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Fibroblast activation protein inhibitor (FAPI) has been the focus of nuclear medicine since its introduction. With the in-depth study of FAPI tracer, its clinical application in various non-malignant diseases has also been gradually reported. Many studies have confirmed its uptake in a variety of non-malignant diseases, which indicate that FAPI tracers have good application prospects. This article reviews the latest research status and clinical application of radiolabeled FAPIs in cardiovascular diseases, rheumatic immune diseases, immunoglobulin (Ig)G4-related diseases, renal fibrosis and other non-malignant diseases at home and abroad.
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Background@#The bispectral index (BIS) may be unreliable to gauge anesthetic depth when dexmedetomidine is administered. By comparison, the electroencephalogram (EEG) spectrogram enables the visualization of the brain response during anesthesia and may prevent unnecessary anesthetic consumption. @*Methods@#This retrospective study included 140 adult patients undergoing elective craniotomy who received total intravenous anesthesia using a combination of propofol and dexmedetomidine infusions. Patients were equally matched to the spectrogram group (maintaining the robust EEG alpha power during surgery) or the index group (maintaining the BIS score between 40 and 60 during surgery) based on the propensity score of age and surgical type. The primary outcome was the propofol dose. Secondary outcome was the postoperative neurological profile. @*Results@#Patients in the spectrogram group received significantly less propofol (1585 ± 581 vs. 2314 ± 810 mg, P < 0.001). Fewer patients in the spectrogram group exhibited delayed emergence (1.4% vs. 11.4%, P = 0.033). The postoperative delirium profile was similar between the groups (profile P = 0.227). Patients in the spectrogram group exhibited better in-hospital Barthel’s index scores changes (admission state: 83.6 ± 27.6 vs. 91.6 ± 17.1; discharge state: 86.4 ± 24.3 vs. 85.1 ± 21.5; group–time interaction P = 0.008). However, the incidence of postoperative neurological complications was similar between the groups. @*Conclusions@#EEG spectrogram–guided anesthesia prevents unnecessary anesthetic consumption during elective craniotomy. This may also prevent delayed emergence and improve postoperative Barthel index scores.
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Heart development protein with EGF-like domains 1 (HEG1) is a novel mucin-like membrane protein with a long O-glycosylation region and EGF domain. HEG1 plays critical roles in embryo development and cardiogenesis, and is closely related to the occurrence and progression of malignant tumors. Here this article demonstrates the research progress on HEG1 in cardiovascular formation and tumor development in recent years, to inspire new ideas for the pathogenesis, diagnosis and treatment of related diseases.
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Humans , Membrane Proteins , Epidermal Growth Factor , Cardiovascular System/pathology , Lung NeoplasmsABSTRACT
Heart development protein with EGF-like domains 1 (HEG1) is a novel mucin-like membrane protein with a long O-glycosylation region and EGF domain. HEG1 plays critical roles in embryo development and cardiogenesis, and is closely related to the occurrence and progression of malignant tumors. Here this article demonstrates the research progress on HEG1 in cardiovascular formation and tumor development in recent years, to inspire new ideas for the pathogenesis, diagnosis and treatment of related diseases.
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Humans , Membrane Proteins , Epidermal Growth Factor , Cardiovascular System/pathology , Lung NeoplasmsABSTRACT
Objective@#The study aimed to analyze the association between different types of obesity and dyslipidemia among rural primary and middle school students in Zhejiang Province, so as to inform strategies for prevention and control of childhood obesity and hyperlipidemia.@*Methods@#As part of Nutrition Improvement Programme for Rural Compulsory Education Students, 1 244 participants were selected by stratified cluster random sampling in 5 counties of Zhejiang Province during September to December 2021. Physical examination, detection of blood lipid and questionnaire survey were conducted. The Chi -square test and Logistic regression analyses were used to assess the association between different types of obesity and dyslipidemia.@*Results@#The prevalence rates of overweight, obesity, abdominal obesity, and hyperlipidemia were 15.11%, 12.46%, 17.60%, and 21.78%. Obesity and abdominal obesity were correlated to high risk of high triglycerides ( OR =3.97, 95% CI =2.54-6.20; OR =4.45, 95% CI =2.95- 6.72 )( P <0.05). Compared with the non overweight and obese group with normal waist circumference,the overweight and obesity group were correlated to high risk of high cholesterol ( OR=2.53, 95%CI =1.45-4.42, P <0.05). Abdominal overweight or obese group had the highest risk for dyslipidemia and triglycerides ( OR =1.82, 95% CI =1.33-2.48; OR =3.64, 95% CI =2.45-5.43) ( P < 0.05).@*Conclusions@#The prevalence rates of overweight, obesity, abdominal obesity, and hyperlipidemia are relatively high in rural primary and middle school students of Nutrition Improvement Programme for Rural Compulsory Education Students in Zhejiang Province. Abdominal obesity is a more important risk factor for hyperlipidemia. Waist circumference should be the focus of considerable attention.
