BACKGROUND Many studies have demonstrated the benefit of complete multivessel revascularization versus culprit-only intervention in patients of ST-segment elevation myocardial infarction(STEMI)and multivessel coronary...BACKGROUND Many studies have demonstrated the benefit of complete multivessel revascularization versus culprit-only intervention in patients of ST-segment elevation myocardial infarction(STEMI)and multivessel coronary artery disease.However,only a few single-center retrospective studies were performed on small Chinese cohorts.Our study aims to demonstrate the advantage of multivessel percutaneous intervention(PCI)strategy on 30-day in-hospital outcomes to patients with STEMI and multivessel disease in larger Chinese population.METHODS From the Improving Care for Cardiovascular Disease in China-Acute Coronary Syndrome(CCC-ACS)project,5935 patients with STEMI and multivessel disease undergoing PCI and hospitalized for fewer than 30 days were analyzed.After 5:1 propensity score matching,3577 patients with culprit-only PCI and 877 with in-hospital multivessel PCI were included.The primary outcome was major adverse cardiovascular and cerebrovascular event(MACCE),defined as a composite of myocardial infarction,all-cause death,stent thrombosis,heart failure,and stroke.RESULTS Multivariable logistic regression analysis revealed that in-hospital multivessel PCI was associated with lower risk of 30-day MACCE(adjusted OR=0.75,95%CI:0.57-0.98,P=0.032)than culprit-only PCI and conferred no increased risk of allcause death,myocardial infarction,stent thrombosis,stroke,or bleeding.Subgroup analysis showed that MACCE reduction was observed more often from patients with trans-femoral access(OR=0.34,95%CI:0.15-0.74)than with trans-radial access(OR=0.87,95%CI:0.66-1.16,P for interaction=0.017).CONCLUSIONS The in-hospital multivessel PCI strategy was associated with a lower risk of 30-day MACCE than culprit-only PCI in patients with STEMI and multivessel coronary artery disease.展开更多
Atrial fibrillation(AF)is the most common sustained cardiac arrhythmia,significantly impacting patients’quality of life and increasing the risk of death,stroke,heart failure,and dementia.Over the past two decades,the...Atrial fibrillation(AF)is the most common sustained cardiac arrhythmia,significantly impacting patients’quality of life and increasing the risk of death,stroke,heart failure,and dementia.Over the past two decades,there have been significant breakthroughs in AF risk prediction and screening,stroke prevention,rhythm control,catheter ablation,and integrated management.During this period,the scale,quality,and experience of AF management in China have greatly improved,providing a solid foundation for the development of guidelines for the diagnosis and management of AF.To further promote standardized AF management,and apply new technologies and concepts to clinical practice in a timely and comprehensive manner,the Chinese Society of Cardiology of the Chinese Medical Association and the Heart Rhythm Committee of the Chinese Society of Biomedical Engineering have jointly developed the Chinese Guidelines for the Diagnosis and Management of Atrial Fibrillation.The guidelines have comprehensively elaborated on various aspects of AF management and proposed the CHA2DS2-VASc-60 stroke risk score based on the characteristics of AF in the Asian population.The guidelines have also reevaluated the clinical application of AF screening,emphasized the significance of early rhythm control,and highlighted the central role of catheter ablation in rhythm control.展开更多
BACKGROUND Endoscopic variceal treatment(EVT)is recommended as the mainstay choice for the management of high-risk gastroesophageal varices and acute variceal bleeding in liver cirrhosis.Proton pump inhibitors(PPIs)ar...BACKGROUND Endoscopic variceal treatment(EVT)is recommended as the mainstay choice for the management of high-risk gastroesophageal varices and acute variceal bleeding in liver cirrhosis.Proton pump inhibitors(PPIs)are widely used for various gastric acid-related diseases.However,the effects of PPIs on the development of post-EVT complications,especially gastrointestinal bleeding(GIB),remain controversial.AIM To evaluate the effects of postoperative use of PPIs on post-EVT complications in patients with liver cirrhosis during hospitalization.METHODS Patients with a diagnosis of liver cirrhosis who were admitted to the Department of Gastroenterology of the General Hospital of Northern Theater Command,treated by an attending physician between January 2016 and June 2020 and underwent EVT during their hospitalization were included.Logistic regression analyses were performed to explore the effects of postoperative use of PPIs on the development of post-EVT complications during hospitalization.Odds ratios(ORs)with 95%confidence intervals(CIs)were calculated.RESULTS A total of 143 patients were included.The incidence of post-EVT GIB and other post-EVT complications was 4.90%and 46.85%,respectively.In the overall analyses,postoperative use of PPIs did not significantly reduce the risk of post-EVT GIB(OR=0.525,95%CI=0.113-2.438,P=0.411)or other post-EVT complications(OR=0.804,95%CI=0.413-1.565,P=0.522).In the subgroup analyses according to the enrollment period,type and route of PPIs after the index EVT,use of PPIs before the index EVT,use of vasoactive drugs after the index EVT,indication of EVT(prophylactic and therapeutic),and presence of portal venous system thrombosis,ascites,and hepatocellular carcinoma,the effects of postoperative use of PPIs on the risk of post-EVT GIB or other post-EVT complications remain not statistically significant.CONCLUSION Routine use of PPIs after EVT should not be recommended in patients with liver cirrhosis for the prevention of post-EVT complications during hospitalization.展开更多
BACKGROUND Recent reviews have outlined the main nanomaterials used in relation to gastrointestinal tumors and described the basic properties of these materials.However,the research hotspots and trends in the applicat...BACKGROUND Recent reviews have outlined the main nanomaterials used in relation to gastrointestinal tumors and described the basic properties of these materials.However,the research hotspots and trends in the application of nanomaterials in gastric cancer(GC)remain obscure.AIM To demonstrate the knowledge structure and evolutionary trends of research into the application of nanomaterials in GC.METHODS Publications related to the application of nanomaterials in GC were retrieved from the Web of Science Core Collection for this systematic review and bibliometric study.VOSviewer and CiteSpace were used for bibliometric and visualization analyses.RESULTS From 2000 to 2022,the application of nanomaterials in GC developed rapidly.The keyword co-occurrence analysis showed that the related research topics were divided into three clusters:(1)The application of nanomaterials in GC treatment;(2)The application and toxicity of nanomaterials in GC diagnosis;and(3)The effects of nanomaterials on the biological behavior of GC cells.Complexes,silver nanoparticles,and green synthesis are the latest high-frequency keywords that represent promising future research directions.CONCLUSION The application of nanomaterials in GC diagnosis and treatment and the mechanisms of their effects on GC cells have been major themes in this field over the past 23 years.展开更多
Background:Transcatheter closure(TCC)has emerged as the preferred treatment for selected congenital heart disease(CHD).While TCC offers benefits for patients with postoperative residual shunts,understanding its mid-an...Background:Transcatheter closure(TCC)has emerged as the preferred treatment for selected congenital heart disease(CHD).While TCC offers benefits for patients with postoperative residual shunts,understanding its mid-and long-term efficacy and safety remains crucial.Objective:This study aims to assess the mid-and long-term safety and efficacy of TCC for patients with residual atrial or ventricular septal shunts following CHD correction.Methods:In this consecutive retrospective study,we enrolled 35 patients with residual shunt who underwent TCC or surgical repair of CHD between June 2011 to October 2022.TCC candidacy was determined based on established criteria.Echocardiography and electrocardiogram were conducted during the perioperative period and continued as part of long-term follow-up.Results:Among the patients,5(14.3%)exhibited interatrial shunt-ing,while 30(85.7%)had interventricular shunting.TCC was successfully implemented in 33 of 35 patients,with exceptions in two cases of post-ventricular septal defect repair due to anatomical challenges involving the shape and aortic angulation.This resulted in a TCC success rate of 94.3%.Trace residual shunt was detected in two interventricular shunting cases and a mild residual shunt in one interventricular shunting case;all resolved by the three-month follow-up after TCC.Minor complications included one hematoma at the puncture site and one transient junctional rhythm during the perioperative period.During a median follow-up of 73 months,there were no instances of residual shunt,device embolization,occluder displacement,valve insufficiency,malignant arrhythmia,infective endocarditis,death,or other serious complications.Conclusion:TCC is an effective and safe therapy for patients with residual atrial or ventricular septal shunts following CHD correction.Thesefindings support the consideration of TCC as the preferred treatment option for appropriate patient populations.展开更多
Central venous catheterization establishes temporary,efficient,and rapid use of deep venous access in patients,which provides high flow rate fluid perfusion,enables measurement of central venous pressure,and acts as a...Central venous catheterization establishes temporary,efficient,and rapid use of deep venous access in patients,which provides high flow rate fluid perfusion,enables measurement of central venous pressure,and acts as an important reference for clinical decision-making.However,various complications such as pneumothorax,hemothorax,hematoma,and puncture failure can easily occur during the puncture and catheterization process.展开更多
