Efficacy of early hyperbaric oxygen combined with median nerve electrical stimulation in the treat-ment of severe traumatic brain injury and its impact on hemodynamics,coma degree and neurologi-cal function / 新乡医学院学报

Objective To explore the efficacy of early hyperbaric oxygen therapy(HBOT)combined with median nerve electrical stimulation(MNES)in the treatment of severe traumatic brain injury(sTBI)and its impact on hemodynamics,coma degree,and neurological function of patients.Methods A total of 78 patients with sTBI admitted to the General Hospital of Western Theater Command from March 2020 to October 2021 were selected as the research subjects.The patients were randomly divided into the control group and the observation group,with 39 patients in each group.The patients in both groups underwent basic treatments such as water,electrolyte and acid-base balance,nutritional support,anti-infection,and decompressive craniectomy.On this basis,patients in the control group received early HBOT,while patients in the observation group received both HBOT and MNES.Their clinical efficacy was compared between the two groups.Before and after treatment,dual-channel transcranial Doppler ultrasound was performed to detect hemodynamic indicators such as peak systolic blood flow velocity(Vs),mean blood flow velocity(Vm),and pulsatility index(PI)in the middle cerebral artery of patients in the two groups.The Glasgow Coma Scale(GCS)score was used to evaluate the degree of coma of patients in the two groups,the National Institutes of Health Stroke Scale(NIHSS)score was used to assess the neurological deficits of patients in the two groups,and the enzyme-linked immunosorbent assay was used to measure the levels of central nervous system specific protein(S100-β),glial fibrillary acidic protein(GFAP),and myelin basic protein(MBP).Complications during treatment of patients in the two groups were recorded,and their incidence was compared.Results The total effective rate of patients in the control and observation groups was 79.49％(31/39)and 92.31％(36/39),respectively.The total effective rate in the observation group was significantly higher than that in the control group(x2=8.971,P＜0.05).There was no significant difference in Vm,Vs,and PI between the two groups before treatment(P＞0.05).After treatment,the Vm and Vs in both groups were significantly higher than those before treatment,while the PI was significantly lower than that before treatment(P＜0.05);and the Vm and Vs in the observation group were signifi-cantly higher than that those in the control group,while the PI was significantly lower than that in the control group(P＜0.05).There was no significant difference in GCS and NIHSS scores between the two groups before treatment(P＞0.05).After treatment,the GCS score in both groups was significantly higher than that before treatment,while the NIHSS score was significantly lower than that before treatment(P＜0.05);and the GCS score in the observation group was significantly higher than that in the control group,while the NIHSS score was significantly lower than that in the control group(P＜0.05).There was no significant difference in S100-β,GFAP,and MBP levels between the two groups before treatment(P＞0.05).After treatment,the S100-β,GFAP,and MBP levels in both groups were significantly lower than those before treatment(P＜0.05),and the S100-β,GFAP,and MBP levels in the observation group were significantly lower than those in the control group(P＜0.05).During treatment,the incidence of complications in the control and observation groups was 23.08％(9/39)and 20.51％(8/39),respectively,showing no significant difference(x2=2.328,P＞0.05).Conclusion Early HBOT combined with MNES shows good efficacy in treating sTBI,which can effectively improve the patients'hemodynamic level,alleviate the severity of coma,enhance neurological function,and promote early recovery of consciousness,without increased risk of complications.

PDHA1 promotes proliferation,invasion and metastasis of triple-nega-tive breast cancer cells / 中国病理生理杂志

AIM:One of the important characteristics of the occurrence and development of triple-negative breast cancer(TNBC)is dysregulated cell metabolism.The aim of this study is to investigate the mechanism of pyruvate dehydrogenase E1 subunit alpha 1(PDHA1),a key enzyme component in aerobic glycolysis,affecting the proliferation,metastasis and invasion of TNBC.METHODS:(1)The expression levels of PDHA1 in breast cancer tissues and adja-cent tissues were analyzed by UALCAN database,KM-plotter database,Gene MANIA database and TCGA database.The expression of PDHA1 was compared according to tumor pathological stage,subtype classification and breast cancer bio-markers.The function of PDHA1 in TNBC was explored by gene enrichment analysis.(2)Immunohistochemistry assays were used to detect the expression of PDHA1 in human TNBC tissue and adjacent tissue samples.(3)Stable PDHA1 knockout and PDHA1 rescue TNBC MDA-MB-231 cells were constructed.The proliferation of MDA-MB-231 cells was de-tected by colony formation assay and cell counting assay.The regulatory effect of PDHA1 on the invasion and migration of MDA-MB-231 cells was detected by in vitro scratch assay and Transwell migration assay.RESULTS:Database analysis showed that the group with high PDHA1 expression in breast cancer had shorter survival and worse prognosis.In clinical specimens,the expression of PDHA1 in cancer tissues was higher than that in adjacent normal tissues.Knockout of PDHA1 inhibited the proliferation,metastasis,invasion and epithelial-mesenchymal transition of MDA-MB-231 cells.CONCLUSION:PDHA1 is overexpressed in TNBC,and it promotes cell proliferation and facilitates TNBC metastasis through the epithelial-mesenchymal transition pathway.

