Efficacy and Safety of Low-Dose Apatinib Combined with Chemotherapy as Second-Line Treatment for Advanced Gastric Cancer: A Meta-Analysis.

INTRODUCTION: At present, there are several studies on low-dose apatinib combined with chemotherapy as a second-line treatment of advanced gastric cancer (AGC), but the conclusions are controversial. Therefore, this meta-analysis aimed to evaluate the efficacy and safety of low-dose apatinib combined with chemotherapy as a second-line treatment of AGC. METHODS: Nine databases were searched for records on apatinib combined with chemotherapy in treating AGC from inception to June 2022. The observation group received low-dose apatinib combined with chemotherapy, while the controls received chemotherapy alone or other non-placebo treatments. Outcomes included objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), overall survival (OS), and adverse events. The relative risk (RR) and weighted mean difference (WMD) were used as effect sizes. RESULTS: Eight studies involving 679 patients were included in this meta-analysis. The results of the meta-analysis showed that the observation group was superior to the controls in terms of ORR (RR = 1.38, 95% confidence interval [CI]: 1.05-1.81, p = 0.02), DCR (RR = 1.35, 95% CI: 1.20-1.53, p < 0.001), OS (WMD = 4.72, 95% CI: 0.71-8.72, p < 0.001), and PFS (WMD = 2.67, 95% CI: 1.7-3.63, p < 0.001). There were no significant differences between the two groups in adverse events of any grade except hypertension (RR = 2.82, 95% CI: 2.07-3.84, p < 0.001), hand-mouth syndrome (RR = 1.84, 95% CI: 1.84-2.48, p < 0.001), and proteinuria (RR = 3.63, 95% CI: 2.31-5.7, p < 0.001). CONCLUSION: Low-dose apatinib combined with chemotherapy as a second-line therapy is more effective in improving the efficacy of AGC compared to chemotherapy alone. However, this option has the potential to increase the risk of hypertension, hand-mouth syndrome, and proteinuria.

A survey on the current status of Helicobacter pylori infection in households in Hainan Province, China.

OBJECTIVE: This study aims to assess the prevalence of Helicobacter pylori (Hp) infection at the household level in Hainan Province in China and identify the factors that contribute to its spread. The findings of this study have significant implications for public health prevention strategies in the Hainan region. METHODS: A total of 421 families, comprising 1355 individuals, were tested for Hp infection across five cities in Hainan Province between July 2021 and April 2022. The study utilized questionnaires that included questions about personal characteristics, household shared lifestyle and dietary habits, and potential pathways of Hp infection in children to identify potential factors linked to household Hp infection and transmission patterns. RESULTS: The prevalence of Hp infection on an individual basis was 46.72% (629/1355), with age ≥ 20 years, being married and having junior secondary education and above as risk factors for Hp infection. The prevalence of Hp infection in households was 80.29% (338/421), household size of 5, 6 and above were risk factors for Hp infection with Odds Ratios (ORs) of 4.09 (1.17-14.33) and 15.19 (2.01-114.73), respectively, household income ≥ 100,000 yuan and drinking boiled water from a tap source were protective factors for Hp infection with ORs of 0.52 (0.31-0.89) and 0.51 (0.28-0.95), respectively. The prevalence of Hp infection among minors in the household was 24.89% (58/233), with paternal infection and maternal infection as risk factors for child infection, with ORs of 2.93 (1.29-6.62) and 2.51 (1.07-5.89), respectively. CONCLUSION: Hp infection was prevalent among Hainan families, and interaction with infected family members may be the primary cause of transmission.

3 liters of polyethylene glycol vs. standard bowel preparation have equal efficacy in a Chinese population: a randomized, controlled trial.

BACKGROUND: The European Society of Gastrointestinal Endoscopy recommends 4L Polyethylene Glycol (PEG) as the standard regimen for bowel preparation (BP). The current study compared 3L and 4L PEG with regard to their effectiveness, tolerability, and safety among Chinese patients to identify the best bowel cleansing method for this population. METHODS: The study employed a prospective, observer-blinded, randomized and controlled design in a high-volume endoscopic center. Consecutive patients undergoing colonoscopy were randomly assigned (1:1) to the 3L-PEG or 4L-PEG group. The quality of bowel cleansing, procedure time, adenoma detection rate (ADR), patient tolerance, and adverse events were compared. RESULTS: A total of 330 patients were included in the study. After exclusions, 160 cases in the 3L-PEG group and 158 cases in the 4L-PEG group were included in the final analysis. The quality of bowel cleansing (Boston Bowel Preparation Scale) for both the whole intestine and each segment had no significant differences between the groups (P > 0.05). No significant differences were found with regard to procedure time or ADR. The incidences of adverse events such as nausea (P = 0.001), vomiting (P = 0.002), and bloating (P < 0.001) were lower in the 3L-PEG group. Moreover, there was a higher rate of satisfaction in the 3L-PEG group than in the 4L-PEG group (P = 0.009). CONCLUSIONS: 3L-PEG bowel cleansing represents an optimal alternative to a 4L-PEG preparation, showing similar efficacy and superior levels of satisfaction, acceptability, and safety among users. We recommend 3L PEG as a routine regimen in the clinical setting for Chinese patients. (ClinicalTrials.gov registration number: NCT03356015, registered in 29 November, 2017, https://www. CLINICALTRIALS: gov/ct2/show/NCT03356015).

