The clinical effect of ossotide for injection in the treatment of condylar fracture.

OBJECTIVES: Patients with condylar fractures were treated with osteopeptide injections as an adjuvant therapy to assess pain control and changes in interleukin-1ß (IL-1ß) and bone G-gla protein (BGP) levels. MATERIALS AND METHODS: Eighty-two patients with a condylar neck fracture were randomly assigned to two groups. The control group received conventional surgical treatment, while the experimental group received osteopeptide injections in addition to surgery. Pain level, IL-1ß, and BGP levels were evaluated at 1, 2, and 4 weeks postsurgery. RESULTS: One and two weeks postsurgery, the experimental group had lower Numeric Rating Scale scores compared to the control group. In addition, the IL-1ß level in patients receiving osteopeptide injections was lower than the control group at all three evaluation points (1, 2, and 4 weeks postsurgery) and the BGP level was higher with statistically significant differences (P < 0.05). CONCLUSIONS: The administration of osteopeptide injections as an adjuvant therapy for patients with condylar fractures can effectively reduce pain and facilitate faster initiation of muscle function training. In addition, the reduction of inflammatory factors and promotion of active osteogenesis leads to quicker wound healing.

Anti-phospholipase A2 receptor antibody levels at diagnosis predicts outcome of TAC-based treatment for idiopathic membranous nephropathy patients.

BACKGROUND: Idiopathic membranous nephropathy (iMN) is recognized as an organ-specific autoimmune disease, mainly caused by anti-PLA2R antibody. This study aimed to study between anti-PLA2R antibody level at diagnosis and the response to tacrolimus (TAC)-based treatment in iMN patients. METHODS: This was a retrospective cohort study including 94 kidney biopsy-proven MN patients with positive anti-PLA2R antibody at diagnosis from May 2017 to September 2021 in our center. All iMN patients received the TAC regimen as the initial immunosuppressive therapy. All patients were divided into two groups according to anti-PLA2R antibody titer at diagnosis: high-level group (> 150 RU/ml; n = 42) and low-level group (≤ 150 RU/ml; n = 52). The association between anti-PLA2R antibody levels and clinical outcomes was assessed using the Kaplan-Meier method. RESULTS: The low density lipoprotein in the high-level group was significantly higher than low-level group at diagnosis, otherwise, serum albumin was significantly lower than low-level group; however, there was no significant difference in creatinine levels between two groups. The remission rates were significantly higher in the low-level group than high-level group after treatment with TAC for 12, 18, or 24 months (all P < 0.05). After 12 months of treatment with TAC, 82.7% of the patients in the low-level group achieved complete remission (CR) or partial remission (PR) (mean, 6.52 ± 0.53 months). However, 38.1% of the patients in high-level group achieved CR or PR (mean, 9.86 ± 0.51 months). Moreover, CR rate at 12 months in the high-level group was only 4.7% (mean, 11.88 ± 0.63 months). The infection frequency in the high-level group (35.6%) was higher than the low-level group (20%) during the TAC treatment, although there was no significant difference (P = 0.065). There were 19% patients who had end-stage kidney disease (ESKD), and 7.1% of patients died of ESKD in the high-level group during the follow-up period. CONCLUSION: Anti-PLA2R antibody level above 150 RU/ml at diagnosis can predict a poor treatment response and outcome of TAC treatment in iMN patients, who may not benefit from TAC or other calcineurin inhibitor regimens as the initial treatment.

The prognostic value of lncRNA AGAP2-AS1 in cancer patients: A meta-analysis.