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Quality control is pivotal in the research and development of traditional Chinese medicine, whose connotation is not limi-ted to the qualitative or quantitative detection of an indicator component, but extends to the establishment of a whole process quality control system from the perspective of pharmaceutical product lifecycle management. This study discussed the quality control strategy of Chinese medicine based on the concept of pharmaceutical product lifecycle management, and proposed the following suggestions:(1) to focus on the "holistic view" and "phased" characteristics of quality control and strengthen the establishment of quality control strategy based on top-level design;(2) to strengthen the research on quality control of Chinese medicine based on quality risk management, focus on the correlations of quality control indicators with the safety and effectiveness of traditional Chinese medicine, and establish a quality evaluation system consistent with the characteristics of traditional Chinese medicine;(3) to consider the characteristics of different registration classifications in the establishment of quality control strategy;(4) to highlight the quality correlation research, strengthen the quality transfer research, ensure the quality traceability, and establish a sound quality management system;(5) to strengthen the quality research on marketed drugs to achieve dynamic quality improvement.
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Medicine, Chinese Traditional , Drugs, Chinese Herbal/therapeutic use , Quality ControlABSTRACT
OBJECTIVE@#To investigate the effect and potential mechanism of dihydromyricetin (Dmy) on H9C2 cell proliferation, apoptosis, and autophagy.@*METHODS@#H9C2 cells were randomly divided into 7 groups, namely control, model, EV (empty pCDH-CMV-MCS-EF1-CopGFP-T2A-Puro vector), IV (circHIPK3 interference), Dmy (50 µ mol/L), Dmy+IV, and Dmy+EV groups. Cell proliferation and apoptosis were detected by cell counting kit-8 assay and flow cytometry, respectivley. Western blot was used to evaluate the levels of light chain 3 II/I (LC3II/I), phospho-phosphoinositide 3-kinase (p-PI3K), protein kinase B (p-AKT), and phospho-mammalian target of rapamycin (p-mTOR). The level of circHIPK3 was determined using reverse transcriptase polymerase chain reaction. Electron microscopy was used to observe autophagosomes in H9C2 cells.@*RESULTS@#Compared to H9C2 cells, the expression of circHIPK in H9C2 hypoxia model cells increased significantly (P<0.05). Compared to the control group, the cell apoptosis and autophagosomes increased, cell proliferation rate decreased significantly, and the expression of LC3 II/I significantly increased (all P<0.05). Compared to the model group, the rate of apoptosis and autophagosomes in IV, Dmy, and Dmy+IV group decreased, the cell proliferation rate increased, and the expression of LC3 II/I decreased significantly (all P<0.05). Compared to the control group, the expressions of p-PI3K, p-AKT, and p-mTOR in the model group significantly reduced (P<0.05), whereas after treatment with Dmy and sh-circHIPK3, the above situation was reversed (P<0.05).@*CONCLUSION@#Dmy plays a protective role in H9C2 cells by inhibiting circHIPK expression and cell apoptosis and autophagy, and the mechanism may be related to PI3K/AKT/mTOR pathway.
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Proto-Oncogene Proteins c-akt/metabolism , Signal Transduction , Phosphatidylinositol 3-Kinases/metabolism , TOR Serine-Threonine Kinases/metabolism , Apoptosis , AutophagyABSTRACT
Objective:To evaluate the effect of sitagliptin on the expression of airway mucin 5AC (MUC5AC) in mice with endotoxin-induced lung injury.Methods:Thirty-six healthy male SPF C57BL/6 mice, aged 6-8 weeks, weighing 20-25 g, were divided into 3 groups ( n=12 each) using a random number table method: control group (group C), endotoxin-induced lung injury group (group L), and endotoxin-induced lung injury+ sitagliptin group (group S). Lipopolysaccharide (LPS) 3 mg/kg was intratracheally infused to prepare endotoxin-induced lung injury model in L and S groups, while the equal volume of normal saline was given instead in group C. Sitagliptin 100 mg/kg was intraperitoneally injected at 1 h before LPS infusion in group S, and normal saline was intraperitoneally injected at 1 h before endotracheal infusion in C and L groups. The arterial blood samples from femoral artery were taken at 24 h of LPS or normal saline infusion for measurement of PaO 2 and glucose levels.The mice were then sacrificed, and broncho-alveolar lavage fluid (BALF) and lung tissues were collected for determination of the concentrations of interleukin-6 (IL-6), interleukin-1beta (IL-1β), and tumor necrosis factor-alpha (TNF-α)in serum and BALF (by enzyme-linked immunosorbent assay), wet/dry weight ratio (W/D ratio), expression of MUC5AC (by immunohistochemistry and immunohistochemical comprehensive score), and expression of MUC5AC mRNA in lung tissues (by quantitative real-time polymerase chain reaction) and for examination of the pathological changes of lung tissues (using haematoxylin and eosin staining) which were scored. Results:Compared with group C, PaO 2 was significantly decreased, the glucose levels, W/D ratio and lung injury score were increased, the concentrations of IL-6, IL-1β and TNF-α in serum and BALF were increased, and the expression of MUC5AC mRNA in lung tissues was up-regulated in L and S groups( P<0.05). Compared with group L, PaO 2 was significantly increased, the glucose levels, W/D ratio and lung injury score were decreased, the concentrations of IL-6, IL-1β and TNF-α in serum and BALF were decreased, and the expression of MUC5AC mRNA in lung tissues was down-regulated in group S( P<0.05). Conclusions:The mechanism by which sitagliptin alleviates endotoxin-induced lung injury is related to down-regulation of MUC5AC expression in mice.
