Prognostic Significance of Serum miR-22, miR-125b, and miR-15b in Non-Small Cell Lung Cancer Patients.

BACKGROUND: Studies have shown that miRNA (miR) can be stably detected in serum, and aberrant expression of various miRNAs has shown diagnostic value in non-small cell lung cancer (NSCLC) patients. However, the role of miRNA in the context of prognosis has not been extensively investigated. Our previous study reported that miR-22, miR-125b, and miR-15b in serum had potential for use as tumor markers for auxiliary diagnosing of NSCLC. Therefore, the objective of this study was to detect the levels of miR-22, miR-125b, and miR-15b in serum from NSCLC patients and explore the potential prognostic significance of the three selected miRNAs. METHODS: The relative expression of miR-22, miR-125b, and miR-15b in 74 patients with advanced NSCLC in pre- and post-chemotherapy were detected by real-time quantitative polymerase chain reaction. RESULTS: Serum level of miR-125b significantly decreased after chemotherapy (p < 0.05) and the levels of miR-15b significantly increased (p < 0.01), while there was no change in the level of serum miR-22 (Z = 0.716, p > 0.05). Compared with pre-chemotherapy, serum miR-125b expression in advanced NSCLC patients of responders (CR + PR) were significantly decreased post-chemotherapy (p < 0.05); serum miR-15b expression in advanced NSCLC patients of responders (CR + PR) were increased (p < 0.01). The chemotherapy sensitivity of advanced NSCLC patients with high expression of miR-125b was lower than that of NSCLC patients with low expression (p < 0.05). The chemotherapy sensitivity of advanced NSCLC patients with high expression of miR-15b was higher than that of NSCLC patients with low expression (p < 0.05). High levels of serum miR-125b and low levels of serum miR-15b were related to poor overall survival (p < 0.05). CONCLUSIONS: The serum levels of miR-125b and miR-15b in advanced NSCLC patients were changed pre- and post-chemotherapy and these changes were associated with chemotherapeutic response. Serum miR-125b and miR-15b have certain potential clinical value for chemotherapeutic response in advanced NSCLC. The serum levels of miR-125b and miR-15b in patients with advanced NSCLC before treatment may be used to estimate the overall survival.

Comparison of Lacrosse Non-Slip Elements and Cutting Balloons in Treating Calcified Coronary Lesions: a Retrospective, Single-Blind Randomized Controlled Study.

INTRODUCTION: The present study aimed to compare Lacrosse non-slip elements (NSE) and cutting balloons in treating calcified coronary lesions. METHODS: A retrospective analysis was performed in 79 patients, who were diagnosed with moderate to severe calcified coronary lesions by coronary angiography, and underwent interventional therapy from January to December 2017. Lacrosse NSEs were used in 41 patients, while cutting balloons were used in 38 patients. The basic clinical characteristics, angiographic images, perioperative parameters, operation durations, interventional complications and incidence of major adverse cardiovascular events were compared. RESULTS: There was no significant difference in age, gender and risk factors between the two groups (P > 0.05). Furthermore, there was no significant difference in operation duration, and perioperative and postoperative complications between the two groups (P > 0.05). CONCLUSION: Compared with cutting balloons, the Lacrosse NSE has a similar effect in treating moderate to severe calcified coronary lesions.

Clinical Characteristics and Efficacy of Radiofrequency Catheter Ablation in the Treatment of Elderly Patients with Atrial Fibrillation.

