A randomized controlled trial of iliopsoas plane block vs. femoral nerve block for hip arthroplasty.

BACKGROUND: Iliopsoas plane block (IPB) is a novel analgesic technique for hip surgery that retains quadriceps strength. However, evidence from randomized controlled trial is remains unavailable. We hypothesized that IPB, as a motor-sparing analgesic technique, could match the femoral nerve block (FNB) in pain management and morphine consumption, providing an advantage for earlier functional training in patients underwent hip arthroplasty. METHODS: We recruited ninety patients with femoral neck fracture, femoral head necrosis or hip osteoarthritis who were scheduled for unilateral primary hip arthroplasty were recruited and received either IPB or FNB. Primary outcome was the pain score during hip flexion at 4 h after surgery. Secondary outcomes included quadriceps strength and pain scores upon arrival at post anesthesia care unit (PACU) and at 2, 4, 6, 24, 48 h after surgery, the first time out of bed, total opioids consumption, patient satisfaction, and complications. RESULTS: There was no significant difference in terms of pain score during hip flexion at 4 h after surgery between the IPB group and FNB group. The quadriceps strength of patients receiving IPB was superior to those receiving FNB upon arrival at PACU and at 2, 4, 6 and 24 h after surgery. The IPB group showed a shorter first time out of bed compared to the FNB group. However, there were no significant differences in terms of pain scores within 48 h after surgery, total opioids consumption, patient satisfaction and complications between the two groups. CONCLUSION: IPB was not superior to FNB in terms of postoperative analgesia for hip arthroplasty. However, IPB could serve as an effective motor-sparing analgesic technique for hip arthroplasty, which would facilitate early recovery and rehabilitation. This makes IPB worth considering as an alternative to FNB. TRIAL REGISTRATION: The trial was registered prior to patient enrollment at the Chinese Clinical Trial Registry (ChiCTR2200055493; registration date: January 10, 2022; enrollment date: January 18, 2022; https://www.chictr.org.cn/searchprojEN.html ).

Spontaneous histological transformation of lung squamous-cell carcinoma to large cell neuroendocrine carcinoma and small cell lung cancer.

BACKGROUND: Histopathological transformation between different types of lung cancer cells has been reported following a variety of anti-tumor treatments. Examples include transformation from lung adenocarcinoma to squamous-cell carcinoma (SCC) and transformation from non-small cell lung cancer (NSCLC) to small cell lung cancer (SCLC). CASE REPORT: A patient with intermittent hemoptysis for 2 days underwent a computed tomography (CT) scan that revealed interstitial pneumonia in addition to two enlarged paratracheal lymph nodes: one on the right (4R) and one on the left (4L) measuring 10 and 7 mm in diameter, respectively (Fig. 1). There was no evidence of a lung or bronchial mass. Bronchoscopy identified an endoluminal primary mass in a superior segmental bronchus of the left lower lobe and pathological examination following surgery confirmed it to be SCC. At 15 months post operation, a CT scan detected that the 4R lymph node had increased in size from 10 to 16 mm in diameter. At the next follow-up 7 months later, a CT scan showed that the R4 lymph node had further increased in size from 16 to 40 mm in the short axis, making it difficult for a surgeon to resect it "en bloc" immediately. The maximum standardized uptake value was 7.5 on PET-CT images. One month following completion of one cycle of neoadjuvant chemotherapy with gemcitabine and nedaplatin, a further CT scan indicated that the lymph node had decreased in size from 40 to 30 mm in the short axis. A complete mediastinal lymphadenectomy via open thoracotomy was performed and the lymph node was resected. Histological examination identified a main large cell neuroendocrine carcinoma (LCNEC) component with a small fraction of small cell carcinoma, confirmed by immunohistochemical analysis and genetic evidence. CONCLUSION: Histopathological transformation from SCC to LCNEC with a small fraction of SCLC may have occurred spontaneously without any treatment.

Relationship between polymorphisms in homologous recombination repair genes RAD51 G172T、XRCC2 & XRCC3 and risk of breast cancer: A meta-analysis.

