Prognostic role of vitamin D receptor in breast cancer: a systematic review and meta-analysis.

BACKGROUND: A higher vitamin D intake improves the prognosis of early stage breast cancer (BC) patients. We hypothesized that vitamin D intake should refer to vitamin D receptor (VDR) expression. In order to prove this hypothesis, we first intend to evaluate the correlation between VDR expression and prognosis of BC patients using meta-analysis. METHODS: Literatures from PubMed, Embase, and the Cochrane Library (last update by May 20, 2020) were retrieved to find studies assessing the prognostic role of VDR in BC. The hazard ratios (HRs) for patients' survival were extracted for pooled analyses. Subgroup analysis, sensitivity analysis and meta-regression were performed to explore the sources of heterogeneity. RESULTS: Seven articles containing eight studies with 2503 patients were enrolled. The results from the pooled analyses showed that the VDR expression generally had no relationship with BC patients' overall survival (OS), disease-free survival (DFS), cancer-specific survival (CSS), and progression-free survival (PFS) (P > 0.05). Because only the number of studies exploring the relationship between VDR expression and OS is greater than five and there is heterogeneity, we explored the sources of heterogeneity of these studies. Subgroup analyses showed that the VDR expression in the nucleus had no relationship with OS, but high total VDR expression in the nucleus and cytoplasm was related to a better OS (pooled HR = 0.41; 95% CI = 0.18-0.95; P = 0.038). In addition, in subgroup of studies using cut-off values other than 'immunoreactive score (IRS)>5' and 'IRS > 25', high VDR expression was associated with a better OS (pooled HR = 0.47; 95% CI = 0.30-0.74; P = 0.001). Sensitivity analysis showed that the result pattern was not obviously affected by any single study. Meta-regression showed that the source of heterogeneity was not country (P = 0.657), pathological type (P = 0.614), molecular type (P = 0.423), staining location (P = 0.481), or cut-off value (P = 0.509). CONCLUSIONS: The protein expression level of VDR in entire BC cells evaluated by immunohistochemistry is related to the OS of BC patients. It is expected that a more individualized vitamin D intake and a more accurate prognosis assessment can be recommended for BC patients based on the VDR expression. Of course, more preclinical and clinical studies are needed.

MiR-1-3p Suppresses the Proliferation, Invasion and Migration of Bladder Cancer Cells by Up-Regulating SFRP1 Expression.

BACKGROUND: Bladder cancer is of compelling morbidity and mortality due to its high recurrence rate. Little development has been made in the last decades in the therapy methods. Thus, the mechanism of its growth and invasiveness involving novel molecular targets are needed. OBJECTIVE: Our research objective is to confirm the hypothesis that miR-1-3p suppresses the proliferation, invasion and migration of bladder cancer cells. METHODS: The expression levels of miR-1-3p and SFRP1 were evaluated using RT-qPCR in bladder cancer tissues and cells as well as in normal tissues and cells. J82 cell lines were selected as experiment subjects due to their low expression levels of miR-1-3p. Plasmids carrying miR-1-3p mimics, miR-1-3p inhibitors and SFRP1 were transfected into the J82 cell lines. Subsequently, the protein expression of SFRP1 was detected using Western Blot analysis, and cell proliferation, apoptosis, invasion and migration ability was measured using MTT, the flow cytometry, the Transwell test and wound healing assays, respectively Results: Bladder cancer tissues and cells exhibited significant decrease in the expression of miR-1-3p and SFRP1 compared to normal tissues and cells, and human bladder cancer cell line J82 exhibited the most significant decrease in these expressions (P < 0.05). MiR-1-3p up-regulates SFRP1 expression in bladder cancer cells, and the over-expression of miR-1-3p can suppress the proliferation, invasion and migration ability of bladder cancer cells. This mechanism is similar to the effect of SFRP1 over-expression on bladder cancer cells. CONCLUSION: MiR-1-3p suppresses the proliferation, invasion and migration of bladder cancer cells by up-regulating SFRP1 expression.

MiR-1-3p inhibits the proliferation and invasion of bladder cancer cells by suppressing CCL2 expression.

