Case Report: A Rare Huge Giant Cell Tumor of the Proximal Tibia.. [DOI: 10.21203/rs.3.rs-606935/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0]

Background: Giant cell tumor of bone is a common primary borderline bone tumor, while giant cell tumor of bone in the extremities are generally not very large. Because most tumors have already been controlled by some treatments at the time of pain or finding the tumor. Huge giant cell tumors of bone in the limbs are very rare.Case presentation: We describe a case of a huge giant cell tumor of the proximal tibia with 6-year history and not receiving any treatment. It is not until the rupture and bleeding appeared that the patient is referred to the doctor, and amputation is the only treatment.Conclusions: This report suggests that although giant cell tumor of bone is a borderline tumor, early diagnosis and treatment are essential in order to improve patient prognosis.

Subcutaneous metastasis after three surgeries for brain metastasis from lung cancer: A case report and review of the literature

Lung cancer is a common malignancy that is frequently associated with distant subcutaneous metastasis. However, reports of subcutaneous metastasis of lung cancer after three surgeries for recurrent brain metastasis are scarce. The present study describes the case of a 49-year-old female patient who was admitted to our hospital with a cutaneous mass. The patient had a history of lung cancer and had undergone three surgeries for brain metastases. The subcutaneous mass was considered to be an implantation metastasis from the previous brain metastases. The cutaneous mass was grossly resected and histopathological examination revealed adenocarcinoma. This case highlights the need to perform a comprehensive analysis for suspected subcutaneous masses in lung cancer patients. Furthermore, pathological examination is crucial for accurate diagnosis and timely treatment.

Safety and efficacy of thoracic radiotherapy combined with chemo-immunotherapy in patients with extensive-stage small cell lung cancer: a multicenter retrospective analysis

Background

Immunotherapy has greatly increased the survival time of patients with extensive-stage small cell lung cancer (ES-SCLC), and is now a standard first-line treatment for these patients. Increasing evidence suggests a possible synergistic effect between immunotherapy and radiotherapy, yet there is a paucity of evidence regarding the efficacy and safety of thoracic radiotherapy (TRT) combined with chemo-immunotherapy for ES-SCLC.

Methods

The medical records of 78 consecutive patients with ES-SCLC who received TRT in combination with chemo-immunotherapy at Jinling Hospital and Jiangsu Cancer Hospital from January 2019 to January 2023 were retrospectively reviewed. The median overall survival (mOS) time and median progression-free survival (mPFS) time were used to evaluate efficacy, and the incidence of adverse events (AEs) was used to evaluate safety.

Results

The median follow-up time was 31.9 months, the objective response rate (ORR) was 59%, and the disease control rate (DCR) was 89.8%. The mOS time was 20.0 months, and the 6-month OS rate was 95%. The mPFS time was 9.2 months, and the 6-month PFS rate was 78%. There were no treatment-related deaths. The incidence of pneumonitis was 23.1%, the incidence of radiation esophagitis was 5.1%, and 2 patients experienced high-grade pneumonitis. Primary liver metastasis was a predictor of poor OS and PFS. Patients who received consolidative TRT after chemo-immunotherapy experienced more benefit than those who received TRT as palliative or salvage treatment for superior vena cava syndrome or disease progression.

Conclusions

TRT is a feasible treatment for patients who receive chemo-immunotherapy for the management of ES-SCLC in consideration of its considerable efficacy and tolerable safety risk. This treatment is especially useful for patients without primary liver metastasis and who receive consolidative TRT after chemo-immunotherapy. Large-scale prospective studies are needed to confirm the efficacy and safety of this treatment modality.

The mediating effect of family resilience between coping styles and caregiver burden in maintenance hemodialysis patients: a cross-sectional study

BACKGROUND

Primary caregivers of hemodialysis patients suffer from varying degrees of stress from their patients. Caring for hemodialysis patients can expose caregivers to many problems, leading to an increased burden of care and even impacting the quality of care. The purpose of our study was to examine whether family resilience could be a mediating variable moderating the relationship between patient coping styles and caregiver burden.

