Research progress on factors affecting the establishment and development of oral microbiota in early life / 口腔疾病防治

@#The oral microbiota has been proven to play an essential role in local and systemic health. Hence, it is essential to understand how the oral microbiota and further microbial ecosystems are established and the associated development process to understand the physiologic and pathologic events related to the oral microbiota and management of the whole lifecycle oral and systemic health. The present review summarizes recent studies of the establishment and development of oral microbial communities in early life with related factors and briefly describes their prospects. By investigating the characteristics and development of the oral microbiota, current studies have shown that health status during pregnancy, mode of delivery, diet, environment, antibiotics and genetic factors are related to oral microbiota development, which is helpful in clinical practice. Nevertheless, current studies are mostly cross-sectional. Prospective cohort studies with larger sample sizes using metagenomics or metatranscriptomics and studies on molecular mechanisms are needed to further elucidate the influences and mechanisms of the related factors on the establishment and development of microbiota in early life and their impact on local or systemic health.

DEPTOR gene silencing promotes β-cell insulin secretion / 中国组织工程研究

BACKGROUND: Mammalian target of rapamycin (mTOR) complexes are a key regulator of pancreatic beta cells mass and function. DEP-domain containing mTOR-interacting protein (DEPTOR) is a common part of mTOR complexes and whether DEPTOR loss in islet β cells affects insulin-secreting function has never been identified. OBJECTIVE: To assess the alternation of insulin secretion by silencing DEPTOR gene in pancreatic β cells NIT-1 and to explore the underlying mechanism. METHODS: Three siRNA sequences for silencing DEPTOR gene were designed and constructed, which were transfected with lipofectamine into NIT-1 cells. There were six groups: blank transfection group (NIT-1 cells plus Lipofectamin), negative control group (NC-FAM), positive control group (GAPDH), siRNA deptor 1 group (siRNA deptor385), siRNA deptor 2 group (siRNA deptor766), and siRNA deptor 3 group (siRNA deptor1275). The transfection efficiency was determined by fluorescence microscope. The relative expression level of DEPTOR mRNA was detected by quantitative-PCR. Insulin secretion in the cell conditioned medium was determined by insulin ELISA kit. The expression level of DEPTOR downstream key protein was detected by western blot assay. RESULTS AND CONCLUSION: Specific green fluorescence accumulated in a punctated pattern under fluorescence microscope, indicating that the effectiveness of transfection was eligible. Quantitative-PCR results showed two (siDEPTOR385 and siDEPTOR766) of the three siRNA sequences could significantly disrupt the expression of DEPTOR mRNA, which had significant difference with negative control group (P＜ 0.05). The ELISA results showed that the total amount of insulin secretion in the effective transfected groups was significantly increased (P＜ 0.05). Western blot assay results showed the grey levels of p-s6 and p-4EBP-1 proteins were significantly elevated, while p-AKT of those former was slightly decreased. These findings suggest that siRNA technology can effectively silence the DEPTOR gene in NIT-1 cells, which improves β-cell insulin secretion in a manner of mTORC1 activation.

Application of iASSIST-assisted total knee arthroplasty in the treatment of genu varum or genu valgus / 中国组织工程研究

BACKGROUND: Compared with conventional total knee arthroplasty (TKA), for patients with genu varum or genu valgus, indications, prosthesis choice, surgical accuracy and perioperative management during TKA should be paid more attention. OBJECTIVE: To compare the clinical effectiveness of iASSIST-assisted TKA and traditional TKA in the treatment of genu varum or genu valgus. METHODS: Twenty-one patients with genu varum or genu valgus undergoing TKA were selected, and were then randomized into two groups: iASSIST-assisted TKA (group A) or traditional TKA (group B). The surgical accuracy was compared between two groups by measuring the knee valgus angle of patients, and the angle between prosthesis components on the coronal and sagittal planes. Besides, the intraoperative blood loss, operation time, postoperative drainage, restored alignment, postoperative complications, hospitalization time, as well as Visual Analogue Scale and American Knee Society scores were recorded to assess the clinical effectiveness. RESULTS AND CONCLUSION: (1) The deviation of hip-knee-ankle angle, frontal femoral component angle, frontal tibial component angle, lateral femoral component angle and lateral femoral component angle in the two groups was less than 3°, and the group A exhibited better corrective efficacy. (2) The operation time in the group A was significantly longer than that in the group B; the hospitalization time in the group was significantly shorter than that in the group B; the restored alignment in the group A was significantly superior to that in the group B;the postoperative drainage, as well as Visual Analogue Scale and American Knee Society scores at 1 day and 1 week postoperatively in the group B were significantly superior to those in the group A (all P < 0.05). There were no significant differences in the intraoperative blood loss, incidence of complications, as well as Visual Analogue Scale and American Knee Society scores at postoperative 2 weeks and 1 and 3 months between two groups (P > 0.05). (3) These results manifest that for the patients with genu varum or genu valgus, both iASSIST-assisted TKA and traditional TKA can obtain satisfactory surgical accuracy, and the former has advantage in restricting the alignment of lower limbs. However, the long-term efficacy needs to be explored in depth.

