Quercetin for myocardial ischemia reperfusion injury: A protocol for systematic review and meta-analysis

BACKGROUND

At present, there is no effective therapy for preventing myocardial ischemia reperfusion injury (MIRI), and it is inevitable. The methods how to effectively decrease MIRI have attracted the attention of medical researches in recent years. Quercetin is a part of natural flavonoids in plant polyphenols. Many studies have found that quercetin has a positive effect on MIRI.

METHODS

In order to clarify the effectiveness and potential mechanisms of quercetin for MIRI animals, we searched for animal studies of quercetin for MIRI in Wanfang data Information, Chinese National Knowledge Infrastructure, VIP information database, China Biology Medicine disc, EMBASE, PubMed, and Web of Science. Participant intervention comparator outcomes of this study are as flowing: P, rats in MIRI; I, received quercetin treatment merely; C, received only vehicle or no treatment; O, Main outcomes are myocardial infarction size and markers of myocardial injury. Additional outcomes are serum indices or protein levels tied to the mechanisms of quercetin in myocardial l/R injury. Review Manager 5.2 software and Stata14.0 will be used for data analysis. SYRCLE's risk of bias tool will be used for risk of bias analysis of animal studies.

DISCUSSION

This preclinical systematic review and meta-analysis will evaluate the effects and mechanisms of quercetin for MIRI animals, and provide more evidence-based guidance for transforming basic research into clinical treatment.

TRIAL REGISTRATION

INPLASY202050067, registered on 16/5/2020.

A comprehensive evaluation of association between homocysteine levels and single nucleotide polymorphisms with hypertension risk: A protocol of systematic review and network meta-analysis

BACKGROUND

According to the relevant reports that single nucleotide polymorphisms (SNPs) may contribute to change of homocysteine (HCY) levels and increase the risk of hypertension (HTN). During the inconsistent results, this meta-analysis purpose is systematically review and synthesized relevant data on HCY levels and SNPs in HTN.

METHODS

The systematic search database, from the following database to find out the association studies of SNPs and HTN publications up until March 2020 from the databases of PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), the Chinese Science and Technology Periodical Database (VIP) and Wan fang databases, and Chinese Biomedical Literature Database (CBM). Network meta-analysis and Thakkinstian's algorithm were used to select the most appropriate genetic model, along with false positive report probability (FPRP) for noteworthy associations. All statistical analyses were calculated with STATA software (version 14.0; StataCorp, College Station, TX).

RESULTS

This meta-analysis will provide high-quality evidence to the effects of SNP on HTN and levels of HCY, and find between SNPs and HTN susceptibility on in all the genetic models, and choose the best one.

CONCLUSIONS

This meta-analysis will research which SNP is the most correlated with HTN risk.

REGISTRATION

INPLASY202050002.

Testing for causality between systematically identified risk factors and glioma: a Mendelian randomization study

BACKGROUND

Whilst epidemiological studies have provided evidence of associations between certain risk factors and glioma onset, inferring causality has proven challenging. Using Mendelian randomization (MR), we assessed whether associations of 36 reported glioma risk factors showed evidence of a causal relationship.

METHODS

We performed a systematic search of MEDLINE from inception to October 2018 to identify candidate risk factors and conducted a meta-analysis of two glioma genome-wide association studies (5739 cases and 5501 controls) to form our exposure and outcome datasets. MR analyses were performed using genetic variants to proxy for candidate risk factors. We investigated whether risk factors differed by subtype diagnosis (either glioblastoma (n = 3112) or non-glioblastoma (n = 2411)). MR estimates for each risk factor were determined using multiplicative random effects inverse-variance weighting (IVW). Sensitivity analyses investigated potential pleiotropy using MR-Egger regression, the weighted median estimator, and the mode-based estimator. To increase power, trait-specific polygenic risk scores were used to test the association of a genetically predicated increase in each risk factor with glioma onset.

RESULTS

Our systematic search identified 36 risk factors that could be proxied using genetic variants. Using MR, we found evidence that four genetically predicted traits increased risk of glioma, glioblastoma or non-glioblastoma: longer leukocyte telomere length, liability to allergic disease, increased alcohol consumption and liability to childhood extreme obesity (> 3 standard deviations from the mean). Two traits decreased risk of non-glioblastoma cancers: increased low-density lipoprotein cholesterol (LDLc) and triglyceride levels. Our findings were similar across sensitivity analyses that made allowance for pleiotropy (genetic confounding).

