Risk and benefit of reinitiating antiplatelet therapy after spontaneous intracerebral hemorrhage: a systematic review and meta-analysis.

OBJECTIVE: This study aimed to assess the risks and benefits of reinitiating antiplatelet therapy after spontaneous intracerebral hemorrhage (ICH) through a systematic review and meta-analysis. The reinitiation of antiplatelet therapy is commonly used to reduce major vascular events in patients with occlusive vascular diseases, but its use in ICH patients may increase the risk of bleeding. MATERIALS AND METHODS: A comprehensive search was conducted on databases including MEDLINE, Embase, Cochrane Library, clinicaltrials.gov, and the International Standard Randomized Controlled Trial Number Register (ISRCTN). Randomized controlled trials and cohort studies that investigated the use of reinitiation of antiplatelet therapy after hemorrhagic stroke were included. Data on ICH recurrence, major bleeding events, major occlusive cerebrovascular events, ischemic stroke, and all-cause mortality were extracted and analyzed using R software. RESULTS: The study included a total of 10 studies with 6,340 participants. The control group consisted of 2,964 patients who did not receive antiplatelet therapy, while the study group included 1,285 patients who received antiplatelet therapy without restrictions on the specific drug type. The meta-analysis showed that antiplatelet therapy significantly reduced the risk of ICH recurrence (RR=0.72, 95% CI: 0.59, 0.87), had no significant impact on the risk of severe bleeding events (RR=0.93, 95% CI: 0.80, 1.08), significantly lowered the risk of major occlusive cerebrovascular events (RR=0.59, 95% CI: 0.46, 0.77), had no significant effect on the risk of ischemic stroke (RR=0.77, 95% CI: 0.53, 1.12), and did not significantly influence the risk of all-cause mortality (RR=0.75, 95% CI: 0.45, 1.15). CONCLUSIONS: Based on the findings, reinitiating antiplatelet therapy after spontaneous ICH appears to be generally safe. However, the benefits in terms of reducing the risk of all-cause mortality are not evident and require confirmation through large-scale, long-term, prospective, randomized controlled trials.

[Effect of vascular changes on prognosis after induced chemotherapy for advanced hypopharyngeal carcinoma].

Objective: To analyze the clinical characteristics of two groups(vascular classification declines or not in narrow band imaging (NBI) of patients with advanced hypopharyngeal carcinoma after induced chemotherapy, to follow-up and compare the survival differences between the two groups, and to explore the effect of vascular changes on clinical prognosis after induced chemotherapy in patients with advanced hypopharyngeal carcinoma. Methods: Clinical data of 56 patients with advanced hypopharyngeal carcinoma from August 2014 to September 2016 in Beijing Tongren Hospital, Capital Medical University were collected. The patients were divided into two groups according to NBI vascular classification declines or not after induced chemotherapy. The survival of patients and the impact of different factors on the prognosis were retrospectively analyzed. SPSS 24.0 statistical software was used for analysis. Frequency data were compared between the two groups using χ(2) test. Kaplan-Meier method and Cox regression analysis were employed for survival analysis and Log-Rank test was used for inter-group comparison, P<0.05 was statistically significant. Results: There was significant difference in overall survival rate(OS) between two groups of patients with advanced hypopharyngeal carcinoma after induced chemotherapy (P<0.05). Multivariate analysis showed that NBI vascular classification changes after induced chemotherapy was the impact factor for prognosis of advanced hypopharyngeal carcinoma after induced chemotherapy. Conclusion: In addition to recurrence and metastasis, NBI vascular classification changes is the important impact factor for prognosis of advanced hypopharyngeal carcinoma after induced chemotherapy. Patients with NBI vascular classification declines have significant survival benefit. The patients with advanced hypopharyngeal carcinoma should be checked with NBI examination before and after induced chemotherapy. NBI should be included in the routine screening indicators for prognosis of advanced hypopharyngeal carcinoma.

[Effects and mechanism of fecal transplantation on acute lung injury induced by lipopolysaccharide in rats].

