[Effect of total flavonoids of buckwheat flower and leaf on myocardial cell apoptosis and Wnt/ß-catenin/PPARγ pathway in arrhythmic rats].

This paper aimed to investigate the effect of total flavonoids of buckwheat flower and leaf on myocardial cell apoptosis and Wnt/ß-catenin/peroxisome proliferator-activated receptor γ(PPARγ) pathway in arrhythmic rats. SD rats were randomly divided into a control group, a model group, a low-dose(20 mg·kg~(-1)) group of total flavonoids of buckwheat flower and leaf, a medium-dose(40 mg·kg~(-1)) group of total flavonoids of buckwheat flower and leaf, a high-dose(80 mg·kg~(-1)) group of total flavonoids of buckwheat flower and leaf, a propranolol hydrochloride(2 mg·kg~(-1)) group, with 12 rats in each group. Except the control group, rats in other groups were prepared as models of arrhythmia by sublingual injection of 1 mL·kg~(-1) of 0.002% aconitine. After grouping and intervention with drugs, the arrhythmia, myocardial cells apoptosis, myocardial tissue glutathione peroxidase(GSH-Px), catalase(CAT), malondialdehyde(MDA), serum interleukin-6(IL-6), prostaglandin E2(PGE2) levels, myocardial tissue apoptosis, and Wnt/ß-catenin/PPARγ pathway-related protein expression of rats in each group were measured. As compared with the control group, the arrhythmia score, the number of ventricular premature beats, ventricular fibrillation duration, myocardial cell apoptosis rate, MDA levels in myocardial tissues, serum IL-6 and PGE2 levels, Bax in myocardial tissues, and Wnt1 and ß-catenin protein expression levels increased significantly in the model group, whereas the GSH-Px and CAT levels, and Bcl-2 and PPARγ protein expression levels in myocardial tissues reduced significantly. As compared with the model group, the arrhythmia score, the number of ventricular premature beats, ventricular fibrillation duration, myocardial cell apoptosis rate, MDA leve in myocardial tissues, serum IL-6 and PGE2 levels, Bax in myocardial tissues, and Wnt1 and ß-catenin protein expression levels reduced in the drug intervention groups, whereas the GSH-Px and CAT levels and Bcl-2 and PPARγ protein expression levels in myocardial tissues increased. The groups of total flavonoids of buckwheat flower and leaf were in a dose-dependent manner. There was no significant difference in the levels of each index in rats between the propranolol hydrochloride group and the high-dose group of total flavonoids of buckwheat flower and leaf. The total flavonoids of buckwheat flower and leaf inhibit the activation of Wnt/ß-catenin pathway, up-regulate the expression of PPARγ, reduce oxidative stress and inflammatory damage in myocardial tissues of arrhythmic rats, reduce myocardial cell apoptosis, and improve the symptoms of arrhythmia in rats.

The effects of stereotactic body radiotherapy on peripheral natural killer and CD3+CD56+ NKT-like cells in patients with hepatocellular carcinoma.

BACKGROUND: Both natural killer (NK) and CD3+CD56+natural killer T (NKT)-like cells play critical roles in the antitumor response. This study aimed to explore the effects of stereotactic body radiotherapy (SBRT) on peripheral NK and NKT-like cells in patients with hepatocellular carcinoma (HCC), and to identify possible surface markers on these cells that correlate with the prognosis. METHODS: Twenty-five HCC patients were prospectively enrolled in our study, and 10 healthy individuals were served as healthy controls. Flow cytometry was used to determine the counts and the percentages of peripheral NK and NKT-like cells, cells with certain receptors, and cells with intracellular interferon-γ and TNF-α secretion at different time points, including time points of prior to SBRT, at post-SBRT, and 3-month and 6-month after treatment. The Kaplan-Meier method with the log-rank test was applied for survival analysis. RESULTS: The peripheral NKT-like cells was increased at post-SBRT. Meanwhile, elevated levels of inhibitory receptors and reduced levels of activating receptors of NK cells were also observed in NK cells at post-SBRT, but the levels was not significantly different at 3-month and 6-month as compared with the baseline levels. Lower percentage of NKp30+NK cells before SBRT and higher percentage of CD158b+NK cells after SBRT were associated with poor progression-free survival. In addition, higher percentage of CD3+CD56+ NKT-like cells was associated with a higher overall survival rate in HCC patients. CONCLUSIONS: SBRT has an apparent effect on both peripheral NK and CD3+CD56+NKT-like cells. Lower percentage of NKp30+NK cells before SBRT and higher percentage of CD158b+NK cells after SBRT are correlated with poor patients' PFS. Higher percentage of CD3+CD56+ NKT-like cells is associated with higher OS in HCC patients.