OBJECTIVE: This study aims to investigate the clinical characteristics and therapeutic effect of radiofrequency catheter ablation (RFCA) in elderly patients with atrial fibrillation (AF). MATERIALS AND METHODS: This retrospective study included 668 patients with AF who underwent RFCA in our hospital from June 2010 to June 2015. Patients were divided into 2 groups according to age: group E (≥60 years old, n = 308) and group N (<60 years old, n = 360). Ablation endpoints included the following 3 points: (1) all preset ablation lines were completed; (2) all pulmonary veins were electrically isolated; and (3) negative evoked results were achieved. The success of follow-up was defined as patients who did not have an atrial arrhythmia attack for at least 3 months without the administration of antiarrhythmia drugs. RESULTS: Clinical characteristics of elderly patients with AF: the proportion accounted for by female patients with AF, patients with hypertension, and patients with a CHADS2 score ≥2 points was significantly higher than that in group N (P < 0.001). RFCA procedure and safety: differences in the success rate of the first operation and severe complications were not statistically significant (P > 0.05). Postoperative follow-up: the follow-up period was between 6 and 12 months after operation. Differences in the proportion of patients with repeated ablation and total success rate were not statistically significant (P > 0.05). CONCLUSIONS: Although elderly patients with AF had more clinical complications, no differences in the success rate of RFCA and postoperative complications between the 2 groups were found. RFCA is a safe and effective treatment for elderly patients with AF.

Shenfu Injection () inhibits inflammation in patients with acute myocardial infarction complicated by cardiac shock.

OBJECTIVES: To investigate the effect of Shenfu Injection (, SFI) on inflammatory factors in patients with acute myocardial infarction complicated by cardiogenic shock (CS) treated with and intra-aortic balloon pump (IABP). METHODS: This study enrolled 60 patients with ST-segment elevation myocardial infarction (STEMI) complicated by CS. Patients underwent IABP and emergency percutaneous coronary intervention (PCI) were randomly divided into two groups by random number table with 30 cases in each group, one given Sfitreatment (100 mL/24 h), one not. The two groups were then compared in a clinical setting for left ventricular function, biochemical indicators and Inflammatory factors, including C-reactive proteins (CRP), interleukin-1 (IL-1) and tumor necrosis factor alpha (TNF-α). Major adverse cardiac and cerebrovascular events (MACCE) events were compared between patients of the two groups both in-hospital and in follow-ups. RESULTS: The IABP support treatment times of patients in the IABP+Sfigroup were signifificantly shorter than the IABP group (52.87±28.84 vs. 87.45±87.31, P=0.047). In the patients of the IABP+Sfigroup, the CRP peak appeared in 24 h after PCI operation. The CRP peak in the patients of the IABP+Sfigroup was signifificantly lower than that in the IABP group (31.27±3.93 vs. 34.62±3.47, P=0.001). The increases in range of TNF-α in the patients of the IABP+Sfigroup were signifificantly lower than those of the IABP group (182.29±22.79 vs. 195.54±12.02, P=0.007). The increases in range of IL-1 in the patients of the IABP+Sfigroup were signifificantly lower than those of the IABP group (214.98±29.22 vs. 228.60±7.03, P=0.019). The amplitude elevated TNF-α 72 h after admission was an independent risk factor of in-hospital MACCE events (OR 0.973, 95% CI 0.890-0.987, P=0.014) in patients with STEMI and CS. CONCLUSION: Patients with STEMI complicated by CS treated by IABP and Sfihad a reduced inflammatory reaction, a reduced dependence of CS on IABP and shortened the course of disease.

No Association Between SNP56 in PDE4D Gene and Susceptibility to Ischemic Stroke: A Meta-Analysis of 15 Studies.

BACKGROUND Recent studies demonstrated that polymorphisms in the PDE4D gene were associated with several processes involved in the occurrence of ischemic stroke (IS). The association between specific PDE4D single-nucleotide polymorphism 56 (SNP56) and IS risk was initially identified via genome-wide association studies (GWAS), although the GWAS in different populations produced inconclusive results. Thus, we performed a meta-analysis to better explain the association between PDE4D SNP56 and IS risk. MATERIAL AND METHODS A literature search was conducted using PubMed, Embase, and Web of Science up to June 1, 2015. A fixed-effects or random-effects model was used to calculate the pooled odds ratios (ORs) based on the results from the heterogeneity tests. RESULTS Finally, we performed a meta-analysis of 15 studies, involving 8731 IS patients and 10,756 controls. The results showed nonsignificant association between PDE4D SNP56 and IS risk (T vs. A: OR=1.01, 95%CI=0.88-1.15, P=0.90). Similarly, in the subgroup analysis by ethnicity, no significant association was observed in Asian (T vs. A: OR=1.08, 95%CI=0.80-1.44, P=0.62) or European (T vs. A: OR=0.96, 95%CI=0.86-1.08, P=0.54) population. Moreover, funnel plots and Egger regression testing showed no evidence of publication bias. CONCLUSIONS In summary, current evidence suggested that PDE4D SNP56 might not be associated with an increased susceptibility to IS. However, this conclusion needs further validation by well-designed studies with large sample sizes.

