bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intracoronary nitroprusside in the prevention of the no-reflow phenomenon in acute myocardial infarction
Authors: PAN Wei , WANG Lan-feng , YU Jia-hui , FAN Ying , YANG Shu-sen , ZHOU Li-jun , LI Yue , LI Wei-min 
Published: January 2024

Background
No-reflow phenomenon during percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) is a predictive factor of continuous myocardial ischemia, ventricular remodeling and cardiac dysfunction, which is closely associated with a worse prognosis. This study aimed to evaluate intracoronary nitroprusside in the prevention of the no-reflow phenomenon in AMI.

Methods
Ninety-two consecutive patients with AMI, who underwent primary PCI within 12 hours of onset, were randomly assigned to 2 groups: intracoronary administration of nitroprusside (group A, n=46), intracoronary administration of nitroglycerin (group B, n=46). The angiographic results were observed. The real-time myocardial contrast echocardiography (RT-MCE), including contrast score index (CSI), wall motion score index (WMSI), transmural contrast defect length (CDL) and serious WM abnormal length (WML) were recorded at 24 hours and 1 week post-PCI.
High sensitivity C-reactive protein (Hs-CRP) was examined by immune rate nephelometry. N-terminal prohormone brain natriuretic peptide (NT-proBNP) was tested with enzyme-linked immunosorbent assay. Patients were followed up for six months. Major adverse cardiac events (MACE) were recorded.

Results
The incidence of final TIMI-3 flow in group A was much higher than that in Group B (P <0.05), final corrected TIMI frame count (cTFC) in group A decreased significantly than that in group B (P <0.01). The CSI, CDL/LV length, WMSI and WL/LV length in group A were significantly lower than that in group B (P <0.01). Levels of Hs-CRP and NT-proBNP at 1 week post-PCI decreased significantly in group A than that in group B (P <0.01). Patients were followed up for 6 months and the incidence of MACE in group A was significantly lower than that in group B (P <0.05).

Conclusion
Intracoronary nitroprusside can improve myocardial microcirculation, leading to the decrease of the incidence of no-reflow phenomenon and better prognosis.
Comparison of main lactobacillus species between healthy women and women with bacterial vaginosis
Authors: YAN Dong-hui , Zhi LÜ , SU Jian-rong 
Published: January 2024

Background
The normal microbial flora of the vagina plays an important role in preventing genital and urinary tract infections in women. Thus an accurate understanding of the composition and ecology of the ecosystem is important to understanding the etiology of these diseases. This study aimed to compare the characteristics of main lactobacillus species between healthy women and women with bacterial vaginosis (BV) by quantitative culture and PCR methods.
Main lactobacillus species include L. crispatus, L. gasseri, L. jensenii and L. iners.

Methods
A total of 150 Women attending Gynecology Outpatient Clinic of Beijing Friendship Hospital, were diagnosed as having BV because three or more of the following criteria were met (standard of Amsel's composite criteria): homogeneous discharge, elevated vaginal pH (pH >4.5), production of amines, and presence of “clue” cells. Those with less than three of the criteria were considered as healthy. Simultaneously, smears were made of vaginal fluid and Gram stained, then were assessed qualitatively as normal (grade I), intermediate (grade II), or consistent with BV (grade III).

Gardnerella vaginalis were identified by using Vitek 2 Compact and PCR methods. Lactobacillus species were identified by PCR methods. Gardnerella vaginalis and lactobacilli colony counts were determined by calculating the most number of colonies of each species in the appropriate plates (colonies between 10 and 300), corrected by the dilution of the sample in the plates, and multiplied by 10 (to account for plating 100 μl), in order to get colony forming units per milliliter of vaginal secretion.

Results
BV was diagnosed in 31% (46/150) patients using the composite criteria, the remainder being regarded as healthy. The majority of patients with BV had a smear assessed as grade III (91%, 42/46) and minority of them had a smear assessed as grade II (9%, 4/46). The majority of healthy women had a smear assessed as grade I (64%, 67/104).
Smears assessed as grade II were found (36%, 37/104) among patients diagnosed as healthy, with less than three of the composite criteria. L. crispatus was cultured from 94% of healthy women and 83% of women with BV, with the former colonies count average value of 106 and the latter of 103. L. gasseri, L. iners, and L. jensenii were cultured from 85%, 68% and 43% of healthy women; and 28%, 89% and 44% of BV women, respectively.

