bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of acute kidney injury as defined by the risk, injury, failure, loss, and end-stage criteria in critically ill patients undergoing abdominal aortic aneurysm repair
Authors: YUE Jia-ning , LUO Zhe , GUO Da-qiao , XU Xin , CHEN Bin , JIANG Jun-hao , YANG Jue , SHI Zhen-yu , ZHU Ting , JU Min-jie , TU Guo-wei , WANG Yu-qi , ZHU Du-ming , FU Wei-guo 
Published: January 2024

Background
Acute kidney injury (AKI) is considered as a common and significant complication following abdominal aortic aneurysm (AAA) repair. This study aimed to assess the associated risk factors of AKI in the critically ill patients undergoing AAA repair and to evaluate the appropriate AKI management in the specific population.

Methods
We retrospectively examined data from all critically ill patients undergoing AAA repairs at our institution from April 2007 to March 2012. Multivariable analysis was used to identify factors associated with postoperative AKI, which was defined by risk, injury, failure, loss and end-stage (RIFLE) kidney disease criteria. The goal-directed hemodynamic optimization (maintenance of optimal hemodynamics and neutral or negative fluid balance) and renal outcomes were also reviewed.

Results
Of the 71 patients enrolled, 32 (45.1%) developed AKI, with 30 (93.8%) cases diagnosed on admission to surgical intensive care unit (SICU). Risk factors for AKI were ruptured AAA (odds ratio (OR)=5.846, 95% confidence interval (CI): 1.346-25.390), intraoperative hypotension (OR=6.008, 95% CI: 1.176 to 30.683), and perioperative blood transfusion (OR=4.611, 95% CI: 1.307-16.276). Goal-directed hemodynamic optimization resulted in 75.0% complete and 18.8% partial renal recovery. Overall in-hospital mortality was 2.8%. AKI was associated with significantly increased length of stay ((136.9±24.5) hours vs. (70.4±11.3) hours) in Surgical Intensive Care Unit.

Conclusions
Critically ill patients undergoing AAA repair have a high incidence of AKI, which can be early recognized by RIFLE criteria. Rupture, hypotension, and blood transfusion are the significant associated risk factors. Application of goal-directed hemodynamic optimization in this cohort appeared to be effective in improving renal outcome.
Blood lead levels among children aged 0 to 6 years in 16 cities of China, 2004-2008
Authors: XIE Xiao-hua , TAN Zang-wen , JIA Ni , FAN Zhao-yang , ZHANG Shuai-ming , LÜ Yan-yu , CHEN Li , DAI Yao-hua 
Published: January 2024

Background
The adverse health effects of lead for children under 6 years are well known. Studies to assess the lead exposure among children in China are small in sample size and lack of national representative data. The aim of this study therefore was to describe blood lead levels and identify risk factors for lead exposure among children aged 0 to 6 years living in 16 cities in China.

Methods
We analyzed data from blood lead levels surveillance in China carried out in 16 large cities between 2004 and 2008. A stratified clustered random sampling strategy was used. A total of 69 968 children aged 0 to 6 years were included. We conducted multiple Logistic regression analyses to explore risk factors to high blood lead level.

Results
The geometric mean blood lead level of the children was 4.50 μg/dl (median: 4.90 μg/dl; IQR: 3.20-7.00 μg/dl). Overall prevalence of blood lead level ≥10.00 μg/dl among 0- to 6-year-old children was 7.57%. But the proportion of blood lead level ≥5.00 but <10.00 μg/dl was 42.12%. Blood lead levels were significantly higher in boys (4.63 μg/dl) than in girls (4.35 μg/dl) (P <0.0001). The geometric mean blood lead levels and prevalence of blood lead level ≥10.00 μg/dl increased with age (P <0.0001 for the two trends). After controlling for sociodemographic, dietary and behavior factors, multivariable analysis indicated that lower maternal education, male gender, younger age, often biting pencil or/and toys, walking or playing for long time on the street, not washing hands before eating are major risk factors for higher lead levels.

Conclusions
The blood lead levels among Chinese children in urban areas are lower than previous studies but close to those of developed countries. However, children with low lead exposure account for almost half and the sociodemographic factors (age, male sex, and low mother education level) continue to be associated with higher blood lead levels.
Transplantation of human umbilical cord-derived endothelial progenitor cells promotes re-endothelialization of the injured carotid artery after balloon injury in New Zealand white rabbits
Authors: HU Cheng-heng , KE Xiao , CHEN Kui , YANG Da-ya , DU Zhi-min , WU Gui-fu 
Published: January 2024

Background
Cell transplantation has great potential for promoting endothelial repair and reducing the complications of percutaneous coronary intervention (PCI). The aim of this study was to investigate the effect of transplantation of human umbilical cord blood endothelial progenitor cells (EPCs) on injured arteries.

