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Objective: To assess the prevalence, risk factors and treatment of anemia in patients with chronic kidney disease (CKD). Methods: A descriptive method was used to analyze the prevalence and treatment of anemia in CKD patients based on regional health data in Yinzhou District of Ningbo during 2012-2018. The multivariate logistic regression analysis was used to identify independent influence factors of anemia in the CKD patients. Results: In 52 619 CKD patients, 15 639 suffered from by anemia (29.72%), in whom 5 461 were men (26.41%) and 10 178 were women (31.87%), and anemia prevalence was higher in women than in men, the difference was significant (P<0.001). The prevalence of anemia increased with stage of CKD (24.77% in stage 1 vs. 69.42% in stage 5, trend χ2 test P<0.001). Multivariate logistic regression analysis revealed that being women (aOR=1.57, 95%CI: 1.50-1.63), CKD stage (stage 2: aOR=1.10, 95%CI: 1.04-1.16;stage 3: aOR=2.28,95%CI: 2.12-2.44;stage 4: aOR=4.49,95%CI :3.79-5.32;stage 5: aOR=6.31,95%CI: 4.74-8.39), age (18-30 years old: aOR=2.40,95%CI: 2.24-2.57, 61-75 years old: aOR=1.35,95%CI:1.28-1.42, ≥76 years old: aOR=2.37,95%CI:2.20-2.55), BMI (<18.5 kg/m2:aOR=1.29,95%CI: 1.18-1.41;23.0-24.9 kg/m2:aOR=0.79,95%CI: 0.75-0.83;≥25.0 kg/m2:aOR=0.70,95%CI: 0.66-0.74), abdominal obesity (aOR=0.91, 95%CI: 0.86-0.96), chronic obstructive pulmonary disease (aOR=1.15, 95%CI: 1.09-1.22), cancer (aOR=3.03, 95%CI: 2.84-3.23), heart failure (aOR=1.44, 95%CI: 1.35-1.54) and myocardial infarction (aOR=1.54, 95%CI:1.16-2.04) were independent risk factors of anemia in CKD patients. Among stage 3-5 CKD patients with anemia, 12.03% received iron therapy, and 4.78% received treatment with erythropoiesis-stimulating agent (ESA) within 12 months after anemia was diagnosed. Conclusions: The prevalence of anemia in CKD patients was high in Yinzhou. However, the treatment rate of iron therapy and ESA were low. More attention should be paid to the anemia management and treatment in CKD patients.
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Chronic kidney disease (CKD) is an important global public health problem that greatly threatens population health. Application of risk prediction model is a crucial way for the primary prevention of CKD, which can stratify the risk for developing CKD and identify high-risk individuals for more intensive interventions. By now, more than twenty risk prediction models for CKD have been developed worldwide. There are also four domestic risk prediction models developed for Chinese population. However, none of these models have been recommended in clinical guidelines yet. The existing risk prediction models have some limitations in terms of outcome definition, predictors, strategies for handling missing data, and model derivation. In the future, the applications of emerging biomarkers and polygenic risk scores as well as advances in machine learning methods will provide more possibilities for the further improvement of the model.