Objective: To investigate the effect of fecal microbiota transplantation (FMT) on acute lung injury (ALI) induced by lipopolysaccharide (LPS) and its regulatory mechanism. Methods: Fifteen rats were divided into control group, LPS group and LPS+FMT group by random number table method. LPS group and LPS+FMT group were intraperitoneally injected with LPS to generate rat ALI model. After 24 h of modeling, feces (10 ml/kg) were given to the LPS+FMT group twice a day, and the control group and LPS group were given the same amount of normal saline. The intervention lasted for 2 days. After 24 h of the last fecal microbiota transplantation, arterial blood gas analysis was performed in each group. Then rats were sacrificed and enzyme-linked immunosorbent (ELISA) method was used to detect intercellular adhesion molecule 1 (ICAM-1) content in the serum and bronchoalveolar lavage fluid (BALF). The lung wet-dry weight ratio (W/D) was evaluated; HE staining and lung tissue pathology scoring, immunohistochemical detection of nuclear factor-kappa B (NF-κB) predominate nuclear expression and expression of ICAM-1 of alveolar epithelial cells were conducted; Western blot was used to detect the expression of proteins related to the intracellular phosphatidylinositol kinase (PI3K)/protein kinase (AKT) signaling pathway. Samples of rat feces were collected and DNA was extracted. Polymerase chain reaction (PCR) products of the V3 and V4 regions of the 16S ribosomal RNA gene (16SrDNA) were sequenced at high throughput, and bioinformatics analysis was conducted on the microbial community based on the operational classification unit. Results: The lung W/D and lung histopathological score of the LPS group were significantly higher than those of the control group, while the arterial partial oxygen pressure (PaO(2)) of the LPS group was significantly lower than that of the control group [(79.2±5.89 vs 95.2±2.77) mmHg, 1 mmHg=0.133 kPa](all P<0.05). The results of intestinal flora sequencing revealed that the diversity index of LPS group was significantly higher than that of the control group, while the lactobacillus of LPS group rats was significantly lower than that of the control group. The content of ICAM-1 in serum, BALF and its relative expression on the cell membrane in the LPS group was significantly higher than that in the control group [(8.64±0.87) vs (7.40±0.32) ng/L; (0.941±0.035) vs (0.739±0.079) ng/L; (0.250±0.010) vs (0.076±0.010)] (all P<0.05). Moreover, the relative expression levels of phosphorylated P65 (p-P65), p-PI3K and p-AKT nucleoprotein in the LPS group were significantly higher than those in the control group (4.89±0.27 vs 3.28±0.13, 0.265±0.030 vs 0.036±0.013 and 0.444±0.040 vs 0.109±0.016) (all P<0.05). The above injury effect was reduced after fecal fungus transplantation. The lung W/D and lung pathological score of LPS+FMT group were significantly lower than those of LPS group, and PaO(2) of LPS+FMT group was significantly higher than that of LPS group [(88.0±3.53) mmHg]. The results of intestinal flora sequencing revealed that the diversity index of LPS+FMT group was significantly lower than that of LPS group, and the lactobacillus genus of LPS+FMT group was significantly higher than that of LPS group. ICAM-1 in the blood serum ((7.44±0.46) ng/L), BALF (0.834±0.040) ng/L) and its relative expression on alveolar epithelial cell membrane (0.173±0.030), the relative expression of p-P65, p-PI3K and p-AKT protein of NF-κB in alveolar epithelial cells was down-regulated ((2.99±0.28, 0.090±0.013 and 0.206±0.018) in LPS+FMT group than those of LPS group, the differences were statistically significant (all P<0.05). Conclusion: Fecal transplantation can alleviate lipopolysaccharide-induced acute lung injury in rats, and its regulatory effect may be related to inhibiting the activation of PI3K/AKT/NF-κB signaling pathway and reducing the expression of inflammatory factor ICAM-1.

[Analysis of distant metastasis and related factors of head and neck mucosal melanoma].

