Increased risk of ischemic heart disease and diabetes in inflammatory bowel disease.

BACKGROUND: Previous studies showed inconsistent results regarding associations between inflammatory bowel disease (IBD) and risk of ischemic heart disease (IHD) and diabetes. The present study aimed to make a meta-analysis to assess the risk of IHD and diabetes in IBD. METHODS: We searched for articles published before February 2020 in the databases as follows: PubMed, Web of Science, Medline, EMBASE, and Google Scholar. We computed odds ratio (OR) or relative risk (RR) and 95 % confidence intervals (CI) regarding the association between IBD and risk of IHD or diabetes by using STATA 13.0 software. RESULTS: The present meta-analysis showed that IBD was associated with higher risk of IHD (OR/RR = 1.26, 95 % CI 1.20 to 1.32, I2 = 88.3 %, p < 0.0001). Additionally, both ulcerative colitis (UC) and Crohn's disease (CD) were associated with higher risk of IHD (UC: OR/RR = 1.19, 95 % CI 1.13 to 1.26, I2 = 65.6 %, p = 0.001; CD: OR/RR = 1.33, 95 % CI 1.17 to 1.51, I2 = 89.5 %, p < 0.0001). The study showed that IBD was associated with elevated risk of diabetes (OR/RR = 1.26, 95 % CI 1.03 to 1.53, I2 = 92.1 %, I2 = 92.1 %, p < 0.0001). Additionally, both UC and CD were associated with higher risk of diabetes (UC: OR/RR = 1.33, 95 % CI 1.03 to 1.71, I2 = 93.8 %, p < 0.0001; CD: OR/RR = 1.39, 95 % CI 1.10 to 1.76, I2 = 76.7 %, p = 0.002). CONCLUSION: In conclusion, patients with IBD are at increased risk of IHD and diabetes. Thus, regular monitoring of biomarkers of IHD and blood glucose levels should be considered for the early detection of IHD and diabetes in IBD patients.

[Clinical effects of low-stretch ventilation on acute respiratory distress syndrome].

OBJECTIVE: To investigate the effectiveness of low-stretch as compared with low-tidal-volume strategy in the treatment of acute respiratory distress syndrome (ARDS). METHODS: Eighty-five cases of ARDS patients were randomly divided into low-stretch group (42 cases) and low-tidal-volume group (43 cases). The former group of patient received pressure assist control mode with not higher than 35 cm H(2)O (1 cm H(2)O=0.098 kPa) of peak pressure or pressure support mode ventilation with not higher than 30 cm H(2)O of Pplateau, while in low-tidal-volume group tidal volume of no more than 6 ml/kg of predicted body weight was given. The mortality rate within 28 days, the incidence of hypercapnia, the duration of using sedatives and neuromuscular blockade agents, the time of ventilation and the length of intensive care unit (ICU) stay were compared between two groups. According to the monitored expiratory tidal volume (V(T)e), the low-stretch group was divided into low-tidal-volume subgroup (V(T)e < or =6 ml/kg, 11 cases) and non-low-tidal-volume subgroup (V(T)e >6 ml/kg, 31 cases). The mortality within 28 days and the incidence of hypercapnia were compared between two subgroups. RESULTS: There was no significant difference in the 28-day mortality rate between two groups (34.0% vs. 37.0%, P>0.05), but patients of low-stretch group had lower incidence of hypercapnia than low-tidal-volume group (10.6% vs. 40.7%, P<0.05), and also the duration of using sedatives [(4.5+/-1.2) days vs. (8.7+/-2.3) days] and neuromuscular blockade agents [(8.4+/-2.1) days vs. (10.7+/-1.2) days], and the length of ventilation and ICU stay [(10.2+/-2.2) days vs. (13.7+/-3.1) days, all P<0.05] were less. Low tidal volume occurred in 26.2% of low-stretch group, and the low-tidal-volume subgroup had higher 28-day mortality rate (40.8%) and incidence of hypercapnia (65.7%) than non-low-tidal-volume subgroup (13.2% and 8.6%, both P<0.05). CONCLUSION: Compared with low-tidal-volume strategy, low-stretch strategy can reduce the incidence of hypercapnia, the length of ventilation and ICU stay for ARDS patients, but have similar mortality rate. When low-stretch strategy is exercised, an inappropriate low tidal volume may be associated with poor outcome of ARDS.

