Changes and significance of serum ubiquitin carboxyl-terminal hydrolase L1 and glial fibrillary acidic protein in patients with glioma.

BACKGROUND: Brain gliomas are malignant tumors with high postoperative recurrence rates. Early prediction of prognosis using specific indicators is of great significance. AIM: To assess changes in ubiquitin carboxy-terminal hydrolase L1 (UCH-L1) and glial fibrillary acidic protein (GFAP) levels in patients with glioma pre-and postoperatively. METHODS: Between June 2018 and June 2021, 91 patients with gliomas who underwent surgery at our hospital were enrolled in the glioma group. Sixty healthy volunteers were included in the control group. Serum UCH-L1 and GFAP levels were measured in peripheral blood collected from patients with glioma before and 3 d after surgery. UCH-L1 and GFAP levels in patients with glioma with different clinicopathological characteristics were compared before and after surgery. The patients were followed-up until February 2022. Postoperative glioma recurrence was recorded to determine the serum UCH-L1 and GFAP levels, which could assist in predicting postoperative glioma recurrence. RESULTS: UCH-L1 and GFAP levels in patients with glioma decreased significantly 3 d after surgery compared to those before therapy (P < 0.05). However, UCH-L1 and GFAP levels in the glioma group were significantly higher than those in the control group before and after surgery (P < 0.05). There were no statistically significant differences in preoperative serum UCH-L1 and GFAP levels among patients with glioma according to sex, age, pathological type, tumor location, or number of lesions (P > 0.05). Serum UCH-L1 and GFAP levels were significantly lower in the patients with WHO grade I-II tumors than in those with grade III-IV tumors (P < 0.05). Serum UCH-L1 and GFAP levels were lower in the patients with tumor diameter ≤ 5 cm than in those with diameter > 5 cm, in which the differences were statistically significant (P < 0.05). Glioma recurred in 22 patients. The preoperative and 3-d postoperative serum UCH-L1 and GFAP levels were significantly higher in the recurrence group than these in the non-recurrence group (P < 0.05). Receiver operating characteristic curves were plotted. The areas under the curves of preoperative serum UCH-L1 and GFAP levels for predicting postoperative glioma recurrence were 0.785 and 0.775, respectively. However, the efficacy of serum UCH-L1 and GFAP levels 3 d after surgery in predicting postoperative glioma recurrence was slightly lower compared with their preoperative levels. CONCLUSION: UCH-L1 and GFAP efficiently reflected the development and recurrence of gliomas and could be used as potential indicators for the recurrence and prognosis of glioma.

[Randomized double-blind placebo-controlled trial of Jingfang Granules in treatment of common cold(wind-cold syndrome)].

Jingfang Granules have the effects of inducing sweating to releasing exterior, dispersing wind and dispelling dampness. Modern studies have demonstrated that it has antipyretic and antiviral activities. Therefore, this trial was conducted to evaluate the efficacy and safety of Jingfang Granules in the treatment of common cold(wind-cold syndrome). A total of 138 common cold(wind-cold syndrome) patients meeting the inclusion and exclusion criteria were randomly assigned into the experimental group(n=92) and the placebo group(n=46) at a ratio of 2∶1 and respectively received Jingfang Granules and Jingfang Granules simulation agent. The treatment lasted for 5 d, and the follow-up time was 8 d. Recovery time was employed as the main indicator of efficacy. The median reco-very time of the experimental group was 3.33 d, shorter than that 7.00 d of the placebo group. The efficacy of the experimental group was better than that of the placebo group(P<0.000 1). The major symptom severity score-time AUC of the experimental group was 489.90±206.95, which was smaller than that of the placebo group(763.50±339.53). The recovery rate and marked effective rate of the experimental group were higher than those of the placebo group, The above outcomes were statistically significant between the two groups(P<0.05). The disappearance time and rate of single symptoms including aversion to cold, nasal congestion, runny nose, cough, headache, pharyngeal itching/pain, white sputum, and somatalgia also had significant differences between the two groups(P<0.05), indicating that Jingfang Granules had good performance in alleviating the above symptoms. During the study period, one case of the experimental group had a slight increase in serum creatinine, which returned to the normal level after re-examination. The incidence of adverse reactions was 1.10%, and no serious adverse reaction was found. The two groups had no significant difference in the incidence of adverse reactions. In conclusion, Jingfang Granules can significantly shorten the course of common cold(wind-cold syndrome) and quickly alleviate the clinical symptoms, demonstrating good safety and clinical advantages.

