Is obstructive sleep apnea syndrome a risk factor for pulmonary thromboembolism?

Background  In many studies, obstructive sleep apnea (OSA) has been shown to be an independent risk factor for cardiovascular disease. Conversely, there are few reports establishing possible relation between OSA and venous thromboembolism (VTE). In this study, the aim is to evaluate OSA via polysomnography in patients with pulmonary embolism and drawing the attention of clinicians to the presence of obstructive sleep apnea syndrome (OSAS) may be a risk factor for pulmonary embolism.

Methods  Fifty consecutive patients who were diagnosed with pulmonary embolism (PE) were evaluated prospectively for OSAS. Polysomnographic examination was conducted on 30 volunteer patients. The frequency of OSAS in PE was determined and PE cases were compared to each other after being divided into two groups based on the presence of a major risk factor.

Results  The study consisted of a total of 30 patients (14 females and 16 males). In 56.7% of the patients (17/30), OSAS was determined. The percent of cases with moderate and severe OSAS (apnea hipoapnea index >15) was 26.7% (8/30). Patients who had pulmonary thromboembolism (PTE) without any known major VTE risk (n=20), were compared to patients with VTE risk factors (n=10), and significantly higher rates of OSAS were seen (70% and 30% respectively; P=0.045). The mean age of the group with major PE risk factors was lower than the group without major PE risk factors (52 years old and 66 years old, respectively; P=0.015), however, weight was greater in the group with major PE risk factors (88 kg and 81 kg, respectively; P=0.025). By multivariate Logistic regression analysis, in the group without any visible major risk factors, the only independent risk factor for PE was OSAS (P=0.049).

Conclusions  In patients with PTE, OSA rates were much higher than in the general population. Moreover, the rate for patients with clinically significant moderate and severe OSA was quite high. PTE patients with OSA symptoms (not syndromes) and without known major risk factor should be examined for OSA. There seems to be a relationship between OSA and PTE. However, whether this relationship is a causal relationship or a relationship due to common risk factors or long-term complications of OSA is not clear. Further comprehensive studies on those special topics are needed to clarify these points.

     

Treatment effects of captopril on non-proliferative diabetic retinopathy

Background  Diabetic retinopathy (DR) is one of the most common complications of diabetes. Angiotensin-converting enzyme inhibitor is thought to play an important role in preventing and treating retinal diseases in animal models of DR. The aim of the present study was to investigate the role of angiotensin-converting enzyme inhibitor (ACEI, captopril) in the treatment of patients with non-proliferative DR.

Methods  Three hundred and seventeen type 2 diabetic patients (88.05% of participants) without or with mild to moderate non-proliferative retinopathy were randomly divided into captopril group (n=202) and placebo group (n=115). All subjects received 24-month follow-up. General clinical examinations, including blood pressure and glycated hemoglobin, as well as comprehensive standardized ophthalmic examinations were performed. Color fundus photography and optical coherence tomography (OCT) were used to grade diabetic retinopathy and detect macular edema respectively.

Results  The levels of blood pressure and glycated hemoglobin in the two groups of patients remained within the normal range during the entire follow-up and no significant difference was found between the initial and last visits, suggesting that ACEI drugs play a protective role on the DR patients independent of its anti-blood pressure role. DR classification showed that 169 eyes (83.66%) remained unchanged and the DR grade of 33 eyes (16.34%) increased in captopril group, while 84 eyes (73.04%) remained unchanged and the grade of 31 eyes (26.96%) increased in placebo group (P=0.024). Captopril treatment improved macular edema in 55.45% eyes, which was significantly higher than the 37.39% improvement in placebo group (P=0.002). No significant difference was found in the visual acuity between the two groups (P=0.271).

Conclusion  Captopril can improve or delay the development of DR and macular edema, which can be used in the early treatment of DR patients with type 2 diabetic mellitus.