We attempted to analyze the effects of miR-1-3p and CCL2 on the proliferation, migration, and invasion of bladder cancer cells. A total of 18 pairs of bladder cancer tissues with corresponding adjacent tissues and the 6 cases of normal tissues were collected. The expressions of miR-1-3p and CCL2 in the cancer tissues were evaluated using quantitative real-time polymerase chain reaction and western blot. The relationship between miR-1-3p and CCL2 was assessed using luciferase reporter assay. The UM-UC-3 bladder cancer cells were transfected with CCL2 small interfering RNA and miR-1-3p mimics. 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay, colony formation assay, wound healing assay, Transwell assay, and the flow cytometry test were used to detect the proliferation, migration, invasion, and apoptosis of bladder cancer cells. Bladder cancer tissues had lower levels of miR-1-3p but higher levels of CCL2 than normal tissues ( p < 0.05). The transfection of miR-1-3p mimics and CCL2 small interfering RNA remarkably suppressed cell proliferation and invasion and promoted apoptosis of cells ( p < 0.05). Results of the luciferase reporter gene assay demonstrated that miR-1-3p targeted CCL2. MiR-1-3p suppresses the proliferation and invasion of urinary bladder cancer cells by targeting CCL2.

Effects of Tolvaptan in patients with acute heart failure: a systematic review and meta-analysis.

BACKGROUND: Acute heart failure, which requires urgent evaluation and treatment, is a leading cause for admission to the emergency department. The aim of this meta-analysis was to evaluate the effects of tolvaptan on acute heart failure and compare them with the effects of conventional therapy or placebo. METHODS: The electronic databases PubMed, EMBASE, and the Cochrane Controlled Trial registry were searched from their starting dates to October 24, 2016. Two authors independently read the trials and extracted related information from the included studies. We used fixed-effects or random-effects models to assess the overall combined risk estimates according to I2 statistics. Analysis to determine sensitivity and publication bias was conducted. RESULTS: Six randomised controlled trials from eight articles, with a total of 746 patients, were included for analysis. Compared with the control, tolvaptan reduced body weight in two days (WMD 1.35; 95% CI 0.75 to 1.96), elevated sodium level in two days (WMD 2.33; 95% CI 1.08 to 3.57) and five days (WMD 1.57; 95% CI 0.04 to 3.09), and ameliorated symptoms of dyspnoea (RR 0.82; 95% CI 0.71-0.95). However, tolvaptan did not improve long-term (RR 1.04; 95% CI 0.66-1.62) or short-term all-cause mortality (RR 0.89; 95% CI 0.45-1.76), incidence of clinical events (worsening heart failure, RR 0.75; 95% CI 0.50-1.12 and worsening renal function, RR 0.97; 95% CI 0.75-1.27), and length of hospital stay in patients (WMD 0.14; 95% CI -0.29 to 2.38) with acute heart failure. CONCLUSION: Tolvaptan can decrease body weight, increase serum sodium level, and ameliorate some of the congestion symptoms in patients with acute heart failure, which may help avoid the overdose of loop diuretics, especially in patients with renal dysfunction.

Clinical and Hemodynamic Effects of Endothelin Receptor Antagonists in Patients With Heart Failure.

The clinical benefit of endothelin receptor antagonists (ERA) for the management of heart failure (HF) remains controversial. To examine this question, we performed a meta-analysis of randomized controlled trials (RCTs) to investigate the clinical and hemodynamic effects of ERA in HF patients.We searched the PubMed, Medline, Embase, and Cochrane Library from inception to March 20, 2016 to identify the pertinent studies. Risk ratio (RR) and weighted mean difference (WMD) were calculated using a fixed or random effect model.A total of 15 RCTs with 3,624 HF patients were included. Compared with control groups, ERA might not improve the mortality (RR 1.12, 95%CI 0.81 to 1.54, P = 0.51) or incidence of worsening HF or cardiovascular events (WHF/ CVE) (RR 1.06, 95%CI 0.94 to 1.19, P = 0.35) in HF patients. Subgroup analysis also suggested that neither nonselective nor selective ERAs had an impact on mortality and WHF/CVE. However, the hemodynamic variables of HF patients, including cardiac index (WMD 0.32, 95%CI 0.22 to 0.43, P < 0.01), pulmonary capillary wedge pressure (WMD -3.10, 95%CI -3.99 to -2.20, P < 0.01), mean pulmonary arterial pressure (WMD -4.42, 95%CI -5.50 to -3.33, P < 0.01), systemic vascular resistance (WMD -276.35, 95%CI -399.62 to -153.09, P < 0.01), and pulmonary vascular resistance (WMD -69.42, 95%CI -105.33 to -33.52, P < 0.01) were significantly improved by ERA.In conclusion, this meta-analysis suggests that ERA therapy could effectively improve cardiac output and pulmonary and systemic hemodynamics, but with less benefit to the clinical outcomes of HF patients.