Methods
Umbilical cord blood mononuclear cells were obtained from post-partum lying-in women, and EPCs were isolated, cultured, expanded and identified by immunofluorescence. The carotid arterial endothelium of New Zealand white rabbits was injured by dilatation with a 3F balloon, and the EPCs were injected into the lumen of the injured artery in the transplanted group (n=16), while an equal volume of phosphated buffered saline (PBS) was injected into the control group after balloon injury (n=16). The animals were sacrificed after either 2 or 4 weeks, and the grafted cells were identified by double immunofluorescence staining with human nuclear antigen (HNA) and CD31 antibodies. Arterial cross sections were analyzed by pathology, immunohistochemisty and morphometry to evaluate the reparative effects of EPCs. Proliferating cell nuclear antigen (PCNA) and transforming growth factor (TGF)-β1 mRNA expression were detected by reverse transcription-polymerase chain reaction (RT-PCR).

Results
Fluorescence-labeled EPCs were found in the neointima. The neointimal area and the neointimal/medial area ratio were significantly lower in the transplanted group than in the control group (P <0.05). von Willebrand factor (vWF) immunohistostaining showed more VWF-positive cells in the transplanted animals than in the controls (8.75±2.92 vs. 4.50±1.77, P <0.05). Compared with the control group, the transplanted group had lower expression of PCNA mRNA (0.67±0.11 vs. 1.25±0.40, P <0.01) and higher expression of TGF-β1 mRNA (1.10±0.21 vs. 0.82±0.07, P <0.05).

Conclusions
EPCs derived from human umbilical cord blood were successfully transplanted into injured vessels. The transplanted EPCs inhibited neointimal hyperplasia and promoted vascular re-endothelialization.
Acortatarin A inhibits high glucose-induced extracellular matrix production in mesangial cells
Authors: ZHAO Zhi-fang , ZHOU Li-li , CHEN Xia , CHENG Yong-xian , HOU Fan-fan , NIE Jing 
Published: January 2024

Background
Diabetic nephropathy (DN) is the leading cause of end-stage renal disease. Various treatment regimens and combinations of therapies provide only partial renoprotection. Therefore new approaches are needed to retard the progression of DN. The aim of the present study was to evaluate the role of a novel spiroalkaloid from Acorus tatarinowii named acortatarin A (AcorA) in inhibiting high glucose-induced extracellular matrix accumulation in mesangial cells (MCs).

Methods
The cytotoxity of AcorA on MCs was examined by 3-(4,5-dimethylthiazol-2-yl)-2.5-diphenyltetrazolium bromide (MTT) assay. The expression of fibronectin and collagen IV was examined by real time PCR and western blotting. The expression of p22phox and p47phox was detected by western blot. The interaction between p22phox and p47phox was examined by co-immunoprecipitation. The phosphorylation of p47phox was examined by immunoprecipitation. The phosphorylation of protein kinase C (PKC) α, PKCβ, phospholiase C gamma (PLCγ1), and the p85 subunit of PI3K was determined by Western blotting.

Results
AcorA significantly inhibited high glucose-induced activation of NADPH oxidase, a ROS-generating enzyme, by increasing phosphorylation of p47phox and enhancing interaction between p22phox and p47phox. Preincubation of AcorA with MCs inhibited high glucose-induced collagen IV and fibronectin production in a dose-dependent manner. Moreover, AcorA attenuated high glucose enhanced phosphorylation of PKCα, PKCβ, PLCγ1, and the p85 subunit of PI3K.

Conclusion
AcorA inhibits high glucose-induced extracellular matrix production via blocking NADPH oxidase activation.
Clinical characteristics of 4355 patients with anterior cruciate ligament injury
Authors: MEI Yu , AO Ying-fang , WANG Jian-quan , MA Yong , ZHANG Xin , WANG Jia-ning , ZHU Jing-xian 
Published: January 2024

Background
Clinical features of anterior cruciate ligament (ACL) injury are important for its prevention, diagnosis and treatment. However, few studies have reported such data, especially in China. The purpose of this study was to describe the clinical characteristics of ACL injury on a large cohort.

