Prognostic and clinicopathological value of CXCL12/SDF1 expression in breast cancer: A meta-analysis.

BACKGROUND: Several studies have demonstrated that stromal cell derived factor-1 (SDF1, also known as CXCL12) expression is a biomarker for breast cancer treatment; however, its significance of prognosis is inconsistent. This study uses a meta-analysis to explore the prognostic value of CXCL12/SDF1 expression in breast cancer. MATERIALS AND METHODS: PubMed, Embase, Cochrane Library, and Web of Science databases were searched from inception to November 25, 2017. Studies investigating the correlation between CXCL12/SDF1 expression and survival in breast carcinoma were included. The pooled hazard ratio (HR) and 95% confidence interval (95% CI) was used to assess the prognostic value of CXCL12/SDF1 in breast cancer. The pooled odds radio (OR) and 95% CI was applied to evaluate the relationship between CXCL12/SDF1 expression and the clinical characteristics of breast cancer. RESULTS: Eight eligible studies involving 2205 patients were identified. Higher CXCL12/SDF1 protein expression was associated with better disease-free survival (DFS) (HR, 0.76; 95% CI, 0.68-0.86; P < .0001) and overall survival (OS) (HR, 0.66; 95% CI, 0.49-0.87; P = .004) in breast cancer. Furthermore, higher CXCL12/SDF1 protein expression was associated with positive ER status (OR, 1.92; 95% CI, 1.08-3.45; P = .03), negative HER2 status (OR, 2.64; 95% CI, 1.06-6.59; P = .04), and small tumor size (OR, 2.49; 95% CI, 1.47-4.22; P = .0007) in breast cancer, respectively. However, there were no significant associations between the CXCL12/SDF1 mRNA expression and other prognostic parameters, such as TNM stage, age, PR status, lymph node, and nuclear grade (P > .05 for all). CONCLUSIONS: This present meta-analysis suggests that CXCL12/SDF1 protein expression is a good prognostic biomarker in breast cancer. In addition, the over-expression of CXCL12/SDF1 protein was associated with positive ER status, negative HER2 status and small tumor size.

[A qualitative research on the psychological experience of hospitalized patients with acute myocardial infarction].

OBJECTIVE: To observe the psychological experience of patients with acute myocardial infarction (AMI) during hospitalization. METHODS: From November 2012 to February 2013, semi-structured interviews were conducted in 10 patients with AMI in the Cardiovascular Department of First Affiliated Hospital of Henan University of Science and Technology. Grounded theory approach was performed to analyze the collected data. RESULTS: The 6 themes and 3 secondary themes during their hospitalization were: helplessness and dependence when AMI was diagnosed fear of immediate death induced by AMI, confusion on various problems such as operation time, excretory after PCI and limited knowledge details, the feel of safety after PCI, the fear of AMI, and the worry about overtreatment. CONCLUSIONS: Hospitalized AMI patients have complicated psychological responses. Medical staff should provide targeted strategies and timely communication with AMI patients to reduce their psychological burden.

Furosemide with saline hydration for prevention of contrast-induced nephropathy in patients undergoing coronary angiography: a meta-analysis of randomized controlled trials.

BACKGROUND: The clinical efficacy of furosemide administration in preventing contrast-induced nephropathy (CIN) remains uncertain. This meta-analysis was designed to update data on the incidence of CIN with additional furosemide treatment beyond saline hydration in comparison with hydration alone in patients undergoing percutaneous coronary intervention (PCI). MATERIAL/METHODS: A computerized literature search of MEDLINE, EMBASE, and Cochrane databases was performed. Trials were eligible if they enrolled patients undergoing coronary angiography and randomly allocated participants to receive furosemide administration in addition to saline hydration or saline hydration alone. We calculated odds ratios (ORs) and 95% confidence intervals (CIs) for combinations of studies. RESULTS: Five trials involving 1294 patients (640 for additional furosemide treatment and 654 for hydration alone) were included in the meta-analysis. In the synthesis of data, additional furosemide administration had little impact on the incidence of CIN post-PCI compared with peri-procedural saline hydration alone (OR=0.96; 95% CI 0.33-2.84, p=0.95). Moreover, as for the subsequent need for dialysis, there was no statistical significant difference between the 2 groups (OR=1.01; 95% CI 0.38-2.67, p=0.99). Sensitivity analyses did not show any relevant influence on the overall results. There was no publication bias in the meta-analysis. CONCLUSIONS: Furosemide administration did not achieve additional benefit beyond saline hydration in reducing the incidence of CIN in patients undergoing PCI.

