[Efficacy of thromboelastography to monitor the clinical massive transfusion in scoliosis: a randomized controlled trial].

OBJECTIVE: To systematically assess the benefits and harms of a thromboela-stogram (TEG) guided transfusion strategy with severe bleeding. METHODS: In this prospective study, 60 patients scheduled for scoliosis were included in the Fourth Affiliated Hospital, Xinjiang Medical University, from May 2014 to February 2014.Patients were allocated into either an TEG group or a standard management group. RESULTS: There was no significant difference in age, weight, height and operation time between the two groups (P>0.05). There were significant differences in red blood cell concentration((4.5±1.5)units and(7.1±1.2)units)(t=4.343, P=0.001), platelet((2.5±1.3)units and (4.2±0.6)units)(t=4.554, P=0.002), fresh frozen plasma((234±46)ml and(514±41)ml)(t=3.723, P=0.004), fibrinogen((2.4±0.6)g and (4.6±0.7)g)(t=3.451, P=0.006) between the TEG group and the standard management group.The two groups in intraoperative blood loss((1 023±103)ml and (1 314±116)ml)(t=2.260, P=0.120), incidence of rebleeding after operation(3.1% and 3.6%)(χ(2)=0.340, P=0.450), hospitalization time((18±4)d and (16±6)d)(t=2.140, P=0.160) had no statistically significant differences. CONCLUSION: Application of a TEG guided transfusion strategy seems to reduce the amount of bleeding during correction operation of scoliosis.

Synovial Fluid HMGB-1 Levels are Associated with Osteoarthritis Severity.

BACKGROUND: Recent data have shown that enhanced cytokine production in knee osteoarthritis (OA) synovium are believed to promote pathological OA. High-mobility group box 1 (HMGB-1) as a well-known pro-inflammatory cytokine may influence the development of knee OA. The purpose of this study is to analyze the amount of and location of HMGB-1 in OA synovium and to compare it with controls who are afflicted with acute meniscal or cruciate ligament tears. We also evaluated the relationship between the level of HMGB-1 in synovial fluid with the severity of synovitis, clinical symptoms (pain, stiffness, daily activity), and radiological changes in patients with knee OA. METHODS: Synovium and synovial fluid were harvested from seventy-four knee OA patients and thirty-four controls afflicted with acute meniscal or cruciate ligament tears. Kellgren-Lawrence (KL) grading system and Western Ontario McMaster University Osteoarthritis Index (WOMAC) assessment scale were applied to evaluate the radiological and clinic severity of OA patients. Additionally, for all patients, the microscopic synovitis was graded to evaluate the severity of synovium pathology. The location of HMGB-1 was determined in the synovium by immunohistochemistry. Synovium and synovial fluid HMGB-1 levels were measured by western blotting and enzyme-linked immunosorbent assay (ELISA), respectively. RESULTS: Synovium immunohistochemical analysis revealed that HMGB-1 displayed a strictly nuclear localization in controls; however, both nuclear and cytoplasmic distributions were present in OA patients. The percentage of HMGB-1 positive cells as well as cytoplasmic HMGB-1 cell population in OA patients were higher than those of controls (42.5% vs. 39.7% and 24.0% vs. 5.7%). Both synovium and synovial fluid HMGB-1 levels in OA patients were significantly higher than controls. In OA patients, HMGB-1 in the KL2/3 group was higher than in the KL4 group. Additionally, synovial fluid HMGB-1 levels in OA patients were positively associated with the severity of synovitis, pain, and daily activities. CONCLUSIONS: Our results demonstrated that HMGB-1 is overexpressed and relocated in synovial membranes of patients with knee OA. The increased synovial fluid HMGB-1 levels were associated with the severity of synovitis, pain, and daily activities in knee OA patients. These results suggested that HMGB-1, as a pro-inflammatory cytokine, may play a crucial role in the progression of knee OA.

Clinical practice guidelines for prevention and treatment of postoperative gastrointestinal disorder with Integrated Traditional Chinese and Western Medicine (2023).

