Mid- and long-term outcomes and prognostic factors of drug-coated balloon angioplasty for treatment of femoropopliteal long lesions / 中华外科杂志

Objective: To examine the effective and safe outcomes of drug-coated balloon (DCB) angioplasty for the treatment of femoropopliteal long lesions in mid-term and long-term follow-up. Methods: The clinical data of 114 patients with symptomatic (Rutherford 2 to 6) femoropopliteal long lesions who underwent angioplasty with DCB between June 2016 and May 2021 at Department of Vascular Surgery,Beijing Tsinghua Changgung Hospital were retrospectively analyzed. A total of 75 males and 39 females were enrolled, aged (71.9±8.4)years (range: 49 to 89 years). Among 138 lesions in 114 patients, there were 111 de nove lesions (80.4%, 111/138). Total occlusions were recanalized in 116 limbs (84.1%, 116/138). The lesion length was (280.9±78.7)mm (range: 150 to 520 mm). DCB angioplasty combined with debulking devices was used in 59 lesions (42.8%, 59/138).The bail-out stent implantation was performed in 27 limbs (19.6%, 27/138). The Kaplan-Meier method was used to evaluate cumulative primary patency rate, freedom from the clinically driven target lesion revascularization (CD-TLR) rate and accumulate survival rate. Univariate and multivariate analyses with Cox proportional hazards models were performed to determine the significant prognostic factors for primary patency. Results: DCB angioplasty was completed in 114 patients. The technical success rate was 98.2%(112/114). The mean follow-up time was 18 months (range: 3 to 54 months).The results showed that primary patency rates at 12, 24 and 36 months postoperatively were 87.5%, 75.2% and 55.1%, respectively. Freedom from CD-TLR rate at 12, 24 and 36 months postoperatively were 92.4%, 81.8% and 68.7%, respectively. Accumulate survival rate at 12, 24 and 36 months postoperatively were 96.2%, 94.0% and 80.2%. Multivariate Cox's regression analyses showed that chronic limb-threatening ischemia(CLTI) (HR=2.629, 95%CI:1.519 to 4.547, P<0.01) and hyperlipidemia (HR=2.228, 95%CI: 1.004 to 4.948, P=0.026) were independent prognosis factors for primary patency in DCB treatment of femoropopliteal long lesions. Conclusions: DCB provided favorable outcomes for the treatment of femoropopliteal long lesions. CLTI and hyperlipidemia are independent prognosis factors for restenosis after DCB angioplasty.

Stasis Caused by Depression and Coronary Heart Disease / 中国实验方剂学杂志

Anxiety and depression are common comorbidities of coronary heart disease and are considered as independent risk factors in addition to traditional cardiovascular risk factors. Anxiety，depression and other mental abnormalities belong to the category of "depressive syndrome" of traditional Chinese medicine，which can lead to stasis of blood due to the lack of Qi flow. "Blood stasis" involves abnormal blood rheology， vascular endothelial dysfunction， chronic inflammatory response， abnormal lipid metabolism and other comprehensive pathological changes， and is the core pathogenesis of coronary heart disease in traditional Chinese medicine. "Depressive syndrome"can aggravate the development of coronary heart disease by promoting blood stasis in multiple ways. Prescriptions and herbs of promoting blood circulation and removing blood stasis can have a clinical effect by promoting blood circulation （improving physiological functions） and removing blood stasis （eliminating pathological changes）. In clinical practice， strengthening the screening of the mental and psychological status of patients with coronary heart disease and providing early and effective psychological interventions and combined Chinese and Western medicine drug treatment can significantly improve the clinical symptoms and prognosis of patients. This article was the first to put forward the academic view of "stasis caused by depression" for the first time，and discuss the modern biological research progress of "depression" in Chinese medicine that promotes blood stasis and aggravates coronary heart disease，in order to provide a basis for the subsequent development of Chinese medicine in the prevention and treatment of coronary heart disease. The aim is to provide a theoretical basis for the subsequent systematic research on the prevention and treatment of coronary heart disease with emotional abnormalities in Chinese medicine.