The efficacy and safety of methylprednisolone in hepatitis B virus-related acute-on-chronic liver failure: a prospective multi-center clinical trial.

BACKGROUND: Hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) is a severe condition with high mortality due to lack of efficient therapy. Until now, the use of methylprednisolone (MP) in HBV-ACLF is still controversial. We aimed to evaluate the efficacy and safety of MP in HBV-ACLF. METHODS: Totally 171 HBV-ACLF patients from three medical centers were randomly allocated into MP group (83 patients treated with MP intravenously guttae for 7 days plus standard treatment: 1.5 mg/kg/day [day 1-3], 1 mg/kg/day [day 4-5], and 0.5 mg/kg/day [day 6-7]) and control group (88 patients treated with standard treatment). The primary endpoints were 6-month mortality and prognostic factors for 6-month survival. The survival time, cause of death, adverse events, liver function, and HBV DNA replication were analyzed. RESULTS: The 6-month mortality was significantly lower in MP group than control group [32.4% vs. 42.5%, P = 0.0037]. MP treatment was an independent prognostic factor for 6-month survival [HR (95% CI) 0.547(0.308-0.973); P = 0.040]. Factors associated with reduced 6-month mortality in MP group included HBV DNA and lymphocyte/monocyte ratio (LMR) (P < 0.05). Based on ROC curve, LMR+MELD had a better predictive value for prognosis of HBV-ACLF under MP treatment. No significant difference in HBV DNA replication was observed between groups (P > 0.05). CONCLUSIONS: MP therapy is an effective and safe clinical strategy in HBV-ACLF, increasing the 6-month survival rate. Clinical trials registered at http://www.chictr.org.cn as ChiCTR-TRC-13003113 registered on 16 March 2013.

[Comparison of MELD-Na versus MELDNa in the prediction of short-term prognosis for acute-on-chronic hepatitis B liver failure].

OBJECTIVE: To evaluate the short-term prognostic values for the model of end-stage liver disease-sodium (MELD-Na), end-stage liver disease sodium (MELDNa) and their dynamic changes in patients with acute-on-chronic hepatitis B liver failure (ACLF-HBV). METHODS: A total of 172 patients diagnosed with ACLF-HBV, admitted between January 2007 to February 2009 and hospitalized for over 2 weeks, were retrospectively recruited. The predictive accuracy of MELD-Na, MELDNa and their dynamic change (Δ) was compared by the method of the area under the receiver operating characteristic curve. RESULTS: The 3-month mortality rate was 43.6%. The largest concordance (c) statistic predicting 3-month mortality was MELDNa score after a 2-week treatment (0.790), followed by MELD-Na (0.728) score, ΔMELDNa (0.713) and ΔMELD-Na (0.646). The average MELD-Na, MELDNa scores after a 2-week treatment and ΔMELD-Na, ΔMELDNa of survival group were 27.7 ± 8.9, 25.9 ± 5.0, -2.1 ± 10.0 and -1.9 ± 4.2 while those of dead group 34.6 ± 8.7, 31.5 ± 5.0, 2.4 ± 10.3 and 2.4 ± 10.3. There was significant difference in MELD-Na, MELDNa, ΔMELD-Na and ΔMELDNa between two groups. The 3-month mortality of the MELD-Na scores group < 25, 25 - 30, 30 - 35 and > 35 were 18.9%, 37.8%, 57.6% and 65.3% while the MELDNa scores group 14.6%, 33.3%, 72.5% and 84.2% respectively. There was significant difference in the 3-month mortality between four groups. The 3-month mortality of the ΔMELD-Na > 0 group was 58.5% while that of the ΔMELD-Na ≤ 0 group 30%; the 3-month mortality of the ΔMELDNa > 0 group was 61.3% while that of the ΔMELDNa ≤ 0 group 29.9%. There was significant difference between two groups. CONCLUSION: MELDNa score after a 2-week treatment is a promising and useful predictor for 3-month mortality in ACLF-HBV patients. The predictive value may further improve if in conjunctions with dynamic changes.