CONCLUSIONS

Our comprehensive investigation provides evidence of a causal link between both genetically predicted leukocyte telomere length, allergic disease, alcohol consumption, childhood extreme obesity, and LDLc and triglyceride levels, and glioma. The findings from our study warrant further research to uncover mechanisms that implicate these traits in glioma onset.

[Efficacy of minimally invasive pulmonary surfactant administration in preterm infants with neonatal respiratory distress syndrome: a multicenter clinical trial]

Objective: To explore the feasibility and safety of minimally invasive surfactant administration (MISA) in preterm neonates with respiratory distress syndrome (NRDS). Methods: In this multicenter prospective randomized controlled trial, 92 preterm infants with gestation age ≤30 weeks and diagnosed with NRDS were enrolled in 8 level Ⅲ neonatal intensive care units (NICU) in Beijing-Tianjin-Hebei Region from 1(st) July 2017 to 31(st) December 2018. They were randomly assigned to minimally invasive surfactant administration (MISA) group or endotracheal intubation surfactant administration (EISA) group according to random number generated by computer. Infants in both groups received calf pulmonary surfactant preparation at a dose of 70-100 mg/kg. The data of demography, perinatal situation, medication administration, complications, clinical outcomes in the two groups were compared with Chi-square test, Student's t-test, Mann-Whitney U test or Fisher's exact test. Results: Among the 92 preterm infants, 53 were males, 39 were females; 47 were in the MISA group (25 males), and 45 were in the EISA group (28 males). The gestational age and birth weight were (29.5±1.2) weeks and (1 271±242) g in all patients, (29.5±1.4) weeks and (1 285±256) g in the MISA group, and (29.6±0.9) weeks and (1 255±227) g in the EISA group. The duration of surfactant infusion and the length of whole procedure in the MISA group were significantly longer than that in the EISA group (60 (18, 270) s vs. 50 (30, 60) s, Z=3.009, P=0.003; 90 (60, 300) s vs. 60 (44, 270) s, Z=3.365, P=0.001). For the outcomes, the incidence of hemodynamically significant patent ductus arteriosus (hsPDA) and bronchopulmonary dysplasia (BPD) were lower in the MISA group than in the EISA group (36% (17/47) vs. 67% (30/45), χ(2)=8.556, P=0.003; 26% (12/47) vs. 47% (21/45), χ(2)=4.464, P=0.035). Conclusions: Minimally invasive surfactant administration is applicable in preterm infants ≤30 weeks gestational age with NRDS. Although the length of whole procedure is longer than route endotracheal administration, the benefit of decreasing the incidences of hsPDA and BPD outweighs this demerit.

Negative magnetization, complex magnetic ordering and applications of Cr-doped Co2TiO4

Polycrystalline Co2Ti1-xCrxO4 (0 ≤ x ≤ 0.2) inverse spinel ceramics have been synthesized via a sol-gel technique. The dc magnetization measurement in the field-cooled mode shows that negative magnetization could be observed until x reaches 0.2. The exchange constants are calculated using the ferrimagnetic Curie-Weiss fitting and the mean-field theory. This reveals that the strength of the inter sublattice magnetic interaction presents a non-monotonic trend with the increase in Cr content and reaches the minimum at x = 0.1, giving rise to the highest compensation temperature in the x = 0.1 sample. The applicability of the x = 0.1 sample is investigated in light of two prominent magnetic effects: (i) the stable magnetic switching effect indicates the potential applications in magnetic switching and data storage and (ii) the coexistence of normal and inverse magnetocaloric effects suggests a potential application in a constant temperature bath at 54 K.

