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Smilax glabra Roxb. (SGR) is known for its high nutritional and therapeutic value. However, the frequent appearance of counterfeit products causes confusion and inconsistent quality among SGR varieties. Herein, this study collected the proportion of SGR adulteration and used high-performance liquid chromatography (HPLC) to measure the astilbin content of SGR. Then Fourier-transform near-infrared (FT-NIR) technology, combined with multivariate intelligent algorithms, was used to establish partial least squares regression quantitative models for detecting SGR adulteration and measuring astilbin content, respectively. The method conducted a quantitative analysis of dual indicators through single-spectrum data acquisition (QADS) to comprehensively evaluate the authenticity and superiority of SGR. The coefficients of determination (R2) for both the calibration and prediction sets exceeded 0.96, which successfully leverages FT-NIR combined with multivariate intelligent algorithms to considerably enhance the accuracy and reliability of quantitative models. Overall, this research holds substantial value in the comprehensive quality evaluation in functional health foods.
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Algorithms , Smilax , Spectroscopy, Near-Infrared , Smilax/chemistry , Spectroscopy, Near-Infrared/methods , Chromatography, High Pressure Liquid , Quality Control , Spectroscopy, Fourier Transform Infrared , Plant Extracts/chemistry , Plant Extracts/analysis , Least-Squares AnalysisABSTRACT
Triterpenoid saponins, a major bioactive component of liquorice, possess high hydrophilicity and often co-occur with other impurities of similar polarity. Additionally, subtle structural differences of some triterpenoid saponins bring challenges to comprehensive characterisation. In this study, triterpenoid saponins of three Glycyrrhiza species were systematically analysed using rapid resolution liquid chromatography quadrupole time-of-flight mass spectrometry (RRLC-Q-TOF-MS) coupled with mass defect filtering (MDF). Firstly, comprehensive date acquisition was achieved using RRLC-Q-TOF-MS. Secondly, a polygonal MDF method was established by summarizing known and speculated substituents and modifications based on the core structure to rapidly screen potential triterpenoid saponins. Thirdly, based on the fragmentation patterns of reference compounds, an identification strategy for characterisation of triterpenoid saponins was proposed. The strategy divided triterpenoid saponins into three distinct classes. By this strategy, 98 triterpenoid saponins including 10 potential new ones were tentatively characterised. Finally, triterpenoid saponins of three Glycyrrhiza species were further analysed using principle component analysis (PCA) and orthogonality partial least squares discriminant analysis (OPLS-DA). Among these, 18 compounds with variable importance in projections (VIP) > 1.0 and P values < 0.05 were selected to distinguish three Glycyrrhiza species. Overall, our study provided a reference for quality control and rational use of the three species.
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Glycyrrhiza , Saponins , Triterpenes , Saponins/chemistry , Saponins/analysis , Glycyrrhiza/chemistry , Triterpenes/chemistry , Triterpenes/analysis , Mass Spectrometry/methods , Chromatography, High Pressure Liquid/methods , Chromatography, Liquid/methods , Plant Extracts/chemistryABSTRACT
Correction for 'Single molecule magnet features in luminescent lanthanide coordination polymers with heptacoordinate Dy/Yb(III) ions as nodes' by Xiang-Tao Dong et al., Dalton Trans., 2023, 52, 12686-12694, https://doi.org/10.1039/D3DT02106H.
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[This corrects the article DOI: 10.1039/D3RA00802A.].
