Trifecta achievement in patients undergoing partial nephrectomy: a systematic review and meta-analysis of predictive factors

ABSTRACT Purpose The predictors of trifecta achievement in partial nephrectomy (PN) were poorly inquired and remained a controversial area of discovery. To evaluate predictive factors of trifecta achievement in patients undergoing PN. Materials and Methods A systematic literature search was performed to identify relevant articles. Only studies focusing on postoperative trifecta achievement and exploring its predictor with multivariable analyses were included. The trifecta achievement was defined as negative surgical margins, warm ischemia time <25 minutes, and no complications. Merged odds ratio (OR) and 95% confidence interval (CI) were used to evaluate the predictive effect. Results Thirteen studies with 7066 patients meeting the inclusion criteria were included. The rate of trifecta achievement ranged from 43.3% to 78.6%. Merged results showed that preoperative eGFR (OR: 1.01, 95% CI: 1.00, 1.02, P=0.02), operative time (OR: 0.99, 95% CI: 0.99, 1.00, P=0.02), estimated blood loss (OR: 1.00, 95% CI: 1.00, 1.00, P <0.001), tumor size (OR: 0.70, 95% CI: 0.58, 0.84, P <0.001), medium (OR: 0.39, 95% CI: 0.18, 0.84, P=0.02) and high PADUA score (OR: 0.23, 95% CI: 0.08, 0.64, P=0.005) were independently associated with trifecta achievement. A publication bias was identified for tumor size. Sensitivity analysis confirmed the stability of result for tumor size. Conclusions Larger tumor size, medium and high PADUA score are associated with decreased probability of trifecta achievement. After verifying by further high-quality studies, these variables can be incorporated into tools to predict probability of trifecta achievement during clinical practice.

Effectiveness of Inactivated COVID-19 Vaccines Against Symptomatic, Pneumonia, and Severe Disease Caused by the Delta Variant: Real World Study and Evidence - China, 2021.

WHAT IS ALREADY KNOWN ABOUT THIS TOPIC?: Effectiveness of China's 2 inactivated vaccines (BBIBP-CorV and CoronaVac) against pre-Delta severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) variants ranged from 47% to over 90%, depending on the clinical endpoint, and with greater effectiveness against more severe coronavirus disease 2019 (COVID-19). During an outbreak in Guangdong, inactivated vaccine effectiveness (VE) against the Delta variant was 70% for symptomatic infection and 100% for severe COVID-19. However, separate or combined VE estimates for the two inactivated vaccines against Delta are not available. WHAT IS ADDED BY THIS REPORT?: In an outbreak that started in a hospital, VEs of completed primary vaccination with inactivated COVID-19 vaccines against symptomatic COVID-19, COVID-19 pneumonia, and severe COVID-19 caused by the Delta variant were 51%, 61%, and 82%. Completed primary vaccination reduced the risk of progressing from mild to moderate or severe COVID-19 by 74%. VE estimates for BBIBP-CorV and CoronaVac or combined vaccination were similar, and partial vaccination was ineffective. WHAT ARE THE IMPLICATIONS FOR PUBLIC HEALTH PRACTICE?: Completed primary vaccination with either of the 2 inactivated COVID-19 vaccines reduces risk of symptomatic COVID-19, COVID-19 pneumonia, and severe COVID-19 caused by the Delta variant. Completion of the completed primary vaccination with two doses is necessary for protection from Delta.

Trifecta achievement in patients undergoing partial nephrectomy: a systematic review and meta-analysis of predictive factors.