Evaluation of synuclein-γ levels by novel monoclonal antibody in saliva and cancer tissues from oral squamous cell carcinoma patients

The clinical value of synuclein-γ (SNCG) in oral squamous cell carcinoma (OSCC) was evaluated by detecting the expression of SNCG in saliva and tissues and its correlation with clinicopathological parameters (age, gender, ethnicity, degree of differentiation, clinical stage, and lymph node metastasis). Salivary samples were collected from 79 patients with OSCC, 31 patients with oral premalignant lesions (OPMLs), such as oral lichen planus, oral leukoplakia, and erythema, and 80 controls, and levels of SNCG in salivary samples were determined by enzyme-linked immunosorbent assay (ELISA). Tissue expression in formalin-fixed tissue biopsies of 94 cases of OSCC and 30 adjacent normal tissues was analyzed by immunohistochemistry (IHC) using an antibody against SNCG. The results showed that the salivary levels of SNCG in patients with OSCC and OPMLs were significantly higher than those detected in the control group (p<0.001). The immunohistochemical results showed that SNCG was highly expressed in tumor cells of OSCC patients, with low expression in the adjacent normal epithelium (p<0.001, OR=6.074). Salivary SNCG level correlated with differentiation (p=0.022). Besides, the expression of SNCG in OSCC tissues was also significantly associated with differentiation (p<0.001).

[Clinical features of 54 cases of lung adenocarcinomas with c-ROS oncogene 1 fusion]

Objective: To study the prevalence of c-ros oncogene 1 fusion in lung adenocarcinoma and to evaluate its relationship with clinical characteristics. Methods: We retrospectively analyzed epidermal growth factor receptor (EGFR) mutation, anaplastic lymphoma kinase (ALK) and c-ros oncogene 1 (ROS1) fusion in 1 482 patients with adenocarcinoma from March 2014 to January 2017 in the first affiliated hospital of Zhejiang University. Furthermore, ROS1 fusion positive patients diagnosed between February 2017 and December 2017 were also included in ROS1 positive group. The data of age, sex, smoking history, TNM stage and chest computed tomography were collected by Electronic Medical Record (EMR). The clinical data were compared by the chi-squared test or Mann-Whitney test. Results: Of these 1 482 patients,54 cases were diagnosed with ROS1 rearrangement, including 19 males and 35 females, while 73 cases were diagnosed with ALK rearrangement, including 28 males and 45 females, and 679 cases diagnosed with EGFR mutation including 293 males and 386 females. And there were 676 patients without driven genes mutation. The mean age in ROS1 fusion group (54±12) was lower than EGFR mutation group (60±11, z=-3.982, P<0.001) and WT group (62±10, z=-4.944, P<0.001). Female proportion in ROS1 fusion group (64.8%, 35/54) was higher than WT group (28.4%, 192/676, χ(2)=30.94, P<0.001). Non-smoker percentages in ROS1 fusion group (72.2%, 39/54) was significantly higher than WT group (38.0%,257/676, χ(2)=24.27, P<0.001). ROS1 fusion group was similar to ALK fusion group in sex, age and smoking history, and there were no significant difference in TNM stage among these groups. On chest CT, adenocarcinomas with ROS1 fusion were found to be more peripheral in location (71.4%, 20/28) and solid in density (75%, 21/28), usually with lobulated margins (75.0%, 21/28) and spiculated in contour (57.1%,16/28). Conclusion: In our study lung adenocarcinoma with c-ROS oncogene 1 fusion was a rare subtype lung cancer and was usually detected in young, never smoking, and female patients.

Cyclophosphamide induces a significant increase in iron content in the liver and spleen of mice

Objective:

Oxidative stress is one of the major mechanisms of cyclophosphamide (CPX)-induced toxicities. However, it is unknown how CPX induces oxidative stress. Based on the available information, we speculated that CPX could increase iron content in the tissues and then induce oxidative stress.

Method:

We tested this hypothesis by investigating the effects of CPX on iron and ferritin contents, expression of transferrin receptor 1 (TfR1), ferroportin 1 (Fpn1), iron regulatory proteins (IRPs), hepcidin, and nuclear factor erythroid 2-related factor-2 (Nrf2) in the liver and spleen, and also on reticulocyte count, immature reticulocyte fraction, and hemoglobin (Hb) in the blood in c57/B6 mouse.

Results:

We demonstrated that CPX could induce a significant increase in iron contents and ferritin expression in the liver and spleen, notably inhibit erythropoiesis and Hb synthesis and lead to a reduction in iron usage. The reduced expression in TfR1 and Fpn1 is a secondary effect of CPX-induced iron accumulation in the liver and spleen and also partly associated with the suppressed IRP/iron-responsive element system, upregulation of hepcidin, and downregulation of Nrf2.