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Objective:To evaluate the role of inositol-requiring kinase 1α-X-box binding protein 1 (IRE1α/XBP1) signaling pathway in endoplasmic reticulumin in endotoxin-induced acute lung injury (ALI) in mice and the relationship with NOD-like receptor pyrin domain containing 3 (NLRP3) inflammasomes.Methods:Thirty-six SPF-grade healthy male C57BL/6 mice, aged 6-8 weeks, weighing 25-30 g, were divided into 3 groups ( n=12 each) according to the random number table method: control group (group C), endotoxin-induced ALI group (group ALI) and endotoxin-induced ALI+ STF-083010 group (group ST). The ALI model was established by inhaling nebulized lipopolysaccharide (LPS) 3 mg/ml for 30 min in ALI and ST groups, while the equal volume of nebulized normal saline was given in group C. IRE1α/XBP1 signaling pathway inhibitor STF-083010 50 mg/kg was intraperitoneally injected at 1 h before inhaling LPS in group ST, while the remaining two groups received the equal volume of normal saline intraperitoneally. Mice were sacrificed at 24 h after inhaling nebulized LPS or normal saline, bronchoalveolar lavage fluid (BALF) were collected and lung tissues were removed for microscopic examination of the pathological changes (by HE staining) which were scored and for determination of wet/dry lung weight ratio (W/D ratio), concentrations of interleukin-1beta (IL-lβ) and IL-18 in BALF (by enzyme-linked immunosorbent assay) and expression of phosphorylated IRE1α (p-IRE1α), XBP1s, NLRP3, ASC and caspase-1 in lung tissues (by Western blot). Results:Compared with group C, the W/D ratio, lung injury score and concentrations of IL-1β and IL-18 in BALF were significantly increased, and the expression of p-IRE1α, XBP1s, NLRP3, ASC and caspase-1 in lung tissues was up-regulated in group ALI and group ST ( P<0.001). Compared with group ALI, the W/D ratio, lung injury score and concentrations of IL-1β and IL-18 in BALF were significantly decreased, and the expression of p-IRE1α, XBP1s, NLRP3, ASC and caspase-1 protein in lung tissues was down-regulated in group ST ( P<0.001). Conclusions:IRE1α/XBP1 signaling pathway is involved in LPS-induced ALI in mice, and the mechanism is related to activation of NLRP3 inflammasomes.
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Objective:To investigate the safety and efficacy of haplo-identical hematopoietic stem cell transplantation (haplo-HSCT) conditioning with the same dosage form of antithymoglobulin (ATG) in patients with severe aplastic anemia (SAA) failure to ATG.Methods:This was a retrospective cohort study. A total of 65 patients with SAA who failed ATG treatment and received haplo-HSCT conditioning with the same dosage of ATG at the Institute of Hematology, Peking University People′s Hospital between July 2008 and October 2020 were included as the ATG treatment failure group. An additional 65 SAA patients who applied ATG for the first time during haplo-HSCT were randomly selected by stratified sampling as the first-line haplo-HSCT group. Baseline clinical data and follow-up data of the two groups were collected. Conditioning-related toxicity within 10 days after ATG application and long-term prognosis were analyzed. The Kaplan-Meier was used to calculate the overall survival rate, and the Log-rank test was applied to compare the rates of the two groups.Results:In the ATG treatment failure group, there were 36 males and 29 females, and the age at the time of transplantation [ M ( Q1, Q3)] was 16 (8, 25) years. In the first-line haplo-HSCT group, there were 35 males and 30 females, with a median age of 17 (7, 26) years. Within 10 days of ATG application, the incidence of noninfectious fever, noninfectious diarrhea, and liver injury in the ATG treatment failure group was 78% (51 cases), 45% (29 cases), and 28% (18 cases), respectively, and in the first-line haplo-HSCT group was 74% (48 cases), 54% (35 cases), and 25% (16 cases), respectively; the difference between the two groups was not statistically significant for any of these three parameters (all P>0.05). For graft-versus-host disease (GVHD), there was no significant difference between the ATG treatment failure group and the first-line haplo-HSCT group in the development of 100 day Ⅱ to Ⅳ acute GVHD (29.51%±0.35% vs. 25.42%±0.33%), Ⅲ to Ⅳ acute GVHD (6.56%±0.10% vs. 6.78%±0.11%), and 3-year chronic GVHD (26.73%±0.36% vs. 21.15%±0.30%) (all P>0.05). Three-year overall survival (79.6%±5.1% vs. 84.6%±4.5%) and 3-year failure-free survival (79.6%±5.1% vs. 81.5%±4.8%) were also comparable between these two groups (both P>0.05). Conclusions:Compared with no exposure to ATG before HSCT, similar early adverse effects and comparable survival outcomes were achieved in patients with SAA who failed previous ATG treatment and received haplo-HSCT conditioning with the same dosage form of ATG. This might indicate that previous failure of ATG treatment does not significantly impact the efficacy and safety of salvaging haplo-HSCT in patients with SAA.
