data obtained from published articles from 1991 to 2012. To perform the PubMed literature search, the following key words were input: HIV and immune evasion.

Study selection

Articles containing information related to HIV immune evasion were selected.

Results

Although HIV is able to induce vigorous antiviral immune responses, viral replication cannot be fully controlled, and neither pre-existing infected cells nor latent HIV infection can be completely eradicated. Like many other enveloped viruses, HIV can escape recognition by the innate and adaptive immune systems. Recent findings have demonstrated that HIV can also successfully evade host restriction factors, the components of intrinsic immune system, such as APOBEC3G (apolipoprotein B mRNA-editing enzyme, catalytic polypeptide-like 3G), TRIM5α (tripartite motif 5-α), tetherin, and SAMHD1 (SAM-domain HD-domain containing protein).

Conclusions

HIV immune evasion plays an important role in HIV pathogenesis. Fully understanding the tactics deployed by HIV to evade various components of the host immune systems will allow for the development of novel strategies aimed toward the prevention and cure of HIV/AIDS.
Volumetric magnetic resonance imaging classification for Alzheimer's disease based on kernel density estimation of local features
Authors: YAN Hao , WANG Hu , WANG Yong-hui , ZHANG Yu-mei
Published: January 2024

Background

The classification of Alzheimer's disease (AD) from magnetic resonance imaging (MRI) has been challenged by lack of effective and reliable biomarkers due to inter-subject variability. This article presents a classification method for AD based on kernel density estimation (KDE) of local features.

Methods

First, a large number of local features were extracted from stable image blobs to represent various anatomical patterns for potential effective biomarkers. Based on distinctive descriptors and locations, the local features were robustly clustered to identify correspondences of the same underlying patterns. Then, the KDE was used to estimate distribution parameters of the correspondences by weighting contributions according to their distances. Thus, biomarkers could be reliably quantified by reducing the effects of further away correspondences which were more likely noises from inter-subject variability. Finally, the Bayes classifier was applied on the distribution parameters for the classification of AD.

Results

Experiments were performed on different divisions of a publicly available database to investigate the accuracy and the effects of age and AD severity. Our method achieved an equal error classification rate of 0.85 for subject aged 60-80 years exhibiting mild AD and outperformed a recent local feature-based work regardless of both effects.

Conclusions

We proposed a volumetric brain MRI classification method for neurodegenerative disease based on statistics of local features using KDE. The method may be potentially useful for the computer-aided diagnosis in clinical settings.
Factors potentially affecting the function of kidney grafts
Authors: LIN Jun , ZHENG Xin , XIE Ze-lin , SUN Wen , ZHANG Lei , TIAN Ye , GUO Yu-wen
Published: January 2024

Background

Donor and recipient risk factors on graft function have been well characterized. The contribution of demographic factors, such as age, gender, and other potential factors of donor and recipient at the time of transplantation on the function of a graft is much less well understood. In this study, we analyzed the effects of factors such as age, gender, etc., on the short-term and long-term graft function in kidney transplant recipients from living donor.

Methods

A total of 335 living donors and their recipients, who had kidney transplantation in our center from May 2004 to December 2009, were included. Serum creatinine level was used as the assessment criterion (serum creatinine level lower than 115 mmol/L is normal). Factors related to graft function such as age, gender, blood relation by consanguinity, human leukocyte antigen (HLA) mismatch, ABO type, etc., were analyzed separately.

Results

Donor age is the key factor affecting both the short-term and long-term function of a grafted kidney from a living donor. The group with donors younger than 48 years showed the best kidney function post transplantation. Match of gender and age is another important factor that influences the function of grafted kidney from a living donor. The older donor to younger recipient group had the worst outcome after kidney transplantation. After 36 months post transplantation, female donor to male recipient group had worse kidney function compared to other groups. We also found that calcinerin inhibitor used in the maintenance period may influence the function of a grafted kidney. No significant statistical differences were found in consanguinity, blood type, and mismatch of HLA.