Identification of DAPK1 Promoter Hypermethylation as a Biomarker for Intra-Epithelial Lesion and Cervical Cancer: A Meta-Analysis of Published Studies, TCGA, and GEO Datasets.

Background: Promoter hypermethylation in death-associated protein kinase 1 (DAPK1) gene has been long linked to cervical neoplasia, but the established results remained controversial. Here, we performed a meta-analysis to assess the associations of DAPK1 promoter hypermethylation with low-grade intra-epithelial lesion (HSIL), high-grade intra-epithelial lesion (HSIL), cervical cancer (CC), and clinicopathological features of CC. Methods: Published studies with qualitative methylation data were initially searched from PubMed, Web of Science, EMBASE, and China National Knowledge Infrastructure databases (up to March 2018). Then, quantitative methylation datasets, retrieved from the Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) databases, were pooled to validate the results of published studies. Results: In a meta-analysis of 37 published studies, DAPK1 promoter hypermethylation progressively increased the risk of LSIL by 2.41-fold (P = 0.012), HSIL by 7.62-fold (P < 0.001), and CC by 23.17-fold (P < 0.001). Summary receiver operating characteristic curves suggested a potential diagnostic value of DAPK1 promoter hypermethylation in CC, with a large area-under-the-curve of 0.83, a high specificity of 97%, and a moderate sensitivity of 59%. There were significant impacts of DAPK1 promoter hypermethylation on histological type (odds ratio (OR) = 3.53, P < 0.001) and FIGO stage of CC (OR = 2.15, P = 0.003). Then, a pooled analysis of nine TCGA and GEO datasets, covering 13 CPG sites within DAPK1 promoter, identified eight CC-associated sites, six sites with diagnostic values for CC (pooled specificities: 74-90%; pooled sensitivities: 70-81%), nine loci associated with the histological type of CC, and all 13 loci with down-regulated effects on DAPK1 mRNA expression. Conclusion: The meta-analysis suggests that DAPK1 promoter hypermethylation is significantly associated with the disease severity of cervical neoplasia. DAPK1 methylation detection exhibits a promising ability to discriminate CC from cancer-free controls.

Outcome of papillary thyroid microcarcinoma: Study of 1,990 cases.

The present study examines the requirement of prophylactic neck node dissection in papillary thyroid microcarcinoma (PTMC) patients by analyzing high-risk factors of neck lymph node metastasis in PTMC. The clinical pathological data was a review of 1,990 patients diagnosed between January 2013 and January 2014. The data included information on patient gender, age, tumor size, multifocal, tumor pathological staging, bilateral thyroid cancer, the subtypes, BRAFV600E mutation, human telomerase reverse transcriptase (hTERT), extrathyroidal invasion and neck lymph node metastasis. The univariate analysis (χ2 test) showed that a number of factors were significantly associated with neck lymph node metastasis in PTMC (P<0.05): Male gender, aged <45 years, extrathyroidal invasion, bilateral thyroid cancer, various subtypes (package type, follicular variant, diffuse sclerosing variant, eosinophils, tall cell and column variant), BRAFV600E mutation-positive, hTERT mutation-positive, pt3/4 and multifocality. The multivariate analysis (regression binary logistic) showed that the male gender, <45 years, tumor size >5 mm, extrathyroidal invasion, bilateral thyroid tumors, multifocality, BRAFV600E mutation-positive, hTERT mutation-positive and pt3/4 are associated with the neck lymph node metastasis in PTMC (P<0.05). These paired analysis results show that the subtypes of PTMC with tumor size >5 mm is more common than the specific types of PTMC in which the tumor is ≤5 mm in neck lymph node metastasis. The neck lymph node metastasis incidence of the >45 years age group patients without high-risk factors in PTMC is 8.13 and 6.80%, respectively. In conclusion, PTMC patients with high-risk factors only are recommended to undergo a prophylactic lymph node dissection.