Pathological observation of acute myocardial infarction in Chinese miniswine.

The acute myocardial infarction (AMI) model in Chinese miniswine was built by percutaneous coronary artery occlusion. Pathological observation of AMI was performed, and the expression of tumor necrosis factor alpha (TNF-α) in the infarct sites was detected at different days after modeling in Chinese miniswine. The experimental findings may be used as the basis for blood flow reconstruction and intervention after AMI. Seven experimental Chinese miniswine were subjected to general anesthesia and Seldinger right femoral artery puncture. After coronary angiography, the gelfoam was injected via the microtube to occlude the obtuse marginal branch (OM branch). At 1 d, 3 d, 5 d, 7 d, 10 d, 14 d and 17 d after modeling, hetatoxylin-eosin (HE) staining was performed to observe the pathological changes and to detect the expression of TNF-α in the myocardial tissues. Cytoplasmic acidophilia of the necrotic myocardial tissues at 1 d after modeling was enhanced, and cytoplasmic granules were formed; at 3 d, the margins of the necrotic myocardial tissues were infiltrated by a large number of inflammatory cells; at 5 d, the nuclei of the necrotic myocardial cells were fragmented; at 7 d, extensive granulation tissues were formed at the margin of the necrotic myocardial tissues; at 10 d, part of the granulation tissues were replaced by fibrous scar tissues; at 14-17 d, all granulation tissues were replaced by fibrous scar tissues. Immunohistochemical detection indicated that no TNF-α expression in normal myocardial tissues. The TNF-α expression was first detected at 3 d in the necrotic myocardial tissues and then increased at 5 d and 7 d. After reaching the peak at 10 d, the expression began to decrease at 14 d and the decrease continued at 17 d. Coronary angiography showed the disappearance of blood flow at the distal end of OM branch occluded by gelfoam, indicating that AMI model was constructed successfully. The repair of the infarcted myocardium began at 10-17 d after modeling with safe blood flow reconstruction. TNF-α expression in the infarcted myocardium was the highest at 10 d, which can be explained by inflammation and repair of the infarcted myocardium.

Long-term outcomes of drug-eluting versus bare-metal stent for ST-elevation myocardial infarction.

BACKGROUND: Long-term outcomes of drug-eluting stents (DES) versus bare-metal stents (BMS) in patients with ST-segment elevation myocardial infarction (STEMI) remain uncertain. OBJECTIVE: To investigate long-term outcomes of drug-eluting stents (DES) versus bare-metal stents (BMS) in patients with ST-segment elevation myocardial infarction (STEMI). METHODS: We performed search of MEDLINE, EMBASE, the Cochrane library, and ISI Web of Science (until February 2013) for randomized trials comparing more than 12-month efficacy or safety of DES with BMS in patients with STEMI. Pooled estimate was presented with risk ratio (RR) and its 95% confidence interval (CI) using random-effects model. RESULTS: Ten trials with 7,592 participants with STEMI were included. The overall results showed that there was no significant difference in the incidence of all-cause death and definite/probable stent thrombosis between DES and BMS at long-term follow-up. Patients receiving DES implantation appeared to have a lower 1-year incidence of recurrent myocardial infarction than those receiving BMS (RR = 0.75, 95% CI 0.56 to 1.00, p= 0.05). Moreover, the risk of target vessel revascularization (TVR) after receiving DES was consistently lowered during long-term observation (all p < 0.01). In subgroup analysis, the use of everolimus-eluting stents (EES) was associated with reduced risk of stent thrombosis in STEMI patients (RR = 0.37, p=0.02). CONCLUSIONS: DES did not increase the risk of stent thrombosis in patients with STEMI compared with BMS. Moreover, the use of DES did lower long-term risk of repeat revascularization and might decrease the occurrence of reinfarction.

Long-term Outcomes of Drug-eluting versus Bare-metal stent for ST-elevation Myocardial Infarction / Resultados a Longo Prazo de Eluição de Fármaco versus Stent Metálico para Infarto do Miocárdio com Elevação ST