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Accurate differential diagnosis among various dementias is crucial for effective treatment of Alzheimer's disease (AD). The study began with searching for novel blood-based neuronal extracellular vesicles (EVs) that are more enriched in the brain regions vulnerable to AD development and progression. With extensive proteomic profiling, GABRD and GPR162 were identified as novel brain regionally enriched plasma EVs markers. The performance of GABRD and GPR162, along with the AD molecule pTau217, was tested using the self-developed and optimized nanoflow cytometry-based technology, which not only detected the positive ratio of EVs but also concurrently presented the corresponding particle size of the EVs, in discovery (n = 310) and validation (n = 213) cohorts. Plasma GABRD+- or GPR162+-carrying pTau217-EVs were significantly reduced in AD compared with healthy control (HC). Additionally, the size distribution of GABRD+- and GPR162+-carrying pTau217-EVs were significantly different between AD and non-AD dementia (NAD). An integrative model, combining age, the number and corresponding size of the distribution of GABRD+- or GPR162+-carrying pTau217-EVs, accurately and sensitively discriminated AD from HC [discovery cohort, area under the curve (AUC) = 0.96; validation cohort, AUC = 0.93] and effectively differentiated AD from NAD (discovery cohort, AUC = 0.91; validation cohort, AUC = 0.90). This study showed that brain regionally enriched neuronal EVs carrying pTau217 in plasma may serve as a robust diagnostic and differential diagnostic tool in both clinical practice and trials for AD.
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Alzheimer Disease , Extracellular Vesicles , Humans , Alzheimer Disease/diagnosis , Diagnosis, Differential , NAD , ProteomicsABSTRACT
The management and coexistence of community cats in urban areas is a growing concern amid global urbanization. Through a survey-based investigation, we examine the residents' perceptions of the general health of community cats and human-cat relationships in urban China. The data from 5382 participants revealed that approximately 70% of participants perceived community cats as being in good health, and 60% reported harmonious or non-conflict coexistence between residents and these cats. Around 45% of the participants rescued or helped community cats, 38% expressed their intention to adopt, and 18% complained about the issues of community cats to management staff. Linear, logistic, and multilevel-logistic regressions were employed to examine the associations between the types of cities and communities or the participants' socio-demographics and the perceived well-being of community cats or human-cat relationships. The results show that the cats in fourth-tier cities (e.g., county-level cities) had poorer living conditions than in first-tier cities (e.g., Beijing), while the cats in urban village communities (e.g., villages in the city) were less likely to exhibit good health than in ordinary commercial housing communities. The results also show that socio-demographic variables, such as educational attainment, marital status, and income level, predicted participants' relationships with community cats. This study is the first of its kind. It provides valuable insights for stakeholders to develop effective policies and interventions on cat management, emphasizing the need for tailored strategies in diverse urban settings and populations.
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This study explored the preparation process of the placebo of Jiawei Ermiao Granules and evaluated the placebo effect, aiming to provide qualified placebo samples for clinical trials of Jiawei Ermiao Granules and a reference for the preparation and quality evaluation of placebos of traditional Chinese medicine granules. On the basis of the comprehensive analysis results of Jiawei Ermiao Granules, the orthogonal experiment was conducted to optimize the flavoring agents and colorants. After manual evaluation, the placebo formula was determined as dextrin 10 g, Codonopsis Radix extract 5.0 g, bitter melon extract 1.6 g, Mume Fructus extract 0.3 g, stevioside 0.1 g, sucrose octaacetate 0.004 g, indigo 0.004 g, lemon yellow 0.003 1 g, sunset yellow 0.001 8 g, bitter tea powder 0.001 8 g, caramel 0.001 3 g. Pilot trials were conducted on the placebo formula. The simulation effect of placebo was evaluated independently and comparatively, and the objectively evaluated by electronic nose and electronic tongue. The results showed that the independent manual evaluation of the placebo formula had higher error rate, and the placebo and Jiawei Ermiao Granules showed the similarity of 99.61% in the comparative manual evaluation. The smell similarity between the placebo and Jiawei Ermiao Granules was 99.19%, and the electronic tongue test showed little difference in the taste. In conclusion, the placebo prepared in this study shows a high similarity to Jiawei Ermiao Granules, which is not easy to break the blindness when being applied to clinical trials. This study provides a reference for the preparation and quality evaluation and promotes the large-scale production of placebos of traditional Chinese medicine granules, playing a role in improving the persuasiveness and acceptance of the efficacy of traditional Chinese medicines.