Molecular characteristics and risk factor analysis of Staphylococcus aureus colonization put insight into CC1 colonization in three nursing homes in Shanghai.

Research indicates that Staphylococcus aureus colonization in the elderly with predisposing risks is associated with subsequent infection. However, the molecular epidemiology and risk factors for S. aureus colonization among residents and staff in nursing homes (NHs) in China remain unclear. A multicenter study was conducted in three NHs in Shanghai between September 2019 and October 2019. We explored the prevalence, molecular epidemiology, and risk factors for S. aureus colonization. All S. aureus isolates were characterized based on antimicrobial resistance, virulence genes, multilocus sequence typing (MLST), staphylococcus protein A (spa) typing, and staphylococcal cassette chromosome mec (SCCmec) typing. NH records were examined for potential risk factors for S. aureus colonization. S. aureus and methicillin-resistant S. aureus (MRSA) isolates were detected in 109 (100 residents and 9 staff, 19.8%, 109/551) and 28 (24 residents and 4 staff, 5.1%, 28/551) subjects among 496 residents and 55 staff screened, respectively. Compared to methicillin-susceptible S. aureus isolates, all 30 MRSA isolates had higher resistance rates to most antibiotics except minocycline, rifampicin, linezolid, vancomycin, and teicoplanin. Sequence type (ST) 1 (21.3%) was the most common sequence type, and t127 (20.5%) was the most common spa type among 122 S. aureus isolates. SCCmec type I (70%) was the dominant clone among all MRSA isolates. CC1 (26/122, 21.3%) was the predominant complex clone (CC), followed by CC398 (25/122, 20.5%), CC5 (20/122, 16.4%) and CC188 (18/122, 14.8%). Female sex (OR, 1.70; 95% CI, 1.04-2.79; P = 0.036) and invasive devices (OR, 2.19; 95% CI, 1.26-3.81; P = 0.006) were independently associated with S. aureus colonization.

Hepatic Resection Versus Stereotactic Body Radiation Therapy Plus Transhepatic Arterial Chemoembolization for Large Hepatocellular Carcinoma: A Propensity Score Analysis.

BACKGROUND AND AIMS: There are no comparative studies on the efficacy of hepatic resection (HR) and CyberKnife stereotactic body radiation therapy (CK-SBRT) plus transhepatic arterial chemotherapy embolization (TACE) in the treatment of large hepatocellular carcinoma (HCC). Therefore, this study aimed to compare the efficacy of HR and CK-SBRT+TACE in large HCC. METHODS: A total of one hundred and sixteen patients were selected from November 2011 to December 2016. Among them, 50 were allocated to the CK-SBRT+TACE group and 66 were allocated to the HR group. The Kaplan-Meier method was applied to calculate overall survival (OS) and progression-free survival (PFS) rates. Propensity score matching was performed to control for baseline differences between the groups. RESULTS: Thirty-six paired patients were selected from the CK-SBRT+TACE and HR groups. After propensity score matching, the 1-, 2- and 3-year OS rates were 83.3%, 77.8% and 66.7% in the HR group and 80.6%, 72.2% and 52.8% in the CK-SBRT+TACE group, respectively. The 1-, 2- and 3-year PFS rates were 71.6%, 57.3% and 42.3% in the HR group and 66.1%, 45.8% and 39.3% in the CK-SBRT+TACE group, respectively (OS: p=0.143; PFS: p=0.445). Both a high platelet count and low alpha-fetoprotein value were revealed as influencing factors in improving OS and PFS. CONCLUSIONS: CK-SBRT+TACE brought local effects that were similar to those of HR in HCC patients with a large and single lesion. Moreover, the liver injury occurrence rate was acceptable in both groups.

