Association of stress hyperglycemia with clinical outcomes in patients with ST-elevation myocardial infarction undergoing percutaneous coronary intervention: a cohort study.

BACKGROUND: In recent years, several studies have demonstrated that stress hyperglycemia is significantly associated with poor prognosis in patients diagnosed with acute coronary syndrome (ACS). In the present study, we aimed to investigate the potential associations between various markers of stress hyperglycemia, such as admission blood glucose (ABG), fasting blood sugar (FBS), and stress hyperglycemia ratio (SHR) with different definitions, and the occurrence of adverse cardiovascular events in patients diagnosed with ST-elevation myocardial infarction (STEMI) who have undergone percutaneous coronary intervention (PCI). METHODS: Our study enrolled a total of 1099 patients diagnosed with STEMI who underwent PCI from 2016 to 2021. The primary outcomes of this study were in-hospital death and all-cause mortality. RESULTS: Stress hyperglycemia was associated with a higher incidence of in-hospital death (ABG OR: 1.27 95% CI 1.19-1.36; FBS OR: 1.25 95% CI 1.16-1.35; SHR1 OR: 1.61 95% CI 1.21-2.14; SHR2 OR: 1.57, 95%CI 1.22-2.01; SHR3 OR: 1.59, 95%CI 1.24-2.05) and all-cause mortality (ABG HR: 1.10, 95% CI 1.07-1.14; FBS HR: 1.12, 95 CI 1.07-1.17; SHR1 HR: 1.19 95% CI 1.03-1.39; SHR2 HR: 1.28, 95%CI 1.14-1.44; SHR3 HR: 1.29, 95%CI 1.14-1.45) after adjusting for ischemic time, age, gender, BMI, hypertension, hyperlipidemia, diabetes mellitus (DM), current smoking history, chronic kidney disease (CKD), previous history of coronary artery disease (CAD), atrial fibrillation (AF), heart failure (HF), stroke, cancer, culprit vessel, multi-vessel disease. These associations exhibited a non-linear, J-shaped pattern, wherein the risk significantly increased when the ABG and FBS levels exceeded 5mmol/L. Moreover, the inflection point for SHR was estimated to be 1.2. CONCLUSIONS: Stress hyperglycemia was significantly associated with an increased risk of in-hospital death and all-cause mortality in STEMI patients treated with PCI. Stress hyperglycemia should be considered a high-risk prognostic marker in all STEMI patients, regardless of with or without diabetes.

Iron-based magnetic superconductorsAEuFe4As4(A=Rb, Cs): natural superconductor-ferromagnet hybrids.

Superconductivity (SC) and ferromagnetism (FM) are normally antagonistic, and their coexistence in a single crystalline material appears to be very rare. Over a decade ago, the iron-based pnictides of doped EuFe2As2were found to render such a coexistence, primarily because of the Fe-3dmulti-orbitals which simultaneously satisfy the superconducting pairing and the ferromagnetic exchange interaction among Eu local spins. In 2016, the discovery of the iron-based superconductorsAEuFe4As4(A= Rb, Cs) provided an additional and complementary material basis for the study of the coexistence and the interplay between SC and FM. The two sibling compounds, which can be viewed as an intergrowth or a hybrid betweenAFe2As2and EuFe2As2, show SC in the FeAs bilayers atTc= 35-37 K and magnetic ordering atTm∼ 15 K in the sandwiched Eu2+-ion sheets. BelowTm, the Eu2+spins align ferromagnetically within each Eu plane, making the system as a natural atomic-thick superconductor-ferromagnet superlattice. This paper reviews the main research progress in the emerging topic during the past five years. An outlook for the future research opportunities is also presented.

Screening and Identification of Key Biomarkers of Gastric Cancer: Three Genes Jointly Predict Gastric Cancer.

