Combined traditional Chinese medicine therapy for the treatment of infertility with polycystic ovary syndrome: A network meta-analysis of randomized controlled trials.

BACKGROUND: Polycystic ovary syndrome (PCOS) infertility has attracted great attention from researchers due to its high incidence. Numerous studies have shown that Chinese medicine is effective in treating this disease, but there is a wide variety of Chinese medicine therapies available, and there is a lack of comparative evaluation of the efficacy of various Chinese medicine combination therapies in the clinic, which requires further in-depth exploration. This study aims to evaluate the efficacy of a combined traditional Chinese medicine (TCM) therapy for the treatment of infertility with PCOS using network meta-analysis (NMA). METHODS: In PubMed, web of Science, Cochrane Library, Embase, China Knowledge Network, Wanfang Data, VIP Database, China Biomedical Literature Database (SinoMed) databases, searchs were conducted for information about the randomized controlled trials (RCTs) of combined TCM therapy for the treatment of infertility with PCOS. Quality evaluation was performed using the Cochrane 5.3 risk of bias assessment tool, and NMA using Stata 16.0. RESULTS: This study comprised 28 RCTs using 8 combined TCM therapies in total. The results of the NMA showed that moxibustion + herbal, fire acupuncture + herbal, acupuncture + herbal, electroacupuncture + herbal, and acupoint application + herbal improved the clinical pregnancy rate better than acupuncture, herbal, and western medicines monotherapy (P < .05). Additionally, ear point pressure + herbal enema + herbal, acupuncture and moxibustion + herbal, fire acupuncture + herbal, and acupuncture + herbal improved the ovulation rate better than acupuncture, herbal, and western medicines monotherapy (P < .05). Moxibustion + herbal, fire acupuncture + herbal, and acupuncture + herbal are the 3 most effective therapies for improving the clinical pregnancy rate. Fire acupuncture + herbal, acupuncture + herbal, and ear point pressure + herbal enema + herbal are the 3 most effective therapies for improving the ovulation rate. CONCLUSION: The combined TCM therapy demonstrated better efficacy for the treatment of infertility with PCOS compared to acupuncture, herbal, and western medicines monotherapy. However, the optimal treatment therapy varied depending on the outcome indicators. Further large sample, high-quality, and standardized RCTs are needed to verify these findings.

Meta-Analysis of the Association Between Asthma and the Risk of Stroke.

Introduction: Asthma and stroke share many risk factors. Previous meta-analysis has indicated that asthma is associated with an increased risk of stroke. However, this study were limited by the small number of articles included and the lack of subgroup analyses of different stroke types and different populations. This meta-analysis aimed to synthesize evidence systematically to investigate the impact of asthma on stroke. Methods: We searched Medline (via PubMed), Web of Science and EMBASE databases and manually identified eligible studies (inception dates to December 25, 2021) that analyzed the association between asthma and stroke. We conducted quality assessment to evaluate the risk of bias of studies and sensitivity analyses to test the robustness of results. Results: We included 8 cohort studies and 10 cross-sectional studies comprised 3,011,016 participants. We found patients with asthma had a higher risk of stroke than patients without asthma [relative risk (RR): 1.34, 95% confidence interval (CI): 1.21-1.47]. Moreover, asthma significantly increased the risk of ischemic stroke (RR: 1.25, 95% CI: 1.06-1.47) without increasing the risk of hemorrhagic stroke (RR: 1.08, 95% CI: 0.87-1.34). Asthma increased the risk of stroke in both men (RR: 1.20, 95% CI: 1.10-1.32) and women (RR: 1.29, 95% CI: 1.12-1.48) with no significant difference between the sexes. We also found that patients with inactive asthma, child-onset asthma, or no smoking history did not have an increased risk of stroke. Conclusions: These results supported the finding that asthma could significantly increase the risk of stroke, but this impact was not consistent in different populations. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=290745, identifier: CRD42021290745.