Statins for the prevention and treatment of acute lung injury and acute respiratory distress syndrome: A systematic review and meta-analysis.

The purpose of this meta-analysis was to assess whether statins could reduce the morbidity of acute lung injury and acute respiratory distress syndrome (ALI/ARDS) in high-risk patients and improve the clinical outcomes of patients with ALI/ARDS. Studies were obtained from PubMed, Medline, Embase and Cochrane Central Register of Controlled Trials. Randomized controlled trials (RCTs) and cohort studies, which reported morbidity, mortality, ventilator-free days, length of stay in intensive care unit and hospital or oxygenation index, were included in our meta-analysis. Risk ratio (RR) and weighted mean difference (WMD) were calculated using fixed or random effect model. A total of 13 studies covering 12 145 patients were included. Both the only RCT (P = 0.10) and cohort studies (RR, 1.02; 95% CI, 0.67 to 1.55; P = 0.94) showed that statin therapy did not lower the morbidity of ALI/ARDS in high-risk patients. The mortality of ALI/ARDS patients was less likely to be improved by statins (RCT, RR, 1.00; 95% CI, 0.84 to 1.20; P = 0.97; cohort studies, RR, 1.04; 95% CI, 0.85 to 1.27; P = 0.72). Moreover, no significant difference was observed in ventilator-free days, length of stay in intensive care unit as well as hospital and oxygenation index. This meta-analysis suggests that statins neither provide benefit for lowering the morbidity of ALI/ARDS in high-risk patients nor improve the clinical outcomes of ALI/ARDS patients. Hence, it may not be appropriate to advocate statin use for the prevention and treatment of ALI/ARDS.

Efficacy and Safety of Spironolactone in Patients with Resistant Hypertension: A Meta-analysis of Randomised Controlled Trials.

BACKGROUND: The treatment of resistant hypertension (RH) is challenging. Several observational studies have suggested that the addition of spironolactone to triple-drug therapy might have a promising anti-hypertensive effect on RH. To provide more definite evidence for the benefit of spironolactone, we performed a meta-analysis of randomised controlled trials (RCTs) to evaluate the efficacy and safety of spironolactone in RH patients. METHODS: Articles were searched from PubMed, EMBASE and Cochrane Library. Randomised controlled trials investigating the effect of additional spironolactone on office blood pressure (BP), ambulatory BP or adverse events in RH patients were included for analysis. Then quality assessment, subgroup, sensitivity, and publication bias analyses were performed. RESULTS: Five RCTs involving a total of 553 patients were eligible for inclusion. Compared with control therapies, additional spironolactone treatment in RH patients significantly decreased 24-h ambulatory systolic BP (ASBP, weight mean difference [WMD]= -10.50, 95% confidence interval [CI] = -12.30 to -8.71, P<0.001), 24-h ambulatory diastolic BP (ADBP, WMD = -4.09, 95% CI = -5.28 to -2.91, P<0.001), daytime ASBP (WMD = -10.20, 95% CI = -12.41 to -7.99, P<0.001), daytime ADBP (WMD = -4.14, 95% CI = -5.50 to -2.78, P<0.001), night-time ASBP (WMD = -10.02, 95% CI = -12.63 to -7.41), night-time ADBP (WMD=-3.21, 95% CI=-4.84 to -1.58, P<0.001), office systolic BP (WMD=-16.99, 95% CI=-25.04 to -8.95, P<0.001) and office diastolic BP (WMD=-6.18, 95% CI=-9.30 to -3.05, P<0.001). However, serum potassium might be slightly elevated by additional spironolactone (WMD=0.181, 95% CI=0.042 to 0.319, P=0.011). CONCLUSION: Spironolactone combined with triple-drug therapy may be an effective and relatively safe strategy for the management of RH patients.