PURPOSE: The predictors of trifecta achievement in partial nephrectomy (PN) were poorly inquired and remained a controversial area of discovery. To evaluate predictive factors of trifecta achievement in patients undergoing PN. MATERIALS AND METHODS: A systematic literature search was performed to identify relevant articles. Only studies focusing on postoperative trifecta achievement and exploring its predictor with multivariable analyses were included. The trifecta achievement was defined as negative surgical margins, warm ischemia time <25 minutes, and no complications. Merged odds ratio (OR) and 95% confidence interval (CI) were used to evaluate the predictive effect. RESULTS: Thirteen studies with 7066 patients meeting the inclusion criteria were included. The rate of trifecta achievement ranged from 43.3% to 78.6%. Merged results showed that preoperative eGFR (OR: 1.01, 95% CI: 1.00, 1.02, P=0.02), operative time (OR: 0.99, 95% CI: 0.99, 1.00, P=0.02), estimated blood loss (OR: 1.00, 95% CI: 1.00, 1.00, P <0.001), tumor size (OR: 0.70, 95% CI: 0.58, 0.84, P <0.001), medium (OR: 0.39, 95% CI: 0.18, 0.84, P=0.02) and high PADUA score (OR: 0.23, 95% CI: 0.08, 0.64, P=0.005) were independently associated with trifecta achievement. A publication bias was identified for tumor size. Sensitivity analysis confirmed the stability of result for tumor size. CONCLUSIONS: Larger tumor size, medium and high PADUA score are associated with decreased probability of trifecta achievement. After verifying by further high-quality studies, these variables can be incorporated into tools to predict probability of trifecta achievement during clinical practice.

Epidemiological and clinical characteristics of 671 COVID-19 patients in Henan Province, China.

BACKGROUND: Despite many reports on the characteristics of coronavirus disease 2019 (COVID-19) in Wuhan, China, relatively little is known about the transmission features of COVID-19 outside Wuhan, especially at the provincial level. METHODS: We collected epidemiological, demographic, clinical, laboratory, radiological and occupation information, along with contact history, of 671 patients with laboratory-confirmed COVID-19 reported from January 23 to February 5, 2020, in Henan province, China. We described characteristics of these cases, compared the diagnostic accuracy and features of blood testing, computed tomography (CT) scans and X-rays, and analysed SARS-CoV-2 transmission sources and patients' occupations in Henan province. RESULTS: The mean age of patients in this case series was 43 years, 56.2% were male and 22.4% had coexisting medical disorders. The death rate was 0.3%. Fourteen patients did not show any symptoms. Lymphocyte percentage was associated with disease severity (χ2 = 6.71, P = 0.035) but had a large variation in each sample group. The mean time from illness onset to diagnosis was 5.6 days. A total of 330 patients had ever lived in or visited Wuhan, 150 had contact with confirmed cases, 323 had been to a hospital and 119 had been to a wet market. There were 33 patients who did not have a traceable transmission source, with 21.2% of these being farmers and 15.2% being workmen. CONCLUSIONS: Lymphocyte percentage was a sign of severe COVID-19 in general but was not a good diagnostic index. Longer time from illness onset to diagnosis was associated with higher COVID-19 severity, older age, higher likelihood of having coexisting cardiovascular diseases including hypertension, and being male. Farming was found to be a high-risk occupation in Henan province, China.

Seasonal response of the synergism of maternal comorbidities and long-term air pollution exposure on birth outcomes.

