Enhancing the management of locally advanced head and neck malignancies and cases with local/neck recurrence and metastasis through the integration of anlotinib with concurrent radiochemotherapy.

The aim of this study is to assess the effectiveness and safety of anlotinib in conjunction with concurrent radiochemotherapy for the treatment of locally advanced head and neck malignant tumors, including cases exhibiting local or neck recurrence and metastasis. Between June 2020 and June 2023, 42 patients diagnosed with locally advanced head and neck malignant tumors or presenting with local or neck recurrence and metastasis were recruited. These individuals received treatment that combined anlotinib with concurrent radiochemotherapy, followed by a minimum of two cycles of oral anlotinib upon completion of the initial treatment regimen. Among the 19 patients diagnosed with nasopharyngeal carcinoma, 14 patients attained a complete response, while four patients achieved partial response, resulting in an overall response rate of 94.74% (18/19). Conversely, among the 23 patients with non-nasopharyngeal carcinoma, two patients achieved complete response and 16 attained partial response, yielding a response rate of 78.26% (18/23). The 6-month progression-free survival rate was 95.24%. After treatment, serum vascular endothelial growth factor receptor levels exhibited a significant decrease compared with pretreatment levels. Notably, no instances of treatment-related serious adverse reactions were recorded. The combination of anlotinib with concurrent radiochemotherapy demonstrates favorable efficacy in managing locally advanced head and neck malignant tumors, including instances of local or neck recurrence and metastasis. Furthermore, the treatment regimen is characterized by an acceptable safety profile and tolerability.

Prophylactic supplement with melatonin prevented the brain injury after cardiac arrest in rats.

Prophylactic pharmacotherapy for health care in patients with high risk of cardiac arrest (CA) is an elusive and less explored strategy. Melatonin has possibilities used as a daily nutraceutical to trigger the cellular adaptation. We sought to find the effects of long-term daily prophylactic supplement with melatonin on the victim of CA. Rats were divided into sham, CA, and melatonin + CA (Mel + CA) groups. The rats in the Mel + CA group received daily IP injection of melatonin 100 mg/kg for 14 days. CA was induced by 8 min asphyxia and followed by manual cardiopulmonary resuscitation. The endpoint was 24 h after resuscitation. Survival, neurological outcome, and hippocampal mitochondrial integrity, dynamics and function were assessed. Survival was significantly higher in the Mel + CA group than the CA group (81 vs. 42%, P = 0.04). Compared to the CA group, neurological damage in the CA1 region and the level of cytochrome c, cleaved caspase-3 and caspase-9 in the Mel + CA group were decreased (P < 0.05). Mitochondrial function and integrity were protected in the Mel + CA group compared to the CA group, according to the results of mitochondrial swelling, ΔΨm, ROS production, oxygen consumption rate, and respiratory control rate (P < 0.05). Melatonin increased SIRT3 and downregulated acetylated CypD. The mitochondrial dynamics and autophagy were improved in the Mel + CA group (P < 0.05). Long-term daily prophylactic supplement with melatonin buy the time from brain injury after CA.

Identification of Key MicroRNAs and Genes between Colorectal Adenoma and Colorectal Cancer via Deep Learning on GEO Databases and Bioinformatics.

Background: Deep learning techniques are gaining momentum in medical research. Colorectal adenoma (CRA) is a precancerous lesion that may develop into colorectal cancer (CRC) and its etiology and pathogenesis are unclear. This study aims to identify transcriptome differences between CRA and CRC via deep learning on Gene Expression Omnibus (GEO) databases and bioinformatics in the Chinese population. Methods: In this study, three microarray datasets from the GEO database were used to identify the differentially expressed genes (DEGs) and differentially expressed miRNAs (DEMs) in CRA and CRC. The FunRich software was performed to predict the targeted mRNAs of DEMs. The targeted mRNAs were overlapped with DEGs to determine the key DEGs. Molecular mechanisms of CRA and CRC were evaluated using enrichment analysis. Cytoscape was used to construct protein-protein interaction (PPI) and miRNA-mRNA regulatory networks. We analyzed the expression of key DEMs and DEGs, their prognosis, and correlation with immune infiltration based on the Kaplan-Meier plotter, UALCAN, and TIMER databases. Results: A total of 38 DEGs are obtained after the intersection, including 11 upregulated genes and 27 downregulated genes. The DEGs were involved in the pathways, including epithelial-to-mesenchymal transition, sphingolipid metabolism, and intrinsic pathway for apoptosis. The expression of has-miR-34c (P = 0.036), hsa-miR-320a (P = 0.045), and has-miR-338 (P = 0.0063) was correlated with the prognosis of CRC patients. The expression levels of BCL2, PPM1L, ARHGAP44, and PRKACB in CRC tissues were significantly lower than normal tissues (P < 0.001), while the expression levels of TPD52L2 and WNK4 in CRC tissues were significantly higher than normal tissues (P < 0.01). These key genes are significantly associated with the immune infiltration of CRC. Conclusion: This preliminary study will help identify patients with CRA and early CRC and establish prevention and monitoring strategies to reduce the incidence of CRC.