Methionine as a methyl donor regulates caste differentiation in the European honey bee (Apis mellifera).

Nutrition contributes to honey bee caste differentiation, but the role of individual nutrients is still unclear. Most essential amino acid contents, except that of methionine (Met), are greater in royal jelly than worker jelly. After ∼3.5 d, the Met content in the latter was slightly greater than in the former. Met is the major raw material used in the synthesis of S-adenosyl-L-methionine, an active methyl donor for DNA methylation, which is an epigenetic driver of caste differentiation. Here, we tested whether Met regulates caste differentiation in honey bees by determining its effects on the caste development of bees receiving four diets: the basic, basic + 0.2% Met, basic + 0.2% Met + 20 mg/kg 5-azacytidine, and basic + 20 mg/kg 5-azacytidine. The presence of Met decreased the adult bee body length and the numbers of ovarioles, indicating that Met may direct the development of female larvae toward worker bees. The upregulated expression of SAMS, Dnmt1, and Dnmt3 caused by Met exposure in 4-d-old larvae indicated that the worker-inductive effects of Met may occur through the promotion of DNA methylation. We investigated the co-effects of Met and glucose on bee development, and found that the effects of an increased glucose level on the number of ovarioles and body length did not strengthen the worker-inductive effects caused by Met. Our results contribute to caste development theory and suggest that Met-as a methyl donor-plays a regulatory, but not decisive, role in caste differentiation.

[Correlation of male libido with the levels of serum reproductive hormones].

OBJECTIVE: To investigate the correlation between male libido and the levels of serum reproductive hormones. METHODS: We collected the clinical data on 134 men complaining of low or decreased sexual desire at our clinic of andrology from January 2013 to July 2018. According to the scores on the 13-item Self-Rating Libido Scale for Males (SRLS-M), we divided the subjects into a low libido (n = 68) and a normal libido group (n = 66), none with thyroid and adrenal diseases, liver and kidney diseases, or administration of drugs affecting sexual function and reproductive hormones in the past two weeks. We compared the age, history and course of disease, SRLS-M scores, levels of serum T, E2, LH, FSH and PRL, and T/E2 ratio between the two groups, and analyzed the correlation of the parameters obtained with the SRLS-M scores of the patients by Pearson correlation analysis. RESULTS: Compared with the males of the normal libido group, the low-libido patients showed a significantly longer course of disease (ï¼»1.83 ± 0.44ï¼½ vs ï¼»2.91 ± 0.08ï¼½ yr, P < 0.05), but lower SRLS-M score (31.47 ± 1.28 vs 19.56 ± 0.89, P < 0.01), T level (ï¼»17.51 ± 3.68ï¼½ vs ï¼»11.46 ± 1.62ï¼½ nmol/L, P < 0.01) and T/E2 ratio (17.27 ± 3.94 vs 12.42 ± 1.38, P < 0.01). No statistically significant differences were found between the normal and low libido groups in age (ï¼»32.22 ± 2.29ï¼½ vs ï¼»31.98 ± 2.19ï¼½ yr) or the levels of E2 (ï¼»103.97 ± 15.70ï¼½ vs ï¼»94.45 ± 10.37ï¼½ pmol/L), FSH (ï¼»9.98 ± 5.26ï¼½ vs ï¼»7.43 ± 3.84ï¼½ IU/L), LH (ï¼»5.70 ± 3.17ï¼½ vs ï¼»5.20 ± 3.37ï¼½ IU/L), or PRL (ï¼»281.96 ± 82.68ï¼½ vs ï¼»371.85 ± 243.38ï¼½ mIU/L). Pearson correlation analysis showed that the SRLS-M scores of the patients in the normal and low libido groups were positively correlated with the T level (r = 0.329 and 0.535, P<0.01) and T/E2 ratio (r = 0.542 and 0.603, P<0.01), and so was the T level with E2 (r = 0.743 and 0.644, P<0.01) and T/E2 (r = 0.387 and 0.618, P<0.01). The areas under the ROC curves for T, E2 and T/E2 were 0.660, 0.527 and 0.669, respectively. A T/E2 ratio of 12.15－15.73 exhibited a relatively high sensitivity (>0.5) and specificity (>0.5) in the diagnosis of low libido. CONCLUSIONS: The T level and T/E2 ratio are important factors, and E2 may also be a factor, influencing male libido, which, however, is more correlated with T/E2. A T/E2 ratio of 12.15－15.73 may be an indicator of normal libido, while a lower or higher T/E2 ratio may suggests low libido.