High expression of RACK1 is associated with poor prognosis in patients with pancreatic ductal adenocarcinoma.

Receptor for activated C kinase 1 (RACK1) is associated with certain aspects of cancer biology and signaling pathways, but its function in pancreatic ductal adenocarcinoma (PDAC) remains unknown. In the present study, 157 patients with PDAC were enrolled. RACK1 mRNA and protein expression levels were analyzed in PDAC tissues and matched adjacent noncancerous tissues by reverse transcription-quantitative polymerase chain reaction and western blotting. RACK1 expression levels in paraffin-embedded PDAC tissues were determined by immunohistochemistry. The associations between RACK1 expression and clinical data were evaluated using χ2 analysis. The relationship between RACK1 expression and the survival data of patients was analyzed using Kaplan-Meier and log rank tests. RACK1 mRNA and protein were revealed to be overexpressed in PDAC tumor tissues compared with adjacent noncancerous tissues. RACK1 expression was associated with clinical stage (P=0.001), lymph node invasion (P=0.003) and liver metastasis (P=0.001). Furthermore, patients with PDAC and high RACK1 expression demonstrated shorter overall survival times compared with patients with low RACK1 expression (P=0.002). Multivariate analysis indicated that RACK1 overexpression was an independent prognostic factor for patients with PDAC. Overexpression of RACK1 may contribute to tumor progression, and may be a potential prognostic biomarker for patients with PDAC.

MicroRNA-143 enhances chemosensitivity of Quercetin through autophagy inhibition via target GABARAPL1 in gastric cancer cells.

MicroRNAs have emerged as fundamental regulators in gene expression through silencing gene expression at the post-transcriptional and translational levels. In this study, miR-143 expression and biological functions in AGS/MNK28 cell lines was investigated. Results indicated that the expression of miR-143 was significantly down-regulated in cancer tissues and in gastric cancer (GC) cell lines. Target prediction algorithms (Target Scan and miRanda) showed that GABARAPL1 was a potential target gene of miR-143. GABARAPL1, also regarded as autophagy-related protein 8 (Atg8) is a ubiquitin-like protein required for the formation of autophagosomal membranes. Then, several different assays were conducted to detect autophagy in AGS/MNK28 after transfected with miR-143. In the present study, miR-143 was firstly identified as a autophagy inhibitor in GC cells via targeting GABARAPL1. Quercetin is one of the most prominent dietary antioxidants in human diet and lately it is grabbing some serious attention as a potentially powerful cancer fighter. However, the effect of Quercetin was unexpected decreased in GC cells on account of the appearance of Quercetin-induced autophagy. Therefore, applicable autophagy inhibitors might enhance the chemosensitivity of Quercetin. Furthermore, the therapeutic response of Quercetin in the combination of miR-143 was evaluated by MTT, Hochest and western blot, results suggesting that the chemosensitivity of Quercetin was enhanced when in combination with miR-143 in AGS/MNK28 cells. In conclusion, we determined miR-143 as a potent inhibitor of autophagy via targeting GABARAPL1 and miR-143 could improve the efficacy of Quercetin though autophagy inhibition in GC cell lines, thus representing a novel potential therapeutic target for gastric cancer.

Primary hepatic malignant melanoma: a case report.

Primary hepatic malignant melanoma is a very rare disease. In order to provide clues concerning diagnosis, differential diagnosis and pathogenesis of the disease, a case of a 49 year-old female patient with primary hepatic malignant melanoma is presented. B-mode ultrasound and Contrast-enhanced abdominal computerized tomography (CT) examinations revealed that nodules of varying sizes are diffusely distributed in her enlarged liver. Pathological examination revealed that tumor cells with poor differentiation were located in nests with prominent melanin deposition. Immuno-histochemical staining showed that the tumor cells were positive for HMB-45 and S-100 protein. No evidence for primary malignant melanoma of other sites had been found by comprehensive examinations. Therefore, the patient was diagnosed with primary malignant melanoma of liver. Our case showed that primary malignant melanoma of liver is of histological heterogeneity, and immunohistochemical staining may aid in differential diagnosis between it and other hepatic neoplasms.