Methods
Between 1993 and 2007, a total of 4355 ACL deficient inpatients (612 athletes and 3743 non-athletes) were registered. Data were collected using a special database system. And the distributions of characteristics in different groups were compared and analyzed statistically.

Results
All subjects were confirmed with ACL tear during surgery. Statistical analysis revealed that the percentage of females in Athlete Group was significantly higher than that in Non-athlete Group (56.05% vs. 24.95%, P<0.001). This study also found that sports trauma was the main cause of ACL tears. Soccer, basketball, judo, wrestling and track and field were the five most responsible activities for athletes. The average injury time for athletes was significantly shorter than that for non-athletes (413.3 days vs. 717.5 days, P<0.001). Three thousand nine hundred and eight cases were ordered ACL reconstruction (76.04% single-bundle, 18.30% double-bundle). Three hundred and forty-five patients (7.92%) were combined with other ligaments injuries, 2667 (61.24%) were found with various grades of cartilage lesions, and 3377 (77.54%) were found with meniscal injury.

Conclusions
Sports trauma was the main cause of ACL tears in China, and reconstruction had become the principal surgical choice. In order to restore knee joint stability and reduce the incidence of cartilage and meniscal injury, patienttailored ACL reconstruction should be suggested at the right moment.
Impact of diabetes on the prognosis of hip fracture: a cohort study in the Chinese population
Authors: WANG Hong , Yan-wei LÜ , LAN Ling , ZHANG Quan , CHEN Hai-ling , ZHANG Guo-ying , DENG Li-li , LI Ju-fen 
Published: January 2024

Background
Diabetes has been associated with increased risk of fracture and impaired fracture healing. The aim of this study was to examine the influence of diabetes on perioperative complications, length of stay and ambulatory ability recovery in individuals with hip fracture, and to determine whether changes could be made to improve treatment outcome.

Methods
The study included 707 hip fracture patients treated at Beijing Jishuitan Hospital between July 2009 and December 2010. The medical history and perioperative complications were compared between non-diabetic and diabetic groups. Length of stay, days awaiting surgery, and days of hospitalization after surgery were also analyzed. Ambulatory ability was compared at 1-year follow-up using the Chi-square test and Fisher's exact test. An independent Student's t-test was used to compare normally distributed continuous data.

Results
Patients with diabetes were more likely than non-diabetic patients to develop cardiac perioperative complications (8.9% vs. 3.0%, P=0.021), urinary tract infections (12.0% vs. 2.8%, P <0.001), and gastrointestinal symptoms (15.0% vs. 6.8%, P=0.003). No difference in perioperative complications was observed between the groups. Days awaiting surgery and length of hospital stay were both longer in the diabetic group ((8.0±5.1) vs. (6.2±3.7) days and (16.5±3.8) vs. (13.3±3.8) days, P <0.001, respectively). Before the occurrence of fracture, patients with diabetes were less likely to be ambulatory outdoors (71.9% vs. 85.9%, P <0.001) and had more restricted walking ability. After at least 1-year follow-up, similar proportions of patients in the non-diabetic and diabetic groups (16.1% and 15.9%, respectively), who were able to ambulate outdoors before the fracture, became housebound till the final follow-up.

Conclusions
Diabetics are at increased risk of specific complications and have a longer time to surgery and longer in-hospital stay, but generally have similar recovery to non-diabetics thereafter.
Reprogramming of adult human neural stem cells into induced pluripotent stem cells
Authors: Xie Li-qian , Sun Hua-ping , Wang Tian , Tang Hai-liang , Wang Pu , Zhu Jian-hong , Yao Zheng-wei , Feng Xiao-yuan 
Published: January 2024

Background
Since an effective method for generating induced pluripotent stem cells (iPSCs) from human neural stem cells (hNSCs) can offer us a promising tool for studying brain diseases, here we reported direct reprogramming of adult hNSCs into iPSCs by retroviral transduction of four defined factors.

Methods
NSCs were successfully isolated and cultured from the hippocampus tissue of epilepsy patients. When combined with four factors (OCT3/4, SOX2, KLF4, and c-MYC), iPSCs colonies were successfully obtained.

Results
Morphological characterization and specific genetic expression confirmed that these hNSCs-derived iPSCs showed embryonic stem cells-like properties, which include the ability to differentiate into all three germ layers both in vitro and in vivo.