Silencing essential meiotic endonuclease 1 inhibits the proliferation of liver cancer cells： A study of related mechanisms / 临床肝胆病杂志

ObjectiveTo investigate the expression of essential meiotic endonuclease 1 （EME1） in liver cancer tissue and its effect on the biological behavior of hepatoma cells. MethodsThe TCGA database was used to identify the differentially expressed genes between liver cancer tissue and paracancerous tissue. Immunohistochemistry and Western Blot were used to measure the expression abundance of EME1 in liver cancer tissue. A lentivirus was constructed by short hairpin RNA， and BEL-7404 cells were transfected with the lentivirus to interfere with the expression of the EME1 gene； the cells were divided into silencing group （shEME1 group） and control group （shCtrl group）. Quantitative real-time PCR and Western Blot were used to measure the mRNA and protein expression levels of EME1； Celigo Image Cytometer and MTT assay were used to measure cell proliferation rate； flow cytometry was used to observe cell cycle； Caspase 3/7 activity was used to measure cell apoptosis. The independent-samples t-test was used for comparison between two groups. ResultsTCGA results showed that the mRNA expression level of EME1 in liver cancer tissue was 18.9 times that in paracancerous tissue （t=5.00， P<0.001）， and the protein expression level of EME1 in liver cancer tissue was 7.0 times （based on immunohistochemistry： 8.4±2.6 vs 1.2±0.4， t=7.55， P<0.001） or 2.5 times （based on Western Blot： 249.0%±35.5% vs 100.0%±77.8%， t=3.02， P<0.05） that in paracancerous tissue. After lentivirus infection， compared with the shCtrl group， the shEME1 group had an mRNA expression level of EME1 reduced by 29.9% （29.9%±0.9% vs 100.0%±3.6%， t=32.82， P<0.001）， a protein expression level of EME1 reduced by 35.7% （35.7%±14.9% vs 100.0%±28.9%， t=3.42， P<0.05）， and a level of cell counting reduced by 45.1% （4 053±167 vs 8 988±477， t=16.91， P<0.001）， as well as a level of cell activity reduced to 66.9% （0.518±0.046 vs 0.774±0.022， t=8.74， P<0.001） and a level of colony forming ability reduced to 29.0% （75±6 vs 260±9， t=28.92， P<0.001）. Compared with the shCtrl group， the shEME1 group had a significant increase in the proportion of cells in G1 phase （49.9% vs 44.0%， t=8.96， P<0.001） and significant reductions in the proportion of cells in G2/M phase （15.9% vs 17.9%， t=9.13， P<0.001） and S phase （34.2% vs 38.1%， t=6.91， P<0.001）， while Caspase 3/7 activity was enhanced by 1.5 times （145.8%±5.9% vs 100.0%±2.3%， t=12.50， P<0.001）. ConclusionEME1 is highly expressed in liver cancer tissue， and silencing the EME1 gene can inhibit the proliferation of hepatoma cells and promote cell apoptosis.

The combination of berberine and cinnamon polyphenol can improve glucose metabolism in T2DM rats through Bas-TGR5-GLP-1 / 药学学报

Berberine (BBR) is the main pharmacological active ingredient of Coptidis, which has hypoglycemic effect, but its clinical application is limited due to its poor oral bioavailability. Polyphenols, derived from cinnamon, are beneficial for type 2 diabetes mellitus (T2DM). The combination of both may have an additive effect. The aim of this study was to investigate the hypoglycemic effect and mechanism of combined medication in diabetic rats. The modeling rats were randomly divided into 5 groups (berberine group, cinnamon group, combined group, metformin group, diabetic control group) and normal control group. The animal experiments were approved by the Animal Ethics Committee (approval number: HMUIRB2022003). The subjects were given orally, and the control group was given equal volume solvent and body weight was measured weekly. Thirty days after administration, oral glucose tolerance test and insulin sensitivity test were performed, and fasting blood glucose (FBG), glycated serum protein (GSP), and serum insulin (INS) levels were detected; high-throughput sequencing technology was used to detect intestinal microbiota structure; real-time quantitative PCR (RT-qPCR) and Western blot were used to detect G protein-coupled receptor 5 (TGR5) and glucagon-like peptide-1 (GLP-1) expression levels. The results showed that, compared with the diabetic control group, the levels of FBG (P < 0.01) and GSP (P < 0.01) in the combined group were lower, and the insulin resistance was improved, which was better than that in the berberine group. Combined treatment increased the relative abundance of Bacteroides, Prevotella and Lactobacillus, reversed the decrease in Lactobacillus in the berberine alone induction group, and the combination of the two could promote the expression of TGR5 and GLP-1. In summary, the combined application of cinnamon and berberine can regulate glucose metabolism better than the application of berberine alone. Berberine combined with cinnamon can improve the function of pancreatic islet β cells in diabetes mellitus type 2 rats by changing the intestinal microbiota, increasing the expression of TGR5 and GLP-1 proteins, and thereby better regulating glucose metabolism.