Postoperative gastrointestinal disorder (POGD) was a common complication after surgery under anesthesia. Strategies in combination with Traditional Chinese Medicine and Western medicine showed some distinct effects but standardized clinical practice guidelines were not available. Thus, a multidisciplinary expert team from various professional bodies including the Perioperative and Anesthesia Professional Committees of the Chinese Association of Integrative Medicine (CAIM), jointly with Gansu Province Clinical Research Center of Integrative Anesthesiology/Anesthesia and Pain Medical Center of Gansu Provincial Hospital of Traditional Chinese Medicine and WHO Collaborating Center for Guideline Implementation and Knowledge Translation/Chinese Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) Center/Gansu Provincial Center for Medical Guideline Industry Technology/Evidence-based Medicine Center of Lanzhou University, was established to develop evidence-based guidelines. Clinical questions (7 background and 12 clinical questions) were identified through literature reviews and expert consensus meetings. Based on systematic reviews/meta-analyses, evidence quality was analyzed and the advantages and disadvantages of interventional measures were weighed with input from patients' preferences. Finally, 20 recommendations were developed through the Delphi-based consensus meetings. These recommendations included disease definitions, etiologies, pathogenesis, syndrome differentiation, diagnosis, and perioperative prevention and treatment.

High expression of SMARCC1 predicts poor prognosis in gastric cancer patients.

The switching/sucrose non-fermenting (SWI/SNF) chromatin remodeling complexes use the energy of ATP hydrolysis to remodel nucleosomes and modulate transcription, which plays an important role in tumors by regulating epigenetics. SWI/SNF Related, Matrix Associated, Actin Dependent Regulator of Chromatin, Subfamily C, Member 1 (SMARCC1) has dual roles in tumors but its role in gastric cancer remains unclear. This study was aimed to find the role of SMARCC1 in gastric cancer. SMARCC1 expression across various tumors from The Cancer Genome Atlas was analyzed using TIMER 2.0 (http://timer.comp-genomics.org/). SMARCC1 mRNA expression profiles in gastric cell lines and gastric tissues were compared with normal tissues and analyzed in the Cancer Cell Line Encyclopedia, Oncomine, and Gene Expression Omnibus databases. SMARCC1 mRNA and protein were then examined in fresh gastric cancer tissues and compared with adjacent normal tissues using quantitative real-time PCR, western blotting, and immunohistochemistry. Associations between SMARCC1 expression and clinicopathological factors, overall survival, and disease-free survival were further evaluated using 130 gastric cancer samples harvested from patients after radical total gastrectomy or subtotal gastrectomy at the Xiangya Hospital of Central South University (Changsha, China). SMARCC1 was frequently upregulated in gastric cancer cells and tissues. SMARCC1 overexpression was significantly associated with tumor size (P=0.002), differentiation (P=0.006), depth of invasion (P=0.001), lymph node involvement (P=0.016), and TNM stage (P=0.007). Furthermore, univariate and multivariate Cox analysis revealed that high SMARCC1 expression, depth invasion, lymph node involvement, and TNM stage were independent risk factors for both overall and disease-free survival in gastric cancer patients (all P<0.05). Kaplan-Meier survival analysis revealed that high SMARCC1 expression predicted poor prognosis in gastric cancer patients (P<0.01). High SMARCC1 expression contributes to poor prognosis in gastric cancer patients. SMARCC1 may be a prognostic biomarker and therapeutic target in gastric cancer.

Does sustainable environmental agenda matter in the era of globalization? The relationship among financial development, energy consumption, and sustainable environmental-economic growth.

The purpose of this research is to explore the connection of financial development, sustainable environmental-economic growth, and energy consumption among the South Asian Nations. This research examines a combine influence on energy consumption, financial development on sustainable environmental economic growth regarding south Asian economies. This study has used autoregressive distributive lag (ARDL) and panel data set from World Development Indicators (WDI) start from 1980 to 2018. The findings of this study indicate a significant and positive effect of financial development toward economic growth of selected south Asian economies. However, energy consumption has also positive impact toward sustainable environmental-economic growth, which further leads toward sustainable environmental agenda progress. Finally, energy consumption results have positive effect on sustainable economic growth among mean group (MG), pooled mean group (PMG), and common correlated effect mean group (CMEMG) results.

