Combined efficacy of low-calorie diets and aerobic training on nutritional status of obese patients with early type 2 diabetes.

OBJECTIVE: The purpose of this study was to evaluate the combined efficacy of low-calorie diets and aerobic training on the nutritional status of obese patients with early type 2 diabetes mellitus. PATIENTS AND METHODS: 120 consecutive obese patients with early type 2 diabetes were admitted to our hospital between August 2021 and December 2022. The patients enrolled were equally and randomly allocated into the control group (60 cases, given conventional diabetes diet intervention) and the study group (60 cases, given a low-calorie diet intervention combined with aerobic training). The parameters, including the nutritional status, fasting insulin (FINS), Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), blood lipid level, and quality of life, were compared between the two groups. RESULTS: Before treatment, there were no measurable differences in the levels of fasting blood glucose (FBG), 2-hour postprandial blood glucose (2hPG), glycosylated hemoglobin (HbAlc), albumin (ALB), prealbumin (PA), and hemoglobin (Hb) between the two groups (p>0.05), whereas two months after treatment, the FBG, 2hPG, and HbAIc levels were greatly lower, and the levels of ALB, PA, and Hb were significantly higher in the study group than those in the control group (p<0.05). Before treatment, no statistically significant differences were found in FINS and HOMA-IR values between the two groups (p>0.05). Two months after treatment, however, the study group showed lower FINS and HOMA-IR values as compared to the control group, with statistically significant differences (p<0.05). Before treatment, there was no statistically significant difference in the levels of triacylglycerol, total cholesterol, high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) between the two groups (p>0.05), while the four levels in the study group were significantly lower than those in the control group two months after treatment (p<0.05). Similarly, there were no statistically significant differences in scores of physiological, psychological, social, and therapy-related problems between the two groups before treatment (p>0.05), whereas the abovementioned scores were evidently higher in the study group than control group two months after treatment (p<0.05). CONCLUSIONS: A low-calorie diet intervention combined with aerobic training exerted good effects in terms of greatly enhancing the nutritional status among obese patients with early type 2 diabetes mellitus, which was deemed appropriate for clinical promotion and implementation.

Safety and efficacy of the Low-Profile Visualized Intraluminal Support stent in treating intracranial atherosclerotic stenosis.

PURPOSE: The performance of the Low-Profile Visualized Intraluminal Support (LVIS) stent deployed following balloon angioplasty is unknown in treating intracranial atherosclerotic stenosis, and this study was to investigate the safety and efficacy of the LVIS stent in treating intracranial atherosclerotic stenosis in the middle cerebral artery M1 segment. METHODS: Thirty-five patients were enrolled with 35 atherosclerotic stenoses at the M1 segment. The stenosis was about 75% in 16 patients, 80% in 15, and 90% in the rest four. The LVIS stent was used to treat these patients. RESULTS: The success rate of stenting was 97.1%. The stenting procedure was failed in one patient because of intraprocedural dissection of the stenotic (75%) segment, resulting in a 30-day periprocedural complication rate of 2.9% (1/35). Before stenting, the stenosis rate ranged 75%-90% (mean 78.9%±4.7%), and after stenting, the diameter of the stented segment was significantly (P<0.0001) increased to 1.5-3.4mm (mean 2.1±0.32mm) ranging 68.2%-100% (mean 94.0%±5.8%) of the normal arterial diameter, with the residual stenosis ranging 0-31.8% (median 4.8%, IQR 2.4%-7.3%). Follow-up was performed at 6-20 months (mean 8.5) after stenting. One patient (2.9%) had occlusion of the stented M1 segment with no symptoms, and two patients (5.7%) had slight asymptomatic instent stenosis (40%) at the M1 segment, with the instent restenosis and occlusion rate of 8.6% (3/35). CONCLUSION: The braided LVIS stent can be safely applied for treatment of intracranial atherosclerotic stenosis in the middle cerebral artery with good safety and efficacy immediately after stenting and at follow-up.

Current status and future prospects of TB digital treatment adherence technology use in China.

