[Analysis of related factors on effects of uterine artery embolization in the treatment of dysmenorrhea of adenomyosis and the construction and validation of prediction model]

Objective: To investigate the related factors on effects of uterine artery embolization(UAE)in the treatment of dysmenorrhea in patients with adenomyosis, and to construct and validate the efficacy prediction model. Methods: A total of 127 cases of adenomyosis patients with symptoms of dysmenorrhea in Guangzhou No.1 People's Hospital and Nanfang Hospital of Southern Medical University from June 1999 to December 2009 were reviewed. The evaluation standard was to improve the degree of dysmenorrhea, the related factors of efficacy were analysed. Combined with artificial neural network theory, the effect prediction model was constructed, and the effectiveness of the model was evaluated using receiver operating characteristic(ROC)curve, and the effectiveness of the cut-off point was calculated. The model was validated by 68 cases of patients with adenomyosis in the Nanfang Hospital from January 2010 to November 2014. Results: (1)In 127 cases of dysmenorrhea patients, UAE treatment was effective in 98 cases, effective rate was 77.2%(98/127).(2)Age was an independent predictor of effective UAE treatment(HR= 1.129, P=0.026); in the range of this study, the greater the age, the higher the UAE treatment efficiency.(3)The developing situation of ovary branches of uterine artery was an independent predictor of effective UAE treatment(HR=0.460, P=0.020), the efficiency of patients whose intraoperative bilateral uterine artery ovarian branch did not develop was 89.7%(35/39), the efficiency of patients whose unilateral uterine artery ovarian branch was developing was 84.1%(37/44)and the efficiency of patients whose bilateral uterine artery ovarian branch were developing was 59.1%(26/44).(4)Blood supply of adenomyosisis was an independent predictor of effective UAE treatment(HR=0.313, P=0.001). Type Ⅰ(bilateral predominated)patients, efficiency was 93.5%(43/46); type Ⅱ(bilateral balanced)patients, efficiency was 78.0%(39/50); type Ⅲ(unilateral predominated)patients, efficiency was 51.6%(16/31).(5)UAE for the treatment of adenomyosis efficacy of artificial neural network prediction model was constructed, the model's area under the ROC curve was 0.808, the optimal cut-off point was 0.669 13. Actual verification of the model, sensitivity was 96.5%, specificity was 81.8%, positive predictive value was 96.5% and negative predictive value was 81.8%, the total accuracy was 94.1%. Conclusions: (1)Age, the developing situation of ovary branches and blood supply of adenomyosis are the independent predictors of effective UAE treatment.(2)The artificial neural network prediction model is satisfied with the accuracy and the accuracy of prediction.

Dysfunction of the WT1-MEG3 signaling promotes AML leukemogenesis via p53-dependent and -independent pathways

Long non-coding RNAs (lncRNAs) play a pivotal role in tumorigenesis, exemplified by the recent finding that lncRNA maternally expressed gene 3 (MEG3) inhibits tumor growth in a p53-dependent manner. Acute myeloid leukemia (AML) is the most common malignant myeloid disorder in adults, and TP53 mutations or loss are frequently detected in patients with therapy-related AML or AML with complex karyotype. Here, we reveal that MEG3 is significantly downregulated in AML and suppresses leukemogenesis not only in a p53-dependent, but also a p53-independent manner. In addition, MEG3 is proven to be transcriptionally activated by Wilms’ tumor 1 (WT1), dysregulation of which by epigenetic silencing or mutations is causally involved in AML. Therefore MEG3 is identified as a novel target of the WT1 molecule. Ten–eleven translocation-2 (TET2) mutations frequently occur in AML and significantly promote leukemogenesis of this disorder. In our study, TET2, acting as a cofactor of WT1, increases MEG3 expression. Taken together, our work demonstrates that TET2 dysregulated WT1-MEG3 axis significantly promotes AML leukemogenesis, paving a new avenue for diagnosis and treatment of AML patients.

Influence of dexmedetomidine to cognitive function during recovery period for children with general anesthesia

OBJECTIVE

We studied the influence of Dexmedetomidine on cognitive function in children during the recovery period of general anesthesia.

