MRI-based radiomics features for the non-invasive prediction of FIGO stage in cervical carcinoma: A multi-center study.

PURPOSE: To develop and validate a model based on MRI radiomics modals for predicting surgical high FIGO(IB3 and ≥ IIA2) and low FIGO(IB1, IB2, and IIA1) stages in patients with cervical carcinoma (CC) . METHODS: A total of 296 early-stage patients with CC (preoperative FIGO stages IB-IIA) confirmed by surgery and pathology were included in this retrospective study from two institutions For each patient,we extracted radiomics features from spectral attenuated inversion-recovery T2-weighted (SPAIR-T2W) and contrast-enhanced T1-weighted (CE-T1W) images.Manual segmentation was performed using the 3D Slicer software, while radiomics features were extracted, screened using the R software. A 2-stage feature extraction strategy involving univariate analysis and the Least Absolute Shrinkage Selection Operator technique was performed. A support vector machine-based model was eventually constructed. Predictive accuracy of the training and validation datasets was assessed in terms of area under the ROC curve (AUC). RESULTS: A total of 1130 features were extracted from SPAIR-T2WI and CET1WI images respectively, in which 8 and 7 features significantly were associated with FIGO staging. AUCs of the SPAIR-T2W and CE-T1W models were were 0.803 and 0.790, respectively, in the internal validation group. In the external validation group, the AUCs were 0.767 and 0.749, respectively, which increased to 0.771 in the combined model. CONCLUSION: Our study demonstrated the feasibility of radiomics features from SPAIR-T2W and CE-T1W images for the prediction of surgical FIGO stage in CC. Our proposed model thereby carries the potential as a non-invasive tool for the staging and treatment planning of this disease. ADVANCES IN KNOWLEDGE: A radiomics model provide a non-invasive and objective method for the detection of FIGO staging in patients with cervical cancer before surgery, thus providing a reference for the selection of treatment options for patients.

Anti-inflammatory effects of acupuncture in the treatment of chronic obstructive pulmonary disease.

Numerous randomised controlled trials have suggested the positive effects of acupuncture on chronic obstructive pulmonary disease (COPD). However, the underlying therapeutic mechanisms of acupuncture for COPD have not been clearly summarized yet. Inflammation is central to the development of COPD. In this review, we elucidate the effects and underlying mechanisms of acupuncture from an anti-inflammatory perspective based on animal studies. Cigarette smoke combined with lipopolysaccharide is often used to establish animal models of COPD. Electroacupuncture can be an effective intervention to improve inflammation in COPD, and Feishu (BL13) and Zusanli (ST36) can be used as basic acupoints in COPD animal models. Different acupuncture types can regulate different types of inflammatory cytokines; meanwhile, different acupuncture types and acupoint options have similar effects on modulating the level of inflammatory cytokines. In particular, acupuncture exerts anti-inflammatory effects by inhibiting the release of inflammatory cells, inflammasomes and inflammatory cytokines. The main underlying mechanism through which acupuncture improves inflammation in COPD is the modulation of relevant signalling pathways: nuclear factor-κB (NF-κB) (e.g., myeloid differentiation primary response 88/NF-κB, toll-like receptor-4/NF-κB, silent information regulator transcript-1/NF-κB), mitogen-activated protein kinase signalling pathways (extracellular signal-regulated kinase 1/2, p38 and c-Jun NH2-terminal kinase), cholinergic anti-inflammatory pathway, and dopamine D2 receptor pathway. The current synthesis will be beneficial for further research on the effect of acupuncture on COPD inflammation. Please cite this article as: Jiang LH, Li PJ, Wang YQ, Jiang ML, Han XY, Bao YD, Deng XL, Wu WB, Liu XD. Anti-inflammatory effects of acupuncture in the treatment of chronic obstructive pulmonary disease. J Integr Med. 2023; 21(6): 518-527.

Early swallowing training after free flap surgery in oral cancer: A randomized controlled trial.