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Drugs, Chinese Herbal , Drugs, Chinese Herbal/therapeutic use , Medicine, Chinese Traditional , TasteABSTRACT
Amyloid-ß, tau pathology, and biomarkers of neurodegeneration make up the core diagnostic biomarkers of Alzheimer disease (AD). However, these proteins represent only a fraction of the complex biological processes underlying AD, and individuals with other brain diseases in which AD pathology is a comorbidity also test positive for these diagnostic biomarkers. More AD-specific early diagnostic and disease staging biomarkers are needed. In this study, we performed tandem mass tag proteomic analysis of paired cerebrospinal fluid (CSF) and serum samples in a discovery cohort comprising 98 participants. Candidate biomarkers were validated by parallel reaction monitoring-based targeted proteomic assays in an independent multicenter cohort comprising 288 participants. We quantified 3,238 CSF and 1,702 serum proteins in the discovery cohort, identifying 171 and 860 CSF proteins and 37 and 323 serum proteins as potential early diagnostic and staging biomarkers, respectively. In the validation cohort, 58 and 21 CSF proteins, as well as 12 and 18 serum proteins, were verified as early diagnostic and staging biomarkers, respectively. Separate 19-protein CSF and an 8-protein serum biomarker panels were built by machine learning to accurately classify mild cognitive impairment (MCI) due to AD from normal cognition with areas under the curve of 0.984 and 0.881, respectively. The 19-protein CSF biomarker panel also effectively discriminated patients with MCI due to AD from patients with other neurodegenerative diseases. Moreover, we identified 21 CSF and 18 serum stage-associated proteins reflecting AD stages. Our findings provide a foundation for developing blood-based tests for AD screening and staging in clinical practice.
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Alzheimer's disease(AD)is the most common cognitive disorder in the elderly and manifests primarily as progressive cognitive function decline, neuropsychiatric symptoms and multiple functional impairments.Obstructive sleep apnea(OSA)is a common type of respiratory disorder.Studies have found that AD and OSA are connected in many ways, including the risk of developing these diseases, biomarkers and neuroimaging features.These connections may result from a variety of mechanisms, such as neuropathological protein deposition, exacerbated immune-mediated inflammation, oxidative stress abnormalities, impaired mitochondrial function, and disturbed neurotransmitter systems, among others.This article reviewed the relationship between AD and OSA, the mechanisms linking them and their treatment.
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Objective:To analyze and summarize the medical security situation of the snowmobile,sled,and steel frame snowmobile tracks at the National Sliding Centre,and to provide experience for future event hosting and medical security work for mass ice and snow sports.Methods:Retrospective analysis of injuries and treatment of athletes participating in the International Training Week and World Cup for Ski,Sled,and Steel Frame Ski from October to November 2021(hereinafter referred to as"Inter-national Training Week"),as well as the Ski,Sled,and Steel Frame Ski events at the Beijing Winter Olympics in February 2022(hereinafter referred to as the"Beijing Winter Olympics").We referred to and drew on the"Medical Security Standards for Winter Snow Sports"to develop specific classification standards for analyzing injured areas,types of injuries,and accident locations.Results:A total of 743 athletes participated in the International Training Week and the Beijing Winter Olympics.During the com-petition,there were 58 incidents of overturning,prying,and collision,of which 28(28 athletes)were in-jured,accounting for 48.3%of the total accidents and 3.8%of the total number of athletes.Among them,there were 9 males(32.1%)and 19 females(67.9%),with an average age of(26.3±4.7)years.Among the 28 injured athletes,20 cases(71.4%)received on-site treatment for Class Ⅰ injuries,while 8 cases(28.6%)had more severe injuries,including Class Ⅱ injuries(7 cases)and Class Ⅲ injuries(1 case),which were referred to designated hospitals for further treatment.Among the 28 injured athletes,3 cases(10.7%)experienced multiple injuries,including 2 cases of 2 injuries and 1 case of 3 injuries.The most common injuries were in the ankle and toes(10/32,31.3%).Out of 28 injured athletes,one(3.6%)experienced two types of injuries simultaneously,with joint and/or ligament injuries being the most common(11/29,37.9%).The most accident prone point on the track was the ninth curve(18/58,31.0%).Conclusion:Through the analysis and summary of medical security work,it can provide better experience and reference for the future development of snowmobile,sled,and steel frame snowmobile sports in China,making the National Snowy and Ski Center truly a sustainable Olympic heritage.