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Humans , Renal Insufficiency, Chronic , Risk Factors , BiomarkersABSTRACT
BACKGROUND@#Cancer stem-like cells (CSCs) are a small subset of cells in tumors that exhibit self-renewal and differentiation properties. CSCs play a vital role in tumor formation, progression, relapse, and therapeutic resistance. B7-H3, an immunoregulatory protein, has many protumor functions. However, little is known about the mechanism underlying the role of B7-H3 in regulating gastric cancer (GC) stemness. Our study aimed to explore the impacts of B7-H3 on GC stemness and its underlying mechanism.@*METHODS@#GC stemness influenced by B7-H3 was detected both in vitro and in vivo . The expression of stemness-related markers was examined by reverse transcription quantitative polymerase chain reaction, Western blotting, and flow cytometry. Sphere formation assay was used to detect the sphere-forming ability. The underlying regulatory mechanism of B7-H3 on the stemness of GC was investigated by mass spectrometry and subsequent validation experiments. The signaling pathway (Protein kinase B [Akt]/Nuclear factor erythroid 2-related factor 2 [Nrf2] pathway) of B7-H3 on the regulation of glutathione (GSH) metabolism was examined by Western blotting assay. Multi-color immunohistochemistry (mIHC) was used to detect the expression of B7-H3, cluster of differentiation 44 (CD44), and Nrf2 on human GC tissues. Student's t -test was used to compare the difference between two groups. Pearson correlation analysis was used to analyze the relationship between two molecules. The Kaplan-Meier method was used for survival analysis.@*RESULTS@#B7-H3 knockdown suppressed the stemness of GC cells both in vitro and in vivo . Mass spectrometric analysis showed the downregulation of GSH metabolism in short hairpin B7-H3 GC cells, which was further confirmed by the experimental results. Meanwhile, stemness characteristics in B7-H3 overexpressing cells were suppressed after the inhibition of GSH metabolism. Furthermore, Western blotting suggested that B7-H3-induced activation of GSH metabolism occurred through the AKT/Nrf2 pathway, and inhibition of AKT signaling pathway could suppress not only GSH metabolism but also GC stemness. mIHC showed that B7-H3 was highly expressed in GC tissues and was positively correlated with the expression of CD44 and Nrf2. Importantly, GC patients with high expression of B7-H3, CD44, and Nrf2 had worse prognosis ( P = 0.02).@*CONCLUSIONS@#B7-H3 has a regulatory effect on GC stemness and the regulatory effect is achieved through the AKT/Nrf2/GSH pathway. Inhibiting B7-H3 expression may be a new therapeutic strategy against GC.
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Humans , Cell Line, Tumor , Neoplasm Recurrence, Local , NF-E2-Related Factor 2/metabolism , Proto-Oncogene Proteins c-akt/metabolism , Signal Transduction , Stomach NeoplasmsABSTRACT
Objective:To construct the transitional care program of elderly patients undergoing ambulatory surgery.Methods:Based on literature review, interviews and surveys of needs, a two-round expert consultation was conducted to determine the content of the transitional care program of elderly patients undergoing ambulatory surgery.Results:A total of 9 experts from geriatrics, geriatric care, nursing management, clinical nursing and ambulatory surgery participated in the consultation. The response rates of two-round consultation were 100%, and the expert′s authority coefficient was 0.89. The formed transitional care program of elderly patients undergoing ambulatory surgery included 6 parts, 29 aspects and 101 detailed rules.Conclusions:The transitional care program of elderly patients undergoing ambulatory surgery is scientific and clinically practical. It reflects the actual needs of patients, and could provide a reference for the transitional care practice of elderly patients undergoing ambulatory surgery.
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The epidermal cell differentiation regulator zinc finger protein 750 (ZNF750) is a transcription factor containing the Cys2His2 (C2H2) domain, the zinc finger structure of which is located at the N-terminal 25-46 amino acids of ZNF750. It can promote the expression of differentiation-related factors while inhibiting the expression of progenitor cell-related genes. ZNF750 is directly regulated by p63 (encoded by the TP63 gene, belonging to the TP53 superfamily). The Krüppel-like factor 4 (KLF4), repressor element-1 (RE-1)-silencing transcription factor (REST) corepressor 1 (RCOR1), lysine demethylase 1A (KDM1A), and C-terminal-binding protein 1/2 (CTBP1/2) chromatin regulators cooperate with ZNF750 to repress epidermal progenitor genes and activate the expression of epidermal terminal differentiation genes (Sen et al., 2012; Boxer et al., 2014). Besides, ZNF750 and the regulatory network composed of bone morphogenetic protein (BMP) signaling pathway, long non-coding RNAs (lncRNAs) (anti-differentiation non-coding RNA (ANCR) and tissue differentiation-inducing non-protein coding RNA (TINCR)), musculoaponeurotic fibrosarcoma oncogene (MAF)/MAF family B (MAFB), grainy head-like 3 (GRHL3), and positive regulatory domain zinc finger protein 1 (PRDM1) jointly promote epidermal cell differentiation (Sen et al., 2012).