METHODS

The study was a cross-sectional and descriptive-analytical study that interviewed 173 pairs of hemodialysis patients and their caregivers at a blood purification center in a public hospital in China. The Brief Coping Styles Scale (Chinese version) was used to assess individuals' coping styles for disease and treatment. From the caregiver's perspective, the Family Resilience Assessment Scale (Chinese version) was used to understand the resilience of families, and the Zarit Caregiver Burden Scale was used to capture the caregiver's subjective experience of burden. Statistical analyses were conducted using SPSS version 23 and Amos version 26 to analyze the relationships between variables to examine for correlation and construct mediated effects models.

RESULTS

Coping styles showed a significant positive correlation with family resilience (r = 0.347, P < 0.01) and a negative correlation with caregiver burden (r = -0.379, P < 0.01). A significant negative correlation was found between family resilience and caregiver burden (r = -0.503, P < 0.01). In the mediation model, patient coping styles directly impacted caregiver burden significantly (95% CI [-0.372, -0.058]), and coping styles indirectly impacted caregiver burden by family resilience in a significant way (95% CI [-0.275, -0.098]).

CONCLUSIONS

Patient coping styles directly affect caregiver burden. Family resilience is a mediating variable between patients' coping styles and the burden on caregivers.

Identification of LDLR mutation in cerebral venous sinus thrombosis co-existing with dural arteriovenous fistulas: a case report

BACKGROUND

Cerebral venous sinus thrombosis (CVST) is typically associated with a prothrombotic state of the blood, with its causative factors varying widely. Prior research has not reported the simultaneous occurrence of CVST and dural arteriovenous fistulas (DAVFs) as potentially resulting from genetic mutations. In this case report, we introduce a unique occurrence wherein a patient with a heterozygous mutation of the low-density lipoprotein receptor (LDLR) gene presented with CVST in conjunction with DAVFs.

CASE

Presentation: A male patient, aged 51, sought treatment at our facility due to a consistent decline in cognitive functions accompanied by recurrent headaches. Comprehensive evaluations were administered, including neurological examinations, laboratory tests, magnetic resonance imaging, digital subtraction angiography, and whole exome sequencing. Digital subtraction angiography identified DAVFs in the patient's right sigmoid sinus and an occlusion within the left transverse sinus. The whole exome sequencing of blood samples pinpointed a heterozygous mutation in the LDLR gene (NM_000527:exon12:c.C1747T:p.H583Y). Following the confirmed diagnosis of CVST and DAVFs, the patient underwent anticoagulant therapy combined with endovascular procedures - these comprised embolization of the arteriovenous fistula in the right sigmoid sinus and balloon dilation with stent implantation in the left transverse sinus. A six-month follow-up indicated a significant abatement in the patient's symptoms.

CONCLUSIONS

This report marks the first documented case of an LDLR gene mutation that could be associated with the onset of CVST and DAVFs. The mutation in the LDLR gene might foster a prothrombotic environment, facilitating the gradual emergence of CVST and the subsequent genesis of DAVFs.

A comparative analysis of clinical characteristics in patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) between Wuhan and Zhoushan, China

BACKGROUND

We aimed to identify any differences in the clinical characteristics of patients treated in Zhoushan Hospital and Wuhan Fourth Hospital, Gutian campus to provide insights into measures to better control the coronavirus disease 2019 (COVID-19) pandemic and treat COVID-19 patients.

METHODS

All cases included in this retrospective study from January 10, 2020 to March 15, 2020 were confirmed by laboratory detection of SARS-CoV-2. Data of epidemiological characteristics, clinical characteristics, laboratory results, radiological findings, treatments, and outcomes were obtained from electronic medical records and compared between the patient groups.

RESULTS

A correlation analysis was performed to detect correlations between the serum C-reactive protein (CRP) level and other laboratory findings. COVID-19 patients treated in Wuhan more commonly had fever and shortness of breath, and less commonly had headache compared to those treated in Zhoushan (P=0.002, 0.039, and 0.015, respectively). The period from illness onset to hospitalization in Wuhan was 11.7±7.2 days, which was longer than that in Zhoushan (4.2±3.7 days; P=0.002), whereas the period from illness onset to shortness of breath in Wuhan was 5.4±5.0 days, which was shorter than that in Zhoushan (14.0±5.6 days; P=0.020). Computed tomography scans showed linear opacities, reticulation, and patchy shadows more commonly in cases treated in Wuhan (P=0.016, 0.013, and 0.008, respectively). The mean CRP level in Zhoushan patients was lower than that in Wuhan patients (P<0.001), and the CRP level was correlated with several laboratory findings related to the immune response.