     

Relationship between 6-minute walk test and pulmonary function test in stable chronic obstructive pulmonary disease with different severities

Background  The relationship between the 6-minute walk test (6MWT) and pulmonary function test in stable chronic obstructive pulmonary disease (COPD) remains unclear. We evaluate the correlation of 6MWT and spirometric parameters in stable COPD with different severities. 6MWT data assessed included three variables: the 6-minute walk distance (6MWD), 6-minute walk work (6MWORK), and pulse oxygen desaturation rate (SPO₂%).

Methods  6MWT and pulmonary function test were assessed for 150 stable COPD patients with different severities. Means and standard deviations were calculated for the variables of interest. Analysis of variance was performed to compare means. Correlation coefficients were calculated for 6MWT data with the spirometric parameters and dyspnea Borg scale. Multiple stepwise regression analysis was used to screen pulmonary function-related predictors of 6MWT data.

Results  The three variables of 6MWT all varied as the severities of the disease. The 6MWD and 6MWORK both correlated with some spirometric parameters (positive or negative correlation; the absolute value of r ranging from 0.34 to 0.67; P <0.05) in severe and very severe patients, and the SPO₂% correlated with the dyspnea Borg scale in four severities (r= -0.33, -0.34, -0.39, -0.53 respectively; P <0.05). The 6MWD was correlated with the 6MWORK in four severities (r=0.56, 0.57, 0.72, 0.81 respectively, P <0.05), and neither of them correlated with the SPO₂%. The percent of predicted forced expiratory volume in 1 second (FEV₁% predicted) and residual volume to total lung capacity ratio (RV/TLC) were predictors of the 6MWD, and the maximum voluntary ventilation (MVV) was the predictor of the 6MWORK.

Conclusions  6MWT correlated with the spirometric parameters in severe and very severe COPD patients. 6MWT may be used to monitor changes of pulmonary function in these patients.

     

High volume practice proved the safety of off-pump coronary artery bypass surgery in left main coronary artery lesions: a two-year single center experience

Background  Left main coronary artery (LMCA) stenosis has been recognized as a risk factor for early death among patients undergoing coronary artery bypass grafting (CABG). This study aimed to assess if LMCA lesions pose an additional risk of early or mid-term mortality and/or a major adverse cardiac and cerebrovascular event (MACCE) after off-pump coronary artery bypass grafting (OPCABG), compared with non-left main coronary artery stenosis (non-mainstem disease).

Methods  From January 1, 2009 to December 31, 2010, 4869 patients had a primary isolated OPCABG procedure at Beijing Anzhen Hospital. According to the pathology of LMCA lesions, they were retrospectively classified as a non-mainstem disease group (n=3933) or a LMCA group (n=936). Propensity scores were used to match the two groups, patients from the non-mainstem disease group (n=831) were also randomly selected to match patients from the LMCA group (n=831). Freedom from MACCE in the two groups was calculated using the Kaplan-Meier method.

Results  The difference in the mortality and the rate of MACCE during the first 30 days between the non-mainstem disease group and the LMCA group did not reach statistical significance (P=0.429, P=0.127 respectively). With a mean follow-up of (12.8±7.5) months and a cumulative follow-up of 1769.6 patient-years, the difference in the freedom from MACCEs between the two groups, calculated through Kaplan-Meier method, did not reach statistical significance (P=0.831).

Conclusion  Analysis of a high volume of OPCABG procedures proved that LMCA lesions do not pose additional early and mid-term risk to OPCABG. Therefore, a LMCA lesion is as safe as non-mainstem disease lesion during the OPCABG procedure.

     

Safety and feasibility of repeated percutaneous transradial coronary intervention in the same route

Background  The radial approach has been increasingly used as an alternative to femoral access. And more procedures using repeated transradial coronary intervention (r-TRI) are performed. However, few data about r-TRI has been obtained. Therefore, we investigated the safety and feasibility of r-TRI using the same route.

Methods  A total of 423 consecutive eligible patients undergoing r-TRI were enrolled in the r-TRI group, and 846 patients with initial TRI (i-TRI) were assigned to the i-TRI group in a 2:1 matching ratio compared to r-TRI group. The primary endpoint included the success rate of the procedure and the incidence of vascular related complications.