Three-dimensional spatial measurement versus conventional CT planning in laparoscopic partial nephrectomy for renal tumors / 南方医科大学学报

<p><b>OBJECTIVE</b>To analyze the advantages of spatial measurement of anatomical parameters in a 3D model in surgical planning for laparoscopic partial nephrectomy (LPN).</p><p><b>METHODS</b>From February, 2016 to October, 2017, 37 patients diagnosed with T1 renal mass underwent LPN based on 3D reconstruction after enhanced CT scanning using the Uromedix-3D system (group A), and another 38 patients received LPN with conventional CT planning (group B). The anatomical parameters were measured in the reconstructed 3D model and the demographic data, surgical outcome and postoperative data were compared between the two groups.</p><p><b>RESULTS</b>In group A, the average time for 3D model reconstruction was (29.3∓9.7) min; the length, width and depth of the renal defect in 3D model were 3.2∓1.1 cm, 2.6∓0.9 cm and 1.7∓0.7 cm, respectively; The distance of the tumor from the collecting system was 3.8∓2.2 mm; The mean R.E.N.A.L score of the patients was 7∓1.5, and 3 patients had accessory renal artery and 2 had early branching of the renal artery. LPNs were completed via the retroperitoneal approach in all the 75 patients without conversion to open or total nephrectomy. Group A and group B showed significant differences in warm ischemic time (26.7∓6.4 vs 31.9∓7.0 min), tumor-excision time (8.4∓2.6 vs 10.4∓2.8 min), renal defect suture time (18.3∓3.9 vs 21.5∓3.4 min), 24-h volume of retroperitoneal drainage (88.6∓40.2 vs 134.3∓58.3 mL) and 48-h volume of retroperitoneal drainage (127.9∓54.5 vs 198.1∓86.3 mL), but not in the demographic data, operation time, intraoperative blood loss or postoperative hospital stay.</p><p><b>CONCLUSIONS</b>3D reconstruction of the renal masses can be completed efficiently and accurately using this system. Compared with conventional CT-based measurement, 3D spatial measurement of the anatomical structures helps to increase the precision in the performance of LPN and reduce the warm ischemia time.</p>

Hsa-miRNA-143-3p Reverses Multidrug Resistance of Triple-Negative Breast Cancer by Inhibiting the Expression of Its Target Protein Cytokine-Induced Apoptosis Inhibitor 1 In Vivo / 한국유방암학회지

PURPOSE: Multidrug resistance (MDR) remains a major obstacle in the treatment of triple-negative breast cancer (TNBC) with conventional chemotherapeutic agents. A previous study demonstrated that hsa-miRNA-143-3p plays a vital role in drug resistance of TNBC. Downregulation of hsa-miRNA-143-3p upregulated the expression of its target protein cytokine-induced apoptosis inhibitor 1 (CIAPIN1) in order to activate MDR, while upregulation of hsa-miRNA-143-3p effectively enhances the sensitivity of drug-resistant TNBC cells to chemotherapeutics. The present study aimed to further verify these findings in vivo. METHODS: We established a hypodermic tumor nude mice model using paclitaxel-resistant TNBC cells. We expressed ectopic hsa-miRNA-143-3p under the control of a breast cancer-specific human mammaglobin promoter that guided the efficient expression of exogenous hsa-miRNA-143-3p only in breast cancer cells. Thereafter, we overexpressed hsa-miRNA-143-3p in xenografts using a recombinant virus system and quantified the expression of hsa-miRNA-143-3p, CIAPIN1 protein, and proteins encoded by related functional genes by western blot. RESULTS: We successfully completed the prospective exploration of the intravenous virus injection pattern from extensive expression to targeted expression. The overexpression of hsa-miRNA-143-3p significantly alleviated chemoresistance of TNBC by inhibiting viability. In addition, we observed that the expression of CIAPIN1 as a hsa-miRNA-143-3p target protein was remarkably decreased. CONCLUSION: We partly illustrated the mechanism underlying the hsa-miRNA-143-3p/CIAPIN1 drug resistance pathway. HsamiRNA-143-3p as a tumor suppressive microRNA may be a novel target to effectively reverse MDR of TNBC in vivo.