Air pollution has been considered as one of the most important factors associating with various birth outcomes. However, the seasonal response of maternal comorbidities effects associated with air pollution has not been investigated, especially in the city with distinguish seasonal pattern and long heating seasons. In this work, 69,945 live births were investigated from 2013 to 2016, and the seasonal relationship between air pollution and preterm birth and low birth weight were assessed, as well as the synergism of maternal comorbidities. Exposures of six pollutants were assigned to maternal residences during pregnancy. The potential effect modification by maternal comorbidities on the associations was evaluated between prenatal air pollution and preterm birth (PTB), as well as effects of seasons and trimesters. Adjusting for seasonality, all six pollutants presented seasonal relationship with preterm birth, which CO, PM10, NO2, and PM2.5 were with [odds ratio (OR) = 1.035 95% CI: 1.015, 1.055, OR = 1.039 95% CI: 1.034, 1.045, OR = 1.042, 95% CI: 1.029, 1.056 and OR = 1.085 95% CI 1.073, 1.097, respectively] for tenth quartile of 10 µg/m3 range increased in autumn (the beginning of heating season). For O3, it associated with PTB in winter and spring with OR = 1.113 95% CI: 1.104, 1.123, and OR = 1.155 95% CI: 1.145, 1.165, respectively. The OR increase of PTB for exposure to all six pollutants was higher among women with preeclampsia and gestational hypertension. The associations between ambient air pollution and preterm birth were modified by gestational hypertension and preeclampsia. The seasonal patterns of six studied air pollutants increases the risk of PTB in autumn and winter distinguishably, which may due to the sudden increased concentrations of pollutants emitted by traditional heating. The seasonal response of the synergism of maternal comorbidities and long-term air pollution exposure on birth outcomes is supported by the data sets of preterm birth.

Identification of key genes in osteosarcoma by meta­analysis of gene expression microarray.

Osteosarcoma (OS) is one of the most malignant tumors in children and young adults. To better understand the underlying mechanism, five related datasets deposited in the Gene Expression Omnibus were included in the present study. The Bioconductor 'limma' package was used to identify differentially expressed genes (DEGs) and the 'Weighted Gene Co­expression Network Analysis' package was used to construct a weighted gene co­expression network to identify key modules and hub genes, associated with OS. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes overrepresentation analyses were used for functional annotation. The results indicated that 1,405 genes were dysregulated in OS, including 927 upregulated and 478 downregulated genes, when the cut off value was set at a ≥2 fold­change and an adjusted P­value of P<0.01 was used. Functional annotation of DEGs indicated that these genes were involved in the extracellular matrix (ECM) and that they function in several processes, including biological adhesion, ECM organization, cell migration and leukocyte migration. These findings suggested that dysregulation of the ECM shaped the tumor microenvironment and modulated the OS hallmark. Genes assigned to the yellow module were positively associated with OS and could contribute to the development of OS. In conclusion, the present study has identified several key genes that are potentially druggable genes or therapeutics targets in OS. Functional annotations revealed that the dysregulation of the ECM may contribute to OS development and, therefore, provided new insights to improve our understanding of the mechanisms underlying OS.

Child compound Endothelium corneum attenuates gastrointestinal dysmotility through regulating the homeostasis of brain-gut-microbiota axis in functional dyspepsia rats.

ETHNOPHARMACOLOGICAL RELEVANCE: Nowadays, there is no specific effective western medicine for functional dyspepsia (FD), especially in children. Clinically, child compound Endothelium corneum (CCEC) has shown to be effective for the therapy of FD, however, the underlying mechanism has not been elucidated yet. MATERIALS AND METHODS: FD was induced in rats by irregular diet plus dilute hydrochloric acid feeding. Gastric emptying and small intestinal transit were examined by intragastric gavage with Evans blue. Histopathology was assessed by H&E staining. Gastrointestinal hormones and brain gut peptides were measured by ELISA assay. mRNA expression level was quantified by real-time PCR. Protein expression level was detected by western blotting assay. Gut microbiota was analyzed by 16S rRNA miseq sequencing. RESULTS: CCEC significantly enhanced gastric emptying and small intestinal transit of FD rats, and prominently suppressed gastrointestinal microinflammation. At phylum level, CCEC prevented the decrease of Firmicutes and the increase of Bacteroidetes in gut of FD rats. In stomach of FD rats, MTL, CCK and VIP levels were significantly increased, which could be repressed by CCEC; however, the decreased GAS level could not be elevated by CCEC. In small intestine of FD rats, MTL and GAS levels were decreased, while VIP content was increased. These alterations could be effectively reversed by CCEC. NPY levels in serum, small intestine and hypothalamus of FD rats were significantly decreased, which could be rescued by CCEC. Moreover, the over-activated POMC/Stat3/Akt pathway in hypothalamus of FD rats could be suppressed by CCEC. CONCLUSION: CCEC enhanced gastrointestinal motility probably through rebalancing the homeostasis of brain-gut-microbiota axis in FD rats. The novel findings may provide insightful theoretical basis for its clinical employment.