Effects of early vitamin D supplementation on the prevention of bronchopulmonary dysplasia in preterm infants.

BACKGROUND: Bronchopulmonary dysplasia (BPD) is a respiratory dysfunction caused by poor lung bronchial development, which may lead to long-term lung disease, threatening the lives of children. Studies have shown that premature infants with low vitamin D are highly associated with BPD. In this study, we aim to obtain insights into whether early vitamin D supplementation could prevent BPD in preterm infants. METHODS: A total of 112 preterm infants were randomly divided into two groups: the control and vitamin D supplementation (VD) group. The VD group received vitamin D (800 IU/day) within 48 h at birth for consecutively 28 days. The serum levels of 25(OH)D3 and C-reactive protein (CRP), IL6, and TNF-α were measured using ELISA assay. The arterial partial pressure of oxygen (PaO2 ) and carbon dioxide (PaCO2 ) was measured using an i-STAT analyzer. RESULTS: The occurrence of BPD was decreased in the VD group compared with the control. The decreased serum 25(OH)D3 was significantly elevated by supplementation with vitamin D. In addition, the serum inflammation factors (CRP, IL6, and TNF-α) were significantly reduced by vitamin D supplementation. CONCLUSION: We demonstrated that early vitamin D supplementation could significantly reduce BPD incidence in preterm infants. We showed that early vitamin D supplementation could significantly increase serum level of 25(OH)D3 and reduce inflammatory response thereby preventing and reducing neonatal BPD. LIMITATION: Firstly, a larger sample size will be needed to be included to gain a comprehensive understanding of the protective effects of vitamin D and BPD mechanistically in preterm infants. Secondly, the pathophysiological process of BPD will need to be studied. In addition, the pathways that vitamin D is responsible for, need to be further researched.

Targeting lncRNA PSMA3-AS1, a Prognostic Marker, Suppresses Malignant Progression of Oral Squamous Cell Carcinoma.

OBJECTIVE: Oral squamous cell carcinoma (OSCC) represents the most common maxillofacial malignancy. This study elucidated the clinicopathological value and molecular mechanisms of PSMA3 antisense RNA 1 (PSMA3-AS1) in OSCC. METHODS: Totally, 135 OSCC patients were recruited. PSMA3-AS1 expression and its prognostic value were assessed in this cohort. si-PSMA3-AS1 was transfected into HN4 and CAL-27 OSCC cells. Then, cell proliferation was evaluated by CCK-8, colony formation, and EdU staining. Migration and invasion were investigated through wound healing, transwell, and western blot. The PSMA3-AS1/miR-136-5p and miR-136-5p/FN1 interactions were validated by dual luciferase report, real-time quantitative polymerase chain reaction (RT-qPCR), and western blot. RESULTS: PSMA3-AS1 upregulation was determined in OSCC tissues. The upregulation indicated pessimistic patients' outcomes. Multivariate Cox regression analyses confirmed PSMA3-AS1 as an independent prognostic indicator. Its upregulation was also found in OSCC cells. Under transfection with si-PSMA3-AS1, proliferation, migration, and invasion were all restrained in HN4 and CAL-27 OSCC cells. Furthermore, its knockdown induced the increase in E-cadherin expression and the reduction in N-cadherin and Vimentin expression. PSMA3-AS1 was a sponge of miR-136-5p. Mutual inhibition was found between two and the interactions were confirmed by dual luciferase report. It was confirmed that FN1 was a target of miR-136-5p. FN1 expression was increased by miR-136-5p inhibitors, which was lessened by si-PSMA3-AS1 cotransfection. CONCLUSION: Collectively, PSMA3-AS1 as a risk factor facilitated malignant behaviors of OSCC cells, related to the miR-136-5p/FN1 axis. Hence, PSMA3-AS1 as a potential therapeutic target for OSCC deserved further exploration.

Circular RNA FNDC3B Protects Oral Squamous Cell Carcinoma Cells From Ferroptosis and Contributes to the Malignant Progression by Regulating miR-520d-5p/SLC7A11 Axis.