Conclusions

Donor age is an important factor affecting the function of a grafted kidney from a living donor. We also recommend taking nephron, immunology factor, infection, and demographic information all into consideration when assessing the outcome of kidney transplantation.
A modified tricuspid valve annuloplasty technique for functional tricuspid regurgitation
Authors: WANG Jun , LI Zhi , ZHU Quan , WU Yan-hu , SHAO Yong-feng , QIN Jian-wei , CHEN Yi-jiang , CHEN Liang
Published: January 2024

Background

Functional tricuspid regurgitation often occurs in patients with concomitant left sided, valve disease. Several types of tricuspid valve annuloplasty have been described, but there is no consensus on the management of functional tricuspid regurgitation. We report a modified annuloplasty technique and compare its efficacy with the conventional Kay technique.

Methods

A retrospective review was made of 60 patients who received tricuspid valve annuloplasty (group A, modified method; group B, Kay technique) and the early and midterm outcomes of modified method and Kay technique were compared.

Results

Three patients underwent ring annuloplasty using a semirigid Carpentier-Edwards ring due to failing suture annuloplasty. All patients were completely cured when they left the hospital. The follow-up time was (32±7) months in group A and (30±7) months in group B. After three years, tricuspid regurgitation decreased by more than two grades in 13 patients in group A and 11 in group B. The mean postoperative regurgitation grade in group A was lower than group B at 12, 24 and 36 months but not significantly. Three of 28 patients developed recurrent tricuspid regurgitation in group A and five of 26 patients in group B during the follow-up period (three deaths and three ring annuloplasties excluded). Freedom from recurrent tricuspid regurgitation in group A was higher than that group B at all follow-up points. Postoperative right atrium diameter, right ventricle endodiastolic dimension and tricuspid regurgitation area decreased obviously in both groups. The right ventricle endodiastolic dimension and tricuspid regurgitation area improved more significantly in group A than group B over three years of follow-up,

Conclusions

The modified annuloplasty technique achieved the same outcomes as the conventional Kay annuloplasty over the first three years postoperation. As this modified technique is simple and less expensive, it is another option for correction of functional tricuspid regurgitation.
Oral everolimus inhibits intimal proliferation in injured carotid artery in rats
Authors: Wang Xiao-fang , Shen De-liang , Zhao Xiao-yan , Ning Hong-jie , Feng Ri-sheng , Zhang Jin-ying
Published: January 2024

Background

Everolimus, a derivative of sirolimus, is a potent immunosuppressant that has important anti-proliferative properties. In the present study, we demonstrated the inhibiting neointimal hyperplasia in injured carotid arteries in rats by using two different doses of everolimus administrated via the oral route for a long time.

Methods

A rat model of carotid artery injury was established by balloon inflation. Eighty rats were randomly divided into the sham-operated group (n=20), injury group (n=20), low dosage of everolimus group (n=20), and high dosage of everolimus group (n=20). The low dose of everolimus (1.5 mg/kg) was given one day before injuring the carotid artery by balloon, followed by 0.75 mg/kg per day for 28 days via intragastric gavage. High dose everolimus (2.5 mg/kg) was given one day before injuring the carotid artery by balloon, followed by 1 mg/kg per day for 28 days. Expression of eukaryotic translation initiation factor 4E (eIF-4E) and phosphorylation of ribosomal protein S6 kinase 1 (P70S6K) were determined by reverse transcription-polymerase chain reaction and Western blotting analysis.

Results

In the injured carotid artery, neointimal hyperplasia was normally observed four weeks after injury. Everolimus inhibited neointimal hyperplasia after balloon injury in a dose dependent manner. At the same time, the study demonstrated that everolimus reduced the expression of P-P70S6K, eIF-4E, transforming growth factor (TGF)-β1 and of proliferating cell nuclear antigen (PCNA).