Results  The baseline clinical characteristics in the two groups were comparable. The success rate of procedures in the r-TRI and i-TRI was similar (96.0% vs. 97.5%, P=0.130). In subgroup analysis (coronary angiography only or angiography with pecutaneous coronary intervention), similar results were also observed. The puncture numbers and incidence of radial artery spasm in the r-TRI group were significantly higher than in the i-TRI group (P=0.024 and P <0.001, respectively). The other procedural outcomes in the two groups were identical. With respect to the incidence of overall vascular related complication and independent events, there were no significant differences in spite of a higher incidence of radial artery occlusion (RAO) in the r-TRI group (RAO: 1.2% vs. 0.7%, P=0.521). The patients in the i-TRI group had more comfortable feeling than patients in the r-TRI group (P=0.001).

Conclusions  R-TRI produces a comparable procedure success rate and incidence of vascular complication when compared to i-TRI. It should be considered as an acceptable and safe procedure.

     

创伤骨科患者创伤严重程度和血浆D二聚体水平的相关分析

Background  The correlation between the plasma D-dimer level and deep vein thrombosis has not been conclusive in various studies. The aim of this research was to study the relationship between plasma D-dimer levels and the severity of orthopedic trauma by retrospective examination of orthopedic trauma cases.

Methods  Clinically acute trauma and non-acute trauma patients were selected and their plasma D-dimer levels were measured. Plasma D-dimer levels in patients of these two groups were compared. The relationship between the plasma D-dimer level and the severity of the trauma was also studied.

Results  There were 548 cases in the acute trauma group and 501 cases in the non-acute trauma group. The levels of plasma D-dimer were significantly higher in the acute trauma group than in the non-acute trauma group (P <0.01). In the acute trauma group, the correlation between the D-dimer level and the number of fractures was a positive linear correlation (r=0.9532).

Conclusions  Elevated plasma D-dimer is common in trauma patients. The D-dimer level and the number of fractures in the trauma patients are closely correlated. D-dimer is not only an indicator for the diagnosis of deep vein thrombosis and pulmonary embolus, but also an indicator of the severity of trauma in acute trauma patients.

     

An Asian population-based survival analysis of patients with distal esophageal and gastric cardia adenocarcinomas

Background  Gastroesophageal junction adenocarcinomas include adenocarcinomas of the distal esophagus (DE) and gastric cardia (GC). It is controversial whether these tumors are the same entity and whether they have the same survival rates. Patients with DE and GC adenocarcinomas have a similar survival rate in the US; however, data are lacking in Asian countries. Therefore, we conducted a retrospective study to understand the implications of the tumor location in the survival of Asian patients.

Methods  A total of 209 patients with pathologically confirmed DE and GC adenocarcinomas, from 2005 to 2007, were included in the study. We identified patients with adenocarcinomas of the DE (DE group, n=91) and GC (GC group) (n=118). We performed an unadjusted survival analysis using the Kaplan-Meier method, and used a Cox proportional hazards regression model to adjust for potential confounding covariates.

Results  We found no significant difference between the overall survival of the DE and GC groups. The 3-year survival rates were 44.8% and 53.0%, respectively, and the 5-year survival rates were 27.9% and 30.2%, respectively (P=0.162). We found no significant difference in early staging, advanced staging, different T staging, and different N staging, between the groups. Both advanced post-operative N staging and advanced AJCC staging had a significant adverse effect on survival.

Conclusions  Patients with DE and GC adenocarcinomas have similar survival rates in the Asian population. Both post-operative N staging and AJCC staging are prognostic factors.

     

Ultrasound facilitates identification of combined spinal-epidural puncture in obese parturients

Background  The palpation method is widely used in clinical practice to identify the puncture site of combined spinal-epidural (CSE) blocks, but it is usually difficult to accurately locate the puncture site in obese parturients. Accurate identification of the puncture site is crucial for successful CSE block. The objective of this study was to evaluate the impact of ultrasound imaging on the success rate of CSE puncture in obese parturients.