The short-term and long-term effects of tolvaptan in patients with heart failure: a meta-analysis of randomized controlled trials.

A comprehensive evaluation of the benefits of tolvaptan for the management of heart failure (HF) is lacking. The objective of this meta-analysis was to assess the short-term and long-term effects of tolvaptan in patients with HF. Articles were searched from PubMed, MEDLINE and Cochrane Library before March 31, 2015. Randomized controlled trials enrolling adult HF patients and reporting the all-cause mortality, cardiac events, body weight change or changes of serum electrolytes including sodium, potassium and creatinine were included in our meta-analysis. Ten studies covering 5574 patients met the inclusion criteria. Based on the data of meta-analysis, tolvaptan had no impact on the all-cause mortality [relative risk (RR) 0.96; 95 % confidence interval (CI) 0.87-1.06; P = 0.40] and incidence of cardiac events (RR 1.03; 95 % CI 0.96-1.11; P = 0.40) of HF patients. Furthermore, in comparison with control treatments, tolvaptan significantly decreased the body weight [weight mean difference (WMD), -0.87; 95 % CI -1.03 to -0.71; P < 0.001] and statistically increased serum sodium (WMD, 2.58; 95 % CI -1.83 to 3.33; P < 0.001) without any change in serum potassium (WMD, 0.01; 95 % CI -0.03 to 0.05; P = 0.577). However, serum creatinine may be increased slightly by tolvaptan (WMD, 0.05; 95 % CI 0.03-0.07; P < 0.001). This meta-analysis suggests that in HF patients, tolvaptan may not bring long-term benefits, but it effectively improves the volume overload and hyponatremia without obvious increases in serum potassium and creatinine. Hence, tolvaptan is likely to be a promising diuretic for the treatment of HF.

CENPA and BRCA1 are potential biomarkers associated with immune infiltration in heart failure and pan-cancer.

Heart failure (HF) and cancer are the two leading causes of death worldwide and affect one another in a bidirectional way. We aimed to identify hub therapeutic genes as potential biomarkers for the identification and treatment of HF and cancer. Gene expression data of heart samples from patients with ischemic HF (IHF) and healthy controls were retrieved from the GSE42955 and GSE57338 databases. Difference analysis and weighted gene co-expression network analysis (WGCNA) were used to identify key modules associated with IHF. The overlapping genes were subjected to gene and protein enrichment analyses to construct a protein-protein interaction (PPI) network, which was screened for hub genes among the overlapping genes. A total of eight hub genes were subjected to correlation, immune cell infiltration, and ROC analyses. Then we analyzed the roles of two significant genes in 33 tumor types to explore their potential as common targets in HF and cancer. A total of 85 genes were identified by WGCNA and differentially expressed gene (DEG) analyses. BRCA1, MED17, CENPA, RXRA, RXRB, SMARCA2, CDCA2, and PMS2 were identified as the hub genes with IHF. Finally, CENPA and BRCA1 were identified as potential common targets for IHF and cancer. These findings provide new perspectives for expanding our understanding of the etiology and underlying mechanisms of HF and cancer.

Atherosclerosis treatment with nanoagent: potential targets, stimulus signals and drug delivery mechanisms.

Cardiovascular disease (CVDs) is the first killer of human health, and it caused up at least 31% of global deaths. Atherosclerosis is one of the main reasons caused CVDs. Oral drug therapy with statins and other lipid-regulating drugs is the conventional treatment strategies for atherosclerosis. However, conventional therapeutic strategies are constrained by low drug utilization and non-target organ injury problems. Micro-nano materials, including particles, liposomes, micelles and bubbles, have been developed as the revolutionized tools for CVDs detection and drug delivery, specifically atherosclerotic targeting treatment. Furthermore, the micro-nano materials also could be designed to intelligently and responsive targeting drug delivering, and then become a promising tool to achieve atherosclerosis precision treatment. This work reviewed the advances in atherosclerosis nanotherapy, including the materials carriers, target sites, responsive model and treatment results. These nanoagents precisely delivery the therapeutic agents to the target atherosclerosis sites, and intelligent and precise release of drugs, which could minimize the potential adverse effects and be more effective in atherosclerosis lesion.