[Clinical features and prognostic analysis of 51 drug-induced case of liver failure].

OBJECTIVE: To enhance the understanding of drug-induced liver failure by analyzing the etiology, clinical features and prognosis associated factors of patients with drug-induced liver failure. METHODS: Fifty-one cases of drug-induced liver failure admitted to our hospital from 2002 - 2007 were reviewed according to their drug history, clinical features, Laboratory tests, complications and prognosis associated factors. RESULTS: The predominant etiological drugs were the traditional Chinese medicine (54.9%) and antitubercular agent (25.5%). Two predominant types of liver failure were acute liver failure (13.7%) and subacute liver failure (78.4%). The common complications were electrolyte disturbance, ascites and hepatic encephalopathy. The total improvement rate in patients was 29.4%. The incidences of hepatic encephalopathy, electrolyte disturbance and PTA value had statistical difference between improvement group and ineffective group. CONCLUSION: The etiologies of drugs-induced liver failure are traditional Chinese medicine and antitubercular agent in China. The prognosis of drug-induced liver failure remains poor. During the therapy of these drugs treatment, liver function test should be monitored.

[The short-term efficacy of nucleoside analogue on the treatment of acute-on-chronic liver failure].

OBJECTIVE: To discuss the short-term efficacy of nucleoside analogue on the treatment of hepatitis B virus induced acute-on-chronic liver failure (HBV-ACLF). METHODS: 348 patients with HBV-ACLF in our hospital from January 2006 to June 2008 were selected. According to the stages of patient's condition and whether or not with nucleoside analogue administration, The patients were divided into early stage therapy group, early stage control group, middle stage therapy group and middle stage control group. Groups were compared on the basis of stages. The clinical data were analyzed using chisquare test and independent-Samples T Test. RESULTS: After 2 weeks of therapy no significant difference found between the therapy group and the control group. the total bilirubin (TBil) and alanine transaminase (ALT) showed no significant difference between the middle stage therapy group and the control group in 4 weeks of therapy. However significant differences existed in the HBV DNA negative rate, PTA, the model for end-stage liver disease (MELD) score and the improvement rate between the two groups (P<0.05, P<0.01). Only the 4 week survival rate and HBV DNA negative rate showed significant difference in patients who received anti-virus therapy on the early stage as compared to the control group. CONCLUSION: Anti-virus therapy with nucleoside analogue is an effective way for the treatment of those patients with HBV-ACLF and can increase the survival rate.

[Study on gene delivery via the bile duct to rat liver using naked DNA particles].

OBJECTIVE: To evaluate the efficacy of gene delivery to the right lateral lobe of the rat liver via a branch of the bile duct using naked DNA. METHODS: We evaluated regional gene delivery to the right lateral lobe of the rat liver via a branch of the bile duct, using naked DNA, including pGL3, pCMV beta and Cy3 labeled CMV beta. RESULTS: Gene expression was observed in right lateral lobe of both the damaged and the normal rats liver. The gene delivery efficiency was similar in two groups (P > 0.05). Gene expression was found in the right lateral lobe of damaged and normal livers. Fluorescence was observed in the region of the portal triads, and occasionally, in the lobule. CONCLUSION: Retrograde infusion of naked DNA via the bile duct is an effective way to deliver genes to in both damaged and normal rat liver.

Molecular Epidemiology and Antimicrobial Resistance of Haemophilus influenzae in Adult Patients in Shanghai, China.