CONCLUSIONS

COVID-19 patients treated at Wuhan Fourth Hospital, Gutian campus had more severe symptoms than those treated at Zhoushan Hospital. Earlier in-hospital treatment, as conducted in Zhoushan, may be beneficial in reducing the severity of illness in COVID-19 patients. Additionally, the correlations between the CRP level and indicators of immune function in COVID-19 patients warrant further investigation.

Exploring exosome data to identify prognostic gene signatures for lung adenocarcinoma

Background: Exosomes are involved in tumorigenesis, growth and metastasis. However, the prognostic value of exosome-related genes in lung adenocarcinoma (LUAD) remains unclear. Methods: Clinical and transcriptome data from The Cancer Genome Atlas LUAD cohort were used to construct a model based on exosome-related genes, which was validated with LUAD data from the Gene Expression Omnibus (GEO). Gene ontology and Kyoto Encyclopedia of Genes and Genomes analysis were used to explore underlying mechanisms; the single-sample gene set enrichment analysis score was used to determine immune functions. Results: A 19-exosome-related gene signature for overall survival in LUAD was predictive in both The Cancer Genome Atlas and GEO LUAD cohorts. Immune-related and extracellular matrix-related pathways were enriched in differentially expressed genes. Immune states differed between high- and low-risk groups. Conclusion: The novel signature can be used to predict outcomes in LUAD.

Antibiotic-induced microbiome depletion promotes intestinal colonization by Campylobacter jejuni in mice

BACKGROUND

To establish a method to induce Campylobacter jejuni colonization in the intestines of C57BL/6 mice through antibiotic-induced microbiome depletion.

RESULTS

Fifty-four female C57BL/6 mice were divided into the normal, control, and experimental groups. The experimental group was administered intragastric cefoperazone sodium and sulbactam sodium (50 mg/mL) for 2 days; then, the experimental and control mice were intragastrically administered 200 µL C. jejuni, which was repeated once more after 2 days. Animal feces were collected, and the HipO gene of C. jejuni was detected using TaqMan qPCR from day 1 to day 14 after modeling completion. Immunofluorescence was used to detect intestinal C. jejuni colonization on day 14, and pathological changes were observed using hematoxylin and eosin staining. Additionally, 16S rDNA analyses of the intestinal contents were conducted on day 14. In the experimental group, C. jejuni was detected in the feces from days 1 to 14 on TaqMan qPCR, and immunofluorescence-labeled C. jejuni were visibly discernable in the intestinal lumen. The intestinal mucosa was generally intact and showed no significant inflammatory-cell infiltration. Diversity analysis of the colonic microbiota showed significant inter-group differences. In the experimental group, the composition of the colonic microbiota differed from that in the other 2 groups at the phylum level, and was characterized by a higher proportion of Bacteroidetes and a lower proportion of Firmicutes.

CONCLUSIONS

Microbiome depletion induced by cefoperazone sodium and sulbactam sodium could promote long-term colonization of C. jejuni in the intestines of mice.

Exosome-transported circHDAC1_004 Promotes Proliferation, Migration, and Angiogenesis of Hepatocellular Carcinoma by the miR-361-3p/NACC1 Axis

Background and Aims

Hepatocellular carcinoma (HCC) is among the most common malignant tumors globally. Circular RNAs (circRNAs), as a type of noncoding RNAs, reportedly participate in various tumor biological processes. However, the role of circHDAC1_004 in HCC remains unclear. Thus, we aimed to explore the role and the underlying mechanisms of circHDAC1_004 in the development and progression of HCC.

Methods

Quantitative real-time polymerase chain reaction (qRT-PCR) was used to detect circHDAC1_004 expression (circ_0005339) in HCC. Sanger sequencing and agarose gel electrophoresis were used to determine the structure of circHDAC1_004. In vitro and in vivo experiments were used to determine the biological function of circHDAC1_004 in HCC. Herein, qRT-PCR, RNA immunoprecipitation, western blotting, and a luciferase reporter assay were used to explore the relationships among circHDAC1_004, miR-361-3p, and NACC1.

Results

circHDAC1_004 was upregulated in HCC and significantly associated with poor overall survival. circHDAC1_004 promoted HCC cell proliferation, stemness, migration, and invasion. In addition, circHDAC1_004 upregulated human umbilical vein endothelial cells (HUVECs) and promoted angiogenesis through exosomes. circHDAC1_004 promoted NACC1 expression and stimulated the epithelial-mesenchymal transition pathway by sponging miR-361-3p.