BACKGROUND: Digital treatment adherence technologies (DATs) have been recommended by the Chinese National Tuberculosis Programme since 2015. However, until now the extent to which DATs have been adopted in China remain unclear. In this study, we aimed to understand the current status and future prospects of DAT use in China.METHODS: A cross-sectional study was undertaken to collect data from all 2,884 county-level TB-designated institutions across China using a quantitative questionnaire and extraction of information from the Chinese TB information management system. Data were collected between 1 July 2020 and 30 June 2021.RESULTS: All of the 2,884 county-level TB-designated institutions responded to the questionnaire. We found that the utilisation rate of DATs in China was 21.5% (n = 620). Among those using DATs, the uptake of DATs among TB patients was 31.0%. Lack of financial, policy and technology support were the main barriers to adoption and scale up DATs at the institution level.CONCLUSIONS: The use of DATs is in an early stage in China; however, the number of institutions who offer DATs have increased significantly after July 2020. To facilitate the use of DATs, the national TB programme should provide more financial, policy and technology support, and a national guideline is required.

Studies on microRNA regulation of multidirectional differentiation of dental pulp stem cells: a narrative review.

OBJECTIVE: Dental pulp stem cells (DPSCs) are adult stem cells of neural crest origin, are readily available, have good self-renewal and multidirectional differentiation properties, can differentiate into a variety of cells, are abundant, less harmful to donate, have no ethical issues, low immunogenicity, and therefore, are widely used as seed cells in the field of tissue engineering and regenerative medicine. MicroRNA (miRNA) is a single-stranded non-coding small RNA consisting of about 22 nucleotides, which plays an important regulatory role in various aspects of cellular activities, such as proliferation, differentiation, and apoptosis. In this paper, we review the regulatory role of small RNA in the differentiation of DPSCs and its mechanism in the past 5 years. This paper aims to reveal the important role of miRNAs in differentiation in DPSCs. MATERIALS AND METHODS: MicroRNAs (miRNAs), differentiation, and DPSCs were extensively searched in three databases from 2014 to 2021. These databases include PubMed, Cochrane Library, Embase. RESULTS: Our study reviews the microRNAs (miR-145, miR-143-3p, miR-140-5p, miR-488, miR-218, miR-125a-3p, miR-27a-5p, miR-223, miR-21, miR-143, miR-215, miR-219a-1-3p, miR-31, miR-496, miR-218, miR-24-3p, miR-146a-5p, miR-196a, miR-188-3p, miR-424, miR-378a, miR-135, miR-124) in the differentiation of DPSCs. CONCLUSIONS: A large body of evidence supports the involvement of miRNAs in differentiation associated with mesenchymal stem cells (MSCs), although the mechanisms involved are not yet clear. Most of the current studies are from in vitro studies, but the ultimate goal is to apply these studies to the clinic, and studies involving in vivo models are needed.

Safety and efficacy of the Low-Profile Visualized Intraluminal Support stent in treating intracranial atherosclerotic stenosis.

PURPOSE: The performance of the Low-Profile Visualized Intraluminal Support (LVIS) stent deployed following balloon angioplasty is unknown in treating intracranial atherosclerotic stenosis, and this study was to investigate the safety and efficacy of the LVIS stent in treating intracranial atherosclerotic stenosis in the middle cerebral artery M1 segment. METHODS: Thirty-five patients were enrolled with 35 atherosclerotic stenoses at the M1 segment. The stenosis was about 75% in 16 patients, 80% in 15, and 90% in the rest four. The LVIS stent was used to treat these patients. RESULTS: The success rate of stenting was 97.1%. The stenting procedure was failed in one patient because of intraprocedural dissection of the stenotic (75%) segment, resulting in a 30-day periprocedural complication rate of 2.9% (1/35). Before stenting, the stenosis rate ranged 75%-90% (mean 78.9%±4.7%), and after stenting, the diameter of the stented segment was significantly (P<0.0001) increased to 1.5-3.4mm (mean 2.1±0.32mm) ranging 68.2%-100% (mean 94.0%±5.8%) of the normal arterial diameter, with the residual stenosis ranging 0-31.8% (median 4.8%, IQR 2.4%-7.3%). Follow-up was performed at 6-20 months (mean 8.5) after stenting. One patient (2.9%) had occlusion of the stented M1 segment with no symptoms, and two patients (5.7%) had slight asymptomatic instent stenosis (40%) at the M1 segment, with the instent restenosis and occlusion rate of 8.6% (3/35). CONCLUSION: The braided LVIS stent can be safely applied for treatment of intracranial atherosclerotic stenosis in the middle cerebral artery with good safety and efficacy immediately after stenting and at follow-up.

Prognostic and predictive roles of DNA mismatch repair status in colon cancer patients treated with oxaliplatin-based chemotherapy: a retrospective study.