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Objective:To investigate the potential of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in mitigating the adverse prognosis associated with central nervous system leukemia (CNSL) and to assess the significance of prophylactic intrathecal injection.Methods:A retrospective cohort analysis was conducted involving 30 patients with acute leukemia who had a history of CNSL who underwent allo-HSCT at Peking University People′s Hospital between September 2012 and March 2018 (referred to as the CNSL-positive group). In addition, 90 patients with acute leukemia were selected from the same period who underwent allo-HSCT without a history of CNSL (referred to as the CNSL-negative group) and a rigorous 1∶3 matching was performed based on disease type, disease status, and transplantation type to form the control group. The prognosis between the two groups was compared using Kaplan-Meier analysis and the high-risk factors for CNSL relapse post-transplant were identified through Cox proportional-hazards model.Results:The median age of patients in the CNSL-negative group was significantly higher than that of patients in the CNSL-positive group (32 years vs. 24 years, P=0.014). No significant differences were observed in baseline data, including sex, disease type, disease status at transplantation, donor-recipient relationship, and human leukocyte antigen consistency between the two groups. The median follow-up time was 568 days (range: 21-1 852 days). The 4-year cumulative incidence of relapse (71.4%±20.9% vs. 29.3%±11.5%, P=0.005) and the cumulative incidence of CNSL post-transplant (33.6%±9.2% vs. 1.2%±1.2%, P<0.001) were significantly higher in the CNSL-positive group than in the CNSL-negative group. Furthermore, the 4-year leukemia-free survival rate in the CNSL-positive group was significantly lower than that in the CNSL-negative group (23.1%±17.0% vs. 71.5%±11.6%, P<0.001). However, no significant differences were observed in the 4-year cumulative transplant-related mortality and overall survival rates between the two groups (both P>0.05). Multivariate analysis revealed that a history of CNSL before transplantation ( HR=25.050, 95% CI 3.072-204.300, P=0.003) was identified as high-risk factors for CNSL relapse post-transplant. Conversely, haploidentical transplantation was associated with a reduced risk of CNSL relapse post-transplant ( HR=0.260, 95% CI 0.073-0.900, P=0.034). Within the CNSL-positive group, seven patients received prophylactic intrathecal therapy after transplantation, and their CNSL relapse rate was significantly lower than that of the 23 patients who did not receive intrathecal therapy after transplantation (0/7 vs. 9/23, P=0.048). Conclusions:Patients with a history of CNSL have a higher risk of relapse and experience poorer leukemia-free survival following transplantation. The use of prophylactic intrathecal injection shows promise in mitigating CNSL relapse rates, although further validation through prospective studies is necessary to substantiate these observations.