Background: Long-term outcomes of drug-eluting stents (DES) versus bare-metal stents (BMS) in patients with ST-segment elevation myocardial infarction (STEMI) remain uncertain. Objective: To investigate long-term outcomes of drug-eluting stents (DES) versus bare-metal stents (BMS) in patients with ST-segment elevation myocardial infarction (STEMI). Methods: We performed search of MEDLINE, EMBASE, the Cochrane library, and ISI Web of Science (until February 2013) for randomized trials comparing more than 12-month efficacy or safety of DES with BMS in patients with STEMI. Pooled estimate was presented with risk ratio (RR) and its 95% confidence interval (CI) using random-effects model. Results: Ten trials with 7,592 participants with STEMI were included. The overall results showed that there was no significant difference in the incidence of all-cause death and definite/probable stent thrombosis between DES and BMS at long-term follow-up. Patients receiving DES implantation appeared to have a lower 1-year incidence of recurrent myocardial infarction than those receiving BMS (RR = 0.75, 95% CI 0.56 to 1.00, p= 0.05). Moreover, the risk of target vessel revascularization (TVR) after receiving DES was consistently lowered during long-term observation (all p< 0.01). In subgroup analysis, the use of everolimus-eluting stents (EES) was associated with reduced risk of stent thrombosis in STEMI patients (RR = 0.37, p=0.02). Conclusions: DES did not increase the risk of stent thrombosis in patients with STEMI compared with BMS. Moreover, the use of DES did lower long-term risk of repeat revascularization and might decrease the occurrence of reinfarction. .

Fundamento: Os resultados a longo prazo dos stents farmacológicos (SF) contra stents convencionais (SC) em pacientes com infarto do miocárdio com elevação do segmento ST (IMEST) permanecem incertos. Objetivo: Investigar os resultados a longo prazo dos stents farmacológicos (SF) contra stents convencionais (SC) em pacientes com infarto do miocárdio com elevação do segmento ST (IMEST) . Métodos: Foi realizada pesquisa de dados nas bases de dados MEDLINE, EMBASE, na Cochrane Library, e na ISI Web of Science (até fevereiro de 2013) para estudos clínicos aleatórios que comparam a eficácia durante mais de 12 meses ou a segurança do SF com SC em pacientes com IMEST. Foi apresentada uma estimativa agrupada com risco relativo (RR) e seu intervalo de confiança de 95 % (IC), utilizando modelo de efeitos aleatórios. Resultados: Dez estudos com 7.592 participantes com IMEST foram incluídos. Os resultados gerais mostraram que não houve diferença significativa na incidência de morte por todas as causas e trombose de stent definida/provável entre SF e SC em seguimento de longo prazo. Os pacientes que receberam implante de SF pareciam ter uma incidência de infarto do miocárdio recorrente inferior a1 ano que aqueles que receberam SC (RR = 0,75, 95% CI 0,56-1,00, p = 0,05). Além disso, o risco de revascularização do vaso alvo (RVA) depois de receber o SF diminui consistentemente durante a observação a longo prazo (todos p <0,01). Na análise de subgrupo, o uso de stents com eluição de everolimus (EEE) foi associado a um risco reduzido de trombose de stent em pacientes IMEST (RR = 0,37, p = 0,02). Conclusões: SF não aumentou o risco de trombose de stent em pacientes com IMEST em comparação com SC. Além disso, o uso de SF fez baixar o risco de longo prazo de repetição ...

Biodegradable polymer drug-eluting stents versus second-generation drug-eluting stents for patients with coronary artery disease: an update meta-analysis.

OBJECTIVE: Permanent polymer drug-eluting stents (DES) are associated with a higher risk of late and very late stent thrombosis (ST); biodegradable polymer drug-eluting stents (BP-DES) were designed to reduce these risks. However, their benefits are not completely clear. METHOD: We undertook a meta-analysis of randomized studies identified in systematic searches of MEDLINE, EMBASE, and the Cochrane Database. Eligible studies were those that compared BP-DES with second-generation permanent polymer DES in patients undergoing percutaneous coronary intervention. RESULTS: Five studies (8,740 patients) with a mean follow-up of 19.2 months were included. Overall, BP-DES were associated with a broadly equivalent risk of definite and probable ST (odds ratio [OR], 1.07; 95 % confidence interval [CI], 0.67 to 1.71; P = 0.76; I (2) = 5.0 %), target vessel revascularization (OR, 1.04; 95 % CI, 0.87 to 1.24; P = 0.68; I (2) = 38.0 %), all-cause mortality (OR, 1.10; 95 % CI, 0.87 to 1.41; P = 0.42; I (2) = 0.0 %), and major adverse cardiac events (OR, 1.03; 95 % CI, 0.88 to 1.20; P = 0.74; I (2) = 0.0 %) when compared with second-generation DES. However, BP-DES significantly decreased in-stent late luminal loss (standard mean difference [SMD], -0.01; 95 % CI, -0.12 to 0.11; P = 0.93; I (2) = 0.0 %) and in-segment late luminal loss (SMD, -0.06; 95 % CI, -0.17 to 0.05; P = 0.27; I (2) = 0.0 %) compared with second-generation DES. CONCLUSIONS: Compared with second-generation permanent polymer DES, biodegradable stents appear to have equivalent short- to medium-term clinical benefits, and it remains unclear whether they reduce the incidence of very late ST.