This study aims to evaluated the prognostic and predictive roles of DNA mismatch repair status in colon cancer patients treated with oxaliplatin-based chemotherapy. From 2005 to 2008, patients who underwent curative surgical resection for high-risk stage II or stage III colon cancer were recruited in this study. These patients had been received oxaliplatin-based chemotherapy. A total 324 patients were included (41.7% at stage II and 58.3% at stage III), and 59 patients (18.2%) exhibited mismatch repair-deficient (dMMR). The prognostic analysis revealed an increase in disease-free survival (DFS) for dMMR patients versus proficient MMR (pMMR) patients (81.4% versus 64.2%, P = 0.009), and overall survival (OS) (86.4% versus 69.1%, P = 0.004). Among the 82 patients who did not receive adjuvant therapy, the 5-year DFS was significantly higher in patients with dMMR (81.3%) than in patients with pMMR (49.7%, P = 0.040). In the multivariate models, dMMR was independently associated with improved DFS (HR = 2.171, 95% CI: 1.108 - 4.253, P = 0.024) and OS (HR = 2.521, 95% CI: 1.190 - 5.339, P = 0.016). In the predictive analysis, it was observed that the benefit of treatment significantly differed according to the DNA MMR status (P = 0.020). Compared with surgery alone, oxaliplatin-based adjuvant chemotherapy improved the 5-year DFS (69.9% versus 56.2%, P = 0.024) among patients with pMMR in the multivariable analysis (HR = 0.794, 95% CI = 0.646 - 0.976, P = 0.029). In contrast, the oxaliplatin-based chemotherapy in the group with dMMR had no benefit in DFS (83.1% versus 81.8%, HR 1.040, 95% CI: 0.276 - 3.922, P = 0.954). Patients with dMMR colon cancer are associated with improved survival rates, compared with pMMR colon cancer. MMR status is an independent prognostic biomarker for DFS in patients with high-risk stage II and stage III colon cancer. Oxaliplatin-based adjuvant chemotherapy mainly benefits patients with pMMR, but may not benefit patients with tumors exhibiting dMMR.

Efficacy and safety of alginate formulations in patients with gastroesophageal reflux disease: a systematic review and meta-analysis of randomized controlled trials.

OBJECTIVE: Alginate formulations are increasingly being used for treating gastroesophageal reflux disease (GERD). However, the benefits of alginate versus control or proton pump inhibitors (PPIs) are somewhat unclear. We performed a systematic review and meta-analysis to summarize data from recent randomized controlled trials (RCTs) comparing the efficacy and safety of alginate-based formulation with PPIs or control for the treatment of GERD. MATERIALS AND METHODS: PubMed, Embase, Scopus, BioMed Central, CENTRAL, and Google scholar databases were searched from 1st January 2000 to 15th June 2020. Primary outcome was a reduction of symptoms while secondary outcomes were adverse events and treatment withdrawals. Ten articles with 11 RCTs were included. RESULTS: Qualitative analysis of four trials indicated better outcomes with alginates vs. placebo/antacids. Our pooled analysis, however, indicated no statistically significant difference between alginates and placebo/antacids for relief of heartburn, regurgitation, or dyspepsia. Similarly, no difference was seen between a combination of alginate and PPI vs. PPI alone for reduction of heartburn, regurgitation, or dyspepsia symptoms. The risk of adverse events and treatment withdrawal did not differ between the two groups in either comparison. Descriptive analysis of studies comparing alginate vs. PPI indicated no difference between the two drugs. CONCLUSIONS: Our study indicates that alginates may have greater efficacy than placebo/antacids in improving outcomes of GERD. However, current evidence on the efficacy of alginate-based formulations vs. PPI or the role of added alginates with PPI is questionable, and suggests no difference between the two drugs. The risk of adverse events with alginates is no greater than that of placebo or PPIs.

Morphine induces the apoptosis of mouse hippocampal neurons HT-22 through upregulating miR-181-5p.