A simple bedside model to predict the risk of in-hospital mortality in Stanford type A acute aortic dissection / 中国胸心血管外科临床杂志

@#Objective     To investigate predictors for mortality among patients with Stanford type A acute aortic dissection (AAD) and to establish a predictive model to estimate risk of in-hospital mortality. Methods     A total of 999 patients with Stanford type A AAD enrolled between 2010 and 2015 in our hospital were included for analysis. There were 745 males and 254 females with a mean age of 49.8±12.0 years. There were 837 patients with acute dissection and 182 patients (18.22%) were preoperatively treated or waiting for surgery in the emergency department and 817 (81.78%) were surgically treated. Multivariable logistic regression analysis was used to investigate predictors of in-hospital mortality. Significant risk factors for in-hospital death were used to develop a prediction model. Results     The overall in-hospital mortality was 25.93%. In the multivariable analysis, the following variables were associated with increased in-hospital mortality: increased age (OR=1.04, 95% CI 1.02 to 1.05, P<0.000 1), acute aortic dissection (OR=2.49, 95% CI 1.30 to 4.77, P=0.006 1), syncope (OR=2.76, 95% CI 1.15 to 6.60, P=0.022 8), lower limbs numbness/pain (OR=7.99, 95% CI 2.71 to 23.52, P=0.000 2), type Ⅰ DeBakey dissection (OR=1.72, 95% CI 1.05 to 2.80, P=0.030 5), brachiocephalic vessels  involvement (OR=2.25, 95% CI 1.20 to 4.24, P=0.011 7), acute liver insufficiency (OR=2.60, 95% CI 1.46 to 4.64, P=0.001 2), white blood cell count (WBC)>15×109 cells/L (OR=1.87, 95% CI 1.21 to 2.89, P=0.004 9) and massive pericardial effusion (OR=4.34, 95% CI 2.45 to 7.69, P<0.000 1). Based on these multivariable results, a reliable and simple bedside risk prediction tool was developed. Conclusion     Different clinical manifestations and imaging features of patients with Stanford type A AAD predict the risk of in-hospital mortality. This model can be used to assist physicians to quickly identify high risk patients and to make reasonable treatment decisions.

Application of CRISPR/Cas9 gene editing technique in cancer drug resistance: Research advances / 国际药学研究杂志

Clustered regularly interspaced short palindromic repeat/CRISPR-associated nuclease 9CRISPR/Cas9gene editing system is derived from a prokaryotic adaptive immune system that confers resistance to invasion of exogenous DNA in bacteria and archaea. The CRISPR/Cas9 system is easier and more efficient in genome editing compared to conventional zinc finger nucleases (ZFN) and transcription- activator- like effector nucleases(TALEN)techniques. So far, this technique has been widely used in the field of cancer drug resistance research, such as breast cancer and leukemia drug resistance. Although the CRISPR/Cas9 system still has some problems such as off- target effects, it opens up a good prospect of application and extension. This review summarizes the progress in the application of CRISPR/Cas9 gene editing in cancer drug resistance.