BACKGROUND: Gastric cancer (GC) is one of the most common cancers all over the world, causing high mortality. Gastric cancer screening is one of the effective strategies used to reduce mortality. We expect that good biomarkers can be discovered to diagnose and treat gastric cancer as early as possible. METHODS: We download four gene expression profiling datasets of gastric cancer (GSE118916, GSE54129, GSE103236, GSE112369), which were obtained from the Gene Expression Omnibus (GEO) database. The differentially expressed genes (DEGs) between gastric cancer and adjacent normal tissues were detected to explore biomarkers that may play an important role in gastric cancer. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses of overlap genes were conducted by the Metascape online database; the protein-protein interaction (PPI) network was constructed by the STRING online database, and we screened the hub genes of the PPI network using the Cytoscape software. The survival curve analysis was conducted by km-plotter and the stage plots of hub genes were created by the GEPIA online database. PCR, WB, and immunohistochemistry were used to verify the expression of hub genes. A neural network model was established to quantify the predictors of gastric cancer. RESULTS: The relative expression level of cadherin-3 (CDH3), lymphoid enhancer-binding factor 1 (LEF1), and matrix metallopeptidase 7 (MMP7) were significantly higher in gastric samples, compared with the normal groups (p<0.05). Receiver operator characteristic (ROC) curves were constructed to determine the effect of the three genes' expression on gastric cancer, and the AUC was used to determine the degree of confidence: CDH3 (AUC = 0.800, P<0.05, 95% CI =0.857-0.895), LEF1 (AUC=0.620, P<0.05, 95%CI=0.632-0.714), and MMP7 (AUC=0.914, P<0.05, 95%CI=0.714-0.947). The high-risk warning indicator of gastric cancer contained 8

A new Majorana platform in an Fe-As bilayer superconductor.

Iron-chalcogenide superconductors have emerged as a promising Majorana platform for topological quantum computation. By combining topological band and superconductivity in a single material, they provide significant advantage to realize isolated Majorana zero modes. However, iron-chalcogenide superconductors, especially Fe(Te,Se), suffer from strong inhomogeneity which may hamper their practical application. In addition, some iron-pnictide superconductors have been demonstrated to have topological surface states, yet no Majorana zero mode has been observed inside their vortices, raising a question of universality about this new Majorana platform. In this work, through angle-resolved photoemission spectroscopy and scanning tunneling microscopy/spectroscopy measurement, we identify Dirac surface states and Majorana zero modes, respectively, for the first time in an iron-pnictide superconductor, CaKFe4As4. More strikingly, the multiple vortex bound states with integer-quantization sequences can be accurately reproduced by our model calculation, firmly establishing Majorana nature of the zero mode.

Study on the Correlation between Metabolism, Insulin Sensitivity and progressive weight loss change in Type-2 Diabetes.

OBJECTIVE: To observe the changes of lipid metabolism, blood glucose level and insulin sensitivity in patients with Type-2 diabetes after progressive weight loss of their body weight, so as to lay a theoretical foundation for diabetes treatment and education in the future. METHODS: One hundred obese patients with Type-2 diabetes (BMI ≥ 25 kg/m2) who visited the endocrinology department of our hospital from April 2017 to April 2018 were given diabetes health education, diabetic diet, exercise and other measures to control their weight. The changes of blood glucose, blood lipid, insulin level and insulin release test before weight loss (T1), and at the time points of weight loss reached 5% (T2), 10% (T3) and 15% (T4) were recorded respectively to understand the influence of progressive weight loss on relevant indexes of patients. RESULTS: With the decrease of body weight, the differences of TC, TG, LDL-C and HDL-C at different weight loss points were significant (p < 0.05), and the changes of fasting blood glucose in 5% and 10% weight loss were significant (p = 0.02). The 2h postprandial blood glucose showed the most significant difference when the weight loss reached 15% (p = 0.00). There was no statistical difference in the change of glycosylated hemoglobin among different weight loss points (p = 0.08). When the weight loss reached 10%, the blood insulin level was significantly lower than that before the weight loss, while the insulin level was not significantly changed when the weight loss reached 15%, but the peak of secretion was shifted forward. It is suggested that insulin sensitivity gradually increases with weight loss. CONCLUSION: Obese patients with Type-2 diabetes can benefit from weight loss, with abnormal blood glucose and lipid metabolism improved, insulin resistance relieved, and insulin sensitivity increased.