Conclusion
Our method would be useful for generating human iPSCs from NSCs and provide an important tool for studying neurological diseases.
Multimodality imaging assessments of response to metformin therapy for breast cancer in nude mice
Authors: Mao Yi , Xia Rui , Wang Lei , Wang Yu-qing , Gao Fa-bao 
Published: January 2024

Background
Metformin is the most widely used anti-diabetic drug in the world. An increasing body of evidence shows metformin also blocks cell cycle progression and selectively induces apoptosis via caspase activation in some breast tumor cells. Diffusion-weighted imaging (DWI) and bioluminescence imaging (BLI) have great potential in the evaluation of the early response to cancer therapies. We used DWI and BLI in evaluating the response of breast cancer to metformin.

Methods
The luciferase-engineered human breast cancer cell line MDA-MB-231 was inoculated into the mammary fat pad of nude mice. Twelve female nude mice bearing tumors were divided into two groups. The mice in the treatment group received metformin (2 mg/ml in drinking water daily) after tumor inoculation, and the mice in the control group were offered drinking water without any drug added. We performed 7T magnetic resonance imaging and optical imaging every week. Imaging included T1- and T2-weighted imaging, DWI, and BLI. After imaging. The tumors were collected and subjected to histological analysis.

Results
The mean photons/second of tumors in the treatment group was (3.00±0.43)×106 at day one, (1.01±0.14)×107 at 2 weeks, (5.79±1.42)×107 at 4 weeks, and (2.33±0.70)×107 at 8 weeks. The mean photons/second of tumors in the control group was (3.29±0.59)×106 at day one, (3.59±0.63)×107 at 2 weeks, (3.87±0.56)×108 at 4 weeks, and (4.12±1.72)×108 at 8 weeks. Compared to the control group, the treatment group showed an obvious decrease in the mean bioluminescence (photons/s) of the tumors and fewer metastases. Histological examination confirmed the presence of fewer metastases. DWI showed the apparent diffusion coefficient (ADC) value of the tumors; the mean ADC value was (0.9287±0.04346)×10-3 mm2/s in the treated tumors and (0.7553±0.01804)×10-3 mm2/s in the untreated tumors. The ADC value of tumors in the treatment group was significantly higher than the control tumors (P=0.0013).

Conclusions
The growth and metastasis of MDA-MB-231 breast cancer may be inhibited by metformin. DWI and BLI have great potentials in the evaluation of the early response to metformin treatment. BLI has a high degree of sensitivity and is able to detect micrometastasis, thus can be used for identifying tumor metastasis in vivo.
Axonal loss and blood flow disturbances in the natural course of indirect traumatic optic neuropathy
Authors: SHI Wei , WANG Huai-zhou , SONG Wei-xian , YANG Wen-li , LI Wei-ye , WANG Ning-li 
Published: January 2024

Background
Indirect traumatic optic neuropathy (TON) is an acute injury of the optic nerve associated with severe visual dysfunction, which may be a result of secondary mechanical injury and vascular disorder of the optic nerve due to trauma. We analyzed the natural course of axonal loss and blood flow disturbances in patients with indirect TON to find a possible therapeutic window.

Methods
A cohort of 54 patients with indirect TON recruited between October 2008 and October 2010 at Beijing Tongren Hospital was retrospectively analyzed. The patients were divided into no light perception group (NLP) and better than NLP (btNLP) group. Specifically, the thickness of the retinal nerve fiber layer (RNFL) measured by spectral domain optical coherence tomography (SD-OCT), and hemodynamic parameters of the ophthalmic artery (OA), central retinal artery (CRA) and posterior ciliary artery (PCA) were determined.

Results
Two weeks after injury, there was a statistically significant decrease in the thickness of RNFL in the btNLP group as compared with the fellow control eyes (P <0.05). In contrast, in the NLP group, RNFL thickness slightly increased for 2 weeks following injury, then overtly reduced after 4 weeks (P <0.05). Peak systolic velocity (PSV) of CRA was significantly decreased 4 weeks after injury (P<0.05) in both the NLP group and btNLP group (P <0.05). The thickness of RNFL in the NLP group was negatively correlated with PSV of CRA after 1 week of injury (P <0.05, r=-0.962).