BACKGROUND: ArfGAP with GTPase domain, Ankyrin repeat and PH domain 2 Antisense 1 (AGAP2-AS1) is a promising long noncoding RNA that may possess prognostic value for different types of tumors. The objective of this meta-analysis is to evaluate the prognostic value of long noncoding RNA AGAP2-AS1 in cancer patients. METHODS: A systematic literature search of the PubMed, Cochrane Library, EMBASE, Medline, Web of Science, CNKI, Weipu, and Wanfang electronic databases were carried out in this meta-analysis. Synthetic hazard ratios (HRs) or odd ratios (ORs) with 95% confidence intervals (CIs) were obtained to determine the prognostic and clinicopathological significance of AGAP2-AS1 expression in tumors. RESULTS: The final meta-analysis included 10 studies that contained 948 patients. The pooled results provided evidence that AGAP2-AS1 overexpression predicted reduced overall survival (OS) (HR = 1.77, 95% CI: 1.49-2.09, P < .00001), disease-free survival (HR = 1.84, 95% CI: 1.40-2.41, P < .0001), and progression-free survival (HR = 1.84, 95% CI: 1.01-3.33, P = .04) and for various cancers. Additionally, the AGAP2-AS1 overexpression was concerned with lymph node metastasis (positive vs negative, OR = 2.95, 95% CI: 1.96-4.45, P < .00001), advanced tumor node metastasis stage (III/IV vs I/II, OR = 3.73, 95% CI: 2.71-5.13, P < .00001), and tumor size (larger vs smaller, OR = 2.28, 95% CI: 1.24-4.18, P = .008). Besides, data from gene expression profiling interactive analysis dataset verified the results in our meta-analysis. The results showed that the expression level of AGAP2-AS1 was higher in most tumor tissues than in the corresponding normal tissues and was linked to poor OS and disease-free survival. CONCLUSIONS: Our results indicated that AGAP2-AS1 overexpression was closely correlated with shorter OS in multiple cancer types, suggesting that AGAP2-AS1 might function as a promising predictor for clinical outcomes in cancer.

Intravenous immunoglobulin in the therapy of adult acute fulminant myocarditis: A retrospective study.

Acute fulminant myocarditis (AFM) is a serious heart disease with limited treatment. This observational retrospective study aimed to investigate whether intravenous immunoglobulin (IVIG) was able to improve left ventricular function and reduce the episodes of arrhythmia in adult patients with AFM. The medical records of all patients with AFM who were admitted to the Critical Care Unit of Guangdong General Hospital (Guangzhou, China) between January 2001 and December 2010 were reviewed. A cohort of 58 patients was included in the study. Of these 58, 32 patients were treated with IVIG (400 mg/kg per day) for five days, while the remaining patients did not receive IVIG therapy. The patients who received IVIG therapy had a higher left ventricular ejection fraction (LVEF) and a reduced left ventricular end-diastolic diameter (LVDD) compared with the non-IVIG therapy patients four weeks subsequent to the treatment (PLVEF=0.011 and PLVDD=0.048). The post-treatment incidence of ventricular tachycardia/ventricular fibrillation (VT/VF) and atrioventricular block (AVB) was reduced in the patients who received IVIG therapy compared with the baseline values (PVT/VF=0.025, PAVB=0.003); however, no significant differences were observed in the non-IVIG therapy patients (PVT/VF=0.564, PAVB=0.083) following treatment. There were two mortalities in the IVIG therapy group and seven in the non-IVIG therapy group (P=0.072). This retrospective study suggested that the use of IVIG for the treatment of AFM may be associated with improved left ventricular function and reduced episodes of fulminant arrhythmias.

Combined use of hydration and alprostadil for preventing contrast-induced nephropathy following percutaneous coronary intervention in elderly patients.