Chinese men living in urban areas of Shijiazhuang, Hebei at higher risk of overweight or obesity.

OBJECTIVE: The prevalence of overweight/obesity in China has increased dramatically in recent years; being overweight/obese can increase the risk of type 2 diabetes and cardiovascular disease. The purpose of this study was to determine the population in China at high risk of being overweight or obese, to explore the relationships between various relevant factors and overweight/obesity, and to identify preventive efforts for high-risk populations. METHODS: We administered a questionnaire survey among a group of 536 social workers in Shijiazhuang City in 2017. We used the Pearson chi-square test, Spearman's rho test, multivariate linear regression, univariate and multivariate logistic regression, and receiver operating characteristic curve analysis to investigate factors that influence overweight/obesity. RESULTS: The prevalence of overweight/obesity was 13.7% among the study participants. Urban residence, eating speed, number of daily meals, overeating, and a high-fat diet were associated with overweight/obesity. In multivariate linear regression analysis, overweight/obesity was correlated with sex, urban residence, eating speed, number of daily meals, and a high-fat diet. CONCLUSION: Among all influencing factors, dietary factors, place of residence, and sex were most closely related to being overweight/obese. Furthermore, living in an urban area and male sex were independent risk factors for being overweight/obese.

Effects of Baduanjin exercise for knee osteoarthritis: A systematic review and meta-analysis.

OBJECTIVES: Baduanjin is a Chinese form of low-intensity aerobic exercise that consists of eight movements. It is one of the most common forms of Chinese Qigong exercise, which originated during the Song dynasty and has a history of more than 1000 years. The aim of this research was to assess the efficacy of Baduanjin exercise for knee osteoarthritis (KOA). METHODS: A literature search was conducted of 10 databases (Web of Science, AMED, Scopus, CINAHL, MEDLINE, EMBASE, KoreaMed Synapse, Oriental Medicine Advanced Searching Integrated System, Chinese Wan Fang and China National Knowledge Infrastructure) from their inception to June 2019. We included eligible randomised controlled trials (RCTs) in which Baduanjin was employed either alone or as an adjuvant treatment for baseline interventions in patients with KOA. The Western Ontario and McMaster Universities Arthritis Index (WOMAC), Visual Analogue Scale (VAS) and response rate were used as important outcomes in this research. Risk of bias was assessed using the Cochrane Collaboration tool. Two reviewers independently selected studies, extracted data and assessed risk of bias. Meta-analysis was applied to quantitative data. RESULTS: Seven RCTs totalling 424 participants were included. Overall, only three studies (43 %) reported adequate random sequence generation, allocation concealment, blinding of outcome assessment and accounting for incomplete outcome data. The results showed a statistically significant mean difference (MD) between Baduanjin exercise and waiting list control on three domains of WOMAC scores [MD=-4.40 (95 % CI: -7.16, -1.64), p < 0.01 in pain; MD=-1.34 (95 % CI: -1.64, -1.04), p < 0.01 in stiffness; MD=-2.44 (95 % CI: -4.33,-0.55), p < 0.01 in physical function] and the response rate [RR = 1.18 (95 % CI: 1.01, 1.37), p = 0.04]. Moreover, when used alone, Baduanjin exercise demonstrated a statistically significant improvement on three domains of WOMAC scores [MD=-1.69 (95 % CI: -2.03, -1.35), p < 0.01 in pain; MD=-0.86 (95 % CI: -1.13, -0.58), p < 0.01 in stiffness; MD=-2.23 (95 % CI: -3.65,-0.82), p < 0.01 in physical function] compared to health education. Furthermore, Baduanjin exercise plus NSAID therapies significantly improved total WOMAC score [MD=-10.26 (95 % CI: -13.41, -7.11), p < 0.01] and reduced VAS [MD=-1.65 (95 % CI: -1.83,-1.48), p < 0.01] compared to NSAID therapies alone. CONCLUSION: The existing weak evidence suggests that Baduanjin exercise may have favourable effects for KOA patients. However, further rigorously designed RCTs are warranted before it can be recommended.