No Association Between Single-Nucleotide Polymorphism 56 (SNP56) in Phosphodiesterase 4D (PDE4D) Gene and Susceptibility to Ischemic Stroke: A Meta-Analysis of 15 Studies.

BACKGROUND Recent studies demonstrated that polymorphisms in the PDE4D gene were associated with several processes involved in the occurrence of ischemic stroke (IS). The association between specific PDE4D single-nucleotide polymorphism 56 (SNP56) and IS risk was initially identified via genome-wide association studies (GWAS), although the GWAS in different populations produced inconclusive results. Thus, we performed a meta-analysis to better explain the association between PDE4D SNP56 and IS risk. MATERIAL AND METHODS A literature search was conducted using PubMed, Embase, and Web of Science up to June 1, 2015. A fixed-effects or random-effects model was used to calculate the pooled odds ratios (ORs) based on the results from the heterogeneity tests. RESULTS Finally, we performed a meta-analysis of 15 studies, involving 8731 IS patients and 10,756 controls. The results showed nonsignificant association between PDE4D SNP56 and IS risk (T vs. A: OR=1.01, 95%CI=0.88-1.15, P=0.90). Similarly, in the subgroup analysis by ethnicity, no significant association was observed in Asian (T vs. A: OR=1.08, 95%CI=0.80-1.44, P=0.62) or European (T vs. A: OR=0.96, 95%CI=0.86-1.08, P=0.54) population. Moreover, funnel plots and Egger regression testing showed no evidence of publication bias. CONCLUSIONS In summary, current evidence suggested that PDE4D SNP56 might not be associated with an increased susceptibility to IS. However, this conclusion needs further validation by well-designed studies with large sample sizes.

Delayed Administration of Tat-HA-NR2B9c Promotes Recovery After Stroke in Rats.

BACKGROUND AND PURPOSE: Previous studies reported that Tat-NR2B9c, a peptide disrupting the N-methyl-d-aspartate receptor-postsynaptic density protein-95 interaction, reduced ischemic damage in the acute phase after stroke. However, its effect in the subacute phase is unknown. The aim of this study is to determine whether disrupting the N-methyl-d-aspartate receptor-postsynaptic density protein-95 interaction in the subacute phase promotes recovery after stroke. METHODS: Studies were performed on Sprague-Dawley rats or nNOS(-/-) mice, and experimental ischemic stroke was induced by middle cerebral artery occlusion. Animals were treated with drugs starting at day 4 after ischemia. Sensorimotor functions and spatial learning and memory ability were assessed after drug treatment. Then, rats were euthanized for morphological observation and biochemical tests. RESULTS: Disrupting the N-methyl-d-aspartate receptor-postsynaptic density protein-95 interaction with Tat-HA-NR2B9c significantly ameliorated the ischemia-induced impairments of spatial memory and sensorimotor functions in rats during subacute stage but did not improve stroke outcome in nNOS(-/-) mice. Consistent with the functional recovery, Tat-HA-NR2B9c substantially increased neurogenesis in the dentate gyrus and dendritic spine density of mature neurons in the motor cortex of rats, meanwhile, reversed the ischemia-induced formation of S-nitrosylation-cyclin-dependent kinase 5 and increased cyclin-dependent kinase 5 activity in ipsilateral hippocampus. However, directly blocking N-methyl-d-aspartate receptors with MK-801 or Ro 25-6981 did not show the beneficial effects above. CONCLUSIONS: Dissociating N-methyl-d-aspartate receptor-postsynaptic density protein-95 coupling by Tat-HA-NR2B9c in the subacute phase after stroke promotes functional recovery, probably because of that it increases neurogenesis and dendritic spine density of mature neurons via regulating cyclin-dependent kinase 5 in the ischemic brain.

