An Evaluation of Fluorouracil plus Paclitaxel and Oxiliplatin as a First-Line Treatment for Advanced Gastric Squamous Cell Carcinoma.

Objective: To investigate the efficacy of fluorouracil (FU) combined with paclitaxel (PTX) and oxaliplatin (OXA) as the first-line treatment for advanced gastric signet ring cell carcinoma (SRCC) and its influence on human epidermal growth factor receptor 2 (HER-2) expression. Methods: We collected one hundred and sixty-eight patients with advanced gastric SRCC, including 87 patients treated with FU combined with PTX and OXA as the study group (SG) and 81 patients treated with FU combined with OXA as the control group (CG). We compared indicators such as efficacy and adverse reactions after treatment between the two groups and also detected serum HER-2 expression pre- and post-treatment. Results: The incidence of adverse reactions differed insignificantly between SG and CG (P > 0.05). SG presented a notably higher objective response rate (ORR) and disease control rate (DCR) than that of CG (P < 0.05). After treatment, the serum HER-2 expression level of patients in both groups decreased significantly (P < 0.05), and that in SG was significantly declined compared to CG (P < 0.05). HER-2 was negatively correlated with the efficacy of both SG and CG. The 1-year survival rate in SG (29.89%) was significantly higher than that in CG (16.05%) (P < 0.05). The median OS and PFS were higher in DG than that in CG (P < 0.05). Conclusion: FU combined with PTX and OXA can effectively improve the efficacy of first-line treatment for advanced gastric SRCC while reducing HER-2 expression, without increasing the adverse reaction rate. This treatment is worthy of clinical promotion.

Cognitive protection of sinomenine in type 2 diabetes mellitus through regulating the EGF/Nrf2/HO-1 signaling, the microbiota-gut-brain axis, and hippocampal neuron ferroptosis.

Recent years have witnessed a growing research interest in traditional Chinese medicine as a neuroprotective nutrient in the management of diabetic cognitive dysfunction. However, the underlying molecular mechanisms of sinomenine in mediating ferroptosis of hippocampal neurons have been poorly understood. This study sought to decipher the potential effect and molecular mechanism of sinomenine in the cognitive dysfunction following type 2 diabetes mellitus (T2DM). Multi-omics analysis was conducted to identify the microbiota-gut-brain axis in T2DM patient samples obtained from the publicly available database. In HT-22 cells, erastin was utilized to create a ferroptosis model, and streptozotocin was injected intraperitoneally to create a rat model of DM. It was noted that intestinal flora imbalance occurred in patients with T2DM-associated cognitive dysfunction. Sinomenine could reduce Erastin-induced hippocampus neuronal ferroptosis by increasing EGF expression. EGF protected hippocampal neurons against ferroptosis by activating the Nrf2/HO-1 signaling pathway. Furthermore, in vivo results confirmed that sinomenine blocked ferroptosis of hippocampal neurons and alleviated cognitive dysfunction in T2DM rats. Collectively, these results suggest that sinomenine confers neuroprotective effects by curtailing hippocampal neuron ferroptosis via the EGF/Nrf2/HO-1 signaling and microbiota-gut-brain axis. It may be a candidate for the treatment of diabetic cognitive dysfunction.

Construction of Selenium Nanoparticle-Loaded Mesoporous Silica Nanoparticles with Potential Antioxidant and Antitumor Activities as a Selenium Supplement.