Superconductivity and magnetism in RbEu(Fe1-x Co x )4As4.

We studied the cobalt-doping effect on superconductivity and magnetism in a hole self-doped RbEuFe4As4 magnetic superconductor which shows superconductivity at [Formula: see text] 36.5 K and Eu2+ -spin ordering at [Formula: see text] 15 K. The Co solubility limit in RbEu(Fe1-x Co x )4As4 achieves x = 0.21 for the solid-state reaction at 880 °C. With increasing x, [Formula: see text] decreases gradually, and superconductivity eventually disappears at [Formula: see text]. A spin-density-wave transition at [Formula: see text] 35-40 K is recovered for [Formula: see text], which can be understood in terms of the hole-depletion and the disorder effects. On the other hand, [Formula: see text] remains unchanged despite the Co doping and, consequently, an intriguing superconducting ferromagnet without Meissner state is realized in the range of 0.125 [Formula: see text] 0.155. Our results indicate that the Eu2+ spins essentially decouple with superconductivity over a wide doping range, making the coexistence of superconductivity and ferromagnetism possible in the 1144-type system.

The PAX6-ZEB2 axis promotes metastasis and cisplatin resistance in non-small cell lung cancer through PI3K/AKT signaling.

Paired-box 6 (PAX6) is an important transcription factor required for the function of human neuroectodermal epithelial tissues. Previous studies have suggested that it is also expressed in several types of tumors and has an oncogenic role. However, little is known about its role in non-small cell lung cancer (NSCLC). Here, we found that PAX6 expression levels were upregulated in human lung cancer tissues and correlated with poor clinical outcomes. PAX6 overexpression significantly promoted NSCLC epithelial-to-mesenchymal transition (EMT) and metastasis, whereas its knockdown inhibited these processes. PAX6 is commonly correlated with EMT-mediated stem cell transformation, thereby inducing cisplatin resistance. Using the RT2 Profiler PCR Array, we found that WNT5A, EGFR, and ZEB2 were differentially regulated in response to PAX6 modulation. In addition, PAX6 directly bound to the promoter region of ZEB2. ZEB2 knockdown significantly reduced the expression and function of PAX6. ZEB2 was upregulated upon PAX6 overexpression and downregulated upon PAX6 knockdown, whereas E-cadherin expression negatively correlated with PAX6 levels. Moreover, p-PI3K and p-AKT were significantly enhanced by PAX6, which was reversed by the addition of the PI3K-AKT inhibitor, LY294002. These data suggest that PAX6 can mediate E-cadherin downregulation through the PI3K/AKT signaling pathway by directly binding the promoter region of ZEB2, thereby mediating cell migration, stem cell transformation, and cisplatin resistance; and ultimately, affecting survival in NSCLC patients.

circ-Sirt1 controls NF-κB activation via sequence-specific interaction and enhancement of SIRT1 expression by binding to miR-132/212 in vascular smooth muscle cells.

NF-κB-mediated inflammatory phenotypic switching of vascular smooth muscle cells (VSMCs) plays a central role in atherosclerosis and neointimal formation. However, little is known about the roles of circRNAs in the regulation of NF-κB signaling. Here, we identify the involvement of circ-Sirt1 that was one of transcripts of SIRT1 host gene in VSMC inflammatory response and neointimal hyperplasia. First, in the cytoplasm, circ-Sirt1 directly interacts with and sequesters NF-κB p65 from nuclear translocation induced by TNF-α in a sequence-dependent manner. The inhibitory complex of circ-Sirt1-NF-κB p65 is not dependent on IκBα. Second, circ-Sirt1 binds to miR-132/212 that interferes with SIRT1 mRNA, and facilitates the expression of host gene SIRT1. Increased SIRT1 results in deacetylation and inactivation of the nuclear NF-κB p65. These findings illustrate that circ-Sirt1 is a novel non-coding RNA regulator of VSMC phenotype.