Objective:To analyze the characteristics and related factors of distant metastasis of head and neck mucosal melanoma, so as to provide better help for the treatment and the control of patients' survival. Method:Retrospectively analyze the patients of head and neck mucosal melanoma who were treated in our hospital from January 2004 to December 2016, through follow-up, of which 37 cases of patients with metastatic disease were analyzed which including the incidence of distant metastasis, specific metastasis and prognosis, time, etc.The age and gender of the patients were controlled, and 37 cases of 1∶1 were selected randomly in the patients who had no distant metastasis. χ² test, Kaplan-Meier analysis and multiple factor logistics regression model were used to analyze the related factors of distant metastasis of head and neck mucosal melanoma. Result: The time from hospitalization to distant metastasis was 5-98 months, and the median progression time was 18 months. 27 people died in the 37 cases, 10 people were still alive,which lung metastasis accounted for 32.43%(12/37) , peritoneal metastasis accounted for 16.22% (6/37), bone metastases accounted for 5.41%(2/37), the presence of multiple organ metastasis (lung, liver, brain) patients accounted for 45.95%(17/37).χ² test and Kaplan_Meier analysis showed that no matter whether there was pigmentation or not, postoperative radiotherapy, AJCC staging and operation mode were the significant factors.Finally,multiple factor logistics regression model showed AJCC staging, and the presence of pigment deposition was associated with metastasis. Conclusion: There is a wide variety of multiple organ metastasis when found.Less brain metastases. According to the AJCC stage, patients with advanced stage usually predict poor prognosis and distant metastasis after operation.The patients' lesion without pigmented melanoma have a great chance of distant metastasis..

[Clinical characteristic and prognostic analyses of 117 cases of head and neck mucosal melanoma].

Objective: To study the clinical characteristics of mucosal melanoma in the head and neck, including the risk factors affecting distant metastasis, recurrence and survival rate, and to provide the basis for the individualized treatment of mucosal melanoma in the head and neck. Methods: The clinical data of 117 cases of mucosal melanoma in the head and neck treated from January 2004 to June 2016 in Beijing Tongren Hospital were analyzed retrospectively, and the risk factors affecting the prognosis, distant metastasis and local recurrence were analyzed.Kaplan-Meier analysis was used for survival analysis, and Log-Rank test was used for comparison between groups. Results: The follow-up time was 5-139 months, with a median of 32 months, and the median survival time was 34 months.The 3 and 5 year cumulative survival rates were 47.0% and 25.0%, respectively.Local recurrence occurred in 27 patients (23.1%), and distant metastasis in 37 cases (31.6%). After the operation, 50 patients received radiotherapy.Multiple factor Cox regression analysis showed that distant metastasis, AJCC staging, and two operations were risk factors affecting survival (P<0.05), and immunologic/targeted therapy was a protective factor affecting survival prognosis(P=0.008). Postoperative radiotherapy and distant metastasis were important factors affecting recurrence (P<0.05). AJCC staging, pigmentation, and postoperative recurrence were risk factors for distant metastasis (P<0.05). Conclusion: The 3 and 5 year survival rates of primary mucosal melanoma in head and neck are low, and the incidence of local recurrence and distant metastasis are high. Surgery is the first choice and the integrity of the initial operation has an important impact on the prognosis of the patients. Postoperative adjuvant radiotherapy is recommended to improve the local control rate, and immunotherapy and targeted therapy should be applied in time to improve survival.

MiR-616 promotes proliferation and inhibits apoptosis in glioma cells by suppressing expression of SOX7 via the Wnt signaling pathway.

OBJECTIVE: Accumulating evidence has indicated that miR-616 exerts tumor promoter roles in several types of cancer. However, the expression pattern and roles of miR-616 in glioma progression remain unknown. This study aimed to reveal the role of miR-616 in glioma cell proliferation and its potential mechanisms. PATIENTS AND METHODS: Real-time polymerase chain reaction was used to assay the expression of miR-616 in glioma tissue samples and glioma cell lines. MTT proliferation assay and flow cytometry analysis were performed to test the apoptosis and proliferation of glioma cell after down-regulation of miR-616. The target of miR-616 was predicted by TargetScan and confirmed by luciferase reporter assay. Changes in Wnt signaling markers expression were assessed using Western blotting. RESULTS: We found that the expression of miR-616 was increased in glioma tissues and cell lines. MTT and low cytometry analysis indicated that down-regulation of miR-616 significantly inhibited proliferation and promoted apoptosis in glioma cells. Moreover, SOX7 was confirmed to be a direct target of miR-616 in glioma cells using luciferase assay and Western blotting. Finally, it was found that down-regulation of miR-616 or upregulation of SOX7 could suppress the activity of Wnt/ß-catenin signaling in glioma cells. CONCLUSIONS: Our findings indicated that miR-616 acted as a tumor promoter in glioma, and its oncogenic roles were involved in the regulation of SOX7 and Wnt/ß-catenin signaling. Moreover, knockdown of miR-616 may provide a potential therapeutic strategy for glioma.