Terpenoids from the barks of Magnolia maudiae (Dunn) Figlar.

A new germacrenolide (1) and fourteen known terpenoids (2-15) were isolated from the barks of Magnolia maudiae (Dunn) Figlar (Magnoliaceae). The structure of (7αH,11ßH)-2α,8α-dihydroxy-4α,5ß-epoxy-germacr-1(10)-en-6α,12-olide (1) was elucidated by physical and spectroscopic data analysis, including 1D, 2D NMR and HR-ESI-MS. Lyratol F (9) was isolated from Magnolia for the first time. The structures of known compounds were established by comparing their spectroscopic data with those in literatures.

De Novo Assembly of the Transcriptome for Oriental Armyworm Mythimna separata (Lepidoptera: Noctuidae) and Analysis on Insecticide Resistance-Related Genes.

Mythimna separata walker (Lepidoptera: Noctuidae) is a polyphagous pest of nearly 100 families of more than 300 kinds of food and industrial crops. So far, both nucleotide and protein sequence information has been rarely available in database for M. separata, strictly limiting molecular biology research in this insect species. In this study, we carried out a transcriptome sequencing for M. separata The sequencing and subsequent bioinformatics analysis yielded 69,238 unigenes, among which 45,227 unigenes were annotated to corresponding functions by blasting with high homologous genes in database, giving annotation rate of 65.32%. Several lepidopteran insects gave best matches with the transcriptome data. To gain insight into the mechanism of insecticide resistance in M. separata, 15 families of genes encoding insecticide resistance-related proteins were investigated. Substantial numbers of unigenes in these families were identified in the transcriptome data, and 17 out of 21 selected unigenes were successfully amplified. Expressions of most of these genes were detected at larval stages and in gut tissue, as was consistent with their putative involvement in insecticide resistance. Our study provides most comprehensive transcriptome data for M. separata to date, and also provides reference sequence information for other Noctuidae family insects.

A new sesquiterpene from the barks of Manglietia hookeri.

A new sesquiterpene manghookerins A (1) was isolated from the barks of Manglietia hookeri (Magnoliaceae) together with five known eudesmane-type sesquiterpenes. The structure of manghookerins A (1) was elucidated by physical and spectroscopic data analysis, including 1D and 2D NMR, HR-ESI-MS and X-ray diffraction. The structures of known sesquiterpenes were established by comparing their spectroscopic data with those in literatures.

[Eudesmane sesquiterpenes from twigs of Manglietia hookeri].

Chemical constituents from the acetone extract of twigs of Manglietia hookeri were isolated and purified by various column chromatographic methods over silica gel and sephadex LH-20, and preparative TLC. The structures of these compounds were identified on the basis of physicochemical properties and spectral analysis, including NMR and MS spectra. Six eudesmane sesquiterpenes were obtained and their structures were identified as trans-eudesmane-4, 11-diol(1), ß-eudesmol(2), (-) -10-epi-5ß-hydroxy-ß-eudesmol (3), epi-carrisone (4), 6-hydroxy-eudesm-4(14) -ene(5) and gynurenol(6). All the compounds were isolated from this plant for the first time. Furthermore, the 13C-NMR data of compound 3 were reported for the first time.

Association between apolipoprotein E gene polymorphism and the risk of recurrent pregnancy loss: a meta-analysis.