LGE-MRI in the Assessment of Left-ventricular Remodelling in Myocarditis.

BACKGROUND: The exact morbidity of myocarditis is unknown, as the treatment is generally delayed in virtue of misdiagnosis or missed diagnosis. AIM: The aim of this study was to identify prognostic factors of left-ventricular remodeling on CMRI performed in patients with pathological proven myocarditis. METHODS: Sixty-two cases with various presentations of myocarditis (39 cases with heart failure; 23 cases with arrhythmias) were selected. All patients, who underwent coronary angiography, endomyocardial biopsy, were divided into positive-remodeling and negative-remodelling groups to analyse LGE and cardiac cine parameters at presentation and subsequent to 3 months. RESULTS: Comparison of two subgroups in CMRI is as follows: positive LGE (65.6% vs. 86.7%; p<0.05), LVEF (41.3±14.8% vs. 37.6±10.1%; p=0.62), (25.7±2.0% vs. 24.0±2.5%; p=0.81), (44.5±3.9mm vs. 46.3±5.4mm; p=0.76), (129.1±8.5ml vs. 135.3±12.2ml; p=0.26), (74.8±7.3ml vs. 79.1±10.0ml; p=0.55), (52.0±5.7g vs. 49.6±6.5g; p=0.71), (34.9±3.5ml vs. 32.4±6.2ml; p=0.68), (3.8±0.7L/min vs. 3.1±0.5L/min; p=0.64), (2.9±0.6L/min*m2 vs. 2.7±0.5L/min*m2; p=0.79). CONCLUSION: LGE-MRI is rewarding as an independent predictor in left-ventricular positive and negative remodelling of myocarditis.

V2Te2O: A Two-Dimensional van der Waals Correlated Metal.

A metastable vanadium oxytelluride V2Te2O is prepared via a topochemical deintercalation of interlayer Rb+ cations in Rb1-δV2Te2O. The new ternary mixed-anion compound crystallizes in a body-centered tetragonal lattice with a = 3.9282(1) Å and c = 13.277(5) Å, containing V2O square nets that are sandwiched by Te-atomic sheets. The charge-neutral [V2OTe2] block layers stack along the c axis with van der Waals forces, which shows a metallic behavior with a dominant T2 dependence for resistivity at low temperatures. The electronic specific-heat coefficient reaches 33.9 mJ K-2 mol-1, ∼4 times that of the electronic structure calculations, suggesting a significant electron-mass renormalization. The electron correlation effect is concurrently demonstrated by the Wilson and Kadowaki-Woods ratios. Neither charge/spin-density wave nor superconductivity was observed down to 0.03 K.

Lycopene exerts anti-inflammatory effect to inhibit prostate cancer progression.

Lycopene is a natural compound that alleviates oxidative stress and inflammation, exerting therapeutic effects in a number of cancers. The aim of this study is to investigate the efficacy of lycopene in inhibiting prostate cancer. Cell viability assays indicated the dose- and time-dependent toxicity of lycopene in prostate cancer cells. Annexin V/propidium iodide double-staining assays revealed the strong apoptotic effects of lycopene. The levels of inflammatory factors, including interleukin-1 (IL1), IL6, IL8, and tumor necrosis factor-α (TNF-α), in lycopene-treated cells were also reduced by lycopene treatment. With the increasing dose of lycopene, the survival of mice bearing prostate cancer xenografts was significantly improved (P < 0.01), and the tumor burden was significantly reduced (P < 0.01). Our results indicate that lycopene is a promising chemotherapy drug, which inhibits prostate cancer progression by suppressing the inflammatory response.

Human colorectal cancer cells induce vascular smooth muscle cell apoptosis in an exocrine manner.

