Endovascular treatment for massive haemoptysis due to pulmonary pseudoaneurysm: report of 23 cases.

PURPOSE: To evaluate the safety and effectiveness of endovascular treatment for massive haemoptysis caused by pulmonary pseudoaneurysm (PAP). METHODS: The clinical data, imaging data, and endovascular treatment protocol of 23 patients with massive haemoptysis caused by continuous PAP were retrospectively analysed. The success, complications, postoperative recurrence rate, and influence of the treatment on pulmonary artery pressure were also evaluated. RESULTS: Nineteen patients with a bronchial artery-pulmonary artery (BA-PA) and/or nonbronchial systemic artery-pulmonary artery (NBSA-PA) fistula underwent bronchial artery embolization (BAE) and/or nonbronchial systemic artery embolization (NBSAE) + pulmonary artery embolization (PAE). The pulmonary artery (PA) pressures before and after embolization were 52.11 ± 2.12 (35-69 cmH2O) and 33.58 ± 1.63 (22-44 cmH2O), respectively (P = 0.001). Four patients did not have a BA-PA and/or NBSA-PA fistula. Embolization was performed in two patients with a distal PAP of the pulmonalis lobar arteria. Bare stent-assisted microcoils embolization was performed in the other two patients with a PAP of the main pulmonary lobar arteries. The PA pressures of the four patients before and after treatment were 24.50 ± 1.32 (22-28 cmH2O) and 24.75 ± 1.70 (22-29 cmH2O), respectively (P = 0.850). The technique had a 100% success rate with no serious complications and a postoperative recurrence rate of 30%. CONCLUSION: Endovascular treatment is safe and effective for massive haemoptysis caused by PAP. BAE and/or NBSAE can effectively reduce pulmonary hypertension in patients with a BA-PA and/or NBSA-PA fistula.

Radioactive versus normal stent insertion for malignant hilar obstruction: a meta-analysis.

PURPOSE: This meta-analysis was designed for examining the relative clinical safety and efficacy of normal stent (NS) and radioactive stent (RS) insertion in malignant hilar obstruction (MHO) patients. MATERIAL AND METHODS: Relevant studies published as of March 2022 were identified through searches of the Medline, Embase, Wanfang, and CNKI databases, and the pooled results of these studies were then analyzed. RESULTS: Eight studies including 258 and 247 patients that underwent NS and RS insertion, respectively, were incorporated into this meta-analysis. RS insertion was found to be associated with significant improvements in functional successful rate (p = 0.04), Δaspertate aminotransferase (AST, p = 0.0004), Δalanine aminotransferase (ALT, p = 0.002), stent patency (p < 0.00001), stent re-obstruction rate (p = 0.03), and OS (p < 0.00001) outcomes as compared to those associated with NS insertion. No differences in Δtotal bilirubin (TBIL, p = 0.38), cholangeitis rate (p = 0.45), cholecystitis rate (p = 0.84), or hemorrhage rate (p = 0.87) were observed when comparing patients that underwent RS and NS insertion. Substantial publication bias was observed for endpoints of cholecystitis and hemorrhage. CONCLUSIONS: These results suggest that relative to NS insertion, RS insertion can effectively prolong stent patency and OS in MHO cases.

Side-by-side versus stent-in-stent bilateral stenting for malignant hilar biliary obstruction: a meta-analysis.

Introduction: Both side-by-side (SBS) and stent-in-stent (SIS) bilateral stenting have been used for patients with malignant hilar biliary obstruction (MHBO). However, it is unclear which technique is better. Aim: This meta-analysis is conducted to investigate the clinical efficacy and safety of SBS and SIS bilateral stenting for patients with MHBO. Material and methods: Relevant studies were searched in PubMed, Embase, Cochrane Library, Wanfang, VIP, and CINK databases. The timeline for the searches was from the establishment of the database to September 2021. The relative outcomes are pooled. Results: A total of 7 studies fulfilled the inclusion criteria and entered into this meta-analysis. The pooled technical success rate was significant higher in the SIS group than that in the SBS group (p = 0.04). The pooled early complication rate was significantly lower in the SIS group than in the SBS group (p = 0.04). The pooled stent re-obstruction rate was significantly lower in the SBS group than in the SIS group (p = 0.04). The pooled stent patency duration was significantly longer in the SBS group than in the SIS group (p = 0.01). The pooled functional success rates (p = 0.79), total complication rates (p = 0.34), and overall survival duration (p = 0.27) were comparable between 2 groups. Egger test did not show any publication bias. Conclusions: When comparing the SBS and SIS bilateral stenting for patients with MHBO, although SIS technique may have the superiorities of technical success and early complication rates, the longer stent patency was achieved by the SBS technique.