OBJECTIVE: To explore the effect of early swallowing training on postoperative outcomes of patients who had undergone oral cancer surgery plus free flap reconstruction. SUBJECTS AND METHODS: In this prospective, randomized controlled trial, 121 patients who had undergone oral cancer surgery plus free flap reconstruction were randomly assigned to the control (n = 59) or intervention group (n = 62). The control group underwent routine nursing measures. The intervention group received swallowing training on the sixth postoperative day. On the 15th day and 1 month after surgery, the swallowing function (Mann Assessment of Swallowing Ability-Oral Cancer [MASA-OC] score), weight loss rate, time of nasogastric tube removal, and quality of life were evaluated. RESULTS: Patients in the intervention group had higher MASA-OC scores and better weight loss rates than those in the control group on the 15th day (MASA-OC: p = 0.014, weight loss: p < 0.001) and 1 month (both p < 0.001) after surgery. The time of nasogastric tube removal and the quality of life was statistically significant between groups (p < 0.001). CONCLUSION: Early swallowing training improves the swallowing function, nutritional status, and quality of life and shortens the indwelling time of nasogastric tube of patients who have undergone oral cancer surgery plus free flap reconstruction.

Chlorogenic acid alleviates hypoxic-ischemic brain injury in neonatal mice.

Recent studies have shown that chlorogenic acid (CGA), which is present in coffee, has protective effects on the nervous system. However, its role in neonatal hypoxic-ischemic brain injury remains unclear. In this study, we established a newborn mouse model of hypoxic-ischemic brain injury using a modified Rice-Vannucci method and performed intraperitoneal injection of CGA. We found that CGA intervention effectively reduced the volume of cerebral infarct, alleviated cerebral edema, restored brain tissue structure after injury, and promoted axon growth in injured brain tissue. Moreover, CGA pretreatment alleviated oxygen-glucose deprivation damage of primary neurons and promoted neuron survival. In addition, changes in ferroptosis-related proteins caused by hypoxic-ischemic brain injury were partially reversed by CGA. Furthermore, CGA intervention upregulated the expression of the key ferroptosis factor glutathione peroxidase 4 and its upstream glutamate/cystine antiporter related factors SLC7A11 and SLC3A2. In summary, our findings reveal that CGA alleviates hypoxic-ischemic brain injury in neonatal mice by reducing ferroptosis, providing new ideas for the treatment of neonatal hypoxic-ischemic brain injury.

Timing of Oral Feeding in Patients Who have Undergone Free Flap Reconstruction for Oral Cancer.

OBJECTIVE: Determine the safety and effectiveness of a nasogastric tube removal plan designed to shorten nasogastric tube indwelling time after oral cancer surgery plus free flap reconstruction. MATERIALS AND METHODS: A parallel randomized clinical trial was conducted from May 2021 to December 2021 at Peking University School of Stomatology. Volunteers (n = 128) were separated into four groups: non-tracheostomy control and intervention groups and tracheostomy control and intervention groups. Control patients received the conventional nasogastric tube removal plan. Non-tracheotomy intervention patients were asked to swallow 5 ml of water on the first postoperative day. If there was no coughing, they were allowed progressively increasing amounts of water for the following 2 days. The nasogastric tube was removed only after ensuring level I/II performance on the Watian water swallowing test, no "wet voice" after drinking water, no marked decrease in blood oxygen saturation after drinking, and satisfactory daily oral nutritional intake. Tracheotomy intervention patients received the same protocol plus an additional Watian water swallowing test after tracheal tube removal. RESULTS: Nasogastric tube removal time was earlier in the intervention subgroups than in control subgroups: 5.0 ± 2.3 days versus 7.8 ± 3.9 days (p = 0.001) in non-tracheostomy patients and 9.8 ± 1.1 days versus 16.2 ± 13.0 days (p = 0.049) in tracheostomy patients. Incidence of wound complications and daily food intake were comparable between the groups. The incidence of pneumonia was lower in the tracheostomy intervention group than in the tracheostomy control group (12.5% vs. 3.1%, p = 0.162). Pharyngeal pain score was lower in tracheotomy intervention patients than in tracheotomy control patients (p = 0.029). Postoperative hospital stay was shorter in tracheotomy intervention patients than in tracheotomy control patients (p = 0.005). CONCLUSIONS: On the basis of ensuring safety and effectiveness, patients undergone free flap reconstruction for oral cancer could be offered oral intake early after surgery, which will not increase the incidence of wound complications and pneumonia or adversely affecting the oral intake of the patients; it can also help minimize pharyngeal pain and shorten postoperative hospital stay of patients with a tracheotomy. LEVEL OF EVIDENCE: 2 Laryngoscope, 133:1382-1387, 2023.