Conclusions

We found that circHDAC1_004 overexpression enhanced the proliferation, stemness, and metastasis of HCC via the miR-361-3p/NACC1 axis and promoted HCC angiogenesis through exosomes. Our findings may help develop a possible therapeutic strategy for HCC.

The current status of primipara's childbirth experience and its correlation with their reproductive intention: a cross-sectional survey study

BACKGROUND

The childbirth experience of primipara profoundly impacts her future physical and mental health, reproductive intention, and choice of childbirth mode. This study aimed to explore the current situation of primipara's childbirth experience, to analyze the factors influencing negative childbirth experience, and to explore the relationship between childbirth experience and reproductive intention.

METHODS

A cross-sectional survey of a convenience sample of 522 primipara 1-5 days postpartum was conducted at five hospitals in Guangdong Province (May to July 2024). Data were collected using the General Information Questionnaire, the Social Support Rating Scale, the Childbirth Readiness Scale, the Caring Behaviors Inventory Scale, the Wijma Delivery Experience Questionnaire, and the Questionnaire on Reproduction Intention of Primipara.

RESULTS

The mean score of fear of childbirth was 68.86 ± 17.68. A total of 137 respondents met the clinical criteria for fear of childbirth (≥ 85 points), indicating that 26.2% of primipara had a negative experience of childbirth. Binary logistic regression model showed that elderly primipara [odds ratio (OR) (95% confidence interval (CI)): 11.167 (2.737-45.559)], pregnancy comorbidities or maternal childbirth complications [OR (95%CI): 6.596 (3.046-14.287)], childbirth intervention [OR (95%CI): 6.168 (2.869-13.258)], and severe pain [OR (95%CI): 4.660 (2.197-9.882)] were risk factors for negative childbirth experience. Childbirth accompaniment [OR (95%CI): 0.081 (0.018-0.368)], high level of social support [OR (95%CI): 0.768 (0.704-0.839)], and high level of childbirth readiness [OR (95%CI): 0.878 (0.812-0.950)] protected against a negative birth experience. There was a negative correlation between the fear of childbirth score and reproduction intention scores.

CONCLUSIONS

Childbirth accompaniment and high levels of social support and childbirth readiness can reduce primipara's perception of negative childbirth experience. Negative childbirth experience can reduce reproduction intention.

ICAM1 and VCAM1 are associated with outcome in patients with sepsis: A systematic review and meta-analysis

Background

Endothelial cell dysfunction and microcirculatory disturbances play crucial roles in the pathogenesis of sepsis. This systematic review and meta-analysis explored the relationship of the plasma levels of the key endothelial proteins intercellular adhesion molecule 1 (ICAM1) and vascular cell adhesion molecule 1 (VCAM1) with clinical outcomes in patients with sepsis.

Methods

MEDLINE and EMBASE were searched through November 28, 2023. ICAM1 and VCAM1 levels and patient outcomes were evaluated. The primary outcome was the relationship of sepsis with ICAM1 or VCAM1. The secondary outcomes were the relationships of septic shock and multiple-organ dysfunction syndrome (MODS) with ICAM1 and VCAM1. Variables were compared using standardized mean differences (SMDs) with 95 % confidence intervals (CIs).

Results

Forty-one studies were included. ICAM1 (SMD = 1.12, 95 % CI = 0.67, 1.57; P < 0.00001) and VCAM1 (SMD = 0.65; 95 % CI = 0.17, 1.13; P = 0.008) were associated with sepsis. Similarly, both ICAM1 (SMD = 2.30; 95 % CI = 1.30, 3.31; P < 0.00001) and VCAM1 (SMD = 0.93; 95 % CI = 0.27, 1.59; P = 0.006) were associated with MODS. ICAM1 was associated with septic shock (SMD = 1.93; 95 % CI = 0.55, 3.30; P = 0.006), overall mortality (SMD = -1.18; 95 % CI = -1.76, -0.61; P < 0.0001), and sepsis-related mortality (SMD = -0.64; 95 % CI = -0.88, -0.39; P < 0.00001). VCAM1 was associated with overall mortality (SMD = -0.71; 95 % CI = -1.02, -0.40; P < 0.00001), sepsis-related mortality (SMD = -0.62; 95 % CI = -1.14, -0.10; P = 0.02), and MODS-related mortality (SMD = -0.55; 95 % CI = -0.89, -0.21; P = 0.002).