Contrast-induced nephropathy (CIN) is a complex syndrome of acute kidney injury that follows exposure to intravascular contrast media. Although a series of preventive measures have been developed, CIN remains a major challenge encountered in elderly patients by interventional cardiologists. No data are currently available concerning the potential effects of the combined use of hydration and alprostadil in the prevention of CIN following percutaneous coronary intervention (PCI) in elderly patients. Therefore, the aim of the present study was to investigate the ability of a combination of hydration and alprostadil to prevent CIN following PCI in elderly patients. From June 1, 2010 to January 31, 2012, 85 elderly patients undergoing PCI were included in the present study. The included patients were randomly allocated into three groups: the control (22 cases), hydration (28 cases) and hydration + alprostadil (35 cases) group. Serum creatinine (SCr) levels were measured prior to PCI and then daily for 3 days following PCI. Creatinine clearance (Ccr) was also calculated. Following investigation of the incidence of CIN, a significant decline in Ccr was observed in the control group but not in the hydration + alprostadil group after PCI. The reduction in the level of Ccr from baseline in the hydration + alprostadil group was the smallest among the three groups. Moreover, the highest incidence of CIN was in the control group (6 cases, 27.27%), followed by the hydration group (3 cases, 10.71%) and the hydration + alprostadil group (1 case, 2.86%). Therefore, the combined use of hydration and alprostadil significantly reduces the incidence of CIN in elderly patients undergoing PCI. Hydration and alprostadil are suggested to act synergistically to protect renal function. In conclusion, the combined use of hydration and alprostadil is more effective in the prevention of CIN in elderly patients undergoing PCI compared with hydration alone.

Takotsubo cardiomyopathy in a 90-year-old Chinese man.

A 90-year-old Chinese man was transferred to the Emergency Department of the Affiliated Shantou Hospital of Sun Yat-sen University for treatment of an acute myocardial infarction. He suffered chest pain with three days of cough, dyspnea and fever. A diagnosis of Takotsubo cardiomyopathy was made in normal coronary arteries from urgent coronary angiography and characteristic apical dyskinesis and basal hyper contractility in left ventriculography. The patient died from severe multi-organ failure on the second day of hospitalization.

Contrast-induced nephropathy in postmenopausal women undergoing percutaneous coronary intervention for acute myocardial infarction.

Contrast-induced nephropathy (CIN) is a complex syndrome of acute kidney injury induced by exposure to intravascular contrast media. CIN occurs frequently in patients undergoing urgent percutaneous coronary intervention (PCI) and is associated with poor outcomes, making it a major challenge faced by interventional cardiologists. It has been suggested that female sex is a risk factor for development of CIN following PCI. However, no data exist in the literature concerning the risks of postmenopausal women with acute myocardial infarction (AMI) developing CIN after undergoing urgent PCI. To explore the incidence, risk factors and in-hospital outcomes of CIN in this special population, we analyzed 69 postmenopausal women with AMI treated with urgent PCI. CIN was defined as a relative increase of >25% or an absolute increase of >or=0.5 mg/dL in serum creatinine concentration from the baseline value 72 h after exposure to contrast medium. We found 1) the incidence of CIN was 37.68%; 2) patients with CIN had worse in-hospital outcomes, including longer hospital stay and more in-hospital adverse events; and 3) in multivariate logistic analysis, independent risk factors for CIN included a longer menopausal duration and the implantation of an intra-aortic balloon pump (an indirect indicator of hemodynamic instability). These results indicate that CIN is a frequent complication associated with worse in-hospital outcomes in postmenopausal women with AMI who are undergoing urgent PCI, particularly those with longer menopausal duration and hemodynamic instability. It is therefore necessary to pay more attention to preventive strategies for renal protection in this special population.

[Correlation between pressure-derived coronary collateral flow and Rentrop grade after primary percutaneous intervention of acute myocardial infarction].

OBJECTIVE: To analyze the correlation between pressure-derived collateral coronary flow (PDCF) and Rentrop grade of patients with acute myocardial infarction (AMI). METHODS: PDCF, determined by the ratio of P(w)/P(a), was measured in 29 patients with AMI of the first onset who received primary percutaneous coronary intervention (PCI) within 12 h after the onset. Sufficient collateral flow (group A, n=19) was defined as PDCF>0.24 and insufficient collateral flow (group B, n=10) as PDCF< or =0.24. Rentrop grade of the collateral flow was evaluated by coronary angiography. Echocardiography was performed on the 3rd and 30th day after PCI. The left ventricular ejection fraction, end-systolic and end-diastolic volumes, and the related indexes were obtained. RESULT: Rentrop grade was significantly related to PDCF (r=0.75, P<0.01), but a wide range of PDCF was observed in patients with Rentrop grade< or =1. CONCLUSION: PDCF measurement allows quantitative evaluation of the collateral flow in patients with AMI.