Visualization Analysis on Research Literature about Acupuncture Treatment of Vascular Dementia from 2003 to 2023 / 中国中医药信息杂志

Objective To analyze the status and development direction of acupuncture treatment for vascular dementia from 2003 to 2023;To provide reference for related research.Methods Relevant literature on acupuncture treatment for vascular dementia was retrieved from CNKI,Wanfang Data,and VIP from January 2003 to September 2023.NoteExpress 3.7.0 and CiteSpace 5.7.R5 software were used to analyze keywords,authors,research institutions,and visualize knowledge maps.Results A total of 934 articles were included in the analysis,showing a slow fluctuating upward trend in publication volume.The study involved 653 authors,with prolific contributors such as Lai Xinsheng,Liu Zhibin,and Niu Wenmin.It included 449 research institutions,with prominent contributors being the First Affiliated Hospital of Heilongjiang University of Chinese Medicine,Heilongjiang University of Chinese Medicine,and Guangzhou University of Chinese Medicine.Additionally,635 keywords were identified,forming 23 clusters.High-frequency keywords included"cognitive function","rats",and"hippocampus".Conclusion The protection and repair of nerves by acupuncture,the improvement of cognitive function,the comprehensive treatment mode,and the prevention of vascular dementia may be the research hotspots and trends in this field.

Trichinella spiralis cathepsin L induces macrophage M1 polarization via the NF-κB pathway and enhances the ADCC killing of newborn larvae.

BACKGROUND: During the early stages of Trichinella spiralis infection, macrophages predominantly undergo polarization to the M1-like phenotype, causing the host's inflammatory response and resistance against T. spiralis infection. As the disease progresses, the number of M2-type macrophages gradually increases, contributing to tissue repair processes within the host. While cysteine protease overexpression is typically associated with inflammation, the specific role of T. spiralis cathepsin L (TsCatL) in mediating macrophage polarization remains unknown. The aim of this study was to assess the killing effect of macrophage polarization mediated by recombinant T. spiralis cathepsin L domains (rTsCatL2) on newborn larvae (NBL). METHODS: rTsCatL2 was expressed in Escherichia coli strain BL21. Polarization of the rTsCatL2-induced RAW264.7 cells was analyzed by enzyme-linked immunosorbent assay (ELISA), quantitative PCR (qPCR), western blot, immunofluorescence and flow cytometry. The effect of JSH-23, an inhibitor of nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB), on rTsCatL2-induced M1 polarization investigated. Cytotoxic effects of polarized macrophages on NBL were observed using in vitro killing assays. RESULTS: Following the co-incubation of rTsCatL2 with RAW264.7 murine macrophage cells, qPCR and ELISA revealed increased transcription and secretion levels of inducible nitric oxide synthase (iNOS), interleukin (IL)-6, IL-1ß and tumor necrosis factor alpha (TNF-α) in macrophages. Western blot analysis showed a significant increase in iNOS protein expression, while the expression level of arginase-1 protein remained unchanged. Flow cytometry revealed a substantial increase in the number of CD86-labeled macrophages. The western blot results also indicated that rTsCatL2 increased the expression levels of phospho-NF-κB and phospho-nuclear factor-κB inhibitor alpha (IκB-α) proteins in a dose-dependent manner, while immunofluorescence revealed that rTsCatL2 induced nuclear translocation of the p65 subunit of NF-κB (NF-κB p65) protein in macrophages. The inhibitory effect of JSH-23 suppressed and abrogated the effect of rTsCatL2 in promoting M1 macrophage polarization. rTsCatL2 mediated polarization of macrophages to the M1-like phenotype and enhanced macrophage adhesion and antibody-dependent cell-mediated cytotoxicity (ADCC) killing of NBL. CONCLUSIONS: The results indicated that rTsCatL2 induces macrophage M1 polarization via the NF-κB pathway and enhances the ADCC killing of NBL. This study provides a further understanding of the interaction mechanism between T. spiralis and the host.

Can Yoga Pranayama Practices Improve Burnout in Elite Mountain Bikers: A Single-arm Pilot Study.

Mountain bike (MTB) racing is a highly intensive physical activity and requires a high degree of technical ability to perform at the elite athlete level, which might compromise mental well-being, increasing symptoms of anxiety and depression through overtraining, injury, and burnout. Yoga Pranayama is the key to bringing about psychosomatic integration and harmony. This study aimed to explore the effects of yoga pranayama practices (YPP) on elite mountain bikers' burnout. This is a single-arm pilot study. Twenty-seven subjects practiced 30 sessions of YPP seven times a week for 1 month. The outcomes measured were blood biochemical parameters accompanied by complete blood count and athlete burnout score. Cubital vein blood test and burnout questionnaire were conducted at baseline and after 1 month. Test results showed a significant decrease in cortisol (CO) (P = 0.001) and urea nitrogen (P < 0.001) and an increase in testosterone: CO ratio (P = 0.001). This study indicates that YPP might improve burnout in elite mountain bikers.

5-Azacytidine promotes HCC cell metastasis by up-regulating RDH16 expression.