[Study on the relation between expression of angiotensin II receptor and apoptosis in myocardium in rats of endotoxemia].

OBJECTIVE: To analyze the expression of angiotensin II (ANG II) receptor and apoptosis in myocardium in rats of endotoxemia. METHODS: Model of endotoxemia was induced by intraperitoneal injection with lipopolysaccharide (LPS) 10 mg/kg in male Wistar rats and saline was injected into control group. The rats were killed at 2 h or 6 h after saline (control) or LPS . Expression of the correlation factors related to apoptosis of Bcl-2, Bax, AT1 and AT2 receptor in myocardial tissue were detected with immunohistochemistry (IHC), and changes of myocardial cells apoptosis was detected by the method of TUNEL. The gene expression of AT1 and AT2 receptor was examined by RT-PCR. The pathological changes of myocardial tissue were observed by electron microscope. RESULTS: Compared with control group , the expression of AT1 and AT2 receptor were significantly decreased, especially in 6 h group; and the expression of Bcl-2 and Bax were decreased, the ratio of Bcl-2/Bax had the downtrend as well as the apoptosis of myocardial cells. CONCLUSION: Interfered by LPS, the down regulation of AT1 and AT2 receptor expression has the negative relation with apoptosis of myocardial cells, this result indicated that down regulation of AT1 and AT2 receptor expression maybe related to cardiac functional impairment, which maybe help us to find a new protective path to prevent myocardial damage induced by systemic inflammatory.

[Impact of pre-procedural plasma brain natriuretic peptide level on atrial fibrillation recurrence post radiofrequency catheter ablation].

OBJECTIVE: Brain natriuretic peptide (BNP) levels are elevated in patients with atrial fibrillation (AF). The aim of this study is to investigate the relation between the pre-procedural BNP level and the incidence of recurrence AF after circumferential pulmonary vein ablation (CPVA). METHODS: Plasma BNP level was measured before CPVA in 69 consecutive symptomatic paroxysmal AF (PAF) patients without heart failure symptom. Atrial thrombus was detected by transesophageal echocardiography in 15 patients and CPVA was not performed in these patients. CPVA was successful in the remaining 54 patients and followed up for 3 months. All patients were asked to keep a log of the duration and frequency of their symptoms and underwent 24 h ECG monitoring at least once per month after the ablation. RESULTS: At the end of follow up, 39 patients were free of AF recurrence (successful group) and 15 patients experienced AF recurrence (failure group). BNP concentration was below the heart failure range (< 500 ng/L) in 69.6% patients, but exceeded the normal range (0 - 144 ng/L) in 59.4% patients. Median baseline BNP level was significantly higher in failure group than in successful group (371.6 ng/L vs. 97.4 ng/L, P = 0.001). Left atrial (LA) dimension was also larger in failure group than in successful group [(53.3 ± 15.1) mm vs. (45.2 ± 11.2) mm, P = 0.036]. Moreover, BNP level was positively correlated with LA dimension (r = 0.574, P < 0.01). CONCLUSION: The pre-procedural BNP level and LA dimension are predictive of successful CPVA for PAF patients.

Sinus node injury as a result of superior vena cava isolation during catheter ablation for atrial fibrillation and atrial flutter.