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Objective:To explore the relationship between CDKN1B expression and clinicopathological features in colorectal cancer.Methods:Human Protein Atlas (HPA) database and Gene Expression Profiling Interactive Analysis (GEPIA) database were used to analyze the expression of CDKN1B in colorectal cancer tissues and its relationship with the prognosis of colorectal cancer. The data of 98 patients with colorectal cancer who underwent surgery from January 2020 to December 2021 at Yixing Clinical College of Yangzhou University Medical School were retrospectively analyzed, and pathological specimens were collected. Immunohistochemistry method was used to detect CDKN1B protein expression level in colorectal cancer and paracancerous normal tissues (2 cm from the tumor site) and the correlation of CDNK1B expression with clinicopathological characteristics was analyzed.Results:The results of bioinfomatics analysis and the prediction from HPA database and GEPIA database suggested that the expression level of CDKN1B in colorectal cancer was lower than that in the normal colorectal tissues; In HPA database, the 5-year overall survival rate of patients in the CDKN1B high expression (425 cases) was higher than that of those in the CDKN1B low expression (172 cases) (65% vs.51%), and the difference in the overall survival of both group was statistically significant ( P < 0.001). GEPIA database staging module analysis showed that CDKN1B gene expression level was correlated with the pathological stage of patients with colorectal cancer ( P = 0.033). Immunohistochemistry analysis showed that CDKN1B expression was localized in the nucleus and cytoplasm. The proportion of patients with CDKN1B high expression in colorectal cancer tissues was lower than that in paracancerous normal tissues [18.37% (18/98) vs. 90.82% (89/98), P < 0.01]. The proportion of CDKN1B high expression in cancer tissues of colorectal cancer patients with poor differentiation [poor differentiation vs. high-middle differentiation: 3.70% (1/27) vs. 23.94% (17/71)], lymph node metastasis [metastasis vs. non-metastasis: 6.38% (3/53) vs. 29.41% (15/45)], TNM higher stage [stage Ⅳ vs. Ⅲ vs. Ⅱ vs. Ⅰ: 5.00% (1/20) vs. 13.95% (3/33) vs. 20.59% (8/30) vs. 36.36% (6/15)] was lower (all P < 0.05), while there were no statistically significant differences in the proportion of patients with CDKMB high expression in colorectal cancer tissues among different subgroups stratified by gender, age and tumor size (all P > 0.05). Conclusions:CDKN1B is mainly expressed in the nucleus and cytoplasm, and is lowly expressed in colorectal cancer. The lower CDKN1B expression may indicate the poorer prognosis of patients. CDKN1B can be used as a marker for clinical diagnosis, treatment and prognosis evaluation of colorectal cancer.
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Objective To investigate the effect of galectin-1 preconditioning on pyroptosis of venti-lator-induced lung injury(VILI)in mice.Methods Thirty clean grade healthy male C57BL/6 mice,aged 6-8 weeks,weighing 22-30 g,were divided into three groups by random number table method:control group(group C),VILI group(group V),and galectin-1+VILI group(group G),10 mice in each group.After endotracheal intubation,group C kept spontaneous breathing for 4 hours,groups V and G kept me-chanical ventilation for 4 hours.One hour before endotracheal intubation,groups C and V were intraperito-neally injected with normal saline 0.75 ml,and group G was intraperitoneally injected with galectin-1 3 μg.Arterial blood was collected before endotracheal intubation and after spontaneous respiration or ventilation to detect PaO2.Then mice were sacrificed and bronchoalveolar lavage fluid(BALF)was collected.Concentra-tions of IL-1β and IL-18 in BALF were detected by ELISA.Lung tissue was collected for determination of the wet weight/dry weight ratio(W/D).The expression of GSDMD,caspase-1,and caspase-11 mRNA and protein in lung tissues were detected by qRT-PCR and Western blot.Pathological changes of the lungs were observed and scored by HE staining.Results Compared with group C,PaO2 were significantly decreased,W/D,concentrations of IL-1β and IL-18 in BALF,mRNA and protein expressions of GSDMD,caspase-1 and caspase-11,and lung injury score were significantly increased in groups V and G(P＜0.05).Com-pared with group V,PaO2 was significantly increased,W/D,concentrations of IL-1β and IL-18 in BALF,mRNA and protein expressions of GSDMD,caspase-1,and caspase-11,and lung injury score were signifi-cantly decreased in group G(P＜0.05).Conclusion Galectin-1 can increase PaO2 in mice and reduce IL-1β and IL-18 concentration,mRNA expression and protein content of classical non-classical pyroptosis pathway related genes,and reduce VILI in mice.
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Objective:To compare and explore the clinical efficacy and safety of endoscopic thyroidectomy by gasless unilateral axillary approach for the treatment of papillary thyroid microcar cinoma (PTMC) .Methods:One hundred and ten patients with unilateral PTMC admitted to the Department of Thyroid and Breast Surgery, Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine, from Jan.3 2019 to Mar. 2022 were used as clinical study subjects, and according to the patients' choice of surgical modality, they were divided into 30 cases in the endoscopic thyroidectomy by gasless unilateral axillary approach (ETGUA) group and 80 cases in the minimally invasive video-assisted thyroidectomy (MIVAT) group. We retrospectively compared and analyzed the differences in the surgery-related indexes, aesthetic satisfaction rate at 3 months postoperatively and functional status of the anterior cervical region between the 2 groups. SPSS 26.0 statistical software was used to process the data, analyze and draw conclusions. P<0.05 was considered a statistically significant difference. Results:The number of lymph nodes cleared in the study group (6.60±4.41) was less than that in the control group (9.63±6.25) ( P<0.05) ; the total operative time (169.83±28.76) min, postoperative drainage (173.60±94.33) ml, and time to remove drainage tubes after surgery (5.73±1.86 ) d was significantly higher than the total operative time (145.56±33.89) min, postoperative drainage (107.28±53.82) ml, and time to remove drainage tubes after surgery (2.88±1.07) d in the control group ( P<0.01) ;the intraoperative bleeding, number of positive lymph nodes, and postoperative hospital stay were not statistically significant between the two groups ( P>0.05) .The aesthetic satisfaction rate of the study group had a significant advantage over the control group (90% vs 70%) ( P<0.01) .Comparing the functional status of the anterior cervical region between the two groups after surgery,the occurrence of swallowing discomfort or with pulling sensation was better in the study group than in the control group 1 week after surgery ( P<0.05), and there was no statistically significant difference between the two groups in the occurrence of neck pain score, abnormal sensory function (neck pressure, foreign body sensation, numbness and pins and needles) and vocal difficulty ( P>0.05) ; 3 months after surgery, abnormal sensory function of the neck in the study group (at 3 months postoperatively, the occurrence of abnormal neck sensory function (neck pressure, foreign body sensation, numbness and pins and needles sensation) and swallowing discomfort or pulling sensation were better in the study group than those in the control group ( P<0.05). There were no signs of local recurrence or distant metastasis in both groups at follow-up to date. Conclusions:Both minimally endoscopic thyroidectomy procedures were safe, feasible, and effective in the treatment of unilateral PTMC. Among them, the ETGUA is more suitable for patients with strong cosmetic needs within the indications because of its concealed incision and its ability to protect the function of the anterior cervical region, and can be the preferred option.