Conclusions

Everolimus significantly inhibited neointimal hyperplasia of the injured carotid artery. The effect depended on dosage and was associated with the reduction of phosphorylation of P70S6K and the eIF-4E expression level.
Chemotherapy with or without gefitinib in patients with advanced non-small-cell lung cancer: a meta-analysis of 6844 patients
Authors: ZHOU Hang , ZENG Chao , WANG Li-yang , XIE Hua , ZHOU Jin , DIAO Peng , YAO Wen-xiu , ZHAO Xin , WEI Yang
Published: January 2024

Background

Gefitinib is widely used in patients with advanced non-small-cell lung cancer (NSCLC), in whom chemotherapy had failed. Previous trials reported inconsistent findings regarding the efficacy of gefitinib on overall survival (OS) and progression free survival (PFS). This study was to evaluate the effects of chemotherapy plus gefitinib versus chemotherapy alone on survival of patients with NSCLC.

Methods

We systematically searched Medline, EmBase, the Cochrane Central Register of Controlled Trials, reference lists of articles, and proceedings of major meetings for relevant literature. Randomized controlled trials (RCTs) comparing chemotherapy with and without gefitinib in the treatment of patients with advanced NSCLC were included in our analysis. The primary endpoints were OS and PFS.

Results

Of 182 relevant studies, 12 were included in the final analysis, which consisted of 6844 patients with NSCLC. Overall, we noted that gefitinib therapy had an 8% improvement in the OS as compared to the gefitinib-free therapy, but this difference was not statistically significant (HR, 0.92; 95% CI: 0.85-1.00; P=0.051). Furthermore, gefitinib therapy had significantly longer PFS compared to gefitinib-free therapy (HR, 0.72; 95% CI 0.60-0.87, P=0.001). Patients receiving gefitinib therapy also had a more frequent objective response rate (ORR) than the control arm (OR, 2.51; 95% CI, 1.67-3.78, P <0.001). Rashes, diarrhea, dry skin, pruritus, paronychia, and abnormal hepatic function were more frequent in the gefitinib therapy group.

Conclusions

Treatment with gefitinib had a clear effect on PFS and ORR, and it might contribute considerably to the OS. Furthermore, there was some evidence of benefit for gefitinib therapy among patients with adenocarcinoma.
A finite element modeling of posterior atlantoaxial fixation and biomechanical analysis of C2 intralaminar screw fixation
Authors: Ma Xuexiao , Peng Xianbo , Xiang Hongfei , Zhang Yan , Zhang Guoqing , Chen Bohua
Published: January 2024

Background

The objective of this study was to use three-dimensional finite element (FE) models to analyze the stability and the biomechanics of two upper cervical fixation methods: the C2 intralaminar screw method and the C2 pedicle screw method.

Methods

From computed tomography images, a nonlinear three-dimensional FE model from C0 (occiput) to C3 was developed with anatomic detail. The C2 intralaminar screw and the C2 pedicle screw systems were added to the model, in parallel to establish the interlaminar model and the pedicle model. The two models were operated with all possible states of motion and physiological loads to simulate normal movement.

Results

Both the C2 intralaminar screw method and the C2 pedicle screw method significantly reduced motion compared with the intact model. There were no statistically significant differences between the two methods. The Von Mises stresses of the internal and external laminar walls were similar between the two methods. Stability was also similar.

Conclusions

The C2 intralaminar screw method can complement but cannot completely replace the C2 pedicle screw method. Clinicians would need to assess and decide which approach to adopt for the best therapeutic effect.
Transplantation of neural stem cells overexpressing glial cell line-derived neurotrophic factor enhances Akt and Erk1/2 signaling and neurogenesis in rats after stroke
Authors: YUAN Miao , WEN Sheng-jun , YANG Chao-xian , PANG Yuan-guang , GAO Xiao-qing , LIU Xiao-qing , HUANG Liang , YUAN Qiong-lan
Published: January 2024

Background

Our previous studies have indicated that the beneficial effects of grafting neural stem cells (NSCs) overexpressing glial cell line-derived neurotrophic factor (GDNF) in rats after stroke. However, the underlying mechanisms are highly debatable. In this study, we investigated whether neurogenesis, Akt, and extracellular signal-regulated kinase 1/2 (Erk1/2) signaling were involved in this process.