The level of DNA methylation could affect the expression of tumor promoting and tumor suppressor genes. DNA methyltransferase inhibitors could reduce high methylation levels in cancer and inhibit the progression of a variety of cancers, including HCC. However, the pro-metastatic effect of DNA methyltransferase inhibitors in some cancers suggest the potential risk of their use. Whether DNA methyltransferase inhibitors also promote metastasis in HCC remains unclear. Our study will explore the effect of DNA methyltransferase inhibitor 5-Azacytidine on HCC metastasis. Our study found that 5-Azacytidine inhibited the proliferation of HCC cells while promoting in vitro and in vivo metastasis of HCC. Mechanistically, our study showed that 5-Azacytidine increased the expression of RDH16 by decreasing the methylation of RDH16 gene promoter. RDH16 is a highly methylated gene and its expression is very low in hepatocellular carcinoma. 5-Azacytidine promoted the migration of hepatocellular carcinoma cells by increasing the expression of RDH16. Our results suggest that 5-Azacytidine up-regulates the expression of RDH16 by decreasing the methylation level of RDH16, and then promoting HCC metastasis. These findings suggest that 5-Azacytidine and even other DNA methyltransferase inhibitors may have the risk of promoting metastasis in HCC treatment. RDH16 could be used as a pro-metastasis biomarker in the treatment of HCC with DNA methyltransferase inhibitors.

Two putative novel serotypes of Tibet orbivirus isolated from Culicoides spp.in Yunnan, China

Tibet orbivirus (TIBOV) was identified as a novel orbivirus in 2014. Antibodies against TIBOV were detected in cattle, Asian buffalo, and goats, while all the sequenced TIBOV strains were isolated from mosquitos and Culicoides. The known TIBOV strains have been classified into four putative serotypes. In this study, two TIBOV strains isolated from Culicoides spp. in Shizong County of Yunnan Province, China, were fully sequenced. The phylogenetic analysis of outer capsid protein 2 (VP2) indicated that these two viral strains belong to two novel putative serotypes of TIBOV. The updated putative serotypes may help in an investigation of the distribution and virulence of TIBOV.

Research progress in 2023 ASCO-GU prostate cancer / 现代泌尿外科杂志

The 2023 American Society of Clinical Oncology Genitourinary Cancers Symposium unveiled numerous research advances which provide meaningful insights into the selection of treatment regimens of prostate cancer. Precision multi-treatment based on patients’ characteristics has become the predominant approach, including the use of a three-drug combination therapy for metastatic hormone-sensitive prostate cancer, and poly adenosine diphosphate ribose polymerase inhibitor therapy for metastatic castration-resistant prostate cancer. Nuclear medicine therapy and radiotherapy are also receiving significant attention. Integrated nuclear medicine diagnosis and therapy show immense potential for non-metastatic castration-resistant prostate cancer. Additionally, for localized prostate cancer, stereotactic body radiotherapy is a preferred alternative to surgery. This article sheds light on several key studies presented at the conference, focuses on prostate cancer treatment at different stages, and intends to enhance the therapeutic outcome for prostate cancer patients.

Dermatomyositis with kidney neoplasm: two cases report and literature review / 中华泌尿外科杂志

Objective:To investigate the clinical characteristics, diagnosis and treatment of dermatomyositis with kidney neoplasm.Methods:The data of two patients with dermatomyositis complicated with kidney neoplasm in Tongji Hospital from January to February 2022 were retrospectively analyzed. The first case was a 55-year-old female, who was admitted with the chief complaints of recurrent erythema of upper extremities for 2 months and facial erythema for 1 month. Physical examination: erythema can be seen on upper limbs and face, no tenderness or percussion pain in kidney area. Myositis enzyme profile test showed that anti-Mi-2 antibody and anti-SSA /Ro-52 antibody were positive. Contrast CT showed nodular uneven enhancement in the right kidney with a size of 50 mm×41 mm. The second case was a 58-year-old female, who was admitted with the chief complaints of kidney occupying for a month. Physical examination: flaky erythema on face, no tenderness or percussion pain in kidney area. Myositis enzyme profile test showed that anti-Ro-52 antibody and anti-MDA5 antibody were positive. Contrast CT showed a significantly uneven enhanced mass with a size of about 50 mm×41 mm on left kidney. Both patients were diagnosed with kidney neoplasm before surgery and underwent laparoscopic partial nephrectomy in Tongji Hospital.Results:Both patients received regular oral prednisone after surgery. The pathological presentation of case 1 was papillary renal cell carcinoma, the facial erythema subsided 1 month after surgery, and there was no tumor recurrence for 13 months. The pathological presentation of case 2 was clear cell renal cell carcinoma, facial erythema subsided 2 weeks after surgery, and there was no tumor recurrence for 12 months.Conclusions:The diagnosis of dermatomyositis should be combined with clinical manifestations and laboratory examination, and the possibility of malignant tumor should be excluded due to the high likelihood of concomitant malignancy. For patients with dermatomyositis with kidney neoplasm, the main treatment is still surgery, and supplemented with glucocorticoid therapy.