Tumor vessels often lack the smooth muscle layer, and the instability is conducive to tumor invasion and metastasis. The effect of tumor microenvironment on vascular smooth muscle cells needs to be explored. In the present study, we examined the density of the tumor vessels in human colorectal cancer tissues, and used the tumor conditioned medium of human colorectal cancer HT29 cells to mimic the tumor microenvironment. We showed that the vessel density in colorectal cancer tissues increased, which displayed a decreased expression of smooth muscle α-actin, a specific marker of vascular smooth muscle cells and an attenuated or a discontinuous layer of vascular smooth muscle cells compared with the matched normal tissues. We also showed that the tumor conditioned medium decreased the cell viability, and induced the apoptosis in vascular smooth muscle cells in a concentration-dependent manner. The expression of pro-Caspase-3 was down-regulated, accompanied by increasing of cleaved-Caspase-3 in the cells treated with the tumor conditioned medium, suggesting that Caspase-3 was activated. Moreover, the expression of Bax was increased, and the ratio of Bcl-2/Bax was decreased under the same conditions. Furthermore, the treatment with the tumor conditioned medium resulted in loss of mitochondrial membrane potential in vascular smooth muscle cells. These findings suggest that HT29 cells induce apoptosis of vascular smooth muscle cells in an exocrine manner, associated with activating caspase-3 via mitochondrial apoptotic pathway. This may be one of the mechanisms underlying tumor vascular structural abnormalities.

Reduced expression of SM22 is correlated with low autophagy activity in human colorectal cancer.

Colorectal cancer (CRC) is a common malignancy with a high incidence and mortality rate. Recent studies have pointed to deregulation of autophagy as a novel pathogenesis of human malignancy. SM22 is considered as a tumor suppressor. The aim of the present study was to evaluate the correlation of the SM22 expression level with the autophagy activity and the clinical characteristics in human CRC tissues. The expressions of SM22 and p62, a biomarker of autophagy activity, in paired tumor and adjacent non-tumor tissues from 43 patients with colorectal cancer were detected by western blot and immunohistochemical staining, respectively. The results showed that the SM22 level decreased significantly in 81.4% CRC tissues, while the expression of p62 increased in 79.1% cases. There was a negative correlation between p62 and SM22 expressions in colorectal cancer tissues (p=0.004). Similarly, the negative correlation between SM22 and p62 was verified in human CRC cell lines. The data suggest that the autophagy activity decreased in human CRC, which was associated with reduction in SM22 expression. However, the expression of SM22 was not associated with the gender, tumor site and Duke's stage of the patients. In conclusion, our findings suggest that the disruption of SM22 may be involved in tumorigenesis in CRC. The autophagic activity may be suppressed in human CRC, and SM22 may act as a positive regulator in the processes of autophagy.

[Analyses of relevant influencing factors in the treatment of tibial pilon fractures].

OBJECTIVE: To explore the relevant influencing factors of surgical outcomes for closed tibial pilon fractures. METHODS: From April 2005 to May 2011, 52 consecutive closed tibial pilon fractures were treated by the same surgical team. There were 35 males and 17 females with a mean age of 40.0 years. According to the Ruedi-Allgower classification, the fracture types included type I (n = 13), type II (n = 22) and type III (n = 17). All patients were evaluated by the scores of American Orthopedic Foot and Ankle Society (AOFAS) and Burwell-Chamley. Postoperative complications were also recorded. The primary influencing factors of clinical outcomes were determined with regards to fracture types, reduction, complications and outcomes. RESULTS: The average follow-up period was 14.1 months (range: 6 - 28). The mean healing time was 5.5 months (range: 4.0 - 11). The reduction status: anatomical (n = 20), functional (n = 24) and poor (n = 8). Ankle function was excellent (n = 12), good (n = 26), fair (n = 9) and poor (n = 5). Incidence of complication was 30.8% (n = 16), including incision skin necrosis (n = 5), superficial soft tissue infection (n = 4), deep infection (n = 1) and posttraumatic arthrosis (n = 6). No significant differences (P > 0.05) existed in the occurrence of incision skin necrosis, superficial infection and deep infection between the outcomes of excellent/good and fair/poor groups while posttraumatic arthrosis rate had significant difference (P = 0.005) between two groups. The quality of reduction was an independent risk factor of final clinical outcomes. CONCLUSION: The quality of reduction, types of fracture and occurrence of posttraumatic arthrosis are risk factors of final outcomes for closed tibial pilon fractures.