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ObjectiveTo investigate the clinicopathological features, diagnosis and treatment methods, and prognosis of gallbladder sarcomatoid carcinoma (GBSC). MethodsA retrospective analysis was performed for the clinical data of 16 patients with GBSC who were admitted to The First Affiliated Hospital of Zhengzhou University from January 2015 to April 2023, including general information, clinical manifestations, imaging features, pathological features, and treatment modality, and follow-up was performed for all patients. The Kaplan-Meier method was used to perform the survival analysis and plot the survival curve, and the Log-rank test was used for comparison between groups. ResultsAmong the 16 patients, there were 6 male patients and 10 female patients, with a mean age of 62.9±8.4 years. The main clinical manifestations were right upper abdominal pain in 13 patients (81.3%), nausea in 5 patients (31.3%), abdominal distension in 4 patients (25.0%), poor appetite in 3 patients (18.8%), weakness in 2 patients (12.5%), fever in 2 patients (12.5%), and jaundice in 1 patient (6.3%), and 3 patients were asymptomatic and were found to have this disease by physical examination. Of all patients, 81.3% (13/16) were in the advanced stage (stage Ⅲ/Ⅳ) at the time of initial diagnosis. Histopathological examination showed that some cancer cells were spindle-shaped under the microscope, with marked nuclear division and noticeable heteromorphism. Immunohistochemistry showed a positive expression rate of 100% (16/16) for Vimentin, AE1/AE3, and CK8/18, and Ki-67 proliferation index was highly expressed in 81.3% (13/16) of the patients (≥50%), with a median of 70% (range 20% — 90%). All 16 patients underwent surgical treatment, with radical surgery in 11 patients and palliative surgery in 5 patients, among whom 9 received R0 resection, 2 received R1 resection, and 5 received R2 resection, and 7 patients received adjuvant therapy after surgery. Effective follow-up was achieved for all 16 patients, with a follow-up time of 0.5 — 26.0 months and a median follow-up time of 11.0 months. By the end of follow-up, 2 patients survived and 14 patients died due to tumor recurrence or metastasis, with a median survival time of 10.0 months, and the 1- and 2-year cumulative survival rates after surgery were 31.3% and 8.3%, respectively. The prognostic analysis showed that TNM stage (χ2=6.727, P=0.009), surgical approach (χ2=7.508, P=0.006), margin condition (χ2=7.934, P=0.005), and adjuvant therapy (χ2=4.608, P=0.032) were associated with the prognosis of patients. ConclusionThe clinical manifestations of GBSC lack specificity, and a confirmed diagnosis relies on immunohistochemical analysis. Most patients are in the advanced disease at the time of initial diagnosis and tend to have a poor prognosis. There are currently no targeted therapies for this disease, and radical surgery with negative margins and adjuvant therapy can improve the survival rate of patients.
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BACKGROUND AND PURPOSE: To assess the relationship between metastatic lymph node (LN) responder status and recurrence-free survival (RFS) in patients undergoing neoadjuvant chemoradiotherapy (NCRT). MATERIALS AND METHODS: We retrospectively reviewed 304 patients with local advanced esophageal squamous cell carcinoma received NCRT followed by esophagectomy. For 112 patients with positive node, according to the proportion of residual viable tumor cells area within the whole tumor beds of all metastatic LNs, we classified LN-tumor regression grade (LN-TRG) into four categories: grade 1, 0%; 2, <10%; 3, 10%-50%; 4, >50%. Patients with grade 1-2 LN-TRG of were considered LN responders, and those with grades 3-4, as LN nonresponders. Univariate and multivariate analyses of RFS were estimated by a Cox regression model, Kaplan-Meier curve, and log-rank test. RESULTS: The median follow-up time of a total of 112 patients was 29.6 months. Fifty-two (46.4%) patients have experienced recurrence. In Cox univariate analysis, differentiation, AJCC stage LN responder status, nerve invasion, and lymphovascular invasion significantly correlated with RFS. Multivariate analysis for RFS revealed that LN responder status and AJCC stage (p < 0.05) were independent prognostic factor. The 3-year RFS rates for patients with LN-TRG of 1-4 grades were 72.7%, 76.5%, 37.4%, and 28.5%, respectively, and the median RFS times were not reach, 43.56, 28.09, and 22.77, respectively. CONCLUSIONS: LN responder status is an independent prognostic factor for RFS in esophageal cancer patients who received NCRT.