Oral squamous cell carcinoma (OSCC) is a common head and neck malignancy with increasing mortality and high recurrence. Ferroptosis is an emerging programed cell death and plays an essential role in tumorigenesis. Circular RNAs (circRNAs) have been reported as a type of critical regulators in OSCC development. In this study, we identified the function of circular RNA FNDC3B (circFNDC3B) in regulating ferroptosis during the malignant progression of OSCC. Our data demonstrated that the silencing of circFNDC3B by shRNA inhibited GPX4 and SLC7A11 expression and enhanced ROS, iron, and Fe2+ levels in OSCC cells. CircFNDC3B knockdown reinforced erastin-induced inhibitory effect on OSCC cells. The depletion of circFNDC3B repressed cell proliferation and enhanced cell apoptosis of OSCC cells. Mechanically, circFNDC3B was able to increase SLC7A11 by targeting miR-520d-5p. The overexpression of SLC7A11 reversed circFNDC3B depletion or miR-520d-5p-induced ferroptosis phenotypes of OSCC cells. Moreover, tumorgenicity assays in nude mice showed that the depletion of circFNDC3B repressed OSCC cell growth in vivo. Taken together, we concluded that circFNDC3B attenuated ferroptosis of OSCC cells and contributed to OSCC progression by regulating the miR-520d-5p/SLC7A11 axis. CircFNDC3B, miR-520d-5p, and SLC7A11 may serve as potential therapeutic targets of OSCC.

Carnosic acid alleviates brain injury through NF­κB­regulated inflammation and Caspase­3­associated apoptosis in high fat­induced mouse models.

High fat diet (HFD) is a risk factor for various diseases in humans and animals. Metabolic disease­induced brain injury is becoming an increasingly popular research topic. Carnosic acid (CA) is a phenolic diterpene synthesized by plants belonging to the Lamiaceae family, which exhibits multiple biological activities. In the present study, a mouse model of HFD­induced metabolic syndrome was generated. The body weight, liver weight, daily food intake, daily caloric intake, serum TG, serum TC, serum insulin and serum glucose of animals treated with CA were recorded. Additionally, the gene and protein expression levels of inflammatory cytokines, NF­κB signaling componnts, and caspase­3 were evaluated in the various CA treatment groups via immunohistochemical analysis, western blotting, reverse transcription­quantitative PCR. CA treatment significantly decreased HFD­induced metabolic syndrome by decreasing the serum levels of triglycerides, total cholesterol, insulin and glucose. Furthermore, CA served a protective role against brain injury by inhibiting the inflammatory response. CA significantly decreased the protein expression levels of various pro­inflammatory cytokines in serum and brain tissues, including interleukin (IL)­1ß, IL­6 and tumor necrosis factor­α, regulated by the NF­κB signaling pathway. In addition, CA was revealed to promote the expression levels of anti­apoptotic Bcl­2, and to decrease the expression levels of pro­apoptotic Bax and matrix metallopeptidase 9. The present results suggested that CA was able to alleviate brain injury by modulating the inflammatory response and the apoptotic pathway. Administration of CA may represent a novel therapeutic strategy to treat metabolic disease­induced brain injury in the future.

Decreased Expression of Tumor-suppressor Gene LKB1 Correlates with Poor Prognosis in Human Gastric Cancer.

BACKGROUND/AIM: The present report describes the correlation of liver kinase B1 (LKB1) expression with tumorigenesis and prognosis in gastric cancer. MATERIALS AND METHODS: LKB1 mRNA and protein expression was detected in gastric-cancer cell lines and patient specimens. Patients were followed-up and clinico-pathological parameters and overall survival (OS) were evaluated. RESULTS: The expression of LKB1 mRNA and protein was lower in gastric-cancer cell lines and tumor tissues compared to normal gastric cells (p<0.05) and tissues (p<0.001). Decreased expression of LKB1 mRNA and protein in patients with gastric cancer was significantly inversely related to TNM stage, T-stage (depth of invasion), lymph-node metastasis and vascular invasion (p<0.05). Patients showing high LKB1 mRNA and high LKB1 protein expression had a significantly longer OS and better 5-year survival rate than those with low mRNA expression (61.3 months vs. 56.1 months and 75% vs. 58.7%, p<0.05, respectively) and low protein expression (64.8 months vs. 55.7 months and 72.9% vs. 64.5%, p<0.05, respectively). Multivariate Cox regression analysis indicated that both LKB1 mRNA and protein expression in gastric cancer were independent prognostic factors for OS. CONCLUSION: Patients with gastric cancer with decreased expression of LKB1 have a poor prognosis with a lower survival rate.