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Objective:To evaluate the effectiveness of remote pulmonary rehabilitation in the elderly COPD patients in order to provide evidence-based basis for the clinical practice and promotion of remote pulmonary rehabilitation.Methods:We searched databases including Web of Science, PubMed, Cochrane Library, Embase, CINAHL,China Biology Medicine disc, China National Knowledge Internet, VIP, and Wanfang and selected all randomized controlled trials (RCTs) that reported the effects of telerehabilitation on the elderly patients with COPD. The retrieval time was from the establishment of the database to April 26, 2023. Meta-analysis was performed by RevMan 5.3.Results:A total of 24 RCTs involving 2 980 patients with COPD were finally included. Meta-analysis results showed that telerehabilitation in the elderly patients with COPD can improve the lung function (FEV 1/FVC) ( MD=2.09, 95% CI 0.30-3.89, P<0.05), quality of life ( MD=-0.66, 95% CI -1.05--0.26, P<0.05), anxiety ( MD=-0.69, 95% CI -1.32--0.05, P<0.05) and depression ( MD=-0.81, 95% CI -1.59--0.04, P<0.05), and the subgroup for the lung function (FEV 1/FVC) of the elderly patients with COPD emphasized that physical activity, intervention time ≤24 weeks, intervention frequency 1-3 times per week, and use of network platform, there were significant differences between those subgroups (all P<0.01). But there was no statistically significant difference in improving the exercise capacity ( MD=-1.54, 95% CI -14.83-11.75, P>0.05). Conclusions:Telerehabilitation in pulmonary can be considered a supplementary intervention for improving the lung function (FEV 1/FVC), the quality of life and the psychological condition on the elderly patients with COPD.
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Objective:To evaluate the role of heat shock transcription factor 1 (HSF1) in the endogenous protective mechanism underlying mechanical ventilator-induced lung injury (VILI) in mice and the relationship with high mobility group box 1 (HMGB1).Methods:Forty SPF healthy male C57BL/6 mice, aged 6-8 weeks, weighing 20-25 g, were divided into 4 groups ( n=10 each) by the random number table method: control group (group C), VILI group (group VILI), negative control siRNA + VILI group (group NV) and HSF1 siRNA + VILI group (group siRNA). At 48 h before mechanical ventilation, negative control siRNA 5 nmol and HSF1 siRNA 5 nmol were intratracheally injected in NV and siRNA groups respectively, and the solution was diluted to 50 μl with the sterile phosphate buffer in both groups. Group C kept spontaneous breathing for 4 h, and the rest animals were mechanically ventilated (tidal volume 35 ml/kg, respiratory rate 75 breaths/min, inspiratory/expiratory ratio 1∶2, fraction of inspired oxygen 21%) for 4 h. Blood samples from the femoral artery were collected for arterial blood gas analysis immediately after endotracheal intubation and at 4 h of ventilation, and PaO 2 was recorded. Then the mice were sacrificed under deep anesthesia to collect lung tissues and bronchoalveolar lavage fluid (BALF). The concentrations of interleukin-1beta (IL-1β), tumor necrosis factor-alpha (TNF-α) and HMGB1 in BALF were determined by enzyme-linked immunosorbent assay. The pathological results were observed by hematoxylin-eosin staining, and lung injury was assessed and scored. The wet/dry (W/D) weight ratio of lung tissues was calculated. The expression of HMGB1 and HSF1 mRNA in lung tissues (by quantitative real-time polymerase chain reaction) and expression of HMGB1 and HSF1 protein in lung tissues (by Western blot) were determined. Results:Compared with group C, PaO 2 was significantly decreased at 4 h of ventilation, the concentrations of TNF-α, IL-1β and HMGB1 in BALF, W/D ratio and lung injury score were increased, and the expression of HMGB1 protein and mRNA in lung tissues was up-regulated in group VILI, group NV and group siRNA ( P<0.05 or 0.01). Compared with group VILI and group NV, PaO 2 was significantly decreased at 4 h of ventilation, the concentrations of TNF-α, IL-1β and HMGB1 in BALF, W/D ratio and lung injury score were increased, and the expression of HMGB1 protein and mRNA in lung tissues was up-regulated, and the expression of HSF1 protein and mRNA was down-regulated in group siRNA ( P<0.05 or 0.01). There was no significant difference in the parameters mentioned above between group VILI and group NV ( P>0.05). Conclusions:HSF1 is involved in the endogenous protective mechanism underlying VILI in mice, which may be related to the down-regulation of HMGB1 expression and attenuation of inflammatory responses in lung tissues.
