[Status of home blood pressure monitoring and influencing factors of regular home blood pressure monitoring among elderly uncontrolled hypertensive patients in Central and Western China]

Objective: To describe the prevalence of home blood pressure monitoring and analyze the factors influencing regular blood pressure monitoring among elderly uncontrolled hypertensive patients in Central and Western China. Methods: It was a cross-sectional study, which enrolled hypertensive patients aged over 60 years with office blood pressure ≥140/90 mmHg (1 mmHg=0.133 kPa) from September 2019 to July 2020 in 72 hospitals in Central and Western China. Patients completed the electronic questionnaires, and were divided into regular and irregular home blood pressure monitoring groups. The proportion of patients using different types of sphygmomanometers and the percentage of patients with regular home blood pressure monitoring (at least weekly) were explored. The generalized linear mixed model was used to define the influencing factors of regular home blood pressure monitoring. Results: A total of 3 857 patients were included in this study. Age was 67(64,71) years old and there were 2 163 males (56.1%). Overall, sphygmomanometer was available at home for 3 044(78.9%) patients, 2 168(56.2%) patients conducted regular home blood pressure monitoring. Among the patients with a sphygmomanometer at home, 2 370(77.9%) of the sphygmomanometers were upper arm electronic device. Older age, higher income, longer history of hypertension, multiple antihypertensive medications and awareness of diagnostic criteria of hypertension and hypertension complications were associated with a higher prevalence of regular home blood pressure monitoring (all P<0.05). Conclusions: Among the elderly hypertensive patients with uncontrolled blood pressure in Central and Western China, there is a relatively high prevalence of home sphygmomanometer ownership and regular monitoring. Age, family income, history of hypertension, number of antihypertensive drugs and knowledge of hypertension are the influencing factors of regular home blood pressure monitoring in this population.

EPA-enriched plasmalogen attenuates the cytotoxic effects of LPS-stimulated microglia on the SH-SY5Y neuronal cell line

Microglia plays an important role in the production of inflammation in the central nervous system. Excessive nerve inflammation can cause neuronal damage and neurodegenerative disease. It has been shown that EPA-enriched ethanolamine plasmalogen (EPA-PlsEtn) significantly inhibited the expressions of inflammatory factors and suppressed neuronal loss in a rat model of Alzheimer's disease. However, whether EPA-PlsEtn protects against neuronal loss by inhibiting the activation of microglia is still not clear. Therefore, we examined the effect of PlsEtn on SH-SY5Y cells incubated by conditioned medium from LPS-induced BV2 cells as a neuroinflammation model. Results showed that pre-incubation of LPS-induced BV2 cells with PlsEtn significantly improved the viability of SH-SY5Y cells by reducing the early apoptosis. The increasing production of NO and TNF-α in BV2 cells was reversed by PlsEtn treatment, while the decreasing level of IL-10 was raised. Polarization toward M1 phenotype and activation of NLRP3 inflammasome pathways are attenuated significantly by pre-treatment of PlsEtn in LPS-induced BV2 cells. The study provides evidence for a positive effect of PlsEtn on neuroprotection and the inhibition of neuroinflammation, and PlsEtn may be explored as a potential functional ingredient with neuroprotection effects.

New advances in renal mechanisms of high fructose-induced salt-sensitive hypertension

Fructose intake has increased dramatically over the past century and the upward trend has continued until recently. Increasing evidence suggests that the excessive intake of fructose induces salt-sensitive hypertension. While the underlying mechanism is complex, the kidney likely plays a major role. This review will highlight recent advances in the renal mechanisms of fructose-induced salt-sensitive hypertension, including (pro)renin receptor-dependent activation of intrarenal renin-angiotensin system, increased nephron Na⁺ transport activity via sodium/hydrogen exchanger 3 and Na/K/2Cl cotransporter, increased renal uric acid production, decreased renal nitric oxide production, and increased renal reactive oxygen species production, and suggest actions based on these mechanisms that have therapeutic implications.

Controllable drug uptake and nongenomic response through estrogen-anchored cyclodextrin drug complex