Background: Genetic variability in DNA double-strand break repair genes such as RAD51 gene and its paralogs XRCC2、XRCC3 may contribute to the occurrence and progression of breast cancer. To obtain a complete evaluation of the above association, we performed a meta-analysis of published studies. Methods: Electronic databases, including PubMed, EMBASE, Web of Science, and Cochrane Library, were comprehensively searched from inception to September 2022. The Newcastle-Ottawa Scale (NOS) checklist was used to assess all included non-randomized studies. Odds ratios (OR) with 95% confidence intervals (CI) were calculated by STATA 16.0 to assess the strength of the association between single nucleotide polymorphisms (SNPs) in these genes and breast cancer risk. Subsequently, the heterogeneity between studies, sensitivity, and publication bias were performed. We downloaded data from The Cancer Genome Atlas (TCGA) and used univariate and multivariate Cox proportional hazard regression (CPH) models to validate the prognostic value of these related genes in the R software. Results: The combined results showed that there was a significant correlation between the G172T polymorphism and the susceptibility to breast cancer in the homozygote model (OR= 1.841, 95% CI=1.06-3.21, P=0.03). Furthermore, ethnic analysis showed that SNP was associated with the risk of breast cancer in Arab populations in homozygous models (OR=3.52, 95% CI=1.13-11.0, P= 0.003). For the XRCC2 R188H polymorphism, no significant association was observed. Regarding polymorphism in XRCC3 T241M, a significantly increased cancer risk was only observed in the allelic genetic model (OR=1.05, 95% CI= 1.00-1.11, P=0.04). Conclusions: In conclusion, this meta-analysis suggests that Rad51 G172T polymorphism is likely associated with an increased risk of breast cancer, significantly in the Arab population. The relationship between the XRCC2 R188H polymorphism and breast cancer was not obvious. And T241M in XRCC3 may be associated with breast cancer risk, especially in the Asian population.

Copepods as Indicators of Different Water Masses during the Northeast Monsoon Prevailing Period in the Northeast Taiwan.

During this research, the average surface temperature, salinity, dissolved oxygen, and pH were 24.65 ± 1.53 (°C), 34.21 ± 0.07 (PSU), 6.85 ± 0.18 (mg/L), and 8.36 ± 0.03, respectively. Based on these environmental parameters, stations were arranged into three groups. Group A represents stations located around Keelung Island with the relative highest average dissolved oxygen, lowest average temperature, and pH values. Instead, the lowest average dissolved oxygen and highest average temperature, salinity, and pH values were recorded at the offshore stations. Keelung Island area was charged by cold water masses, which were driven by the Northeast monsoon, and stations in group C were affected by the Kuroshio Current. Kueishan Island area was mainly affected by mixed water masses resulting from the Kuroshio intrusion and monsoon-derived cold water. In this study, a total of 108 copepod species were identified, with an average abundance of 774.24 ± 289.42 (inds. m-3). Most species belong to the orders Calanoida and Poecilostomatoida, with an average relative abundance (RA) of 62.96% and 30.56%, respectively. Calanoid copepodites were the most dominant group, with a RA of 28.06%. This was followed by Paracalanus aculeatus, with a RA of 18.44%. The RA of Clausocalanus furcatus and Canthocalanus pauper was 4.80% and 3.59%, respectively. The dominant species P. aculeatus, C. pauper, Paracalanus parvus, and Temora turbinata were positively correlated with dissolved oxygen and negatively correlated with temperature in the surface waters. pH showed a negative correlation with P. parvus and T. turbinata, while the temperature was negatively correlated with these two dominant species. Indicator species were selected by an indicator value higher than 50%. Temora turbinata, Calanopia elliptica, C. pauper, Euchaeta concinna, Temora discaudata, Acartia pacifica, Macrosetella gracilis, Corycaeus speciosus, and P. parvus were considered as monsoonal cold water indicator species in Group A. Indicator copepod species for the Kuroshio Current were Farranula concinna, Copilia mirabilis, Candacia aethiopica, Corycaeus agilis, Farranula gibbula and Acrocalanus monachus in the study area. Paracandacia truncata, Oncaea clevei, P. aculeatus, and Centropages furcatus were considered suitable indicators for mixed water masses.

The effect of continuous adductor canal block combined with distal interspace between the popliteal artery and capsule of the posterior knee block for total knee arthroplasty: a randomized, double-blind, controlled trial.