The inlfuence of ACSS2 knockdown on the proliferation, apoptosis and migration of NSCLC cell line A549 / 中国癌症杂志

Background and purpose:Metabolism change is one of the main characteristics of the tumor de-velopment. Many studies have conifrmed that cytosolic acetyl-CoA synthetase 2 (ACSS2) plays a critical role in hydro-carbon metabolism of cancer cells. This study aimed to explore the effect of ACSS2 on cellular proliferation, apoptosis and migration of A549 cells by RNA interference.Methods:The ACSS2 interference fragment ACSS2-siRNA and neg-ative control were designed and synthesized for RNA interference followed by the transient transfection in non-small cell lung cancer (NSCLC) cell line A549. Real-time lfuorescence quantitative polymerase chain reaction (RTFQ-PCR) was used to detect ACSS2 mRNA expression. Methyl thiazolyl tetrazolium (MTT), lfow cytometry and wound healing assay were used to detect cell proliferation, apoptosis rate and migration.Results:The expression of ACSS2 mRNA was signiifcantly decreased after transfection with the interference fragment ACSS2-siRNA in NSCLC cell line A549. The proliferation and migration activity of ACSS2-siRNA treated cells were decreased significantly compared with the control group. The apoptosis rate, especially the early apoptosis, was increased..Conclusion:Knockdown of the ACSS2 expression in NSCLC cell line A549 can signiifcantly inhibit the cell proliferation, migration ability and pro-mote the apoptosis rate, especially early apoptosis. This study indicates that ACSS2 may contribute to the progression of human lung adenocarcinoma and may have the potential to serve as a novel therapeutic target.

The influences of ultrafiltration and alcohol sedimentation on protective effects of Radix Astragali and Radix Hedyseri against rat's cerebral ischemia / 中国应用生理学杂志

<p><b>OBJECTIVE</b>To investigate the influences of ultrafiltration and alcohol sedimentation on protective effects of Radix Astragali and Radix Hedyseri against rat's cerebral ischemia.</p><p><b>METHODS</b>Using dexamethasone (im.) and ligating common carotid artery, the rat stasis model combined transient cerebral ischemia was established to evaluate the effects of the ultrafiltration and alcohol sedimentation through detecting antioxidant system and other indexes in brain tissue.</p><p><b>RESULTS</b>The results showed that the 6 g/kg water extract(crude drug), ultrafiltration and alcohol sedimentation of Radix Astragali and Radix Hedyseri could upgrade adenosine-triphosphate (ATP), superoxide dismutase (SOD) and catalase (CAT), and degrade malondialdehyde(MDA) and water content of brain tissue in rat stasis model combined transient cerebral ischemia, the water extract and ultrafiltration of them could degrade lactic acid (LD) of brain tissue, and the effects of alcohol sedimentation of Radix Astragali and Radix Hedyseri become weaker than water extract of them.</p><p><b>CONCLUSION</b>The water extract, ultrafiltration and alcohol sedimentation of Radix Astragali and Radix Hedyseri have some protective effects on cerebral ischemia in rats, the effective differences of the extract through the same extraction method are not remarkable, and alcohol precipitation method has obvious influences effect on Radix Astragali and Radix Hedyseri.</p>

Effects of lactic acid bacteria isolated from fermented mustard on lowering cholesterol

Objective: To evaluate the ability of lactic acid bacteria (LAB) strains isolated from fermented mustard to lower the cholesterol in vitro. Methods: The ability of 50 LAB strains isolated from fermented mustard on lowering cholesterol in vitro was determined by modified o-phtshalaldehyde method. The LAB isolates were analyzed for their resistance to acid and bile salt. Strains with lowering cholesterol activity, were determined adherence to Caco-2 cells. Results: Strain B0007, B0006 and B0022 assimilated more cholesterol than BCRC10474 and BCRC 17010. The isolated strains showed tolerance to pH 3.0 for 3 h despite variations in the degree of viability and bile-tolerant strains, with more than 10

Effects of lactic acid bacteria isolated from fermented mustard on lowering cholesterol