CircTMEM59 Serves as miR-410-3p Sponge to Inhibit the Proliferation and Metastasis of Colorectal Cancer by Regulating HOXD8.

Circular RNAs (circRNAs) have been confirmed to be involved in the regulation of malignant progression of colorectal cancer (CRC). Our research aims to explore the role and mechanism of circTMEM59 (hsa_circ_0012634) in CRC progression. The expression of circTMEM59, miR-410-3p and Homeobox D8 (HOXD8) was measured by quantitative real-time PCR. Cell proliferation, migration and invasion were assessed by EdU assay, colony formation assay, wound healing assay and transwell assay. Marker protein expression was evaluated by western blot analysis. In addition, RNA interaction was confirmed by dual-luciferase reporter assay, RIP assay and RNA pull-down assay. CircTMEM59 was lowly expressed in CRC tumor tissues and cells. Upregulation of circTMEM59 repressed CRC cell proliferation, migration and invasion. MiR-410-3p could be sponged by circTMEM59, and its mimic also reversed the inhibition effect of circTMEM59 on CRC cell proliferation and metastasis. Also, HOXD8 was targeted by miR-410-3p, and its knockdown abolished the negative regulation of miR-410-3p inhibitor on CRC cell proliferation and metastasis. Furthermore, circTMEM59 inhibited CRC tumor growth by overexpressing HOXD8 through sponging miR-410-3p. In summary, our results demonstrated that circTMEM59 participated in the regulation of CRC progression through the miR-410-3p/HOXD8 axis, showing that circTMEM59 might be a potential target for the treatment of CRC.

Circ_0009910 Serves as miR-361-3p Sponge to Promote the Proliferation, Metastasis, and Glycolysis of Gastric Cancer via Regulating SNRPA.

Circular RNA (circRNA) has been proved to be a key regulator of gastric cancer (GC) progression. Circ_0009910 was found to be highly expressed in GC and related to GC progression, but its role and mechanism in GC progression need to be further improved. Our study aims to further reveal circ_0009910 roles in GC progression and elucidate its potential molecular mechanism. The expression of circ_0009910, microRNA (miR)-361-3p, and small nuclear ribonucleoprotein polypeptide A (SNRPA) mRNA was measured by quantitative real-time PCR. Protein expression was determined using western blot analysis. Cell proliferation, migration, invasion, and apoptosis were evaluated using EDU staining, transwell assay, and flow cytometry. Cell glycolysis were assessed by detecting glucose consumption, lactate production, and glycolysis-related markers protein expression. The relationship between miR-361-3p and circ_0009910 or SNRPA was confirmed by RNA pull-down assay and dual-luciferase reporter assay. In vivo experiments were performed to explore the effect of circ_0009910 silencing on GC tumorigenesis. Circ_0009910 and SNRPA were upregulated in GC tumor tissues and cells. Knockdown of circ_0009910 or SNRPA could inhibit GC cell proliferation, migration, invasion, glycolysis, and promote apoptosis. Circ_0009910 could sponge miR-361-3p, and miR-361-3p could target SNRPA. Further experiments confirmed that circ_0009910 positively regulated SNRPA by sponging miR-361-3p. Additionally, SNRPA overexpression abolished the negative regulation of circ_0009910 silencing on GC progression. Furthermore, silenced circ_0009910 also reduced GC tumorigenesis in vivo. Our data showed that circ_0009910 might be a target for GC treatment, which could promote GC proliferation, metastasis, and glycolysis by the miR-361-3p/SNRPA axis.

[Arthroscopic double-bundle double-tunnel anterior cruciate ligament reconstruction using multi-strand hamstring autograft].

OBJECTIVE: To explore surgical reconstruction and clinical effect of arthroscopic double-bundle double-tunnel reconstruction of anterior cruciate ligament (ACL) with multi-strand hamstring tendons autograft. METHODS: Twenty-one patients (13 males and 8 females) with ACL deficiency were diagnosed with arthroscopy, with an average age of 25.4 (17 approximately 50) years. The 2 separate tibial tunnels and 2 femoral tunnels were drilled on the footprint of the ACL to reconstruct the anteromedial and posterolateral bundles with arthroscopy.Tendons were fixed with Endo-button/polyester tape constructs at the femoral side and with biodegradable interference screw at the tibial side. RESULTS: All patients were followed up for 15.8 (13 approximately 23) months. The anterior drawer test was positive in all patients and Lachman test was positive in all but 2 preoperatively. The postoperative results of anterior drawer test were negative in all but 1 at 90 degree of knee flextion. Lachman test was positive in 1, suspiciously positive in 1 and negative in other patients. The Lysholm knee score increased from 36 approximately 58 preoperatively to 71 approximately 95 postoperatively and the fineness rate was 95.2%. CONCLUSION: Arthroscopic double-bundle double-tunnel reconstruction ACL with multi-strand hamstring tendons autograft is effective and reliable to restore the better dynamic stability of the knee.