Excessive reactive oxygen species (ROS) can damage cells and affect normal cell functions, which are related to various diseases. Selenium nanoparticles are a potential selenium supplement for their good biocompatibility and antioxidant activity. However, their poor stability has become an obstacle for further applications. In this study, mesoporous silica nanoparticles (MSNs) were prepared as a carrier of selenium nanoparticles. Pluronic F68 (PF68) was used for the surface modification of the compounds to prevent the leakage of the selenium nanoparticles. The prepared MSN@Se@PF68 nanoparticles were characterized by transmission electron microscopy, energy-dispersive X-ray spectroscopy, dynamic light scattering, X-ray photoelectron spectroscopy, confocal micro-Raman spectroscopy, and Fourier transform infrared spectroscopy. The MSN@Se@PF68 nanoparticles showed excellent antioxidant activity in HeLa tumor cells and zebrafish larvae. The cytotoxicity of MSN@Se@PF68 nanoparticles was concentration- and time-dependent in HeLa tumor cells. The MSN@Se@PF68 nanoparticles showed a negligible cytotoxicity of ≤2 µg/mL at 48 h. At a concentration of 50 µg/mL, the cell viability of the HeLa tumor cells decreased to about 50%. The results indicated that the MSN@Se@PF68 nanoparticles could be a potential antitumor agent. The embryonic development of zebrafish cocultured with the MSN@Se@PF68 nanoparticles showed that there was no lethal or obvious teratogenic toxicity. The results implied that the MSN@Se@PF68 nanoparticles could be a safe selenium supplement and have the potential for antioxidant and antitumor activity.

Products distribution during in situ and ex situ catalytic fast pyrolysis of Chinese herb residues.

Catalytic fast pyrolysis (CFP) for biomass treatment is a research hotspot but there is little information about the difference between the in situ and ex situ methods. In present work, the Ni-Fe/CaO-Al2O3 catalysts with different Ni/Fe ratios have been synthesized by coprecipitation method, and the product distribution about the Chinese herb residue (CHR) catalytic fast pyrolysis by in situ and ex situ methods in a quartz tube reactor system has been investigated. The results show that the CFP pyrolysis would upgrade the quality of bio-oil but decrease the yields, no matter in situ or ex situ CFP process. During the in situ CFP process, heteroatoms may be absorbed by the catalyst support and cannot be transferred to the bio-oil, but the results of ex situ CFP are the opposite. In addition, the ex situ CFP reaction significantly increases the content of aromatic hydrocarbons. As to the gas products' distribution, the effect of Fe in catalysts to promote CH4 formation is reflected in in situ CFP process, while the promotion effect of H2 generation for Ni added in catalyst is mainly reflected in ex situ CFP process. However, due to the high reaction temperature (800 °C), the adsorption of CO2 by CaO support is not particularly significant. The possible mechanism of CHR in CFP process has also been summarized for understanding the process of in situ and ex situ CFP, and this study may provide a choice or reference for CHR treatment.

Effects of Applying Different Doses of Selenite to Soil and Foliar at Different Growth Stage on Selenium Content and Yield of Different Oat Varieties.

(1) Background: With the increase in people's consumption of processed oat products, the production of selenium (Se)-enriched oat has become a possibility to supplement the human body with Se. Therefore, the effects of various factors on the Se-enriched ability and yield of different oat varieties were comprehensively studied. (2) Methods: cv."Pinyan 5" and cv."Bayou 18" were applied at the stem-elongation stage and heading stage in the Jinzhong (JZ), and cv."Bayou 1" and cv."Jinyan 18" were applied at the heading stage and flowering stage in the northwestern Shanxi (JXB) with different doses of Na2SeO3 (0, 5.48, 10.96, 21.92, 43.84, 65.76, 98.64, 0, 5.48, 10.96, 21.92, 43.84, 65.76, 98.64, 147.96 g hm-2) by soil application and foliar spraying. (3) Results: The grain Se content and yield of oat were affected by the variety, Se application dose, stage and method of Se supplementation. Additionally, the Se content in oat grain was positively correlated with the Se application dose while the yield of oat first increased and then decreased with the Se application dose. (4) Conclusions: In the JZ and JXB, 21.92 g hm-2 and 43.84 g hm-2 Se was sprayed on the leaves of cv."Bayou 18" and cv."Bayou 1" at the heading stage, respectively, was the most effective Se biofortification program.

Effects of selenium application concentration, period and method on the selenium content and grain yield of Tartary buckwheat of different varieties.