Treatment with Cordyceps sinensis enriches Treg population in peripheral lymph nodes and delays type I diabetes development in NOD mice.

Cordyceps sinensis is a widely used Chinese traditional herb with a long history. In China C. sinensis is usually applied in the treatment of respiratory diseases, however, the efficacy of C. sinensis still lacks experimental evidence. Type I diabetes is a multi-factor related autoimmune disease caused by cellular-mediated destruction of insulin-producing pancreatic beta cells in the islets in human. We tested C. sinensis for its ability to work as an immune modulator in NOD mice, an animal model which mimicks the progression of type I diabetes in humans and found that treatment with C. sinensis extract could slow down disease development in NOD mice. Further research also suggested that treatment with C. sinensis extract increased the frequency of Treg cells and IFN-gama producing Th1 cells in peripheral lymph nodes. However, C. sinensis has no effect on the natural Treg cell differentiation in thymus.

Removal of a broken guide wire entrapped in a fractured femoral neck.

Guide wire plays an important role in the fixation of femoral neck fracture with dynamic hip screw (DHS). Breakage of a guide wire during operation is a very rare condition. We met such a dilemma in DHS fixation of a 54-year-old male patient who sustained Garden type IV fracture of the right femoral neck. The distal end of the guide wire broke and was entrapped in the fractured femoral neck. We tried to get the broken part out by a cannulated drill. Reaming was started with the cannulated drill slowly rotating around the guide K-wire until the reamer fully contained the target under fluoroscope. A bone curette was used to get the broken wire out but failed, so we had to use the cannuated drill to dredge this bone tunnel. Finally the broken wire end was taken out, mixed with blood and bone fragments. Through the existing drilling channel, DHS fixation was easily finished. The patient had an uneventful recovery without avascular necrosis of femoral head or non-union of the fracture at one year's follow-up. A few methods can be adopted to deal with the broken guide wire. The way used in our case is less invasive but technically challenging. When the guide wire is properly positioned, this method is very practical and useful.

The effect of familial aggregation on the children with primary nocturnal enuresis.

OBJECTIVE: To evaluate the effect of familial aggregation on the children with PNE by evaluating nocturnal urine output, bladder, and arouse function. PATIENTS AND METHODS: According to whether relatives of family of probands over three generations were affected by PNE, forty-five children with familial aggregation PNE (FPNE), seventy children with sporadic PNE (SPNE) and ten children with normal lower urinary tract function but waiting for operation (control group) were included. Questionnaire of arousal from sleep (AS scores), bladder diary and daytime urodynamic studies were performed in all patients. RESULTS: The incidences of severe PNE and nonmonosymptomatic PNE in FPNE group were significantly higher than those in SPNE group. The nocturnal urine output and AS scores in both PNE groups was significantly higher, maximal voided volume significantly smaller than those in control group. Moreover, the incidences of small bladder in FPNE group was 44%, significantly higher than that in SPNE group (21%), but no significantly difference was found in nocturnal polyuria and arousal AS scores between two PNE groups. There were 53% patents with daytime detrusor overactivity and 60% patents with urodynamic functional bladder outflow obstruction in FPNE group, significantly higher than those in SPNE group (19% and 37%). Maximum cystometric capacity significantly decreased from control group to FPNE group. CONCLUSION: Familial aggregation has significant effects on the children with PNE, and FPNE are more likely to be severe symptoms and bladder dysfunction. It would be beneficial to have an urodynamic study for their diagnosis and treatment. Neurourol. Urodynam. 28:423-426, 2009. (c) 2008 Wiley-Liss, Inc.

Family and segregation studies: 411 Chinese children with primary nocturnal enuresis.

