[Comparative Analysis of Thromboelastogram and Coagulation Items in Mongolian Patients with Thrombosis].

OBJECTIVE: To investigate the age distribution of Mongolian patients with cerebral infarction caused by thrombosis and the correlation and consistency between thromboelastography (TEG) and four parameters of coagulation. METHODS: The age distribution of 298 Mongolian patients with cerebral infarction treated in Affiliated Hospital of Inner Mongolia Minzu University from January 2020 to December 2021 and their TEG, four items of routin coagulation and platelet count were analyzed retrospectively. The correlation and consistency of above-mentioned two detection methods were statistically analyzed. RESULTS: The onset age of 298 Mongolian patients with cerebral infarction was mainly 61-70 years old, accounting for 38.3%, followed by 51-60 years old, accounting for 26.8%. The R time detected by TEG was linearly correlated with PT and APTT（r=0.186，r=0.152）. K value, MA value and α-Angle measured by TEG was linearly correlated with Fib (r=-0.364，r=0.616，r=0.359), K value, MA value and α-Angle measured by TEG was linearly correlated with Plt (r=0.318，r=0.519，r=0.301). The R time detected by TEG was consistent with PT and APTT, and the Kappa values were 0.252 (P<0.001), 0.336 (P<0.001). K, MA, and α-Angle measured by TEG was consistent with Fib, the Kappa values were 0.265 (P<0.001), 0.289 (P<0.001) and 0.290 (P<0.001), respectively; K、MA and α-Angle measured by TEG was consistent with Plt, the Kappa values were 0.276 (P<0.001), 0.285 (P<0.001) and 0.302 (P<0.001), respectively. CONCLUSION: The onset age of Mongolian patients with cerebral infarction caused by thrombosis is mainly 61-70 years old, followed by 51-60 years old. The onset age shows a younger trend. There is a significant correlation between TEG and coagulation, but the consistency is weak, therefore, the two methods can not be replaced each other.

Platelet-rich plasma injection for the treatment of chronic Achilles tendinopathy: A meta-analysis.

BACKGROUND: Platelet-rich plasma (PRP) is used as an alternative therapy to reduce pain and improve functional restoration in patients with Achilles tendinopathy (AT). We evaluated the current evidence for the efficacy of PRP as a treatment for chronic AT. METHODS: The PubMed, Embase, Web of Science, and The Cochrane Library databases were searched for articles on randomized controlled trials (RCTs) that compared the efficacy of PRP with that of with placebo injections plus eccentric training as treatment for AT. The articles were uploaded over the establishment of the databases to May 01, 2018. The Cochrane risk of bias (ROB) tool was used to assess methodological quality. Outcome measurements included the Victorian Institute of Sports Assessment-Achilles (VISA-A), visual analog scale (VAS) and Achilles tendon thickness. Statistical analysis was performed with RevMan 5.3.5 software. RESULTS: Five RCTs (n = 189) were included in this meta-analysis. Significant differences in the VISA-A were not observed between the PRP and placebo groups after 12 weeks [standardized mean difference (SMD) = 0.2, 95% confidence interval (95% CI): 0.36 to 0.76, I = 71%], 24 weeks (SMD = 0.77, 95% CI: -0.10-1.65, I = 85%) and 1 year (SMD = 0.83, 95% CI: -0.76-2.42, I = 72%) of treatment. However, PRP exhibited better efficacy than the placebo treatment after 6 weeks (SMD = 0.46, 95% CI: 0.15-0.77, I = 34%). Two studies included VAS scores and tendon thickness. VAS scores after 6 weeks (SMD = 1.35, 95% CI: -0.1.04-3.74, I = 93%) and 24 weeks (SMD = 1.48, 95% CI: -0.1.59-4.55, I = 95%) were not significantly different. However, VAS scores at the 12th week (SMD = 1.10, 95% CI: 0.53-1.68, I = 83%) and tendon thickness (SMD = 1.51, 95% CI: 0.39-2.63, I = 53%) were significantly different. CONCLUSION: PRP injection around the Achilles tendon is an option for the treatment of chronic AT. Limited evidence supports the conclusion that PRP is not superior to placebo treatment. These results still require verification by a large number of well designed, heterogeneous RCT studies.

Fisetin inhibits liver cancer growth in a mouse model: Relation to dopamine receptor.