BACKGROUND Postpartum quality of life(QoL)in women with heart disease has been neglected.AIM To improve clinical communication and treatment,we integrated medical data and subjective characteristics to study postpartu...BACKGROUND Postpartum quality of life(QoL)in women with heart disease has been neglected.AIM To improve clinical communication and treatment,we integrated medical data and subjective characteristics to study postpartum QoL concerns.METHODS The study assessed QoL 6 wk after birth using the 12-Item Short-Form Health Survey.The Edinburgh Postnatal Depression Scale,Cardiac Anxiety Questionnaire,European Heart Failure Self-Care Behavior Scale,and a self-designed questionnaire based on earlier research were also used to assess patient characteristics.Patient data were collected.Prediction models were created using multiple linear regression.RESULTS This retrospective study examined postpartum QoL in 105 cardiac patients.Postpartum QoL scores were lower(90.69±13.82)than those of women without heart disease,with physical component scores(41.09±9.91)lower than mental component scores(49.60±14.87).Postpartum depression(33.3%),moderate anxiety(37.14%),pregnancy concerns(57.14%),offspring heart problems(57.14%),and life expectancy worries(48.6%)were all prevalent.No previous cardiac surgery,multiparity,higher sadness and cardiac anxiety,and fear of unfavorable pregnancy outcomes were strongly related to lower QoL(R^(2)=0.525).CONCLUSION Postpartum QoL is linked to physical and mental health in women with heart disease.Our study emphasizes the need for healthcare workers to recognize the unique characteristics of these women while developing and implementing comprehensive management approaches during their maternity care.展开更多
BACKGROUND The outcome of surgical treatment for colorectal cancer(CRC)remains unsatis-factory and warrants further exploration and optimization.AIM To clarify the impact of chemotherapy plus cellular immunotherapy[de...BACKGROUND The outcome of surgical treatment for colorectal cancer(CRC)remains unsatis-factory and warrants further exploration and optimization.AIM To clarify the impact of chemotherapy plus cellular immunotherapy[dendritic cell-cytokine-induced killer(DC-CIK)cell immunotherapy]on patients after CRC surgery and to explore the mediating variables.METHODS A total cohort of 121 patients who underwent CRC surgery between January 2019 and April 2022 were selected.The sample comprised a control group of 55 pa-tients who received the XELOX chemotherapy regimen and a research group of 66 patients who received XELOX+DC-CIK immunotherapy.We performed compa-rative analyses of the clinical and pathological data of the two groups,including efficacy(2-year disease-free survival[DFS]rate),the incidence of adverse events(diarrhea,myelosuppression,gastrointestinal reactions,and peripheral neuritis),serum levels of tumor markers[carcinoembryonic antigens and carbohydrate an-tigens(CA)19-9 and CA242],and T-cell subsets[cluster of differentiation(CD)3+,CD3+CD4+,CD3+CD8+,natural killer(NK),and NK T cells].We also conducted preliminary univariate and mul-tivariate analyses of the variables that affected the efficacy of the treatments.RESULTS We found a significantly higher 2-year DFS rate of treatment efficacy in the research group than in the control group,with a statistically lower incidence of adverse events.Both groups showed a reduction in serum tumor markers after treatment but there was no marked intergroup difference.After treatment,the various T-cell subgroup indicators in the control group were significantly lower than those in the research group.The indices of T-cell subsets in the research group showed no significant change from preoperative levels.Univariate analysis revealed a significant correlation between TNM staging,tumor differentiation,and the rates of nonresponse to treatment in CRC patients after surgery.Multivariate results indicated that the treatment approach significantly affected the efficacy of postoperative CRC treatment.CONCLUSION We concluded that XELOX+DC-CIK immunotherapy for postsurgical CRC patients offers reduced rates of treatment-induced adverse events,extended 2-year DFS,enhanced immunity,and increased physiological antitumor responses.展开更多
BACKGROUND Lupus mesenteric vasculitis(LMV)is a serious condition that may occur as an acute manifestation of gastrointestinal(GI)involvement and is not easily diagnosed by physicians.Delayed diagnosis and treatment o...BACKGROUND Lupus mesenteric vasculitis(LMV)is a serious condition that may occur as an acute manifestation of gastrointestinal(GI)involvement and is not easily diagnosed by physicians.Delayed diagnosis and treatment of LMV may lead to rapid disease progression and can be life threatening.CASE SUMMARY A previously healthy 27-year-old woman presented with abdominal pain following a history of fatigue and consumption of cold water.Laboratory invest-igations,physical examinations,and enhanced abdominal computed tomography(CT)suggested systemic lupus erythematosus complicated by LMV.She received treatments,such as GI decompression,somatostatin,glucocorticoids,and immu-nosuppressants,and was evaluated using color ultrasonography.Twenty days later,the patient reported no stomach discomfort and was able to consume semi-liquid food.Laboratory investigations showed that inflammatory factors decreased to normal levels and complement levels increased slightly.One year after discharged,she recovered with methylprednisolone being tapered to 4 mg per day,mycophenolate mofetil to 0.75 g bid,and hydroxychloroquine to 0.2 g bid;however,only C3 complement level was slightly below the normal level.CONCLUSION Early diagnosis of LMV is essential for successful treatment;this depends on a combination of clinical manifestations,laboratory investigations,and imaging findings.Enhanced CT is preferred,but ultrasonography can be used for prompt screening and follow-up.展开更多
BACKGROUND Intrahepatic cholangiocarcinoma(ICC)is a malignant tumor of the hepatobiliary system with concealed onset,strong invasiveness and poor prognosis.AIM To explore the disease characteristic genes that may be h...BACKGROUND Intrahepatic cholangiocarcinoma(ICC)is a malignant tumor of the hepatobiliary system with concealed onset,strong invasiveness and poor prognosis.AIM To explore the disease characteristic genes that may be helpful in the diagnosis of ICC and affect immune cell infiltration.METHODS We downloaded two ICC-related human gene expression profiles from GEO database as the training group(GSE26566 and GSE32958 datasets)for difference analysis,and performed enrichment analysis on differential genes.The least absolute shrinkage and selection operator(LASSO),support vector machinerecursive feature elimination(SVM-RFE)and random forest(RF),three machine learning algorithms,were used to screen the characteristic genes.Double verification was carried out on GSE107943 and The Cancer Genome Atlas,two verification groups.Receiver operating characteristic curve and area under the curve(AUC)were used to evaluate the diagnostic efficacy of genes for ICC.CIBERSORT and ssGSEA algorithms were used to evaluate the effect of characteristic genes on immune infiltration pattern.Human Protein Atlas(HPA)was used to analyze the protein expression level of the target gene.RESULTS A total of 1091 differential genes were obtained in the training group.Enrichment analysis showed that the above genes were mainly enriched in small molecular catabolism,complement and coagulation cascade,bile secretion and other functions and pathways.Twentyfive characteristic genes were screened by LASSO regression,19 by SVM-RFE algorithm,and 30 by RF algorithm.Three algorithms were used in combination to determine the characteristic gene of ICC:MMP14.The verification group confirmed that the genes had a high diagnostic accuracy(AUC values of the training group and the verification group were 0.960,0.999,and 0.977,respectively).Comprehensive analysis of immune infiltration showed that MMP14 could affect the infiltration of monocytes,activated memory CD4 T cells,resting memory CD4 T cells,and other immune cells,and was closely related to the expression of CD200,cytotoxic T-lymphocyteassociated antigen 4,CD14,CD44,and other immune checkpoints.The results of immunohistochemistry in HPA database showed was indeed overexpressed in ICC.CONCLUSION MMP14 can be used as a disease characteristic gene of ICC,and may regulate the distribution of immune-infiltrating cells in the ICC tumor microenvironment,which provides a new method for the determination of ICC diagnostic markers and screening of therapeutic targets.展开更多
BACKGROUND The carcinogenesis of stomach adenocarcinoma(STAD)involves many different molecules and multiple pathways,including the NOTCH signaling pathway.As a key factor that functions as a critical link in the NOTCH...BACKGROUND The carcinogenesis of stomach adenocarcinoma(STAD)involves many different molecules and multiple pathways,including the NOTCH signaling pathway.As a key factor that functions as a critical link in the NOTCH pathway,mind bomb 1(MIB1)is upregulated in various tumors and has been reported to promote cell metastasis and invasion.However,studies on the role of MIB1 in STAD are limited.Here,we evaluated the prognostic value of MIB1 in STAD and its association with immune infiltration and copy number variation.AIM To elucidate the relationship between MIB1 gene and gastric cancer(GC)and provide a new idea for the treatment of GC.METHODS We identified mutations in the MIB1 gene by searching the cBioPortal database and then analyzed their relationship with the overall survival rate and diseasefree survival rate using the Kaplan-Meier method.The Cancer Genome Atlas(TCGA)database provided transcript levels for MIB1 in STADs and normal tissues.As a method of distinguishing the STAD tissues from adjacent normal tissues,a receiver operating characteristic(ROC)curve was generated.Kaplan-Meier plotter was used to determine the effect of MIB1 expression on survival.Based on the LinkedOmics database,we were able to identify the coexpressed genes of the MIB1 gene,the top 50 positively correlated genes,and the top 50 negatively correlated genes.STRING was used to construct protein-protein interaction networks related to the MIB1 gene.An analysis of functional enrichment was carried out using the R package“Cluster Profiler”.The relationships between mRNA expression of MIB1 and immune infiltrates were assessed by Tumor IMmune Estimation Resource(TIMER)and the“GSVA package”in R.RESULTS According to the cBioPortal database,the MIB1 mutation rate in 287 patients in the TCGA dataset was approximately 6%.Kaplan-Meier survival analysis showed that patients with STAD in the mutated group had a worse prognosis than those in the unmutated group(P=0.0156).There was a significant upregulation of MIB1 expression in STAD tissues compared to adjacent normal tissues.A high T stage was associated with increased MIB1 mRNA expression.The ROC curve analysis revealed 59.4%sensitivity and 85.6%specificity of MIB1 for differentiating STAD tissues from adjacent normal tissues at a truncation level of 2.248.Kaplan-Meier plotter indicated that patients with higher MIB1 levels had a worse prognosis than those with lower levels(26.4 mo vs 56.2 mo,P=0.0330).A correlation analysis demonstrated an association between immune infiltrates and MIB1 mRNA expression.CONCLUSION Upregulation of MIB1 expression is significantly associated with poor survival rate and immune infiltration in gastric adenocarcinoma.MIB1 may be a biomarker for the poor prognosis of STAD patients and a potential immunotherapeutic target.展开更多