Analysis of the causes of long-standing pelvic anterior sacral space infection and discussion of management techniques / 中华肿瘤杂志

Objective: To investigate the causes and management of long-term persistent pelvic presacral space infection. Methods: Clinical data of 10 patients with persistent presacral infection admitted to the Cancer Hospital of Zhengzhou University from October 2015 to October 2020 were collected. Different surgical approaches were used to treat the presacral infection according to the patients' initial surgical procedures. Results: Among the 10 patients, there were 2 cases of presacral recurrent infection due to rectal leak after radiotherapy for cervical cancer, 3 cases of presacral recurrent infection due to rectal leak after radiotherapy for rectal cancer Dixons, and 5 cases of presacral recurrent infection of sinus tract after adjuvant radiotherapy for rectal cancer Miles. Of the 5 patients with leaky bowel, 4 had complete resection of the ruptured nonfunctional bowel and complete debridement of the presacral infection using an anterior transverse sacral incision with a large tipped omentum filling the presacral space; 1 had continuous drainage of the anal canal and complete debridement of the presacral infection using an anterior transverse sacral incision. 5 post-Miles patients all had debridement of the presacral infection using an anterior transverse sacral incision combined with an abdominal incision. The nine patients with healed presacral infection recovered from surgery in 26 to 210 days, with a median time of 55 days. Conclusions: Anterior sacral infections in patients with leaky gut are caused by residual bowel secretion of intestinal fluid into the anterior sacral space, and in post-Miles patients by residual anterior sacral foreign bodies. An anterior sacral caudal transverse arc incision combined with an abdominal incision is an effective surgical approach for complete debridement of anterior sacral recalcitrant infections.

Expression of β-xylosidase An-xyl from Aspergillus niger and characterization of its xylose tolerance / 生物工程学报

The hydrolysis of xylo-oligosaccharides catalyzed by β-xylosidase plays an important role in the degradation of lignocellulose. However, the enzyme is easily inhibited by its catalytic product xylose, which severely limits its application. Based on molecular docking, this paper studied the xylose affinity of Aspergillus niger β-xylosidase An-xyl, which was significantly differentially expressed in the fermentation medium of tea stalks, through cloning, expression and characterization. The synergistic degradation effect of this enzyme and cellulase on lignocellulose in tea stems was investigated. Molecular docking showed that the affinity of An-xyl to xylose was lower than that of Aspergillus oryzae β-xylosidase with poor xylose tolerance. The Ki value of xylose inhibition constant of recombinant-expressed An-xyl was 433.2 mmol/L, higher than that of most β-xylosidases of the GH3 family. The Km and Vmax towards pNPX were 3.6 mmol/L and 10 000 μmol/(min·mL), respectively. The optimum temperature of An-xyl was 65 ℃, the optimum pH was 4.0, 61% of the An-xyl activity could be retained upon treatment at 65 ℃ for 300 min, and 80% of the An-xyl activity could be retained upon treatment at pH 2.0-8.0 for 24 h. The hydrolysis of tea stem by An-xyl and cellulase produced 19.3% and 38.6% higher reducing sugar content at 2 h and 4 h, respectively, than that of using cellulase alone. This study showed that the An-xyl mined from differential expression exhibited high xylose tolerance and higher catalytic activity and stability, and could hydrolyze tea stem lignocellulose synergistically, which enriched the resource of β-xylosidase with high xylose tolerance, thus may facilitate the advanced experimental research and its application.

A Novel Chinese Medicine Formula Inhibits Non-small Cell Lung Cancer by Triggering Oxidative Stress Dependent on Pentose Phosphate Pathway / 中国肺癌杂志

BACKGROUND@#Non-small cell lung cancer (NSCLC) is one of the most lethal malignancies worldwide. A novel Chinese medicine formula-01 (NCHF-01) has shown significant clinical efficacy in the treatment of NSCLC, but the mechanism of this formula in the treatment of NSCLC is not fully understood. The aim of this study is to investigate the molecular mechanism of NCHF-01 in inhibiting NSCLC.@*METHODS@#Lewis lung cells (LLC) tumor bearing mice were established to detect the tumor inhibitory effect of NCHF-01. The morphological changes of tissues and organs in LLC tumor-bearing mice were detected by hematoxylin-eosin (HE) staining. NSCLC cells were treated by NCHF-01. The effects of cell viability and proliferation were detected by MTT and crystal violet staining experiment. Flow cytometry was used to detect cell cycle, apoptosis and reactive oxygen species (ROS). Network pharmacology was used to predict the mechanism of its inhibitory effect of NSCLC. Western blot and immunohistochemistry (IHC) were used to detect the expression of related proteins.@*RESULTS@#NCHF-01 can inhibit tumor growth in LLC tumor-bearing mice, and has no obvious side effects on other tissues and organs. NCHF-01 could inhibit cell viability and proliferation, induce G2/M phase arrest and apoptosis, and promote the increase of ROS level. Network pharmacological analysis showed that NCHF-01 exerts anti-NSCLC effects through various biological processes such as oxidative stress and central carbon metabolism. NCHF-01 can reduce the protein expression and enzyme activity of the key enzymes 6-phosphate glucose dehydrogenase (G6PD) and 6-phosphogluconate dehydrogenase (6PGD) in the pentose phosphate pathway (PPP).@*CONCLUSIONS@#NCHF-01 can inhibit NSCLC through oxidative stress dependent on the PPP.