A multicenter, randomized, double-blind, placebo-controlled, phase 3 trial of olanzapine plus triple antiemetic regimen for the prevention of multiday highly emetogenic chemotherapy-induced nausea and vomiting (OFFER study).

Background: Evidence supports prophylactic use of olanzapine for the treatment of chemotherapy-induced nausea and vomiting (CINV). However, most studies to date have focused on patients with single-day highly emetogenic chemotherapy (HEC). Currently, administration of antiemetic therapies for nausea and vomiting induced by multiday chemotherapy regimens remains a challenge. In this study, we evaluated the efficacy of olanzapine combined with triple antiemetic therapy for the prevention of CINV in patients receiving multiday chemotherapy. Methods: We performed a randomized, double-blind, placebo-controlled phase 3 trial in 22 hospitals. Eligible patients were between 18 and 75 years old, were diagnosed with malignant solid tumors, and they had an Eastern Cooperative Oncology Group (ECOG) performance status of 0-2. All the study participants were scheduled to be treated with chemotherapy regimens containing 3-day cisplatin (3-day total dose ≥75 mg/m2). Randomization was computer generated and stratified by gender and chemotherapy treatment history. Allocation was done via an interactive web response system. Enrolled patients were randomly assigned 1:1 to receive either 5 mg olanzapine or placebo orally before bedtime for 5 days combined with intravenous fosaprepitant (150 mg) 1 h before the administration of cisplatin on day 1, ondansetron hydrochloride intravenously, and dexamethasone orally 30 min before cisplatin from days 1 to 3. Dexamethasone was also administered at the same time on days 4 and 5. The primary endpoint was the proportion of subjects with complete response (no vomiting and no rescue therapy) within the overall phase (days 1-8) after starting chemotherapy. Baseline plasma concentrations of P-substance and 5-HT were measured for exploratory analysis. This study was registered at ClinicalTrials.gov, number NCT04536558. Findings: Between December 2020 and September 2021, 349 patients with malignant solid tumors were enrolled in the study, with 175 participants randomly assigned to receive olanzapine and 174 participants assigned to receive placebo. The proportion of patients who achieved a complete response in the overall phase was significantly higher in the olanzapine group than in the placebo group (69% vs. 58%, P = 0.031). A complete response benefit was observed in the olanzapine group versus the placebo group in almost all the subgroups. Four factors were considered significantly associated with complete response in multivariable analysis: treatment group, gender, baseline plasma concentration of 5-HT, and prior radiotherapy. All the reported adverse events associated with olanzapine administration were grades 1 and 2. Interpretation: Olanzapine (5 mg) combined with fosaprepitant, ondansetron, and dexamethasone was better than triple antiemetic therapy alone for patients receiving multiday chemotherapy regimens. Based on these results, the four-drug combination should be recommended as the best antiemetic regimen given to patients receiving multiday cisplatin-based chemotherapy and baseline plasma concentration of 5-HT may be used to identify individuals who are prone to CINV. However, all these findings need to be further validated in future studies. Funding: Jiangsu Hansoh Pharmaceutical Group Co., Ltd. provided research grant and study drugs for this investigator-initiated study.

The stress hyperglycemia ratio improves the predictive ability of the GRACE score for in-hospital mortality in patients with acute myocardial infarction.