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Humans , Adenocarcinoma/metabolism , Carcinogenesis/genetics , Colonic Neoplasms/metabolism , Histone Demethylases/metabolism , RNA, Long Noncoding/genetics , Transcription Factors/metabolism , Tumor Suppressor Proteins/metabolismABSTRACT
Objective:To analyze the clinical application and main roles of Cardiopulmonary Exercise Test (CPET) in patients with lung cancer based on the theory of the World Health Organization Family International Classifications (WHO-FICs). Methods:An evidence-based scoping review was implemented. Literatures related to the applications of CPET in patients with lung cancer were retrieved, from databases including PubMed, Web of Science, CNKI and Wanfang data; from January, 2013 to April, 2021. The indications, contraindications, motor dysfunction, pulmonary rehabilitation interventions, evaluation methods and indicators, and the environment factors of CPET applicated in patients with lung cancer was reviewed based on WHO-FICs framework. Results:This paper analyzed the included literatures from five aspects: the type of disease, functioning, pulmonary rehabilitation exercise interventions, functioning evaluation and environment factors. The major diseases included different pathological types of non-small cell lung cancer (NSCLC) (2C25), and the most common complication of lung cancer was chronic obstructive pulmonary disease (COPD) (CA22). The obstacles of CPET conducted in lung cancer patients mainly included physical structure and functional activities and participation obstacles. Pulmonary rehabilitation based on the CPET was divided into therapeutic, preventive and health promotion interventions. The evaluation tools and indicators were oxygen intake, carbon dioxide output, oxygen pulse, heart rate, blood pressure, electrocardiogram, Borg Scale, 6-minute Walking Test, the MOS Item Short Form Health Survey (SF-36), etc. The classification and description of environmental factors were provided. Conclusion:The application of CPET in lung cancer mainly included preoperative evaluation and prognosis prediction, exercise prescription formulation and exercise effect assessment, anti-cancer treatment impact assessment. Based on WHO-FICs theory system, the applications of CPET mainly involved NSCLC, and COPD was the most common complication of lung cancer. Pulmonary rehabilitation for lung cancer is function- and demand-oriented. Based on CPET evaluation results, individualized therapeutic, preventive and health promotion interventions are conducted to improve the overall function and optimize the health outcomes of patients with lung cancer.
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BACKGROUND@#Whether there is an association between serum uric acid (SUA) level and risk of mortality in the general population remains unclear. Based on the China National Survey of Chronic Kidney Disease linked to mortality data, a population-based cohort study was performed to investigate the association between SUA level and all-cause mortality, cardiovascular disease (CVD) mortality, and cancer mortality in China.@*METHODS@#The survival status of participants in the cross-sectional survey was identified from January 1, 2006 to December 31, 2017. Only 33,268 individuals with complete SUA data among the 47,204 participants were included in the analysis. We determined the rates of all-cause mortality, CVD mortality, and cancer mortality. We used Cox proportional hazards regression models to evaluate the effect of the SUA level on mortality.@*RESULTS@#During a total of 297,538.4 person-years of follow-up, 1282 deaths occurred. In the Cox proportional hazards regression model, the rate of all-cause mortality, CVD mortality, and cancer mortality had a U-shaped association with SUA levels only in men, whereas no significant associations were detected in women. For all-cause mortality in men, the multivariable-adjusted hazard ratios (HRs) in the first, second, and fourth quartiles compared with the third quartile were 1.31 (95% confidence interval [CI] 1.04-1.67), 1.17 (95% CI 0.92-1.47), and 1.55 (95% CI 1.24-1.93), respectively. For CVD mortality, the corresponding HRs were 1.47 (95% CI 1.00-2.18), 1.17 (95% CI 0.79-1.75), and 1.67 (95% CI 1.16-2.43), respectively. For the cancer mortality rate, only a marginally significant association was detected in the fourth quartile compared with the third quartile with an HR of 1.43 (95% CI 0.99-2.08).@*CONCLUSIONS@#The association between SUA and mortality differed by sex. We demonstrated a U-shaped association with SUA levels for all-cause and CVD mortalities among men in China.