I-125 seeds with chemotherapy for progressive non-small-cell lung cancer after first-line treatment: a meta-analysis.

BACKGROUND: Continuing therapy for aggressive non-small-cell lung cancer (NSCLC) after first-line treatment (FLT) is challenging. The clinical efficacy of second-line chemotherapy (SLCT) for progressive NSCLC is limited. In this meta-analysis, we aim to evaluate the clinical efficacy of the combination of I-125 seeds brachytherapy (ISB) and SLCT in progressive NSCLC after FLT. METHODS: The PubMed, Embase, Cochrane Library, CNKI, Wanfang, and VIP databases were screened for relevant publications until September 2021. Meta-analyses are conducted by RevMan 5.3 and Stata 12.0. RESULTS: Our meta-analysis encompassed 6 studies (4 retrospective studies and 2 randomized controlled trials), which included 272 patients that underwent ISB with SLCT (combined group) and 257 patients that received SLCT alone (chemotherapy alone group). The complete response (24.7% vs. 7.0%, P < 0.00001), treatment response (65.7% vs. 38.1%, P = 0.0002), and disease control (95.2% vs. 80.4%, P < 0.00001) rates are markedly elevated for patients receiving combined therapy versus those receiving chemotherapy alone. Moreover, pooled progression-free survival (P = 0.0001) and overall survival (P < 0.00001) were remarkably extended for patients that received the combination therapy, while no obvious differences were detected in the pooled myelosuppression (39.0% vs. 30.6%, P = 0.05) and gastrointestinal response (38.5% vs. 35.9%, P = 0.52) rates between 2 groups. Significant heterogeneity was found in the endpoints of the treatment response and progression-free survival. CONCLUSIONS: This meta-analysis demonstrated that ISB could enhance the clinical efficacy of SLCT in patients with progressive NSCLC after FLT without inducing major toxic side effects.

Unilateral Versus Side-By-Side Metal Stenting for Malignant Hilar Biliary Obstruction: A Meta-Analysis.

Purpose: The present meta-analysis was designed to compare the relative clinical efficacy of unilateral and side-by-side metal stenting for the treatment of malignant hilar biliary obstruction (MHBO). Materials and Methods: The PubMed, Embase, and Cochrane Library databases were searched to identify all relevant studies published as of May 2020. This meta-analysis was conducted using RevMan v5.3, and relevant endpoint data pertaining to rates of technical and clinical success, overall survival, complications, and stent dysfunction were extracted from all studies. Results: In total, we identified seven relevant studies that were included in the present meta-analysis, with these studies including 683 total MHBO patients who were treated via either unilateral (n = 366) or side-by-side bilateral (n = 317) metal stenting. We observed no significant differences between these two groups with respect to technical success rates (odds ratio [OR]: 0.81; 95% confidence interval [CI]: 0.40-1.63, P = .56) or overall survival (hazard ratio: 1.03; 95% CI: 0.83-1.28, P = .79). However, the side-by-side group exhibited significantly higher clinical success (OR: 3.56; 95% CI: 1.62-7.82, P = .002) and stent patency (OR: 1.74; 95% CI: 1.16-2.61, P = .007) rates, whereas complication rates trended toward being lower in the unilateral group (OR: 0.51; 95% CI: 0.30-1.00, P = .05). No significant heterogeneity among included studies was detected for any of these endpoints. Conclusion: These results suggest that side-by-side metal stenting can yield better clinical success rates and a reduced incidence of stent dysfunction compared with unilateral stenting in MHBO patients.

Endovascular treatment for hepatic vein-type Budd-Chiari syndrome: effectiveness and long-term outcome.

PURPOSE: To determine the clinical effectiveness and long-term outcomes of endovascular treatment for hepatic vein (HV)-type Budd-Chiari syndrome (BCS). MATERIALS AND METHODS: From June 2011 to August 2016, 68 consecutive patients with symptomatic HV-type BCS underwent endovascular treatment in our center. Data on the baseline characteristics, technical success, clinical success, and long-term outcomes were collected and analyzed retrospectively. RESULTS: The technical success rate of endovascular treatment was 100%. Fifty patients underwent HV recanalization, and 18 underwent accessory HV (AHV) recanalization. The clinical success rate was 95.6% (65/68). During a mean follow-up period of 29.4 ± 13.6 months, 19 patients experienced re-obstruction of either the HV (n = 18) or the AHV (n = 1). The cumulative 1-, 2-, and 5-year primary patency rates were 80.0, 72.8, and 67.9%, respectively. The cumulative 1-, 2-, and 5-year secondary patency rates were 93.8, 90.3, and 82.9%, respectively. Univariate and multivariate analyses revealed that the independent predictor of a prolonged primary patency duration was recanalization of the AHV. Five patients died 1-28 months (median, 15 months) after treatment. The cumulative 1-, 2-, and 5-year survival rates were 96.9, 93.4, and 91.2%, respectively. There was no significant difference in survival between the HV and AHV recanalization groups. CONCLUSION: Endovascular treatment is effective for patients with HV-type BCS. It can result in excellent long-term patency and survival rates. If it is applicable, AHV recanalization should be considered prior to treatment in order to achieve a longer patency.