Conclusions:

The reduced iron usage is one of the causes for iron overload in the liver and spleen and the increased tissue iron might be one of the mechanisms for CPX to induce oxidative stress and toxicities.

Rapid Determination of 13 Sedative Substances and Their Metabolites in Blood by LC-MS/MS

Objective To establish an analysis method for simultaneous determination of 13 sedative substances and their metabolites in blood by liquid-liquid extraction and liquid chromatography-tandem mass spectrometry （LC-MS/MS） technology and to apply the method to actual cases. Methods The samples were extracted with ethyl acetate after an internal standard was added. The extract was condensed until it was nearly dry and then its residues were dissolved with methanol, filtered through 0.22 μm filter and finally determined. The 13 sedative substances and their metabolites were separated through the C₁₈ chromatographic column, then gradient elution was performed on them with methanol and 20 mmol/L ammonium formate （containing 0.1% formic acid） solution. After that, they were determined in the electrospray positive ion mode and quantified by internal standard method. Results The 13 sedative substances and their metabolites in blood showed good linearity in the range of 5-200 μg/L with correlation coefficients ranging from 0.990 3 to 0.999 8. The detection limits were 0.1-1.0 μg/L. Recovery rates of sedative substances were in the range of 71.2%-93.4% when solutions with concentrations of 10, 50 and 200 μg/L were added. The deviations of intra-day and inter-day relative standard deviations （RSD） were not more than 8.6%. Accuracies （bias） were within ±9.8%. Conclusion This method is rapid, simple, effective and sensitive, and can be applied to analysis of 13 sedative substances and their metabolites in blood in forensic toxicology.

Survival physiology and sex ratio of the Chinese white pine beetle Dendroctonus armandi (Coleoptera: Scolytinae) during host colonization and overwintering

The Chinese white pine beetle Dendroctonus armandi (Coleoptera: Scolytinae) typically displays bivoltinism at altitudes below 1700 m in the Qinling Mountains, China. The periods of host colonization and larval overwintering are two important phases in the life cycle of bark beetles, as it is during these periods that they have to contend with host plant defences and periods of intense cold, respectively. Although during different seasons, the females and males of Chinese white pine beetles show varying tolerances to host plant terpenoids, the sex ratio and survival physiology condition of the two beetle generations are unknown. We investigated the sex ratio of individuals, and also examined the body mass, energy stores, and detoxication enzymes of males and females in each of the two generations in order to determine the overall population stability of each generation. We identified a female-biased sex ratio among adults in both generations. Furthermore, patterns of body mass, energy stores, and detoxication enzymes were found to differ between the two sexes and two seasons. Compared with the males, the females have a larger body mass and higher amounts of stored lipids, which are assumed to be adaptations designed to overcome host resistance and facilitate subsequent oviposition.

A comprehensive evaluation of single nucleotide polymorphisms associated with hepatocellular carcinoma risk in Asian populations: A systematic review and network meta-analysis

BACKGROUND

Single nucleotide polymorphisms (SNPs) have been inconsistently associated with hepatocellular carcinoma (HCC) risk. This meta-analysis aimed to synthesize relevant data on SNPs associated with HCC in the Asian population.

METHODS

Databases were searched to identify association studies of SNPs and HCC in Asians published through January 2019. Summary odds ratios (ORs) and 95% confidence intervals (CIs) were calculated based on 41 studies (13,167 patients with HCC and 15,886 noncancer controls). Network meta-analysis and Thakkinstian's algorithm were used to select the most appropriate genetic model, along with false positive report probability (FPRP) for noteworthy associations.

RESULTS

Eleven SNPs meeting the inclusion criteria were tested for association with HCC, including CCND1 rs9344, PTGS2 rs689466, IL18 rs187238 and rs1946518, KIF1B rs17401966, MDM2 rs2279744, MIR146A rs2910164, MIR149 rs2292832, MIR196A2 rs11614913, MIR499A rs3746444, and TGFB1 rs1800469. A significant increase for HCC risk was observed for MDM2 rs2279744, and the dominant (pooled OR = 1.59, 95% CI: 1.26-2.00) and codominant (pooled OR = 1.37, 95% CI: 1.18-1.60) models were determined to be the most appropriate models. MIR499A rs3746444 also showed a significant association with HCC risk under the allele contrast model (pooled OR = 1.36, 95% CI: 1.05-1.77). Only the significance of MDM2 rs2279744 was noteworthy (FPRP < 0.2).