Conclusions
The quantities of four lactobacillus species except L. jensenii had a significant difference between healthy women and women with BV. Our results provide support for the negative association between L. iners and L. gasseri. Although L. crispatus were existent both in healthy and BV positive women's vagina, the numbers of L. crispatus were significantly different for the dominant number in healthy women. Smears of vaginal fluid and Gram stain play an important guiding role in bacteria culture.
Prognostic impact of splenectomy on advanced proximal gastric cancer with No. 10 lymph node metastasis
Authors: HUANG Chang-ming , WANG Jia-bin , LU Hui-shan , ZHENG Chao-hui , LI Ping , XIE Jian-wei , ZHANG Xiang-fu 
Published: January 2024

Background
This study evaluated the prognostic impact of D2 lymphadenectomy combined with splenectomy in patients with advanced proximal gastric cancer and lymph node metastasis at the splenic hilum (No. 10 lymph nodes).

Methods
The clinical records of 216 patients with advanced proximal gastric cancer and No. 10 lymph node metastasis who underwent D2 curative resection were retrospectively analyzed. Seventy-three patients underwent simultaneous splenectomy (splenectomy group), while 143 patients did not (spleen-preserving group). Five-year survival rates, mean numbers of dissected No. 10 lymph nodes and metastatic No. 10 lymph nodes, and operative morbidity and mortality were calculated and compared between the two groups. Potential prognostic factors were evaluated by univariate and multivariate analysis.

Results
The 5-year survival rate was 30.0% for the splenectomy group and 19.7% for the spleen-preserving group (χ2=14.73, P <0.05). The mean numbers of dissected No. 10 lymph nodes and metastatic No. 10 lymph nodes in the splenectomy group were significantly greater than in the spleen-preserving group (P <0.05). Multivariate analysis revealed that the depth of invasion, splenectomy, and type of gastrectomy were independent prognostic factors. The survival rate for T3 patients with and without splenectomy was 38.7% and 18.9%, respectively (χ2 =15.03, P <0.05). For patients undergoing total gastrectomy, survival rates were 33.4% and 20.7%, respectively (χ2 =13.63, P<0.05). Operative morbidity and mortality in splenectomy group was 24.7% and 4.1%, respectively, and in the spleen-preserving group was 17.5% and 3.5%, respectively. The differences were not statistically significant (P >0.05).

Conclusions
Splenectomy is beneficial for No. 10 lymph node dissection in patients with advanced proximal gastric cancer. To improve patient prognosis, total gastrectomy with splenectomy is recommended for patients with T3 proximal gastric cancer who have No. 10 lymph node metastasis.
Morphologic characteristics of late stent malapposition after drug-eluting stents implantation by optical coherence tomography follow-up
Authors: HOU Jing-bo , LIU Hui-min , MA Li-jia , YANG Shuang , MENG Ling-bo , HAN Zhi-gang , ZHANG Shuo , YU Bo 
Published: January 2024

Background
Late stent malapposition was frequently observed after DES implantation, which has been associated with the occurrence of late stent thrombosis due to poor neointimal coverage. This study was designed to evaluate the frequency of late stent malapposition at least 1 year after different DESs implantation by optical coherence tomography (OCT).

Methods
Angiographic and OCT examinations were given to 68 patients who had received total 126 various DESs implantation for at least 1 year to detect late stent malapposition. Malapposed strut distance (MSD), malapposed strut area (MSA), reference lumen area (RLA) and reference stent area (RSA) were checked with off-line OCT analysis.

Results
Totally 26 Cypher Select stents, 15 Taxus Liberte stents, 51 Partner stents and 34 Firebird I stents were examined. Among 68 patients who underwent DES implantation, 7 patients (10.3%) had late malapposition. Average RSA, MSA and MSD were (7.9±2.8) mm2,(2.0±1.6) mm2 and (590±270) μm respectively. According to the MSA/RSA ratio, 4 patients had slight malapposition, 2 patients had moderate malapposition and 1 patient had severe malapposition.

Conclusions
Late stent malapposition is detected frequently after implantation of DES, but if this predisposes to late stent thrombosis and requires any specific therapy needs to be further elucidated.
A multicenter, phase III trial of hemocoagulase Agkistrodon: hemostasis, coagulation, and safety in patients undergoing abdominal surgery
Authors: WEI Jun-min , ZHU Ming-wei , ZHANG Zhong-tao , JIA Zhen-geng , HE Xiao-dong , WAN Yuan-lian , WANG Shan , XIU Dian-rong , TANG Yun , LI Jie , XU Jing-yong , ZHENG Qing-shan 
Published: January 2024

Background
Hemocoagulase Agkistrodon for injection is a single component thrombin which has passed phases I and II clinical trials. The purpose of this phase III clinical trial was to evaluate the effect of Hemocoagulase Agkistrodon on hemostasis and coagulation in abdominal skin and subcutaneous incisions and to assess the safety of this agent in surgical patients.