Clinical practice guideline for transurethral plasmakinetic resection of prostate for benign prostatic hyperplasia (2021 Edition).

Benign prostatic hyperplasia (BPH) is highly prevalent among older men, impacting on their quality of life, sexual function, and genitourinary health, and has become an important global burden of disease. Transurethral plasmakinetic resection of prostate (TUPKP) is one of the foremost surgical procedures for the treatment of BPH. It has become well established in clinical practice with good efficacy and safety. In 2018, we issued the guideline "2018 Standard Edition". However much new direct evidence has now emerged and this may change some of previous recommendations. The time is ripe to develop new evidence-based guidelines, so we formed a working group of clinical experts and methodologists. The steering group members posed 31 questions relevant to the management of TUPKP for BPH covering the following areas: questions relevant to the perioperative period (preoperative, intraoperative, and postoperative) of TUPKP in the treatment of BPH, postoperative complications and the level of surgeons' surgical skill. We searched the literature for direct evidence on the management of TUPKP for BPH, and assessed its certainty generated recommendations using the grade criteria by the European Association of Urology. Recommendations were either strong or weak, or in the form of an ungraded consensus-based statement. Finally, we issued 36 statements. Among them, 23 carried strong recommendations, and 13 carried weak recommendations for the stated procedure. They covered questions relevant to the aforementioned three areas. The preoperative period for TUPKP in the treatment of BPH included indications and contraindications for TUPKP, precautions for preoperative preparation in patients with renal impairment and urinary tract infection due to urinary retention, and preoperative prophylactic use of antibiotics. Questions relevant to the intraoperative period incorporated surgical operation techniques and prevention and management of bladder explosion. The application to different populations incorporating the efficacy and safety of TUPKP in the treatment of normal volume (< 80 ml) and large-volume (≥ 80 ml) BPH compared with transurethral urethral resection prostate, transurethral plasmakinetic enucleation of prostate and open prostatectomy; the efficacy and safety of TUPKP in high-risk populations and among people taking anticoagulant (antithrombotic) drugs. Questions relevant to the postoperative period incorporated the time and speed of flushing, the time indwelling catheters are needed, principles of postoperative therapeutic use of antibiotics, follow-up time and follow-up content. Questions related to complications incorporated types of complications and their incidence, postoperative leukocyturia, the treatment measures for the perforation and extravasation of the capsule, transurethral resection syndrome, postoperative bleeding, urinary catheter blockage, bladder spasm, overactive bladder, urinary incontinence, urethral stricture, rectal injury during surgery, postoperative erectile dysfunction and retrograde ejaculation. Final questions were related to surgeons' skills when performing TUPKP for the treatment of BPH. We hope these recommendations can help support healthcare workers caring for patients having TUPKP for the treatment of BPH.

Neferine Protects against Hypoxic-Ischemic Brain Damage in Neonatal Rats by Suppressing NLRP3-Mediated Inflammasome Activation.