OBJECTIVE: To elucidate the role of morphine in inducing apoptosis of mouse hippocampal neurons HT-22 by upregulating microRNA-181-5p (miR-181-5p). MATERIALS AND METHODS: After treatment of different doses of morphine, changes in proliferative ability, apoptosis, and expression levels of miR-181-5p and MAPK1 in HT-22 cells were assessed through a series of functional experiments. Regulatory effects of miR-181-5p on morphine-induced phenotype changes of HT-22 cells were examined. The interaction between miR-181-5p and MAPK1, and their involvement in morphine-induced neuron apoptosis were explored by Luciferase assay and rescue experiments, respectively. RESULTS: Morphine treatment markedly attenuated viability and proliferative ability in HT-22 cells, while apoptotic rate increased. MiR-181-5p was upregulated and MAPK1 was downregulated in HT-22 cells by morphine induction. Knockdown of miR-181-5p enhanced viability and proliferative ability, as well as reduced apoptosis in morphine-induced HT-22 cells. MiR-181-5p could specifically bind MAPK1 and negatively regulate its expression level. Knockdown of MAPK1 was able to reverse the regulatory effects of miR-181-5p on morphine-induced phenotype changes of HT-22 cells. CONCLUSIONS: Morphine induces apoptosis of hippocampal neurons HT-22 by upregulating miR-181-5p to suppress the level of MAPK1.

LncRNATCF7 up-regulates DNMT1 mediated by HPV-18 E6 and regulates biological behavior of cervical cancer cells by inhibiting miR-155.

OBJECTIVE: This work aimed to study the mechanism of lncRNATCF7 upregulating DNMT1 mediated by HPV-18 E6 and regulating the biological behavior of cervical cancer cells by inhibiting miR-155. PATIENTS AND METHODS: HPV-16 E6 enhanced DNMT1 expression in cervical cancer cells, which was detected by Western blotting. The expression of miR-155 in cervical cancer was detected by qPCR, the interaction between TCF-7 and miR-155 by Dual-luciferase reporter gene. The changes in invasion ability of cervical cancer cells and the effect of miR-155 on the invasion ability of cervical cancer cells after inhibiting TCF-7 were detected by the transwell invasion assay, while changes in migration ability of cervical cancer cells and the effect of miR-155 on migration ability of cervical cancer cells after inhibiting TCF-7 were observed by the scratch assay. The effect of inhibiting TCF-7 on the tumor size and volume of cervical cancer was detected by the subcutaneous tumor formation in nude mice. RESULTS: E6 expression was significantly inhibited by E6 siRNA. The knockdown of endogenous HPV-16 E6 markedly inhibited the expression of DNMT1; TCF-7 specifically bound to the 3' UTR of miR-155; inhibition of TCF-7 can inhibit invasion and migration of cervical cancer cells; enhanced miR-155 after the inhibition of TCF-7 can promote the invasion and migration of cervical cancer cells; compared with NC group, the tumor volume and weight of TCF-7-siRNA group tumor-bearing was significantly reduced. CONCLUSIONS: TCF-7 plays an important role in the development of cervical cancer. TCF-7 can target miR-155 to regulate the invasion and migration of cervical cancer cells.

Coexistence of hyper-uricaemia and low urinary uric acid excretion further increases risk of chronic kidney disease in type 2 diabetes.

AIM: To investigate whether hyper-uricaemia and decreased urinary uric acid excretion (UUAE) are associated with increased risk of chronic kidney disease (CKD), and whether the coexistence of hyper-uricaemia and low UUAE further increases CKD risk in type 2 diabetes mellitus (T2DM). METHODS: In this cross-sectional study based on serum uric acid (SUA) and UUAE levels, 2846 T2DM inpatients were divided into those with normal SUA and UUAE (group 1), normal SUA and low UUAE (group 2), hyper-uricaemia and normal UUAE (group 3), and hyper-uricaemia and low UUAE (group 4). Hyper-uricaemia was defined as SUA levels ≥ 420 µmol/L in men and ≥ 360 µmol/L in women. Low UUAE was defined as levels below the first UUAE quintiles (< 2161 µmol/24 h in men, 1977 µmol/24 h in women). RESULTS: There were trends for significantly increased prevalences of CKD (4.3%, 12.6%, 18.3%, 47.8%; P < 0.001), albuminuria (20.2%, 26.4%, 36.9%, 54.9%; P < 0.001) and macroalbuminuria (3.3%, 10.1%, 10.7%, 31.9%; P < 0.001) from groups 1 to 4, respectively. After controlling for multiple confounding factors, prevalences of CKD (P < 0.001) and urinary albumin levels (P = 0.013) showed significantly increasing trends, whereas eGFR levels were markedly decreased from groups 1 to 4 (P < 0.001). CONCLUSION: Hyper-uricaemia and low UUAE levels are closely associated with presence of CKD, and the concomitant presence of hyper-uricaemia and decreased UUAE levels further increased CKD risk in T2DM. Thus, the combined consideration of SUA and UUAE levels may help to identify those T2DM patients at higher CKD risk.