Background: The serotype and antimicrobial resistance of Haemophilus influenzae in adult patients have changed due to the application of antimicrobials and H. influenzae type b (Hib) vaccine worldwide. However, the epidemiologic characteristics of H. influenzae in Shanghai are still unavailable. Objective: To determine the serotype distribution, antimicrobial resistance and multilocus sequence type (MLST) of H. influenzae in adult patients in Shanghai. Methods: A total of 51 clinical isolates from adult patients were consecutively collected. Serotypes were determined according to specific capsule gene, bexA, amplified by PCR. Antimicrobial susceptibility test was carried out by the broth microdilution method. ß-lactamase production was detected by cefinase disk and the ftsI gene were amplified and sequenced to determine the penicillin binding protein 3 (PBP3) mutation. Molecular epidemiology was performed by MLST analyses. Results: All isolates studied were nontypeable H. influenzae (NTHi) and three of them (5.88%) caused invasive infection. The resistant rates of ampicillin and trimethoprim/sulfamethoxazole were both 45.10%. One third of these isolates produced TEM-1 type ß-lactamase and 11.76% were ß-lactamase negative ampicillin resistant strains (BLNAR). The PBP3 mutation was detected in 74.51% of the isolates, of which 12 belonged to group III. A total of 36 sequence types (STs) were identified among all isolates. Four isolates of ST103 (7.84%) all produced ß-lactamase without mutation of PBP3. Conclusion:H. influenzae infections among adults in Shanghai are predominately caused by NTHi with genetic diversity among adult patients. The prevalence of both ß-lactamase production and PBP3 mutation may contribute to high ampicillin resistance rate in Shanghai.

Stereotactic body radiotherapy versus hepatic resection for hepatocellular carcinoma (≤ 5 cm): a propensity score analysis.

BACKGROUND: CyberKnife stereotactic body radiation therapy (CK-SBRT) has been applied to hepatocellular carcinoma (HCC) patients for several years. The study aim was to compare the efficacy of hepatic resection (HR) and CK-SBRT in naive small hepatocellular carcinoma (sHCC) patients with hepatitis virus-related cirrhosis using a 5-year follow-up study. MATERIALS AND METHODS: This retrospective cohort study included 317 naive sHCC patients (246 men and 71 women) with hepatitis B or C virus cirrhosis who were treated with HR (n = 195) or CK-SBRT (n = 122) from November 2011 to December 2015. Cumulative overall survival (OS) rates and progression-free survival (PFS) rates were calculated using Kaplan-Meier method. RESULTS: After the propensity score-matched analysis, 104 patients were selected from each group for further analysis. The 1-, 2-, 3-, and 5-year OS rates were 96.2%, 89.4%, 85.5% and 70.7% in the HR group and 93.3%, 89.4%, 83.7% and 71.0% in the CK-SBRT group, respectively. The 1-, 2-, 3-, and 5-year PFS rates were 78.8%, 64.3%, 56.4% and 47.3% in the HR group and 84.5%, 67.8%, 58.9% and 49.0% in the CK-SBRT group, respectively. No significant difference was found between the two groups in the OS and PFS rates (OS, p = 0.673; PFS, p = 0.350). No death occurred due to the toxicity or complications of HR or CK-SBRT. CONCLUSION: CK-SBRT could be an effective alternative to HR for sHCC naive patients with hepatitis-related cirrhosis, especially if patients have higher CP scores and lower PLT counts. PLT counts should be factored into survival evaluation of HCC treatment.

Synthesis and Neuroprotective Biological Evaluation of Quinazolinone Derivatives via Scaffold Hopping.

