Anisodamine hydrobromide in the treatment of critically ill patients with septic shock: a multicenter randomized controlled trial.

BACKGROUND: Septic shock is the development of sepsis to refractory circulatory collapse and metabolic derangements, characterized by persistent hypotension and increased lactate levels. Anisodamine hydrobromide (Ani HBr) is a Chinese medicine used to improve blood flow in circulatory disorders. The purpose of this study was to determine the therapeutic efficacy of Ani HBr in the treatment of patients with septic shock. METHODS: This was a prospective, multicenter, randomized controlled trial focusing on patients with septic shock in 16 hospitals in China. Patients were randomly assigned in a 1:1 ratio to either the treatment group or the control group. The primary endpoint was 28-day mortality. The secondary outcomes included 7-day mortality, hospital mortality, hospital length of stay, vasopressor-free days within 7 days, etc. These indicators were measured and collected at 0, 6h, 24h, 48h, 72h and 7d after the diagnosis. RESULTS: Between September 2017 and March 2021, 404 subjects were enrolled. 203 subjects received Ani HBr and 201 subjects were assigned to the control group. The treated group showed lower 28-day mortality than the control group. Stratified analysis further showed significant differences in 28-day mortality between the two groups for patients with a high level of illness severity. We also observed significant differences in 7-day mortality, hospital mortality and some other clinical indicators between the two groups. CONCLUSION: Ani HBr might be an important adjuvant to conventional treatment to reduce 28-day mortality in patients with septic shock. A large-scale prospective randomized multicenter trial is warranted to confirm our results.

LncRNA-CASC15 knockdown inhibits the progression of esophageal squamous cell carcinoma through targeting miR-33a-5p/PTGS2 axis.

LncRNA CASC15 has been determined as a novel tumor-related lncRNA in many cancers. However, the in-detail role of CASC15 remains elusive in esophageal squamous cell carcinoma (ESCC). CASC15 expression level was detected in 113 ESCC tissues and paired adjacent normal tissues and in human ESCC cell lines. The effects of CASC15 on ESCC proliferation, migration, and invasion were assessed using CCK-8 and transwell assays. In addition, the potential downstream molecules of CASC15 were searched and confirmed by software algorithms, RT-qPCR, western blot, dual-luciferase reporter, and rescue experiments. CASC15 was upregulated in ESCC tissues and cell lines. CASC15 overexpression was associated with poorer prognosis in ESCC patients. Functionally, CASC15 knockdown inhibited cell proliferation, migration, and invasion of ESCC cells. Mechanistically, it was confirmed that CASC15 acts as competing endogenous RNA for miR-33a-5p to regulate PTGS2 expression. In addition, rescue assay showed that miR-33a-5p knockdown or PTGS2 overexpression abolished the cell proliferation, migration, and invasion inhibition role of CASC15 knockdown. In conclusion, this study indicates that CASC15 was upregulated in ESCC and CASC15 knockdown hindered ESCC progression through targeting the miR-33a-5p/PTGS2 axis. CASC15 might serve as a novel biomarker and therapeutic target for ESCC.

Effect of Guo Qing Yi Tang combined with Western medicine cluster therapy on acute pancreatitis.

BACKGROUND: This study evaluated the effect of Guo Qing Yi Tang (GQYT) combined with Western medicine cluster therapy on acute pancreatitis (AP). METHODS: A total of 138 AP patients were recruited and divided into the observation group (68 patients) and control group (70 patients). The control group was treated with cluster therapy alone, while the observation group was treated with trans-jejunum feeding of GQYT combined with cluster therapy. Blood samples were taken before the treatment and 24 h, 72 h, and 1 week after the treatment. The serum concentrations of Di amine oxidase(DAO), Endotoxin(ET), D-lactic acid, Intestinal trefoil factor(ITF), MFG-E8, TNF-α, IL-1ß, IL-6, and IL-8 were determined by using spectrophotometry and enzyme-linked immunosorbent assay. The concentrations of urinary lactulose and mannitol (L/M) were determined by high-performance liquid chromatography, and the urinary L/M value was calculated. RESULTS: Compared with the control group, the observation group had shorter hospital stay, faster recovery, significantly lower APACHE II score, and higher complete response rate (94.12%) after 1 week of treatment (P < 0.05). Moreover, the indicators related to intestinal mucosal barrier function (DAO, MFG-8, L/M) and inflammatory cytokines (TNF-α, IL-6, IL-8) were significantly reduced in the observation group after 1 week of treatment (P < 0.05). CONCLUSION: GQYT combined with cluster therapy for the treatment of AP has definite curative effect and rapid onset, reduces the level of inflammatory factors, and improves intestinal mucosal barrier function and APACHE II score. Thus, it has obvious clinical therapeutic advantages and can be used as a new therapeutic regimen for AP.