Development of fluorogenic probe-based and high-resolution melting-based polymerase chain reaction assays for the detection and differentiation of Bartonella quintana and Bartonella henselae.

Bartonella henselae and Bartonella quintana are the major etiological agents of infective endocarditis, which pose a serious threat to human health. To simultaneously detect and differentiate B. henselae and B. quintana, a reliable and fast method to simultaneously detect and differentiate B. henselae and B. quintana is required. In this study, we developed and validated two rapid, highly sensitive and specific, duplex, real-time polymerase chain reaction (PCR) assays-one based on high-resolution melting (HRM) analysis, and the other on TaqMan probes-to simultaneously detect and differentiate B. henselae and B. quintana. The sensitivity of developed assays were found 100 times more sensitive than that of conventional PCR. The specificity of the assays were validated by the absence of any cross reaction with the other Bartonella species, non-Bartonella bacteria and other animals. The results indicate that the duplex HRM-based and TaqMan probe-based assays have high specificity and sensitivity, and good reproducibility for simultaneous the detection of B. henselae and B. quintana. They are cost-effective, sensitive and reliable methods; and are thus suitable for clinical diagnosis, epidemiological surveys, and disease surveillance.

Programmed co-delivery of paclitaxel and doxorubicin boosted by camouflaging with erythrocyte membrane.

Combination chemotherapy has been proven promising for cancer treatment, but unsatisfactory therapeutic data and increased side effects slow down the development in the clinic. In this study, we develop an effective approach to co-encapsulate a hydrophilic-hydrophobic chemotherapeutic drug pair (paclitaxel and doxorubicin) into magnetic O-carboxymethyl-chitosan nanoparticles. To endow them with the ability of programmed delivery, these carriers are further camouflaged with an Arg-Gly-Asp anchored erythrocyte membrane. Compared with the traditional polyethylene glycol coating method, this biomimetic decoration strategy is demonstrated to be superior in prolonging circulation time, improving tumor accumulation, facilitating tumor uptake, and tuning intracellular fate. These outstanding properties enable the as-designed nanodevice to exhibit greater tumor growth inhibition ability and much lower side effects than the combined use of commercial formulations.

Characterization of the immune defense related tissues, cells, and genes in amphioxus.

Amphioxus is an important animal model for phylogenetic analysis, including comparative immunology. Exploring the immune system in amphioxus contributes to our understanding of the origin and evolution of the vertebrate immune system. We investigated the amphioxus immune system using ultrastructural examination and in situ hybridization. The expression patterns of TLR1 (toll-like receptor 1), C1Q (complement component 1, q subcomponent), ECSIT (evolutionarily conserved signaling intermediate in Toll pathways), SoxC, DDAHa (Dimethylarginine dimethylaminohydrolase a), and NOS (nitric oxide synthase) show that these genes play key roles in amphioxus immunity. Our results suggest that the epidermis and alimentary canal epithelium may play important roles in immune defense, while macrophages located in the coelom and so-called lymph spaces may also be crucial immune cells.

[Effects of cold-stress stimulation on filial growth and development of pregnant mice].

AIM: To inspect the effects of cold-stress on filial growth and development of pregnant mice. METHODS: Pregnant mice were divided into pregnant control group(PN) and pregnant cold-stress group (PC). The PC were kept in (4 +/- 2) C from 8:00 to 12:00 every day and the PN were kept in 25 degrees C. After 18 days, the blood pressure of pregnant mice were measured, and the weight of fetus, placenta and amniotic fluid were recorded. The natal mice visceral organs weight, visceral organs weight and body weight ratio were also measured. Growth curve and increment ratio curve of body weight were protracted every day from 1 st day to 44th day. Blood pressure of all filiality were measured in 8 weeks after they were born. RESULTS: The blood pressure in PC was increased than that in PN (P < 0.05), the weight of fetus, placenta and amniotic fluid of PC decreased significantly compared with PN (P < 0.01). The filial visceral organ weight of PC reduced obviously compared with PN (P < 0.05), while the visceral organs weight and body weight ratio had no statistical meanings between the offspring of PC and PN (P > 0.05). Obvious difference of growth curve of the two filial groups was also existed until sexual maturity, but increment ratio curve of body weight of the two filial groups was basically fitted close. Filial blood pressure of PC was evidently higher than that in PN. CONCLUSION: Cold-stress stimulations seriously affect filial growth and development of pregnant mice.