OBJECTIVE: To develop efficient method for the synthesis of quinazolinone derivatives bearing different functional groups on ring A and ring B and evaluation as neuroprotective agents. METHODS: Synthetic route to quinazolinone derivatives was furnished by condensation/cyclocondensation/ reduction sequence of the activated N-acylbenzotriazoles. The structures of the targets compounds have been deduced upon their spectral data (1HNMR, 13CNMR and Mass spectroscopy). The neuroprotective activities of the synthesized compounds are also evaluated. RESULTS: Preliminary screening on a MPP+ induced SH-SY5Y cell injury model of the synthesized compounds resulted in four compounds (6q, 6r, 6u, and 8e) showed promising neural cell protection activities. The action mechanisms of these compounds on neuroprotection were then analyzed by docking and reverse docking modeling. CONCLUSION: A series of quinazolinone derivatives, including different substitution types on rings A and B were designed and synthesized via scaffold hopping. With the help of neuroprotective biological evaluation, several efficient therapeutic neuroprotective agents were found for further evaluation as drug candidate against neurodegenerative disorder.

Human LINE1 endonuclease domain as a putative target of SARS-associated autoantibodies involved in the pathogenesis of severe acute respiratory syndrome.

BACKGROUND: Severe acute respiratory syndrome (SARS) is a disease with a mortality of 9.56%. Although SARS is etiologically linked to a new coronavirus (SARS-CoV) and functional cell receptor has been identified, the pathogenesis of the virus infection is largely unclear. METHODS: The clinical specimens were processed and analyzed using an indirect enzyme-linked immunosorbent assay (ELISA) in-house. Further investigations of target antigen included reviews of phage display technique, rapid amplification of cDNA ends (RACE) technique, protein expression and purification, Western blotting validation, serological and immunohistochemical staining in postmortem tissue. RESULTS: A type of medium or low titer anti-lung tissue antibodies were found in the sera of SARS patients at the early stage of the disease. Human long interspersed nuclear element 1 (LINE1) gene endonuclease (EN) domain protein was one of the target autoantigens and it was aberrantly expressed in the lung tissue of SARS patients. Anti-EN antibody was positive in the sera of 40.9% of SARS patients. CONCLUSIONS: Human LINE1 endonuclease domain was identified as a putative target of SARS-associated autoantibodies, which were presented in the serum of SARS patients and may be involved in the pathogenesis of SARS.

[Regional gene delivery via the bile duct to damaged liver using peptide/DNA particles: experiment with rats].

OBJECTIVE: To evaluate the efficacy of gene delivery to the right lateral lobe of liver via a branch of the bile duct. METHODS: Twenty LEW rats underwent intraperitoneal injection of D-galactosamine to establish acute liver damage models and were randomly divided into 5 groups to undergo ligation of the common bile duct and left bile duct 4, 5, 6, or 7 days after the acute liver damage. Non-viral vector gene compound, polylysine-molossin/pGL3 containing firefly luciferin gene or CMVbeta containing beta-galactosidase of Escherichia coli/fusogenic) was injected in to the right lateral lobes 2 and 3 via the branch of right bile duct. Four rats without injection of D-galactosamine but undergoing injection of polylysine-molossin/pGL3 or CMVbeta/fusogenic were used as normal controls. Twenty-four hours after the regional gene delivery the rats were killed. The expressions of luciferin and beta-galactosidase in different lobes were detected. Pathological examination of liver was conducted. RESULTS: All rats survived after the operation. The expression levels of luciferin in the liver on the days 4, 5, and 6 were all significantly higher than that of the normal control rats (all P < 0.05). The expression levels of luciferin in the liver on the day 7 was the highest compared with the normal control rats (P = 0.01). However, the level of luciferin in the liver on the day 9 was lower and not significantly different from that of the normal rats (P > 0.05). Scattered distribution of beta-galactosidase was seen in the lobe 2 of the rats with acute liver damage. The levels of alanine transaminase and aspartate aminotransferase were slightly increased and the albumin level was slightly decreased in the rats with acute liver damage on the days 4 and 7, however, these biochemical indexes were not significantly correlated with the gene expression. There was no obvious histological difference between the lobes 2 and 3 and lobe 1. CONCLUSION: Gene delivery with peptide/DNA complexes shows a good expression in the acute damaged liver without aggravating the liver damage, thus providing a technical platform for the experimental research of liver gene therapy.

[Comparison and analysis of two international diagnostic criteria for the diagnosis of 230 cases with drug-induced liver injury].