Icariside II Promotes the Differentiation of Adipose Tissue-Derived Stem Cells to Schwann Cells to Preserve Erectile Function after Cavernous Nerve Injury.

Icariside II (ICA II) is used in erectile dysfunction treatment. Adipose tissue-derived stem cells (ADSCs) are efficient at improving erectile function. This study aimed to explore the action mechanism of ADSCs in improving erectile function. ADSCs were isolated from the adipose tissues of rats. Cell proliferation was determined using the Cell Counting Kit-8 (CCK-8) assay. The expressions of mRNA and protein were determined separately through qRT-PCR and western blot. The endogenous expressions of related genes were regulated using recombinant plasmids and cell transfection. A Dual-Luciferase Reporter Assay was performed to determine the interaction between miR-34a and STAT3. Rat models with bilateral cavernous nerve injuries (BCNIs) were used to assess erectile function through the detection of mean arterial pressure (MAP) and intracavernosal pressure (ICP). ICA II promoted ADSCs' proliferation and differentiation to Schwann cells (SCs) through the inhibition of miR-34a. Suppressed miR-34a promoted the differentiation of ADSCs to SCs by upregulating STAT3. ICA II promoted the differentiation of ADSCs to SCs through the miR-34a/STAT3 pathway. The combination of ICA II and ADSCs preserved the erectile function of the BCNI model rats. ADSCs treated with ICA II markedly preserved the erectile function of the BCNI model rats, which was reversed through miR-34a overexpression. ICA II promotes the differentiation of ADSCs to SCs through the miR-34a/STAT3 pathway, contributing to erectile function preservation after the occurrence of a cavernous nerve injury.

Laparoscopic Subcutaneous Transposition of a Pedicled Adrenal for ACTH-Independent Bilateral Macronodular Adrenal Hyperplasia.

BACKGROUND AND PURPOSE: Bilateral adrenalectomy or unilateral adrenalectomy and contralateral partial adrenalectomy are indicated for the treatment of ACTH-independent macronodular adrenal hyperplasia. Independent of the surgical procedure, the prognosis is poor. This article discusses a new treatment method and its efficacy for treating nodular adrenal hyperplasia. METHODS: We performed a retrospective review of the medical records of 12 patients operated on between January 2008 and October 2014 at the First Affiliated Hospital of Zhengzhou University. All patients were treated by laparoscopic subcutaneous transposition of a pedicled adrenal. We performed postoperative monitoring of patients, including clinical symptoms and 24-hour levels of serum-free and urinary-free cortisol. RESULTS: All 12 patients were pathologically confirmed to have nodular adrenal hyperplasia and were followed for an average of 45.5 months (range 24-60 months). The clinical symptoms of all patients disappeared, and the 24-hour plasma-free cortisol and urinary-free cortisol levels were within the normal range. CONCLUSIONS: Laparoscopic subcutaneous transposition of a pedicled adrenal is a new and effective method for treating bilateral macronodular adrenal hyperplasia and can achieve long-term remission of Cushing's syndrome.

[Transurethral seminal vesiculoscopy for the treatment of vesiculitis with hemospermia:A report of 64 cases].