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Female , Humans , Male , Cause of Death , China/epidemiology , Cohort Studies , Cross-Sectional Studies , Proportional Hazards Models , Risk Factors , Uric AcidABSTRACT
OBJECTIVE：To summarize the current output research status of collaboration between clinical pharmacists and physicians in China ，and to provide reference for comprehensively understanding the development trend of relevant research and the collaborative value of clinical pharmacists and physicians. METHODS ：Literature analysis was used to sort out the general characteristics，the indexes and results of output related researches ，and investigate the focuses and results of collaboration output indexes from 3 dimensions，such as time ，hospital level and disease type /situation. RESULTS & CONCLUSIONS ：In the aspect of focuses，the number of output related researches in China had decreased in recent years ，among which tertiary hospitals conducted more related researches ；secondary hospitals had few related researches and a limited perspective on evaluating outputs. On the whole，the current researches paid more attention to t he use of antibiotics in bacterial in fection. Most of the research sites were inpatient departments ，and most of the research designs were historical controlled parallel trials and single arm trials. In addition，the three output measurement indexes of safety ， cpulucyxia@163.com effectiveness and economy develop diversely ， scientifically and comprehensively. Ho wever，at the present ，little attention was paid to complex and dif ficult measurement indexes ，such as“cognitive level of patients ”“recurrence rate ”improvement in “quality of life ”“cost-effectiveness/benefit analysis of clinical pharmaceutical care ”. In aspect of research result ，most of the existing researches could prove that the collaboration can significantly improve medication safety ，effectiveness and economy ；the proportion of “significantly improved ”results of most indicators had been stable or had increased stage by stage. However ，there were still a small number of researches that had not carried out statistical test on the results before and after collaboration. In the future ，relevant researchers still need to strengthen the research on outpatient pharmaceutical care ，randomized controlled trials and multi disease and multi situation ，and should scientifically and reasonably select output measurement indicators and pay attention to the application of statistical methods ，so as to further expand the focus of research and comprehensively explore the value of collaboration between clinical pharmacists and physicians.
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There is increasing evidence that long non-coding RNA (lncRNA) plays critical roles in cancer progression. However, the role of long non-coding RNA 00665 (LINC00665) in most cancers is poorly understood. The purpose of the present study was to reveal the functional role of LINC00665 in cervical cancer cells. HeLa cells were subjected to LINC00665 short hairpin RNA (shRNA) or control shRNA treatment to investigate the metastasis and proliferation phenotype of cervical cancer cells in vitro and in vivo. Transcriptome sequencing experiments of HeLa cells in LINC00665 silencing or control group were conducted, and the differentially expressed genes (DEGs) were screened. The DEGs were subjected to Metascape database functional analysis and gene set enrichment analysis. Epithelial-mesenchymal transition (EMT) related markers and a key element of WNT/β‑catenin pathway, CTNNB1 (catenin beta 1), were detected by Western blot and immunofluorescence assay. The results showed that silencing LINC00665 reduced cell viability of Hela cells, up-regulated protein expression level of E-cadherin, down-regulated protein expression levels of N-cadherin, Vimentin and CTNNB1, and inhibited cell migration and invasion of HeLa cells. Bioinformatics analysis results showed that LINC00665 might promote EMT by activating WNT-CTNNB1/β‑catenin signaling pathway. These results indicate that LINC00665 has functions in transcriptional EMT regulation via WNT-CTNNB1/β‑catenin signaling pathway and therefore can be developed as a therapeutic target for cervical cancer.