Metallothionein 1M (MT1M) inhibits lung adenocarcinoma cell viability, migration, and expression of cell mobility-related proteins through MDM2/p53/MT1M signaling.

BACKGROUND: Metallothionein 1M (MT1M) functions to regulate cell proliferation and cancer metastasis. This study assessed the effects of MT1M overexpression and mouse double minute 2 homolog (MDM2) knockdown on the regulation of non-small cell lung cancer A549 cell viability, migration, and protein expression in vitro and explored the underlying molecular events. METHODS: A549 cells were stably infected with lentivirus carrying MT1M cDNA or transiently transfected MDM2 siRNA and/or treated with the p53 inhibitor for the assessment of changes in cell viability, wound healing, Transwell migration, and qRT-PCR and Western blot assays. Luciferase reporter assay was performed to investigate p53 binding to the MT1M promoter. RESULTS: The data showed that MT1M overexpression inhibited A549 cell viability and migration capacity in vitro, whereas the p53 inhibitor reversed the inhibition of A549 cell viability and migration caused by MT1M overexpression as well as the expression of MMP2, MMP9, and MMP14. Furthermore, knockdown of MDM2, an upstream inhibitor of p53 activity, was able to reduce A549 cell viability, migration, and protein expression. Thus, MDM2 knockdown had synergistic effects with MT1M overexpression on the suppression of A549 cell viability, migration, and protein expression. CONCLUSIONS: In conclusion, MDM2 can bind to and phosphorylate p53 protein to inactivate the protein, thereby reducing MT1M expression and leading to tumor cell proliferation and migration.

[The design and applications of a non-invasive intelligent detector for cardiovascular functions].

An apparatus based on a high sensitive sensor which detects cardiovascular functions is introduced in this paper. Some intelligent detecting technologies, such as syntactic pattern recognition and a medical expert system are used in this detector. Its embedded single-chip microcomputer processes and analyzes pulse signals for gaining automatically the parameters about heart, blood vessel and blood etc., so as to get the health evaluation, correct medical diagnosis and prediction of cardiovascular diseases.

[Analysis of 174 cases with cervical cancer in women under 35 years old].

OBJECTIVE: To analyse the prevalence, etiology, presentation, preserving ovary and prognosis of cervical cancer in women under 35 years old. METHODS: The clinical information of 174 patients were retrospectively analysed. RESULTS: The percentage of new cervical cancer cases from 1991 to 2001 was 1.2%, 1.2%, 4.3%, 4.2%, 4.6%, 4.5%, 7.3%, 9.0%, 10.7%, 9.4%, 10.8%, respectively (P < 0.01). Contact bleeding was the main symptom that occurred in 101 cases (101/174, 58.0%). Cervicitis was incorrectly diagnosed in 45 cases (45/174, 25.9%). Sex irregularities occurred in 51 cases (51/174, 29.3%). The number of cases with carcinoma in situ, stage I, stage II, stage III was 22, 40, 94, 18, respectively. There are 29 cases with lymph vascular involvement, 60 with 1/2 or more penetration of the cervical stroma. The incidence of HPV16/18 infection was 34%. The ovarian metastasis was 0.8%. The 5 year survival rate of stage I - III was 71.6%, 60.4% and 13.3%, respectively (P < 0.01). COX regression analysis indicated that stage, lymph-vascular involvement and the depth of tumor infiltration were independently prognostic factors. For patients with one risk factor after radical surgery, the survival of patients with adjuvant radiation therapy and chemotherapy or not was 100%, 88%, respectively (P > 0.05). For patients with two or more risk factors, it was 68%, 1/7, respectively (P < 0.05). CONCLUSIONS: There is an increasing prevalence of cervical cancer in women under 35 years old, which is possibly related to the sexual transition. The preserving ovary in young cervical cancer patients is safe and effective. Patients with late stage, lymph-vascular involvement and deep infiltration of cervical stroma have poor prognosis. Adjuvant treatment may be helpful for patients with 2 or more risk factors after radical surgery.