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This is a report of three cases of three male patients. One of the patients had myelodysplastic syndrome, and two had aplastic anemia; their ages were 28, 32, and 21 years old, respectively. Two patients underwent sibling allogeneic hematopoietic stem cell transplantation, and one underwent haploidentical hematopoietic stem cell transplantation. All the patients showed elevated hemoglobin and hematocrit at 6, 16, and 9 months after transplantation, with normal white blood cells and platelets and no splenomegaly. All causes of secondary polycythemia were ruled out. Bone marrow morphology showed no erythroid hyperplasia. The PCR result for BCR-ABL (P210, P230, P190, and variants) was negative, and there were no mutations at the amino acid site 617 of JAK2, exon 12 of JAK2, exon 9 of CALR, and amino acid site 515 of MPL. All three patients had hypertension. One patient was treated with amlodipine, and the other two patients were treated with angiotensin receptor blockers. The durations of erythrocytosis for these three patients were 6 years and 3 months, 4 years and 7 months, and 5 years and 3 months, respectively through December 2022. There was no tendency for spontaneous remission. Erythrocytosis after hematopoietic stem cell transplantation is a rare complication. Previous reports in the literature suggest that the mechanism of post-transplant erythrocytosis in recipients of allogeneic hematopoietic stem cell transplantation may be different from that of recipients of other transplants.
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Objective:In order to reduce the transactional burden of scientific researchers and ensure the researchers concentrate on their scientific research, the hospital implemented the whole-process management and optimization of the scientific research approval process based on the DingTalk platform to improve the efficiency of scientific research.Methods:We sorted out the list of routine work in the implementation of scientific research projects and analyzed the key points affecting the efficiency of scientific research management, specifically the processes of reimbursement of scientific research funds, budget adjustment, paper submission approval, and research drug application, then we developed corresponding modules on the DingTalk platform.Results:In 2021, the hospital approved 3 214 scientific research funding reimbursements, including 1 917 approvals below 5 000 yuan, with a median approval time of 19 (5~28) hours, 1 297 approvals above 5 000 yuan, with a median approval time of 26 (10~50) hours. In addition, 17 budget adjustments, 456 paper submissions, and 31 research drug applications were approved on the DingTalk platform, resulting in a smooth overall approval process, saving the time costs of medical staff and improving work efficiency.Conclusions:The scientific research approval management based on this platform realizes the concept of refined management, which can meet the needs of the normalization of epidemic prevention and control and effectively promote the high-quality development of hospital scientific research management.