Methods
This is a phase III, prospective, randomized, double-blind, and controlled multicenter clinical trial including 432 consecutive patients randomized into either a study group (injected with hemocoagulase Agkistrodon at 2 U, n=324) or a control group (injected with hemocoagulase Atrox, n=108). The hemostatic time, hemorrhagic volume, hemorrhagic volume per unit area, blood coagulation, and adverse events were measured and compared between the two groups.

Results
The mean hemostatic time in the study group was (36.8±18.7) seconds; the hemorrhagic volume was (3.77±3.93) g; and the hemorrhagic volume per unit area was (0.091±0.125) g/cm2. In the control group, the corresponding values were (38.1±19.7) seconds, (4.00±4.75) g, and (0.095±0.101) g/cm2, respectively. No significant difference in values existed between the two groups (P >0.05). Blood coagulation results and hepatic and renal function were also similar between the two groups. Adverse events were reported in two cases, but were deemed non-drug-related.

Conclusions
Hemocoagulase Agkistrodon has good hemostatic and coagulative function and is safe for the use of arresting capillary hemorrhage that occurs while incising the abdomen during surgery.
Prevalence, clinical characteristics and outcome in patients with chronic heart failure and diabetes
Authors: SHI Chuan , WANG Ling-jie , HU Dan-feng , LI Jin-ping , ZHU Tian-qi , SHAN Ying , ZHAO Jian-rong , ZHANG Feng-ru , SHEN Wei-feng 
Published: January 2024

Background
Chronic heart failure (CHF) and diabetes mellitus portend high morbidity and mortality because of an interrelated pathophysiologic process. This large cohort study aimed to analyze the prevalence, clinical characteristics and long-term outcome of patients with CHF and diabetes.

Methods
A total of 1119 patients with NYHA functional class II-IV and left ventricular ejection fraction (LVEF) <45% between January 1995 and May 2009 were recruited. Clinical variables, biochemical and echocardiographic measurements were retrospectively reviewed, and composite major cardiac events (MCE) including death, heart transplantation, and refractory heart failure requiring multiple hospitalizations were recorded.

Results
The prevalence of CHF with diabetes was progressively increased with time (16.9% in 1995-1999; 20.4% in 2000-2004, and 29.1% in 2005-2009) and age (18.5% in <60 years, 26.6% in 60-80 years, and 26.6% in >80 years). Compared with CHF patients without diabetes, those with diabetes had worse cardiac function, more abnormal biochemical changes, and higher mortality. Treatment with glucose-lowering agents significantly improved LVEF and decreased MCE. An elevated serum HbA1c level was associated with large left ventricular end-systolic diameter (P <0.05), decreased LVEF (P <0.01) and reduced survival (P <0.05). Multivariable Logistic regression analysis revealed that after adjustment for confounding factors, NYHA functional class (OR 2.65, 95% CI 1.14-6.16, P=0.024) and HbA1c level ≥7% (OR 2.78, 95% CI 1.00-7.68, P=0.049) were independent risk factors for adverse outcomes in CHF patients with diabetes.

Conclusions
Prevalence of CHF with diabetes was increasing during past decades, and patients with CHF and diabetes had worse clinical profiles and prognosis. Aggressive anti-CHF and diabetes therapies are needed to improve overall outcomes for these patients.
Differentially expressed genes identified by microarray analysis following leptin treatment of hepatic stellate cells
Authors: ZHONG Li-hua , CHENG Jun , ZHU Li-ying 
Published: January 2024

Background
Liver fibrosis is the process through which numerous chronic liver diseases develop into liver cirrhosis. Leptin can activate hepatic stellate cells (HSCs) and play an important role in the formation of liver fibrosis. However, the process by which leptin activates HSCs is complicated, and research on this process is limited. The aim of this study was to explore the related changes in gene expression and the control mechanisms involved in leptin activated HSCs to understand the overall mechanism of liver fibrosis development.

Methods
We cultivate rat HSCs, with and without stimulation by leptin, and extracted mRNA. Differentially expressed genes were detected by microarray analysis.

Results
The differentially expressed genes identified included six upregulated genes and six downregulated genes. The representative upregulated genes included short chain dehydrogenase (CY5/CY3=2.265) and pulmonary surfactant protein A1 (CY5/CY3=2.036). The significant downregulated gene encoded hepatic stearoyl coenzyme A desaturase 1 (SCD-1) (CY5/CY3=0.351).