BACKGROUND: The optimal analgesia for total knee arthroplasty (TKA) requires excellent analgesia while preserving muscle strength. This study aimed to determine the hypothesis that continuous adductor canal block (CACB) combined with the distal interspace between the popliteal artery and the posterior capsule of the knee (IPACK) block could effectively alleviate the pain of the posterior knee, decrease opioids consumption, and promote early recovery and discharge. METHODS: Patients undergoing unilateral, primary TKA were allocated into group CACB+SHAM (receiving CACB plus sham block) or group CACB+IPACK (receiving CACB plus IPACK block). The primary outcome was cumulative opioid consumption. Secondary outcomes included the incidence of postoperative pain originated from the posterior knee, visual analogue scale (VAS) score, range of motion, ambulation distance, and satisfaction for pain management. RESULTS: The incidence of moderate-severe pain of the posterior knee was lower in group CACB+IPACK than that of the group CACB+SHAM at 4 hours (17.1% vs. 42.8%; p = 0.019), 8 hours (11.4% vs. 45.7%; p = 0.001), and 24 hours (11.4% vs. 34.3%; p = 0.046) after TKA. The VAS scores of the posterior knee were lower in group CACB+IPACK than that of the group CACB+SHAM at 4 hours [2 (2) vs. 3 (2-4); p = 0.000], 8 hours [1 (1, 2) vs. 3 (2-4); p = 0.001], and 24 hours [1(0-2) vs. 2 (1-4); p = 0.002] after TKA. The overall VAS scores were lower in group CACB+IPACK than that of the group CACB+SHAM at 4 hours [3 (2, 3) vs. 3 (3, 4); p = 0.013] and 8 hours [2 (2, 3) vs. 3 (2-4); p = 0.032] at rest and 4 hours [3 (3, 4) vs. 4 (4, 5); p = 0.001], 8 hours [3 (2-4) vs. 4 (3-5); p = 0.000], 24 hours [2 (2, 3) vs. 3 (2-4); p = 0.001] during active flexion after TKA. The range of motion (59.11 ± 3.90 vs. 53.83 ± 5.86; p = 0.000) and ambulation distance (44.60 ± 4.87 vs. 40.83 ± 6.65; p = 0.009) were superior in group CACB+IPACK than that of the group CACB+SHAM in postoperative day 1. The satisfaction for pain management was higher in group CACB+IPACK than that of the group CACB+SHAM [9 (8, 9) vs. 8 (7-9); p = 0.024]. There was no difference in term of cumulative opioids consumption between group CACB+IPACK and group CACB+SHAM [120(84-135) vs. 120(75-135); p = 0.835]. CONCLUSION: The combination of CACB and distal IPACK block could decrease the incidences of moderate-severe posterior knee pain, improve the postoperative pain over the first 24 hours after TKA, as well as promoting recovery of motor function. However, the opioids consumption was not decreased by adding distal IPACK to CACB. TRIAL REGISTRATION: This study was registered at Chinese Clinical Trial Registry ( ChiCTR2200059139 ; registration date: 26/04/2022; enrollment date: 16/11/2020; http://www.chictr.org.cn ).

Analgesic effect of iliopsoas plane block for hip fracture.

BACKGROUND: Hip fracture and surgery are associated with moderate to severe pain, which hampers early mobilization and extends the hospital stay. Femoral nerve block and fascia iliaca compartment block could provide effective postoperative pain relief. Unfortunately, they could weaken the strength of the quadriceps muscle and increase the risk of falls. Iliopsoas plane block (IPB) is a novel motor-sparing regional technique, which targets the sensory branches of the hip joint originating from the femoral nerve. However, the analgesic effect of IPB has not been confirmed yet. CASE PRESENTATION: In the present case series, IPB and lateral femoral cutaneous nerve block were implemented under the guidance of ultrasound for eight patients with hip fractures. The median (IQR) visual analog scale (VAS) score (0-10; 0: no pain, 10: worst pain) decreased from 1.5 (0.25-2) before IPB to 0 (0-0) 0.5h after IPB at rest. The median (IQR) VAS score decreased from 8 (7-8) before IPB to 2 (1-2) 0.5h after IPB during flexion of hip 30°. Pain score was no more than one at rest and three during flexion of the hip 30° within 48h after surgery. Furthermore, the MMT grades of quadriceps strength were no less than four after IPB. CONCLUSIONS: Our case series firstly highlights that IPB might be an effective analgesic technique for hip fracture and surgery, while retaining motor function.