Phosphorylated PKM2 regulates endothelium-dependent vasodilation in diabetes / 中南大学学报(医学版)

OBJECTIVES@#Endothelium-dependent vasodilation dysfunction is the pathological basis of diabetic macroangiopathy. The utilization and adaptation of endothelial cells to high glucose determine the functional status of endothelial cells. Glycolysis pathway is the major energy source for endothelial cells. Abnormal glycolysis plays an important role in endothelium-dependent vasodilation dysfunction induced by high glucose. Pyruvate kinase isozyme type M2 (PKM2) is one of key enzymes in glycolysis pathway, phosphorylation of PKM2 can reduce the activity of pyruvate kinase and affect the glycolysis process of glucose. TEPP-46 can stabilize PKM2 in its tetramer form, reducing its dimer formation and phosphorylation. Using TEPP-46 as a tool drug to inhibit PKM2 phosphorylation, this study aims to explore the impact and potential mechanism of phosphorylated PKM2 (p-PKM2) on endothelial dependent vasodilation function in high glucose, and to provide a theoretical basis for finding new intervention targets for diabetic macroangiopathy.@*METHODS@#The mice were divided into 3 groups: a wild-type (WT) group (a control group, C57BL/6 mice) and a db/db group (a diabetic group, db/db mice), which were treated with the sodium carboxymethyl cellulose solution (solvent) by gavage once a day, and a TEPP-46 group (a treatment group, db/db mice+TEPP-46), which was gavaged with TEPP-46 (30 mg/kg) and sodium carboxymethyl cellulose solution once a day. After 12 weeks of treatment, the levels of p-PKM2 and PKM2 protein in thoracic aortas, plasma nitric oxide (NO) level and endothelium-dependent vasodilation function of thoracic aortas were detected. High glucose (30 mmol/L) with or without TEPP-46 (10 μmol/L), mannitol incubating human umbilical vein endothelial cells (HUVECs) for 72 hours, respectively. The level of NO in supernatant, the content of NO in cells, and the levels of p-PKM2 and PKM2 protein were detected. Finally, the effect of TEPP-46 on endothelial nitric oxide synthase (eNOS) phosphorylation was detected at the cellular and animal levels.@*RESULTS@#Compared with the control group, the levels of p-PKM2 in thoracic aortas of the diabetic group increased (P<0.05). The responsiveness of thoracic aortas in the diabetic group to acetylcholine (ACh) was 47% lower than that in the control group (P<0.05), and that in TEPP-46 treatment group was 28% higher than that in the diabetic group (P<0.05), while there was no statistically significant difference in the responsiveness of thoracic aortas to sodium nitroprusside (SNP). Compared with the control group, the plasma NO level of mice decreased in the diabetic group, while compared with the diabetic group, the phosphorylation of PKM2 in thoracic aortas decreased and the plasma NO level increased in the TEPP-46 group (both P<0.05). High glucose instead of mannitol induced the increase of PKM2 phosphorylation in HUVECs and reduced the level of NO in supernatant (both P<0.05). HUVECs incubated with TEPP-46 and high glucose reversed the reduction of NO production and secretion induced by high glucose while inhibiting PKM2 phosphorylation (both P<0.05). At the cellular and animal levels, TEPP-46 reversed the decrease of eNOS (ser1177) phosphorylation induced by high glucose (both P<0.05).@*CONCLUSIONS@#p-PKM2 may be involved in the process of endothelium-dependent vasodilation dysfunction in Type 2 diabetes by inhibiting p-eNOS (ser1177)/NO pathway.

Restore irreducible atlantoaxial dislocation by anterior joint release through wedge-end-mini-channel and posterior fixation / 中华骨科杂志

Objective:To investigate the feasibility and safety of a novel surgery, to restore irreducible atlantoaxial dislocation (IAAD) by atlantoaxial joint release through wedge-end-mini-channel (via conventional Smith-Robinson anterolateral approach) combined with posterior fixation.Methods:Five patients with IAAD from May 2013 to December 2021 were retrospectively analyzed, including 3 males and 2 females, aged 44.6±9.0 years (range, 38-61). All the patients received atlantoaxial joint release through wedge-end-mini-channel (via conventional Smith-Robinson anterolateral approach) combined with posterior fixation. The Japanese Orthopedic Association (JOA) score and improvement rate, American Spinal Injury Association (ASIA) grade, atlantodental interval (ADI) and reduction rate, space available for the cord (SAC) and fusion of bone graft were measured and recorded.Results:The follow-up time was 80.0±23.1 months (range, 34-96 months). The surgery time of anterior joint release was 105±23 min (range, 75-135 min), and the total surgery time was 234±42 min (range, 212-276 min). The blood loss of anterior joint release was 80±16 ml (range, 60-100 ml), and the total blood loss was 123±34 ml (range, 85-150 ml). JOA scores were 6.6±0.9 before surgery, 11.2±0.4 at post-operative 1 month, and 14.8±0.80 at the last follow-up ( F=97.28, P<0.001), and the improvement rate of the last follow-up JOA score was 79.1%±7.64%. The ASIA grade were three cases of 'C’ level and two cases of 'D’ level before surgery, and two cases of 'D’ level and three cases of 'E’ level at the last follow-up. The ADI before surgery, at post-operative 6 months and the last follow-up were 9.56±1.07 mm, 1.46±0.39 mm and 1.48±0.29 mm, respectively ( F=206.54, P<0.001). The reduction rate of last follow-up ADI was 84.6%±1.4%. The SAC before surgery, at post-operative 6 months and last follow-up were 10.3±1.83 mm, 20.12±1.19 mm and 20.06±1.25 mm, respectively ( F=44.47, P<0.001). Grafted bone fuse was seen in 3 cases at post-operative 6 months, and 5 cases at post-operative 12 months. The only complication was unexpected titanium rod fracture in 1 case at post-operative 14 months. Conclusion:For IAAD, the novel surgery of atlantoaxial joint release through wedge-end-mini-channel (via conventional Smith-Robinson anterolateral approach) combined with posterior fixation could achieve well joint restoration and neural function improvement, which was a safe and effective procedure.