BACKGROUND: The Global Registry of Acute Coronary Events (GRACE) score is a powerful tool used to predict in-hospital mortality after acute myocardial infarction (AMI) and does not include a glycometabolism-related index. We investigated whether the addition of the stress hyperglycemia ratio (SHR) provides incremental prognostic value in addition to the GRACE score. METHODS: A retrospective cohort of 613 AMI patients was enrolled in the present analyses. The patients were stratified according to the primary endpoint (in-hospital mortality) and the tertiles of the SHR. RESULTS: During hospitalization, 40 patients reached the primary endpoint, which was more frequently observed in patients with a higher SHR. The SHR, but not admission blood glucose (ABG), adjusted for the GRACE score independently predicted in-hospital mortality [odds ratio 2.5861; 95% confidence interval (CI), 1.3910-4.8080; P = 0.0027]. The adjustment of the GRACE score by the SHR improved the predictive ability for in-hospital death (an increase in the C-statistic value from 0.787 to 0.814; net reclassification improvement, 0.6717, 95% CI 0.3665-0.977, P < 0.01; integrated discrimination improvement, 0.028, 95% CI 0.0066-0.0493, P = 0.01028). The likelihood ratio test showed that the SHR significantly improved the prognostic models, including the GRACE score. Adding the SHR to the GRACE score presented a larger net benefit across the range of in-hospital mortality risk than the GRACE score alone. CONCLUSION: The SHR, but not the ABG, is an independent predictor of in-hospital mortality after AMI even after adjusting for the GRACE score. The SHR improves the predictability and clinical usefulness of prognostic models containing the GRACE score.

Cultural and Creative Product Design and Image Recognition Based on Deep Learning.

In today's technological world, advanced intelligence technologies such as deep learning (DL) techniques are widely applied in various fields. In this study, people are going to research cultural and creative product design and image recognition based on deep learning. Cultural creative products are referred to as products that are designed by taking inspiration from the cultural aspects. The use of cultural and creative products has increased among the people, thus creating a fair market. Artificial intelligence deep learning (DL) is employed for the design of culturally creative objects. Deep learning is referred to as a machine learning technique that is used to teach machines to imitate human behaviour so that computers can learn from examples. The proposed system utilizes image recognition technique which is referred as the ability of computer systems to identify objects from an image. The image recognition technique integrates machine vision technology, which uses cameras and artificial intelligent software for recognising images. This technology is widely used for various functions, such as self-driven cars, image content searches, and machine vision robots. In our proposed system, image recognition based on deep learning is used in the design of cultural and creative products through the utilisation of randomized algorithms. The system is found to deliver more accurate solutions when compared with the existing LDA, HMM, and optimization algorithms.

Inspecting Decorative Ceramic Defects by Fusing Convolutional Neural Network and Image Recognition.

The intelligent inspection of ceramic decorative defects is one of the hot research at present. This work aims to improve the defect inspection automation of finished decorative ceramic workpieces. First, it introduces the multi-target detection algorithm and compares the performance of different network models on the public data set. Second, the initial images are collected on the spot. The initial pictures are easy to produce noise in actual deployment, affecting the image quality. Therefore, image preprocessing is performed for the initial images, and a median filtering method is used to calculate the denoising. Finally, the original You Only Look Once version 3 network model is realized. Based on this, the decorative ceramic-oriented Automated Surface Defect Inspection model is proposed. Then, decorative ceramic defect images are inputted for model training. The experimental conclusions are deeply studied and analyzed. The results show that the proposed decorative ceramic-oriented Automated Surface Defect Inspection model based on Deep Learning technology has good feature extraction and inspection ability. The detection accuracy is 94.90% on the test set, and the detection speed reaches 25 frames per second. Compared with the traditional manual inspection method, the proposed model greatly improves the inspection effect and can meet the on-site inspection requirements of surface defects of decorative ceramics under complex backgrounds. It is of great significance to improve the quality inspection efficiency and economic benefits of China's decorative ceramics industry.

Postoperative Adjuvant Chemoradiotherapy on the Survival of Stage III Gastric Cancer.

Objective: Although adjuvant therapy has been shown to be beneficial in gastric cancer, the use of adjuvant chemoradiotherapy remains controversial. This paper investigated the effects of postoperative adjuvant chemoradiotherapy on the survival of patients with stage III gastric cancer. Methods: In total, the data of 72 stage III gastric cancer patients treated at our hospital from January 2014 to December 2019 were retrieved and assessed. They were categorized into a chemotherapy group (CT group) and a radiochemotherapy group (RCT group) according to their given treatment regimens. A 3-year follow-up was conducted to record their incidence of disease-free survival (DFS), overall survival (OS), and adverse events. Results: For the CT and RCT groups, DFS was 86.4% and 92.6% in the first year, decreasing to 55.1% and 73.7% in the second year, and 41.3% and 69.1% in the third year. There was no significant difference in DFS between the two groups during the three-year follow-up. Additionally, for the CT and RCT groups, their respective 1-year, 2-year, and 3-year OS were 95.6% and 96.3%, 75.1% and 87.9%, and 50.3% and 74.2%, indicating that the OS of patients in the RCT group was significantly higher than that in the CT group during 3 years of follow-up. Further, no significant difference in the incidence of adverse events was found between the two treatment groups. Conclusions: Collectively, adjuvant radiochemotherapy after radical gastrectomy for stage III gastric cancer was associated with better survival outcomes than chemotherapy, without increase in adverse events.