Objective:This study was designed to determine the long-term safety and efficacy of using the Amplatzer Duct Occluder II(ADO II)for the closure of various ventricular septal defects(VSDs).Methods:From January 2011 to ...Objective:This study was designed to determine the long-term safety and efficacy of using the Amplatzer Duct Occluder II(ADO II)for the closure of various ventricular septal defects(VSDs).Methods:From January 2011 to December 2019,selected VSD patients were treated through transcatheter intervention using ADO II occluders.The closure results and complications from 188 patients,involving 167 perimembranous ventricular septal defects(pmVSDs),9 intracristal VSDs,11 post surgery residual shunts and 1 post closure residual shunt with the mean outlet diameter3.1±0.8 mm under angiography,were enrolled in this study.Results:The success rate was 98.9%for all procedures.During the median 77-month follow-up period,no cases of complete atrioventricular block(cAVB),infective endocarditis or death occurred.One major adverse event(0.5%)was recorded:cerebrovascular accident occurred 1 day after the procedure in one patient who was transferred to the neurology department.The residual shunt rate was 44.6%,which was the most common minor adverse event.The cardiac conduction block rate was 4.3%.Specifically,one pmVSD patient developed intermittent LBBB during the 28-month follow-up.There were 3 patients(1.6%)with new-onset mild tricuspid insufficiency,and the insufficiency degree was stable during follow-up.There was no new-onset aortic insufficiency that occurred.Conclusions:Transcatheter closure of pmVSDs,some intracristal VSDs,some postsurgery or postclosure residual shunts using ADO II occluders were both safe and effective and yielded excellent long-term results in selected patients.展开更多
Background: The late detection of endometrial carcinoma (EC) at an advanced stage often results in a poorpatient prognosis. It is hence important to identify reliable biomarkers to facilitate early detection of EC. Si...Background: The late detection of endometrial carcinoma (EC) at an advanced stage often results in a poorpatient prognosis. It is hence important to identify reliable biomarkers to facilitate early detection of EC. Signaltransducer and activator of transcription (STAT) family members play an important role in several tumors, however,their impact on EC development and progression remains unclear. Methods: Machine learning methods were used toinvestigate the importance of STAT5B in EC. Results: Hence, we explored the UALCAN data mining platform andfound that while STAT1 and STAT2 were upregulated, STAT5A, STAT5B, and STAT6 were downregulated in EC.This high expression of STAT5B and STAT6 predicted favorable clinical outcomes, whereas the increased expressionof STAT1 and STAT2 predicted poor clinical outcomes. Subsequent pathway enrichment analysis revealed that theSTAT family was mainly involved in apoptosis pathway activation, cell cycle disruption, and epithelial–mesenchymaltransition. Drug sensitivity analysis demonstrated that STAT5A/5B expression was negatively correlated with drugresistance in EC. Further, the expression of STAT5B mRNA and protein was correlated with severalclinicopathological characteristics. Tumor Immune Estimation Resource (TIMER) analysis revealed that STAT5Bexpression was positively correlated with the abundance of infiltrating CD8+ T cells and neutrophils while its copynumber variation was associated with the overall immune cell infiltration. The data on the correlations betweenSTAT5B expression and related genes in uterine corpus endometrial carcinoma (UCEC) in cBio Cancer Portalshowed the closest correlation of STAT5B expression with that of KIAA0753 (also known as moonraker and OFIP),followed by COL27A1 in EC. Pathway enrichment analysis further showed that STAT5B-related genes were involvedin the mitogen-activated protein kinase (MAPK) and Ras signaling pathways. Conclusion: Collectively, our findingsprovided new insights into the role of the STAT family in EC. It also highlighted new targets for future research ondiagnostic and prognostic markers and STAT5B as a novel marker for drug sensitivity screening.展开更多
BACKGROUND The efficacy and safety of anti-tumor necrosis factor-α(TNF-α)monoclonal antibody therapy[adalimumab(ADA)and infliximab(IFX)]with therapeutic drug monitoring(TDM),which has been proposed for inflammatory ...BACKGROUND The efficacy and safety of anti-tumor necrosis factor-α(TNF-α)monoclonal antibody therapy[adalimumab(ADA)and infliximab(IFX)]with therapeutic drug monitoring(TDM),which has been proposed for inflammatory bowel disease(IBD)patients,are still controversial.AIM To determine the efficacy and safety of anti-TNF-αmonoclonal antibody therapy with proactive TDM in patients with IBD and to determine which subtype of IBD patients is most suitable for proactive TDM interventions.METHODS As of July 2023,we searched for randomized controlled trials(RCTs)and observa-tional studies in PubMed,Embase,and the Cochrane Library to compare anti-TNF-αmonoclonal antibody therapy with proactive TDM with therapy with reactive TDM or empiric therapy.Pairwise and network meta-analyses were used to determine the IBD patient subtype that achieved clinical remission and to determine the need for surgery.RESULTS This systematic review and meta-analysis yielded 13 studies after exclusion,and the baseline indicators were balanced.We found a significant increase in the number of patients who achieved clinical remission in the ADA[odds ratio(OR)=1.416,95%confidence interval(CI):1.196-1.676]and RCT(OR=1.393,95%CI:1.182-1.641)subgroups and a significant decrease in the number of patients who needed surgery in the proactive vs reactive(OR=0.237,95%CI:0.101-0.558)and IFX+ADA(OR=0.137,95%CI:0.032-0.588)subgroups,and the overall risk of adverse events was reduced(OR=0.579,95%CI:0.391-0.858)according to the pairwise meta-analysis.Moreover,the network meta-analysis results suggested that patients with IBD treated with ADA(OR=1.39,95%CI:1.19-1.63)were more likely to undergo TDM,especially in comparison with patients with reactive TDM(OR=1.38,95%CI:1.07-1.77).CONCLUSION Proactive TDM is more suitable for IBD patients treated with ADA and has obvious advantages over reactive TDM.We recommend proactive TDM in IBD patients who are treated with ADA.展开更多
Background:Some observational associations between body weight and breast cancer have attracted attention.However,the causal relationship between these 2 factors remains unclear,and more clinical outcomes are needed f...Background:Some observational associations between body weight and breast cancer have attracted attention.However,the causal relationship between these 2 factors remains unclear,and more clinical outcomes are needed for its validation.Methods:Based on statistical data from a Genome Wide Association Study,we performed a bidirectional Mendelian randomization analysis to assess the bidirectional causal relationship between body weight and breast cancer using 4 methods,with inverse variance weighting as the primarymethod.To verify the robustness and reliability of the causal relationship,we performed a sensitivity analysis using horizontal pleiotropy,outlier,and one-by-one elimination tests.Results:The inverse variance weighting results revealed no significant positive causal relationship between body weight and breast cancer.Similarly,the reverse analysis revealed no causal effect of breast cancer on body weight.Conclusions:The relationship between body weight and breast cancer may be attributed to confounding factors.展开更多
BACKGROUND Premature ovarian insufficiency(POI)and premature ovarian failure(POF)have become one of the major problems threatening women of childbearing age.Studies have shown that stem cells transplanted from bone ma...BACKGROUND Premature ovarian insufficiency(POI)and premature ovarian failure(POF)have become one of the major problems threatening women of childbearing age.Studies have shown that stem cells transplanted from bone marrow,umbilical cord,peripheral blood and amniotic fluid can migrate and proliferate to the ovary,promote ovarian function repair,increase the number of follicles and granulosa cells at all levels of ovary,improve endocrine function,and can differentiate into oocytes in specific ovarian environment to restore fertility to some extent.AIM To study the ability of human umbilical cord mesenchymal stem cells(hUCMSCs)to repair ovarian injury after chemotherapy.METHODS A total of 110 female BALB/c mice(aged 7-8 wk old)with body masses of 16.0-20.0 g were selected.The mice were fed until 12 wk of age,and cyclophosphamide was administered by intraperitoneal injection for 14 consecutive days to induce premature ovarian failure in mice.Seventy-five mice with estrous cycle disorder were screened and randomly divided into 3 groups according to their body weight:model group,positive control group and hUCMSC group,and each group had 25 mice.Another 25 mice were used as negative controls.The mice in the hUCMSC group were injected with hUCMSCs in the tail vein,and the mice in the positive control group were given an oestradiol valerate solution and a medroxyprogesterone acetate solution in the