<p><b>OBJECTIVE</b>To evaluate the ability of lactic acid bacteria (LAB) strains isolated from fermented mustard to lower the cholesterol in vitro.</p><p><b>METHODS</b>The ability of 50 LAB strains isolated from fermented mustard on lowering cholesterol in vitro was determined by modified o-phtshalaldehyde method. The LAB isolates were analyzed for their resistance to acid and bile salt. Strains with lowering cholesterol activity, were determined adherence to Caco-2 cells.</p><p><b>RESULTS</b>Strain B0007, B0006 and B0022 assimilated more cholesterol than BCRC10474 and BCRC 17010. The isolated strains showed tolerance to pH 3.0 for 3 h despite variations in the degree of viability and bile-tolerant strains, with more than 10(8) CFU/mL after incubation for 24 h at 1% oxigall in MRS. In addition, strain B0007 and B0022 identified as Lactobacillus plantarum with 16S rDNA sequences were able to adhere to the Caco-2 cell lines.</p><p><b>CONCLUSIONS</b>These strains B0007 and B0022 may be potential functional sources for cholesterol-lowering activities as well as adhering to Caco-2 cell lines.</p>

Prevalence and characterization of plasmid-mediated blaESBL with their genetic environment in Escherichia coli and Klebsiella pneumoniae in patients with pneumonia / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The extended spectrum β-lactamase (ESBL)-producing Escherichia coli (E. coli) and Klebsiella pneumoniae (K. pneumoniae) are the major pathogens causing pneumonia and have a significant impact on the clinical course. Limited data exist on molecular characterization of ESBL-producing E. coli and K. pneumoniae that cause pneumonia. The aim of this study was to investigate the comprehensive multilevel characteristics of E. coli and K. pneumoniae causing pneumonia in China for the first time.</p><p><b>METHODS</b>E. coli (17) and K. pneumoniae (21) isolates responsible for pneumonia were isolated from 1270 specimens collected in a prospective multi-center study in eight teaching hospitals in China from June to December in 2007. The susceptibilities, ESBL confirmation, sequence typing, blaCTX-M and blaSHV genes, their genetic environment and plasmid Inc/rep types were determined.</p><p><b>RESULTS</b>Sixteen E. coli (94.1%) and eleven K. pneumoniae (52.4%) isolates were ESBL producers. About 77.8% and 66.7% of them were resistance to ciprofloxacin and levofloxacin, and 100% were susceptible to imipenem. The most prevalent ESBL gene was CTX-M-14, followed by SHV-2, CTX-M-15, CTX-M-3, CTX-M-65, SHV-12, SHV-26 and SHV-28. SHV-1 and SHV-11 were also detected and coexisted with blaCTX-Ms in five strains, and three strains contained only SHV-1. All CTX-M-14 were detected ISEcp1 upstream and nine were found IS903 downstream and the majority of them (64.3%) were carried by IncF plasmids. All blaSHV were flanked by recF and deoR, located on IncF, IncN, IncX and IncH plasmids. Two SHV-2, one SHV-1 and the only SHV-28 were further preceded by IS26. Genes lacY and lacZ were detected at further upstream of two blaSHV-1. The K. pneumoniae carrying SHV-28 was susceptible to β-lactams, and no mutations or deletions in gene or promoter sequences were identified to account for susceptibility. Multilocus sequence typing experiments showed the ESBL-producing strains were genetically diverse.</p><p><b>CONCLUSIONS</b>The rate of occurrence of blaESBL in E. coli and K. pneumoniae causing pneumonia was high, and blaCTX-M-14 was dominant and probably mobilized by ISEcp1 mainly on IncF plasmids. Importantly, unexpressed blaESBL genes may occur in susceptible isolates and hence may have clinical implications.</p>