CONCLUSIONS

MDM2 rs2279744 is associated with HCC susceptibility in Asians, and the dominant and codominant models are likely the most appropriate models to estimate HCC risk.

[Study on the causes, prevention and treatment of complications after transsphenoidal pituitary tumor resection under neuroendoscope]

Objective: To analyze the causes of complications after endoscopic transsphenoidal pituitary adenoma resection and summarize the corresponding prevention and treatment measures. Methods: The pathological data of 120 patients with pituitary adenoma in hospital were analyzed retrospectively. All patients were treated surgically, five kinds of common complications were collected, the risk factors of complications were statistically analyzed, the causes of postoperative complications were determined, and then the specific prevention and treatment strategies were summarized. Results: Long operation time (P<0.05), hypopituitarism before operation (P<0.01) and large tumor (P<0.01) were the main inducing factors of CSF rhinorrhea after operation; long operation time (OR=1.394, P<0.01), lumbar cistern puncture (OR=1.531, P<0.01) and CSF rhinorrhea after operation (OR=3.861, P<0.01) were the independent risk factors of infection; Age, large tumor and preoperative hypophysis are the main factors of postoperative hypophysis; Postoperative hypophysis and intraoperative cerebrospinal fluid rhinorrhea are the main factors of postoperative diabetes insipidus; Postoperative hypophysis and giant adenoma are the main factors of postoperative hyponatremia. Conclusion: Endoscopic transnasal transsphenoidal resection of pituitary adenoma is the most minimally invasive method at present. There are still risk factors for postoperative complications. Targeted prevention of risk factors for complications and corresponding interventions can effectively reduce the incidence of postoperative complications of pituitary adenoma.

IκB kinase α: an independent prognostic factor that promotes the migration and invasion of oral squamous cell carcinoma

IκB kinase α (IKKα) is associated with tumourigenesis, metastasis, and poor prognosis. However, its expression and function in oral squamous cell carcinoma (SCC) remain unknown. The aim of this study was to elucidate the clinicopathological associations and functions of IKKα in oral squamous cell carcinoma (SCC). We made an immunohistochemical analysis of IKKα in 94 tissue microarrays of specimens of oral SCC. We also examined IKKα expression in the patients' samples by quantitative real-time polymerase chain reaction (qRT-PCR), as well as the migration, invasion, and matrix metalloproteinase (MMP) activity of the cells under IKKα knockdown treatment. In oral SCC, immunostaining for IKKα was found in 60 of the 94 patients, and it correlated with lymph node status and poor prognosis. Univariate and multivariate analysis using Cox's proportional hazards model identified that IKKα expression was an independent predictor of distant- disease-free survival (p<0.05) and overall survival in oral SCC (p<0.05). Knocking down IKKα suppressed cell migration and invasion in oral SCC cells. Our results indicate that IKKα has an important role in promoting oral SCC, and it may be a useful biomarker and therapeutic target for diagnosis and treatment.

In vitro antioxidant and angiotensin-converting enzyme inhibitory activity of fermented milk with different culture combinations