Improvement of Diagnostic Accuracy for Pancreatic Cancer with Serum Lactate Dehydrogenase.

PURPOSE: Due to the lack of early-stage detection, pancreatic cancer (PC) remains a devastating disease worldwide. Lactate dehydrogenase (LDH) is associated with tumorigenesis and cancer progression. This study aims to analyze the diagnostic improvements in serum LDH levels combined with other common tumor biomarkers, including carbohydrate antigen 19-9 (CA19-9) and carcinoembryonic antigen (CEA), for monitoring PC. PATIENTS AND METHODS: A retrospective analysis was performed on 73 patients with newly diagnosed PC, 90 patients with pancreatic benign diseases (PBD), and 92 people with healthy physical examination (HPE) at Zhongda Hospital, Southeast University from July 2013 to July 2020. The diagnostic efficiencies of serum levels of LDH, CA19-9, and CEA were analyzed through receiver operating characteristic (ROC) curves for PC. The sensitivity and specificity were evaluated at an optimal cutoff. The prognostic impacts of LDH on PC patients were also assessed. RESULTS: The LDH level was elevated in 21 (28.77%) patients with PC, 3 (3.33%) PBD patients, and no HPE individuals (P<0.05). The sensitivities of LDH, CA19-9, and CEA for the diagnosis of PC were 63.0%, 78.1%, and 72.6%, respectively, but the combination of these three markers increased predictive sensitivity significantly to 87.6%. The specificities of LDH, CA19-9, and CEA for the diagnosis of PC were 93.4%, 84.1%, and 73.1%, respectively. The combined specificity reached up to 96.7%. The medium survival time of PC patients with low-level LDH was 21 ± 5.1 months, whereas that of patients with high-level LDH was only 7 ± 0.92 months (P<0.05). CONCLUSION: The serum LDH level was higher in PC patients than in PBD patients and HPE individuals and was associated with a poor prognosis. The combined assessment of LDH, CEA, and CA19-9 showed higher sensitivity and specificity for the diagnosis of PC.

MiR-326: Promising Biomarker for Cancer.

MicroRNAs (miRNAs) are small non-coding and highly conserved RNAs that act in biological processes including cell proliferation, invasion, apoptosis, metabolism, signal transduction, and tumorigenesis. The previously identified miRNA-326 (miR-326) has been reported to participate in cellular apoptosis, tumor growth, cell invasion, embryonic development, immunomodulation, chemotherapy resistance, and oncogenesis. This review presents a detailed overview of what is known about the effects of miR-326 on cell invasion, metastasis, drug resistance, proliferation, apoptosis, and its involvement in signaling pathways.

Application of remifentanil combined with propofol in the diagnosis of colon cancer with awakening painless digestive endoscopy.

Anesthetic effect of remifentanil combined with propofol in awakening painless endoscopy was analyzed. Retrospective analysis of 120 cases of colon cancer were treated in Dongying People's Hospital from June 2015 to December 2017. All of them were treated by awakening painless digestive endoscopy, divided into 60 cases in observation group (combined with remifentanil and propofol anesthesia), and 60 cases in control group (combined intravenous anesthesia of finanib and propofol). The data were respectively recorded at time-points of oxygen inhalation, intubation for 10 min, awakening time, waking time, and the time-points for each represented as the time-points of T1, T2, T3, T4, T5 and recorded the diastolic blood pressure (DBP), respiratory rate (RR) and heart rate (HR), and compared the awakening effect and the occurrence of adverse reaction. There was no significant difference in the DBP index between the two groups at time-point T1 (P>0.05). The time-points of T2, T3, T4 and T5 were significantly different from the observation group (P<0.05). There was no significant difference in RR index between the two groups and between the same groups (P>0.05). Compared with the control group, the awakening time and consciousness recovering of the observation group is lower (P<0.05). The incidence of adverse reactions after awakening operation between the two groups was statistically significant (P<0.05). The local pain rate in the observation group after the awakening operation was lower than the control group. The combined use of trace remifentanil and small dose propofol in the awakening painless digestive endoscopy can make the patients with colon cancer more stable when they are in the awakening state, so as to improve the safety of awakening painless digestive endoscopy. It is worth promoting in clinical practice.