Comparative results of non-operative and operative treatment of humeral shaft fractures / 北京大学学报(医学版)

Objective:To compare the difference between non-operative and operative treatment of humeral shaft fractures.Methods:From March 2005 to October 2012,252 cases of humeral shaft fractures were treated and were adequately followed up.According to the treatment methods,the patients were divided into 2 groups:the non-operative group and the operative group.In the non-operative group,there were 76 cases treated with plaster/small splint fixation,meanwhile there were 176 cases treated with inter nal fixation either by plating or by nailing in the operative group.The follow-up parameters included:fracture healing rate,fracture union time,complications rate,Constant-Murley shoulder score and Mayo elbow score.Results:The mean follow-up period was (31.24 ± 20.06) months (ranging 6 to 103 months).There were no statistical differences in age,open fracture number,fracture site and Arbeitsgemeinschaft ftir Osteosynthesefragen (AO) classification between the non-operative group and the operative group.The fracture healing rate:the non-operative group:96.1％ (72/76),the operative group:97.7％ (172/176),P =0.46;the fracture union time:the non-operative group:(10.24 ± 2.93) weeks,the operative group:(10.69 ± 2.51) weeks,P =0.22;the complication rate:the non-operative group:5.3％ (4/76),the operative group:15.3％ (27/176),P =0.03.The complications included:nonunion:the non-operative group:3.95％ (3/76),the operative group:2.3％ (4/176),P =0.434;radial nerve palsies:the non-operative group:0％ (0/76),the operative group:5.7％ (10/176),P =0.035;bone split:the non-operative group:0％ (0/76),the operative group:1.7％ (3/176),P =0.556;elbow stiffness:the non-operative group:l.3％ (1/76),the operative group:0.6％ (1/176),P =1.000;shoulder pain:the non-operative group:0％ (0/76),the operative group:5.1％ (9/176),P =0.061.The Constant-Murley shoulder score:the non-operative group:97.37±4.94,the operative group:96.34 ± 6.88,P =0.244.The Mayo elbow score:the non-operative group:99.80 ± 1.72,the operative group:99.49 ± 2.73,P =0.923.Conclusion:The results of non-operative treatment of humeral shaft fractures appeared with excellent results with lower complications rate compared with that of the operative treatment.

Effect of different compatibility of Sargassum and Glycyrrhizae Radix in Haizao Yuhu Decoction on goiter model rats and its mechanism / 中草药

Objective: To explore the mechanism and compensation proceeding of Haizao Yuhu Decoction (HYD) with different compatibility of Sargassum and Glycyrrhizae Radix in goiter model rats caused by propylthiouracil (PTU). Methods: HYD with different compatibility of Sargassum and Glycyrrhizae Radix was set up according to the principle uniform design (two factors, seven levels), and 120 Wistar rats were randomly divided into 10 groups. PTU was ig given to rats for 14 d to establish the goiter model, and then the rats were ig administered with HYD for 28 d. All animals were sacrificed after the last dosage, the thyroid weight and changes of thyroid hormone levels of triiodothyronine (T3), thyroxine (T4), and thyroid stimulating hormone (TSH) in serum were determined, and the mRNA expression of thyroid peroxidase (TPO) and thyroglobulin (Tg) was detected by RT-PCR. Results: HYD with different compatibility of Sargassum and Glycyrrhizae Radix could regulate thyroid hormone levels and inhibit thyroid enlargement induced by PTU in some degree. Compared with the model group, the TPO mRNA expression of group 5 (0.135:8.32) was significantly increased, and groups 1 (14.522:6.24), 5, and 6 (29.040:4.16) could also increase the Tg mRNA level significantly. Conclusion: HYD with different compatibility could inhibit thyroid enlargement induced by PTU in some extent, the effects in groups 1 (14.522:6.24), 3 (19.363:0.54), and 6 (29.040:4.16) are the most obvious, and the mechanism may be related to the activation of gene transcription of TPO and Tg. The groups 1 and 5 could enhance the compensatory action to a certain degree.