Methods  Sixty obese parturients with a body mass index ³30 kg/m² who were scheduled for caesarean section were randomized into two equal-sized groups for location of the puncture site: an ultrasound group and a palpation group. The success rate of puncture at the first puncture site, the number of puncture attempts, duration of CSE procedure, time taken to determine the puncture site, and the depth of the epidural space were compared between groups. The frequencies of complications such as puncture site hemorrhage, neurological damage, and inadvertent dural puncture were also studied.

Results  There were no differences in age, body weight, height, body mass index, or gestational age between the two groups. The success rate of puncture at the first puncture site was significantly higher in the ultrasound group than the palpation group (100.00% vs. 70.00%, P=0.004). The number of puncture attempts was significantly lower in the ultrasound group than the palpation group (c²=6.708, P=0.035). The time taken for determining the puncture site was (0.30±0.12) minutes in the palpation group and (2.60±0.61) minutes in the ultrasound group (P <0.001). The duration of CSE procedure was (7.67±1.52) minutes in the palpation group and (9.37±1.35) minutes in the ultrasound group (P <0.001). The depth of the epidural space was similar in both groups (P=0.586). Puncture site hemorrhage was observed in 6 (20.00%) patients in the palpation group and 2 (6.67%) patients in the ultrasound group (P=0.255).

Conclusions  Ultrasound imaging improves the rate of successful puncture at the first puncture site and decreases the number of puncture attempts. It facilitates CSE puncture in obese parturients.

     

Effect of chronic intermittent hypoxia on theophylline metabolism in mouse liver

Background Chronic intermittent hypoxia (CIH) has been associated with abnormalities in the liver,which is the most important organ for drug metabolism.This study aimed to investigate the effect of CIH...     

Impact of multidisciplinary team working on the management of colorectal cancer

Background  The continual and rapid development of techniques which are used for diagnosis and treatment makes management of colorectal cancer more difficult depending on single discipline. Colorectal cancer multidisciplinary team (MDT) working model is recommended by UK and other countries, but there is little information on the impact of MDT working on management of colorectal cancer in China. The aim of this study was to assess the effect on management of colorectal cancer after the inception of an MDT.

Methods  A total of 595 consecutive colorectal cancer patients were referred to the Department of Gastroenterological Surgery, the pre-MDT cohort include 297 patients, recruited from January 1999 to November 2002, and the MDT cohort had 298 patients enrolled from December 2002 to September 2006. Information recorded included: TNM stage from histological reports, degree of differentiation, the number of examined lymph nodes and CT TNM staging performed or not, and its accuracy, including local and distant recurrence.

Results  The number of examined lymph nodes and the accuracy of TNM staging by CT in the MDT group were significantly more than those in pre-MDT group. CT TNM staging was more accurate in the MDT group compared to the pre-MDT group (P=0.044). The rate of tumor recurrence in the MDT group was lower than pre-MDT group (log-rank test, P <0.001). Multivariate analysis revealed that age (P=0.001), management after inception of the MDT (P=0.002), degree of differentiation (P=0.003), number of examined lymph nodes (P=0.002), and TNM stage (P=0.000) were important factors that independently influence overall survival.

Conclusions  The inception of MDT working improved the diagnostic accuracy and overall survival of colorectal cancer patients. MDT working promoted communication and cooperation between disciplines and ensured high-quality diagnosis, evidence-based decision making, and optimal treatment planning.

     

Transitional cell carcinoma associated with aristolochic acid nephropathy: most common cancer in chronic hemodialysis patients in China

Background  The research of cancer in patients on hemodialysis (HD) in China has not been reported. The aim of this study was to investigate the clinical and histological features and outcomes of cancer in Chinese HD patients.

Methods  The study subjects were 49 cancer patients (1.4%) out of 3448 end stage renal disease (ESRD) patients maintained on HD at China-Japan Friendship Hospital from October 1997 to July 2011.

Results  Urinary tract cancer (74%) was the most common followed by gastrointestinal tract cancer (12%), breast cancer (6%), lung cancer (4%), thyroid cancer (2%), and hematologic cancer (2%). Thirty-three patients (67%) had urinary tract transitional cell carcinoma (TCC) and 29 of them had aristolochic acid nephropathy (AAN) as underlying disease. Death occurred in eight patients out of 49, and the survival rate of HD patients with cancer was similar to those without cancer (P=0.120).