OBJECTIVE: To compare and analyze the accuracy of two diagnostic criteria of drug-induced liver injuries. METHODS: 230 cases of drug-induced liver injury diagnosed clinically in the 302 hospital of PLA were retrospectively studied. The drugs which induced liver injuries were summarized and analyzed. Danan's international consensus criteria and Maria's diagnostic scale were applied to diagnose these 230 cases again and then the differences of diagnostic results were analyzed and compared. RESULTS: The drugs which induced liver injuries in the 230 patients were arranged in order of their usage frequencies: traditional Chinese herbs and the like, antibiotics, antipyretic analgesics, antituberculosis medicines, cardiovascular drugs, over-the-counter health stuff, psychopharmaceuticals, dermatological agents, drug for diabetes, tapazol, and others. Based on the 230 adult inpatients with drug-induced liver injury, according to Danan's international consensus criteria, 149 cases (64.8%), 71 (30.9%) and 10 (4.3%) were classified as drug-related, indeterminate and drug-unrelated respectively; according to Maria's diagnostic scale, not one was a definite drug-induced liver injury, 55 cases (23.9%) were probable, while 126 (54.8%), 33 (14.3%) and 16 (7.0%) were possible, unlikely and excluded respectively. CONCLUSION: The accordance rate of Danan's international consensus criteria and clinical diagnosis was higher than that of Maria's diagnostic scale. Neverthelessìthe current diagnostic methods for drug-induced liver injury need to be revised for clinical practice.

Meta-analysis of coronary artery bypass graft surgery combined with stem cell transplantation in the treatment of ischemic heart diseases.

OBJECTIVE: The use of bone marrow cells (BMCs) to regenerate the myocardium and vessels is a new treatment for ischemic heart diseases (IHD) that has been receiving attention. In this study, a meta-analysis was used to analyze the efficacy of combining coronary artery bypass graft (CABG) surgery with BMC transplantation in the treatment of IHD. METHODS AND RESULTS: MEDLINE, EMBASE, Cochrane, CNKI, WAN-FANG, and WEI-PU databases were searched. The main inclusion criteria were as follows: (a) studies that analyzed patients diagnosed with chronic IHD. (b) Studies that had randomized-controlled trials. (c) Studies that included research comparing the efficacy of CABG and CABG combined with bone BMC transplantation in the treatment of IHD. (d) Studies with specific enumeration data at the end of the follow-up with a follow-up time of at least 3 months. Nine randomized trials were included. There were 158 patients in the group that received the treatment of CABG surgery as well as stem cell transplantation, referred to as the 'cell transplantation group.' A total of 147 patients were in the group that only received the treatment of CABG surgery, referred to as the 'CABG group'. Our data show that not only did stem cell transplantation significantly improve left ventricular ejection fraction (odds ratio=11.7, 95% confidence interval: 4.04-19.36; P=0.003) but it also significantly reduced the left ventricular end-diastolic volume and left ventricular end-systolic volume (P<0.001). CONCLUSION: BMC transplantation is associated with a significant improvement in left ventricular ejection fraction and the attenuation of left ventricular remodeling.

[Therapeutic effect of puerarin therapy on sudden deafness].

OBJECTIVE: To evaluate the therapeutic effect of puerarin in the treatment against sudden deafness. METHODS: Seventy-two patients with sudden deafness were randomly assigned into therapeutic group (n= 40) who received intravenous infusion of puerarin injection and the control group (n=32) who were given intravenous infusion of anisodamine. The therapeutic effects of the two treatments were observed and compared. RESULTS: The total efficacy rates against sudden deafness and tinnitus in the therapeutic group were 89.68 % and 84.37 % respectively, but only 62.5 % and 56.52 % respectively in the control group, showing significant difference (P<0.05). CONCLUSION: Puerarin is effective in dilating the blood vessels and promoting microcirculation of the inner ear, with significant therapeutic effect in the treatment of sudden deafness.