Fisetin (3,3',4',7-tetrahydroxyflavone), a natural abundant flavonoid, is produced in different vegetables and fruits. Fisetin has been reported to relate to various positive biological effects, including anti-proliferative, anticancer, anti-oxidative and neuroprotective effects. Dopamine receptors (DRs) belonging to G protein­coupled receptor family, are known as the target of ~50% of all modern medicinal drugs. DRs consist of various proteins, functioning as transduction of intracellular signals for extracellular stimuli. We found that fisetin performed as DR2 agonist to suppress liver cancer cells proliferation, migration and invasion. Caspase-3 signaling was activated to induce apoptosis for fisetin administration. Furthermore, TGF­ß1 was also inhibited in fisetin-treated liver cancer cells, reducing epithelial-mesenchymal transition (EMT). Additionally, fisetin downregulated VEGFR1, p-ERK1/2, p38 and pJNK, ameliorating liver cancer progression. In vivo, the orthotopically implanted tumors from mice were inhibited by fisetin adminisatration accompanied by prolonged survival rate and higher levels of dopamine. Together, the results indicated a novel therapeutic strategy to suppress liver cancer progression associated with DR2 regulation, indicating that dopamine might be of importance in liver cancer progression.

Analgesic effect and pharmacological mechanism of fentanyl and butorphanol in a rat model of incisional pain.

OBJECTIVES: To explore analgesic effects of fentanyl and butorphanol on incisional pain in rats and to investigate the pharmacological mechanism of combination. METHODS: Seventy rats were randomly divided into control group (group N, n = 10), fentanyl group (group F, n = 30), and butorphanol group (group B, n = 30), to determine median effective dose (ED50) in fentanyl and butorphanol. Another 50 rats were treated with both fentanyl and butorphanol (joint group) to quantitatively detect response rate of joint application. Ninety rats were randomly divided into 1/4 ED50 fentanyl (group 1, n = 30), 1/2 ED50 fentanyl (group 2, n = 30), and 3/4 ED50 fentanyl (group 3, n = 30), to detect the correlation between combined pharmacological effects of 2 drugs and their dose proportionality. Statistical analysis was performed using SPSS 17.0. RESULTS: Probit analysis revealed that ED50 of fentanyl was 4.1 µg/kg, whereas ED50 of butorphanol was 295 µg/kg. The qualitative response rate of combination (Po) was 0.84, and expected qualitative response rate (Pe) was 0.75, with no statistical significance (P = 0.3). Furthermore, probit analysis showed that 155 µg/kg butorphanol with 1/4 ED50 fentanyl could reach experimental ED50 of combination of 2 drugs; 115 µg/kg butorphanol with 1/2 ED50 fentanyl could reach experimental combination ED50; and 88 µg/kg butorphanol with 3/4 ED50 fentanyl could reach experimental combination ED50. CONCLUSION: Both fentanyl and butorphanol showed good analgesic effect on incisional pain in rats, but fentanyl was superior to butorphanol. The pharmacological mechanism of combination with ED50 of fentanyl and butorphanol showed independent joint action, and the combination efficacy was related to the dosage.

MiR­214 promotes osteosarcoma tumor growth and metastasis by decreasing the expression of PTEN.

MicroRNAs (miRNAs) are a class of small non­coding RNAs, which function as critical gene regulators by targeting mRNAs for translational repression or degradation, and they are essential in cancer development and progression. Several previous studies have indicated that abnormal expression of miRNAs occurs frequently in human osteosarcoma (OS) tissues compared with that of adjacent normal tissues. In the present study, the role of miR­214 in the progression and metastasis of OS was investigated. The expression of miR­214 was frequently increased in OS tissues and cell lines. Inhibition of miR­214 in OS cell lines markedly suppressed cell proliferation, migration and invasion. Phosphatase and tensin homolog (PTEN) was identified as a direct target of miR­214, and ectopic expression of miR­214 inhibited PTEN by directly binding to its 3'­untranslated region. The expression of miR­214 negatively correlated with PTEN in OS tissues. Together, these data indicated that miR­214 acts as an oncogenic miRNA and may contribute to the progression, and metastasis of OS, suggesting that miR­214 may be a potential novel diagnostic and therapeutic target of OS.

Birth weight and subsequent risk of asthma: a systematic review and meta-analysis.

BACKGROUND: Previous studies suggest that birth weight is related to later risk of asthma. However, few meta-analyses have investigated these associations. Therefore, we performed a meta-analysis with different classifications to further validate the relationship between birth weight and asthma. METHODS: PubMed (1990-2013), ScienceDirect (1990-2013), EMBASE(1990-2013),EBSCO (1990-2013) and Springer (1990-2013) were searched for articles. The following MeSH terms were used: "birth weight", "fetal growth retardation", "intrauterine growth restriction", "asthma", "wheezing". RESULTS: We included 18 studies with data from a total of over 90,000 children and adults. (1) Low birth weight (<2,500g) as compared with BW>2,500g and BW=2500-4000g was associated with increased risk of asthma (Children: OR, 1.28; 95% CI, 1.09-1.50, P<0.05; OR, 1.34; 95% CI, 1.13-1.60, P<0.05, Adults: OR, 1.25; 95% CI, 1.12-1.39, P<0.05; OR, 1.25; 95% CI, 1.12-1.40, P<0.05). (2) High birth weight (>4,000g) was not associated with the risk of asthma when BW<4,000g and BW=2500-4000g were used as the reference. CONCLUSIONS: These results suggest that low birth weight (<2,500g) is associated with increased risk of asthma both in children and adults and may serve as a mediator between prenatal influences and later disease risk; but high birth weight (>4,000g) was not associated with increased risk of asthma.