Subject(s)
Carcinoma, Squamous Cell , Esophageal Neoplasms , Esophageal Squamous Cell Carcinoma , Humans , Esophageal Squamous Cell Carcinoma/pathology , Prognosis , Neoadjuvant Therapy , Esophageal Neoplasms/pathology , Carcinoma, Squamous Cell/pathology , Retrospective Studies , Lymph Nodes/pathology , Neoplasm Staging , EsophagectomyABSTRACT
Two sets of 1D/2D lanthanide coordination polymers with formulas of Ln(oqa)3·2H2O [Hoqa = 2-(4-oxoquinolin-1(4H)-yl) acetic acid, Ln = Dy (1), Yb (2)] and Ln(oaa)2(HCOO)(H2O) [Hoaa = 2-(9-oxoacridin-10(9H)-yl) acetic acid, Ln = Dy (3), Yb (4)] have been synthesized and their physical properties were investigated. All four complexes are constructed from seven-coordinate lanthanide ions and corresponding organic linkers. The lanthanide ions in 1 and 2 adopt a pentagonal bipyramid coordination geometry, whereas the coordination geometry of lanthanide ions in 3 and 4 can be described as a capped octahedron. Slow magnetic relaxation behaviors were observed in these four products at a zero/non-zero static magnetic field. Complexes 1, 2 and 4 exhibit the characteristic emission of Ln(III) ions, whereas complex 3 shows ligand-based emission. Bright yellow light emission was also observed when a voltage was applied, demonstrating the potential of 1 for application in light-emitting diodes (LEDs). Compounds 3 and 4 are the first examples of lanthanide complexes based on Hoaa ligands.
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Lonicera japonica Thunb. has attracted much attention for its treatment of bacterial and viral infectious diseases, while its active ingredients and potential mechanisms of action have not been fully elucidated. Here, we combined metabolomics, and network pharmacology to explore the molecular mechanism of Bacillus cereus ATCC14579 inhibition by Lonicera japonica Thunb. In vitro inhibition experiments showed that the Lonicera japonica Thunb.'s water extracts, ethanolic extract, luteolin, quercetin, and kaempferol strongly inhibited Bacillus cereus ATCC14579. In contrast, chlorogenic acid and macranthoidin B had no inhibitory effect on Bacillus cereus ATCC14579. Meanwhile, the minimum inhibitory concentrations of luteolin, quercetin, and kaempferol against Bacillus cereus ATCC14579 were 15.625 µg mL-1, 31.25 µg mL-1, and 15.625 µg mL-1. Based on the previous experimental basis, the metabolomic analysis showed the presence of 16 active ingredients in Lonicera japonica Thunb.'s water extracts and ethanol extracts, with differences in the luteolin, quercetin, and kaempferol contents between the water extracts and ethanol extracts. Network pharmacology studies indicated that fabZ, tig, glmU, secA, deoD, nagB, pgi, rpmB, recA, and upp were potential key targets. Active ingredients of Lonicera japonica Thunb. may exert their inhibitory effects by inhibiting ribosome assembly, the peptidoglycan biosynthesis process, and the phospholipid biosynthesis process of Bacillus cereus ATCC14579. An alkaline phosphatase activity assay, peptidoglycan concentration assay, and protein concentration assay showed that luteolin, quercetin, and kaempferol disrupted the Bacillus cereus ATCC14579 cell wall and cell membrane integrity. Transmission electron microscopy results showed significant changes in the morphology and ultrastructure of the cell wall and cell membrane of Bacillus cereus ATCC14579, further confirming the disruption of the cell wall and cell membrane integrity of Bacillus cereus ATCC14579 by luteolin, quercetin, and kaempferol. In conclusion, Lonicera japonica Thunb. can be used as a potential antibacterial agent for Bacillus cereus ATCC14579, which may exert its antibacterial activity by destroying the integrity of the cell wall and membrane.