Conclusion
Leptin might mediate the molecular biological mechanisms of liver fibrosis.
Up-regulation of the transient A-type K+ current (IA) in the differentiation of neural stem cells of the early postnatal rat hippocampus
Authors: GUO Hong-bo , HUANG Lian-yan , ZOU Yu-xi , ZOU Fei 
Published: January 2024

Background
Neural stem cells (NSCs) not only are essential to cell replacement therapy and transplantation in clinical settings, but also provide a unique model for the research into neurogenesis and epigenesis. However, little attention has been paid to the electrophysiological characterization of NSC development. This work aimed to identify whether the morphological neuronal differentiation process in NSCs included changes in the electrophysiological properties of transient A-type K+ currents (IA).

Methods
NSCs were isolated from early postnatal rat hippocampus and were multiplied in basic serum-free medium containing basic fibroblast growth factor. Potassium currents were investigated and compared using whole-cell patch-clamp techniques and one-way analysis of variance (ANOVA), respectively.

Results
Compared with NSC-derived neurons, cloned NSCs (cNSCs) had a more positive resting membrane potential, a higher input resistance, and a lower membrane capacitance. Part of cNSCs and NSC-derived neurons possessed both delayed-rectifier K+ currents (IDR) and IA, steady-state activation of IA in cNSCs (half-maximal activation at (21.34±4.37) mV) occurred at a more positive voltage than in NSC-derived neurons at 1–6 days in vitro (half-maximal activation at (12.85±4.19) mV).

Conclusions
Our research revealed a developmental up-regulation of the IA component during differentiation of postnatal NSCs. Together with the marked developmental up-regulation of IDR in vitro neuronal differentiation we have previously found, the voltage-gated potassium channels may participate in neuronal maturation process.

Chin Med J 2010;123(13):1731–1735
Current role of surgery for the treatment of fulminant Clostridium difficile colitis
Authors: WANG Ming-fei , DING Zhao , ZHAO Jian , JIANG Cong-qing , LIU Zhi-su , QIAN Qun 
Published: January 2024

Objective
This review discusses the current status and progress in studies on fulminant Clostridium difficile colitis (FCDC), including the definition, risk factor, diagnostic role of CT, surgical treatment, postoperative mortality, and new therapeutic strategy.

Data sources
A literature search was conducted mainly in Medline and PubMed published in English between January 2000 and May 2011. The search terms were “fulminant Clostridium difficile colitis”, “treatment””, “surgery” and “mortality”.

Results
Recent studies show that the overall mortality rate for FCDC remains high despite early surgical intervention. It has been difficult to identify the real value for surgical intervention in patients with FCDC due to the absence of prospective, randomized studies. Early recognition of patients with FCDC will help a clinician decide the need for treatment in an intensive care setting, multi-disciplinary consultation, and appropriate therapeutic selection. Some studies emphasize the importance of early recognition and emergent surgery at a less severe stage. Monoclonal antibody therapy and intravenous immunoglobulin treatment may be useful for the treatment of FCDC.

Conclusions
Present studies do not provide strong evidence for guiding the surgical treatment of FCDC; hence, creation of collaborative research networks is crucial in order to undertake large prospective multi-center studies for improvement in overall survival.
Spine surgery may cause more spinal epidural hematomas than spinal puncture
Authors: Jian-xiong AN , FANG Qi-wu , Sullivan Erin A. , Williams John P. 
Published: January 2024

Background
Spinal epidural hematoma (SEH) is a rare but acute and possibly devastating clinical event. The purpose of this study is to assess the multiple etiologies of SEH seen in an academic medical center over a 15-year span. We have examined the etiologies of SEH occurring in a single institution, the University of Pittsburgh Medical Center (UPMC) over the last fifteen years using an electronic record keeping system and database: the Medical Archive Retrieval System (MARS).

Methods
We screened MARS from 1986-2001 using key words: epidural, hematoma and spinal. All potential SEH cases were reviewed and only those confirmed by surgical intervention were identified as positive SEH and reported in this study.

Results
There were 17 cases of confirmed SEH. Among them, seven cases were from spontaneous bleeding, seven cases following spinal surgery, and three cases from traumatic spinal fracture. There were no findings of SEH that were related to spinal or epidural anesthesia. Among the seven patients with spontaneous SEH; two were receiving anti-coagulants for deep venous thrombosis (DVT) and had elevated prothrombin time (PT) and activated partial thromboplastine time (APTT), one had hemophilia (type B), four had hypertension, and three out of seven had chronic renal or liver disease. Among postoperative SEH patients, two of the seven patients were receiving chemotherapy and radiation therapy and one had ongoing hemodialysis for renal failure. Among three patients with traumatic SEH, two had ankylosing spondylitis. Six patients had a history of alcohol abuse.