Comparison of the outcomes between open and hybrid approaches in the treatment of thoracoabdominal aortic aneurysms repair / 北京大学学报(医学版)

OBJECTIVE@#Thoracoabdominal aortic aneurysm is one of the most challenging aortic diseases. Open surgical repair remains constrained with considerable perioperative morbidity and mortality. The emergence of a hybrid approach utilizing visceral debranching with endovascular aneurysm repair has brought an alternative for high-risk patients. This study aimed to compare the short- and long-term outcomes between hybrid and open repairs in the treatment of thoracoabdominal aortic aneurysms.@*METHODS@#In this retrospectively observational study, patients with thoracoabdominal aortic aneurysm treated in a single center between January 2008 and December 2019 were reviewed, of whom 11 patients with hybrid repair, and 18 patients with open repair were identified. Demographic characteristic, operative data, perioperative morbidity and mortality, freedom from reintervention, and long-term survival were compared between the two groups.@*RESULTS@#In the hybrid repair group, the patients with dissection aneurysm, preoperative combined renal insufficiency, and American Society of Anesthesiologists (ASA) score of 3 or more were significantly overwhelming than in the open repair group. The operation time of debranching hybrid repair was (445±85) min, and the intraoperative blood loss was (955±599) mL. There were 2 cases of complications in the early 30 days after surgery, without paraplegia, and 1 case died. The 30-day complication rate was 18.2%, and the 30-day mortality was 9.1%. The operation time of the patients with open repair was (560±245) min, and the intraoperative blood loss was (6 100±4 536) mL. Twelve patients had complications in the early 30 days after surgery, including 1 paraplegia and 4 deaths within 30 days. The 30-day complication rate was 66.7%, and the 30-day mortality was 22.2%. The bleeding volume in hybrid repair was significantly reduced compared with open repair (P < 0.001). Besides, the incidence of 30-day complications in hybrid surgery was significantly reduced (P=0.011). During the follow-up period, there were 4 reinterventions and 3 deaths in hybrid repair group. The 1-year, 5-year, and 10-year all-cause survival rates were 72%, 54%, and 29%, respectively. In open repair group, reintervention was performed in 1 case and 5 cases died, and the 1-year, 5-year, and 10-year all-cause survival rates were 81%, 71%, and 35%, respectively. There was no significant difference between hybrid repair and open repair in all-cause survival and aneurysm-specific survival.@*CONCLUSION@#Hybrid approach utilizing visceral debranching with endovascular aneurysm repair is a safe and effective surgical method for high-risk patients with thoracoabdominal aortic aneurysms. The incidence of early postoperative complications and mortality is significantly reduced compared with traditional surgery, but the efficacy in the medium and long term still needs to be improved.

Clinical and genetic characteristics of patients with newly diagnosed acute promyelocytic leukemia: a single-center retrospective of 790 cases / 中华血液学杂志

Objective: To retrospectively analyze the data of Chinese patients with newly diagnosed acute promyelocytic leukemia (APL) to preliminarily discuss the clinical and cytogenetic characteristics. Methods: From February 2004 to June 2020, patients with newly diagnosed APL aged ≥ 15 years who were admitted to the Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Science & Peking Union Medical College were chosen. Clinical and laboratory features were retrospectively analyzed. Results: A total of 790 cases were included, with a male to female ratio of 1.22. The median age of the patients was 41 (15-76) years. Patients aged between 20 and 59 predominated, with 632 patients (80%) of 790 patients classified as low and intermediate risk and 158 patients (20%) of 790 patients classified as high risk. The white blood cell, platelet, and hemoglobin levels at diagnosis were 2.3 (0.1-176.1) ×10(9)/L, 29.5 (2.0-1220.8) ×10(9)/L, and 89 (15-169) g/L, respectively, and 4.8% of patients were complicated with psoriasis. The long-form type of PML-RARα was most commonly seen in APL, accounting for 58%. Both APTT extension (10.3%) and creatinine>14 mg/L (1%) are rarely seen in patients at diagnosis. Cytogenetics was performed in 715 patients with newly diagnosed APL. t (15;17) with additional chromosomal abnormalities were found in 155 patients, accounting for 21.7%; among which, +8 was most frequently seen. A complex karyotype was found in 64 (9.0%) patients. Next-generation sequencing was performed in 178 patients, and 113 mutated genes were discovered; 75 genes had an incidence rate>1%. FLT3 was the most frequently seen, which accounted for 44.9%, and 20.8% of the 178 patients present with FLT3-ITD. Conclusions: Patients aged 20-59 years are the most common group with newly diagnosed APL. No obvious difference was found in the ratio of males to females. In terms of risk stratification, patients divided into low and intermediate risk predominate. t (15;17) with additional chromosomal abnormalities accounted for 21% of 715 patients, in which +8 was most commonly seen. The long-form subtype was most frequently seen in PML-RARα-positive patients, and FLT3 was most commonly seen in the mutation spectrum of APL.