BACKGROUND: The aim of the present paper was to determine the incidence of primary nocturnal enuresis (PNE) among relatives of Chinese children with PNE, the inheritance pattern, and to identify the characteristics of PNE with positive family history. METHODS: From July 2003 to June 2004, an epidemiological survey on PNE children was carried out by self-administered questionnaires to parents of 5-18-year-old Chinese students in Henan Province, central China. A detailed family history was recorded in order to determine the presence of familial PNE as defined as any close relative with PNE beyond the age of 5 years. RESULTS: The response rate was 88% (10 383/11 799), and 411 children (235 boys and 176 girls) with PNE were identified. A positive family history was found in 94 families (22.87%) of 411 probands with PNE, including 48.94% of fathers, 8.51% of mothers, 6.38% of both parents, 6.38% of the siblings and 29.79% of grandfathers or (and) mothers. Among the probands the ratio of male to female was 1.3:1 excluding sex-linked inheritance. Autosomal dominant inheritance was in 14.60%, and autosomal recessive inheritance was consistent in 1.46% of families. In PNE children with positive family history, the proportion of adolescents, with associated daytime symptoms, marked PNE and seeking professional help were significantly higher than those in PNE children without positive family history. CONCLUSIONS: PNE has a significant family clustering, and all modes of inheritance can occur in different families on the basis of a formal genetic analysis. Those with positive family history often manifest marked PNE, and have daytime symptoms.

Bed-wetting in Chinese children: epidemiology and predictive factors.

AIMS: To estimate the prevalence and severity of bed-wetting in 1-18-year-old Chinese children. MATERIALS AND METHODS: A cross-sectional study of bed-wetting was performed by using 13,515 self-administered questionnaires distributed to the parents of 1-18-year-old Chinese children in Henan province. The prevalence of bed-wetting was determined. The relationship of wetting to age, gender, community characteristics (rural or urban), arousal dysfunction, associated day-time symptoms (frequency, urgency, and incontinence), and family history were analyzed. RESULTS: There was a response rate of 87% (5,978 boys and 5,786 girls). The overall prevalence of bed-wetting was 23.03% in those aged 1-4, 5.66% in those 5-12, and 1.37% in those 13-18. When a logistic regression analysis was applied to determine risk factors for the bed-wetting, a positive relationship was seen with male gender and living in rural areas. Further, living in rural areas, arousal dysfunction, and associated day symptoms were significantly related to more severe bed-wetting. Only 3.64% of the children had undergone professional evaluation. CONCLUSION: The prevalence of bed-wetting is significant in Chinese children, but lower than in most western countries, which is likely due to cultural differences. Living in rural areas, having arousal dysfunction, and having associated day-time symptoms may be predicative factors for marked bed-wetting.

[Soy isoflavones with supplemental calcium provide protection against the loss of bone mass and influence insulin-like growth factor (IGF)-I after ovariectomy in rat].

OBJECTIVE: To compare the effects of soy isoflavone with supplemental calcium to soy isoflavone or Ca alone on preservation of bone mineral density (BMD) and the expression of insulin-like growth factor (IGF)-I. METHODS: Sprague-Dawley (SD) female Rats, 6 months old, were ovariectomized and randomized into five groups: sham-operated group (n = 10) or ovx (n = 40) group. Shams were fed a 3.272 g/kg Ca diet. Ovx rats were randomized to a 3.272 g/kg Ca diet alone (OVX) or with soy isoflavone (SI) extract (37.95 mg/kg.bw) or to a supplemental Ca diet (Ca, 4.676 g/kg) alone or a supplemental Ca diet with the isoflavone extract (SI + Ca) for 12 weeks. BMD of femur was measured by scanner of bone mineral density. The level of IGF-1 mRNA expression was measured by reverse transcriptase-polymerase chain reaction (RT-PCR), respectively. RESULTS: There was no significant difference between group Sham (0.267 +/- 0.008) and group SI + Ca (0.263 +/- 0.007) g/cm(2) (P > 0.05) on femur BMD of distal end. Femur BMD of distal end in group Sham and group SI + Ca was greater (P < 0.05) as compared to group OVX (0.245 +/- 0.005) g/cm(2), SI (0.258 +/- 0.011) g/cm(2) or Ca (0.255 +/- 0.004) g/cm(2), P < 0.05. The liver tissue IGF-1 mRNA contents (IGF-1 cDNA/B-actin cDNA) were significantly decreased in group Sham (0.200 +/- 0.023) g/cm(2), SI (0.278 +/- 0.019) g/cm(2), Ca (0.302 +/- 0.026) g/cm(2) or SI + Ca (0.231 +/- 0.025) g/cm(2) as compared to group OVX (0.362 +/- 0.031) g/cm(2), P < 0.05; The liver tissue IGF-1 mRNA contents (IGF-1 cDNA/B-actin cDNA) were significantly decreased in group SI + Ca (0.231 +/- 0.025) g/cm(2) compared to group SI (0.278 +/- 0.019) g/cm(2) and Ca (0.302 +/- 0.026) g/cm(2), P < 0.05. CONCLUSIONS: Soy isoflavones combined with supplemental Ca are more protective against the loss of femur BMD than soy isoflavones or supplemental Ca diet alone. The dose of SI (37.95 mg/kg.bw) might significantly restrain the rising of the liver tissue IGF-1 mRNA contents caused by ovariectomy.