Conclusion

Elevated plasma ICAM1 and VCAM1 levels could increase the risks of sepsis, septic shock, MODS, and mortality.

Lumbar Fusion for Spondylolisthesis: A Bayesian Network Meta-analysis of Randomized Controlled Trials

STUDY DESIGN

This was a Bayesian network meta-analysis.

OBJECTIVE

We aimed to assess the comparative efficacies of the 5 most commonly used procedures for spondylolisthesis in a Bayesian network meta-analysis.

SUMMARY OF BACKGROUND

Lumbar fusion procedures are the backbone for the surgical treatment of spondylolisthesis. However, the current evidence has only considered head-to-head comparisons of different fusion procedures and failed to definitively favor one fusion procedure over another.

MATERIALS AND METHODS

A Bayesian random-effects model was used, and radiographic fusion and complications were assessed by risk ratio with a corresponding 95% credible interval; Oswestry Disability Index (ODI) scores were assessed by mean difference and 95% credible interval. Furthermore, with respect to each endpoint, ranking probabilities for each fusion procedure were evaluated using the value of the surface under the cumulative ranking curve.

RESULTS

In all, 12 studies were identified. Significant differences in associated complications were found between minimally invasive transforaminal lumbar interbody fusion (MTLIF) and each of the other 4 fusion procedures. Surface under the cumulative ranking curve results suggested that for the most effective radiographic fusion, open transforaminal lumbar interbody fusion (OTLIF) had the maximum probability of being successful (76.6%), followed by MTLIF (70.4%) and open posterior lumbar interbody fusion (OPLIF, 48.7%). In terms of ODI scores, OTLIF might be the best intervention (70.5%), followed by MTLIF (68.8%) and then OPLIF (44.0%). However, MTLIF is ranked the safest (99.8%) regarding associated complications, followed sequentially by OTLIF (57.1%) and posterolateral fusion (30.1%).

CONCLUSIONS

OTLIF for spondylolisthesis was found to be the more efficient procedure in terms of radiographic fusion and ODI scores. Importantly, MTLIF is most likely to have a lower associated complication rate compared with other fusion procedures.

Effects of Bifidobacterium and rosuvastatin on metabolic-associated fatty liver disease via the gut-liver axis

BACKGROUND/AIMS

Research has indicated that treatment with rosuvastatin can improve liver pathology in metabolic-associated fatty liver disease (MAFLD) patients and that treatment with Bifidobacterium can improve MAFLD. Therefore, the effects of Bifidobacterium, rosuvastatin, and their combination on related indices in a rat model of diet-induced MAFLD need to be investigated.

METHODS

Forty rats were divided into five groups: the normal diet group (N), high-fat diet (HFD) model group (M), HFD + probiotic group (P), HFD + statin group (S), and HFD + probiotic + statin group (P-S). To establish the MAFLD model, the rats in Groups M, P, S, and P-S were fed a HFD for 8 weeks. The treatments included saline in Group N and either Bifidobacterium, rosuvastatin, or their combination in Groups P, S, and P-S by intragastrical gavage. After 4 weeks of intervention, the rats were euthanized, and samples were harvested to analyze gastrointestinal motility and liver function, pathological changes, inflammatory cytokine production, and the expression of proteins in key signaling pathways.

RESULTS

HFD feeding significantly increased the body weight, liver index, and insulin resistance (IR) index of the rats, indicating that the MAFLD model was successfully induced. Bifidobacterium reduced the liver of MAFLD rats, while Bifidobacterium with Rosuvastatin decreased the liver index, IR index, and levels of aspartate aminotransferase and alanine aminotransferase in MAFLD rats. The MAFLD model showed altered expression of proteins in signaling pathways that regulate inflammation, increased production of inflammatory cytokines, an elevated MAFLD activity score (MAS), and pathological changes in the liver. The MAFLD model also showed reduced relative counts of intestinal neurons and enteric glial cells (EGCs), altered secretion of gastrointestinal hormones, and slowed gastrointestinal emptying. Bifidobacterium, rosuvastatin, or their combination inhibited these various changes. HFD feeding changed the rats' gut microbiota, and the tested treatments inhibited these changes. These results suggest that the gastrointestinal motility disorder and abnormal liver function in MAFLD rats may be related to a reduction in Escherichia-Shigella bacteria and an increase in Asticcacaulis bacteria in the gut microbiota and that the improvement in liver function induced by Bifidobacterium plus rosuvastatin may be related to increases in Sphingomonas and Odoribacter bacteria and a decrease in Turicibacter bacteria in the gut microbiota.

