ABSTRACT
Objective To compare the safety and efficacy of carotid artery stenting (CAS) and carotid endarterectomy(CEA) for the treatment of carotid stenosis. Methods The electronic databases (PubMed, EMbase, Cochrane Central Register of Controlled Trials, CNKI, VIP and Wanfang) were searched in order to retrieve randomized controlled trials (RCTs) about comparing CAS and CEA for the treatment of carotid stenosis. Cochrane collaboration's RevMan 5.0.24 were used for analyzing data. Results Twelve RCTs totalling 6903 patients (3460 patients were randomized to CAS and 3443 randomized to CEA) with symptomatic or asymptomatic stenosis were included in the meta-analysis. There were significantly higher 30-day relative risks after CAS than after CEA for death or any stroke [RR=1.64, 95%CI (1.33-2.03), P＜0.00001] and for stroke [RR=1.70, 95%CI (1.34-2.14), P＜0.00001]. The relative risks of myocardial infarction [RR=0.62, 95%CI (0.39-0.97), P=0.04] and cranial neuropathy [RR=0.07, 95%CI (0.03-0.16), P＜0.00001] was significantly less after CAS than after CEA. The relative risks of death [RR=1.27, 95%CI (0.82-1.96), P=0.29] or disabling stroke within 30 days [RR=1.33, 95%CI (0.78-2.28), P=0.29] and any stroke or death at 1 year after the procedures [RR=0.96, 95%CI (0.63-1.46), P=0.84] did not differ significantly between CAS and CEA operation. Conclusions CEA remains the first choice for treatment of carotid stenosis for patients with low surgery risk. For patients with high surgery risk and unsuitable for surgery, CAS has more advantages. It is reasonable to view CAS and CEA as complementary rather than competing modes of therapy.
ABSTRACT
Objective To assess the effects of hepatitis B virus(HBV) large envelope protein (LHB) on the apoptosis of HepG2 cells and explore the possible mechanism by proteomic approaches.Methods LHB gene was cloned into pShuttle-IRES-hrGFP-1,and the recombinant adenovirus either barboring LHB(Ad-LHB) or empty vector(Ad-GFP) were separately generated.Annexin V-FITC apoptosis detection kit,JC-1 mitochondrial membrane potential assay kit and propidium iodide(PI) staining kit were employed combined with flow cytometry to detect the apoptotic cells infected with Ad-LHB or control of Ad-GFP.The cellular proteins were collected after infection of HepG2 cells by Ad-LHBs or Ad-GFP,and a total of 600 μg proteins were submitted to two-dimensional gel electrophoresis(2-DE) and stained with R350.The gel images were captured by ImageScanner Ⅱ Imaging System,the differentially expressed proteins were identified by ImageMaster 2D Platinum analysis software and picked up by Ettan Spot Picker.After enzyme digestion,the protein samples were analyzed by MALDI-TOF-TOF MS.Results HepG2 cells infected with Ad-LHB were much more prone to apoptosis.There were thirty nine differentially expressed proteins were determined by 2-DE between HepG2 cells infected with Ad-LHB and Ad-GFP,and they were identified ultimately and categorized into thirty three kinds of proteins by MALDI-TOF-TOF MS.Among these proteins,nine were found to be closely related to cell apoptosis,in which CAPN2,eIF3K and PPP2CB were higher expressed in Ad-LHB infected HepG2 cells,and SERPINH1,LASP1,PRDX1,DHRS2,LDHA and PS-MA4 were lower expressed in Ad-LHB infected HepG2 cells.Conclusion LHB could induce apoptosis of HepG2 cells,and several apoptosis-related proteins participated in this process.