HOTAIR alleviates ox-LDL-induced inflammatory response in Raw264.7 cells via inhibiting NF-κB pathway.

OBJECTIVE: To investigate the possible role of hox transcript antisense intergenic RNA (HOTAIR) in the pathogenesis of atherosclerosis and its underlying mechanism. PATIENTS AND METHODS: The expression of HOTAIR in peripheral blood lymphocytes of atherosclerosis (AS) and healthy controls was detected by quantitative Real-time-polymerase chain reaction (qRT-PCR). In vitro AS model was established by ox-LDL induction in Raw264.7 cells. Viability of Raw264.7 cells after ox-LDL induction was detected by cell counting kit-8 (CCK-8) assay. Levels of TC (total cholesterol), TG (triglyceride), LDL-C (low density lipoprotein cholesterol) and HDL-C (high density lipoprotein cholesterol) in Raw264.7 cells were detected by enzyme-linked immunosorbent assay (ELISA). Overexpression plasmid of HOTAIR was constructed. Levels of TG, TC, LDL-C, and HDL were detected again after HOTAIR overexpression by ELISA. CD68+ cells and CD168+ cells in Raw264.7 cells were detected by flow cytometry. Protein expressions of pro-inflammatory and anti-inflammatory genes were detected by Western blot. Lipid metabolism in Raw264.7 cells was evaluated by oil red O staining and Western blot, respectively. Finally, rescue experiments were conducted to explore the specific mechanism of HOTAIR in regulating AS development. RESULTS: HOTAIR was lowly expressed in peripheral blood lymphocytes of AS patients and Raw264.7 cells induced by ox-LDL. Overexpression of HOTAIR upregulated adipose genes (PPARα and CPT-1) and downregulated lipogenesis genes (SREBP-1c and ACS). Besides, overexpression of HOTAIR decreased expressions of pro-inflammatory cytokines (TNF-α and IL-1ß), but increased expressions of anti-inflammatory cytokines (IL-4 and IL-10). In the in vitro AS model, FXR1 was remarkably downregulated in Raw264.7 cells. HOTAIR reduced inflammatory response via promoting FXR1 expression in Raw264.7 cells. Rescue experiments showed that the effect of HOTAIR on nuclear factor-kappa B (NF-κB) pathway was reversed by FXR1 knockdown. CONCLUSIONS: We found that TAIR was lowly expressed in AS patients. Overexpression of HOTAIR can reduce the lipid accumulation and inhibit inflammatory response by suppressing FXR1 via NF-κB pathway.

MiR-4299 suppresses non-small cell lung cancer cell proliferation, migration and invasion through modulating PTEN/AKT/PI3K pathway.

OBJECTIVE: The aim of the present study was to investigate clinical significances and biological roles of miR-4299 in non-small cell lung cancer (NSCLC) PATIENTS AND METHODS: Expression of miR-4299 in NSCLC tissues and matched non-tumor tissues was determined by quantitative real-time PCR (qRT-PCR). The correlations between miR-4299 expression and clinicopathological characteristics and prognosis were also analyzed. MTT assay and Transwell assay were performed to determine the proliferation, migration and invasion. Western blotting was used to examine the expressing patterns of PTEN/AKT/PI3K signaling pathway-related proteins. RESULTS: We found that the expression level of miR-4299 was downregulated in NSCLC tissues and cell lines. Low miR-4299 expression was positively correlated with TNM stage (p=0.002), histological grade (p=0.002) and lymph node metastasis (p=0.028). Moreover, Kaplan-Meier survival analysis showed that the patients with low miR-4299 expression had shorter survival time than those with high miR-4299 expression (p=0.0011). More importantly, multivariate analysis suggested that decreased miR-4299 expression was a poor independent prognostic predictor for NSCLC patients (p=0.009). Functionally, overexpression of miR-4299 inhibited the proliferation, migration and invasion in A549 cells. Mechanistically, the results of Western blot showed that miR-4299 exhibited its tumor-suppressive role by modulating PTEN/AKT/PI3K signaling pathway. CONCLUSIONS: We firstly indicated that miR-4299 may be a candidate independent marker for NSCLC prognosis and suppressed the progression of NSCLC by modulating the activation of PTEN/AKT/PI3K signaling pathway, suggesting that miR-4299 could be a potential target for developing therapies in treating NSCLC.