Conclusions
SD-OCT is a useful supplement in detecting the axonal loss in TON. The dynamic change of the thickness of RNFL appears to correlate with the hemodynamic disturbances in the natural course of TON. The first 2 weeks following an injury is critical and should be considered as the therapeutic window for TON patients.
Evaluation of neuro-intensive care unit performance in China: predicting outcomes of Simplified Acute Physiology Score II or Glasgow Coma Scale
Authors: Zhao Xiao-xia , Su Ying-ying , Wang Miao , Zhang Yan , Ye Hong , Feng Huan-huan , Zhang Yun-zhou , Gao Dai-quan , Chen Wei-bi 
Published: January 2024

Background
Severity scoring systems are useful tools for measuring the severity of the disease and its outcome. This pilot study was to verify and compare the prognostic performance of the Simplified Acute Physiology Score II (SAPS II) and Glasgow Coma Scale (GCS) in neuro-intensive care unit (N-ICU) patients.

Methods
A total of 1684 patients consecutively admitted to the N-ICU at Xuanwu Hospital between January 1, 2005 and December 31, 2011 were enrolled in this study. The data-base included admission data, at 24-, 48-, and 72-hour SAPS II and GCS. Repeated measure data analysis of variance, Logistic regression analysis, the Hosmer-Lemeshow goodness-of-fit statistic, and the area under the receiver operating characteristic were used to evaluate the performance.

Results
There was a significant difference between the SAPS II or GCS score at four time points (F=16.110, P=0.000 or F=8.108, P=0.000). The SAPS II scores or GCS score at four time points interacted with the outcomes with significant difference (F=116.771, P=0.000 or F=65.316, P=0.000). Calibration of the SAPS II or GCS score at each time point on all patients was good. The percentage of a risk estimate prediction corresponding to observed mortality was also good. The 72-hour score have the greatest consistency. Discriminations of the SAPS II or GCS score at each time were all satisfactory. The 72-hour score had the greatest discriminative power. The cut-off value was 33 (sensitivity of 85.2% and specificity of 74.3%) and 6 (sensitivity of 70.6% and specificity of 65.0%). The SAPS II at each time point on all patients showed better calibration, consistency and discrimination than GCS. The binary Logistic regression analysis identified physiological variables, GCS, age, and disease category as significant independent risk factors of death. After the two variables including underlying disease and type of admission were excluded, we built the simplified SAPS II model. A correlation was suggested between the simplified SAPS II score at each time point and outcome, regardless of the diagnosis.

Conclusions
The GCS scoring system tends to be a little weaker in the predictive power than the SAPS II scoring system in this Chinese cohort of N-ICU patients. The advantage of SAPS II scoring system still exists that it dose not need to take into account the diagnosis or diseases categories, even in the special N-ICU. The simplified SAPS II scoring system is considered a new idea for the estimation of effectiveness.
Spectrum and antimicrobial resistance of common pathogenic bacteria isolated from patients with acute exacerbation of chronic obstructive pulmonary disease in mainland of China
Authors: YE Feng , HE Li-xian , CAI Bo-qiang , WEN Fu-qiang , CHEN Bai-yi , Mangunnegoro Hadiarto , CHEN Rong-chang , YUAN Jin-ping , SUN Hong-li 
Published: January 2024

Background
Bacteria-induced respiratory infection has been long considered to be the major cause of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Therefore, a clear picture about the distribution and drug-resistance of pathogenic bacteria in the lower airways should be helpful for treatment of the disease. So far, data on this topic among Chinese are lacking.

Methods
A surveillance study was performed in consecutive patients with AECOPD at five areas in China between October 2006 and April 2008. The sputum from these patients was cultured and isolated for bacteria. Agar dilution method was used to determine the minimal inhibitory concentrations (MICs) of levofloxacin and other 15 antibiotics against these strains.

Results
Three hundred and fifty-nine pathogenic bacterial strains were isolated among 884 patients with AECOPD. The predominant bacteria were Pseudomonas aeruginosa (21.7%), Klebsiella pneumoniae (12.3%), Haemophilus influenzae (14.2%) and Streptococcus pneumoniae (11.7%), followed by Haemophilus parainfluenzae (9.5%), Acinetobacter baumannii (7.8%), Moraxella catarrhalis (6.4%) and Escherichia coli (3.6%). The majority of bacterial pathogens isolated in this study were susceptible to fluoroquinolones, ceftazidime, cefepime and imipenem.

Conclusions
Gram-negative bacilli are the leading pathogens in patients with AECOPD in China. Haemophilus parainfluenzae may be one of the most important pathogens in AECOPD. This study provides evidence for local surveillance of AECOPD pathogens and appropriate choice of antimicrobials in China.