This study investigated the effects of Lactobacillus plantarum (Lp) and Bifidobacterium animalis ssp. lactis (Ba) in co-cultures with Streptococcus thermophilus (St) on changes in the acidification profile, proteolytic activity, peptide production, in vitro antioxidant activity, and angiotensin-converting enzyme (ACE) inhibitory properties of fermented milks during 21 d of storage at 4°C. The pH values and proteolysis in all batches showed a gradual decrease and increase during storage, respectively. The ACE-inhibitory activity and total antioxidant capacity of all co-fermented milk samples followed a similar pattern, with maximum values on d 6 of storage. The St starter, in conjunction with Ba or Lp or both, enhanced proteolysis, peptide generation, and ACE-inhibitory and antioxidant activity, but decreased pH values compared with St alone. The St-Ba-Lp samples showed higher DPPH^• (1,1-diphenyl-2-picrylhydrazyl) radical scavenging activity, hydroxyl radical scavenging activity, and total antioxidant capacity, but similar superoxide anion scavenging activity compared to St-Ba or St-Lp samples. The St-Ba samples showed higher DPPH^• radical scavenging activity but lower hydroxyl radical scavenging activity than St-Lp samples. In the ACE-inhibitory assays, the St-Lp samples exhibited relatively low activity among the co-fermented milks, digested or not. The presence of Ba and Lp in fermentation together did not affect ACE-inhibitory activity in undigested fermented milks compared with the presence of Ba alone, and St-Ba-Lp fermented milks demonstrated an increase in ACE-inhibitory activity after simulated gastrointestinal digestion in storage. Pepsin digestion largely improved ACE-inhibitory activity, except in St-Lp samples, in which the activity was reduced. Further hydrolysis by trypsin reduced final activity in digestion. This study suggests that co-cultured fermentation with probiotics improves in vitro antioxidant and ACE inhibition activity in fermented milks, and this effect is partly due to the higher proteolytic activity of probiotics.

Investigation of Streptococcus agalactiae using pcsB-based LAMP in milk, tilapia and vaginal swabs in Haikou, China

AIMS

To develop a pcsB-based Loop-mediated isothermal amplification (LAMP) method for the detection of Streptococcus agalactiae (GBS) in milk, tilapia and vaginal swabs.

METHODS AND RESULTS

The sensitivity of the LAMP method using real-time turbidity monitoring was 1 pg of template within 1 h at 64°C, 100-fold higher than conventional PCR. The sensitivity of visual detection dropped an order of magnitude using SYBR Green I or hydroxynaphthol blue. The validity of the visual LAMP assay was assessed by the detection of GBS in 180 vaginal swabs from one hospital, 14 brain tissues samples of diseased tilapias from two fishponds and fresh milk of 67 dairy cattle from one farm. In total, 17 samples (4 vaginal swabs, 13 tilapia brain tissues but no milk sample) tested positive for GBS. Subsequent bacterial identification confirmed the specificity and reliability of the LAMP method. Molecular serotyping and multilocus sequence typing demonstrated that all 13 tilapia GBS isolates were identical (serotype Ia, ST7), whereas the four human GBS isolates were more diverse and could be classified into two serotypes (Ia, III) and four sequence types (ST19, ST23, ST24, ST862). Virulence gene testing showed that only the bac, rib and lmb genes were not present in all isolates. Antimicrobial susceptibility profiles of the isolates were basically consistent with their genotypes, except for sulphonamide and fluoroquinolone.

CONCLUSIONS

We developed a reliable pcsB-based LAMP assay for GBS detection. Our results demonstrated that the prevalence of GBS was 92·9% among diseased tilapia, 2·2% among female patients and 0% on a dairy farm in Hainan.

SIGNIFICANCE AND IMPACT OF THE STUDY

The pcsB-based LAMP method is suitable for GBS detection and contains great potential of application in dairy industry, aquiculture and clinical.

Correlations of serum VEGF and MMP-2 levels with CLM in CRC patients and effects of TACE on their expressions

OBJECTIVE

To investigate the correlations of serum vascular endothelial growth factor (VEGF) and matrix metalloproteinase-2 (MMP-2) levels with colorectal liver metastasis (CLM) in patients with colorectal cancer (CRC), and determine the effects of transhepatic arterial chemoembolization (TACE) on their expressions.

PATIENTS AND METHODS

A total of 110 CRC patients treated in the department of interventional radiology of our hospital from May 2013 to May 2016 were randomly enrolled. All patients received treatment of TACE after surgery. During surgery, 10 mL venous blood was taken, and the protein levels of VEGF and MMP-2 in serum were detected via enzyme-linked immunosorbent assay (ELISA). The correlations of VEGF and MMP-2 levels with clinicopathological features of patients were analyzed. The values of VEGF and MMP-2 in predicting CLM were analyzed using the receiver operating characteristic (ROC) curve. Moreover, changes in serum VEGF and MMP-2 levels in CRC patients were analyzed before TACE, and at 1 and 6 months after TACE.