BACKGROUND: The ectopic foci originating from superior vena cava (SVC) may act as triggers in the occurrence and perpetuation of atrial fibrillation (AF). Unfortunately, the SVC isolation may result in potential dysfunction of sinus node. Furthermore, little is known about the occurrence of sinus node injury complicated by the SVC isolation. METHODS: Patients with AF or atypical atrial flutter experienced SVC isolation. The junctional rhythm or sinus arrest could be observed, if sinus node was injured. Atropin and dopamine administration ruled out the vagal irritation of sinus node, when junctional rhythm or sinus arrest occurred. RESULTS: One hundred and thirty-two patients who had no electrocardiogram signs of sinus node dysfunction before ablation experienced the SVC isolation. Six patients (three men, three women, mean age 62.5 ± 8.6 years) had sinus node injury (4.5%, 6/132): four patients had junctional rhythm and one male patient had junctional rhythm and sinus arrest simultaneously; another male patient required AAI mode permanent pacemaker implantation due to the persistent junctional rhythm after SVC isolation. The ablation sites of all six patients closed to the junction of right atrium and SVC during the ablation of anterolateral free wall of the SVC. CONCLUSION: Sinus node may be damaged due to the ablation sites closer to sinus node. The definition of the junction of right atrium and SVC is very important, the ablation sites of anterolateral free wall of the SVC should not be too close to the SVC orifice.

Ablation of right-sided accessory pathways with atrial insertion far from the tricuspid annulus using an electroanatomical mapping system.

BACKGROUND: It is difficult to ablate a right-sided accessory pathway (AP) with atrial insertion far from the tricuspid annulus (TA). We report our initial experience of ablating this rare AP by a 3-dimensional electroanatomical mapping system (CARTO). METHODS: From January of 2006 to April of 2008, 18 patients with right-sided APs who failed previous outside ablations were enrolled in this study. Retrograde AP conduction was mapped during pacing at the right ventricular apex by activation-mapping the right atrium (RA) using a 3-dimensional electroanatomical mapping system. AP atrial insertion was defined as the earliest retrograde atrial activations and successful ablation of the APs at this site. RESULTS: Among the 18 patients who had failed previous ablation, 10 patients (7 patients with right manifest APs and 3 patients with right conceal APs) had atrial insertions far from the TA. Of the 10 patients, the atrial insertions were found at the base of the RA appendage in 3 patients, at the high lateral RA in 5 patients, at the low lateral RA in other 2 patients. Ablation at the atrial insertions successfully abolished the AP conduction. The mean distance between the atrial insertion sites and the TA was 20.2 ± 2.7 mm. No patients reported recovered AP conduction or recurrent tachycardias after 6-month follow-up. CONCLUSIONS: The right-sided APs may have atrial insertion far from the TA. These uncommon variation of APs can be reliably identified and ablated using CARTO system.

[Efficacy and safety of erlotinib as monotherapy for advanced non-small cell lung cancer].

OBJECTIVE: To explore the efficacy and safety of erlotinib monotherapy for advanced non-small cell lung cancer (NSCLC). METHODS: Totally 50 patients with advanced NSCLC received oral erlotinib 150 mg/d treatment, and tumor specimen in 19 patients were collected for epidermal growth factor receptor (EGFR) gene mutation tests. Median survival (MS) was calculated using the Kaplan-Meier method. RESULTS: The most common adverse events (AEs) were skin rash (96%) and diarrhea (32%). The overall survival (OS) of all patients was 21.8 months 95% confidential interval (CI): 17.1-26.4 months and the median progression-free survival (PFS) of all patients was 7.0 months (95% CI: 3.9-10.1 months). EGFR mutation analysis showed gene mutation in 8 cases and wild type in 11 cases. The objective response rate in patients with or without EGFR gene mutations were 62.5% and 9.1%, respectively (chi(2)=6.631, P=0.036). PFS in patients with or without EGFR gene mutations were 16.330 (95% CI: 2.803-29.857 months) and 5.570 months (95% CI: 2.441-8.699 months), respectively (chi(2)=8.799, P=0.003). CONCLUSION: Erlotinib monotherapy is safe and effective for some Chinese NSCLC patients after failure of prior chemotherapy.