Breast cancer is a leading killer of women worldwide. Cyclodextrin-based estrogen receptor-targeting drug-delivery systems represent a promising direction in cancer therapy but have rarely been investigated. To seek new targeting therapies for membrane estrogen receptor-positive breast cancer, an estrogen-anchored cyclodextrin encapsulating a doxorubicin derivative Ada-DOX (CDE₁-Ada-DOX) has been synthesized and evaluated in human breast cancer MCF-7 cells. First, we synthesized estrone-conjugated cyclodextrin (CDE₁), which formed the complex CDE₁-Ada-DOX via molecular recognition with the derivative adamantane-doxorubicin (Ada-DOX) (K_d =1,617 M⁻¹). The structure of the targeting vector CDE₁ was fully characterized using ¹H- and ¹³C-nuclear magnetic resonance, mass spectrometry, and electron microscopy. CDE₁-Ada-DOX showed two-phase drug-release kinetics with much slower release than Ada-DOX. The fluorescence polarization analysis reveals that CDE₁-Ada-DOX binds to recombinant human estrogen receptor α fragments with a K_d of 0.027 µM. Competition assay of the drug complex with estrogen ligands demonstrated that estrone and tamoxifen competed with CDE₁-Ada-DOX for membrane estrogen receptor binding in MCF-7 cells. Intermolecular self-assembly of CDE₁ molecules were observed, showing tail-in-bucket and wire-like structures confirmed by transmission electronic microscopy. CDE₁-Ada-DOX had an unexpected lower drug uptake (when the host–guest ratio was >1) than non-targeting drugs in MCF-7 cells due to ensconced ligands in cyclodextrins cavities resulting from the intermolecular self-assembly. The uptake of CDE₁-Ada-DOX was significantly increased when the host–guest ratio was adjusted to be less than half at the concentration of CDE₁ over 5 µM due to the release of the estrone residues. CDE₁ elicited rapid activation of mitogen-activated protein kinases (p44/42 MAPK, Erk1/2) in minutes through phosphorylation of Thr202/Tyr204 in MCF-7 cells. These results demonstrate a targeted therapeutics delivery of CDE₁-Ada-DOX to breast cancer cells in a controlled manner and that the drug vector CDE₁ can potentially be employed as a molecular tool to differentiate nongenomic from genomic mechanism.

Postoperative bladder and sexual function in patients undergoing surgery for rectal cancer: a systematic review and meta-analysis of laparoscopic versus open resection of rectal cancer

There have been conflicting opinions regarding the superiority of open and laparoscopic surgery in preserving bladder and sexual function after rectal cancer surgery. This systematic review and meta-analysis aims to pool the available data comparing the impact of surgical approaches on postoperative sexual and urinary function. A search of Pubmed, Medline, Cochrane and Embase was undertaken and studies from January 2000 to February 2013 were identified. We included, in our meta-analysis, both prospective and retrospective studies that compared laparoscopic surgery and open surgery for rectal cancer. A total of 876 patients undergoing rectal cancer surgery (lap n = 468, open n = 408) were examined. In men, postoperative ejaculatory function and erectile dysfunction evaluated from two studies comprising of 74 patients showed no difference between groups. The rate of overall sexual dysfunction evaluated from five studies comprising of 289 patients revealed a rate of 34 % in both the open and lap groups. Postoperative urinary function evaluated from five studies comprising of 312 patients showed no difference between groups. In women, postoperative sexual and urinary function were evaluated from five studies comprising of 321 patients. Three studies (n = 219) reported no difference in sexual function between groups. Postoperative urinary function evaluated from four studies comprising of 212 patients was found to be comparable. The available data are limited, but suggest that neither form of surgical approach be it laparoscopy or open surgery demonstrate superiority in preservation of sexual and bladder function. Further research into the technical aspects of surgery and evaluating newer minimally invasive technologies such as the robot may prove to be useful in improving functional outcomes of rectal cancer patients.

Effect of cattle breeds on milk composition and technological characteristics in china

Cattle breeds have a striking effect on milk, including milk composition and technological characteristics. This study aims to compare milk composition, acidification activity, viscosity, milk dispersion system stability and casein molecular weight among three buffalo breeds in China. The technological characteristics of milk produced by three cattle breeds of river buffalo (Murrah), crossbreed 1st generation (F1), crossbreed multiple generation (FH, H≥3) buffaloes were investigated. Cattle breeds showed evident effect on milk protein, fat and total solids content, but little effect on most of buffalo casein molecular weight. Milk fat, protein content and the viscosity of buffalo milk from river buffalo were lower than those of F1 and FH, so was the buffer capacity. The viscosity was negatively correlated to temperature and concentration. Results of stability coefficient showed that milk dispersion system had the best dynamic stability characteristics under pH 6.6 and 6 times dilution, while zeta potential of Murrah milk was slightly higher than that of hybrid offspring (F1, FH). SDS-PAGE results showed that buffalo αs-casein had a slightly faster mobility than standard αs-casein; while buffalo β-casein showed a slightly slower mobility than standard β-casein. There is no clear differences in molecular weight of αs-, β-, and κ-casein among Murrah, F1 and FH.

Palliative resection of the primary tumour in patients with Stage IV colorectal cancer: systematic review and meta-analysis of the early outcome after laparoscopic and open colectomy

AIM

Resection of the primary tumour in patients with Stage IV colorectal cancer may be performed to avoid future tumour-related complications whilst on systemic treatment. We compared the safety and efficacy of laparoscopic and open colectomy in this patient group.