BACKGROUND: As a potential selenium-enriched crop, it is of great significance to study the selenium application of Tartary buckwheat. Therefore, to study the effects of selenium application concentration, variety, selenium application period and method on the grain selenium content and yield of Tartary buckwheat, an orthogonal experimental design was used to carry out field experiments in the Jinzhong and Northwest Shanxi ecological regions at the same time. Heifeng 1 and Jinqiao 2 were applied at the branching stage and flowering stage in the Jinzhong, and Heifeng 1 and Jinqiao 6 were applied at the early flowering stage and peak flowering stage in the Northwest Shanxi with different concentrations of sodium selenite (0, 1.37, 2.74, 5.48, 8.22, 12.33, 18.495, 27.7425 g hm-2 ) by foliar spraying and soil application. RESULTS: The results showed that the selenium content in Tartary buckwheat grains was positively correlated with the selenium application concentration and increased with increasing selenium application concentration, while the yield of Tartary buckwheat first increased and then decreased with the selenium application concentration. The grain selenium content and yield of Tartary buckwheat were affected by the selenium application concentration, variety and application method. CONCLUSION: The most effective selenium biofortification program was spraying 2.32 g hm-2 sodium selenite on the leaves of Heifeng 1 at the early flowering stage in the Jinzhong. In the Northwest Shanxi, spraying 11.01 g hm-2 sodium selenite on the leaves of Jinqiao 6 at the flowering stage was the most effective selenium biofortification program. © 2022 Society of Chemical Industry.

Sapidolide A alleviates acetaminophen-induced acute liver injury by inhibiting NLRP3 inflammasome activation in macrophages.

Macrophages play a critical role in the pathogenesis of acetaminophen (APAP)-induced liver injury (AILI), a major cause of acute liver failure or even death. Sapidolide A (SA) is a sesquiterpene lactone extracted from Baccaurea ramiflora Lour., a folk medicine used in China to treat inflammatory diseases. In this study, we investigated whether SA exerted protective effects on macrophages, thus alleviated the secondary hepatocyte damage in an AILI. We showed that SA (5-20 µM) suppressed the phosphorylated activation of NF-κB in a dose-dependent manner, thereby inhibiting the expression and activation of the NOD-like receptor protein 3 (NLRP3) inflammasome and pyroptosis in LPS/ATP-treated mouse bone marrow-derived primary macrophages (BMDMs). In human hepatic cell line L02 co-cultured with BMDMs, SA (10 µM) protected macrophages from the pyroptosis induced by APAP-damaged L02 cells. Moreover, SA treatment reduced the secondary liver cell damage aggravated by the conditioned medium (CM) taken from LPS/ATP-treated macrophages. The in vivo assessments conducted on mice pretreated with SA (25, 50 mg/kg, ip) then with a single dose of APAP (400 mg/kg, ip) showed that SA significantly alleviated inflammatory responses of AILI by inhibiting the expression and activation of the NLRP3 inflammasome. In general, the results reported herein revealed that SA exerts anti-inflammatory effects by regulating NLRP3 inflammasome activation in macrophages, which suggests that SA has great a potential for use in the treatment of AILI patients.

Co-pyrolysis of different torrefied Chinese herb residues and low-density polyethylene: Kinetic and products distribution.

In present work, the synergistic effects during co-pyrolysis of low-density polyethylene (LDPE) and torrefied Chinese herb residues (CHR) have been investigated by thermogravimetric analysis. The kinetic parameters of co-pyrolysis were calculated by Coats-Redfern method, and the difference values of experiment and theoretical were also investigated for gas and oil compounds. The results show that the extent of synergistic or inhibitory effects of co-pyrolysis was connection with the severity of CHR torrefaction, and the activation energy depend on the blend ratio of LDPE and CHRs. In addition, co-pyrolysis tends to generate more small molecule products and reduce oil yield, and increase the CO content but decreases CH4 in the gas product. The results also found that the liquid products have a significant interaction during the co-pyrolysis process, because the content of aliphatic hydrocarbons and alcohols in the blends pyrolysis oil has been greatly increased, and improving the quality of oil.

Traditional Chinese medicine for septic patients undergoing ulinastatin therapy: A meta-analysis.