Association between downexpression of miR-1301 and poor prognosis in patients with glioma.

OBJECTIVE: MiR-1301 has been shown to be frequently down-regulated in various tumors. However, the clinical significance of miR-1301 in human glioma is still unclear. The aim of this study was to evaluate the prognostic impact of the expressions of miR-1301 in patients with glioma. PATIENTS AND METHODS: Quantitative Real-time PCR was used to determine the expression miR-1301 in glioma tissues and pair-matched adjacent normal tissues. The relationships between miR-1301 expression and clinicopathological parameters were examined by X2 test. Kaplan-Meier curves and multivariate Cox proportional models were used to study the impact on clinical outcome. RESULTS: We observed that miR-1301 expression was significantly lower in glioma tissues compared with adjacent non-cancerous tissues (p<0.01). Also, low expressions of miR-1301 were significantly associated with high WHO grade (p<0.006), low Karnofsky performance score (KPS) (p=0.001), and large tumor size (p=0.004). Furthermore, the data of Kaplan-Meier survival analysis showed that low miR-1301 expression significantly associated with a worse overall survival (p=0.003) and disease-specific survival (p=0.001). Finally, the univariate and multivariate analysis showed that the miR-1301 expression was an independent predictor for both overall survival and disease-specific survival in glioma. CONCLUSIONS: Our findings suggested lower miR-1301 expression resulted in poorer survival in patients with glioma, which may provide important indicators for further research.

[The related factors of head and neck mocosal melanoma with lymph node metastasis].

Objective:To investigate the related factors of mucosal melanoma of head and neck with lymph node metastasis for early diagnosis and further treatments. Method:A retrospective analysis of 117 cases of head and neck mucosal malignant melanoma patients which received surgical treatment was performed. Eleven cases of patients with pathologically confirmed lymph node metastasis and 33 cases without lymph node metastasis (1∶3) were randomly selected to analyze. The related factors of lymph node metastasis of head and neck mucosal melanoma patients including age, gender, whether the existence of recurrence, bone invasion, lesion location were analyzed. The single factor and logistic regression analysis were performed, P<0.05 difference was statistically significant. Result:The lymph node metastasis rate of head and neck mucosal melanoma was 9.40%(11/117), the single factor analysis showed that there were 3 factors to be associated with lymph node metastasis, which was recurrence (P=0.0000), bone invasion (P=0.001), primary position (P=0.007). Recurrence (P=0.021) was a risk factor for lymph node metastasis according to the Logistic regression analysis, and the impact of bone invasion (P=0.487) and primary location (P=0.367) remained to be further explored. Conclusion:The patients of head and neck mucosal melanoma with the presence of recurrent usually accompanied by a further progression of the disease, such as lymph node metastasis, so for recurrent patients should pay special attention to the situation of lymph node and choose the reasonable treatment.

Molecular characterization and tissue expression profile of three novel ovine genes: ATP5O, NDUFA12 and UQCRH from muscle full-length cDNA library of black-boned sheep.

Three novel ovine genes were obtained from muscle full-length cDNA library of black-boned sheep. Sequence analysis revealed that nucleotide sequences of these genes were not homologous to any of the known sheep or goat genes, but these genes have high similarity to ATP synthase subunit O (ATP5O), NADH dehydrogenase (ubiquinone) 1 alpha subcomplex, 12 (NDUFA12) and ubiquinol-cytochrome c reductase hinge protein (UQCRH) genes of other mammal animals (accession number: FJ546085, FJ546078 and FJ546083). The alignment analysis showed that the ovine ATP5O, NDUFA12 and UQCRH genes and proteins have closer genetic relationships with the ATP5O, NDUFA12 and UQCRH genes and proteins from cattle. Conserved domain prediction showed that these three genes included OSCP, NDUFA12 superfamily and UCR-hinge superfamily domains respectively. The deduced sequence of ATP5O, NDUFA12 and UQCRH protein had 213, 145 and 91 amino acid residues, with a molecular weight of approximately 23419.66, 17089.50 and 10657.75 Da and a theoretical isoelectric point of 9.90, 9.68 and 4.45. The secondary structure prediction revealed that 60% helix structure in ATP5O, 60% coils in NDUFA12 and no strand in UQCRH. One potential signal peptide structure in ATP5O protein were found. NDUFA12 and UQCRH have the extremely low possibility of signal peptides. Meanwhile, RasMol was used for visualizing the PDB files generated by Swiss-Model in cartoon or three-dimensional format. ATP5O and UQCRH protein were modeled by Swiss-Model. Tissue expression profile indicated that the ovine ATP5O, NDUFA12 and UQCRH genes could be expressed in all detected tissues including muscles, heart, liver, spleen, lung, kidney and adipose tissues, but the expression abundance of these genes were various in the different tissues. Our experiment supplied the primary foundation for further researches on these three ovine genes.