[Effect of various intervention factors on MMP-3 and TIMP-1 level in synovial fluid in knee joints with osteroarthritis].

OBJECTIVE: To examine the expression of MMP-3 and TIMP-1 in the synovial fluid in knee joints with osteoarthritis before and after being treated with hyaluronic acid(HA), glucosamine sulfate(GS) and arthroscopic de bridment(AD), and to explore the therapeutic mechanism. METHODS: Sixty patients (64 knees) with osteoarthritis(OA) were randomly divided into HA group AD group and GS+AD group. Some patients from the HA group and the GS+HA group were selected, and served as HA' group and GS+HA' group. The expression of MMP-3 and TIMP-1 in the synovial fluid was measured by enzyme-linked immunosorbent assay (ELISA) before and after 4 week and 6 month therapy. RESULTS: The level of MMP-3 and the ratio of MMP-3/TIMP-1 in the synovial fluid decreased after being treated for 4 weeks, and the effect on MMP-3 and MMP-3/TIMP-1 lasted for 6 months in the HA group and the GS+HA groups. The levels of TIMP-1 increased significantly after being treated for 4 weeks only in the GS+HA group. The level of MMP-3 and the ratio of MMP-3/TIMP-1 in the synovial fluid decreased, but the level of TIMP-1 increased after being treated for 4 weeks, and the effect on MMP-3 and MMP-3/TIMP-1 lasted for 6 months. The level of MMP-3 and the ratio of MMP-3/TIMP-1 in the synovial fluid increased after being treated for 6 months compared with those for 4 weeks. The level of TIMP-1 increased in the GS group more than that in the HA group after being treated for 4 weeks. The level of TIMP-1 increased in the AD group more than that in the HA' group and the GS+HA' group after being treated for 4 weeks. CONCLUSION: (1) HA, GS and AD all can decrease the level of of MMP-3 and the ratio of MMP-3/TIMP-1 in the synovial fluid in knee joints with OA. (2) The level of TIMP-1 in the synovial fluid has no difference before and after being treated with HA. The AD group and GS group can increase the level of TIMP-1, which indicates that the AD group or GS group might produce better therapeutic effect. (3) The level of TIMP-1 increased in the AD group is more than that in the HA' group and the GS+HA' group after being treated for 4 weeks, which indicates that the AD group might get better therapeutic effect than the other 2 groups. (4) One of the most important mechanisms of HA, GS and AD in treating OA might be attributed to the expression of MMPs and TIMPs in knee joints with OA.

[Preliminary study on treating patellar instability guided by arthroscopy].

OBJECTIVE: To explore the operation method in treating patellar instability guided by arthroscopy and to evaluate its therapeutic effects. METHODS: Thirty-two patients (34 knees) with patellar instability including 2 patellar tilt (2 knees), 26 (27 knees) patellar subluxation, and 4 (5 knees) patellar dislocation, diagnosed by clinical and arthroscopical standard, were treated with anterior transfer of the gracilis or medial transfer of the tibial tuberosity based on the lateral retinacular release and medial tightening. RESULTS: Twenty-eight patients were followed up for 5-87 (mean 36.6) months. The excellence rates was 92.8%. CONCLUSION: The patellofemoral alignment can be seen directly and dynamically under the arthroscopy. The combinational treatment including anterior transfer of the gracilis in repairing patellar instability can avoid the recurrence effectively and get satisfactory results.

[Clinical study on sodium hyaluronate intra-articular injection in treatment of degenerative osteoarthritis of knee].

OBJECTIVE: To evaluate the clinical effect of sodium hyaluronate (SH) intra-articular injection in treatment of degenerative osteoarthritis (DOA) of knees. METHODS: One hundred patients (116 knees) suffered from DOA were treated by SH injection intra-articularly once a week for three times. According to Lysholm scoring, clinical signs such as pain, swelling, excludes, range of movement (ROM), and the ability of walking, going upstairs and downstairs, squatting, running, were assessed before and after treatment. RESULTS: Ninety-six cases were followed up for 1 to 6 months. There were obvious improvements in the signs and function of knee in 39 patients (40.6%), only some improvements in 48 patients (50.0%), and no obvious improvements in other 9 patients (9.4%). The total effectiveness rate was 74.0%. No toxic or side effect was observed. CONCLUSION: Intraarticular injection of SH has a positive effect in relief of clinical symptoms and in improvement of articular function of DOA of knee.