PURPOSE: This study aimed to assess the efficacy of traditional Chinese medicine (TCM) in septic patients treated with ulinastatin. METHODS: PubMed, EmBase, and the Cochrane library were searched up to January 2021 to identify randomized controlled trials. The weight mean difference (WMD) and relative risk (RR) with 95% confidence intervals were used with the random-effects model. RESULTS: Twenty-three randomized controlled trials with 1903 septic patients were included. TCM significantly reduced the APACHE II score (WMD: -5.18; P < .001), interleukin-6 (WMD: -63.00; P < .001), tumor necrosis factor-α (WMD: -8.86; P < .001), c-reactive protein (WMD: -9.47; P < .001), mechanical ventilation duration (WMD: -3.98; P < .001), intensive care unit stay (WMD: -4.18; P < .001), procalcitonin (WMD: -0.53; P < .001), lipopolysaccharide (WMD: -9.69; P < .001), B-type natriuretic peptide (WMD: -159.87; P < .001), creatine kinase isoenzyme MB (WMD: -45.67; P < .001), cardiac troponin I (WMD: -0.66; P < .001), and all-cause mortality risk (RR: 0.55; P < .001). CONCLUSIONS: TCM lowers inflammation levels and reduces the risk of all-cause mortality for septic patients.

Leukocyte proteomics coupled with serum metabolomics identifies novel biomarkers and abnormal amino acid metabolism in Kawasaki disease.

Kawasaki disease (KD) is a systemic vasculitis that can lead to severe cardiovascular complications, whereas the development and clinical usage of specific biomarkers might help diagnose KD and avoid certain complications. To this end, the molecular profiles of acute KD patients with coronary artery lesions (CAL) were first investigated through leukocyte proteomics and serum metabolomics assays. A total of 269 differentially abundant proteins and 35 differentially abundant metabolites with the top fold-changed levels were identified in acute KD patients compared to those in the healthy controls. Among them, several highly promising candidate marker proteins and metabolites indicative of KD progression were further analysed, such as the increased proteins ALPL, NAMPT, and S100P, as well as the decreased proteins C1QB and apolipoprotein family members. Moreover, metabolites, including succinic acid, dGMP, hyaluronic acid, L-tryptophan, propionylcarnitine, inosine, and phosphorylcholine, were found to be highly accurate at distinguishing between KD patients and healthy controls. Interestingly, the abnormal expression levels of a distinct set of proteins and metabolites in acute KD patients can be restored to normal levels upon intravenous immunoglobulin (IVIG) treatment. Overall, this work has revealed novel biomarkers and abnormal amino-acid metabolism as a prominent feature involved in KD patients with CAL. SIGNIFICANCE: KD is frequently concomitant with the development of life-threatening coronary vasculitis. Here, the profiles of leukocyte proteomics and serum metabolomics in acute KD patients with CALs were first investigated, and several hub molecules identified here could be used as supplemental biomarkers for KD diagnosis. Moreover, the metabolomic abnormalities especially the amino acids are particularly prominent in KD patients. Interestingly, the abnormal expression levels of a distinct set of proteins and metabolites in acute KD patients can be restored to normal levels upon IVIG treatment. Therefore, these findings might help understand the IVIG activities and also the underlying mechanisms of IVIG-resistant patients, thereby providing a new perspective for the exploration of mechanisms related to KD.

Changes in physicochemical properties and microfauna community during vermicomposting of municipal sludge under different moisture conditions.

The present study aimed to explore the effect of a range of moisture content levels, including 65%, 72%, and 78%, on physicochemical properties and microfauna communities during vermicomposting of municipal sludge. As a result, death of perishable microfauna together with the degradation of organic matter was the dominant response in all groups in the early period of vermicomposting, while the effects of moisture content levels on various physiochemical parameters did not appear until the mid-later period. After the treatment with 78% moisture content, the content of mineral nitrogen was 1.186 g/kg in the sludge, with a 9.36 × 103 ind./g of microfauna quantity and 663.01 g of earthworm biomass. The values of these three measurements in 78% group were significantly higher than other two groups (p < 0.05), indicating that the effects of 78% moisture content were more pronounced for promoting nitrogen mineralization as well as microfauna and earthworms growth during vermicomposting. Specifically, testate amoebae were strongly associated with nitrification process, while nematodes were related to ammonification and phosphorus mineralization, of which testate amoebae had great potential of being bioindicators during vermicomposting of municipal sludge.