New evidence that deformed wing virus and black queen cell virus are multi-host pathogens.

The host-range breadth of pathogens can have important consequences for pathogens' long term evolution and virulence, and play critical roles in the emergence and spread of the new diseases. Black queen cell virus (BQCV) and Deformed wing virus (DWV) are the two most common and prevalent viruses in European honey bees, Apis mellifera. Here we provide the evidence that BQCV and DWV infect wild species of honey bees, Apis florea and Apis dorsata. Phylogenetic analyses suggest that these viruses might have moved from A. mellifera to wild bee species and that genetic relatedness as well as the geographical proximity of host species likely play an important role in host range of the viruses. The information obtained from this present study can have important implication for understanding the population structure of bee virus as well as host-virus interactions.

[An investigation of the bio-tribological performance of diamond-like carbon/ultrahigh molecular weight polyethylene couple].

OBJECTIVE: To evaluate the friction property of diamond-like carbon (DLC) film/Ti6Al4V gradient material sliding against UHMWPE couple. METHOD: Tests of this couple were made under dry sliding and lubrication of Hank's solution and 0.9% NaCl solution respectively, and they were compared with the friction property of Ti6Al4V sliding against UHMWPE couple. The tests were performed on an SRV friction and wear tester by means of surface-contact and coefficients of friction were recorded real-time. RESULT: DLC film could reduce the friction coefficient evidently. The coefficients of friction reduced 24%, 5.0%, 10% than these of Ti6Al4V under dry sliding and lubrication of Hank's solution and 0.9% NaCl solution respectively. Mechanism of friction was also studied by observing scanning electrical microscopy (SEM) morphology of frictional surfaces. CONCLUSION: Friction-reduction mechanism of DLC film/Ti6Al4V could be resulted from amorphous structure of DLC film which was smooth and hard.

[Hepatic hemodynamic changes in liver cancer patients during intrahepatic arterial angiotensin II infusion induced hypertension and chemoembolization].

In this report, hepatic hemodynamics were studied by pulsed ultrasound doppler during the process of intrahepatic arterial angiotensin II infusion induced hypertension and chemoembolization (IHCE) in 20 liver cancer patients. It was found that at 90 seconds after I-HCE, tumor blood supply increased by an average of 1.786 times while the blood flow of proper hepatic artery decreased to an average of 0.5665 times of its original level. At the same time patients' peripheral blood pressure increased by 3.7kPa. It is evidenced that angiotensin II infusion augments blood flow to tumor region while decreases blood supply in healthy tissues.

Serotonergic projections from the nucleus raphe dorsalis to the amygdala in the rat.

Previous studies have shown a possible connection between the nucleus raphe dorsalis (NRD) and the amygdala in mediating opioid analgesia. In the present study, horseradish peroxidase (HRP) retrograde tracing was used in combination with serotonin (5-HT) immunocytochemical staining in an attempt to search for serotonergic projections from the NRD to the amygdala. In rats which received an injection of HRP into the amygdala, HRP retrogradely labelled 5-HT-immunoreactive cells were observed in the NRD. About 10% of the 5-HT-immunoreactive neurons in the NRD give rise to axons to the amygdala. These cells are predominantly situated in the ipsilateral wing and ventromedial part of the NRD. These data indicate the existence of serotonergic projections from the NRD to the amygdala, providing a morphological substrate for the putative antinociceptive pathway from the NRD to the amygdala.