Association and prognostic significance of alpha-L-fucosidase-1 and matrix metalloproteinase 9 expression in esophageal squamous cell carcinoma.

BACKGROUND: Alpha-L-fucosidase-1 (FUCA1) has been demonstrated to play opposing regulatory roles in adenocarcinoma and non-adenocarcinoma. Moreover, recent studies reported that FUCA1 could decrease the invasion capability by downregulating matrix metalloproteinase 9 (MMP-9) expression. However, the potential role and prognostic significance of FUCA1 in esophageal squamous cell carcinoma (ESCC) have not yet been explored. AIM: To evaluate the status, association, and prognostic value of FUCA1 and MMP-9 expression in ESCC. METHODS: Patients who underwent esophagectomy for ESCC between January 1, 2014, and December 31, 2014 at Sun Yat-Sen University Cancer Center were enrolled. The expression status of FUCA1 and MMP-9 in cancerous tissues was detected using immunohistochemistry. In addition, the expression profiles of the FUCA1 and MMP-9 genes in non-metastatic ESCC were extracted from The Cancer Genome Atlas (TCGA) database. RESULTS: High expression of FUCA1 and MMP-9 was found in 90 patients (75.6%) and 62 patients (52.1%), respectively. In the high FUCA1 expression group, the constituent ratios of patients with stage III disease (61.1% vs 37.9%, P = 0.029), lymphatic invasion (62.2% vs 31.0%, P = 0.003), and high MMP-9 expression (60.0% vs 27.6%, P = 0.002) were significantly higher than those in the low FUCA1 expression group. In Kaplan-Meier univariate analysis, advanced tumor-node-metastasis stage (III, P = 0.001), positive regional lymph node metastasis (N+, P = 0.002), high FUCA1 expression (P = 0.001), and high MMP-9 expression (P = 0.002) were potential predictors of shorter overall survival (OS), which was similar to the results analyzed based on the TCGA database. Further Cox multivariate regression analyses still demonstrated that FUCA1 and MMP-9 expression levels were independent prognostic factors of OS [hazard ratio (HR): 0.484, 95% confidence interval (CI): 0.239-0.979; P = 0.044; and HR: 0.591, 95%CI: 0.359-0.973, P = 0.039, respectively]. CONCLUSION: FUCA1 cooperation with MMP-9 may have a major role in affecting the ESCC invasion and metastatic capability, and serve as a valuable prognostic biomarker in ESCC.

Effects of alcohol consumption on viral hepatitis B and C.

The liver is the main target organ for hepatitis viruses and the vital organ for alcohol metabolism. These two factors of viral hepatitis and alcohol abuse in combination can exert dual harmful actions, leading to enhanced damage to the liver. Epidemiological studies have revealed a higher prevalence of hepatitis C virus (HCV) infection among alcoholics than the general population. The interaction of alcohol with viral hepatitis [e.g., hepatitis B virus (HBV), HCV] and the underlying mechanisms are not fully understood. The effects of alcohol on viral hepatitis include promoted viral replication, weakened immune response, and increased oxidative stress. Clinically, alcohol abuse is correlated with an increased risk of developing end-stage liver cirrhosis and hepatocellular carcinoma in patients with chronic hepatitis B and C, suggesting that the combination of alcohol and HBV/HCV lead to more severe liver damage. The influence of mild to moderate alcohol drinking on the HBV-induced liver fibrosis, cirrhosis, and hepatocellular carcinoma among patients infected with HBV remains unclear. Unlike HBV infected patients, no safe level of alcohol intake has been established for patients with HCV. Even light to moderate alcohol use can exert a synergistic effect with viral hepatitis, leading to the rapid progression of liver disease. Furthermore, interferon-based therapy is less effective in alcohol drinkers than in control patients, even after abstinence from alcohol for a period of time. Therefore, abstaining from alcohol is highly recommended to protect the liver, especially in individuals with HBV/HCV infection, to improve the clinical efficacy of antiviral treatment and prevent the rapid progression of chronic viral hepatitis.

Endobronchial Metastasis of Renal Carcinoma: A Case Report and Review of Previous Literature.