Conclusion  The urinary tract TCC is the most common cancer in HD patients with AAN in one of the centers of northern China.

     

Influential factors and effect evaluation of the intra-operative puncture biopsy for pancreatic masses

Background  It is a challenge for the surgeons to accurately diagnose the pancreatic masses preoperatively, which decides the choice of surgical managements and subsequently results in different survivor outcomes, operative complications, and mortality rates. The purposes of this study were to evaluate the diagnostic role that intra-operative puncture biopsy may play in pancreatic masses and to explore the relevant factors influencing the diagnosis.

Methods A retrospective study was performed on 94 in-patients admitted to Peking University First Hospital for pancreatic masses during the period from June 1994 to December 2007. They all underwent intra-operative puncture biopsy during exploratory laparotomy. The sensitivity and specificity of intra-operative puncture biopsy were calculated and the relevant factors to the diagnosis of biopsy were selected for the statistical analysis.

Results The overall sensitivity, specificity, positive predictive value, and negative predictive value of intra-operative puncture biopsy were 76.0%, 94.7%, 98.3% and 50.0%, respectively. The analysis of bivariate correlations showed that the size of the pancreatic masses (P=0.000), the number of puncture biopsies (P=0.000), and the presence of pancreatic fibrosis (P=0.012) had statistic significance for the diagnosis. But the multivariate analysis identified the size of the pancreatic masses (P=0.004) and the number of puncture biopsies (P=0.000) as independent predictive factors for intra-operative puncture biopsy. In addition, as the number of puncture biopsies increased, the sensitivity and specificity of diagnosis was improved (P=0.000). The sensitivity and specificity of intra-operative puncture biopsy were found to be lower for the pancreatic masses less than 25 mm compared with the masses larger than 25 mm (P=0.000). It was noted, however, that even if the masses were less than 25 mm, the sensitivity and specificity could be improved significantly as the number of puncture biopsies reached 3 to 6 (P=0.007).

Conclusions Intra-operative puncture biopsy is simple and accurate for qualitatively differentiating various types of pancreatic masses. Three to 4 biopsies could significantly improve the diagnostic effect for pancreatic masses, even if the masses are less than 25 mm in size.

     

Predictive factors improving survival after gastric and hepatic surgical treatment in gastric cancer patients with synchronous liver metastases

Background  The prognosis for patients with gastric cancer and synchronous liver metastases is very poor. However, a standard therapeutic strategy has not been well established. The clinical benefit and prognostic factors after hepatic surgical treatment for liver metastases from gastric cancer remain controversial.

Methods  Records of 105 patients who underwent gastrectomy regardless of hepatic surgical treatment for gastric cancer with synchronous liver-only metastases in our center between 1995 and 2010 were retrospectively reviewed.

Results  The overall survival rate for the 105 patients was 42.1%, 17.2%, and 10.6% at 1, 2, and 3 years, respectively, with a median survival time of 11 months. Multivariate survival analysis revealed that the extent of lymphadenectomy (D) (P <0.001), lymph node metastases (P <0.001), extent of liver metastases (H) (P=0.008), and lymphovascular invasion (P=0.002) were significant independent prognostic factors for survival. Among patients who underwent D2 lymphadenectomy, those who underwent hepatic surgical treatment had a significantly improved survival compared with those who underwent gastrectomy alone (median survival, 24 vs. 12 months; P <0.001). However, hepatic surgical treatment was not a prognostic factor for patients who underwent D1 lymphadenectomy (median survival, 8 vs. 8 months; P=0.495). For the 35 patients who underwent gastrectomy plus hepatic surgical treatment, D2 lymphadenectomy (P <0.001), lymph node metastases (P=0.015), and extent of liver metastases (H1 vs. H2 and H3) (P=0.017) were independent significant prognostic factors for survival.

Conclusions  D2 lymphadenectomy plus hepatic surgical treatment may provide hope for long-term survival of judiciously selected patients with hepatic metastases from gastric cancer. Patients with a low degree of lymph node metastases and H1 liver metastases would make the most appropriate candidates. However, if D2 dissection cannot be achieved, hepatic surgical treatment is not recommended.