CONCLUSIONS

The combined use of Bifidobacterium and rosuvastatin could better regulate the gut microbiota of MAFLD model rats, promote gastrointestinal emptying, and improve liver pathology and function than single treatment with Bifidobacterium or rosuvastatin. This provides a better strategy for the treatment of MAFLD.

Little things with significant impact: miRNAs in hepatocellular carcinoma

Hepatocellular carcinoma (HCC) has developed into one of the most lethal, aggressive, and malignant cancers worldwide. Although HCC treatment has improved in recent years, the incidence and lethality of HCC continue to increase yearly. Therefore, an in-depth study of the pathogenesis of HCC and the search for more reliable therapeutic targets are crucial to improving the survival quality of HCC patients. Currently, miRNAs have become one of the hotspots in life science research, which are widely present in living organisms and are non-coding RNAs involved in regulating gene expression. MiRNAs exert their biological roles by suppressing the expression of downstream genes and are engaged in various HCC-related processes, including proliferation, apoptosis, invasion, and metastasis. In addition, the expression status of miRNAs is related to the drug resistance mechanism of HCC, which has important implications for the systemic treatment of HCC. This paper reviews the regulatory role of miRNAs in the pathogenesis of HCC and the clinical applications of miRNAs in HCC in recent years.

Extracellular Vesicles Act as Carriers for Cargo Delivery and Regulate Wnt Signaling in the Hepatocellular Carcinoma Tumor Microenvironment

As the primary type of liver cancer, hepatocellular carcinoma (HCC) causes a large number of deaths every year. Despite extensive research conducted on this disease, the prognosis of HCC remains unclear. Recently, research has largely focused on extracellular vesicles (EVs), and they have been found to participate in various ways in the development of various diseases, including HCC, such as by regulating cell signaling pathways. However, recent studies have reported the mechanisms underlying the regulation of Wnt signaling by EVs in HCC, primarily focusing on the regulation of the canonical pathways. This review summarizes the current literature on the regulation of Wnt signaling by EVs in HCC and their underlying mechanisms. In addition, we also present future research directions in this field. This will deepen the understanding of HCC and provide new ideas for its treatment.

Prevalence of preterm birth and risk factors associated with it at different gestational ages: A multicenter retrospective survey in China

OBJECTIVES

To investigate the prevalence of preterm birth (PTB) and the risk factors for different gestational age subgroups of preterm birth in China.

METHODS

We carried out a descriptive cross-sectional study encompassing all singleton live births (24⁺⁰ to 41⁺⁶ weeks) with completed data in 23 provinces in China from 2010 to 2017 during investigation period. We compared both the preterm group (24⁺⁰ to 36⁺⁶ weeks) and preterm subgroups (<32 weeks, 32⁺⁰ to 33⁺⁶ weeks, and 34⁺⁰ t0 36⁺⁶ weeks) with the term group (37⁺⁰ to 41⁺⁶ weeks). We collected information on maternal and fetal characteristics from medical records. Logistic regression was use.

RESULTS

The prevalence of PTB was 7.4% (15,833/215,254) in singleton births. After adjusting for maternal age, parity, and potential risk factors in univariate analysis, the high-risk factors for PTB at <32 weeks were placental abruption (aOR=41.52; 95% CI, 25.89-66.58), placenta previa (aOR=40.04; 95% CI, 32.00-50.09), chorioamnionitis (aOR=11.06; 95% CI, 8.738-14.02), and hypertension disorders in pregnancy (HDP) (aOR=3.564; 95% CI, 2.930-4.335). Intrahepatic cholestasis of pregnancy (ICP) was significantly associated with PTB at 34-36 weeks (aOR=5.763; 95% CI, 5.049-6.577), particularly with spontaneous PTB (aOR=10.04; 95% CI, 8.79-11.47). Gestational diabetes mellitus (GDM) was significantly associated with PTB at 34-36 weeks only (aOR=1.156; 95% CI, 1.054-1.267).