PATIENTS AND METHODS

Ninety-three children who underwent general anesthesia were selected and randomly divided into (1) the control group, (2) the dexmedetomidine group, and (3) the dezocine group. Fentanyl, propofol, and rocuronium were used in all patients to induce anesthesia, while sevoflurane inhalation and propofol were used to maintain anesthesia. In the control group, 20 ml NS were infused intravenously 10 min before anesthetic induction. In the dexmedetomidine group, 1.0 μg/kg dexmedetomidine in 20 ml was infused for 10 min. In the dezocine group, 0.1 mg/kg dezocine in 20 ml was infused for 10 min. Mean arterial blood pressure, average heart rate, and average oxygen saturation (SaO2) were compared at the following time points: end of surgery (T0), before extubation (T1), during extubation (T2), and 30 min after extubation (T3). The VAS scale, Ramsay sedation score, delirium grading scale and occurrence of adverse reactions at 30 min after extubation were recorded. The occurrence of postoperative cognitive dysfunction (POCD) and the expression of serum neuron-specific enolase (NSE) and IL-6 at postoperative days 1 and 7 were recorded.

RESULTS

Comparing mean arterial blood pressure, average heart rate, and average oxygen saturation (SaO2) at the different time points in the dexmedetomidine group, there were no statistically significant differences (p>0.05). The difference in the occurrence of adverse reactions in the different groups was statistically significant (p<0.05). The occurrence of postoperative cognitive dysfunction (POCD) at postoperative day 1 was significantly higher in the control group than the other two groups (p<0.05), and on the postoperative day 7th, the differences were not statistically significant (p>0.05). Regarding the expression of neuron-specific enolase (NSE) and IL-6, the levels were the highest in the control group, followed by the dezocine group (p<0.05).

CONCLUSIONS

The dexmedetomidine is safer than dezocine in aspects of hemodynamics, sedation, analgesia, degree of delirium, occurrence of adverse reactions, and postoperative cognitive dysfunction (POCD). The improvement in the occurrence of postoperative cognitive dysfunction (POCD) is related to the levels of serum neuron-specific enolase (NSE) and IL-6.

Protective effects of fraction 4a of polysaccharides isolated from Lycium barbarum against KBrO3-induced renal damage in rats

LBP-4a exhibits protective effects on KBrO₃-induced renal damage, and the mechanism correlates with the increase of oxidation resistance in renal cells.

An instrument for measuring scintillators efficiently based on silicon photomultipliers

An instrument used for measuring multiple scintillators' light output and energy resolution was developed. The instrument consisted of a light sensor array which was composed of 64 discrete SiPMs (Silicon Photomultipliers), a corresponding individual channel readout electronics system, and a data processing algorithm. A Teflon grid and a large interval between adjacent SiPMs were employed to eliminate the optical cross talk among scintillators. The scintillators' light output was obtained by comparing with a reference sample with known light output. Given the SiPM temperature dependency and the difference among each SiPM, a temperature offset correction algorithm and a non-uniformity correction algorithm were added to the instrument. A positioning algorithm, based on nine points, was designed to evaluate the performance of a scintillator array. Tests were performed to evaluate the instrument's performance. The uniformity of 64 channels for light output measurement was better than 98%, the stability was better than 98% when temperature varied from 15 °C to 40 °C, and the nonlinearity under 511 keV was better than 2%. This instrument was capable of selecting scintillators and evaluating the packaging technology of scintillator arrays with high efficiency and accuracy.

Identifying the role of PTPN12 expression in predicting the efficacy of capecitabine to neoadjuvant chemotherapy in breast cancer treatment

OBJECTIVE

The aim of this study was to investigate the expression of PTPN12 in human breast cancer and its role in predicting the efficacy of neoadjuvant chemotherapy (NACT) for breast cancer.

PATIENTS AND METHODS

The PTPN12 expression levels were assessed by immunohistochemical staining in 114 breast cancer patients. The correlation of PTPN12 with clinicopathological features was also analyzed. Multivariate logistic regression was used to explore the effect of PTPN12 expression in predicting clinical response.