Objective: To explore the treatment of vesiculitis with hemospermia by transurethral seminal vesiculoscopy. Methods: We treated 64 cases of vesiculitis with hemospermia by transurethral seminal vesiculoscopy. During the operation,we removed the stones and inflammatory substances and collected seminal vesicle fluid to be cultured for bacteria,ureaplasma urealyticum(UU),chlamydia trachomatis(CT),and mycoplasma hominis(MH),followed by infusion of levofloxacin at 0. 3 g/100 ml into the seminal vesicle. Regular follow-up was conducted post-operatively. Results: All the operations were successfully accomplished, the operation time averaging(40 ± 15) min(25- 50 min). The ejaculatory duct opening was observed on the verumontanum surface in the posterior urethra in 2 cases, abnormal passages found in the prostatic utricle in 8 cases, and seminal vesicle fenestration from the prostatic utricle conducted in the other 54 cases(32 by seminal vesiculoscopy and 22 with holmium laser). Stones were seen in the prostatic utricle in 5 cases, in the seminal vesicle in 6 cases, and in both the prostatic utricle and seminal vesicle in 2 cases. Culture of the seminal vesicle fluid showed the acinetobacter to be positive in 1 case and UU, CT, and MH to be negative. At 3 months after surgery, hemospermia was cured in 52 cases, relieved in 8,and unimproved in 4. Conclusion: Seminal vesicle fenestration drainage by transurethral seminal vesiculoscopy for the treatment of vesiculitis with hemospermia has the advantages of short operation time, high effectiveness and no obvious complications and can also be employed for the examination of the seminal vesicle as well as removal of stones and inflammatory substances.

Laparoscopic Extravascular Stent Placement for Nutcracker Syndrome: A Report of 13 Cases.

OBJECTIVE: To report our techniques and experience of laparoscopic extravascular stent placement for nutcracker syndrome. PATIENTS AND METHODS: This study included 13 nutcracker syndrome patients who were treated by laparoscopic extravascular stent placement from June 2009 to August 2013. Clinical and surgical data and short-term outcomes were analyzed retrospectively. RESULTS: The average duration of the operation was 72 minutes and the average blood loss was 30 mL. The average postoperative length of stay was 6 days. Retroperitoneal hematoma was relieved by conservative therapy in one patient. The postoperative computed tomography showed that the blood outflow of the left renal vein was smooth and the inner diameter was also decreased. The gonadal vein varices diminished in diameter in four patients. The follow-up was 8-52 months (mean 32.6); symptoms resolved in 10 patients and improved in 2 patients. One patient developed recurrent gross hematuria because of migration of the extravascular stent. CONCLUSION: Laparoscopic extravascular stent placement appears feasible and safe and it is a minimally invasive alternative to open surgery.

Association of BTBD7 with Metastasis and Poor Prognosis in Non-Small-Cell Lung Cancer Patients.

Metastasis in lung cancer portends a poor prognosis, and the epithelial-mesenchymal transition (EMT) in lung cancer cells is considered a prerequisite to achieve metastatic potential. Recent studies indicate that BTB/POZ domain-containing protein 7 (BTBD7) regulates EMT-associated proteins in human malignancies and however, the role of BTBD7 in lung cancer have not been identified. In present study, we examined BTBD7 expression status and its association with unfavorable clinical features in non-small-cell lung cancer (NSCLC). Firstly, we studied the fresh specimens, and found that both mRNA and protein expression levels of BTBD7 in NSCLC tissue were significantly increased compared with the adjacent nontumorous lung tissue. Then, we determined BTBD7 protein expressions in the paraffin-embedded samples from NSCLC patients, and analyzed the relations of BTBD7 expression with clinicopathologic features of the patients. The results showed that incidence of metastasis in patients with positive BTBD7 expression was significantly higher than that in those with negative BTBD7 expression, and the positive BTBD7 expression rate in metastatic cases was significantly higher than that in non-metastatic ones; furthermore, Cox regression analyses revealed that BTBD7 was an independent risk factor for either metastasis or survival in NSCLC patients. Thus, we conclude that BTBD7 contributes to metastasis of NSCLC and BTBD7-positive NSCLC may have a high potential for metastasis and thereby a poor prognosis.