The effects of dexmedetomidine for patient-controlled analgesia on postoperative sleep quality and gastrointestinal motility function after surgery: A prospective, randomized, double-blind, and controlled trial.

Background: Postoperative poor sleep quality and decreased gastrointestinal motility function are common clinical problems. This study investigated the effects of dexmedetomidine (DEX) combined with sufentanil for patient-controlled analgesia (PCA) on postoperative sleep quality and gastrointestinal motility function after surgery in patients with colorectal cancer. Methods: Patients undergoing colorectal cancer surgery were randomly divided into three groups, DEX 0, 200, or 400 µg, each combined with sufentanil 150 µg for PCA immediately after surgery. The primary outcome was sleep quality in the first 7 days after surgery based on the Athens Insomnia Scale (AIS) score. The secondary outcome was postoperative gastrointestinal motility recovery evaluated by the time of first flatus, first feces and first diet. Postoperative pain intensity, side effects and the length of postoperative hospital stay were also compared among groups. The study was registered with the Chinese Clinical Trial Registry (https://www.chictr.org.cn/enIndex.aspx, ChiCTR2000032601). Results: Ultimately, 210 cases were included. Sleep quality was better in the DEX 200 µg group and DEX 400 µg group than in the DEX 0 µg group. Overall, in the DEX 200 µg group and DEX 400 µg group, the AIS score (p < 0.05) and the incidence of sleep disturbance (7.3%, 4.5% vs. 19.6%, p < 0.001) were lower than those in the DEX 0 µg group in the first 7 days after surgery. There were no significant differences in postoperative gastrointestinal motility among the three groups in the total surgical categories (p > 0.05). In the laparoscopic surgery patients of each group, the time of postoperative first flatus (p = 0.02) and first feces (p = 0.01) was significantly longer in the DEX 400 µg group than in the DEX 0 µg group. There were no differences in postoperative pain intensity, side effects or length of postoperative hospital stay (p > 0.05). Conclusion: The continuous infusion of DEX (200 or 400 µg) for PCA significantly improved postoperative sleep quality after colorectal cancer surgery. DEX (200 µg) was better at improving postoperative sleep quality without affecting gastrointestinal motility function than DEX (400 µg) in patients who underwent laparoscopic colorectal cancer surgery.

Association of microRNA polymorphisms with gastric cancer risk in the North Chinese Han population.

Background and Aims: MicroRNA (miRNA) was found as a class of endogenous, important regulators of gene expression and involved in the regulation of many biological processes such as cell proliferation, apoptosis, and differentiation. Increasing studies have suggested that miR-146a, miR-196a2, and miR-499 play important roles in the development processes of gastric cancer (GC). The aim of our study is to investigate whether three common miRNA polymorphisms are associated with the susceptibility of GC. Materials and Methods: MiR-146a rs2910164 (G > C), miR-196a2 rs11614913 (C > T), and miR-499 rs3746444 (A > G) were genotyped by Taq-man assays in the present case-control study (386 patients, 341 controls). The associations between the selected miRNA single-nucleotide polymorphisms (SNPs) and the risk of GC were estimated by odds ratio (OR) with 95% confidence interval using logistic regression analysis. Results: Our results showed that none of the three SNPs was associated with the risk of GC in allelic frequencies and multiple genetic models. Further stratified analysis with regard to clinical-pathological parameters of GC patients indicated that miR-146a rs2910164 SNP was strongly associated with age (OR = 0.53, P = 0.001) and gender (OR = 0.61, P = 0.006). Conclusions: The present study showed no association of the investigated miRNA SNPs with the risk of GC in the north Chinese population.