tail vein.On the 1^st,15^th,30^th,45^th,and 60^th days after intravenous administration,vaginal smears were made to monitor the estrous cycles of the mice.The ovaries were weighed,and pathological sections were made to observe the morphology of the follicles;blood samples were collected to monitor the concentration of sex hormones(oestradiol and follicle-stimulating hormone).RESULTS The estrous cycles of the model group mice were disrupted throughout the experiment.Mice in the hUCMSC group and the positive control group resumed normal estrous cycles.The ovarian weight of the model group mice continued to decline.The ovarian weight of the hUCMSC group mice and the positive control group mice decreased first and then gradually increased,and the ovarian weight of the hUCMSC group mice was heavier than that of the positive control group mice.The difference was statistically significant(P<0.05).Compared with the negative control group,the model group experienced a decrease in oestradiol and an increase in follicle-stimulating hormone,and the difference was statistically significant(P<0.05).Compared with the model group,the hUCMSC and positive control groups experienced a slight increase in oestradiol and a decrease in follicle-stimulating hormone;the difference was statistically significant(P<0.05).The pathological examination revealed that the mouse ovaries from the model group were atrophied,the volume was reduced,the cortical and medullary structures were disordered,the number of follicles at all stages was significantly reduced,the number of atretic follicles increased,the number of primordial follicles and corpus luteum significantly decreased,and the corpus luteum had an irregular shape.Compared with those of the model group,the lesions of the hUCMSC and positive control groups significantly improved.CONCLUSION hUCMSCs can repair ovarian tissue damaged by chemotherapy to a certain extent,can improve the degree of apoptosis in ovarian tissue,and can improve the endocrine function of mouse ovaries.展开更多
BACKGROUND At present,the preventive treatment for pregnancy-related venous thromboembolism(VTE)in China is in its infancy,and there is no uniform or standardized industry guide.Drug prevention and treatment of pregna...BACKGROUND At present,the preventive treatment for pregnancy-related venous thromboembolism(VTE)in China is in its infancy,and there is no uniform or standardized industry guide.Drug prevention and treatment of pregnancyrelated VTE rely highly on foreign guidelines;however,due to the differences in ethnicity and national conditions,there are many controversies over the indications for drug treatment,drug selection,and dose selection for anticoagulant therapy.AIM To investigate the risk scores,prevention,and treatment of maternal VTE to promote the prevention and standardized treatment of maternal thrombosis.METHODS A retrospective analysis was performed on 7759 patients who gave birth at our hospital from June 2018 to June 2019.Risk factors for pregnancy-related VTE,prenatal and postpartum VTE risk scores,prophylactic anticoagulant therapy,side effects after medication,and morbidity were analysed.RESULTS The risk factors for VTE were mainly caesarean delivery,obesity,and advanced maternal age.Regarding pregnancy-related VTE risk scores,there were 7520 patients in the low-risk group with a prenatal score<3 points and 239 in the high-risk group with a score≥3,and 44 patients received drug prevention and treatment during pregnancy.There were 4223 patients in the low-risk group with a postpartum score<2 points and 3536 in the high-risk group with a score≥2 points,and 824 patients received drug prevention and treatment for 10 d.Among the patients who did not present with VTE before delivery,we found one case each of pulmonary embolism secondary to lower extremity venous thrombosis,intracranial venous sinus thrombosis,and asymptomatic lower extremity venous thrombosis during the postpartum follow-up.CONCLUSION VTE poses a serious threat to maternal safety,and the society should increase its vigilance against pregnancy-related VTE.展开更多
Objective This study aimed to explore the potential effects of terahertz(THz) waves on primary cultured neurons from 4 rat brain regions(hippocampus, cerebral cortex, cerebellum, and brainstem)and 3 kinds of neuron-li...Objective This study aimed to explore the potential effects of terahertz(THz) waves on primary cultured neurons from 4 rat brain regions(hippocampus, cerebral cortex, cerebellum, and brainstem)and 3 kinds of neuron-like cells(MN9 D, PC12, and HT22 cells) under nonthermal conditions.Methods THz waves with an output power of 50(0.16 THz) and 10(0.17 THz) m W with exposure times of 6 and 60 min were used in this study. Analysis of temperature change, neurite growth, cell membrane roughness, micromorphology, neurotransmitters and synaptic-related proteins(SYN and PSD95) was used to evaluate the potential effects.Results Temperature increase caused by the THz wave was negligible. THz waves induced significant neurotransmitter changes in primary hippocampal, cerebellar, and brainstem neurons and in MN9 D and PC12 cells. THz wave downregulated SYN expression in primary hippocampal neurons and downregulated PSD95 expression in primary cortical neurons.Conclusion Different types of cells responded differently after THz wave exposure, and primary hippocampal and cortical neurons and MN9 D cells were relatively sensitive to the THz waves. The biological effects were positively correlated with the exposure time of the THz waves.展开更多
BACKGROUND Hypertension is prevalent in the general population and is regarded as the second leading cause of renal damage and dysfunction,outnumbered only by diabetes.However,the mechanisms remain unclear.AIM To inve...BACKGROUND Hypertension is prevalent in the general population and is regarded as the second leading cause of renal damage and dysfunction,outnumbered only by diabetes.However,the mechanisms remain unclear.AIM To investigate podocyte injury induced by hypertension in the early course without massive proteinuria or renal dysfunction.METHODS The hypertension group comprised 18 patients with hypertension accompanied by microalbuminuria,diagnosed with hypertensive renal injury according to biopsy results.For a comparison of pathological changes in renal tissue,control group 1 comprised 10 healthy volunteers,and control group 2 comprised 16 patients who underwent surgery for renal trauma.RESULTS The hypertension group had significantly higher blood pressure(P=0.000)and microalbuminuria(P=0.000)compared with control group 1.In the hypertension group,urinary podocytes were detected following positive staining of podocytespecific nephrin and/or CD2-associated protein(CD2AP)in urine sediment.Podocyte foot process fusion and a significant decrease in nephrin and/or CD2AP expression in glomeruli were observed in the hypertension group compared with control group 2.This indicated that hypertension caused podocyte injury and detachment from the glomerular basement membrane,which was consistent with urinary detection of podocytes.CONCLUSION Our results suggest that podocyturia appears early in the course of hypertensive renal injury,and may be a sensitive marker for early prediction of hypertensive renal injury.展开更多
BACKGROUND Vaginal delivery is the ideal mode of delivery for the termination of a pregnancy.However,the cesarean section rate in China is much higher than the published by the World Health Organization in the Lancet ...BACKGROUND Vaginal delivery is the ideal mode of delivery for the termination of a pregnancy.However,the cesarean section rate in China is much higher than the published by the World Health Organization in the Lancet in 2010.AIM To retrospectively analyze the factors related to failed trial of labor and the clinical indications for cesarean section conversion,explore how to promote the trial of labor success rate,and determine the feasibility of reducing the rate of conversion to cesarean section.METHODS A retrospective analysis was performed on 9240 maternal women who met vaginal delivery conditions and required a trial of labor from January 2016 to December 2018 at our hospital.Among them,8164 pregnant women who had a successful trial of labor were used as a control group,and 1076 pregnant women who had a failed trial of labor and converted to an emergency cesarean section were used as an observation group.The patients’clinical data during hospitalization were collected for comparative analysis,the related factors of the failed trial of labor were discussed,and reasonable prevention and resolution strategies were proposed to increase the success rate of trial of labor.RESULTS The analysis revealed that advanced age(≥35 years old),macrosomia(≥4000 g),delayed pregnancy(≥41 wk),use of uterine contraction drugs,primipara,and fever during labor were associated with conversion to an emergency cesarean section in the failed trial of labor.Multivariate regression analysis showed that age,gestational age,primipara,use of uterine contraction drugs,fever duringbirth,and newborn weight led to a higher probability of conversion to an emergency cesarean section in the failed trial of labor.The analysis indicated that the following clinical indications were associated with the conversion to cesarean section in the failed trial of labor:Fetal distress(44.3%),social factors(12.8%),malpresentation(face presentation,persistent occipitoposterior position,and persistent occipitotransverse position)(9.4%),and cephalopelvic disproportion(8.9%).CONCLUSION The conversion to emergency cesarean section in failed trial of labor is affected by many factors.Medical staff should take appropriate preventive measures for the main factors,increase the trial of labor success rate,improve the quality of delivery,ensure the safety of mother and child during the perinatal period,and improve the relationship between doctors and patients.展开更多
基金We thank all hospitals and staff participating in the Improving Care for Cardiovascular Disease in China-Acute Coronary Syndrome(CCC-ACS)project.The CCC-ACS Project is a collaborative project of the American Heart Association and the Chinese Society of Cardiology.The American Heart Association received funding from Pfizer through an independent grant for learning and change and AstraZeneca as a quality improvement initiative.