Effect of NF-κB inhibitor on Toll-like receptor 4 expression in left ventricular myocardium in two-kidney-one-clip hypertensive rats.

OBJECTIVE: To investigate the effects of an inhibitor of NF-κB, PDTC (pyrrolidine dithiocarbamate), on TLR4 (Toll-like receptor 4) expression in the left ventricle of Goldblatt hypertension rats. MATERIALS AND AND METHODS: Goldblatt rat model of two-kidney, one-clip (2K1C) hypertension was established in 70 healthy male rats. The rats were randomly divided into sham operation group (S group, n=20), non-drug intervention hypertension group (H group, n=25), and PDTC intervention group (P group, n=25). P group was injected with PDTC. The clip was inserted in the left renal artery of H group and P group (2K1C). Eight weeks after the operation, the rats were sacrificed and the samples of the left ventricle were collected. The concentration of AngII in the left ventricle was assessed by radioimmunoassay. RT-PCR was used to examine the mRNA expression of TLR4 in the left ventricle. Immunohistochemistry was adopted to examine the location of TLR4 and NF-κB in the myocardium. Victoria blue-Ponceau staining of Cardiac collagen was used to evaluate the degree of myocardial fibrosis. RESULTS: Eight weeks after the operation, caudal SBP, meridional end-systolic stress, left ventricular mass index, relative wall thickness, cardiac fibrosis degree, and the concentration of AngII in the left ventricle in P group were significantly lower than those in H group (p<0.01). In cardiac myocytes of S group and P group, TLR4 expression was diffused and presumably cytoplasmic. TLR4 mRNA expression in P group was significantly lower than that of H group (p<0.01). CONCLUSIONS: PDTC not only inhibited the activation of NF-κB, but decreased TLR4 expression and AngII content, indicating that the inflammatory signals and oxidative stress mediated by TLR4/NF-κB are involved in the occurrence and development of left ventricular remodeling. Intervention with TLR4/NF-κB and anti-inflammatory and anti-oxidative therapy may be a new target to reverse left ventricular remodeling.

LKB1 inhibits HPV-associated cancer progression by targeting cellular metabolism.

Liver kinase B1 (LKB1) is mutationally inactivated in Peutz-Jeghers syndrome and in a variety of cancers including human papillomavirus (HPV)-caused cervical cancer. However, the significance of LKB1 mutations in cervical cancer initiation and progress has not been examined. Herein, we demonstrated that, in mouse embryonic fibroblasts, loss of LKB1 and transduction of HPV16 E6/E7 had an additive effect on constraining cell senescence while promoting cell proliferation and increasing glucose consumption, lactate production and ATP generation. Knockdown of LKB1 increased and ectopic expression of LKB1 decreased glycolysis, anchorage-independent cell growth, and cell migration and invasion in HPV-transformed cells. In the tumorigenesis and lung metastasis model in syngeneic mice, depletion of LKB1 markedly increased tumor metastatic colonies in lungs without affecting subcutaneous tumor growth. We showed that HPV16 E6/E7 enhanced the expression of hexokinase-ll (HK-II) in the glycolytic pathway through elevated c-MYC. Ectopic LKB1 reduced HK-II along with glycolysis. The inverse relationship between HK-II and LKB1 was also observed in normal and HPV-associated cervical lesions. We propose that LKB1 acts as a safeguard against HPV-stimulated aerobic glycolysis and tumor progression. These findings may eventually aid in the development of therapeutic strategy for HPV-associated malignancies by targeting cell metabolism.

Study on clinical effect and immunologic mechanism of infants capillary bronchitis secondary bronchial asthma treated with bacterial lysates Broncho-Vaxom.