PURPOSE: The association between apolipoprotein E (ApoE) gene polymorphism and the risk of recurrent pregnancy loss (RPL) remains controversial. The present meta-analysis was performed to derive a precise estimate of the relationship. METHOD(S): We searched the PubMed, Embase, and Web of Science data- bases for studies related to the association between the ApoE genotype and the risk of RPL. We estimated the summary odds ratio (OR) with 95% confidence interval (CI) to assess the association. RESULT(S): Seven studies, including 2,090 RPL cases and 742 control samples, were identified. The results showed a significant association between ApoE E4 mutation and RPL risk (for E4 allele: OR =1.98, 95 %CI =1.14-3.43, P=0.499; for E2E3 vs. E3E3: OR =1.33, 95%CI =1.12-1.42, P=0.008; for E2E4 vs. E3E3: OR =1.26, 95 % CI =1.07-1.49, P=0.005). CONCLUSION(S): The meta-analysis suggests an association between ApoE E4 mutation and increased risk of RPL.

[Expression and significance of estrogen receptor alpha gene polymorphisms in blood and villi of missed abortion].

OBJECTIVE: To explore the differences of estrogen receptor α (ERα) gene polymorphism in patients with missed abortion and normal pregnancy and examine the relationship between ERα gene polymorphism and missed abortion. METHODS: A total of 100 cases of missed abortion patients and 102 cases of normal pregnant women were selected as the experimental and control groups. And 2ml blood samples and chorionic villus specimens were collected. The method of polymerase chain reaction restriction fragment length polymorphism was employed for ERα gene PvuII and XbaI polymorphism. And the data was analyzed to explore the relationship between ERα gene polymorphism and missed abortion. RESULTS: There was statistic significance in the frequency of ERα gene PvuII enzyme cleavage allele P and p from blood and villi samples between two groups, blood (χ(2) = 5.542, P < 0.05) OR: 1.742, villi (χ(2) = 7.559, P < 0.01), OR: 1.948. Statistic significances existed in the difference of frequency for ERα gene XbαI enzyme cleavage allele X and x from blood and villi samples between two groups, blood (χ(2) = 15.205, P < 0.01), OR:2.519; villi (χ(2) = 13.750, P < 0.01), OR: 2.499. There was a positive correlation of the frequency in ERα gene PvuII and XbαI genotype from blood and villi samples in the experimental group. CONCLUSIONS: It suggests that ERα gene polymorphism is correlated with the pathogenesis of missed abortion. Alleles P and X may be susceptibility genes.

Dietary intake and development of a quantitative FFQ for a nutritional intervention to reduce the risk of chronic disease in the Navajo Nation.

OBJECTIVES: To characterize dietary intake for Navajo adults, to identify foods for a nutritional intervention programme and to develop a culturally appropriate quantitative FFQ (QFFQ) for evaluating the impact of the intervention programme. DESIGN: A cross-sectional study was conducted using 24 h dietary recalls. SETTING: Navajo Nation, USA. SUBJECTS: Seventy-nine (forty men, thirty-nine women) aged 18-71 years completed 24 h dietary recalls. RESULTS: The median daily energy intake was 11 585 kJ (2769 kcal) for men and 8519 kJ (2036 kcal) for women. The greatest contributors to energy were fried potato dishes, sweetened juices/drinks, regular pop, bread, tortillas and burritos (contributing approximately 30 % of total energy intake). The mean number of meat servings was over twice that recommended (2-3 servings recommended v. 7.4 consumed by men and 5.3 by women). The mean servings of vegetables were well below the recommendation of 3-5 servings (1.0 serving for men and 1.2 servings for women). The final QFFQ contains 177 food and drink items. CONCLUSIONS: Our study found that major contributors to total energy, fat and sugar intakes in the Navajo Nation included mostly processed meats and sweetened drinks. A nutritional intervention will target these foods and promote acceptable and healthier alternatives. In addition, we were able to identify foods and beverages for inclusion on a culturally appropriate QFFQ to assess dietary intake. This QFFQ will be used to evaluate the effectiveness of our intervention on food and food group consumption and nutrient intake.