文摘BACKGROUND Many studies have demonstrated the benefit of complete multivessel revascularization versus culprit-only intervention in patients of ST-segment elevation myocardial infarction(STEMI)and multivessel coronary artery disease.However,only a few single-center retrospective studies were performed on small Chinese cohorts.Our study aims to demonstrate the advantage of multivessel percutaneous intervention(PCI)strategy on 30-day in-hospital outcomes to patients with STEMI and multivessel disease in larger Chinese population.METHODS From the Improving Care for Cardiovascular Disease in China-Acute Coronary Syndrome(CCC-ACS)project,5935 patients with STEMI and multivessel disease undergoing PCI and hospitalized for fewer than 30 days were analyzed.After 5:1 propensity score matching,3577 patients with culprit-only PCI and 877 with in-hospital multivessel PCI were included.The primary outcome was major adverse cardiovascular and cerebrovascular event(MACCE),defined as a composite of myocardial infarction,all-cause death,stent thrombosis,heart failure,and stroke.RESULTS Multivariable logistic regression analysis revealed that in-hospital multivessel PCI was associated with lower risk of 30-day MACCE(adjusted OR=0.75,95%CI:0.57-0.98,P=0.032)than culprit-only PCI and conferred no increased risk of allcause death,myocardial infarction,stent thrombosis,stroke,or bleeding.Subgroup analysis showed that MACCE reduction was observed more often from patients with trans-femoral access(OR=0.34,95%CI:0.15-0.74)than with trans-radial access(OR=0.87,95%CI:0.66-1.16,P for interaction=0.017).CONCLUSIONS The in-hospital multivessel PCI strategy was associated with a lower risk of 30-day MACCE than culprit-only PCI in patients with STEMI and multivessel coronary artery disease.
文摘Atrial fibrillation(AF)is the most common sustained cardiac arrhythmia,significantly impacting patients’quality of life and increasing the risk of death,stroke,heart failure,and dementia.Over the past two decades,there have been significant breakthroughs in AF risk prediction and screening,stroke prevention,rhythm control,catheter ablation,and integrated management.During this period,the scale,quality,and experience of AF management in China have greatly improved,providing a solid foundation for the development of guidelines for the diagnosis and management of AF.To further promote standardized AF management,and apply new technologies and concepts to clinical practice in a timely and comprehensive manner,the Chinese Society of Cardiology of the Chinese Medical Association and the Heart Rhythm Committee of the Chinese Society of Biomedical Engineering have jointly developed the Chinese Guidelines for the Diagnosis and Management of Atrial Fibrillation.The guidelines have comprehensively elaborated on various aspects of AF management and proposed the CHA2DS2-VASc-60 stroke risk score based on the characteristics of AF in the Asian population.The guidelines have also reevaluated the clinical application of AF screening,emphasized the significance of early rhythm control,and highlighted the central role of catheter ablation in rhythm control.
文摘BACKGROUND Endoscopic variceal treatment(EVT)is recommended as the mainstay choice for the management of high-risk gastroesophageal varices and acute variceal bleeding in liver cirrhosis.Proton pump inhibitors(PPIs)are widely used for various gastric acid-related diseases.However,the effects of PPIs on the development of post-EVT complications,especially gastrointestinal bleeding(GIB),remain controversial.AIM To evaluate the effects of postoperative use of PPIs on post-EVT complications in patients with liver cirrhosis during hospitalization.METHODS Patients with a diagnosis of liver cirrhosis who were admitted to the Department of Gastroenterology of the General Hospital of Northern Theater Command,treated by an attending physician between January 2016 and June 2020 and underwent EVT during their hospitalization were included.Logistic regression analyses were performed to explore the effects of postoperative use of PPIs on the development of post-EVT complications during hospitalization.Odds ratios(ORs)with 95%confidence intervals(CIs)were calculated.RESULTS A total of 143 patients were included.The incidence of post-EVT GIB and other post-EVT complications was 4.90%and 46.85%,respectively.In the overall analyses,postoperative use of PPIs did not significantly reduce the risk of post-EVT GIB(OR=0.525,95%CI=0.113-2.438,P=0.411)or other post-EVT complications(OR=0.804,95%CI=0.413-1.565,P=0.522).In the subgroup analyses according to the enrollment period,type and route of PPIs after the index EVT,use of PPIs before the index EVT,use of vasoactive drugs after the index EVT,indication of EVT(prophylactic and therapeutic),and presence of portal venous system thrombosis,ascites,and hepatocellular carcinoma,the effects of postoperative use of PPIs on the risk of post-EVT GIB or other post-EVT complications remain not statistically significant.CONCLUSION Routine use of PPIs after EVT should not be recommended in patients with liver cirrhosis for the prevention of post-EVT complications during hospitalization.
文摘BACKGROUND Recent reviews have outlined the main nanomaterials used in relation to gastrointestinal tumors and described the basic properties of these materials.However,the research hotspots and trends in the application of nanomaterials in gastric cancer(GC)remain obscure.AIM To demonstrate the knowledge structure and evolutionary trends of research into the application of nanomaterials in GC.METHODS Publications related to the application of nanomaterials in GC were retrieved from the Web of Science Core Collection for this systematic review and bibliometric study.VOSviewer and CiteSpace were used for bibliometric and visualization analyses.RESULTS From 2000 to 2022,the application of nanomaterials in GC developed rapidly.The keyword co-occurrence analysis showed that the related research topics were divided into three clusters:(1)The application of nanomaterials in GC treatment;(2)The application and toxicity of nanomaterials in GC diagnosis;and(3)The effects of nanomaterials on the biological behavior of GC cells.Complexes,silver nanoparticles,and green synthesis are the latest high-frequency keywords that represent promising future research directions.CONCLUSION The application of nanomaterials in GC diagnosis and treatment and the mechanisms of their effects on GC cells have been major themes in this field over the past 23 years.
文摘Background:Transcatheter closure(TCC)has emerged as the preferred treatment for selected congenital heart disease(CHD).While TCC offers benefits for patients with postoperative residual shunts,understanding its mid-and long-term efficacy and safety remains crucial.Objective:This study aims to assess the mid-and long-term safety and efficacy of TCC for patients with residual atrial or ventricular septal shunts following CHD correction.Methods:In this consecutive retrospective study,we enrolled 35 patients with residual shunt who underwent TCC or surgical repair of CHD between June 2011 to October 2022.TCC candidacy was determined based on established criteria.Echocardiography and electrocardiogram were conducted during the perioperative period and continued as part of long-term follow-up.Results:Among the patients,5(14.3%)exhibited interatrial shunt-ing,while 30(85.7%)had interventricular shunting.TCC was successfully implemented in 33 of 35 patients,with exceptions in two cases of post-ventricular septal defect repair due to anatomical challenges involving the shape and aortic angulation.This resulted in a TCC success rate of 94.3%.Trace residual shunt was detected in two interventricular shunting cases and a mild residual shunt in one interventricular shunting case;all resolved by the three-month follow-up after TCC.Minor complications included one hematoma at the puncture site and one transient junctional rhythm during the perioperative period.During a median follow-up of 73 months,there were no instances of residual shunt,device embolization,occluder displacement,valve insufficiency,malignant arrhythmia,infective endocarditis,death,or other serious complications.Conclusion:TCC is an effective and safe therapy for patients with residual atrial or ventricular septal shunts following CHD correction.Thesefindings support the consideration of TCC as the preferred treatment option for appropriate patient populations.