Hypoxic-ischemic encephalopathy (HIE) is recognized as the main cause of neonatal death, and efficient treatment strategies remain limited. Given the prevalence of HIE and the associated fatality, further studies on its pathogenesis are warranted. Oxidative stress and neuroinflammatory injury are two important factors leading to brain tissue injury and nerve cell loss in HIE. Neferine, an alkaloid extracted from lotus seed embryo, exerts considerable effects against several diseases such as cancers and myocardial injury. In this study, we demonstrated the neuroprotective effect of neferine on HIE and hypothesized that it involves the inhibition of neuronal pyroptosis, thereby ameliorating neurological inflammation and oxidative stress. We demonstrated that the mRNA levels of proteins associated with pyroptosis including caspase-1, the caspase adaptor ASC, gasdermin D, interleukin- (IL-) 18, IL-1ß, and some inflammatory factors were significantly increased in neonatal HIBD model rats compared to those in the control group. The increase in these factors was significantly suppressed by treatment with neferine. We stimulated PC12 cells with CoCl2 to induce neuronal HIBD in vitro and investigated the relationship between neferine and pyroptosis by altering the expression of the NLRP3 inflammasome. The overexpression of NLRP3 partially reversed the neuroprotective effect of neferine on HIBD, whereas NLRP3 knockdown further inhibited caspase-1 activation and IL-1ß and IL18 expression. In addition, simultaneous alteration of NLRP3 expression induced changes in intracellular oxidative stress levels after HIBD. These findings indicate that neferine ameliorates neuroinflammation and oxidative stress injury by inhibiting pyroptosis after HIBD. Our study provides valuable information for future studies on neferine with respect to neuroinflammation and pyroptosis.

Coexistence of Lung Squamous Cell Carcinoma and Pulmonary Tuberculosis Within a Single Lesion: A Case Report.

Pulmonary tuberculosis (TB) and lung cancer are both common diseases with poor prognosis and high mortality worldwide. The coexistence of the two diseases has rarely been reported while their relationship has been noted. Here we describe a patient diagnosed with both TB and squamous cell carcinoma in a single lesion. The patient had a cough for four months and polypnea for two months, with a smoking history of over 40 years. Chest computed tomography (CT) showed a lobular mass in the right hilar region, which was diagnosed as TB by transbronchial lung biopsy. The symptoms and CT findings indicated the possibility of lung cancer. So, the patient underwent a further lung biopsy at the periphery of the mass, which was confirmed as squamous cell carcinoma. This case illuminated that when the mass with cancer-like morphologic features and location instead of typical TB, even the initial pathological result shows TB, coexistence of the diseases should be considered.

Compensation of high-pressure processing for the solubility of sodium-reduced chicken breast myosin with three anion types of potassium salts.

The effect of high-pressure processing (200 MPa, 10 min) on the solubility of chicken breast myosin with 25% molar substitution of Na+ by 3 anion types of potassium salts (KCl, K-lactate, and K-citrate) was investigated. The results showed that the lower hydrophobic group and reactive sulfhydryl group of nonpressurized myosin with the replacement of organic K-lactate or K-citrate possibly contributed to the aggregation of myosin molecules compared with the KCl group and thus decreased the solubility of both. In the presence of lactate or citrate, the high-pressure processing caused an increase in the surface hydrophobicity and reactive sulfhydryl group, indicating the unfolding of myosin molecule. Meanwhile, the increased hydration state and the decreased apparent viscosity suggested the disruption of protein-protein interactions and the strengthening of myosin-water interactions in pressurized myosin, ultimately resulting in increased solubility of the pressurized myosin with both organic potassium salts. The compensation of high-pressure processing is interesting for the efficient selection of the anion type in developing sodium-reduced industrial meat products.

Improvement of the patient early mobilization protocol after oral and maxillofacial free flap reconstruction surgery.

OBJECTIVE: There is lack of standardized management and mobilization strategies after oral and maxillofacial reconstruction surgery. We used prospective randomized controlled trials to explore improvements in postoperative mobilization protocol in such patients. METHODS: A total of 149 patients were randomly divided into tracheotomy control group A (38 cases) and test group A (37 cases), nontracheotomy control group B (38 cases) and test group B (36 cases). Test group patients sat up in bed on the 2nd day after surgery and performed off-bed activity on the 3rd day, whereas control group patients sat up in bed on the 4th day postoperatively and performed off-bed activity on the 6th day. Objective evaluation included free flap success rate, postoperative complications, sleep time, and catheter removal time, among other parameters. Subjective evaluation included postoperative pain and comfort evaluation. RESULTS: The success rate of free flaps was 97.3% in test group A and 100% in the other groups. In terms of mean sleep time, 4.6 ± 1.0 h in test group A, which was longer than 4.1 ± 1.0 h in control group A (P = 0.034); 5.7 ± 1.4 h in test group B, which was longer than 4.9 ± 1.7 h in control group B (P = 0.026). Early activity makes catheter removal time (tracheal incision, nasogastric tube, urethral catheter) shorter and gets higher comfort evaluation scores in both test groups versus control groups (P < 0.05). CONCLUSIONS: The early mobilization protocol for patients undergoing free flap reconstruction was safe, and can effectively improve sleep, shorten the catheter indwelling time, and increase the patient's comfort level.