The definition of endobronchial metastasis (EBM) lacks clarity because it is currently based on the judgments of surgeons; it is rare in patients with nonpulmonary malignancies. Although EBM represents an advanced stage of malignancy, it does not necessarily indicate a poorer prognosis than that for its primary tumors. The present study defines EBM as bronchoscopy-visible lesions with histologically confirmed primary extrapulmonary tumors, excluding those primary lung tumors with involvement of the bronchial lumen. A bronchoscopy and biopsy provide strong proof for diagnosis. Complete surgical resection is the best choice for patients with EBM. This study analyzed the case of a 69-year-old male patient who had undergone a radical left nephrectomy several years previously after the identification of a bronchoscopy-visible lesion in the left main bronchus. The lesion was initially diagnosed as an angiogenic tumor but was eventually confirmed by surgical biopsy as EBM from the left kidney. After diagnosis, the patient underwent a left pneumonectomy. The analysis of this case focused on diagnosis, symptoms, radiographic findings, treatment, and prognosis. A review of the previous literature relating to EBM was also conducted.

Efficacy and Safety of Glecaprevir/Pibrentasvir for Chronic Hepatitis C Patients: A Systematic Review and Meta-analysis.

Background and Aims: Glecaprevir/pibrentasvir is a pangenotypic regimen recently approved for the treatment of chronic hepatitis C virus (HCV) infection. The objective of the present review was to summarize the findings from clinical trials to understand how patient-related factors influence glecaprevir/pibrentasvir efficacy (sustained virologic response rates at 12 weeks' after treatment [referred to as SVR12]) and safety. Methods: Data from 21 phase III clinical trials were analyzed. Results: The integrated efficacy analysis included 4,817 patients. Findings showed 97.5% of all included patients with chronic HCV achieved SVR12 in the intention-to-treat population. SVR12 rate was >95% across subgroups of interest. The integrated safety analysis included 4,015 patients. Findings showed that 64.1% of patients reported an adverse event, and <0.1% of patients reported a serious adverse event related to glecaprevir/pibrentasvir. Conclusions: These results indicate that the 8- or 12-week glecaprevir/pibrentasvir treatment is effective for patients infected with HCV genotypes 1-6 without or with compensated cirrhosis, with good safety profiles, irrespective of treatment-experience. Glecaprevir/pibrentasvir is a good option for patients with human immunodeficiency virus/HCV coinfection and comorbid HCV and severe renal impairment.

Comparison of Adductor Canal Block and Femoral Triangle Block for Total Knee Arthroplasty.

OBJECTIVES: Adductor canal block (ACB) could provide effective postoperative pain control for patients after total knee arthroplasty (TKA). However, some authors pointed out that the ACB as originally described may be more similar to a femoral triangle block (FTB). Recent neuroanatomic evidences made the authors conjecture that the "true" ACB would provide superior analgesia compared with FTB. Therefore, the study was designed to determine the hypothesis that postoperative analgesia after TKA could be improved by a "true" ACB compared with FTB. MATERIALS AND METHODS: Patients undergoing unilateral, primary TKA were randomized into the ACB group or FTB group. The primary outcome was postoperative pain during active flexion at 8 hours after surgery measured by the visual analog scale (VAS). In addition, pain scores at other time points, quadriceps strength, morphine consumption, satisfaction of the patient, and side effects of morphine were also evaluated. RESULTS: Sixty participants completed the research. The VAS scores were lower in the ACB group than the FTB group at 8 and 24 hours at rest (P<0.05). The VAS scores were lower in the ACB group than the FTB group at 4, 8, 24, and 48 hours during active flexion (P<0.05). The quadriceps strength was superior in the ACB group than the FTB group at 4, 8, and 24 hours (P<0.05). The consumption of morphine was lower in the ACB group than the FTB group (P<0.05). However, there were no significant differences for both patient satisfaction and the incidence of adverse reactions (P>0.05). DISCUSSION: ACB can provide superior analgesia and preserve more quadriceps strength than FTB. ACB facilitates functional recovery in the early stages and is compatible with the highly recognized concept of rapid rehabilitation, which should be promoted in the clinic.

The role of IL22 polymorphisms on liver cirrhosis in patients with hepatitis B virus: A case control study.