Heat stress induces Cdc2 protein decrease prior to mouse spermatogenic cell apoptosis.

Both mitosis and meiosis are driven by M-phase promoting factor (MPF), a complex with Cdc2 and Cyclin B. The concentration of Cdc2 remains relatively constant during the cell cycle, while the concentration of Cyclin B fluctuates periodically. Many studies have demonstrated high expression levels of Cdc2 and Cyclin B in the testis. In some gene knock-out mice insufficient amounts of MPF blocked the spermatocytes at the G2/M transition and this was followed by spermatocyte apoptosis. In this study, we examined the expression and the alteration of Cdc2 in testis during the spermatocyte apoptosis process induced by transient heat stress. The results showed that the spermatogenic cell apoptosis was detectable by the TUNEL assay at 4h post-treatment. At 10h, almost all spermatocytes began apoptosis. In situ hybridization and immunohistochemistry indicated that cdc2 was primarily expressed in spermatocytes. Neither the distribution nor the amount of cdc2 mRNA was significantly influenced by the heat stress. In contrast, the amount of Cdc2 protein decreased significantly at 3h post-treatment, which was detectable before apoptosis. This indicated that Cdc2 was susceptible to heat stress in the testis. Cdc2 levels remained low until 8h post-treatment. It was possible that the swift decline in Cdc2 and the resulting lack of MPF blocked the spermatocytes at G2/M transition. Meiosis in the spermatocytes was disrupted leading to the initiation of apoptosis. The results provide evidence that the lack of Cdc2 might induce spermatocyte apoptosis after transient heat stress.

The expression of AmphiTCTP, a TCTP orthologous gene in amphioxus related to the development of notochord and somites.

The translationally controlled tumor protein (TCTP) is highly conserved and has been widely found in eukaryotic organisms. Here, we report the phylogenetic analysis and developmental expression of AmphiTCTP, a TCTP homologous gene in cephalochordate amphioxus. Phylogenetic analysis indicates that the putative protein of AmphiTCTP is close to its vertebrate orthologs. The mRNA of AmphiTCTP is found in fertilized eggs, early cleavage embryo and most of the early developmental stages by in situ hybridization and RT-PCR, but its expression is not detectable from late cleavage stage to mid-gastrula. The expression of AmphiTCTP in zygotes and early cleavage stages shows that AmphiTCTP may be a maternal gene. From the early neurula stage onward, AmphiTCTP transcript is localized in the presumptive notochord, presomitic mesoderm, and nascent somites. However, its expression is gradually down-regulated after the notochord and somites have been formed. The expression pattern of AmphiTCTP thus coincides with the differentiation of the notochord and somites, this suggests that AmphiTCTP may not be a housekeeping gene and may play an important role in mesoderm development.

Identification and expression of the amphioxus Cks1 gene.

A full-length Cks1 homologue gene, AmphiCks1, was identified in amphioxus, Branchiostoma belcheri tsingtauense. Sequence characteristics, phylogeny and patterns of expression during embryonic and larval development were established. The protein predicted from AmphiCks1 showed high sequence identity with vertebrate and invertebrate homologues. Protein structural studies and phylogenetic analysis suggested that Cks homologues are evolutionarily conserved. The AmphiCks1 transcript was detected in most early developmental stages by northern blotting and whole-mount in situ hybridization, suggesting a role for the gene in cell division.

The expression of AmphiMdp during amphioxus early development.

We report here the expression of AmphiMdp in embryos and larvae. Faint AmphiMdp transcripts were first detected in the mesendoderm at the mid-gastrula stage and later in the somites of the early neurula. Expression remained in somites throughout the neurula and early larval stages and then disappeared from the somites starting with the most anterior somite and progressing posteriorly. At the 48-h larval stage, transcripts were detected in the developing tail bud. No transcripts were detectable in the somites of the 72-h larva. The result suggests that AmphiMdp is involved in myogenesis in amphioxus.

Developmental expression of amphioxus GABAA receptor-associated protein-like 2 gene.

A full-length amphioxus gamma-aminobutyric acid type-A receptor-associated protein-like 2 ( GABARAPL2) cDNA was isolated. Its sequence and developmental expression are first described in this paper. The phylogenetic analysis shows that the amphioxus GABARAPL2 and GABARAPL2 in vertebrates are highly homologous. The results of in situ hybridization show that the amphioxus GABARAPL2 gene is expressed in the neural tube, neurenteric canal, notochord, muscle and developing alimentary canal.