Modification, Antitumor Activity, and Targeted PPARγ Study of 18ß-Glycyrrhetinic Acid, an Important Active Ingredient of Licorice.

Licorice is a traditional Chinese medicine, which is often used as sweetener and cosmetic ingredients in food and pharmaceutical industries. Among them, glycyrrhetic acid is one of the most important agents. Studies have shown that glycyrrhetic acid exhibited antitumor activities as PPARγ agonist. However, the limited number of PPARγ glycyrrhetinic agonists and their high toxicity greatly limit the design based on the structure. Therefore, clarifying the binding mode between PPARγ and small molecules, we focused on the introduction of a natural active piperazine skeleton in the position of glycyrrhetinic acid C-3. According to the Combination Principle and the Structure-Based Drug Design, 19 glycyrrhetic acid derivatives were designed and synthesized as potential PPARγ agonists. Compounds 4c and 4q were screened as high-efficiency and low-toxicity lead compounds.

The Effects of Astragalus Polysaccharide on Bone Marrow-Derived Mesenchymal Stem Cell Proliferation and Morphology Induced by A549 Lung Cancer Cells.

BACKGROUND The tumor microenvironment in lung cancer plays an important role in tumor progression and metastasis. Bone marrow-derived mesenchymal stem cells (MSCs) co-cultured with A549 lung cancer cells show changes in morphology, increase cell proliferation, and cell migration. This study aimed to investigate the effects of Astragalus polysaccharide (APS), a traditional Chinese herbal medicine, on the changes induced in bone marrow-derived MSCs by A549 lung cancer cells in vitro. MATERIAL AND METHODS Bone marrow-derived MSCs were co-cultured with A549 cells (Co-BMSCs). Co-cultured bone marrow-derived MSCs and A549 cells treated with 50 µg/ml of APS (Co-BMSCs + APS) were compared with untreated Co-BMSCs. Cell proliferation was measured using the cell counting kit-8 (CCK-8) assay. Flow cytometry evaluated the cell cycle. Microarray assays for mRNA expression and Western blot for protein expression were used. RESULTS Compared with untreated Co-BMSCs, APS treatment of Co-BMSCs improved cell morphology, reduced cell proliferation, and inhibited cell cycle arrest. The mitogen-activated protein kinase (MAPK)/nuclear factor-kappa B (NF-kappaB) pathway, TP53, caspase-3, acetylated H4K5, acetylated H4K8, and acetylated H3K9 were involved in the regulatory process. CONCLUSIONS APS treatment reduced cell proliferation and morphological changes in bone marrow-derived MSCs that were co-cultured with A549 lung cancer cells in vitro.

Rhododendron Molle (Ericaceae): phytochemistry, pharmacology, and toxicology.

Rhododendron molle G. Don, belonging to the Ericaceae family, is a traditional Chinese medicinal plant with a wide spectrum of pharmacological effects. This paper aimed to review the phytochemistry, pharmacology and toxicology of R. molle, and to discuss the tendency of future investigations on this plant. A systematic review of literature about R. molle was carried out using resources including classic books about Chinese herbal medicine, and scientific data bases including CNKI, Pubmed, SciFinder, Scopus, and Web of Science. Over 67 compounds, including diterpenes, triterpenes, flavonoids, and lignans, had been extracted and identified from R. molle. The extracts/monomers isolated from the root, flower and fruits of this plant were used as effective agents for treating pains, inflammatory diseases, hypertension, and pest, etc. In addition, diterpenes, such as rhodojaponin III, were considered as the toxic agents associated with the toxicities of this plant. These findings will be significant for the discovery of new drugs from this plant and full utilization of R. molle.

Anti-hyperlipidemia of garlic by reducing the level of total cholesterol and low-density lipoprotein: A meta-analysis.