METHOD

PubMed, MEDLINE and the Cochrane Library were searched in the English literature for studies between January 2000 and October 2012 dealing with laparoscopic resection of the primary tumour in Stage IV disease. Single-arm laparoscopic studies were systematically reviewed. Prospective and retrospective studies were included for meta-analysis. End-points include safety, complications, mortality and cancer specific outcome including 5-year and median survival.

RESULTS

Eleven studies comprising 1165 patients undergoing palliative laparoscopic colectomy for Stage IV colorectal cancer were included. Five studies were comparative studies of laparoscopic and open colectomy. The former took longer (pooled mean difference (MD) = 41.52, 95% CI = 11.47-71.56, Z = 2.71, P = 0.007), but resulted in a shorter length of stay (pooled MD = -2.41, 95% CI = -3.84 to -0.99, Z = 3.32, P = 0.0009), with fewer postoperative complications (pooled odds ratio = 0.53, 95% CI = 0.32-0.87, Z = 2.51, P = 0.01) and lower estimated blood loss (pooled MD = -47.71, 95% CI = -80.00 to -15.42, Z = 2.90, P = 0.004). Median survival ranged between 11.4 and 30.1 months.

CONCLUSION

Palliative colectomy performed laparoscopically is associated with a better perioperative outcome than open colectomy. Survival is dependent on the response to systemic chemotherapy.

IgE myeloma with elevated level of serum CA125

OBJECTIVE

To explore clinical and laboratory features and significance of detecting serum carbohydrate antigen 125 (CA125) in immunoglobulin E (IgE) multiple myeloma.

METHODS

We reported the clinical findings of a male patient with IgE myeloma and elevated level of serum CA125 and reviewed the literature.

RESULTS

Laboratory tests of this patient on admission showed extremely high serum IgE and CA125, a bone marrow aspirate revealed abnormal plasma cells (38.4% of nucleated cells: 16.4% mature and 22% atypical), and in bone marrow biopsy, immunoperoxidase staining showed positive cytoplasmic staining for IgE and kappa light chain within the vast majority of plasma cells. Computed tomography (CT) bone scans indicated wedge shape change and compressive fracture of thoracic vertebrae, and emission computed tomography (ECT) discovered multiple punctiform aggregation of radiation in both cervical ribs and spine. The serum IgE and CA125 gradually decreased to normal limits after eight cycles of chemotherapy. This patient is alive well with an 18-month complete remission.

CONCLUSION

We reported the first case of IgE myeloma with elevated level of serum CA125. To further evaluate clinical characteristics and significance of CA125 in IgE myeloma, more cases are needed.

N-hydroxysuccinimidyl-fluorescein-O-acetate for precolumn fluorescence derivatization of amino acids and oligopeptides in liquid chromatography

A new fluorescent derivatizing reagent, N-hydroxysuccinimidyl-fluorescein-O-acetate, is used for the high-performance liquid chromatographic analysis of amino acids and oligopeptides. This reagent has the advantages of high-detection sensitivity in the visible region, specifically with amino groups, mild derivatization conditions, and little interference induced. The fluorescence properties of the reagent and its derivatives with amino acids and oligopeptides are studied. The conditions of the derivatization are investigated in detail. In the mobile phase of methanol-water (42:58, v/v) containing a 10 mM pH 5.0 citric acid-Na2HPO4 buffer, six amino acids and oligopeptides are separated in 20 min with fluorescence detection at excitation and emission wavelengths of 492 and 513 nm, respectively, with the detection limits for injected standards ranging from 0.64 to 12 fmol.

N-hydroxysuccinimidyl fluorescein-O-acetate as a fluorescent derivatizing reagent for catecholamines in liquid chromatography

A new amine-reactive derivatizing reagent, N-hydroxysuccinimidyl fluorescein-O-acetate (SIFA), was developed for catecholamine (CA) analysis in liquid chromatography. The reactivity of this reagent with the CAs norepinephrine (NE), epinephrine (E), and dopamine (DA) was investigated in detail. In aqueous methanol containing 32 mmol/L pH 9.0 H3BO3-Na2B4O7 buffer, SIFA reacted with NE, E, and DA under mild conditions. The derivatives were separated in 20 min on a C18 column with a mobile phase of methanol/water (38:62, v/v) containing 10 mmol/L pH 5.0 H3cit-Na2HPO4 buffer. At lambda(ex)/lambda(em) = 490/516 nm, the detection limits were 3.2, 12, and 56 fmol, respectively, with a signal-to-noise ratio of 3, which were comparable to those using 1,2-diphenylethylenediamine as the derivatizing reagent for CA analysis. Amino acids, aliphatic amines, and alcohols had no obvious interference with the determination. The proposed method has been applied to the determination of CAs in human urine, with recoveries of 95.3-103.9%.