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Female , Humans , Cell Line, Tumor , Cell Movement , Cell Proliferation , Epithelial-Mesenchymal Transition , Gene Expression Regulation, Neoplastic , HeLa Cells , Wnt Signaling Pathway , beta Catenin/metabolismABSTRACT
Objective@#To clarify the importance and practical significance of the standardized rate in primary healthcare work by comparing the differences in the prevalence of myopia in districts in Beijing before and after standardization.@*Methods@#This study recruited a total of 41 029 students from 107 primary and secondary schools and 35 kindergartens from the 16 districts of Beijing municipality. All participants underwent distance vision and refractive testing. The presence of myopia was defined as naked eye vision of <5.0 and non-ciliary muscle paralysis under computer optometry with a spherical equivalent objective refractive error of <-0.50 diopters (<-0.50 D). The student composition outlined in the 2018-2019 Beijing Education Development Statistics Summary was used as a standard group to standardize the prevalence of myopia in students from various districts of Beijing. The difference in the pre-and post-standardization rates was used to compare the change in myopia in each district before and after standardization.@*Results@#In 2018, the prevalence of myopia in students from Beijing was 57.3%. Stratified by school period, the prevalence of myopia in preschool, primary school, junior high school, ordinary high school, and vocational high school students was 12.1%, 38.4%, 77.2%, 88.3%, and 73.1%, respectively. Although the prevalence of myopia in Daxing District was the highest both before and after standardization, the difference in the prevalence rate was 13.8 percentage points. The prevalence of myopia in Miyun District was the lowest before standardization. However, after standardization, the prevalence of myopia was lowest in Huairou District.@*Conclusion@#The prevalence of myopia among Beijing students is generally high. Before and after standardization, the prevalence of myopia in different districts was quite different. The results show that, in practice, the standardized prevalence can reveal the true epidemiological characteristics of specific disease.
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Coronavirus , Diarrhea , Erythrocytes , Hemagglutination , Methods , Neuraminidase , Population Characteristics , Swine , Trypsin , VirionABSTRACT
Porcine deltacoronavirus (PDCoV) is an emerging swine enteric coronavirus that causes diarrhea in piglets. However, the biological characteristics of PDCoV are unclear. In this study, the hemagglutination (HA) abilities of two PDCoV strains (CH-01 and HNZK-04) were investigated. Our results showed that PDCoV has the ability to agglutinate rabbit erythrocytes after virion pretreatment with trypsin or neuraminidase. Additionally, the HA assay results showed a significant positive correlation with the infectious viral titer. Our results suggest that assessing the HA activity of PDCoV may be a useful diagnostic method for investigating and surveilling PDCoV infections.
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OBJECTIVE@#To evaluate the efficacy and safety of hydroxychloroquine (HCQ) in the treatment of patients with moderate coronavirus disease 2019 (COVID-19).@*METHODS@#We prospectively enrolled 30 treatment-naïve patients with confirmed COVID-19 after informed consent at Shanghai Public Health Clinical Center. The patients were randomized 1：1 to HCQ group and the control group. Patients in HCQ group were given HCQ 400 mg per day for 5 days plus conventional treatments, while those in the control group were given conventional treatment only. The primary endpoint was negative conversion rate of SARS-CoV-2 nucleic acid in respiratory pharyngeal swab on days 7 after randomization. This study has been approved by the Ethics Committee of Shanghai Public Health Clinical Center and registered online (NCT04261517).@*RESULTS@#One patient in HCQ group developed to severe during the treatment. On day 7, nucleic acid of throat swabs was negative in 13 (86.7%) cases in the HCQ group and 14 (93.3%) cases in the control group (>0.05). The median duration from hospitalization to virus nucleic acid negative conservation was 4 (1,9) days in HCQ group, which is comparable to that in the control group [2 (1,4) days, Z=1.27, >0.05]. The median time for body temperature normalization in HCQ group was 1 (0,2) day after hospitalization, which was also comparable to that in the control group [1 (0,3) day]. Radiological progression was shown on CT images in 5 cases (33.3%) of the HCQ group and 7 cases (46.7%) of the control group, and all patients showed improvement in follow-up examinations. Four cases (26.7%) of the HCQ group and 3 cases (20%) of the control group had transient diarrhea and abnormal liver function (>0.05).@*CONCLUSIONS@#The prognosis of COVID-19 moderate patients is good. Larger sample size study are needed to investigate the effects of HCQ in the treatment of COVID-19. Subsequent research should determine better endpoint and fully consider the feasibility of experiments such as sample size.