[Radiation-induced oxidative stress and claudin-11 mRNA expression in the testis].

OBJECTIVE: To investigate the role of claudin-11, a tight junction component of Sertoli cells, in spermatogenic dysfunction induced by oxidative stress in mice exposed to local radiation. METHODS: We randomly allocated 48 male Kunming mice to a blank control group (A) and three radiation groups (B, C and D) of equal number, the latter three exposed to local radiation of the lower abdomen with 2 Gy, 6 Gy and 10 Gy of 60Co-gamma-ray, respectively, to induce oxidative stress. Four weeks later, we killed the animals, obtained their body and testis weights, observed the histological changes of the testis by HE staining, measured the levels of serum FSH, testosterone and LH by ELISA, and determined the mRNA levels of claudin-11 and inhibin beta B in Sertoli cells by real time quantitative PCR. RESULTS: After exposure to 60Co-gamma-ray radiation, the testis weights were (129.4 +/- 10.81), (87.5 +/- 16.83) and (56.1 +/- 12.36) mg in groups B, C and D, significantly decreased as compared with (182.9 +/- 8.43) mg in group A (P < 0.05); the testis indexes were (3.39 +/- 0.57), (2.46 +/- 0.46) and (1.63 +/- 0.44) mg/g in groups B, C and D, remarkably lower than (4.28 +/- 0.31) mg/g in group A (P < 0.01). Histological analysis revealed obviously decreased diameters of seminiferous tubules, reduced seminiferous epithelia and disarranged spermatogenic cells in the three radiation groups. The tubule differentiation indexes (TDI) were markedly lower in groups B, C and D than in A (P < 0.01). The levels of serum FSH were (6.74 +/- 1.95), (8.41 +/- 2.44) and (10.93 +/- 3.16) IU/L in groups B, C and D, 1.9 times higher in D than in A. With increased dose of radiation, the mRNA levels of inhibin beta in the testis tissue were descended, while the transcription levels of claudin-11 elevated, significantly higher in groups C and D than in A (P < 0.01). CONCLUSION: Local radiation-induced testicular oxidative stress can decrease the mRNA level of inhibin beta , increase serum FSH, damage Sertoli cells and elevate the expression of claudin-11 in the testis tissue. Increased claudin-11 and serum FSH may delay the cyclical restitution of hemo-testicular barrier and reduce the number of meiotic spermatocytes in the seminiferous epithelium, which consequently leads to male infertility.

Overexpression of DNA damage-induced 45 α gene contributes to esophageal squamous cell cancer by promoter hypomethylation.

BACKGROUND: Environmental factors-induced dysfunction of esophageal squamous epithelium, including genomic DNA impairment and apoptosis, play an important role in the pathogenesis of esophageal squamous cell cancer. DNA damage-induced 45α (GADD45α) has been found promoting DNA repair and removing methylation marker, Therefore, in this study we will investigate whether GADD45α expression is induced and its mechanism in esophageal squamous cell cancer. METHODS: Two human esophageal squamous cell lines (ESCC), ECA109 and KYSE510 were cultured in RPMI-1640 medium supplemented with 10% fetal bovine serum (FBS). Lipofectamine 2000 was used to transfect cells. mRNA level of GADD45α was measured by reverse transcription-quantitive PCR (RT-qPCR), protein level of GADD45α was detected by western blot and Immunohistochemistry. Global DNA methylation of tissue sample was measured using the Methylamp Global DNA Methylation Quantification Ultra kit (Epigentek Group) and promoter methylation was measured by bisulfite sequencing. RESULTS: GADD45a mRNA and protein levels were increased significantly in tumor tissue than that in adjacent normal tissue. Hypomethylation of global genomic DNA and GADD45α promoter were found in ESCC. The cell sensitivity to Cisplatin DDP was decreased significantly in Eca109 and Kyse510 cells, in which GADD45α expression was down-regulated by RNA interference (RNAi). In addition, silence of GADD45a expression in ESCC cells inhibited proliferation and promoted apoptosis. CONCLUSION: Overexpression of GADD45α gene is due to DNA hypomethylation in ESCC. GADD45α may be a protective factor in DDP chemotherapy for esophageal squamous cell carcinoma.