AIMS: Interleukin(IL)-22 plays an important role in promoting liver regeneration and repair, but its role in chronic HBV-related liver diseasesis not clear. The goal of this study was to evaluate associations between eight IL22 single nucleotide polymorphisms (SNPs) and the development of chronic HBV cirrhosis and HBV-related HCC within a Chinese Han population. METHODS: We investigated associations between single nucleotide polymorphisms (SNPs) in the IL22 gene (rs1026788, rs2227472, rs2227491, rs2227485, rs1179249, rs2046068,rs2227473, and rs7314777) and the risk of HBV-related chronic liver diseases within a Han population in Northeast China. A total of 649 participants were included in the study, including 103 patients with CHB, 264 patients with LC, and 282 patients with HCC. The odds ratios (OR) and corresponding 95% confidence intervals (CI) were calculated using chi-square test. Haplotype analysis was conducted by haploview software. RESULTS: Genotype and allele distributions of SNPs rs1179249 and rs2227472 differed between LC and CHB groups (both P < 0.05).The G alleles of SNP rs2227491 and rs1026788 were more frequent in the LC group than in the CHB group (P = 0.046, P = 0.041 respectively). A IL22 haplotype consisting of the minor alleles of SNP rs1179249 and the major alleles of seven other SNPs occurred less frequently in the LC and HCC groups than in the CHB group (28.2%, 33.94%, and 37.86%, respectively, P < 0.05). Moreover, there were no significant associations between smoking or drinking and IL22 SNPs on the risk of HCC (P > 0.05). CONCLUSION: IL22 genetic variations were associated with chronic HBV infection progression, especially in the HBV-LC group. The IL22 genetic variations may help clinicians initiate the correct treatment strategy at the CHB stage.

Iron metabolism disorders in patients with hepatitis B-related liver diseases.

AIM: To investigate the relationship between levels of iron metabolism markers and hepatitis B virus (HBV)-related chronic liver diseases. METHODS: This case-control study with 318 participants included 78 cases of chronic hepatitis B, 85 cases of HBV-related liver cirrhosis, 77 cases of HBV-related hepatocellular carcinoma, and 78 healthy controls. Markers of iron metabolism were detected in participants. Hematological and biochemical parameters and HBV-DNA were assessed. Child-Pugh grade and Barcelona Clinic Liver Cancer stage were determined for each hepatocellular carcinoma patient. Perls' staining was performed on liver sections. The SPSS program was used for all statistical analyses, and statistical significance was considered if a P-value < 0.05. RESULTS: Significantly higher serum ferritin and lower serum hepcidin levels were detected in all groups of HBV-infected patients compared with healthy controls. Serum iron, total iron binding capacity, and serum transferrin levels were significantly lower in patients with cirrhosis and hepatocellular carcinoma, whereas the hepcidin level was higher than that in chronic hepatitis B patients. Correlation analysis indicated that serum hepcidin was negatively correlated with HBV-DNA load (P < 0.01). Serum ferritin and transferrin saturation levels increased proportionally to the extent of liver cirrhosis and poorer Child-Pugh scores (P < 0.05). The decreased serum iron and transferrin saturation levels were significantly correlated with a smaller hepatocellular carcinoma tumor burden according to Barcelona Clinic Liver Cancer staging. Liver histology showed a clearly increasing trend in iron deposition in the liver tissues with increased fibrosis, which became prominent at stages 3 (severe liver fibrosis) and 4 (cirrhosis). CONCLUSION: Iron metabolism disorders occur in patients with HBV-related liver diseases. The serum markers of iron metabolism disorders vary in different stages of HBV-related liver diseases.

Psychophysiological and self-reported responses in individuals with methamphetamine use disorder exposed to emotional video stimuli.

Individuals with methamphetamine use disorder (MUD) exhibit irritability and compulsive emotional responses, yet the relevant study is scarce. The characteristic of their positive and negative emotional responses can provide effective targets for the clinical intervention. In this study, we compared the emotional responses of 60 participants with MUD and 30 healthy participants to visual stimuli. They watched four types of video to elicit anger, fear, amusement, and joy emotional responses. The self-report of emotional responses (i.e., arousal, valence, and proximity), skin conductance level, and startle response were measured. Comparing to the healthy controls, the methamphetamine group's subjective arousal level of fear is significantly lower (t = 3.763, p < .01); the skin conductance level of joy is significantly higher (t = 2.086, p < .05), and the level of anger is marginal significantly higher (t = 1.984, p = .05); the startle response level of anger (t = 2.069, p < .05) and joy (t = 2.406, p < .05) is significantly higher. The methamphetamine group exhibited an enhanced emotion response to anger and a decreased response to joy which may indicate the emotion dysregulation problem caused by drug. These results provide effective targets for clinical intervention in treating patients of MUD with emotion dysregulation problems.