Neuroprotective effects of a Smoothened receptor agonist against postoperative cognitive dysfunction by promoting autophagy in the dentate gyrus of aged rats.

Objectives: To investigate the effect of purmorphamine (PUR), a Shh co-receptor Smoothened (Smo) agonist, on postoperative cognitive dysfunction (POCD) rat models. Methods: Eighteen-month-old male Sprague-Dawley rats were subjected to intramedullary fixation of a tibial fracture with 7% chloral hydrate anesthesia to mimic human clinical surgery. PUR was administered via an intraperitoneal injection at a dose of 15mg/kg/day for 3 consecutive days at 6 h after surgery. The aged rats were sacrificed after performing a Morris water maze test 1, 3, and 7 days postoperatively to evaluate the expression of related proteins at the appointed time. Results: Compared to the POCD + vehicle group and sham + PUR group, the POCD + PUR group restored neurological deficit (P = 0.01). PUR administration induced upregulation of Shh expression on postoperative day 1 (P = 0.02), which continued on the third day (P = 0.008) but dropped by the 7th day (P = 0.03). Immunofluorescent analysis, similar to western blot analysis, showed a significant increase in the autophagy-marker LC3 (P = 0.006) as well as p62 degradation (P = 0.000) in the dentate gyrus of the aged rats (P = 0.000) after PUR treatment. Importantly, LC3 was mainly found in the presynaptic and postsynaptic membranes of the hippocampus. Conclusions: These results indicate a link between Shh and autophagy in the rat model of POCD, providing new insights into Shh signaling pathway-mediated mechanisms of neuroprotection and cognitive repair after POCD. It also provides a potential entry point for the development of clinical drugs.

Amelioration of Growth Performance, Lipid Accumulation, and Intestinal Health in Mice by a Cooked Mixture of Lean Meat and Resistant Starch.

SCOPE: The intake of resistant starch (RS) may attenuate the risks of chronic illness, including colorectal cancer. However, whether the attenuated functionality of RS is maintained in cooked meat products needs to be clarified. METHODS AND RESULTS: The effects of a cooked mixture of lean pork meat and RS (MS) on the growth performance, lipid accumulation, and intestinal health of mice is investigated compared to those of RS-free cooked meat (M) and the addition of RS to cooked meat (M+S). The results show that both M+S and MS diets improve growth performance, alleviate lipid accumulation, and ameliorate colon health via promoting food intake and body weight gain, attenuating adipose tissue weight and triglyceride levels in liver and serum, regulating short-chain fatty acids and ammonia concentrations, ameliorating gut morphology and remodeling the gut microbiome, including Desulfovibrio, Escherichia-Shigella, Lactococcus, Ruminococcus 2, and the Firmicutes-to-Bacteroidetes ratio in mice, compared to the M diet. In particular, the MS diet exerts preferable effects on promoting growth performance and intestinal benefits and alleviating lipid accumulation in mice. CONCLUSION: Cooked mixtures of meat and RS are promising for developing novel functional meat products for nutritional health interventions.

Glycine Protects against Hypoxic-Ischemic Brain Injury by Regulating Mitochondria-Mediated Autophagy via the AMPK Pathway.