Subject(s)
Humans , Betacoronavirus , China , Coronavirus Infections , Diagnostic Imaging , Drug Therapy , Hydroxychloroquine , Therapeutic Uses , Pandemics , Pilot Projects , Pneumonia, Viral , Diagnostic Imaging , Drug Therapy , RNA, Viral , Treatment OutcomeABSTRACT
Objective:To analyze the effects of angiotensin converting enzyme inhibitor/angiotensin receptor blocker (ACEI/ARB) on coronavirus disease 2019 (COVID-19) patients with hypertension, and to provide an evidence for selecting antihypertensive drugs in those patients.Methods:Clinical data were retrospectively analyzed in 58 COVID-19 patients with hypertension admitted to Shanghai Public Health Clinical Center from January 20 to February 22, 2020, including epidemiological history, clinical manifestations, laboratory findings, chest CT and outcome. Patients were divided into ACEI/ARB group and non-ACEI/ARB group.Results:Twenty-six patients were in ACEI/ARB group and the other 32 patients in non-ACEI/ARB group, with median age 64.0 (49.5, 72.0) years and 64.0 (57.0, 68.8) years respectively. The median time to onset was 5(3, 8) days in ACEI/ARB group and 4 (3, 7) days in non-ACEI/ARB group, the proportion of patients with severe or critical illness was 19.2% and 15.6% respectively. The main clinical symptoms in two groups were fever (80.8% vs. 84.4%) and cough (23.1% vs. 31.3%). The following parameters were comparable including lymphocyte counts, C-reactive protein, lactate dehydrogenase, D-dimer, bilateral involvement in chest CT (76.9% vs. 71.9%), worsening of COVID-19 (15.4% vs. 9.4%), favorable outcome (92.3% vs. 96.9%) between ACEI/ARB group and non-ACEI/ARB group respectively (all P>0.05). However, compared with non-ACEI/ARB group, serum creatinine [80.49 (68.72, 95.30) μmol/L vs. 71.29 (50.98, 76.98) μmol/L, P=0.007] was higher significantly in ACEI/ARB group. Conclusions:ACEI/ARB drugs have no significant effects on baseline clinical parameters (serum creatine and myoglobin excluded) , outcome, and prognosis of COVID-19 patients with hypertension. Antihypertensive drugs are not suggested to adjust in those patients, but the potential impairment of renal function as elevation of serum creatinine should be paid attention in patients administrating ACEI/ARB drugs.
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Porcine deltacoronavirus (PDCoV) is an emerging swine enteric coronavirus that causes diarrhea in piglets. However, the biological characteristics of PDCoV are unclear. In this study, the hemagglutination (HA) abilities of two PDCoV strains (CH-01 and HNZK-04) were investigated. Our results showed that PDCoV has the ability to agglutinate rabbit erythrocytes after virion pretreatment with trypsin or neuraminidase. Additionally, the HA assay results showed a significant positive correlation with the infectious viral titer. Our results suggest that assessing the HA activity of PDCoV may be a useful diagnostic method for investigating and surveilling PDCoV infections.
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Objective:To investigate the renal protective effect of Tangshenping capsule (Tangshenping) on diabetic nephropathy (DN) KKAy mice and its effect on Wnt/β-catenin signaling pathway. Method:Sixty female Sprague-Dawley KKAy mice aged 10 weeks old were induced with KKAy rat feed for 10 weeks. The DN animal model was successfully determined with blood glucose (>16.7 mmol·L-1) and 24 hour urine protein (>0.4 mg). The model mice were randomly divided into a model group, an irbesartan group, and low, medium and high-dose Tangshenping group, with 10 female C57BL/6J mice as a control group. The treatment groups were given the corresponding drugs by gavage. The normal group and the model group were given an equal volume of deionized water by gavage. The intragastric dose was 0.01 mL·g-1 body weight coefficient once a day. The general conditions of the mice were observed, the body mass was weighed every 4 weeks, and 24 h urine protein was quantified. At the 26th week, the blood was collected from eyeballs, and the mice were put to death. The quality of the kidneys, serum blood urea nitrogen (BUN), serum creatinine (SCr), triglyceride (TG), malondialdehyde (MDA), nitric oxide (NO) and superoxide dismutase (SOD) content were measured. In situ hybridization and immunohistochemistry were used to detect the expressions of Wnt4, glycogen synthase kinase 3β(GSK3β) and β-catenin in kidney tissues. Result:Compared with model group, body mass, kidney mass/body mass, and 24 h urine protein were significantly lower in high-dose Tangshenping group (PPPβ and β-catenin were decreased (PConclusion:Tangshenping may inhibit the activation of Wnt/β-catenin signaling pathway, reverse the transdifferentiation of renal tubular epithelial cells in DN KKAy mice, delay the progression of renal interstitial fibrosis, and then exert renal protection.