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Compound Glycyrrhizin Tablet (CGT) is a glycyrrhizin-containing (monoammonium glycyrrhizate, MAG) preparation, which has been widely used in clinical treatment of chronic liver diseases, eczema, atopic dermatitis and other conditions. However, the impurity profile of CGT has not yet been completely elucidated. In this study, eight main saponin-related impurity compounds were initially isolated and identified. Thereafter, based on the characteristic MS/MS fragmentation pathways analysis of the isolated compounds, a novel strategy for characterization and identification of saponin-related impurities was proposed. Then, a total of 41 saponin-related impurities were identified or tentatively characterized in CGTs. Furthermore, principal component analysis (PCA), Wayne diagram and heatmap analysis revealed that the process-related impurity profile in CGTs from three different manufacturers was significantly different. Overall, our findings provided additional technological support for evaluating saponin-related impurities, thereby laying a solid foundation to develop strategies for future product quality improvement.
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Glycyrrhizic Acid , Tandem Mass Spectrometry , Chromatography, High Pressure Liquid , Drug Contamination , TabletsABSTRACT
Two organic-inorganic manganese(II) halide hybrids (OIMHs) with formulas of [(TEA)(TMA)]MnCl4 (1) and [(TPA)(TMA)3](MnCl4)2 (2) (TEA = tetraethylammonium, TMA = tetramethylammonium, and TPA = tetrapropylammonium) were synthesized by a mixed-ligand strategy. Both compounds crystallize in the acentric space group and are composed of isolated [MnCl4]2- tetrahedral units separated by two types of organic cations. They show high thermal stability and emit strong green light with different emission bandwidths, quantum yields, and high-temperature photostability. Remarkably, the quantum yield of 1 can reach up to 99%. Due to the high thermal stability and quantum yield of 1 and 2, green light-emitting diodes (LEDs) were fabricated. Furthermore, mechanoluminescence (ML) was observed in 1 and 2 when stress was applied. The ML spectrum of 1 is similar to the photoluminescence (PL) spectrum, suggesting ML and PL emissions come from the same transition of Mn(II) ions. Finally, rewritable anticounterfeiting printing and information storage were achieved by utilizing the outstanding photophysical properties and ionic features of the products. The printed images still remain clear after several cycles, and the information stored on the paper can be read out by a UV lamp and commercial mobile phones.
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Based on the CX3C chemokine ligand 1(CX3CL1)-CX3C chemokine receptor 1(CX3CR1) axis, this study explored the potential mechanism by which Zuogui Jiangtang Jieyu Formula(ZGJTJY) improved neuroinflammation and enhanced neuroprotective effect in a rat model of diabetes mellitus complicated with depression(DD). The DD rat model was established by feeding a high-fat diet combined with streptozotocin(STZ) intraperitoneal injection for four weeks and chronic unpredictable mild stress(CUMS) combined with isolated cage rearing for five weeks. The rats were divided into a control group, a model group, a positive control group, an inhibitor group, and a ZGJTJY group. The open field test and forced swimming test were used to assess the depression-like behaviors of the rats. Enzyme-linked immunosorbent assay(ELISA) was performed to measure the expression levels of the pro-inflammatory cytokines interleukin-1β(IL-1β) and tumor necrosis factor-α(TNF-α) in plasma. Immunofluorescence staining was used to detect the expression of ionized calcium-binding adapter molecule 1(Iba1), postsynaptic density protein-95(PSD95), and synapsin-1(SYN1) in the hippocampus. Hematoxylin-eosin(HE) staining, Nissl staining, and TdT-mediated dUTP nick end labeling(TUNEL) fluorescence staining were performed to assess hippocampal neuronal damage. Western blot was used to measure the expression levels of CX3CL1, CX3CR1, A2A adenosine receptor(A2AR), glutamate receptor 2A(NR2A), glutamate receptor 2B(NR2B), and brain-derived neurotrophic factor(BDNF) in the hippocampus. Compared with the model group, the ZGJTJY group showed improved depression-like behaviors in DD rats, enhanced neuroprotective effect, increased expression of PSD95, SYN1, and BDNF(P<0.01), and decreased expression of Iba1, IL-1β, and TNF-α(P<0.01), as well as the expression of CX3CL1, CX3CR1, A2AR, NR2A, and NR2B(P<0.01). These results suggest that ZGJTJY may exert its neuroprotective effect by inhibiting the CX3CL1-CX3CR1 axis and activation of hippocampal microglia, thereby improving neuroinflammation and abnormal activation of N-methyl-D-aspartate receptor(NMDAR) subunits, and ultimately enhancing the expression of synaptic-related proteins PSD95, SYN1, and BDNF in the hippocampus.