Hypoxic-ischemic encephalopathy (HIE) is detrimental to newborns and is associated with high mortality and poor prognosis. Thus, the primary aim of the present study was to determine whether glycine could (1) attenuate HIE injury in rats and hypoxic stress in PC12 cells and (2) downregulate mitochondria-mediated autophagy dependent on the adenosine monophosphate- (AMP-) activated protein kinase (AMPK) pathway. Experiments conducted using an in vivo HIE animal model and in vitro hypoxic stress to PC12 cells revealed that intense autophagy associated with mitochondrial function occurred during in vivo HIE injury and in vitro hypoxic stress. However, glycine treatment effectively attenuated mitochondria-mediated autophagy. Additionally, after identifying alterations in proteins within the AMPK pathway in rats and PC12 cells following glycine treatment, cyclosporin A (CsA) and 5-aminoimidazole-4-carboxamide-1-b-4-ribofuranoside (AICAR) were administered in these models and indicated that glycine protected against HIE and CoCl2 injury by downregulating mitochondria-mediated autophagy that was dependent on the AMPK pathway. Overall, glycine attenuated hypoxic-ischemic injury in neurons via reductions in mitochondria-mediated autophagy through the AMPK pathway both in vitro and in vivo.

Effectiveness of high-intensity interval training on glycemic control and cardiorespiratory fitness in patients with type 2 diabetes: a systematic review and meta-analysis.

AIMS: The aim of this systematic review and meta-analysis was to quantify the effect of high-intensity interval training (HIIT) on glycemic control and cardiorespiratory fitness compared with moderate-intensity training (MICT) and no training at all in patients with type 2 diabetes (T2D). METHODS: Relevant articles were sourced from PubMed, Embase, the Web of Science, EBSCO, and the Cochrane Library. Randomized-controlled trials were included based upon the following criteria: participants were clinically diagnosed with T2D, outcomes that included glycemic control (e.g., hemoglobin A1c); body composition (e.g., body weight); cardiorespiratory fitness (e.g., VO2peak) are measured at baseline and post-intervention and compared with either a MICT or control group. RESULTS: Thirteen trials involving 345 patients were finally identified. HIIT elicited a significant reduction in BMI, body fat, HbA1c, fasting insulin, and VO2peak in patients with type 2 diabetes. Regarding changes in the body composition of patients, HIIT showed a great improvement in body weight (mean difference: - 1.22 kg, 95% confidence interval [CI] - 2.23 to - 0.18, P = 0.02) and body mass index (mean difference: - 0.40 kg/m2, 95% CI - 0.78 to - 0.02, P = 0.04) than MICT did. Similar results were also found with respect to HbA1c (mean difference: - 0.37, 95% CI - 0.55 to - 0.19, P < 0.0001); relative VO2peak (mean difference: 3.37 ml/kg/min, 95% CI 1.88 to 4.87, P < 0.0001); absolute VO2peak (mean difference: 0.37 L/min, 95% CI 0.28 to 0.45, P < 0.00001). CONCLUSIONS: HIIT may induce more positive effects in cardiopulmonary fitness than MICT in T2D patients.

Contribution of three ionic types of polysaccharides to the thermal gelling properties of chicken breast myosin.

The effects of anionic (κ-carrageenan, KCG), neutral (locust bean gum, LBG), and cationic polysaccharides (water-soluble chitosan, WSC) on the water-holding capacity (WHC) and hardness of chicken myosin gels were investigated at 0-1.0% addition levels. The changes of gel properties were explained using different instrumental techniques. The results revealed that KCG and LBG at 0.5-1.0% could respectively cause significant increases of both WHC and hardness of corresponding heat-induced myosin-polysaccharide gels (P < 0.05). These increases could be ascribed to a slower relaxation, reinforced cross-linked extent, enhanced hydrogen bonding, and a fine-stranded gel network, according to the analysis of low-field nuclear magnetic resonance, dynamic rheology, Fourier transform infrared spectroscopy, and scanning electron microscopy measurements. However, the weak molecular interaction within myosin-WSC gels induced an insignificant change of the WHC and hardness (P > 0.05). Therefore, it is interesting to search for the anionic polysaccharide and neutral polysaccharide for use as fat substitutes in the development of low-fat meat products.

Effects of dissolved low molecular weight organic acids on oxidation of ferrous iron by Acidithiobacillus ferrooxidans.