RESULTS

The median VEGF and MMP-2 levels in serum of CRC patients were 64.8 ng/mL and 114.4 ng/mL, respectively, which were significantly higher than those in healthy control group (5.3 ng/mL and 6.8 ng/mL) (p<0.05). The expressions of VEGF and MMP-2 in serum of CRC patients were correlated with the depth of tumor infiltration, Dukes' staging, CLM and lymph node metastasis (p<0.05). Logistic regression analyses showed that the expression levels of VEGF and MMP-2 were positively correlated with CLM (p<0.05). The ROC curve revealed that the sensitivity, specificity and accuracy of serum VEGF in the diagnosis of CLM were 62.2%, 78.5% and 80.2%, respectively. The sensitivity, specificity and accuracy of serum MMP-2 in the diagnosis of CLM were 68.9%, 85.5% and 82.2%, respectively. The serum VEGF levels in CRC patients before TACE, and at 1 and 6 months after TACE were (64.8±58.8) ng/mL, (43.1±27.3) ng/mL and (24.8±12.3) ng/mL, respectively, showing a downward trend (p<0.05). The serum MMP-2 levels in CRC patients before TACE, and at 1 and 6 months after TACE were (114.4±136.2) ng/mL, (73.4±58.5) ng/mL and (39.6±30.4) ng/mL, respectively, also indicating a reducing trend (p<0.05).

CONCLUSIONS

The levels of VEGF and MMP-2 in portal vein serum of CRC patients can be used as effective indexes for judging the prognosis of CRC and predicting CLM. Patients with high expression of VEGF and MMP-2 should be actively treated with TACE after surgery to improve the survival rate.

Tai Chi exercise for sleep problems in older adults: A protocol of systematic review and meta-analysis

BACKGROUND

Sleep plays a crucial role in the general health of the human body. However, sleep problems become increasingly severe with age, and its incidence is on the rise. Notably, Tai Chi exercise may be an efficacious means to ameliorate sleep problems among older adults. This is especially since Tai Chi has been widely used to manage sleep problems in China for many years, but there is limited evidence regarding its effectiveness. We will conduct this study aiming to investigate the efficacy of Tai Chi as a complementary and alternative therapy for sleep problems in older adults.

METHODS

We will systematically search Scopus, Embase, PubMed, Cochrane Library, China National Knowledge Infrastructure, and Wanfang database from their inceptions to August 2019. Only randomized controlled trials of Tai Chi for sleep problems among older adults will be considered for inclusion and the Pittsburgh sleep quality index will be the primary outcome measurement. Moreover, study selection, data extraction, and the evaluation of the methodological quality of trials will each be independently completed by at least 2 researchers. We will employ the software Stata version 12.0 to implement the statistical analysis.

RESULTS

The current systematic review and meta-analysis will provide synthesized results of the effectiveness and safety of Tai Chi exercise for sleep problems among older adults.

CONCLUSION

This systematic review and meta-analysis will provide high-quality evidence on the effectiveness and safety of Tai Chi exercise for sleep problems in older adults.

REGISTRATION

PEROSPERO CRD42019129782.

Association between intraplaque neovascularization assessed by contrast-enhanced ultrasound and the risk of stroke

AIM

To determine the cut-off value of the area ratio under the curve (ARUC) for predicting symptoms of stroke.

MATERIALS AND METHODS

Contrast-enhanced ultrasound was used to analyse intraplaque neovascularization (IPN). The correlations between the ARUC and risk factors of stroke were examined. A receiver operating characteristic curve was used to determine the cut-off value of the ARUC.

RESULTS

Using a quantitative analysis method for IPN, the ARUC was significantly higher in the symptomatic group than in the asymptomatic group (p=0.017). The ARUC was positively associated with the homocysteine level (r=0.429, p=0.002) and high-sensitivity C-reactive protein level (r=0.424, p=0.003). Regression analysis showed that the ARUC was a risk factor for symptoms of stroke. The receiver operating characteristic curve showed that the cut-off value for symptoms was 0.24; the sensitivity was 77%, and the specificity was 70%; the positive predictive value was 68%, and the negative predictive value was 78%.

CONCLUSION

IPN was a risk factor for the occurrence of the clinical symptoms of stroke. Patients with an ARUC of >0.24 had a higher risk of stroke.