Methods

Transient ischemic stroke were induced by occluding middle cerebral artery for 2 hours and reperfusion. At 3 days after reperfusion, GDNF/NSCs, NSCs, and vehicle were administered. Immunohistochemical staining was used to evaluate neurogenesis by nestin antibody; phosphorylation of Akt and Erk1/2 was investigated by Western blotting analysis.

Results

Transplantation of GDNF/NSCs and NSCs significantly increased nestin-positive cells compared to control group (vehicle) from 1 to 7 weeks after reperfusion, and GDNF/NSCs showed stronger effect than NSCs at 2 and 3 weeks after reperfusion. Meanwhile, enhanced phosphorylation level of Erk1/2 was observed in the GDNF/NSCs and NSCs groups compared with control group, and phosphorylation level of Erk1/2 in GDNF/NSCs group was remarkably higher than that of NSCs group at any given time. In contrast, expression of mitogen-activated protein kinase phosphatase-1 (MKP-1), known as inhibitor of Erk1/2 signaling, was significantly decreased in the GDNF/NSCs and NSCs groups compared with the control group. Moreover, much enhanced and prolonged phosphorylation level of Akt of GDNF/NSCs group was detected compared with control and NSCs group.

Conclusion

Grafting GDNF/NSCs enhances neurogenesis and activates Akt and Erk1/2 signaling, that may provide the potential for GDNF/NSCs in stroke treatment.
Eye-movement study during visual search in Chinese children with developmental dyslexia
Authors: LI Xiu-Hong , JING Jin , YANG De-Sheng , WANG Hui , WANG Qing-Xiong , SONG Shan-Shan , FAN Fang
Published: January 2024

Background

Developmental dyslexia (DD) is a disorder in which children with normal intelligence and sensory abilities show learning deficits in reading. Abnormal eye movements have been found in DD. However, eye-movement abnormalities during visual search among Chinese children with DD remain unknown. We aimed to identify the eye-movement characteristics and search efficiency of Chinese children with DD during visual search for targets of different conceptual categories, under same-category conditions.

Methods

We compared 32 Chinese dyslexic children and 39 non-dyslexic children in visual search tasks, which were assessed using EyeLink II High-Speed Eye Tracker (SR Research Ltd., Canada). Letters, single Chinese characters, digits, Chinese phrases, figures and facial expressions were used as stimuli. Targets were similar to distractors in meaning, phonology and/or shape.

Results

A main effect of task on visual search scores and all eye-movement parameters were found. Search scores, average saccade amplitude and saccade distance were significantly smaller in the DD group than in the controls. An interaction between group and task was found for pupil diameter.

Conclusions

Unlike normal readers, children with DD had a reduction in the visual attention span and search accuracy. Besides, children with DD could not increase their mental workload with increase in task difficulty. The conceptual category of the stimulus materials significantly impacts search speed, accuracy and eye-movement parameters.
Screening for amblyopia among grade-1 students in primary school with uncorrected vision and stereopsis test in central China
Authors: FU Jing , LI Shi-ming , LI Jin-ling , LI Si-yuan , LIU Luo-ru , WANG Yang , LI He , ZHU Bi-dan , JI Ya-zhou , YANG Zhou , LI Lei , CHEN Wei , WANG Ning-li
Published: January 2024

Background

Screening for amblyopia at earliest is important for early treatment and better prognosis. This study aimed to evaluate the validity of uncorrected distant and near visual acuity (VA) and stereoacuity for screening amblyopia in grade-1 students in primary school in central China.