[Chinese medicinal monomer and compound for 60Co-gamma-induced spermatogenic disturbance in mice].

OBJECTIVE: To explore the effects of the monomer and compound of the Chinese herbal drugs resveratrol, lycium barbarum polysaccharide (LBP) and icariin on 60Co-gamma-induced spermatogenic disturbance in mice based on the theory of modern Chinese medicine. METHODS: A total of 105 male Kunming mice were randomly divided into seven groups, with 15 in each. Group A were normally raised and Groups B, C, D, E, F and G irradiated by 60Co-gamma 6 Gy followed by 60Co-gamma 4 Gy at the interval of 7 days. A week later, Groups C, D, E, F and G received intragastrically the suspension of resveratrol, resveratrol + LBP, resveratrol + icariin, resveratrol + LBP + icariin and resveratrol + LBP + icariin + L-carnitine, respectively, at the dose of 80 mg/(kg x d) for 60 days. The general condition, physical signs and body weight changes of the mice were recorded, and 24 hours after the intragastric medication, their testes were harvested to obtain the testicular weight and indexes, the levels of FSH, LH, T and E2 determined by ELISA, the T/E2 ratio calculated, and the histology of the testis tissues observed under the microscope. RESULTS: The testicular indexes of the mice were decreased by radiation-induced damage, but restored to some extent after intragastric medication, especially in Groups E, F and G. The levels of FSH, LH and T were obviously improved by LBP. The T level and testis weight were increased by Icariin. The level of T/E2 was elevated in Groups E, F and G. The best results were achieved in Group F, which exhibited almost complete recovery from reproductive endocrine disorder and spermatogenic damage. CONCLUSION: The Chinese medicinal monomer is effective for 60Co-gamma-induced spermatogenic disturbance in mice, and the compound suspension of resveratrol + LBP + icariin produces the best result.

[Transperitoneal laparoscopic adrenalectomy for adrenal neoplasm: a report of 371 cases].

BACKGROUND AND OBJECTIVE: Open adrenalectomy has been almost replaced by mini-invasive laparoscopic surgery. There are two popular mini-invasive laparoscopic adrenalectomy approaches: retroperitoneal and transperitoneal approaches. This study was to summarize our experience in transperitoneal laparoscopic adrenalectomy. METHODS: In total 371 cases undergoing transperitoneal adrenalectomy in the First Affiliated Hospital of Zhengzhou University from February 2003 to August 2008 were reviewed retrospectively. There were 127 cases of primary hyperaldosteronism adenoma, 117 cases of Cushing's adenoma, 58 cases of phaeochromo-cytoma, 37 cases of incidentoma and 32 cases of other types. The type of adrenal diseases, operating time, blood loss, complications and prognosis were summarized and the operating method was analyzed. RESULTS: Three hundred and sixty-five out of 371 patients (98.4%) were successfully operated, five cases (1.4%) were transferred to open surgery, and one patient gave up surgery due to extensive invasion. The operating time was 40-240 min (average, 70 min). The blood loss was 20-1000 ml (average, 80 ml). Two patients suffered from diaphragm injuries, one patient had right renal vein injury and one had colon injury. The mean time of hospital stay was five days. CONCLUSION: Transperitoneal laparoscopic adrenalectomy is one of the favorable approaches for the treatment of adrenal neoplasm.

[Expression and significance of Pin1 mRNA in circulating mononuclear cells from non-small cell lung cancer patients during perioperative period].