OBJECTIVE: To study the clinical effects and immunologic mechanism of infant capillary bronchitis secondary bronchial asthma treated with bacterial lysates (Broncho-Vaxom OM-85BV). PATIENTS AND METHODS: Between February 2013 and February 2014, 136 infant capillary bronchitis secondary bronchial asthma cases were chosen. This research was approved by Ethics Committee in our hospital and obtained the informed consent right from patients and guardians. Patients were divided into the control group (n = 62) and the observation group (n = 74) using random number table method. Patients in the control group were treated with normal glucocorticoid atomizing inhalation, aminophylline and antibiotic treatment. In the observation group besides the abovementioned treatment, we added Broncho-Vaxom OM-85BV, qd po for 10 days continuously and quitted it for 20 days. This continued for a total of 3 months. Follow-ups were set for about one year to compare the effects. RESULTS: The onset frequency and duration of capillary bronchitis and asthma in observation group declined remarkably compared with control group and the differences were statistically significant (p < 0.05). The level of IL-17 and IL-4 in the observation group decreased significantly, whereas, the level of IL-10 and IFN- γ increased considerably. Differences were all statistically significant (p < 0.05). Peripheral blood CD4+ T lymphocytes in the observation group patients expressed lower levels of nicotinic acetylcholine receptors α7 (α7nAChR) compared to the control group. Then difference was statistically significant (p < 0.05). CONCLUSIONS: Broncho-Vaxom OM-85BV reduced the onset of infant capillary bronchitis secondary bronchial asthma, relating to the reduced inflammation reaction. It also regulated the immunologic function of Th1/Th2, and lowered the α7nAChR level.

Supraglottic jet oxygenation and ventilation during colonoscopy under monitored anesthesia care: a controlled randomized clinical trial.

OBJECTIVE: Supraglottic jet oxygenation and ventilation may provide active pulse oxygenation and ventilation in patients with respiratory suppression. This randomized controlled clinical study was designed to determine the efficacy and safety of supraglottic jet oxygenation/ventilation during monitored anesthesia care (MAC) by intravenous (IV) infusion of propofol in patients undergoing colonoscopy. PATIENTS AND METHODS: Forty-nine adult patients receiving colonoscopy were randomly divided into two groups: the control group with passive oxygen supply from regular nasal cannula (N = 24) and the supraglottic jet oxygenation/ventilation (SJV) group with active pulse oxygen supply and ventilation using a manual jet ventilator (N = 25). MAC was induced and maintained by intravenous injection of propofol. HR, ECG, BP, SaO2 were continuously monitored during and 1 hour after the procedure. RESULTS: Demographic characteristics were similar in height, weight, age and BMI (Body Mass Index) between the two groups. Compared to the control group, the SJV group had similar averaged lowest SaO2, but highest SaO2 in SJV group were significantly lower during operation (p = 0.01). The proportion of maximum chest rise movement were increased significantly in SJV group (p = 0.03) compared with control group. Demographic characteristics were similar in the times needed to use facial mask ventilation, percentage of time to maintain SaO2 above 96%, average PetCO2 during the procedure, or complications between the two groups. CONCLUSIONS: SJV can provide adequate oxygenation/ventilation during monitored anesthesia care and convenient monitoring for patients' breath, without complications.

A study of autologous stem cells therapy assisted regeneration of cartilage in avascular bone necrosis.

Application of 'regenerative medicine' has given a new hope to surgeons for the treatment of several chronic diseases and disorders including severe orthopedic conditions. There are a myriad of orthopedic conditions and injuries that presently have limited therapeutic treatments and could benefit from new developing therapies in regenerative medicine with the help of stem cell therapy[1]. Regenerative medicine therapies are mainly based on the applications of stem cells. Stem cells play a vital role in orthopedic treatments and the studies have shown to have promising results in repair of bone, tendon, cartilage including avascular necrosis (AVN), spondylitis etc. Bone and cartilage regeneration ability of stem cells has been demonstrated clinically. However, success rate may not be same in every case and it depends on the patient profile. Several factors can be responsible for the same which include patient's immune response, the type and grade of the disease, which along with other confounding factors decide the outcome of the treatment. In this paper we have presented some of the orthopedic case studies performed through autologous transplantation of the stem cells.

Angiogenic characteristics of blood outgrowth endothelial cells from patients with von Willebrand disease.