文摘Central venous catheterization establishes temporary,efficient,and rapid use of deep venous access in patients,which provides high flow rate fluid perfusion,enables measurement of central venous pressure,and acts as an important reference for clinical decision-making.However,various complications such as pneumothorax,hemothorax,hematoma,and puncture failure can easily occur during the puncture and catheterization process.
基金Supported by Department of Science and Technology of Liaoning Province,No.2021JH2/10300095.
文摘BACKGROUND Postpartum quality of life(QoL)in women with heart disease has been neglected.AIM To improve clinical communication and treatment,we integrated medical data and subjective characteristics to study postpartum QoL concerns.METHODS The study assessed QoL 6 wk after birth using the 12-Item Short-Form Health Survey.The Edinburgh Postnatal Depression Scale,Cardiac Anxiety Questionnaire,European Heart Failure Self-Care Behavior Scale,and a self-designed questionnaire based on earlier research were also used to assess patient characteristics.Patient data were collected.Prediction models were created using multiple linear regression.RESULTS This retrospective study examined postpartum QoL in 105 cardiac patients.Postpartum QoL scores were lower(90.69±13.82)than those of women without heart disease,with physical component scores(41.09±9.91)lower than mental component scores(49.60±14.87).Postpartum depression(33.3%),moderate anxiety(37.14%),pregnancy concerns(57.14%),offspring heart problems(57.14%),and life expectancy worries(48.6%)were all prevalent.No previous cardiac surgery,multiparity,higher sadness and cardiac anxiety,and fear of unfavorable pregnancy outcomes were strongly related to lower QoL(R^(2)=0.525).CONCLUSION Postpartum QoL is linked to physical and mental health in women with heart disease.Our study emphasizes the need for healthcare workers to recognize the unique characteristics of these women while developing and implementing comprehensive management approaches during their maternity care.
文摘BACKGROUND The outcome of surgical treatment for colorectal cancer(CRC)remains unsatis-factory and warrants further exploration and optimization.AIM To clarify the impact of chemotherapy plus cellular immunotherapy[dendritic cell-cytokine-induced killer(DC-CIK)cell immunotherapy]on patients after CRC surgery and to explore the mediating variables.METHODS A total cohort of 121 patients who underwent CRC surgery between January 2019 and April 2022 were selected.The sample comprised a control group of 55 pa-tients who received the XELOX chemotherapy regimen and a research group of 66 patients who received XELOX+DC-CIK immunotherapy.We performed compa-rative analyses of the clinical and pathological data of the two groups,including efficacy(2-year disease-free survival[DFS]rate),the incidence of adverse events(diarrhea,myelosuppression,gastrointestinal reactions,and peripheral neuritis),serum levels of tumor markers[carcinoembryonic antigens and carbohydrate an-tigens(CA)19-9 and CA242],and T-cell subsets[cluster of differentiation(CD)3+,CD3+CD4+,CD3+CD8+,natural killer(NK),and NK T cells].We also conducted preliminary univariate and mul-tivariate analyses of the variables that affected the efficacy of the treatments.RESULTS We found a significantly higher 2-year DFS rate of treatment efficacy in the research group than in the control group,with a statistically lower incidence of adverse events.Both groups showed a reduction in serum tumor markers after treatment but there was no marked intergroup difference.After treatment,the various T-cell subgroup indicators in the control group were significantly lower than those in the research group.The indices of T-cell subsets in the research group showed no significant change from preoperative levels.Univariate analysis revealed a significant correlation between TNM staging,tumor differentiation,and the rates of nonresponse to treatment in CRC patients after surgery.Multivariate results indicated that the treatment approach significantly affected the efficacy of postoperative CRC treatment.CONCLUSION We concluded that XELOX+DC-CIK immunotherapy for postsurgical CRC patients offers reduced rates of treatment-induced adverse events,extended 2-year DFS,enhanced immunity,and increased physiological antitumor responses.
文摘BACKGROUND Lupus mesenteric vasculitis(LMV)is a serious condition that may occur as an acute manifestation of gastrointestinal(GI)involvement and is not easily diagnosed by physicians.Delayed diagnosis and treatment of LMV may lead to rapid disease progression and can be life threatening.CASE SUMMARY A previously healthy 27-year-old woman presented with abdominal pain following a history of fatigue and consumption of cold water.Laboratory invest-igations,physical examinations,and enhanced abdominal computed tomography(CT)suggested systemic lupus erythematosus complicated by LMV.She received treatments,such as GI decompression,somatostatin,glucocorticoids,and immu-nosuppressants,and was evaluated using color ultrasonography.Twenty days later,the patient reported no stomach discomfort and was able to consume semi-liquid food.Laboratory investigations showed that inflammatory factors decreased to normal levels and complement levels increased slightly.One year after discharged,she recovered with methylprednisolone being tapered to 4 mg per day,mycophenolate mofetil to 0.75 g bid,and hydroxychloroquine to 0.2 g bid;however,only C3 complement level was slightly below the normal level.CONCLUSION Early diagnosis of LMV is essential for successful treatment;this depends on a combination of clinical manifestations,laboratory investigations,and imaging findings.Enhanced CT is preferred,but ultrasonography can be used for prompt screening and follow-up.
文摘BACKGROUND Intrahepatic cholangiocarcinoma(ICC)is a malignant tumor of the hepatobiliary system with concealed onset,strong invasiveness and poor prognosis.AIM To explore the disease characteristic genes that may be helpful in the diagnosis of ICC and affect immune cell infiltration.METHODS We downloaded two ICC-related human gene expression profiles from GEO database as the training group(GSE26566 and GSE32958 datasets)for difference analysis,and performed enrichment analysis on differential genes.The least absolute shrinkage and selection operator(LASSO),support vector machinerecursive feature elimination(SVM-RFE)and random forest(RF),three machine learning algorithms,were used to screen the characteristic genes.Double verification was carried out on GSE107943 and The Cancer Genome Atlas,two verification groups.Receiver operating characteristic curve and area under the curve(AUC)were used to evaluate the diagnostic efficacy of genes for ICC.CIBERSORT and ssGSEA algorithms were used to evaluate the effect of characteristic genes on immune infiltration pattern.Human Protein Atlas(HPA)was used to analyze the protein expression level of the target gene.RESULTS A total of 1091 differential genes were obtained in the training group.Enrichment analysis showed that the above genes were mainly enriched in small molecular catabolism,complement and coagulation cascade,bile secretion and other functions and pathways.Twentyfive characteristic genes were screened by LASSO regression,19 by SVM-RFE algorithm,and 30 by RF algorithm.Three algorithms were used in combination to determine the characteristic gene of ICC:MMP14.The verification group confirmed that the genes had a high diagnostic accuracy(AUC values of the training group and the verification group were 0.960,0.999,and 0.977,respectively).Comprehensive analysis of immune infiltration showed that MMP14 could affect the infiltration of monocytes,activated memory CD4 T cells,resting memory CD4 T cells,and other immune cells,and was closely related to the expression of CD200,cytotoxic T-lymphocyteassociated antigen 4,CD14,CD44,and other immune checkpoints.The results of immunohistochemistry in HPA database showed was indeed overexpressed in ICC.CONCLUSION MMP14 can be used as a disease characteristic gene of ICC,and may regulate the distribution of immune-infiltrating cells in the ICC tumor microenvironment,which provides a new method for the determination of ICC diagnostic markers and screening of therapeutic targets.
基金Supported by the Science and Technology Program of Liaoning Province,No.2021-MS-040.