     

Gliosis after traumatic brain injury in conditional ephrinB2-knockout mice

Background  In response to the injury of the central nervous system (CNS), the astrocytes upregulate the expression of glial fibrillary acidic protein (GFAP), which largely contributes to the reactive gliosis after brain injury. The regulatory mechanism of this process is still not clear. In this study, we aimed to compare the ephrin-B2 deficient mice with the wild type ones with regard to gliosis after traumatic brain injury.

Methods  We generated ephrin-B2 knockout mice specifically in CNS astrocytes. Twelve mice from this gene-knockout strain were randomly selected along with twelve mice from the wild type littermates. In both groups, a modified controlled cortical impact injury model was applied to create a closed traumatic brain injury. Twenty-eight days after the injury, Nissl staining and GFAP immunofluorescence staining were used to compare the brain atrophy and GFAP immunoreactivity between the two groups. All the data were analyzed by t-test for between-group comparison.

Results  We successfully set up the conditional ephrin-B2 knockout mice strain, which was confirmed by genotyping and ephrin-B2/GFAP double staining. These mice developed normally without apparent abnormality in general appearance. Twenty-eight days following brain injury, histopathology revealed by immunohistochemistry showed different degrees of cerebral injuries in both groups. Compared with wild-type group, the ephrin-B2 knockout group exhibited less brain atrophy ratio for the injured hemispheres (P=0.005) and hippocampus (P=0.027). Also the wild-type group demonstrated greater GFAP immunoreactivity increment within hippocampal regions (P=0.008).

Conclusions  The establishment of conditional ephrin-B2 knockout mice provides us with a new way to explore the role of ephrin-B2 in astrocytes. Our findings revealed less atrophy and GFAP immunoreactivity in the knockout mice strain after traumatic brain injury, which implied ephrin-B2 could be one of the promoters to upregulate gliosis following brain injury.

     

Evaluation of respiratory dysfunction in a pig model of severe acute dichlorvos poisoning

Background  Respiratory failure is the main cause of death in acute organophosphorus pesticide poisoning. In this study, a pulse-induced contour cardiac output monitor was used to evaluate the respiratory status in a pig model of acute dichlorvos poisoning.

Methods  Twenty female pigs were randomly allocated to dichlorvos (n=7), atropine (n=7), and control (n=6) groups. In the dichlorvos group, pigs were administered 80% emulsifiable dichlorvos (100 mg/kg) via a gastric tube. In the atropine group, pigs were similarly administered dichlorvos, and 0.5 hours later, atropine was injected to attain and maintain atropinization. The control group was administered saline solution. Arterial blood gas was measured at 0, 0.5, 1, 2, 4, and 6 hours post-injection. The extravascular lung water index and pulmonary vascular permeability index were recorded by the pulse-induced contour cardiac output monitor. At termination of the study, the animals were euthanized, the lung wet-to-dry weight ratio was determined, and histopathology was observed.

Results  In the dichlorvos group, the extravascular lung water index and pulmonary vascular permeability index were substantially increased from 0.5 hours and were particularly high within 1 hour. In the atropine group, these indices increased initially, but decreased from the 1-hour mark. The control group exhibited no obvious changes. In both the dichlorvos and atropine groups, the extravascular lung water index was negatively correlated with partial pressure of oxygen/fraction of inspiration oxygen (PO₂/FiO₂) and positively correlated with the pulmonary vascular permeability index. Compared with the control group, the lung wet-to-dry weight ratio markedly increased and the histopathological findings obviously changed in the dichlorvos group, but only mildly increased and changed, respectively, in the atropine group.

Conclusion  The extravascular lung water index is an appropriate and valuable parameter for assessment of respiratory function in acute dichlorvos poisoning.

     

Influential factors and effect evaluation of the intra-operative puncture biopsy for pancreatic masses

Background  Polyunsaturated omega-3 fatty acids may beneficially influence healing processes and patient outcomes. The aim of this research was to study the clinical efficacy of fish oil enriched total parenteral nutrition in elderly patients after colorectal cancer surgery.