BACKGROUND: Endothelial von Willebrand factor (VWF) inhibits angiogenesis. Accordingly, blood outgrowth endothelial cells (BOECs) isolated from von Willebrand disease (VWD) patients showed enhanced in vitro angiogenesis when compared with healthy control BOECs. Characterization of the angiogenic response of VWD BOECs is limited and differences between the different types of VWD have not been investigated in detail. OBJECTIVES: The aim of this study was to further explore the potential pathogenic effect of VWF mutations on angiogenesis. METHODS: BOECs were isolated from four healthy individuals, 10 patients with VWD and one heterozygous carrier of a type 2N mutation. Cell migration and tube formation were measured. RESULTS: Migration velocity and total tube formation were similar between VWD patients and controls in general. BOECs from the type 3 VWD patient and one type 2B patient showed increased migratory velocity and tube formation compared with BOECs from other patients and healthy controls. Directional migration was impaired in eight out of 10 VWD BOECs and the ability to form tubes was limited to early passage numbers, but not for BOECs from healthy controls. CONCLUSION: BOECs can be a useful tool for ex vivo assessment of endothelial cell function in patients with different types of VWD, but possible limitations, such as early loss of angiogenic capacity, should be recognized. BOECs from most VWD patients consistently showed impairment in the directionality of migration. This is the first report on angiogenic properties of a type 3 VWD BOEC, which showed increased in vitro angiogenesis.

A regime of two intravenous injections of tranexamic acid reduces blood loss in minimally invasive total hip arthroplasty: a prospective randomised double-blind study.

Tranexamic acid (TXA), an inhibitor of fibrinolysis, reduces blood loss after total knee arthroplasty. However, its effect on minimally invasive total hip arthroplasty (THA) is not clear. We performed a prospective, randomised double-blind study to evaluate the effect of two intravenous injections of TXA on blood loss in patients undergoing minimally invasive THA. In total, 60 patients (35 women and 25 men with a mean age of 58.1 years; 17 to 84) who underwent unilateral minimally invasive uncemented THA were randomly divided into the study group (30 patients, 20 women and ten men with a mean age of 56.5 years; 17 to 79) that received two intravenous injections 1 g of TXA pre- and post-operatively (TXA group), and a placebo group (30 patients, 15 women and 15 men with a mean age of 59.5 years; 23 to 84). We compared the peri-operative blood loss of the two groups. Actual blood loss was calculated from the maximum reduction in the level of haemoglobin. All patients were followed clinically for the presence of venous thromboembolism. The TXA group had a lower mean intra-operative blood loss of 441 ml (150 to 800) versus 615 ml (50 to 1580) in the placebo (p = 0.044), lower mean post-operative blood loss (285 ml (120 to 570) versus 392 ml (126 to 660) (p = 0.002), lower mean total blood loss (1070 ml (688 to 1478) versus 1337 ml (495 to 2238) (p = 0.004) and lower requirement for transfusion (p = 0.021). No patients in either group had symptoms of venous thromboembolism or wound complications. This prospective, randomised controlled study showed that a regimen of two intravenous injections of 1 g TXA is effective for blood conservation after minimally invasive THA.

Icariin may benefit the mesenchymal stem cells of patients with steroid-associated osteonecrosis by ABCB1-promoter demethylation: a preliminary study.

UNLABELLED: In this study, we found out a previously undefined function of icariin which restored the dynamic balance between osteogenic and adipogenic differentiation of mesenchymal stem cells (MSCs) in patients with osteonecrosis of femoral head (ONFH) via ABCB1-promoter demethylation. These findings provided important information regarding potential implication of icariin targeting epigenetic changes for the treatment of steroid -associated ONFH. INTRODUCTION: Here, we investigated whether icariin can also exert a beneficial role in the reactivation of MSCs in the patients with steroid-associated ONFH via ABCB1-promoter demethylation. METHODS: Bone marrow was collected from the proximal femur in patients with steroid-associated ONFH (n = 20) and patients with new femoral neck fractures (n = 22), and then MSCs were isolated. We investigated cell viability, intracellular reactive oxygen species (ROS) level, mitochondrial membrane potential (MMP), P-glycoprotein (P-gp) activity, the transcript levels of ABCB1 and oxidative stress-related genes, methylation extent at CpG islands of ABCB1 promoter, and osteogenic and adipogenic differentiation ability of MSCs from the femoral neck fractures group and from the steroid-associated ONFH group treated with or without icariin. RESULTS: We observed that MSCs from the steroid-associated ONFH group showed reduced proliferation ability, elevated ROS level, depressed MMP, weakened osteogenesis, and enhanced adipogenesis while low P-gp activity, transcription level of ABCB1, and oxidative stress-related genes as well as aberrant CpG islands hypermethylation of ABCB1 were also noted in steroid-associated ONFH group. Treatment with icariin obviously induced de novo P-gp expression, decreased oxidative stress, and promoted osteogenesis. CONCLUSION: Icariin may be a potential drug targeting epigenetic changes for the treatment of steroid-associated ONFH.