Folfox4 regimen administered through combined hepatic arterial and systemic infusion for treatment of colorectal cancer with unresectable liver metastases / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Hepatic arterial infusion chemotherapy for liver metastases is under evaluation because of the high target dose and low general toxicity. To investigate the efficacy and safety of a Folfox4 regimen administered through a combined hepatic arterial and systemic infusion for the first-line treatment of colorectal cancer (CRC) with unresectable liver metastases.</p><p><b>METHODS</b>Twenty-seven CRC patients with unresectable hepatic metastases and no prior chemotherapy were enrolled into the study. They received a Folfox4 regimen; 1st day: HAI of oxaliplatin 85 mg/m(2) and L-folinic acid 200 mg/m(2), followed by a bolus hepatic arterial injection of 5-fluorouracil 400 mg/m(2), then continuous HAI of 5-FU 600 mg/m(2); 2nd day: infusion of L-folinic acid 200 mg/m(2) i.v. followed by an intravenous bolus injection of 5-Fluorouracil 400 mg/m(2), then continuous infusion of 5-fluorouracil 600 mg/m(2) i.v. The patients received HAI during the odd cycles, and the intravenous administration of the same Folfox4 regimen during the even cycles.</p><p><b>RESULTS</b>A total of 236 treatment cycles were given with a median of 10 cycles. The therapy generated the following results after six treatment cycles: complete response (CR) 1/27 (3.7%), partial response (PR) 17/27 (63.0%), stable disease (SD) 6/27 (22.2%), and progress disease (PD) 3/27 (11.1%). Five patients had hepatectomy. The serum levels of both carcinoembryonic antigen (CEA) and CA19-9 were significantly reduced (P < 0.05). A median time to progression of 11 months and a median overall survival of 24 months were documented. The major adverse events included grade 1/2 nausea/vomiting, upper abdominal pain, peripheral neuropathy, and neutropenia/thrombocytopenia.</p><p><b>CONCLUSIONS</b>The Folfox4 regimen administered through combined hepatic arterial and systemic infusions is efficacious and safe for the treatment of CRC with unresectable liver metastases, and it facilitates the control of local lesions.</p>

Sex-dependent association of phosphodiesterase 4D gene polymorphisms with ischemic stroke in Henan Han population / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Recent evidence has implicated the gene for phosphodiesterase 4D (PDE4D) as susceptibility gene for ischemic stroke (IS) in Icelandic population. However, there are few reports on the associations between PDE4D gene polymorphisms and IS in Chinese individuals. The present study aimed to investigate the possible association of genetic polymorphisms in PDE4D gene with IS in Henan Han population.</p><p><b>METHODS</b>A total of 400 patients with IS and 400 matched controls were examined using a case-control design. Two single nucleotide polymorphism (SNPs) (rs918592 and rs2910829) in PDE4D gene were genotyped by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. Odds ratios (OR) and 95% confidence intervals (95%CI) were calculated to test the association between the genetic factors and IS. Genetic parameter and association studies were carried out with SPSS 16.0.</p><p><b>RESULTS</b>Among the two SNPs tested, the rs918592 was significantly associated with IS (OR: 1.351, 95%CI: 1.110 - 1.645), especially in male patients (OR: 1.427, 95%CI: 1.105 - 1.844). Haplotype analysis showed that A-T was associated with an increased risk of the IS (OR: 2.114, 95%CI: 2.005 - 2.230) while G-T was associated with decreased risk of IS (OR: 0.419, 95%CI: 0.302 - 0.583). Protecting effect of haplotype G-T was also significant in males (OR: 0.264, 95%CI: 0.162 - 0.431).</p><p><b>CONCLUSIONS</b>The present study demonstrated a strong association of rs918592 with IS. Haplotype A-T increased the risk of IS while haplotype G-T had a protective effect in Henan Han population. The association was sex-dependent with male patients showing stronger effect.</p>

Comparative study on two types of 3S and P-loops digestive reconstruction after total gastrectomy for gastric cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To compare the clinical effect of 3S-type and P-loops digestive reconstruction after total gastrectomy for gastric cancer.</p><p><b>METHODS</b>From February 2005 to February 2009, 85 cases underwent total gastrectomy in The First Affiliated Hospital of Henan University of Science and Technology. Two types of digestive reconstruction were performed with 3S-type jejunum(n=46) and P-loops Roux-en-Y esophagojejunostomy(n=39). The postoperative complications, nutrition index and the quality of life at half a year after surgery were comparatively analyzed.</p><p><b>RESULTS</b>Two types of digestive reconstruction had no statistical differences in operative time, postoperative complications and mortality(P>0.05). Compared with P-loops Roux-en-Y esophagojejunostomy at 6 months after operation, 3S-type jejunum had a lower incidence in dumping syndrome[4.3% (2/46) vs. 10.3% (4/39), P<0.05] and reflux esophagitis [10.8% (5/46) vs. 33.3% (13/39), P<0.05]. 3S-type jejunum was superior to P-loops Roux-en-Y esophagojejunostomy in serum total protein(55.7±3.1 g/L vs 50.3±5.1 g/L, P<0.05), albumin(36.5±3.6 g/L vs. 31.6±4.4 g/L, P<0.05), hemoglobin(120.2±13.4 g/L vs. 110.4±23.0 g/L, P<0.05), and nutritional assessment index(73.2±4.8 vs. 56.0±6.3, P<0.05).</p><p><b>CONCLUSION</b>Reconstruction of stomach with 3S-type jejunum may be an effective way to prevent reflux esophagitis and dumping syndrome, and to improve the nutritional status and the quality of life.</p>