[Completely severed unilateral alas nasi survived replantation: report of one case].

We reported a case in which the right wing of the nose had been completely severed and heavily contaminated 3 h before successful replantation, and survival of the right wing was retained postoperatively.

Comparison of four prognostic models and a new Logistic regression model to predict short-term prognosis of acute-on-chronic hepatitis B liver failure.

BACKGROUND: Acute-on-chronic hepatitis B liver failure (ACLF-HBV) is a clinically severe disease associated with major life-threatening complications including hepatic encephalopathy and hepatorenal syndrome. The aim of this study was to evaluate the short-term prognostic predictability of the model for end-stage liver disease (MELD), MELD-based indices, and their dynamic changes in patients with ACLF-HBV, and to establish a new model for predicting the prognosis of ACLF-HBV. METHODS: A total of 172 patients with ACLF-HBV who stayed in the hospital for more than 2 weeks were retrospectively recruited. The predictive accuracy of MELD, MELD-based indices, and their dynamic change (D) were compared using the area under the receiver operating characteristic curve method. The associations between mortality and patient characteristics were studied by univariate and multivariate analyses. RESULTS: The 3-month mortality was 43.6%. The largest concordance (c) statistic predicting 3-month mortality was the MELD score at the end of 2 weeks of admission (0.8), followed by the MELD: sodium ratio (MESO) (0.796) and integrated MELD (iMELD) (0.758) scores, DMELD (0.752), DMESO (0.729), and MELD plus sodium (MELD-Na) (0.728) scores. In multivariate Logistic regression analysis, the independent factors predicting prognosis were hepatic encephalopathy (OR = 3.466), serum creatinine, international normalized ratio (INR), and total bilirubin at the end of 2 weeks of admission (OR = 10.302, 6.063, 5.208, respectively), and cholinesterase on admission (OR = 0.255). This regression model had a greater prognostic value (c = 0.85, 95%CI 0.791 - 0.909) compared to the MELD score at the end of 2 weeks of admission (Z = 4.9851, P = 0.0256). CONCLUSIONS: MELD score at the end of 2 weeks of admission is a useful predictor for 3-month mortality in ACLF-HBV patients. Hepatic encephalopathy, serum creatinine, international normalized ratio, and total bilirubin at the end of 2 weeks of admission and cholinesterase on admission are independent predictors of 3-month mortality.

[The clinical efficacy and safety of adefovir dipivoxil in combination with bicyclol for the treatment of senior patients with chronic hepatitis B].

OBJECTIVE: To investigate the clinical efficacy and safety of adefovir dipivoxil (ADV) in combination with bicyclol for the treatment of chronic hepatitis B (CHB) in seniors. METHODS: 96 senior patients with CHB were randomly divided into two groups, the treatment group and the control group. On the basis of routine liver protective treatment, patients in the treatment group received ADV (10 mg/d) and bicyclol tablets (25 mg, tid.) orally, and those in the control group were orally administrated ADV tablets (10 mg/d) only. The treatment course for both groups was 24 weeks. Serum ALT, AST, and alterations of virological parameters were observed before and after the treatment. RESULTS: Before and at the end of the 24 weeks treatment, ALT level for the treatment group was (208.44 +/- 94.22) and (34.47 +/- 12.79) U/L, and those for the control group was (205.73 +/- 96.48) and (44.20 +/- 21.96) U/L, respectively (difference between groups P < 0.01). At the end of the 24 weeks treatment, ALT normalization rates for the treatment group and the control group were 76.6% and 54.5%, respectively, and AST normalization rates for them were 76.6% and 54.5%, respectively (both differences between groups P < 0.05); HBV DNA loads for the treatment group and the control group were decreased by (3.1 +/- 1.40) lgIU/ml and (2.98 +/- 1.17) lgIU/ ml, respectively (difference between groups P > 0.05). The incidence rates of adverse events between two groups were not statistically significant. CONCLUSION: It suggested that the treatment of ADV in combination with bicyclol for senior patients with CHB is effective and safe.