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Objective: To study the chemical constituents of agarwood originating from Aquilaria crassna in Cambodia. Methods: The compounds were isolated and purified by silica gel column chromatography and semi-preparetive HPLC and so on. Their structures were identified by spectroscopic data. All compounds were tested for cytotoxic activities against two human cancer cell lines by MTT method. Results: Four compounds were isolated and elucidated as 6-methoxy-8-hydroxy-2-(2-phenylethyl) chromone (1), 6-methoxy-7-hydroxy-2-[2-(4-methoxyphenyl) ethyl] chromone (2), 7β,8β-epoxy-6α-hydroxy-5α-methoxy-5,6,7,8-tetrahydro-2-[2-(4- methoxyphenyl) ethyl] chromone (3), and rel-(1aR,2R,3R,7bS)-5,6-epoxy-7,8-dihydroxy-5,6,7,8-tetrahydro-2-[2-(4-methoxyphenyl) ethyl] chromone (4). Conclusion: Compound 1 is a new compound, while compounds 2-4 are isolated from this agarwood for the first time. Among them, compound 4 showed inhibitory activities against SGC-7901 and A549 cells.
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Objective: To evaluate the safety and efficacy of transurethral enucleation of bladder tumor(TUEBT) in the treatment of non muscle-invasive bladder cancer (NMIBC). Methods: The clinical and pathological data of 82 NMIBC patients treated between No-vember 2015 and January 2018 in the First Affiliated Hospital of the Jinzhou Medical University were retrospectively analyzed. The 82 NMIBC patients were divided into a TUEBT group (38 cases) and a transurethral resection of bladder tumor (TURBT) group (44 cases). The differences in intraoperative indices, postoperative indices, and pathological staging between the two groups were compared. Re-sults: The bladder irrigation, indwelling catheter, and postoperative hospitalization times in the TUEBT group were (21.00 ± 3.55) h, (4.34±0.81) d, and (5.29±0.96) d, respectively, compared with (27.57±3.87) h, (5.32±0.83) d, and (6.32±0.86) d in the TURBT group, and the differences between groups were statistically significant (P<0.05). The operative time in the TUEBT group [(29.55±4.13) min] was longer than in the TURBT group [(25.30±4.01) min]. The hemoglobin decrease in the TUEBT group [(2.00±0.38) g/dL] was less than that in the TURBT group [(2.30±0.32) g/dL]. The incidence of obturator nerve reflex in the TUEBT group was 13.16% (5/38), compared to 34.09% (15/44) in the TURBT group. The recurrence rate in the TUEBT group was 10.53% (4/38), compared to 29.55% (13/44) in the TURBT group. The detrusor deletion rate in the TUEBT group was 0 (0/38), compared to 31.82% (14/44) in the TURBT group. The re-peat transurethral resection (ReTUR) standard was met in 22 cases in the TUEBT group and 33 in the TURBT group. ReTUR due to lack of a detrusor was required in 0 cases in the TUEBT group and 14 in the TURBT group. The differences in the above clinical characteris-tics were statistically significant (P<0.05). Conclusions: TUEBT can remove a tumor completely, while preserving the detrusor, improv-ing the accuracy of pathological staging, and reducing the probability of ReTUR. For NMIBC, TUEBT can obtain satisfactory clinical effi-cacy, with surgical safety and long-term efficacy superior to those of TURBT.