RESULTS

We observed a significant association of PTPN12 expression with cTNM classification. The overall pathological complete response (pCR) rate was 23.2 % in high PTPN12 expression group, whereas it was 5.2% in low PTPN12 expression group. The multivariate regression analyses further indicated that clinical response correlated with PTPN12 expression level and cycles of NACT, and CEX regimen was associated with the overall pathological complete response. In addition, Spearman rank correlation analyses suggested that higher PTPN12 expression indicated better clinical response in breast cancer patients. Furthermore, PTPN12 expression statistically related with pathological response in TNBC and Luminal B subtypes, as assessed by Pearson Chi-square test or Fisher's exact test.

CONCLUSIONS

Our study informed that cTNM classification is an independent risk factor for PTPN12 expression and PTPN12 is an independent predictor to clinical remission.

ESMO consensus guidelines for the management of patients with metastatic colorectal cancer

Colorectal cancer (CRC) is one of the most common malignancies in Western countries. Over the last 20 years, and the last decade in particular, the clinical outcome for patients with metastatic CRC (mCRC) has improved greatly due not only to an increase in the number of patients being referred for and undergoing surgical resection of their localised metastatic disease but also to a more strategic approach to the delivery of systemic therapy and an expansion in the use of ablative techniques. This reflects the increase in the number of patients that are being managed within a multidisciplinary team environment and specialist cancer centres, and the emergence over the same time period not only of improved imaging techniques but also prognostic and predictive molecular markers. Treatment decisions for patients with mCRC must be evidence-based. Thus, these ESMO consensus guidelines have been developed based on the current available evidence to provide a series of evidence-based recommendations to assist in the treatment and management of patients with mCRC in this rapidly evolving treatment setting.

[Some suggestions on improving the capacity of offshore trauma treatment in China]

With the development of national marine strategy, the importance of developing marine medicine and marine medical support capability has been highly regarded. In this paper, the problems regarding improvement on medical support for offshore trauma are discussed. Based on the analysis of the influence of environmental factors on offshore trauma treatment, and positive experience of trauma care practiced in the United States civilian ships and navy, we analyze the problems involving risk control for offshore trauma, establishment of standardized treatment and personnel training project, improvement of mobile rescue forces, and research for rescue technique and equipment, with the purpose to propose some effective and practical suggestions.

The prognostic nutritional index is a predictive indicator of prognosis and postoperative complications in gastric cancer: A meta-analysis

BACKGROUND

The clinical value of the prognostic nutritional index (PNI) in gastric cancer (GC) remains controversial. Therefore, we performed the meta-analysis to determine the prognostic and clinicopathological values of PNI in patients with GC.

METHODS

A literature search was performed in the PubMed, Embase, and Web of Science databases. Hazard ratios (HRs) and odds ratios (ORs) were extracted to estimate the association of PNI with survival and clinicopathological characteristics, respectively.

RESULTS

Ten studies involving 3396 patients with GC were analyzed. The pooled results indicated that a low PNI was a significant predictor of poor overall survival (OS) (HR = 1.89, 95% confidence interval [CI] = 1.67-2.13, P < 0.01) and postoperative complications (OR = 1.74, 95% CI = 1.41-2.16, P < 0.01). In the subgroup analysis, a low PNI was significantly associated with poor OS in patients with GC at stage I, II and III, but not at stage IV (HR = 1.14, 95% CI = 0.84-1.55, P = 0.40). Moreover, a low PNI was significantly associated with more advanced tumor features, such as older age, deeper depth of tumor, positive lymph node metastasis, more advanced TNM stages, and positive vessel and lymphatic invasion.

CONCLUSION

PNI was a predictive indicator of survival and postoperative complications, and was associated with clinicopathological features in GC patients. However, a low PNI was not significantly associated with poor OS in patients with GC at stage IV.