Methods  Fifty-seven elderly patients with colorectal cancer were enrolled in this prospective, randomized, double-blind, controlled clinical trial. All patients received isocaloric and isonitrogenous total parenteral nutrition by continuous infusion (20–24 hours per day) for seven days after surgery. The control group (n=28) received 1.2 g/kg soybean oil per day, whereas the treatment group (n=29) received 0.2 g/kg fish oil and 1.0 g/kg soybean oil per day. Blood samples were taken pre-operatively, and at days one and eight after the operation. The plasma levels of CD4, CD8, CD4/CD8, interleukin 6 (IL-6) and tumor necrosis factor α (TNF-α) were measured. Clinical outcomes were then analysed.

Results  Patient characteristics were comparable between the two groups. At day eight post-surgery, IL-6, TNF-α and CD8 titres were lower in the treatment group when compared to the control group; these results reached statistical significance. In the treatment group, there were fewer infectious complications and incidences of systemic inflammatory response syndrome (SIRS), and shorter lengths of hospital stay were observed. The total cost of medical care was comparable for the two groups. No serious adverse events occurred in either group.

Conclusions  Fish oil 0.2 g/kg per day administrated to elderly patients after colorectal surgery was safe and may shorten the length of hospital stay and improve clinical outcomes.

     

Effects of phlorizin on vascular complications in diabetes db/db mice

Background  Diabetic macrovascular complications are important causes of cardiovascular and cerebrovascular diseases and also one of the major causes of morbidity and mortality in patients with type 2 diabetes mellitus (T2DM). Phlorizin has been reported to be effective in reducing the blood glucose level in diabetic mellitus, while little is known about its effects on vascular complications. This study aimed to observe the effects of phlorizin on the aorta of diabetes db/db mice and explore its mechanism.

Methods  Diabetic db/db mice (n=16) and age-matched db/m mice (n=8) were divided into three groups: normal control group (CC group, db/m mice, n=8), untreated diabetic group (DM group, db/db mice, n=8) and diabetic group treated by phlorizin (DMT group, db/db mice, n=8). Phlorizin (20 mg/kg body weight) was given in normal saline solution intragastrically for 10 weeks. Animals were weighed weekly. At the 10th weekend, all mice were fasted overnight and then sacrificed. Fasting blood was collected, and the aortas were dissected. The blood samples were analyzed for fasting blood glucose (FBG), serum advanced glycation end products (AGEs), malondialdehyde (MDA) and superoxide dismutase (SOD) activity, the aortic ultrastructure was studied.

Results  The weight and serum concentration of FBG, AGEs, and MDA in the DM group were higher than that in the CC group (P <0.01), and they were significantly lower in the DMT group (P <0.05). Serum SOD activity was lower than that in the CC group (P <0.01), and it is significantly higher in the DMT group (P <0.05). The severity of aorta damage in the DMT group was less than that in the DM group.

Conclusions  Phlorizin protected the db/db mice from diabetic macrovascular complications, attributed to the decreasing of blood glucose and AGEs level, and its antioxidant potential. This study may provide a new natural medicine for treating diabetic macrovascular complications.

     

Proteomic analysis for detecting serum biomarkers related to smoking in humans

Background  Smoking is the leading cause of death in the world. This study focused on the difference of the serum proteomic profiling between healthy smokers and nonsmokers in order to find smoking-specific serum biomarkers.

Methods  Pattern-based proteomic profiling of 100 serum samples (from 50 Chinese male smokers and 50 matched nonsmokers) was performed through magnetic bead fractionation coupled with matrix-assisted laser desorption/ionization time-of-flight mass spectrometry analysis (MALDI-TOF-MS) and resulting data were statistically analyzed by Ciphergen ProteinChip software 3.0.2.

Results  We found 72 serum peaks were significantly different between smokers and nonsmokers (P <0.05). Marker peaks of mass-to-charge ratio (m/z) 3159.13, 7561.03 and 9407.32 were smoking-specific.

Conclusion  The preliminary data suggested that smoking-specific serum biomarkers could be detected in humans.