Methods

By stratified cluster sampling, 3112 grade-1 students from 11 Anyang primary schools were selected for the study. All the participants underwent uncorrected distant and near VA, stereopsis test, cycloplegic refraction, best corrected VA (BCVA), cover test, and ocular movement examination. VA was measured with a logarithm of the minimum angle of resolution (logMAR) chart. Stereoacuity was measured with the Lang II stereo card and TNO test. Amblyopia was defined as the BCVA less than or equal to 0.1 logMAR units of any eye in the absence of significant pathological abnormalities. The sensitivity, specificity, and positive and negative predictive value of uncorrected VA and stereoacuity for amblyopia were analyzed.

Results

Out of the 3112 eligible students, 2893 (92.96%) completed the examinations. The average age of the students was (7.10t0.41) years. Screened by distant VA with low cutoff (logMAR 0.1), high cutoff (logMAR 0.0), and near VA (logMAR 0.0), 31.64%, 73.18%, and 50.23% students were abnormal, respectively. Screened by stereopsis test, only 4.69% students were abnormal. Diagnosed by a senior pediatric ophthalmologist, 61 students had amblyopia. The sensitivities of distant VA with low/high cutoff and near VA were 92.31%, 100%, and 80.77%, respectively, whereas that of stereoacuity by TNO test was 15.38%. Simultaneous testing of either two of the three tests improved the sensitivity.

Conclusions

Distant VA test of high cutoff alone displays a high sensitivity but a low specificity. Simultaneous testing of distant VA of low cutoff and stereoacuity is a better choice to balance between sensitivity and specificity.
Efficacy and safety of a novel nano-porous polymer-free sirolimus-eluting stent in pigs
Authors: CHEN Ming , ZHENG Bo , WU Zheng , PENG Hong-yu , WANG Xin-gang , ZHANG bin , HUO Yong
Published: January 2024

Background

Drug-eluting stents represent a major advance in interventional cardiology. However, the current drug-eluting stents have significant limitations. One of the major problems is very late stent thrombosis, which is likely caused by inflammation and a hypersensitivity reaction related to a polymer on the stent. A polymer-free sirolimus-eluting stent with a unique nano-porous surface has been developed. This study aimed to evaluate this novel polymer-free sirolimus-eluting stent for its efficacy and safety in a pig model.

Methods

Stents were directly coated with sirolimus (a drug concentration of 2.2 μg/mm2 on the stent surface). The polymer-free sirolimus-eluting stents (PFSES) were compared to standard polymer-coated sirolimus-eluting stents (PCSES) and bare-metal stents (BMS) in 18 pigs.

Results

At one month the degree of neointimal hyperplasia was similar between the two sirolimus-eluting stent groups and was significantly less compared to BMS ((1.93±0.51) mm2, (1.57±0.69) mm2 vs. (4.45±1.05) mm2, P <0.05) At three months, PFSES maintained the low level of neointima ((2.41±0.99) mm2 vs. (4.32±1.16) mm2, P <0.05), whereas PCSES had developed significant neointimal proliferation similar to BMS. The inflammation level was significantly higher in PCSES when compared with BMS three months post-implantation (2.50±0.55 vs. 0.83±0.75, P <0.05) whereas PFSES showed a low level of inflammation comparable to PCSES (1.33±0.52 vs. 2.50±0.55, P <0.05).

Conclusion

The PFSES is effective and safe, and appears to be superior to standard PCSEs.
Retrograde approach for the recanalization of coronary chronic total occlusion: collateral selection and collateral related complication
Authors: Ma Jian-ying , Qian Ju-ying , Ge Lei , Fan Bing , Wang Qi-bing , Yan Yan , Zhang Feng , Yao Kang , Huang Dong , Ge Jun-bo
Published: January 2024

Background The retrograde approach through collaterals has been applied in the treatment of chronic total occlusion (CTO) lesions during percutaneous recanalization of coronary arteries. This study was to investigate the success rate of recanalization and collateral related complications in patients when using the retrograde approach.