A few researchers have reported on work concerning bioleaching of heavy-metal-contaminated soil using Acidithiobacillus ferrooxidans, since this acidophile is sensitive to dissolved low molecular weight (LMW) organic acids. Iron oxidation by A. ferrooxidans R2 as well as growth on ferrous iron was inhibited by a variety of dissolved LMW organic acids. Growth experiments with ferrous iron as an oxidant showed that the inhibition capability sequence was formic acid>acetic acid>propionic acid>oxalic acid>malic acid>citric acid. The concentrations that R2 might tolerate were formic acid 0.1mmolL(-1) (2mmolkg(-1)soil), acetic and propionic acids 0.4mmolL(-1) (8mmolkg(-1)soil), oxalic acid 2.0mmolL(-1) (40mmolkg(-1)soil), malic acid 20mmolL(-1) (400mmolkg(-1)soil), citric acid 40mmolL(-1) (800mmolkg(-1)soil), respectively. Although R2 was sensitive to organic acids, the concentrations of LMW organic acids in the contaminated soils were rather lower than the tolerable levels. Hence, it is feasible that R2 might be used for bioleaching of soils contaminated with metals or metals coupled with organic compounds because of the higher concentrations of LMW organic acids to which R2 is tolerant.

[Effect of pericardial suction blood re-transfusion in off-pump coronary artery bypass grafting on inflammatory cytokines, myocardial injury and pulmonary function].

OBJECTIVE: To investigate the effect of pericardial suction blood re-transfusion in off-pump coronary artery bypass grafting (CABG) on inflammatory cytokines, myocardial injury and lung function. METHODS: 31 patients of off-pump CABG were divided into two study groups (OPCABG1 group and OPCABG2 group) according to the amount of pericardial suction blood re-transfusion beyond or less than 600 ml. 13 patients of on-pump CABG were control group. Serum samples from vein were collected for measurement of IL-6, IL-8, IL-10 and TNF-alpha pre-operation and 1, 4, 24, 48 hours post-operation respectively. The results of CK-MB, TnI, AaDO2 and PaO2/FiO2 were recorded. RESULTS: Patients of the three groups had no significant difference in terms of gender, age, bodyweight, history of hypertension and cardiac infarction and diabetes, EF and left ventricular end diastolic of pre-operation, the amount of bypass graft and shed blood. Of the three groups, IL-6, IL-8 and IL-10 reached peak level one hour after the operation, and dropped to the pre-operation level 72 hours after the operation. One hour after the operation, the level of IL-6 and IL-8 in OPCABG1 group was higher than in OPCABG2 group (P < 0.05) and about the same in CABG group (P > 0.05). Four hours after the operation, the level of CK-MB in OPCABG1 group was lower than that of CABG group (P < 0.05) and about the same in OPCABG2 group (P >0.05). 4 and 24 hours after the operation, the level of TnI in OPCABG1 group was lower than that of CABG group (P < 0.05) and about the same in OPCABG2 group (P > 0.05). Among the three groups, there was no significant difference in AaDO2 and PaO2/FiO2. CONCLUSIONS: Re-transfusion of large amount of pericardial suction blood can increase serum level of IL-6, IL-8, but it can not cause myocardial injury and affect the gas exchange function of lung significantly.

[Impact of hypertension on angiogenesis in the tissues of benign prostatic hyperplasia].