Identification of the Features of Emotional Dysfunction in Female Individuals With Methamphetamine Use Disorder Measured by Musical Stimuli Modulated Startle Reflex.

Emotional dysregulation contributes to the development of substance use disorders (SUDs) and is highly associated with drug abuse and relapse. Music as a contextual auditory stimulus can effectively stimulate the reward circuitry, modulate memory associated with drug taking, and enhance emotional experiences during drug taking. However, the studies of the emotional responses to music in individuals with SUDs are scarce. Using startle reflex and self-reports, this study assessed the psychophysiological and cognitive emotional responses (i.e., valence, arousal and proximity) to happy, peaceful, and fearful music stimuli in 30 females with methamphetamine use disorder (MUD) and 30 healthy females. The results found that participants with MUD showed an inhibited startle response to fearful music compared to normal controls (t = 3.7, p < 0.01), and no significant differences were found in the startle responses to happy and peaceful music between the two groups. For the self-reported ratings, participants with MUD showed a decreased arousal in the response to fearful (t = 4.1, p < 0.01) and happy music (t = 3.8, p < 0.01), an increased valence in the response to fearful music (t = 4.4, p < 0.01), and a higher level of proximity in the response to fearful (t = 3.8, p < 0.01) and happy music (t = 2.2, p = 0.03). No significant differences were found in the rating of arousal to peaceful music, the valence to happy and peaceful music, as well as the proximity to peaceful music between the two groups. The females with MUD showed attenuated psychophysiological response and potentiated cognitive response (i.e., valence, arousal) to fearful music, as well as a high proximity to musical stimuli with high arousal regardless of its valence. These results have important implications for promoting the effectiveness of assessment and therapy selections for female MUD patients with impaired emotion regulation.

[Clinical value of DC and DRs in warning sudden cardiac death of patients with coronary artery disease].

OBJECTIVE: To make risk stratification of aged patients with coronary artery disease by deceleration capacity of rate (DC) and heart rate deceleration runs (DRs) and to investigate the value of the two detection technologies in warning sudden cardiac death. METHODS: Two hundrend and eighteen patients diagnosed with coronary artery disease (CAD) by coronary angiography (CAG) were selected as observa-tion group:including 55 patients with latent coronary artery disease (LCHD), 56 patients with acute myocardial infarction (AMI), 53 patients with angina pectoris (AP), 54 patients with ischemic heart failure. Fifty-five healthy controls in our hospital were selected at the same time (control group). All patients were detected by 24-hour dynamic electrocardiogram while values of DC and DRs were automatically analyzed and calculated by software. RESULTS: The values of DC and DRs descended significantly in all CHD groups (AMI group, AP group, Ischemic Heart Failure group, LCHD group) and the difference was statistically significant (P < 0.01) compared with normal group; DC and DRs indicated the risk classification of each CAD subgroup was obviously higher than those in normal group and the difference was statistically significant(P < 0.01); CAG showed that the more coronary lesions, the larger the rage, prompt the heavier the illness, which was consistent with the risk classification of each CHD subgroup indicated by DC and DRs. CONCLUSIONS: DC and DRs can be used to analyze the function of vagus nerve, it also can be used to make risk classification of patients with CHD, and it has a higher value of pre-warning for high-risk groups. DC and DRs can be used as sensitive indexes in warning sudden cardiac death of patients with CHD.

Emodin Exerts an Antiapoptotic Effect on Human Chronic Myelocytic Leukemia K562 Cell Lines by Targeting the PTEN/PI3K-AKT Signaling Pathway and Deleting BCR-ABL.

The BCR-ABL kinase inhibitor, imatinib mesylate, is the front-line treatment for chronic myeloid leukemia, but the emergence of imatinib resistance has led to the search for alternative drug treatments. There is a pressing need, therefore, to develop and test novel drugs. Natural products including plants, microorganisms, and halobios provide rich resources for discovery of anticancer drugs. In this article, we demonstrate that emodin inhibited the growth of K562 cells harboring BCR-ABL in vitro and in vivo, and induced abundant apoptosis, which was correlated with the inhibition of PETN/PI3K/Akt level and deletion of BCR-ABL. These findings suggest that emodin is a promising agent to kill K562 cells harboring BCR-ABL.