BACKGROUND: This study aimed to understand the impact of garlic on improving blood lipids using a meta-analysis. METHODS: A literature search of the PubMed, EMBASE, and Cochrane Library databases was performed using keywords such as "garlic" and "hypercholesterolemia," and the deadline "July 14 (th), 2017." After extracting relevant details, each selected literature was evaluated for quality according to the quality evaluation criteria of bias risk recommended by Cochrane Collaboration recommendations and heterogeneity tests were performed. Standardized mean difference (SMD) and 95% confidence interval (CI) were evaluated using R 3.12 software. The publication bias was assessed using Egger method. RESULTS: A total of 14 eligible papers published from 1981 to 2016 were included. The quality of the literatures was of moderate to high qualities. The values of TC (SMD = -1.26, 95% CI, -1.86 to -0.66), low-density lipoprotein (LDL) (SMD = -1.07, 95% CI, -1.67 to -0.47), and high-density lipoprotein (HDL) (SMD = 0.50, 95% CI, 0.06-0.94) after taking garlic in the experimental group and the control group have statistical significance, while there was no significant difference of TG in the 2 groups (SMD = -0.16, 95% CI, -0.87-0.55). However, the result of HDL was reversed when removed some of the literatures. No significant publication bias among the eligible studies with values of TC (P = .0625), LDL (P = .0770), HDL (P = .2293), and TG (P = .3436). CONCLUSION: Garlic can reduce the level of TC and LDL instead of HDL and TG, indicating the ability of anti-hyperlipidemia.

[Influence of different cultivation measures on the content of three free carbohydrates of Codonopsis Radix].

To provide a scientific evidence for the quality control of Codonopsis Radix, a method was established for determining the content of three free carbohydrates of Codonopsis Radix. The developed method showed good linearity. The calibration curves were linear within the range of 2.312 5-18.500 0 µg for sucrose, 1.500 0-12.000 0 µg for glucose, and 2.000 0-16.000 0 µg for fructose, resgectwely. The recoveries varied between 96.31%-101.8%. The method is simple, accurate and reproducible, and can be used for determining the content of sucrose, glucose and fructose of Codonopsis Radix. The results showed that different cultivation measures had an effect on the content of three free carbohydrates of Codonopsis Radix. According to the content of sucrose, using Zhuanggenling>not using Zhuanggenling. While, not pinching, shelving>not pinching, not shelving>pinching, not shelving>pinching, shelving. According to the content of glucose and fructose, not using Zhuanggenling>using Zhuanggenling. While, pinching, shelving>not pinching, not shelving>not pinching, shelving>pinching, not shelving. In consideration of the differences of sweetness and content of the three free carbohydrates in Codonopsis Radix, we recommend that the content of free carbohydrates could be considered as the marker to evaluate the quality of Codonopsis Radix.

Ethyl Acetate Extract Components of Bushen-Yizhi Formula Provides Neuroprotection against Scopolamine-induced Cognitive Impairment.

Alzheimer's disease (AD) is a multifactorial neurodegenerative disorder and there is no effective cure for this devastating disease to date. Bushen Yizhi Formula (BSYZ-F), a Chinese herbal compound, has proved to be effective for AD. In this study, we further investigate the effective part of BSYZ-F, ethyl acetate extract components of BSYZ-F (BSYZ-E), protects scopolamine (SCOP)-induced cognitive impairment, which shows a similar effect to BSYZ-F. We also find that BSYZ-E could protect against SCOP-induced cholinergic system dysfunction. In neuron function level, BSYZ-E remarkably elevates protein levels of nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF). BSYZ-E also significantly mitigates SCOP-induced apoptosis, oxidative stress and nitrosative stress. Conclusively, BSYZ-E, the effective part of BSYZ-F, can provide neuroprotection against SCOP-induced cognitive impairment through a multifunctional strategy. These findings suggest that BSYZ-E might be developed as a therapeutic drug for AD by targeting multiple pathways of the pathogenesis.

Tea consumption and prostate cancer: an updated meta-analysis.