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OBJECTIVE@#To explore the association between anemia and cardiovascular disease and all-cause mortality among diabetic patients, and whether the association is modified by the presence of chronic kidney disease (CKD).@*METHODS@#Physical examination data of 8 563 patients with diabetes who met the inclusion and exclusion criteria between 2010 and 2011 were collected, based on the prospective cohort data of Kailuan study. The deadline of the follow-up was December 31, 2015, and the endpoints comprised all-cause mortality and cardiovascular disease. Survival analysis was performed by Kaplan-Meier method. Cox proportional hazards regression model was used to assess the association between anemia with or without CKD, and cardiovascular events and all-cause mortality after adjustment for confounding factors.@*RESULTS@#The average age of the subjects was (57.3±10.3) years, of whom the patients with anemia accounted for 5.2%. The proportion of the patients with anemia combined with CKD was higher than that of the patients without anemia (27.2% vs. 20.8%, P=0.001). The median follow-up time was 4.9 years (interquartile range: 4.6-5.2 years). During the follow-up period, 559 patients died, and 434 patients had cardiovascular disease. Compared with the patients without anemia, the all-cause mortality rate of the patients with anemia was higher (3 220.3/100 000 person-years vs. 1 257.9/100 000 person-years, P<0.001). There was no statistically significant difference in the incidence of cardiovascular disease between the above two groups (999.8/100 000 person-years vs. 1 081.2/100 000 person-years, P>0.05). The mortality and incidence of cardiovascular disease among the patients with CKD were higher than those of the patients without CKD (2 558.3/100 000 person-years vs. 1 044.0/100 000 person-years, P<0.001; 1 605.9/100 000 person-years vs. 941.6/100 000 person-years, P<0.001). Results of Cox regression model showed that, after adjustment for confounding factors, the all-cause mortality risk increased by 95% in the diabetic patients with anemia (HR=1.95, 95% CI: 1.50-2.54). Anemia and CKD significantly increased the mortality risk among diabetic patients (HR=3.61, 95% CI: 2.48-5.26). The CKD patients without anemia had an increased risk of cardiovascular disease (HR=1.41, 95% CI: 1.13-1.74).@*CONCLUSION@#Anemia is associated with an increased mortality risk in Chinese diabetic patients. Patients with CKD have an increased risk of cardiovascular disease and mortality. The all-cause mortality risk increases significantly in anemia patients with the presence of CKD, which indicates that we should focus on the prevention and treatment of diabetic patients with anemia and CKD.
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Humans , Anemia/epidemiology , Cardiovascular Diseases/epidemiology , Diabetes Mellitus, Type 2 , Proportional Hazards Models , Prospective Studies , Renal Insufficiency, Chronic/epidemiology , Risk Factors , Survival AnalysisABSTRACT
Background:The incidence of ulcerative colitis (UC)in developed countries is higher than that in developing countries,which may be related with westernized lifestyle,especially high animal protein and low complex carbohydrate diet. With the increased high fat and meat intake,synthesis and secretion of bile acid in liver is also increased,which may have an impact on the occurrence of UC. Aims:To investigate the expressions of farnesoid X receptor (FXR)and G protein-coupled bile acid receptor 5 (TGR5)in patients with UC. Methods:Thirty patients with active UC from January 2013 to June 2016 at the Affiliated Jiangning Hospital of Nanjing Medical University were enrolled,and 30 healthy subjects were served as controls. Expressions of FXR and TGR5 were determined by immunohistochemistry. Results:Compared with control group,expression of FXR was significantly decreased in UC patients (4. 63 ± 2. 07 vs. 6. 91 ± 2. 62,P =0. 00),however,no significant difference in expression of TGR5 was found between the two groups (6. 70 ± 2. 90 vs. 6. 11 ± 2. 44,P = 0. 40). Expression of FXR was significantly increased in right hemicolon colitis than in left hemicolon colitis (P < 0. 05). Conclusions:There is a significant decrease in FXR in active UC patients,indicating that FXR may have some role in the pathogenesis of UC,however,TGR5 may have no obvious effect in the pathogenesis of UC.