CONCLUSION

Placental abruption, placenta previa, chorioamnionitis, and HDP were more predictive of early PTB; GDM and ICP were more predictive of late PTB.

Utilizing press needle acupuncture to treat mild-to-moderate COVID-19: A single-blind, randomized controlled trial

BACKGROUND

In China, acupuncture has been employed as an adjunctive therapy for coronavirus disease 2019 (COVID-19). Press needle acupuncture is a special type of acupuncture that provides prolonged stimulation to acupuncture points and simultaneously reduces the pain associated with traditional acupuncture. This study assessed the effectiveness of integrating press needles alongside pharmacologic treatment in patients with mild-to-moderate COVID-19.

METHODS

Patients hospitalized with mild-to-moderate COVID-19 symptoms between December 2022 and January 2023 were included in the study. The enrolled patients were randomly assigned to receive pharmacologic treatment alone (control group) or both pharmacologic treatment and press needle acupuncture (intervention group). Patients were evaluated for clinical outcomes, including symptom scores, deterioration rates, fever durations, and nucleic acid test results. The patients' complete blood count and C-reactive protein levels were also analyzed using venous blood samples both before and after treatment.

RESULTS

Both groups exhibited a reduction in clinical symptom scores, but symptoms regressed faster in the intervention group. Nucleic acid test negativity was achieved faster in the intervention group than in the control group. The intervention group also had a lower deterioration rate. Furthermore, the increase in the lymphocyte count and decrease in C-reactive protein levels following treatment were more pronounced in the intervention group than in the control group.

CONCLUSION

This study suggests that utilizing press needle acupuncture as an adjunct to pharmacologic treatment can be effective in patients with mild-to-moderate COVID-19 symptoms.

A Circulating MicroRNA-375 for the Detection of Liver Cancer: A Meta-Analysis

Background: Liver cancer is one of the most frequently diagnosed malignant tumors, with an extremely high incidence rate. Diagnosis of liver cancer is difficult with the existing methods and improved biomarkers are urgently needed. A number of studies have established a link between abnormal miR-375 expression and liver cancer. Therefore, we conducted a systematic analysis to appraise whether miR-375 can be used as a screening tool for liver cancer detection. Methods: Through a systematic database search, studies investigating miR-375 expression in serum by the quantitative real-time reverse transcription-PCR (qRT-PCR) method were included in the study. A total of 1,100 participants (576 with liver cancer and 534 without liver cancer) were recruited. The efficacy of microRNA-375 in the detection of liver cancer was assessed by sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under curve (AUC). Results: The pooled sensitivity and specificity of miR-375 in the detection of liver cancer were 0.91 (95% confidence interval [CI]: 0.74-0.98) and 0.83 (95% CI: 0.67-0.92), respectively. Furthermore, the pooled PLR was 5.40 (95% CI: 2.58-11.31), NLR was 0.10 (95% CI: 0.03-0.36), DOR was 52.52 (95% CI: 10.02-275.42), and AUC was 0.93 (95% CI: 0.90-0.95), indicating that miR-375 is effective at detecting liver cancer. Conclusions: According to our meta-analysis, measuring serum miR-375 has high sensitivity and specificity, which will facilitate its clinical application in liver cancer monitoring.

Analysis of the potential association between ferroptosis and immune in hepatocellular carcinoma and their relationship with prognosis

Background

The development of targeted therapy and immunotherapy has enriched the treatment of hepatocellular carcinoma (HCC), however, have had poor or no reponse, or even no response. Previous research suggested that ferroptosis and tumor immune microenvironment (TIME) may have a fundamental impact on efficacy during HCC immunotherapy and targeted therapy. Therefore, there is a clinical need to develop a signature that categorizes HCC patients in order to make more accurate clinical decisions.

Methods

Clinical data and gene expression data of HCC patients were obtained from The Cancer Genome Atlas (TCGA) portal and International Cancer Genome Consortium (ICGC) portal. To identify ferroptosis-related immune-related genes (ferroptosis-related IRGs), Pearson correlation analysis was conducted. The ferroptosis-related IRGs prognostic signature (FIPS) was constructed using Univariate Cox and LASSO Cox algorithms. The predictive effectiveness of FIPS was evaluated using Receiver Operating Characteristic (ROC) curves and survivorship curve. The correlation ship between FIPS and TIME was evaluated using single-sample Gene Set Enrichment Analysis (ssGSEA) and CIBERSORT. The relationship between FIPS and immunotherapy responsiveness was evaluated using immunophenoscore. The expression level of 10 ferroptosis-related IRGs in normal liver tissues and HCC tissues was compared using immunohistochemistry. Finally, we established a nomogram (based on FIPS, TNM stage, and age) for clinical application.