文摘BACKGROUND The carcinogenesis of stomach adenocarcinoma(STAD)involves many different molecules and multiple pathways,including the NOTCH signaling pathway.As a key factor that functions as a critical link in the NOTCH pathway,mind bomb 1(MIB1)is upregulated in various tumors and has been reported to promote cell metastasis and invasion.However,studies on the role of MIB1 in STAD are limited.Here,we evaluated the prognostic value of MIB1 in STAD and its association with immune infiltration and copy number variation.AIM To elucidate the relationship between MIB1 gene and gastric cancer(GC)and provide a new idea for the treatment of GC.METHODS We identified mutations in the MIB1 gene by searching the cBioPortal database and then analyzed their relationship with the overall survival rate and diseasefree survival rate using the Kaplan-Meier method.The Cancer Genome Atlas(TCGA)database provided transcript levels for MIB1 in STADs and normal tissues.As a method of distinguishing the STAD tissues from adjacent normal tissues,a receiver operating characteristic(ROC)curve was generated.Kaplan-Meier plotter was used to determine the effect of MIB1 expression on survival.Based on the LinkedOmics database,we were able to identify the coexpressed genes of the MIB1 gene,the top 50 positively correlated genes,and the top 50 negatively correlated genes.STRING was used to construct protein-protein interaction networks related to the MIB1 gene.An analysis of functional enrichment was carried out using the R package“Cluster Profiler”.The relationships between mRNA expression of MIB1 and immune infiltrates were assessed by Tumor IMmune Estimation Resource(TIMER)and the“GSVA package”in R.RESULTS According to the cBioPortal database,the MIB1 mutation rate in 287 patients in the TCGA dataset was approximately 6%.Kaplan-Meier survival analysis showed that patients with STAD in the mutated group had a worse prognosis than those in the unmutated group(P=0.0156).There was a significant upregulation of MIB1 expression in STAD tissues compared to adjacent normal tissues.A high T stage was associated with increased MIB1 mRNA expression.The ROC curve analysis revealed 59.4%sensitivity and 85.6%specificity of MIB1 for differentiating STAD tissues from adjacent normal tissues at a truncation level of 2.248.Kaplan-Meier plotter indicated that patients with higher MIB1 levels had a worse prognosis than those with lower levels(26.4 mo vs 56.2 mo,P=0.0330).A correlation analysis demonstrated an association between immune infiltrates and MIB1 mRNA expression.CONCLUSION Upregulation of MIB1 expression is significantly associated with poor survival rate and immune infiltration in gastric adenocarcinoma.MIB1 may be a biomarker for the poor prognosis of STAD patients and a potential immunotherapeutic target.
基金This study was supported by grant from Doctoral Start-Up Foundation of Liaoning Province of China(2019-BS-266).
文摘Objective:This study was designed to determine the long-term safety and efficacy of using the Amplatzer Duct Occluder II(ADO II)for the closure of various ventricular septal defects(VSDs).Methods:From January 2011 to December 2019,selected VSD patients were treated through transcatheter intervention using ADO II occluders.The closure results and complications from 188 patients,involving 167 perimembranous ventricular septal defects(pmVSDs),9 intracristal VSDs,11 post surgery residual shunts and 1 post closure residual shunt with the mean outlet diameter3.1±0.8 mm under angiography,were enrolled in this study.Results:The success rate was 98.9%for all procedures.During the median 77-month follow-up period,no cases of complete atrioventricular block(cAVB),infective endocarditis or death occurred.One major adverse event(0.5%)was recorded:cerebrovascular accident occurred 1 day after the procedure in one patient who was transferred to the neurology department.The residual shunt rate was 44.6%,which was the most common minor adverse event.The cardiac conduction block rate was 4.3%.Specifically,one pmVSD patient developed intermittent LBBB during the 28-month follow-up.There were 3 patients(1.6%)with new-onset mild tricuspid insufficiency,and the insufficiency degree was stable during follow-up.There was no new-onset aortic insufficiency that occurred.Conclusions:Transcatheter closure of pmVSDs,some intracristal VSDs,some postsurgery or postclosure residual shunts using ADO II occluders were both safe and effective and yielded excellent long-term results in selected patients.
文摘Background: The late detection of endometrial carcinoma (EC) at an advanced stage often results in a poorpatient prognosis. It is hence important to identify reliable biomarkers to facilitate early detection of EC. Signaltransducer and activator of transcription (STAT) family members play an important role in several tumors, however,their impact on EC development and progression remains unclear. Methods: Machine learning methods were used toinvestigate the importance of STAT5B in EC. Results: Hence, we explored the UALCAN data mining platform andfound that while STAT1 and STAT2 were upregulated, STAT5A, STAT5B, and STAT6 were downregulated in EC.This high expression of STAT5B and STAT6 predicted favorable clinical outcomes, whereas the increased expressionof STAT1 and STAT2 predicted poor clinical outcomes. Subsequent pathway enrichment analysis revealed that theSTAT family was mainly involved in apoptosis pathway activation, cell cycle disruption, and epithelial–mesenchymaltransition. Drug sensitivity analysis demonstrated that STAT5A/5B expression was negatively correlated with drugresistance in EC. Further, the expression of STAT5B mRNA and protein was correlated with severalclinicopathological characteristics. Tumor Immune Estimation Resource (TIMER) analysis revealed that STAT5Bexpression was positively correlated with the abundance of infiltrating CD8+ T cells and neutrophils while its copynumber variation was associated with the overall immune cell infiltration. The data on the correlations betweenSTAT5B expression and related genes in uterine corpus endometrial carcinoma (UCEC) in cBio Cancer Portalshowed the closest correlation of STAT5B expression with that of KIAA0753 (also known as moonraker and OFIP),followed by COL27A1 in EC. Pathway enrichment analysis further showed that STAT5B-related genes were involvedin the mitogen-activated protein kinase (MAPK) and Ras signaling pathways. Conclusion: Collectively, our findingsprovided new insights into the role of the STAT family in EC. It also highlighted new targets for future research ondiagnostic and prognostic markers and STAT5B as a novel marker for drug sensitivity screening.
基金Supported by National College Students Innovation and Entrepreneurship Training Program of Shenyang Pharmaceutical University,No.202210163003.
文摘BACKGROUND The efficacy and safety of anti-tumor necrosis factor-α(TNF-α)monoclonal antibody therapy[adalimumab(ADA)and infliximab(IFX)]with therapeutic drug monitoring(TDM),which has been proposed for inflammatory bowel disease(IBD)patients,are still controversial.AIM To determine the efficacy and safety of anti-TNF-αmonoclonal antibody therapy with proactive TDM in patients with IBD and to determine which subtype of IBD patients is most suitable for proactive TDM interventions.METHODS As of July 2023,we searched for randomized controlled trials(RCTs)and observa-tional studies in PubMed,Embase,and the Cochrane Library to compare anti-TNF-αmonoclonal antibody therapy with proactive TDM with therapy with reactive TDM or empiric therapy.Pairwise and network meta-analyses were used to determine the IBD patient subtype that achieved clinical remission and to determine the need for surgery.RESULTS This systematic review and meta-analysis yielded 13 studies after exclusion,and the baseline indicators were balanced.We found a significant increase in the number of patients who achieved clinical remission in the ADA[odds ratio(OR)=1.416,95%confidence interval(CI):1.196-1.676]and RCT(OR=1.393,95%CI:1.182-1.641)subgroups and a significant decrease in the number of patients who needed surgery in the proactive vs reactive(OR=0.237,95%CI:0.101-0.558)and IFX+ADA(OR=0.137,95%CI:0.032-0.588)subgroups,and the overall risk of adverse events was reduced(OR=0.579,95%CI:0.391-0.858)according to the pairwise meta-analysis.Moreover,the network meta-analysis results suggested that patients with IBD treated with ADA(OR=1.39,95%CI:1.19-1.63)were more likely to undergo TDM,especially in comparison with patients with reactive TDM(OR=1.38,95%CI:1.07-1.77).CONCLUSION Proactive TDM is more suitable for IBD patients treated with ADA and has obvious advantages over reactive TDM.We recommend proactive TDM in IBD patients who are treated with ADA.
基金supported by grants from the China Postdoctoral Science Foundation(2021MD703842).
文摘Background:Some observational associations between body weight and breast cancer have attracted attention.However,the causal relationship between these 2 factors remains unclear,and more clinical outcomes are needed for its validation.Methods:Based on statistical data from a Genome Wide Association Study,we performed a bidirectional Mendelian randomization analysis to assess the bidirectional causal relationship between body weight and breast cancer using 4 methods,with inverse variance weighting as the primarymethod.To verify the robustness and reliability of the causal relationship,we performed a sensitivity analysis using horizontal pleiotropy,outlier,and one-by-one elimination tests.Results:The inverse variance weighting results revealed no significant positive causal relationship between body weight and breast cancer.Similarly,the reverse analysis revealed no causal effect of breast cancer on body weight.Conclusions:The relationship between body weight and breast cancer may be attributed to confounding factors.