Pharmaceutical analysis of different antibiotic regimens in the treatment of lower respiratory tract infection.

The present study aimed to discuss and compare the effects and expenses of different antibiotic regimens in the treatment of lower respiratory tract infection (LRTI). A retrospective analysis was performed on 200 patients diagnosed with LRTI and treated at the Department of Respiratory Medicine of Dongying People's Hospital from February 2015 to May 2017. The patients were randomly divided into Group A, Group B, Group C and Group D, with 50 cases in each group, and were treated with ceftriaxone sodium, ceftizoxime sodium, levofloxacin and azithromycin, respectively. Venous blood of patients was collected. White blood cells (WBC) of venous blood were detected using a hematology analyzer and C-reactive protein (CRP) was tested with latex immunoturbidimetry. Moreover, therapeutic effects and drug costs of four different antibiotics were compared. No adverse reactions occurred to patients in the four groups during the treatment process. The value at each time point after treatment was significantly decreased compared with that at the previous time point before treatment within the group (P<0.01). The treatment expenses of patients in Group A, Group B and Group D were significantly increased compared with those in Group C (P<0.01), the treatment expenses of patients in Group B and Group D were significantly increased compared with those in Group A (P<0.01) and the treatment expenses of patients in Group D were significantly increased compared with those in Group B (P<0.01). Ceftriaxone sodium, ceftizoxime sodium, levofloxacin and azithromycin all have a good antimicrobial efficacy. The treatment condition of LRTI can be dynamically monitored by WBC and CRP which can accurately reflect the progression condition of patients' illness and the treatment effect. In economic terms, the treatment cost of levofloxacin is the lowest; thus, it is worthy of clinical popularization and application.

Naringenin ameliorates LPS-induced acute lung injury through its anti-oxidative and anti-inflammatory activity and by inhibition of the PI3K/AKT pathway.

The aim of the present study was to explore the effect of naringenin on lipopolysaccharide (LPS)-induced acute lung injury (ALI) in a mouse model, as well as the underlying mechanism. The animals were randomly assigned to four groups: PBS-treated healthy control (Control), LPS-induced ALI (LPS), vehicle-treated ALI (LPS + Vehicle), and naringenin-treated ALI (LPS + Nar) group. Naringenin (100 mg/kg) was administered orally for 4 consecutive days, starting 3 days prior to induction of ALI. The survival rates of mice, lung wet/dry weight ratios, lung injury score, protein levels of bronchoalveolar lavage fluid (BALF), lactate dehydrogenase (LDH) activity in the BALF, lung myeloperoxidase (MPO) activity, the number of infiltrated neutrophils and reactive oxygen species (ROS) levels (H2O2 and malondialdehyde) were assessed. In addition, the serum and BALF levels of inflammatory cytokines [tumor necrosis factor-α, interleukin (IL)-1ß, IL-6 and macrophage inflammatory protein 2] were determined, along with the total and the phosphorylated protein levels of phosphatidylinositol 3-hydroxy kinase (PI3K) and AKT in lung tissues. The results showed that naringenin pre-treatment significantly increased the survival rate, improved histopathologic changes, alleviated pulmonary edema and lung vascular leak, downregulated the levels of ROS and reduced neutrophil infiltration as well as the levels of inflammatory cytokines in the serum and BALF. Moreover, naringenin pre-treatment reduced the total and the phosphorylated protein levels of PI3K and AKT. The present study suggested that naringenin pre-treatment ameliorated LPS-induced ALI through its anti-oxidative and anti-inflammatory activity and by inhibition of the PI3K/AKT pathway in mice.