OBJECTIVE: To investigate the impact of primary hypertension on angiogenesis in the tissues of benign prostatic hyperplasia (BPH). METHODS: Immunohistochemistry was carried out to examine the expression of CD34, so as to calculate the microvassel density (MVD), and the expression of vascular endothelial growth factor (VEGF) in the tissues of prostatic gland, resected during operation, of 50 simple BPH patients, aged 68.3 (56 approximately 83), and 50 patients with BPH with hypertension, aged 69.0 (55 approximately 91) with a course of hypertension of 16.5 +/- 11.9 years (1 - 41 years). RESULTS: The MVD of the simple BPH group was 23.1 +/- 9.2, significantly lower than that of the BPH complicated with hypertension group (28.2 +/- 9.5, P < 0.01), especially the BPH complicated with hypertension group with a course >/= 15 years (31.3 +/- 8.5). The MVD of the BPH complicated with hypertension group with a course >/= 15 years was significantly higher than that of the BPH complicated with hypertension group with a course < 15 years (25.7 +/- 9.7, P < 0.05). The VEGF positive rate of the stroma of the simple BPH group was 46.0%, significantly lower than that of the BPH complicated with hypertension group (66.0%, P < 0.05), especially that of the BPH complicated with hypertension group with a course >/= 15 years (81.8%). The VEGF positive rate of the stroma of the BPH complicated with hypertension group with a course >/= 15 years was significantly higher than that of the BPH complicated with hypertension group with a course < 15 years (53.6%, P < 0.05). In the group of BPH with hypertension, MVD was positively correlated with the expression of VEGF in the stromal tissue (R = 0.11, P < 0.05). CONCLUSION: Hypertension may be closely related to the increased expression of VEGF in prostatic stroma. The increased expression of VEGF may induce angiogenesis and consequently lead to clinical progression of BPH in patients with hypertension.

[Correlation of benign prostatic hyperplasia with hyperlipemia].

OBJECTIVE: To investigate relationship between benign prostatic hyperplasia (BPH) and hyperlipemia, and to clear out possible factors related to BPH etiology. METHODS: A total of 462 cases of BPH diagnosed by pathological examination were studied retrospectively. RESULTS: Of 462 cases, BPH with hyperlipemia was noted in 232 cases (50.22%). In comparison with the data of simple BPH, both prostate volume (P = 0.029) and residual urine (P = 0.03) were significantly increased in the BPH patients with hyperlipemia. Statistical analysis regarding the effects of different components of serum lipid on BPH clinical factors showed that the level of high density lipoprotein was significantly associated with both the enlargement of prostate volume (P < 0.05) and increasing of serum PSA (P < 0.05) Further study indicated that hypertension was demonstrated in 39.2% patients of BPH with hyperlipemia. Hyperlipemia accompanied with hypertension in BPH patients was significantly related to increased IPSS (P = 0.004). CONCLUSION: The situation of BPH with hyperlipemia is frequently noted in clinics, and the decreased level of high-density lipoprotein is significantly associated with the enlargement of prostate volume. Co-existence of hypertension with hyperlipemia in BPH patients greatly worsens the lower urinary tract symptoms (LUTS) of BPH. Hyperlipemia may be one of the risk factors in the processes of BPH growth and progression.

[Association study between benign prostatic hyperplasia and primary hypertension].

OBJECTIVE: To assess whether primary hypertension affects the occurrence and progression of benign prostatic hyperplasia (BPH). METHODS: A total of 423 cases of BPH, undergoing transurethral resection of prostate (TURP) or open surgery due to severe low urinary tract symptoms, were reviewed and analyzed. All cases were verified to be BPH postoperatively following histopathological examination. RESULTS: Of 423 patients, 295 cases (69.7%) were simple BPH (group BPH-NT); 128 cases (30.3%) were BPH with hypertension (group BPH-HT). The mean age and the incidence of haematuria were significantly higher in group BPH-HT than those in group BPH-NT (P < 0.05). The time of BPH occurrence and surgical treatment in group BPH-HT with mean diastolic blood pressure >/= 90 mmHg was significantly earlier than those with diastolic blood pressure < 90 mmHg (P < 0.05; P < 0.01). As compared with group BPH-NT, the time of BPH occurrence was significantly earlier in group BPH-HT with more than 10 years hypertension; the rate of urinary retention and haematuria was significantly higher and prostatic volume was significantly greater in group BPH-HT with more than 20 years hypertension; (all P < 0.05). Additionally, prostatic volume was positively correlated with the years of hypertension in group BPH-HT (Rsq = 0.056, P = 0.009). CONCLUSIONS: The present results demonstrate that BPH may be frequently accompanied by the disease of hypertension. A long-term hypertension, particularly the condition of high diastolic blood pressure may improve the occurrence and clinical progression of BPH.