Therapeutic Efficacy of the Traditional Chinese Medicine Baishaoqiwu on TNBS-induced Colitis is Associated with Down-regulation of the TLR4/MyD88/NF-κB Signaling Pathway.

BACKGROUND/AIM: The traditional Chinese medicine Baishaoqiwu (BSQW) has been previously used to clinically treat inflammatory bowel diseases. However, the mechanisms of it's therapeutic efficacy remain unclear. The aim of this study was to examine the efficacy of BSQW on ulcerative colitis (UC) and the TLR4/MyD88/NF-κB signaling pathway in a rat model of colitis. MATERIALS AND METHODS: The colitis rat model was induced by anal instillation of 2,4,6-trinitrobenzene sulfonic acid (TNBS). The animals with induced colitis were treated with BSQW at a dose of 13.2 mg/kg daily, p.o. Mesalazin was used as a positive control and was given to the animals with induced colitis at a dose of 420 mg/kg daily, p.o. The untreated animals with induced colitis and normal animals served as model controls and normal controls, respectively. Macroscopic and histological assessments were performed after treatment. The expression of MyD88, NF-κB P65 and TLR4 were determined by immunohistochemical analysis. RESULTS: Administration of BSQW or Mesalazin ameliorated TNBS-induced macroscopic and histological damage in the rats with induced colitis. The macroscopic score and total colitis index were significantly reduced in the BSQW- and Mesalazin-treated groups compared to the model control group (p<0.05). BSQW or Mesalazin significantly inhibited TNBS-induced expression of the TLR4, MyD88 and NF-κB P65 genes. No treatment-related toxicity was found in either the BSQW- or the Mesalazin-treated groups. CONCLUSION: Suppression of the TLR4/MyD88/NF-κB signaling pathway may be one of the mechanisms involved in the therapeutic efficacy of BSQW against UC.

Comparisons of serum total IgE, IgG, and IgG1 levels in patients with and without echinococcosis-induced anaphylactic shock.

We investigated serum total immunoglobulin E (IgE), IgG, and IgG1 levels in patients with and without echinococcosis-induced anaphylactic shock. This was a case-control study of 11 patients with echinococcosis-induced anaphylactic shock and 22 echinococcosis patients with cyst rupture but without anaphylactic shock. Blood was collected before surgery (T0), at the time of cyst rupture (T1), and shock (Tx), 1 h (T2), 1 day (T3), and 1 week (T4) after cyst rupture. Serum IgE, IgG, and IgG1 were determined by enzyme-linked immunosorbent assay. Serum IgE, IgG, and IgG1 levels were significantly higher in patients who developed anaphylactic shock at all time points. Increased pre-surgical IgG and IgG1 levels were identified to be a significant risk factors for developing anaphylactic shock. The results showed that a serum IgG concentration of 312.25 µg/mL could be used as a cut-off point to predict whether an echinococcosis patient would develop anaphylactic shock.

Demographic and clinical characteristics of patients with anaphylactic shock after surgery for cystic echinococcosis.

We reviewed the records of 446 patients who were treated surgically for cystic echinococcosis (CE) to identify risk factors for anaphylactic shock. Of 446 patients, 10 had final diagnoses of anaphylactic shock induced by CE; none died. The incidence of anaphylactic shock was significantly higher in younger age groups (P < 0.001) and in patients with pulmonary cysts. Anaphylactic shock induced by CE appears to differ from type I immediate hypersensitivity shock, which suggests that in CE, shock may be caused by a combination of immediate hypersensitivity and endotoxic shock. This possibility suggests that additional precautions should be taken during surgery. These precautions include reducing intracystic pressure, which would prevent possible leaked liquid from reaching other organs by surrounding the cyst with sterile gauze and decrease the chance of spreading the echinococcus; preventing antigen from contacting other tissues where it might trigger anaphylaxis; and resecting the cyst completely when feasible.