Effect of Sleeve Gastrectomy on Glycometabolism via Forkhead Box O1 (FoxO1)/Lipocalin-2 (LCN2) Pathway.

BACKGROUND The mechanism by which sleeve gastrectomy (SG) improves glycometabolism has remained unclear so far. Increasing evidence has demonstrated that bone is a regulator of glucose metabolism, and osteoblast-derived forkhead box O1 (FoxO1) and lipocalin-2 (LCN2) are regulators of energy metabolism. The aim of this study was to investigate whether the FOXO1/LCN2 signaling pathway is involved in the anti-diabetic effect of SG. MATERIAL AND METHODS Insulin resistance was induced in Wistar rats, which were then intraperitoneally injected with streptozotocin to induce a type 2 diabetic state. Levels of fasting blood glucose, serum insulin, HbA1c, and LCN2 were analyzed at corresponding time points after SG and sham surgeries. The expressions of FOXO1, LCN2, and the melanocortin 4 receptor (MC4R) in bone and hypothalamus were detected by immunofluorescence. FOXO1 siRNA was applied to downregulate FOXO1 expression in osteoblasts of rats. The influence of FOXO1 gene on expression of LCN2 was investigated in cultured osteoblasts by western blot and PCR. RESULTS Glucose metabolism in the SG group was significantly improved. The LCN2 expression in bone in the SG group was higher than that in the sham group, whereas FOXO1 expression in the SG group was lower than that in the sham group. The binding rate of LCN2 and MC4R in the hypothalamus was also higher in the SG group compared with that in the sham group. The downregulation of FOXO1 expression in osteoblasts was accompanied by upregulation of LCN2 expression. CONCLUSIONS These results suggest that the FOXO1/LCN2 signaling pathway participates in the anti-diabetic effect of SG.

Accurate vessel extraction via tensor completion of background layer in X-ray coronary angiograms.

This paper proposes an effective method for accurately recovering vessel structures and intensity information from the X-ray coronary angiography (XCA) images of moving organs or tissues. Specifically, a global logarithm transformation of XCA images is implemented to fit the X-ray attenuation sum model of vessel/background layers into a low-rank, sparse decomposition model for vessel/background separation. The contrast-filled vessel structures are extracted by distinguishing the vessels from the low-rank backgrounds by using a robust principal component analysis and by constructing a vessel mask via Radon-like feature filtering plus spatially adaptive thresholding. Subsequently, the low-rankness and inter-frame spatio-temporal connectivity in the complex and noisy backgrounds are used to recover the vessel-masked background regions using tensor completion of all other background regions, while the twist tensor nuclear norm is minimized to complete the background layers. Finally, the method is able to accurately extract vessels' intensities from the noisy XCA data by subtracting the completed background layers from the overall XCA images. We evaluated the vessel visibility of resulting images on real X-ray angiography data and evaluated the accuracy of vessel intensity recovery on synthetic data. Experiment results show the superiority of the proposed method over the state-of-the-art methods.

Low-rank and sparse decomposition with spatially adaptive filtering for sequential segmentation of 2D+t vessels.

This letter proposes to extract contrast-filled vessels from overlapped noisy complex backgrounds in an x-ray coronary angiogram image sequence using low-rank and sparse decomposition. A refined vessel segmentation is finally achieved by implementing a radon-like feature filtering plus local-to-global adaptive thresholding to tackle the spatially varying noisy residuals in the extracted vessels. Based on real and synthetic XCA data, the experiment results demonstrate the superiority of the proposed method over the state-of-the-art methods.

[Microsurgical repair of syndactyly of the fingers in children].

OBJECTIVE: To evaluate the effectiveness of microsurgical technique for repairing syndactyly of the fingers in children. METHODS: Microsurgical repair of syndactyly of the fingers was performed in 32 children. The skin joining the syndactyly was incised and relaxed under microscope, and dorsal metacarpal flap of comparable size was used to repair the lateral skin defect of the finger and also to reconstruct the finger web. RESULTS: All the flaps survived without scar leaving on the lateral skin of the fingers, and the reconstruction of the finger web was satisfying. CONCLUSION: Microsurgical technique is applicable in the surgical repair of syndactyly of the fingers in children.