Endostar combined with chemotherapy for treatment of metastatic colorectal and gastric cancer: a pilot study / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Antiangiogenesis is a promising field of cancer therapy. Endostar, a novel recombinant human endostatin, is one of the few approved drugs acting as angiogenesis inhibitors of cancer in China. However, there are few clinical studies about Endostar in gastrointestinal cancer. This pilot study aimed to evaluate the efficacy and safety of the combination of Endostar and chemotherapy in patients with metastatic colorectal and gastric cancers.</p><p><b>METHODS</b>From March 2007 to October 2009, 23 patients were enrolled. Patients received Endostar intravenously at a dose of 15 mg daily from day 1 to 14 and day 1 to 7 when combined with 3- and 2-week chemotherapy regimens, respectively, which were determined according to patients' previous chemotherapy history. Treatment was repeated until disease progression, unacceptable toxicity or patients' refusal.</p><p><b>RESULTS</b>Seven, six and ten patients received Endostar as first-, second- and third-line therapy, respectively. A total of 75 cycles were administered. Twenty-one patients were assessable for responses. The overall response rate and disease control rate were 19.0% and 47.6%, respectively. All the four partial responses were among patients receiving Endostar as first-line therapy, whose response rate was 57.1%. The median time to progression and overall survival were 2.6 months (95%CI, 2.0 - 3.2 months) and 10.3 months (95%CI, 3.9 - 16.7 months), respectively. Toxicity was tolerable, with grade 3-4 toxicities observed for leucopenia (30.4%), neutropenia (34.8%), thrombocytopenia (17.4%) and anemia (13.0%). Three patients (13.0%) encountered transient sinus bradycardia with spontaneous remission.</p><p><b>CONCLUSION</b>Endostar combined with chemotherapy is well-tolerated in patients with metastatic colorectal and gastric cancers, and it is relatively effective as a first-line therapy.</p>

Safety of recombinant human growth hormone in treating children with growth hormone deficiency and idiopathic short stature / 中国医学科学院学报

Recombinant human growth hormone is generally safe in treating children with growth hormone deficiency and idiopathic short stature. However, side effects such as sodium and water retention, benign intracranial hypertension, insulin insensitivity, increasing risk of secondary neoplasm, scoliosis, and slipped capital femoral epiphysis may occur occasionally, although the overall incidence remains low.

Effect of obstructive sleep apnea syndrome on serum C-reactive protein level, left atrial size and premature atrial contraction / 南方医科大学学报

<p><b>OBJECTIVE</b>To assess the changes of serum C-reactive protein (CRP) level, left atrial size and atrial premature contraction (PAC) in patients with obstructive sleep apnea syndrome (OSAS).</p><p><b>METHODS</b>This study involved 277 patients with OSAS diagnosed after an overnight polysomnography, who underwent a 24-h Holter electrocardiography and ambulatory blood pressure monitoring for detection of PAC. According to the apnea-hypopnea index (AHI), 137 patients with PAC identified from these patients were classified into 3 groups, namely the mild (5≥AHI<15), moderate (15≥AHI<30) and severe (AHI≥30) groups. Serum CRP level was assessed by a high-sensitivity radio-immunoassay. The left atrial diameter and echocardiographic parameters were recorded by transthoracic Doppler echocardiography (TTE).</p><p><b>RESULTS</b>We found a high prevalence of PAC in these OSAS patients (137/277, 49.4%). Serum CRP was significantly higher in severe OSAS group (5.01∓4.68 mg/L) than in the moderate (3.03∓1.94 mg/L) and mild OSAS (2.98∓1.82 mg/L) groups (P=0.040 and 0.033, respectively). The left atrial diameter was significantly increased in severe OSAS group (40.1∓7.9 mm) as compared to that in moderate (37.9∓5.5 mm) and mild (33.7 ∓ 3.8 mm) groups (P=0.025 and 0.002, respectively). The severity of OSAS was positively correlated to both CRP (r=0.304, P=0.034) and left atrial diameter (r=0.411, P=0.003). After adjusting for gender, age and body mass index (BMI), a strong correlation was found between the left atrial diameter and CRP (r=0.594, P=0.0005).</p><p><b>CONCLUSION</b>There is a high prevalence of PAC in OSAS patients. The progression of OSAS is associated with increased serum CRP level and left atrial size in patients with premature atrial complexes. Our study suggests that inflammation associated with OSAS might contribute to atrial structural and electrical remodeling in OSAS patients with PAC.</p>