Clinical analysis of primary lung tumors in 56 children / 中华肿瘤杂志

Objective: To investigate the clinical manifestation, pathological type, treatment and prognosis of primary lung tumors in children. Methods: We collected and retrospectively analyzed the clinical manifestation, pathological type, therapeutic method and prognosis of 56 primary lung tumors patients who diagnosed from 2009 to 2019 in Guangzhou Women and Children Medical Center. Results: There were 56 patients identified as the primary lung tumors, including pleuropulmonary blastoma (PPB, n=28), pulmonary inflammatory myofibroblastic tumor(IMT, n=20), mucoepidermoid carcinoma(n=6), infantile hemangioma (n=1), pulmonary sclerosing hermangioma(n=1). Respiratory symptoms were the most manifestation at the time of diagnosis including 26 patients with cough, 3 with hemoptysis, and 17 with dyspnea. Others included 15 with fever, 3 with chest pain, and 2 with epigastiric pain. The primary tumor of 18 cases were located in the lower lobe of left lung, 11 cases in the lower lobe of right lung, 10 cases in the upper lobe of left lung, 7 cases in the upper lobe of right lung, 6 cases in the middle lobe of right lung, and 4 cases in pulmonary hilum. Among the 56 patients, 41 patients underwent thoracotomy, 13 thoracoscopy, and 2 fiberoptic bronchoscopy. Five patients with type Ⅰ PPB were still alive at the end of follow-up without chemotherapy. Among 5 patients with type Ⅱ PPB, 2 patients without chemotherapy died after recurrence, 3 patients suffered postoperative chemotherapy were still alive at the end of follow-up. All of the 18 patients with type Ⅲ PPB underwent postoperative chemotherapy with IVADo regimen. Recurrence occurred in 6 cases, distant metastasis occurred in 3 cases, and cancer-related deaths occurred in 8 cases. For 20 patients with IMT, recurrence occurred in 5 of 13 patients experienced wedge resection, 1 of 6 patients experienced lobectomy and 1 of 6 underwent fiberoptic bronchoscopy, respectively. For 6 mucoepidermoid carcinoma patients, lobectomy was carried on 5 patients, wedge resection on 1 patient, all of them were still alive at the end of follow-up. One hermangioma patient underwent fiberoptic bronchoscopy and other 1 sclerosing hermangioma patient underwent wedge resection, both of them were still alive at the end of follow-up. Conclusions: The clinical manifestations of the primary lung tumors in children are nonspecific. Complete resection and achieving negative marginattribute to the excellent outcome. Adjunctive treatment such as chemotherapy is necessary for patients with type Ⅱ and type Ⅲ PPB.

Sequential Treatment with Syndrome Differentiation on Children's Refractory Nephrotic Syndrome with Yiqi Huayu Qingre Prescription / 中国实验方剂学杂志

ObjectiveTo evaluate the clinical efficacy of sequential syndrome differentiation of Yiqi Huayu Qingre prescription （YHQ） in the treatment of refractory nephrotic syndrome in children. MethodA total of 112 children with refractory nephrotic syndrome were randomly divided into an observation group （57 cases） and a control group（55 cases）. The children in the control group were treated with prednisone tablets combined with tacrolimus，and those in the observation group were treated with YHQ by sequential syndrome differentiation on the basis of the control group. The total effective rates of the two groups after treatment were observed. The 24-hour urinary total protein（24 h UTP），plasma albumin（ALB），cholesterol（CHO），triglycerides（TG）， and traditional Chinese medicine quality of life scale scores before treatment and after four weeks，eight weeks，16 weeks，24 weeks，32 weeks，40 weeks，and 52 weeks in the two groups were recorded. The total course of treatment and the total accumulation of hormones were compared among the children with reduced or no hormone treatment till 52 weeks during treatment. ResultThe total effective rate in the observation group was higher （Z=-2.052，P<0.05）. The observation group had lower 24 h UTP and higher ALB at each follow-up time point than the control group（P<0.05，P<0.01）. At four weeks，eight weeks，and 16 weeks of treatment，there was no statistically significant difference in CHO between the observation group and the control group，and the observation group was lower than the control group in CHO at the rest of the time points （P<0.05，P<0.01）. For TG， the observation group was not significantly different from the control group at four weeks，eight weeks，16 weeks，and 40 weeks of treatment，but lower at 24，32，and 52 weeks （P<0.05，P<0.01）. The total treatment course of hormones in the observation group was shorter（P<0.01）， with less total accumulation（P<0.01）. At different follow-up time points，the total score of traditional Chinese medicine quality of life scale in the observation group was superior to that in the control group（P<0.05，P<0.01），and the scores of the observation group in the four dimensions （physiological function，independent factor，social factor，and psychological factor） after treatment were higher than those in the control group（P<0.05，P<0.01）. ConclusionYHQ under sequential syndrome differentiation has a definite clinical effect in treating children with refractory nephrotic syndrome. It has advantages in shortening the total course of hormone treatment and reducing the total accumulation of hormones，and can improve the quality of life of children with refractory nephrotic syndrome.