Is it possible to use urodynamic variables to predict upper urinary tract dilatation in children with neurogenic bladder-sphincter dysfunction?

OBJECTIVE: To investigate the possibility of using urodynamic variables to predict upper urinary tract dilatation (UUTD) in children with neurogenic bladder-sphincter dysfunction (NBSD). PATIENTS AND METHODS: The study included 200 children with NBSD, of whom 103 had UUTD and 97 did not; they were examined using routine urological, neurological and urodynamic methods. The group with UUTD was divided into three subgroups (group 1-3, from mild to severe hydronephrosis). A urodynamic risk score (URS) was calculated, including a detrusor leak-point pressure (DLPP) of >40 cmH2O, a bladder compliance (BC) of <9 mL/cmH2O and evidence of acontractile detrusor (ACD). RESULTS: The postvoid residual urine volume (PVR), DLPP, incidences of ACD and DLPP of >40 cmH2O were greater and the BC significantly less in groups 1-3 than in the control group. Moreover, the BC decreased, while the PVR, DLPP and the incidence of DLPP of >40 cmH2O were significantly higher in group 3 than in group 2. The relative safe cystometric capacity of groups 2 and 3 were lower, respectively, than that of the control and group 1, and the relative unsafe cystometric capacity (RUCC) and relative risk rate of cystometric capacity (RRRCC) were significantly greater with the severity of UUTD. The maximum detrusor pressure on voiding or at maximum flow rate, and the Abrams-Griffiths number for voluntary contractile bladders, of the UUTD group were significantly higher than those of the control group. There was a positive correlation between URS and UUTD. CONCLUSIONS: The selective use of urodynamic variables might be valuable for predicting the risk of UUTD in children with NBSD. Decreased BC, and increased DLPP and ACD are the main urodynamic risk factors, and they reciprocally increase the occurrence and grades of UUTD. The grades of UUTD are compatible with increases in RUCC, RRRCC and URS.

Gastroduodenal ulcer treated by pylorus and pyloric vagus-preserving gastrectomy.

AIM:To evaluate the curative effect of pylorus and pyloric vagus-preserving gastrectomy (PPVPG) on peptic ulcer.METHODS:Treating 132 cases of GU and DU with PPVPG, and comparative studies made with 24 cases treated with Billroth II (B II ) and 20 cases with Billroth I(BI); advantages and shortcomings evaluated.RESULTS:Not a single death after PPVPG. No recurrence of the disorder in the subsequent follow-up for an average of 6.5 years. Curative effect (visik II & I) 97.7%. Acidity reduction similar to that found in B II and BI, but 97.7% of the B II and all BIcases having more than second degree intestinal fluid reflux, in contrast to 7.1% in PPVPG cases. Dumping syndrome occurred in the B II and BI cases, none in PPVPG cases. With regard to gastric emptying, food digestion, absorption, body weight and life quality, PPVPG proved to be superior to Billroth procedure.CONCLUSION:PPVPG has the advantages of conventional Billroth gastrectomy in reducing acid, removing ulcer focus, and at the same time preserves the pylorus and pyloric vagus for maintaining the normal gastric physiological function.Dumping syndrome,intestinal fluid reflux and other complications of conventional gastrectomy may be avoided.