BACKGROUND AND OBJECTIVE: The catalytic reaction of Pin1 (peptidylprolyl cis/trans isomerase NIMA-interacting 1) is a signal pathway for changing the functions of phosphorylated proteins, which plays an important role in tumorigenesis. Pin1 is called the catalytic molecule for tumorigenesis. This study was to detect the expression of Pin1 mRNA in blood samples from non-small cell lung cancer (NSCLC) patients, and explore its significance. METHODS: Twenty-six NSCLC patients who underwent radical resection were assigned to pulmonary artery first ligation group (PA-first group) and pulmonary vein first ligation group (PV-first group). The blood samples were collected before operation (after anesthesia), during operation from the proximal part and distal part of the pulmonary vein when it was ligated, and at 7 days later. Additionally, ten patients with benign lung disease who underwent resection served as disease control, and ten healthy subjects served as negative control. The expression of Pin1 in the blood samples was detected by real-time reverse transcription-polymerase chain reaction (RT-PCR). RESULTS: The mRNA level of Pin1 was obviously higher in blood samples from NSCLC patients than in those from benign lung disease patients and healthy subjects: it in NSCLC group was 1.69-34.78 times of that in negative control group. It was associated with lymph node metastasis and clinical stage of NSCLC (p=0.043, p=0.038). The mRNA level of Pin1 was significantly higher in the distal part of the pulmonary vein than in the proximal part (p=0.019), and was significantly lower at 7 days after operation than before operation (p=0.031). There was no significant difference between PA-first group and PV-first group (p=0.082, p=0.106). CONCLUSION: Pin1 is overexpressed in circulation of NSCLC, and may be used as a tumor marker or as a target for cancer therapy.

[Expression of pin1 mRNA in the circulation of non-small cell lung cancer patients and influence of sequence of vessel ligation].

OBJECTIVE: To detect the expression of peptidylprolyl cis/trans isomerase NIMA-interacting l (pin1 mRNA) in the circulation of non-small cell lung cancer (NSCLC) and to investigate the effect of ligating pulmonary vein first or ligating pulmonary artery first during operation on haematogenous dissemination of cancer cells. METHODS: Twenty-six consecutive patients with NSCLC who underwent surgical resection with curative intention were randomly assigned into pulmonary artery first-ligation group (PA group) and pulmonary vein first-ligation group (PV group). Blood samples were collected just before and 7 days after the operation. During the lobectomy, blood samples of the proximal part and distal part of the pulmonary vein when it was ligated were collected. Another 10 patients with benign lung disease served as control subjects undergoing surgical resection, and 10 healthy persons served as negative controls. All blood samples were subjected to real-time RT-PCR with pin1 mRNA as the marker. RESULTS: Compared with the benign lung disease and healthy persons, pin1 mRNA in NSCLC was overexpressed (1.45 to approximately 29.86 vs.0.83 to approximately 1.26 vs 1, P<0.05). pin1 mRNA in stage III NSCLC and lymph node positive were significantly higher than in stage I to approximately II and lymph node negative(18.48+/-1.64 vs.10.57+/-1.05, P<0.05;18.93+/-2.10 vs.10.02+/-1.23, P<0.05). Expression of pin1 mRNA in the distal part of the pulmonary vein was significantly higher than that of the proximal part (30.56+/-1.37 vs.20.31+/-1.48, P<0.05); the expression 7 days after the operation was significantly lower than that of preoperation (20.68+/-1.17 vs.29.43+/-2.62, P<0.05). There was no significant difference between the PA group and PV group (9.95+/-0.91 vs.14.71+/-1.64, P>0.05; 16.84+/-2.36 vs.13.36+/-1.78, P>0.05). CONCLUSION: pin1 mRNA was overexpressed in the circulation of NSCLC. Ligation of pulmonary vein before the ligation of the pulmonary artery may decrease the expression of pin1 mRNA in the circulation, which can prevent the release of tumor cells into the bloodstream.

[Influence of lidocaine on systemic inflammation in perioperative patients undergoing cardiopulmonary bypass].