Subject(s)
Rats , Animals , Depression/drug therapy , Brain-Derived Neurotrophic Factor , Neuroprotective Agents , Tumor Necrosis Factor-alpha/metabolism , Neuroinflammatory Diseases , Diabetes Mellitus , Receptors, Glutamate , CX3C Chemokine Receptor 1/geneticsABSTRACT
Objective: To propose a new staging system for presacral recurrence of rectal cancer and explore the factors influencing radical resection of such recurrences based on this staging system. Methods: In this retrospective observational study, clinical data of 51 patients with presacral recurrence of rectal cancer who had undergone surgical treatment in the Department of Gastrointestinal Surgery, Peking University People's Hospital between January 2008 and September 2022 were collected. Inclusion criteria were as follows: (1) primary rectal cancer without distant metastasis that had been radically resected; (2) pre-sacral recurrence of rectal cancer confirmed by multi-disciplinary team assessment based on CT, MRI, positron emission tomography, physical examination, surgical exploration, and pathological examination of biopsy tissue in some cases; and (3) complete inpatient, outpatient and follow-up data. The patients were allocated to radical resection and non-radical resection groups according to postoperative pathological findings. The study included: (1) classification of pre-sacral recurrence of rectal cancer according to its anatomical characteristics as follows: Type I: no involvement of the sacrum; Type II: involvement of the low sacrum, but no other sites; Type III: involvement of the high sacrum, but no other sites; and Type IV: involvement of the sacrum and other sites. (2) Assessment of postoperative presacral recurrence, overall survival from surgery to recurrence, and duration of disease-free survival. (3) Analysis of factors affecting radical resection of pre-sacral recurrence of rectal cancer. Non-normally distributed measures are expressed as median (range). The Mann-Whitney U test was used for comparison between groups. Results: The median follow-up was 25 (2-96) months with a 100% follow-up rate. The rate of metachronic distant metastasis was significantly lower in the radical resection than in the non-radical resection group (24.1% [7/29] vs. 54.5% [12/22], χ2=8.333, P=0.026). Postoperative disease-free survival was longer in the radical resection group (32.7 months [3.0-63.0] vs. 16.1 [1.0-41.0], Z=8.907, P=0.005). Overall survival was longer in the radical resection group (39.2 [3.0-66.0] months vs. 28.1 [1.0-52.0] months, Z=1.042, P=0.354). According to univariate analysis, age, sex, distance between the tumor and anal verge, primary tumor pT stage, and primary tumor grading were not associated with achieving R0 resection of presacral recurrences of rectal cancer (all P>0.05), whereas primary tumor pN stage, anatomic staging of presacral recurrence, and procedure for managing presacral recurrence were associated with rate of R0 resection (all P<0.05). According to multifactorial analysis, the pathological stage of the primary tumor pN1-2 (OR=3.506, 95% CI: 1.089-11.291, P=0.035), type of procedure (transabdominal resection: OR=29.250, 95% CI: 2.789 - 306.811, P=0.005; combined abdominal perineal resection: OR=26.000, 95% CI: 2.219-304.702, P=0.009), and anatomical stage of presacral recurrence (Type III: OR=16.000, 95% CI: 1.542 - 166.305, P = 0.020; type IV: OR= 36.667, 95% CI: 3.261 - 412.258, P = 0.004) were all independent risk factors for achieving radical resection of anterior sacral recurrence after rectal cancer surgery. Conclusion: Stage of presacral recurrences of rectal cancer is an independent predictor of achieving R0 resection. It is possible to predict whether radical resection can be achieved on the basis of the patient's medical history.