Methods Eighty-four cases subjected to retrograde approach identified from July 2005 to July 2012 were included in this study. Patient characteristics, procedural outcomes and in-hospital clinical events were evaluated.

Results Mean age of the patient was (59.6±11.2) years old and 91.7% were men. The target CTO lesions were distributed among the left anterior descending artery in 45 cases (53.5%), left circumflex artery in one case (1.2%), right coronary artery in 34 cases (40.5%), and left main in four cases (4.8%). The overall success rate of recanalization was 79.8%. The septal collateral was three times more frequently used for retrograde access than the epicardial collateral, 68/84 (81%) vs. 16/84 (19%). Successful wire passage through the collateral channel was achieved in 58 (72.6%) patients. The success rate of recanalization was 93.1% (54/58) in patients with and 50% (13/26) in patients without successful retrograde wire passage of the collateral channel (P <0.01). Successful retrograde wire passage through the collaterals was achieved in 49 of 68 septal collaterals (72.1%) and in 9 of 16 epicardial collaterals (56.3%) (P=NS). There was no significant difference between the septal collateral group and the epicardial group in the success rate of recanalization after retrograde wire crossing the collaterals (91.8% vs. 100%, P >0.05). CART or reverse CART technique was used in 15 patients, and 14 patients (93.3%) were recanalized successfully. Collateral related perforation occurred in three (18.8%) cases with the epicardial collateral as the first choice (compared with the septal collateral group (0), P <0.01). There were 17 (20.2%) patients failure of recanalize the CTO lesions, among which 13 (15.5%) were due to the failure of retrograde wire crossing the collaterals.

Conclusions The retrograde approach is an effective technique to recanalize CTO lesions, the septal collateral was preferable. When the epicardial collateral is selected, careful manipulation of devices and wires is essential due to the potential risk of perforation of collateral channels.
Prevalence of chronic kidney disease and prediabetes and associated risk factors: a community-based screening in Zhuhai, Southern China
Authors: GU Dong-feng , SHI Yan-lin , CHEN You-ming , LIU Hong-mei , DING Ya-nan , LIU Xin-yu , LI Yong-qiang , SHAO Xiao-fei , LIANG Yan , CHEN Ying-shan , YUAN Zhi-yong , ZOU He-qun
Published: January 2024

Background

The prevalence of chronic kidney disease (CKD) and prediabetes has increased in China, and at different rates in different locations. Therefore a community-based screening research was conducted in order to determine the prevalence of CKD and prediabetes, and to analyze associated risk factors of CKD and prediabetes in a city of Southern China.

Methods

Atotal of 7801 community residents aged 18 year and older from 6 communities were screened by a stratified random cluster sampling method. An estimated glomerular filtration rate (eGFR), albuminuria, fasting plasma glucose (FPG), and homeostatic model assessment of insulin resistance (HOMA-IR) were measured. Age-standardized prevalence was calculated by the direct method with the use of data on the population distribution in China in 2006.

Multivariate logistic analysis was used to analyze the risk factors of CKD and prediabetes, and association of insulin resistance (IR) with CKD and prediabetes was analyzed.

Results

The age-standardized prevalence of CKD was 12.5%, eGFR <60 ml·min-1·1.73 m-2 was 2.7% and ACR (albumin to creatinine ratio) >30 mg/g was 10.3%. The age-standardized prevalence of prediabetes was 12.1%. Logistic regression suggests that IR was a common independent risk factor of CKD and prediabetes. Further analysis show that HOMA-IR was increased with the aggravation of kidney injury and FPG.

Conclusion

CKD and prediabetes have become a major public health problem in Zhuhai, Southern China; insulin resistance may be an important risk factor.