Comparison of eight equations for estimating glomerular filtration rate in patients with cardiovascular diseases / 南方医科大学学报

<p><b>OBJECTIVE</b>To assess the diagnostic value of 8 equations using different variables for determining the estimated glomerular filtration rate (eGFR) in patients with cardiovascular diseases.</p><p><b>METHODS</b>GFR was estimated in 208 patients with cardiovascular diseases by (99m)Tc-DTPA dynamic renal imaging, and the eGFR was derived from 8 equations using different variables.</p><p><b>RESULTS</b>In patients with chronic kidney disease (CKD) stages 1-3, the eGFR calculated suing serum creatinine (SCr)-based equation was better correlated to GFR estimated by (99m)Tc-DTPA renal imaging than that derived from cystatin C (Cys C)-based equations, whereas in patients with CKD stages 4 and 5, the estimates by the latter equation showed a better correlation to GFR. Compared with (99m)Tc-DTPA renal imaging, MDRD-based equation and simple MDRD equation resulted in a higher eGFR in patients with CKD stages 4 and 5, the Rule equation had a lower eGFR in CKD stages 1 and 2, the Macisaac equation yielded a higher eGFR in CKD stages 2-5, and the Tan equation showed a higher eGFR in CKD stages 2 and 3. In patients with mild renal dysfunction, the Scr-based equation had a higher AUC(ROC) than Cys C-based equation, which was reversed in patients with severe renal dysfunction; the AUC(ROC) of the two equations were comparable in patients with moderate renal dysfunction. Compared with (99m)Tc-DTPA renal imaging, the modified MDRD equation and Arnal-Dade equation showed no significant difference in the eGFR in patients with CKD stages 1-5.</p><p><b>CONCLUSION</b>Modified MDRD equation (or simple MDRD equation) and Arnal-Dade equation are superior to other calculation methods for estimating the GFR in Chinese patients with cardiovascular disease.</p>

Clinical pathological characteristics and treatment patterns of breast cancer in elderly women / 中国医学科学院学报

<p><b>OBJECTIVE</b>To summarize the clinical pathological characteristics and treatment patterns of breast cancer in elderly women.</p><p><b>METHODS</b>A total of 87 patients (≥ 60 years) admitted to our hospital between January and December 2007 were included in this retrospective study. The patients were divided into 60-69-year group and ≥ 70-year group, and their clinical pathological data and treatment modes were summarized and compared.</p><p><b>RESULTS</b>The tumor size (T2-T3), number of involved axillary lymph nodes,and positive rates of estrogen/progesterone receptors,over-expression of epidermal growth factor receptor 2, and ≥ 2 complication were not significantly different between two groups (P > 0.05). The ≥ 70-year group tended to have similar p53 gene mutation and Ki-67 labeling index with the 60-69-year group, although the P values were close to 0.05 (P = 0.09, P = 0.08,respectively). In the ≥ 70-year group, 33.3% of patients underwent extended resection,while in the 60-69-year group, all patients received modified radical treatment (P < 0.005). The percentages of adjuvant chemotherapy were 25% and 56.9% in the ≥ 70-year group and the 60-69-year group (0.005). The percentages of adjuvant endocrine therapy applied after surgery were similar in 2 groups (77.8% and 68.6% separately, P=0.347). Binary logistic regression showed that age,number of involved axillary lymph nodes,and estrogen receptor-positive rate were independently associated with adjuvant chemotherapy,while the pathological tumor size and complication were irrelevant. The 2-year disease-free survival rates of 2 groups were not significantly different.</p><p><b>CONCLUSIONS</b>The clinical pathological characteristics of breast cancer were similar in elderly patients who are 60-69 years old or ≥ 70 years. In the treatment pattern,patients who are ≥ 70 years tend to receive endocrine therapy rather than adjuvant chemotherapy.</p>