Conclusions
Spontaneous bleeding is by far the leading cause of SEH with spinal surgery being the second leading cause. Patients with multiple co-morbidities that result in coagulopathy from a variety of causes include liver or renal disease, alcohol abuse, radiation therapy, or chemotherapy. Neuraxial anesthesia is an extremely rare cause of SEH.
Antagonism between gene therapy and epigenetic therapy on human laryngeal carcinoma tumor-bearing mice
Authors: LIAN Meng , WANG Qi , FANG Ju-gao , WANG Hong , FAN Er-zhong 
Published: January 2024

Background
Gene therapy and epigenetic therapy have gained more attention in cancer treatment. However, the effect of a combined treatment of gene therapy and epigenetic therapy on head and neck squamous cell carcinoma have not been studied yet. To study the mechanism and clinical application, human laryngeal carcinoma cell (Hep-2) tumor-bearing mice were used.

Methods
A xenograft tumor model was established by the subcutaneous inoculation of Hep-2 cells in the right armpit of BALB/c nu/nu mice. The mice with well-formed tumor were randomly divided into six groups. Multisite injections of rAd-p53 and/or 5-aza-dC were used to treat tumor. Tumor growth was monitored by measuring tumor volume and growth rate. p53 and E-cadherin protein levels in tumor tissues were detected by immunohistochemical staining. The mRNA levels were monitored with FQ-PCR.

Results
Gene therapy was much more effective than single epigenetic therapy and combined therapy. The gene therapy group has the lowest tumor growth rate and the highest expression levels of p53 and E-cadherin.

Conclusions
The combined treatment of gene and epigenetic therapy is not suggested for treating head and neck carcinoma, because gene therapy shows an antagonistic effect to epigenetic therapy. However, the mechanisms of action are still unclear.
Robotic stereotactic irradiation and reirradiation for spinal metastases: safety and efficacy assessment
Authors: Wang Qi , Song Yongchun , Zhuang Hongqing , Wang Xiaoguang , Li Fengtong , Dong Yang , Wang Jingsheng , Yuan Zhiyong 
Published: January 2024

Background
Spine is the most common site of bone metastases in patients with cancer. Conventional external beam radiotherapy lacks precision to allow delivery of large fraction radiation but simultaneously limit the dose to spinal cord. The purpose of this study was to evaluate the safety and efficacy of CyberKnife® radiation therapy for spinal metastases.

Methods
Seventy-three lesions in 62 patients treated with CyberKnife radiotherapy from September 2006 to June 2010 for spinal metastases were retrospectively reviewed. Thirteen tumors in 12 patients had received prior radiation. Patients were followed clinically and radiographically for at least 12 months or until death. In all patients, the spinal cord and thecal sac were contoured for dose-volume constraints, and maximum doses to 0.1, 0.5, 1, 2, and 5-ml volumes were analyzed.

Results
Using the CyberKnife System, 20-48 Gy in one to five fractions for unirradiated patients, and 21-38 Gy in one to five fractions for the previously irradiatied patients, were delivered. Median 2-Gy normalized Biological Equvalent Dose (nBED) of unirradiated targets and irradiated targets were 49.6 Gy10/2 (range, 31.25-74.8 Gy10/2) and 46.9 Gy10/2 (range, 29.8-66 Gy10/2), respectively. With a median follow-up of 9.4 months (range, 2.5-45 months), twenty-nine patients (46.7%) were alive, whereas the others died of progressive disease. Fifty-six patients (93.3%) reported complete or partial reduction of pain after CyberKnife radiotherapy at one-month follow-up, 17 patients (28.3%) reported some degree of pain relief after first fraction of the treatment course. Two patients experienced local recurrence at fifth and ninth months postradiotherapy. Median maximum nBED for spinal cord and thecal sac of naive targets were 68.6 Gy2/2 (range, 8.3-154.5 Gy2/2) and 83.5 Gy2/2 (range, 10.5-180.5 Gy2/2), respectively. Median maximum nBED for spinal cord and thecal sac for the re-irradiated targets were 58.6 Gy2/2 (range, 17.7-140 Gy2/2) and 70.5 Gy2/2 (range, 21.7-141.3 Gy2/2), respectively. No patient developed radiation related myelopathy during the follow-up period.

Conclusion
Cyberknife radiotherapy is clinically effective and safe for spinal metastases, even in previously irradiated patients.