[Comparison and analysis of different diagnostic criteria for peripartum cardiomyopathy].

OBJECTIVE: To compare the differences and similarities between the diagnostic criteria of obstetrics and internal medicine in China with that of Hibbard for peripartum cardiomyopathy (PPCM). METHODS: From March 1995 to September 2009, a total of 49 patients were diagnosed as PPCM at the Peking University People's Hospital and the Fu Wai Hospital in Beijing, China. Obstetric diagnostic criteria was: PPCM was one of dilated cardiomyopathy, occurred during the third trimester of pregnancy through the 6th month postpartum, and without cardiovascular diseases before. Internal medicine diagnostic criteria was: PPCM was unexplained cardiomegaly and heart failure, occurred during the last month of pregnancy through the 5th month postpartum, and meet the echocardiographic criteria of dialated cardiomyopathy as follows:left ventricular end-diastolic dimension (LVEDd) greater than 5.0 cm; left ventricular ejection fraction (LVEF) less than 45%, and(or) left ventricular fractional shortening (LVFS) less than 30%; or LVEDd greater than 2.7 cm/body surface area (m2); or LVEDd>117% of age and body surface area predictive value. Hibbard diagnostic criteria was: All four of the following: (1) heart failure within last month of pregnancy and 5 months postpartum; (2) absence of prior heart disease; (3) no determinable cause; (4) strict echocardiographic indication of left ventricular dysfunction: LVEF less than 45%, and/or LVFS less than 30%, and LVEDd greater than 2.7 cm/m2. The compliance between obstetric and internal criteria with Hibbard criteria, and the reasons of incompliance between Chinese and international criteria were analyzed. RESULTS: Eight patients were diagnosed of PPCM by obstetricians according to Chinese obstetric criteria. Among them, 6 patients (6/8) did not meet Hibbard criteria.2 of the six did not reach the time regulated in the criteria. All of the six had other determinable causes for heart failure, and their echocardiographic results did not meet the diagnostic standard either. The other 41 patients were diagnosed of PPCM by physicians according to Chinese internal medicine criteria. Among them, 7 patients (17%) did not meet Hibbard criteria, 3 of the seven did not reach the time regulated in the criteria, and had other determinable causes for heart failure either.4 of the seven did not meet the echocardiographic standard part in the criteria. The Chinese internal medicine diagnostic criteria has a significant higher coincidence rate with Hibbard criteria, compared to Chinese obstetric criteria (83% vs. 25%; P<0.01). Among all 13 patients whose PPCM diagnosis did not meet Hibbard criteria, 5 cases did not reach the time regulated in the criteria, 9 cases had other determinable causes for heart failure, and 10 cases did not meet the echocardiographic standard part in the criteria. Preeclampsia was the most common determinable causes for heart failure, accounted for 7 cases. CONCLUSION: There is obvious difference between Chinese and Hibbard diagnostic criteria for PPCM, especially Chinese obstetric criteria.

[Effect of general anesthesia used in cesarean section on maternal-neonatal outcome of pregnancy complicated with severe thrombocytopenia].

OBJECTIVE: To investigate the effect of general anesthesia on pregnancy women with thrombocytopenia and neonate during cesarean section (CS). METHODS: Sixty-five singleton pregnant women with low platelet count (< 50 x 10(9)/L) and gestation>35 weeks were allocated into general anesthesia group (35 cases) and local anesthesia group (30 cases) randomly. The time from skin incision to fetal delivery, the oxyhemoglobin saturation (SO2) before and after anesthesia, the blood loss during operation, Apgar scores at 1 min, birth weight,umbilical cord blood gas analysis were recorded. RESULTS: The mean time from anesthesia induction to fetal delivery was (9.7 +/- 3.5) minutes in general anesthesia group. The time from skin incision to fetal delivery in general anesthesia group [(7.7 +/- 2.5) minutes] was shorter than that in local anesthesia group [(12.5 +/- 3.0) minutes, P < 0.01], while the operation time had no significant differences. There were no significant difference for the value of SO2 before and after general anesthesia or local anesthesia (P > 0.05). There was no significant difference for the blood loss [(471 +/- 245) ml vs. (452 +/- 213) ml, P > 0.05], Apgar scores at 1 minute, birth weight and umbilical cord blood gas analysis between the two groups (P > 0.05). There had two infants with blue asphyxia in local anesthesia group while no infant with asphyxia in general anesthesia group. CONCLUSION: General anesthesia is safe to pregnant women with thrombocytopenia during CS.