Results

The FIPS was established with ten ferroptosis-related IRGs. The high-FIPS subgroup showed a poor clinical prognosis and an obviously higher proportion of HCC patients with advanced TNM stage, high WHO grade and high alpha fetoprotein(AFP) value. Analysis of TIME indicated that patients in the high-FIPS subgroup may be in immunosuppressed state. Meanwhile, we found that ferroptosis may be inhibited in the high-FIPS subgroup and this subgroup may be impervious to immunotherapy and sorafenib.

Conclusion

We constructed a novel potential prognostic signature for HCC patients that predicts overall survival, ferroptosis and immune status, sorafenib sensitivity, and immunotherapy responsiveness.

Detection of muscular system adverse reaction signals in sacubitril/valsartan treatment combined with statins

Objective

To detect muscular system adverse reaction signals of sacubitril/valsartan treatment combined with statins (atorvastatin, rosuvastatin, simvastatin) to provide a reference for clinical administration.

Methods

Multiplicative and additive models were used to mine the FDA's spontaneous reports database to detect signals of drug-drug interactions between sacubitril/valsartan and statins. SAS 9.4 software was used to conduct statistical tests for suspicious signals to determine whether the signals were statistically significant.

Results

A total of 8,883,870 adverse reaction reports were analyzed. The combinations "sacubitril/valsartan - simvastatin - musculoskeletal muscle pain" had statistically significant correlation signals in both models (P < 0.05). The combination "sacubitril/valsartan - atorvastatin - myopathy" and "sacubitril/valsartan-simvastatin - myopathy" had statistically significant correlation signal in the multiplicative model (P < 0.05).

Conclusion

Compared with a single drug, coadministration of sacubitril/valsartan with atorvastatin may increase safety risks to myopathy, with simvastatin may increase safety risks to the musculoskeletal pain and myopathy, which should be closely monitored in clinical practice.

Beneficial Effects of Traditional Chinese Medicine Fuzheng Huayu on the Occurrence of Hepatocellular Carcinoma in Patients with Compensated Chronic Hepatitis B Cirrhosis Receiving Entecavir: A Multicenter Retrospective Cohort Study

BACKGROUND AND AIMS

The application of antifibrotic drugs to treat patients with chronic liver diseases who are receiving antiviral therapies for hepatocellular carcinoma (HCC) has not been established. Here, we aimed to assess the impact of the Traditional Chinese Medicine Fuzheng Huayu (FZHY) on the occurrence of HCC in patients with hepatitis B virus-related compensated cirrhosis receiving the antiviral drug entecavir (ETV).

METHODS

A multicenter retrospective cohort study was performed. Compensated liver cirrhosis patients were divided into the ETV+FZHY group or the ETV group according to treatment. The cumulative incidence of HCC was analyzed using Kaplan-Meier and log-rank tests. Propensity score matching was used for confounding factors. Stratified analysis and Cox regression were used to determine the effects of FZHY on the occurrence of HCC and liver function decompensation.

RESULTS

Out of 910 chronic hepatitis B patients, 458 were in the ETV+FZHY group and 452 were in the ETV group. After propensity score matching, the 5-year cumulative incidence of HCC was 9.8% in the ETV+FZHY group and 21.8% in the ETV group (p<0.01). The adjusted hazard ratio for HCC was 0.216 (0.108, 0.432) when FZHY treatment was >36 months. Age, diabetes, alanine aminotransferase, γ-glutamyl transpeptidase, albumin, hepatitis B e-antigen, and fibrosis 4 score were associated with the occurrence of HCC. FZHY decreased the risk of HCC in patients aged >45 years with a hepatitis B virus DNA level of ≥2,000 IU/l.

CONCLUSION

Adjunctive FZHY treatment reduced HCC occurrence in patients with hepatitis B virus cirrhosis who were treated with ETV, possibly due to the antifibrotic properties of FZHY.