OBJECTIVES: Tea is supposed to have chemopreventive effect against various cancers. However, the protective role of tea in prostate cancer is still controversial. The aim of this study is to elucidate the association between tea consumption and prostate cancer risk by meta-analysis. METHODS: A total of 21 published articles were retrieved via both computerized searches and review of references. Estimates of OR/RR for highest versus non/lowest tea consumption levels were pooled on the basis of random effect model or fixed effect model as appropriate. Stratified analyses on tea type, population and study design were also conducted. RESULTS: No statistical significance was detected between tea consumption and prostate cancer risk in meta-analysis of all included studies (odds ratio (OR) = 0.86, 95% CI (0.69-1.04)). Furthermore, stratified analyses on population (Asian, OR = 0.81, 95% CI (0.55-1.08); non-Asian, OR = 0.89, 95% CI (0.72-1.07)) and tea type (green tea, OR = 0.79, 95% CI (0.43-1.14); black tea, OR = 0.88, 95% CI (0.73-1.02)) also yielded non-significant association. Only the case-control study subgroup demonstrated a borderline protective effect for tea consumption against prostate cancer (OR = 0.77, 95% CI (0.55-0.98)). CONCLUSION: Our analyses did not support the conclusion that tea consumption could reduce prostate cancer risk. Further epidemiology studies are needed.

Vitamin B supplementation, homocysteine levels, and the risk of cerebrovascular disease: a meta-analysis.

OBJECTIVE: To perform a meta-analysis on the effect of lowering homocysteine levels via B vitamin supplementation on cerebrovascular disease risk. METHODS: Using clinical trials published before August 2012 to assess stroke events, we used relative risks (RRs) with 95% confidence intervals (95% CIs) to measure the association between B vitamin supplementation and endpoint events using a fixed-effects model and χ(2) tests. We included 14 randomized controlled trials with 54,913 participants in this analysis. RESULTS: We observed a reduction in overall stroke events resulting from reduction in homocysteine levels following B vitamin supplementation (RR 0.93; 95% CI 0.86-1.00; p = 0.04) but not in subgroups divided according to primary or secondary prevention measures, ischemic vs hemorrhagic stroke, or occurrence of fatal stroke. There were beneficial effects in reducing stroke events in subgroups with ≥3 years follow-up time, and without background of cereal folate fortification or chronic kidney disease (CKD). Some trials that included CKD patients reported decreased glomerular filtration rate with B vitamin supplementation. We conducted detailed subgroup analyses for cyanocobalamin (vitamin B12) but did not find a significant benefit regarding intervention dose of vitamin B12 or baseline blood B12 concentration. Stratified analysis for blood pressure and baseline participant medication use showed benefits with >130 mm Hg systolic blood pressure and lower antiplatelet drug use in reducing stroke risk. CONCLUSIONS: B vitamin supplementation for homocysteine reduction significantly reduced stroke events, especially in subjects with certain characteristics who received appropriate intervention measures.

[Transurethral vapor enucleation and resection of prostate with TURis button electrode].

OBJECTIVE: To describe an efficient and effective method of using Olympus TURis button plasma vaporization electrode plus loop electrode for transurethral vapor enucleation and resection of prostate. METHODS: Between July 2011 and October 2011, the investigators performed transurethral vapor enucleation and resection of prostate using Olympus TURis button plasma vaporization electrode plus loop electrode in 16 consecutive patients at our institution. The parameters of prostate weight, International Prostate Symptom Score (IPSS), quality of life (QOL), operative duration, blood loss volume, catheterization period, duration of hospitalization, perioperative complications and the weight of enucleated tissue were evaluated. IPSS and QOL were recorded during the follow-up. RESULTS: No patient had significant blood loss or signs of transurethral resection syndrome. The mean patient age was 67.3 ± 8.1 years. Mean preoperative prostate weight was 49 ± 24 g (range: 19 - 91) and mean resected tissue weight 36 ± 16 g (range: 10 - 50). Serious complications were not observed. Operative duration was 116 ± 31 minutes, mean catheter time 4.9 ± 1.8 days and the duration of hospitalization was 16.6 ± 5.5 days. Transurethral vapor enucleation and resection of prostate induced significant, pronounced, immediate and lasting improvement in IPSS (15.6 ± 6.8 vs 6.7 ± 2.4, P < 0.01) and QOL (3.4 ± 1.4 vs 1.6 ± 0.6, P < 0.01). CONCLUSION: Transurethral vapor enucleation and resection of prostate with Olympus TURis plasma button electrode is a safe, effective and thorough surgical method in the treatment of benign prostatic hyperplasia.