[Effects of docosahexaenoic acid on ion channels of rat coronary artery smooth muscle cells].

OBJECTIVE: To investigate the effects of docosahexaenoic acid (DHA) on large-conductance Ca(2+)-activated K(+) (BK(Ca)) channels and voltage-dependent K(+) (K(V)) channels in rat coronary artery smooth muscle cells (CASMCs), and evaluate the vasorelaxation mechanisms of DHA. METHODS: BK(Ca) and K(V) currents in individual CASMC were recorded by patch-clamp technique in whole-cell configuration. Effects of DHA at various concentrations (0, 10, 20, 40, 60 and 80 µmol/L) on BK(Ca) and K(V) channels were observed. RESULTS: (1) DHA enhanced IBK(Ca) and BK(Ca) tail currents in a concentration-dependent manner while did not affect the stably activated curves of IBK(Ca). IBK(Ca) current densities were (68.2 ± 22.8), (72.4 ± 24.5), (120.4 ± 37.9), (237.5 ± 53.2), (323.6 ± 74.8) and (370.6 ± 88.2)pA/pF respectively (P < 0.05, n = 30) with the addition of 0, 10, 20, 40, 60 and 80 µmol/L DHA concentration, and half-effect concentration (EC(50)) of DHA was (36.22 ± 2.17)µmol/L. (2) IK(V) and K(V) tail currents were gradually reduced, stably activated curves of IK(V) were shift to the right, and stably inactivated curves were shifted to the left in the presence of DHA. IK(V) current densities were (43.9 ± 2.3), (43.8 ± 2.3), (42.9 ± 2.0), (32.3 ± 1.9), (11.7 ± 1.5) and (9.6 ± 1.2)pA/pF respectively(P < 0.05, n = 30)post treatment with 0, 10, 20, 40, 60 and 80 µmol/L DHA under manding potential equal to +50 mV, and EC(50) of DHA was (44.19 ± 0.63)µmol/L. CONCLUSION: DHA can activate BK(Ca) channels and block K(V) channels in rat CASMCs, the combined effects on BK(Ca) and K(V) channels lead to the vasodilation effects of DHA on vascular smooth muscle cells.

[Effects of docosahexaenoic acid on sodium channel current and transient outward potassium channel current in rat ventricular myocytes].

OBJECTIVE: To investigate the effects of docosahexaenoic acid (DHA) on sodium channel current (I(Na)) and transient outward potassium channel current (I(to)) in rat ventricular myocytes and to evaluate potential anti-arrhythmic mechanisms of DHA. METHODS: I(Na) and I(to) of individual ventricular myocytes were recorded by patch-clamp technique in whole-cell configuration at room temperature. Effects of DHA at various concentrations (0, 20, 40, 60, 80, 100 and 120 micromol/L) on I(Na) and I(to) were observed. RESULTS: (1) I(Na) was blocked in a concentration-dependent manner by DHA, stably inactivated curves were shifted to the left, and recover time from inactivation was prolonged while stably activated curves were not affected by DHA. At -30 mV, I(Na) was blocked to (1.51 ± 1.32)%, (21.13 ± 4.62)%, (51.61 ± 5.73)%, (67.62 ± 6.52)%, (73.49 ± 7.59)% and (79.95 ± 7.62)% in the presence of above DHA concentrations (all P < 0.05, n = 20), and half-effect concentration (EC(50)) of DHA on I(Na) was (47.91 ± 1.57)micromol/L. (2) I(to) were also blocked in a concentration-dependent manner by DHA, stably inactivated curves were shifted to the left, and recover time from inactivation was prolonged with increasing concentrations of DHA, and stably activated curves were not affected by DHA. At +70 mV, I(to) was blocked to (2.61 ± 0.26)%, (21.79 ± 4.85)%, (63.11 ± 6.57)%, (75.52 ± 7.26)%, (81.82 ± 7.63)% and (84.33 ± 8.25)%, respectively, in the presence of above DHA concentrations (all P < 0.05, n = 20), and the EC(50) of DHA on I(to) was (49.11 ± 2.68)micromol/L. CONCLUSION: The blocking effects of DHA on APD and I(to) may serve as one of the anti-arrhythmia mechanisms of DHA.