OBJECTIVE: To investigate the influence of lidocaine on systemic inflammation in the perioperative ventricular septal defect (VSD). METHODS: Twenty patients, scheduled for ventricular septal defect were randomly divided into 2 groups: lidocaine and control groups. Before rebeat lidocaine 1 mg/kg was given. The venous blood samples were obtained from the central venous at the following points: after induction of anesthesia and before cardiopulmonary bypass(CPB,T1),1 h after CPB(T2),2 h after CPB(T3), and 4 h after CPB(T4). IL-6 and IL-8 were determined by radio-immunoassay. RESULTS: Compared with those at T1, the levels of white blood cells,polymorphonuclear neutrophils,IL-6 and IL-8 increased significantly from T2 to T4 in both groups. IL-6 and IL-8 levels reached the peak at T2. Compared with those in control groups, IL-6 level decreased obviously in lidocaine group from T2 to T4, but IL-8 level remained unchanged significantly. CONCLUSION: Under CPB and VSD repair the systemic inflammation is obvious, reaches the peak 30 min after CPB and persists to 4 h after CPB. Perioperative administration of lidocaine is effective against the inflammation.

[Factors associated with acute ST-segment elevation myocardial infarction with normal angiographic findings of the coronary artery].

OBJECTIVE: To identify the factors related to acute ST-segment elevation myocardial infarction (STEMI) with normal angiographic findings of the coronary artery. METHODS: An retrospective analysis of the electrocardiographic, echocardiographic, and angiographic data of 271 STEMI cases was conducted. Of these patients, 29 had normal coronary artery by angiography and from the rest patients presenting abnormal angiographic findings of the coronary artery, 60 were randomly selected to serve as the control group. Multiple logistic regression analysis was performed to identify the independent factors related to acute STEMI with normal coronary artery by angiography. RESULTS: The incidence rate of STEMI with normal coronary artery was 10.7%. Univariate analysis showed that age, smoking, diabetes mellitus, absence of pre-infarction angina, and wall motion score were related to STEMI with normal coronary artery (P<0.05), whereas multiple logistic regression analysis identified the former 3 factors as the related factors (P<0.05). Wall motion score, left ventricular ejection fraction, cardiac index, and stroke volume index were higher, and cardiac events fewer in patients with normal coronary artery than in those with abnormal coronary artery (P<0.01). CONCLUSION: Acute STEMI with normal coronary artery is more likely to occur in young smokers without pre-infarction angina, possibly in association with spontaneous reperfusion.

[Effect of ischemic preconditioning on human lung cell apoptosis in vivo and the expression of regulating gene bcl-2].

OBJECTIVE: To investigate whether ischemic reperfusion injury induces lung cell apoptosis and the effect of ischemic preconditioning on lung cell apoptosis by altering the expression of bcl-2 protein. METHODS: Sixteen patients, who needed to occlude the main pulmonary artery to undergo pulmonectomy, were randomly put to two groups: the control group (Group C) and the ischemic preconditioning group (Group I). Ischemic preconditioning was achieved by two 5-minute cycles of ischemic, and each was followed by a 5-minute reperfusion. The lung tissue was sampled at the time of preoccluding, 30 minutes after the ischemic, and 30 and 60 minutes after the reperfusion. Apoptotic cells were stained by the terminal deoxynucleotidyl transferase-mediated dUTP nickend labeling (TUNEL) technique. Immunohistochemistry was used to detect the expression of bcl-2 protein. RESULTS: The apoptosis index (AI) of lung cells increased significantly 30 and 60 minutes after the reperfusion, and also significantly increased as the reperfusion period prolonged. Apoptosis was significantly reduced in Group I 30 and 60 minutes after the reperfusion compared with that of Group C at the same time points (P < 0.05). Immunohistochemistry analysis showed that the expression of bcl-2 protein significantly increased in Group I compared with that of Group C(P < 0.05), while there was no significant difference at each time point in Group C(P > 0.05). CONCLUSION: 1. Ischemic reperfusion injury may induce human lung cell apoptosis. 2. Ischemic preconditioning may reduce the apoptosis of human lung cells in vivo by upregulating bcl-2 protein expression.