Enhanced antitumor effect of combining TRAIL and MnSOD mediated by CEA-controlled oncolytic adenovirus in lung cancer

Lung cancer, especially adenocarcinoma, is one of the leading causes of death in the world. Carcinoembryonic antigen (CEA), a superb non-small-cell lung cancer marker candidate, showed a beneficial effect in cancer therapy with oncolytic adenovirus in recent studies. Cancer-targeting dual gene-virotherapy delivers two therapeutic genes, linked by a connexon, in the replication-deficient vector instead of one gene so that they can work in common. In this study, we constructed a tumor-specific oncolytic adenovirus, CD55-TRAIL-IETD-MnSOD. The virus has the fusion protein complementary DNAs for tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) and for manganese superoxide dismutase (MnSOD) complementary DNA linked through a 4-amino acid caspase-8 cleavage site (IETD), and uses a CEA promoter to control virus E1A express. This is the first work to use a CEA promoter-regulated oncolytic adenovirus carrying two therapeutic genes for cancer research. Its targeting and anticancer capacity was evaluated by in vitro and in vivo experiments. The results indicated that CD55-TRAIL-IETD-MnSOD caused more cell apoptosis than CD55-TRAIL or CD55-MnSOD alone, or their combination in vitro, with low cytotoxicity of normal cells. In the A549 tumor xenograft model in nude mice, data showed that CD55-TRAIL-IETD-MnSOD could effectively suppress tumor growth than single gene groups, with no histological damage in liver, spleen or kidney tissues. Thus, the CEA-regulated dual-gene oncolytic virus CD55-TRAIL-IETD-MnSOD may be a novel potential therapy for lung cancer.

Dietary Features and Blood Pressure among 18-88-Year-Old Residents in an Island Population in China

OBJECTIVES

Dietary recommendations to reduce blood pressure (BP) have been widely disseminated and residents who live on islands have unique dietary characteristics. Here, we identified associations between dietary intake and BP levels among island residents in China.

DESIGN

Cross-sectional study.

SETTING

The Changhai islands, which is an important island county in China.

PARTICIPANTS

A total of 876 residents, 18-88 years old, of Changhai county.

MEASUREMENTS

Dietary intake and BP measurements were assessed using standardized questionnaires and protocols, respectively. Dietary intake was compared across BP categories and linear regression analyses were performed between dietary intake and systolic blood pressure (SBP) and diastolic blood pressure (DBP).

RESULTS

Participants previously diagnosed with hypertension consumed less salt than those with undiagnosed high BP (p < 0.01). After exclusion of participants previously diagnosed with hypertension, salt and meat consumption were positively and linearly associated with both SBP (p < 0.01 and < 0.001, respectively) and DBP (p = 0.03 and < 0.01, respectively), whereas consumption of marine products was inversely associated with SBP (p = 0.047). Mixed edible oil and edible oil consumption were associated with SBP (p < 0.01) and DBP (p = 0.021), respectively. In the multiple linear regression model, meat intake was positively associated with both SBP and DBP (β = 0.139, p < 0.001; β = 0.066, p = 0.047, respectively), whereas consumption of marine products was inversely associated with SBP (β = -0.102, p <0.001), while mixed edible oil was associated with SBP (β = 0.062, p = 0.03).

CONCLUSION

Adherence to nutritional recommendations can be improved among hypertensive patients, even those aware of their conditions. In the general island population, eating habits regarding salt, meat, edible oil consumption, and use of mixed edible oil increased the risk of hypertension onset, whereas marine products were found to decrease this risk.

[The differentiation and vicissitude of variety of Aucklandiae Radix]

Aucklandiae Radix is a commonly used Chinese herbal medicine. Historically, the varieties of Aucklandiae Radix for its medicinal use are complicated. Early Radix Aucklandiae was produced domestically, and it began to be imported since the Northern and Southern Dynasties. The two families, four genera, including Saussure Aucklandiae Radix of Compositae, Inula Inulae Radix, Vladimiria Vladimiriae Radix, dali Aucklandiae Radix and Aristolochiaceae Aristolochic aristolochia debilis, are all applied for medicinal purposes. In modern time, there are 3 major classes of crude drugs of Aucklandiae Radix, namely, Aucklandiae Radix, Inulae Radix, root of common Vladimiriae Radix.