Subject(s)
Humans , Neoplasm Recurrence, Local/diagnosis , Rectal Neoplasms/therapy , Retrospective Studies , Pelvis/pathology , Recurrence , Treatment OutcomeABSTRACT
Objective: To investigate the clinical efficacy of entecavir combined with Biejiajian pills and its influence on TCM syndrome scores during the treatment of chronic hepatitis B with hepatic fibrosis and blood stasis syndrome by prospective, randomized and controlled study. Methods: Patients with chronic hepatitis B with hepatic fibrosis and blood stasis syndrome were selected as the research subjects and randomly divided into a treatment group and a control group. Entecavir plus Biejiajian pills or entecavir plus a simulant of Biejiajian pills were given for 48 weeks. The changes in liver stiffness measurement (LSM) and TCM syndrome scores before and after treatment were compared between the two groups to analyze the correlation. The data between groups were analyzed by t-test/Wilcoxon rank sum test or χ(2) test. Pearson correlation coefficient was used to analyze the correlation between TCM syndrome scores and LSM values. Results: After 48 weeks of treatment, the LSM values of the two groups were significantly lower than those of the baseline (P < 0.001), liver fibrosis was significantly improved, and the LSM values of the treatment group were lower than those of the control group [(8.67 ± 4.60) kPa and (10.13 ± 4.43) kPa, t = -2.011, P = 0.049]. After 48 weeks of treatment, the TCM syndrome scores of the two groups were significantly reduced compared with the baseline (P < 0.001), and the clinical symptoms were significantly relieved, and the total effective rates of the improvement of the TCM syndrome scores in the two groups were 74.19% and 72.97%, respectively, but the differences between the groups were not statistically significant (χ(2) = 0.013, P = 0.910). Correlation analysis showed that there was no obvious trend between TCM syndrome scores and LSM values. There were no serious adverse reactions associated with the drug during the observation period of this study. Conclusion: Based on antiviral treatment with entecavir, regardless of whether it is combined with the Biejiajian pill, it can effectively reduce the LSM value, improve liver fibrosis, reduce TCM syndrome scores, and alleviate symptoms in patients with chronic hepatitis B with liver fibrosis and blood stasis syndrome. Compared with entecavir alone, the combined Biejia pill has greater efficacy in improving liver fibrosis and a favorable safety profile, meriting its implementation and widespread application.
Subject(s)
Humans , Antiviral Agents/therapeutic use , Hepatitis B, Chronic/drug therapy , Liver Cirrhosis/drug therapy , Prospective Studies , Treatment OutcomeABSTRACT
BACKGROUND: Language deficits frequently occur during the prodromal stages of Alzheimer's disease (AD). However, the characteristics of linguistic impairment and its underlying mechanism(s) remain to be explored for the early diagnosis of AD. METHODS: The percentage of silence duration (PSD) of 324 subjects was analyzed, including patients with AD, amnestic mild cognitive impairment (aMCI), and normal controls (NC) recruited from the China multi-center cohort, and the diagnostic efficiency was replicated from the Pitt center cohort. Furthermore, the specific language network involved in the fragmented speech was analyzed using task-based functional magnetic resonance. RESULTS: In the China cohort, PSD increased significantly in aMCI and AD patients. The area under the curve of the receiver operating characteristic curves is 0.74, 0.84, and 0.80 in the classification of NC/aMCI, NC/AD, and NC/aMCI+AD. In the Pitt center cohort, PSD was verified as a reliable diagnosis biomarker to differentiate mild AD patients from NC. Next, in response to fluency tasks, clusters in the bilateral inferior frontal gyrus, precentral gyrus, left inferior temporal gyrus, and inferior parietal lobule deactivated markedly in the aMCI/AD group (cluster-level P < 0.05, family-wise error (FWE) corrected). In the patient group (AD+aMCI), higher activation level of the right pars triangularis was associated with higher PSD in in both semantic and phonemic tasks. CONCLUSIONS: PSD is a reliable diagnostic biomarker for the early stage of AD and aMCI. At as early as aMCI phase, the brain response to fluency tasks was inhibited markedly, partly explaining why PSD was elevated simultaneously.