ABSTRACT
Objective:To investigate the clinical values of progastrin-releasing peptide (Pro-GRP), neuron-specific enolase (NSE), cytokeratin 19 fragment antigen 21-1 (CYFRA21-1), squamous cell carcinoma antigen (SCCA) and human human epididymis protein 4 (HE4) detections in the diagnosis of lung cancer patients.Methods:The clinical data of 200 lung cancer patients who were admitted to the Second Affiliated Hospital of Xuzhou Medical University from January 2020 to December 2021 were retrospectively analyzed. According to the pathological type, the patients were divided into lung adenocarcinoma group (80 cases), lung squamous cell carcinoma group (75 cases) and small cell lung cancer group (45 cases). Fifty patients with benign lung diseases and 50 healthy physical examiners who were admitted to the hospital during the same period were selected. All the subjects were tested for the levels of Pro-GRP, NSE, CYFRA21-1, SCCA and HE4, and the differences of each index level in the subjects of different subgroups were compared. The receiver operating characteristic (ROC) curve was drawn, and using pathological diagnosis result as the gold standard, the diagnostic efficacy of each index alone and in combination for lung cancer was compared.Results:The serum levels of Pro-GRP, NSE, CYFRA21-1, SCCA and HE4 in lung cancer group were higher than those in the benign lung diseases group and the healthy control group (all P < 0.001). There were no statistical differences in the levels of serum Pro-GRP, NSE, CYFRA21-1, SCCA and HE4 between the benign lung diseases group and the healthy control group (all P > 0.05). The levels of Pro-GRP, NSE and HE4 in the small cell lung cancer group were higher than those in the lung adenocarcinoma group and the lung squamous cell carcinoma group (all P < 0.05). NSE and HE4 levels in the lung adenocarcinoma group were higher than those in the lung squamous carcinoma group (both P < 0.05), while CYFRA21-1 and SCCA levels were lower than those in the lung squamous carcinoma group (both P < 0.05). The AUC of lung cancer diagnosed by HE4 was the largest (0.813), the AUC of lung adenocarcinoma diagnosed by HE4 was the largest (0.824), the AUC of lung squamous carcinoma diagnosed by CYFRA21-1 was the largest (0.884), and the AUC of small cell lung cancer diagnosed by NSE was the largest (0.959). The AUC of lung cancer diagnosed by combined detection of 5 indicators was 0.951, the AUC of lung adenocarcinoma and small cell lung cancer diagnosed by combined detection of 5 indicators was 0.975 and 0.996, and the AUC of lung squamous cell carcinoma diagnosed by combined detection of CYFRA21-1, SCCA and HE4 was 0.967. Conclusions:The levels of Pro-GRP, NSE, CYFRA21-1, SCCA, HE4 and other indicators have certain clinical values in the diagnosis of lung cancer and its pathological types, and the combined detection of each index is more valuable than a single index.
ABSTRACT
Objective:To investigate the clinical application of free/total prostate-specific antigen (f/tPSA), peripheral blood neutrophil-to-lymphocyte ratio (NLR), interleukin-6 (IL-6) and prostate health index density (PHID) detection in the early diagnosis of prostate cancer.Methods:The clinical data of 160 patients with abnormal prostate specific antigen (PSA) who were admitted to the Second Affiliated Hospital of Xuzhou Medical University from January 2020 to January 2022 were retrospectively analyzed. According to the pathological results of prostate biopsy or electrical resection, the patients were divided into prostate cancer group (68 cases) and benign prostatic hyperplasia group (92 cases), and 50 male healthy physical examiners in the Second Affiliated Hospital of Xuzhou Medical University during the same period were selected as healthy control group. All enrolled members were tested for total prostate-specific antigen (tPSA), free prostate-specific antigen (fPSA), and prostate specific antigen isoform 2 (p2PSA), IL-6 and other indicators, and the f/tPSA, prostate health index (PHI), PHID and NLR were calculated. Receiver operating characteristic (ROC) curve was plotted to compare the efficacy of each index in diagnosing and differentially diagnosing prostate cancer and benign prostatic hyperplasia.Results:The serum levels of tPSA, fPSA, p2PSA, PHI and PHID in the prostate cancer group were higher than those in the benign prostatic hyperplasia group and the healthy control group (all P < 0.05), and the serum f/tPSA was lower than that in the benign prostatic hyperplasia group and the healthy control group ( P < 0.05). The area under the curve (AUC) of PHID for the diagnosis of early stage prostate cancer was the largest [0.915 (95% CI 0.864-0.966)], followed by PHI [0.884 (95% CI 0.823-0.944)]. The sensitivity of both f/tPSA and PHI in diagnosing early stage prostate cancer was 86.80%, which was higher than other indicators; the specificity of PHID in diagnosing early stage prostate cancer was 94.00%, which was higher than other indicators. The AUC of f/tPSA for the diagnosis of benign prostatic hyperplasia was the largest [0.828 (95% CI 0.739-0.917)], followed by PHID [0.826 (95% CI 0.760-0.892)]. The sensitivity of f/tPSA in diagnosing benign prostatic hyperplasia (85.90%) was higher than other indicators, and the specificity of PHI in diagnosing benign prostatic hyperplasia (94.00%) was higher than other indicators. The AUC of fPSA, PHID, f/tPSA and p2PSA in differentiating early stage prostate cancer and benign prostatic hyperplasia were 0.752 (95% CI 0.663-0.841), 0.730 (95% CI 0.647-0.812), 0.713 (95% CI 0.623-0.803), 0.710 (95% CI 0.629-0.791), respectively, and there was no significant difference in each pairwise comparison (all P > 0.05). The sensitivity of NLR in differentiating early stage prostate cancer and benign prostatic hyperplasia was 91.20%, which was higher than other indicators, and the specificity of fPSA in differentiating early stage prostate cancer and benign prostatic hyperplasia was 94.00%, which was higher than other indicators. Conclusions:The f/tPSA, PHI and PHID detection have certain clinical values in the early diagnosis of prostate cancer, and can provide references for early diagnosis, early treatment and prognosis evaluation of high-risk population of prostate cancer.