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Purpose@#Through meta-analysis, we aimed to assess the efficacy and safety of drug-coated balloons (DCB), compared with drugeluting stents (DES) or uncoated devices, in the treatment of de novo coronary lesions. @*Materials and Methods@#Only randomized controlled trials were included. The primary outcomes were late lumen loss (LLL), target lesion revascularization (TLR), and major adverse cardiac events (MACEs). Subgroup analyses were conducted based on clinical indications, whether DCBs were used with a systematic or bailout stent, and types of DESs. @*Results@#The present meta-analysis demonstrated that DCBs elicit significantly lower incidences of TLR, MACE, and LLL, compared with uncoated devices, and similar incidences, compared with DESs, in the treatment of de novo coronary lesions. Subgroup analysis indicated that DCBs used with a bailout stent achieved lower incidences of binary restenosis and myocardial infarction, compared with uncoated devices, and provided less LLL than DESs. DCBs showed similar rates of TLR and MACE, with significantly less LLL, than DESs in treating de novo small-vessel diseases. The clinical efficacy of DCBs was similar to that of secondgeneration DES. @*Conclusion@#Overall, DCB is favored over bare metal stent alone in treating de novo coronary lesions. DCBs appear to be a promising alternative to DESs in the treatment of de novo coronary lesions.
ABSTRACT
Objective To investigate the expression of inflammatory mediators in renal tubular epithelial cells in patients with diabetic nephropathy (DN) and to explore the possible clinicopathological significance. Methods Twenty-three patients with DN diagnosed by renal biopsy and 10 patients with renal cell carcinoma undergone nephrectomy were allocated into DN group and control group, respectively. The renal expression of NF-κB p50, NF-κB p65, NF-κB p65 mRNA, MCP-1, OPN, α-SMA, and FN was detected by immunohistochemical or in situ hybridization assay. Serum creatinine, urinary N-acetylglucosaminedase (NAG), urinary albumin and 24-hour urinary protein were detected. The correlation between these inflmmnatory markers and clinicopathological data were analyzed. Results (1)Among all the 23 DN patients, granular degeneration of the renal tubular epithelium, focal tubular atrophy, infiltration of inflammatory cells and interstitial fibrosis were apparent, and none of these were found in control group. (2) Immunohistochemical and in situ hybridization assay showed that, compared with control group, expression of these factors increased significantly in renal tubular cells or interstitium in DN patients, and expression of α-SMA or FN was not found in tubular epithelial cells. (3)Statistics assay showed the tubular NF-κB p65 protein expression was correlated with all of the following factors: NF-κB p50 protein (r=0.792) and NF-κB p65 mRNA (r=0.763), tubular MCP-1 (r=0.825) and OPN (r=0.869) expression, interstitial α-SMA (r=0.327) and FN (r=0.432) expression, proteinuria(r=0.710), estimated glomerular filtration rate (eGFR) (r=-0.728), and urinary NAG (r= 0.930), P<0.01 respectively. Conclusion Tubular inflammation may play a role in the pathogenesis and progression of DN.
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Objective To investigate the protective effects and mechanism of Pentoxifylline(PTX) on rats with renal interstitial fibrosis following unilateral ureteral obstruction(UUO).Methods The rats were randomly divided into 5 groups: Sham operation group(group A),UUO group(group B),Enalapril group(group C),PTX group(group D) and PTX plus Enalapril group(group E).On the 3th,7th and 14th day after operation,5 rats of each group were sacrificed by exsanguinations,respectively.The concentration of hydroxyproline was measured,and the ratio of collagen and renal weight was tested.The expressions of transforming growth factor-?1(TGF-?1),tissue inhibitor of metalloproteinase-1(TIMP-1),vascular endothelial growth factor(VEGF),bone morphogenetic protein-7(BMP-7),NF-?B and CD34 were measured by immunohistochemistry.The peritubular capillary index(PCI) was regarded as the expression of CD34.Results The ratio of collagen and renal weight in the rats of group B was higher than that of other 4 groups(P