文摘BACKGROUND Premature ovarian insufficiency(POI)and premature ovarian failure(POF)have become one of the major problems threatening women of childbearing age.Studies have shown that stem cells transplanted from bone marrow,umbilical cord,peripheral blood and amniotic fluid can migrate and proliferate to the ovary,promote ovarian function repair,increase the number of follicles and granulosa cells at all levels of ovary,improve endocrine function,and can differentiate into oocytes in specific ovarian environment to restore fertility to some extent.AIM To study the ability of human umbilical cord mesenchymal stem cells(hUCMSCs)to repair ovarian injury after chemotherapy.METHODS A total of 110 female BALB/c mice(aged 7-8 wk old)with body masses of 16.0-20.0 g were selected.The mice were fed until 12 wk of age,and cyclophosphamide was administered by intraperitoneal injection for 14 consecutive days to induce premature ovarian failure in mice.Seventy-five mice with estrous cycle disorder were screened and randomly divided into 3 groups according to their body weight:model group,positive control group and hUCMSC group,and each group had 25 mice.Another 25 mice were used as negative controls.The mice in the hUCMSC group were injected with hUCMSCs in the tail vein,and the mice in the positive control group were given an oestradiol valerate solution and a medroxyprogesterone acetate solution in the tail vein.On the 1^st,15^th,30^th,45^th,and 60^th days after intravenous administration,vaginal smears were made to monitor the estrous cycles of the mice.The ovaries were weighed,and pathological sections were made to observe the morphology of the follicles;blood samples were collected to monitor the concentration of sex hormones(oestradiol and follicle-stimulating hormone).RESULTS The estrous cycles of the model group mice were disrupted throughout the experiment.Mice in the hUCMSC group and the positive control group resumed normal estrous cycles.The ovarian weight of the model group mice continued to decline.The ovarian weight of the hUCMSC group mice and the positive control group mice decreased first and then gradually increased,and the ovarian weight of the hUCMSC group mice was heavier than that of the positive control group mice.The difference was statistically significant(P<0.05).Compared with the negative control group,the model group experienced a decrease in oestradiol and an increase in follicle-stimulating hormone,and the difference was statistically significant(P<0.05).Compared with the model group,the hUCMSC and positive control groups experienced a slight increase in oestradiol and a decrease in follicle-stimulating hormone;the difference was statistically significant(P<0.05).The pathological examination revealed that the mouse ovaries from the model group were atrophied,the volume was reduced,the cortical and medullary structures were disordered,the number of follicles at all stages was significantly reduced,the number of atretic follicles increased,the number of primordial follicles and corpus luteum significantly decreased,and the corpus luteum had an irregular shape.Compared with those of the model group,the lesions of the hUCMSC and positive control groups significantly improved.CONCLUSION hUCMSCs can repair ovarian tissue damaged by chemotherapy to a certain extent,can improve the degree of apoptosis in ovarian tissue,and can improve the endocrine function of mouse ovaries.
文摘BACKGROUND At present,the preventive treatment for pregnancy-related venous thromboembolism(VTE)in China is in its infancy,and there is no uniform or standardized industry guide.Drug prevention and treatment of pregnancyrelated VTE rely highly on foreign guidelines;however,due to the differences in ethnicity and national conditions,there are many controversies over the indications for drug treatment,drug selection,and dose selection for anticoagulant therapy.AIM To investigate the risk scores,prevention,and treatment of maternal VTE to promote the prevention and standardized treatment of maternal thrombosis.METHODS A retrospective analysis was performed on 7759 patients who gave birth at our hospital from June 2018 to June 2019.Risk factors for pregnancy-related VTE,prenatal and postpartum VTE risk scores,prophylactic anticoagulant therapy,side effects after medication,and morbidity were analysed.RESULTS The risk factors for VTE were mainly caesarean delivery,obesity,and advanced maternal age.Regarding pregnancy-related VTE risk scores,there were 7520 patients in the low-risk group with a prenatal score<3 points and 239 in the high-risk group with a score≥3,and 44 patients received drug prevention and treatment during pregnancy.There were 4223 patients in the low-risk group with a postpartum score<2 points and 3536 in the high-risk group with a score≥2 points,and 824 patients received drug prevention and treatment for 10 d.Among the patients who did not present with VTE before delivery,we found one case each of pulmonary embolism secondary to lower extremity venous thrombosis,intracranial venous sinus thrombosis,and asymptomatic lower extremity venous thrombosis during the postpartum follow-up.CONCLUSION VTE poses a serious threat to maternal safety,and the society should increase its vigilance against pregnancy-related VTE.
基金finantial support from the National Defense Science and Technology Innovation Special Zone Project
文摘Objective This study aimed to explore the potential effects of terahertz(THz) waves on primary cultured neurons from 4 rat brain regions(hippocampus, cerebral cortex, cerebellum, and brainstem)and 3 kinds of neuron-like cells(MN9 D, PC12, and HT22 cells) under nonthermal conditions.Methods THz waves with an output power of 50(0.16 THz) and 10(0.17 THz) m W with exposure times of 6 and 60 min were used in this study. Analysis of temperature change, neurite growth, cell membrane roughness, micromorphology, neurotransmitters and synaptic-related proteins(SYN and PSD95) was used to evaluate the potential effects.Results Temperature increase caused by the THz wave was negligible. THz waves induced significant neurotransmitter changes in primary hippocampal, cerebellar, and brainstem neurons and in MN9 D and PC12 cells. THz wave downregulated SYN expression in primary hippocampal neurons and downregulated PSD95 expression in primary cortical neurons.Conclusion Different types of cells responded differently after THz wave exposure, and primary hippocampal and cortical neurons and MN9 D cells were relatively sensitive to the THz waves. The biological effects were positively correlated with the exposure time of the THz waves.
基金Supported by the Natural Science Foundation of Liaoning Provincial Department of Science and Technology,No.2017225020
文摘BACKGROUND Hypertension is prevalent in the general population and is regarded as the second leading cause of renal damage and dysfunction,outnumbered only by diabetes.However,the mechanisms remain unclear.AIM To investigate podocyte injury induced by hypertension in the early course without massive proteinuria or renal dysfunction.METHODS The hypertension group comprised 18 patients with hypertension accompanied by microalbuminuria,diagnosed with hypertensive renal injury according to biopsy results.For a comparison of pathological changes in renal tissue,control group 1 comprised 10 healthy volunteers,and control group 2 comprised 16 patients who underwent surgery for renal trauma.RESULTS The hypertension group had significantly higher blood pressure(P=0.000)and microalbuminuria(P=0.000)compared with control group 1.In the hypertension group,urinary podocytes were detected following positive staining of podocytespecific nephrin and/or CD2-associated protein(CD2AP)in urine sediment.Podocyte foot process fusion and a significant decrease in nephrin and/or CD2AP expression in glomeruli were observed in the hypertension group compared with control group 2.This indicated that hypertension caused podocyte injury and detachment from the glomerular basement membrane,which was consistent with urinary detection of podocytes.CONCLUSION Our results suggest that podocyturia appears early in the course of hypertensive renal injury,and may be a sensitive marker for early prediction of hypertensive renal injury.
基金Supported by Liaoning Provincial Natural Science Foundation Guidance Program,No.2019-ZD-1037。
文摘BACKGROUND Vaginal delivery is the ideal mode of delivery for the termination of a pregnancy.However,the cesarean section rate in China is much higher than the published by the World Health Organization in the Lancet in 2010.AIM To retrospectively analyze the factors related to failed trial of labor and the clinical indications for cesarean section conversion,explore how to promote the trial of labor success rate,and determine the feasibility of reducing the rate of conversion to cesarean section.METHODS A retrospective analysis was performed on 9240 maternal women who met vaginal delivery conditions and required a trial of labor from January 2016 to December 2018 at our hospital.Among them,8164 pregnant women who had a successful trial of labor were used as a control group,and 1076 pregnant women who had a failed trial of labor and converted to an emergency cesarean section were used as an observation group.The patients’clinical data during hospitalization were collected for comparative analysis,the related factors of the failed trial of labor were discussed,and reasonable prevention and resolution strategies were proposed to increase the success rate of trial of labor.RESULTS The analysis revealed that advanced age(≥35 years old),macrosomia(≥4000 g),delayed pregnancy(≥41 wk),use of uterine contraction drugs,primipara,and fever during labor were associated with conversion to an emergency cesarean section in the failed trial of labor.Multivariate regression analysis showed that age,gestational age,primipara,use of uterine contraction drugs,fever duringbirth,and newborn weight led to a higher probability of conversion to an emergency cesarean section in the failed trial of labor.The analysis indicated that the following clinical indications were associated with the conversion to cesarean section in the failed trial of labor:Fetal distress(44.3%),social factors(12.8%),malpresentation(face presentation,persistent occipitoposterior position,and persistent occipitotransverse position)(9.4%),and cephalopelvic disproportion(8.9%).CONCLUSION The conversion to emergency cesarean section in failed trial of labor is affected by many factors.Medical staff should take appropriate preventive measures for the main factors,increase the trial of labor success rate,improve the quality of delivery,ensure the safety of mother and child during the perinatal period,and improve the relationship between doctors and patients.