Comparison of the therapeutic effects of paclitaxel liposome-5-Fu versus paclitaxel-5-Fu on 67 patients with advanced gastric cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To explore the efficacy, time to disease progression (TTP), overall survival (OS) and toxicity of paclitaxel liposome versus paclitaxel combined with 5-fluorouracil (5-Fu) for patients with advanced gastric cancer.</p><p><b>METHODS</b>The therapeutic efficacy of chemotherapy with either of the two regimens for 67 cases of naïve advanced gastric cancer was analyzed. Among them, 31 patients in the paclitaxel liposome-5-Fu group received paclitaxel liposome 175 mg/m(2) d1, CF 200 mg/m(2) d1, 5-Fu 2.6 g/m(2) civ. 46 hours, 21 days as one cycle, and 34 patients in the paclitaxel-5-Fu group received paclitaxel 175 mg/m(2) d1, CF 200 mg/m(2) d1, 5-Fu 2.6 g/m(2) civ. 46 hours, 21 days as one cycle.</p><p><b>RESULTS</b>The objective response rate was 54.8% in the paclitaxel liposome group and 44.1% in the paclitaxel group (P = 0.388). The median time to progression was 5.10 months vs. 5.20 months (P = 0.266) and the median survival time was 10.07 months vs. 8.97 months (P = 0.186). The most frequent side-effects were nausea, vomit and hematological toxicities. The rates of grade III-IV nausea and vomit were 16.1% and 50.0% (P = 0.038), muscle and joint pain were 9.7% and 29.4% (P = 0.047).</p><p><b>CONCLUSION</b>Both regimens are effective in the treatment of advanced gastric cancer. However, less adverse effects occur in the paclitaxel liposome group.</p>

Efficacy and safety of combination of irinotecan and capecitabine in patients with metastatic colorectal cancer after failure of chemotherapy with oxaliplatin / 中国医学科学院学报

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of irinotecan combined with xeloda (CAPIRI regimen) in patients with metastatic colorectal cancer after failure of chemotherapy with oxaliplatin.</p><p><b>METHODS</b>Totally 38 patients with metastatic colorectal cancer after failure of chemotherapy with oxaliplatin were enrolled. Patients received xeloda 1 000 mg/m2 orally twice daily on day 1 to 14 and intravenous irinotecan 100 mg/m2 on day 1 and 8 every 3 weeks.</p><p><b>RESULTS</b>The median age of 38 patients was 58.5 (27-77) years. CAPIRI regimen was used 11.0 (3.0-24.0) months after the diagnosis of metastatic colorectal cancer (CAPIRI regimen as second-line chemotherapy in 33 patients, third-line in 4 patients, and fourth-line in 1 patient). A total of 121 cycles of chemotherapy (median 3.0) were administered. Thirty-four patients were evaluable for response. The overall response rate and disease control rate were 5.9% and 61.8%, respectively. The median time to progression and overall survival were 4.5 months (95% CI, 3.4-5.6 months) and 11.0 months (95% CI, 10.2-11.8 months), respectively. All 38 patients were evaluable for safety. The most common adverse events were leukopenia (73.7%), neutropenia (65.8%), nausea and vomiting (60.5%), and diarrhea (28.9%). The occurrence rates of these grade 3-4 events were 10.5%, 13.2%, 10.5%, and 7.9%, respectively. All adverse events were tolerable.</p><p><b>CONCLUSION</b>CAPIRI regimen is effective and well-tolerated in Chinese patients with metastatic colorectal cancer after failure of chemotherapy with oxaliplatin.</p>