Acetylbritannilactone suppresses growth via upregulation of krüppel-like transcription factor 4 expression in HT-29 colorectal cancer cells.

Acetylbritannilactone (ABL) is a new active compound isolated from Inula Britannica L, a traditional Chinese medicinal herb. It has been reported that ABL can inhibit the proliferation of vascular smooth muscle cells (VSMCs) and neointima formation after balloon injury in rats. ABL also shows chemopreventive properties by inducing cell apoptosis in breast and ovarian cancers, but the antitumor activity and the molecular targets of ABL in colon cancer cells have not been determined. In this study, we showed that ABL inhibits the growth in dose- and time-dependent manners by inducing cell cycle arrest in G0/G1 phase of HT-29 human colon cancer cells. This suppression was accompanied by a strong decrease of cyclin E and CDK4 protein levels, and an increase in p21 protein expression in HT-29 cells. We also show that ABL-induced growth inhibition is associated with the upregulation of KLF4 expression. The overexpression of KLF4 by infection with pAd-KLF4 resulted in growth inhibition, with decrease in the protein levels of cyclin E and CDK4, and increase in the expression of p21, similarly to the effects of ABL. Conversely, knockdown of KLF4 using a specific siRNA impaired the ABL-induced growth inhibition in HT-29 cells. These results suggest that KLF4 as an important cellular target of ABL mediates the growth inhibition of HT-29 cells induced by ABL via upregulation of p21 expression.

Clinical effects of applying a tourniquet in total knee arthroplasty on blood loss.

BACKGROUND: Tourniquets used during total knee arthroplasty may lead to many complications. The aim of this study was to determine perioperative blood loss and its clinical relevance in total knee replacement surgery after applying a tourniquet. METHODS: From June 2009 to October 2009, 60 consecutive patients who underwent routine total knee arthroplasty were randomly divided into two groups and were treated with or without a tourniquet (30 patients/group). There were no significant differences in patient baseline characteristics between the two groups. We compared the two groups of patients in terms of intra- and postoperative bleeding, invisible or visible bleeding, and total blood loss. RESULTS: None of the patients showed poor wound healing, lower extremity deep venous thrombosis or other complications. The amount of blood loss during surgery was lower in the tourniquet group than in the control group (P < 0.01). However, postoperative visible bleeding (P < 0.05) and occult bleeding (P < 0.05) were significantly greater in the tourniquet group than in the control group. There was no significant difference in the total amount of blood loss between the two groups (P > 0.05). CONCLUSIONS: Tourniquet can reduce bleeding during total knee replacement surgery, but is associated with greater visible and invisible blood loss.

Polymorphisms of the ICAM-1 exon 6 (E469K) are associated with differentiation of colorectal cancer.

BACKGROUND: Genetic factors are thought to play a role in development for colorectal carcinogenesis. ICAM-1 is a polymorphic gene, thus, the present study investigated the relationship between the polymorphisms of ICAM-1 and the susceptibility and phenotypical characteristics of colorectal cancer (CRC). METHODS: The polymorphisms at ICAM-1 exon 4 (G241R) and exon 6 (E469K) were detected by PCR with sequence-specific primers. The relationship between specific genotypes of ICAM-1 and differentiation of CRC was evaluated by the histological grade. RESULTS: We showed only GG genotype of ICAM-1 individuals in either CRC or normal controls. The KK genotype of ICAM-1 K469E was found more frequently than in the controls (P < 0.05). Patients with well-differentiated CRC displayed the KK more frequently than those of poor differentiation (P < 0.05). CONCLUSION: The findings indicate that polymorphisms of G241R are rare in Chinese population and that KK genotype of ICAM-1 K469E is significantly associated with well differentiation of CRC.