Application of the sheepskin mattress in clinical care for pressure relieving: a quantitative experimental evaluation

This study aimed at quantitatively evaluating the effectiveness of sheepskin mattress (SSM) in pressure relieving, and then variables of peak pressure (mmHg) (PP), average pressure (AP) and contact area (cm²) (CA) at the total, back, sacrum and heel regions of 18 students supinely lying in a control mattress (CM), standard hospital mattress (SHM), SHM + SSM, SSM + CM and AM + CM were measured and contrasted. Paired-T test with a significant level of .05 shows that: the intervention of SSM significantly increased the total CA of SHM by 395.6 cm² and lowered its PP and AP by 8.8 and 2.0 mmHg respectively; further, the pressure distribution of SSM + CM was superior to that of AM + CM. The reliability of this study, with exception of the heel area, was proven to be good. Overall, the sheepskin mattress is an effective product in pressure reliving.     

Effects of chlorogenic acid on adenine nucleotides hydrolyzing enzyme activities and expression in platelets of rats experimentally demyelinated with ethidium bromide

BackgroundThe effects of chlorogenic acid (one of the major phenolic acid found in human diets) were investigated on the adenine nucleotides hydrolyzing enzymes; ecto-nucleotide pyrophosphatase/phophodiesterase (E-NPP), ecto-nucleoside triphosphate diphosphohydrolase (E-NTPDase), E-5′- nucleotidase and ecto-adenosine deaminase (E-ADA) activities and expression in platelets of rats experimentally demyelinated with ethidium bromide.MethodsRats were divided into four groups of eight animals each. Group I rats were control rats; injected with saline (CT), group II rats were injected with saline and treated with chlorogenic acid (AC), group III rats were injected with 0.1% ethidium bromide (EB) and group IV rats were injected with 0.1% EB and treated with chlorogenic acid (EB + AC). The activities of the enzymes were analyzed using colorimetric methods, and the gene expression of NTPDase 1, 2 and 3 were analyzed using the polymerase chain reaction (PCR).ResultsThe results revealed that there was a significant (P < 0.01) reduction in E-NPP activity in EB group (1.63 ± 0.10 nmol p-nitrophenol released/min/mg protein) when compared to CT group (2.33 ± 0.14 nmol p-nitrophenol released/min/mg protein). However, treatment with chlorogenic acid significantly (P < 0.05) increased E-NPP activity in EB group. Furthermore, no significant (P > 0.05) change was observed in the E-NPP activity of EB + AC group (2.19 ± 0.08 nmol p-nitrophenol released/min/mg protein) when compared to CT group (2.33 ± 0.14 nmol p-nitrophenol released/min/mg protein). In addition, there was a significant (P < 0.05) increase in AMP hydrolysis in EB rat group when compared to CT group. No significant (P > 0.05) difference was observed in AMP hydrolysis between AC, AC + EB and CT groups. Conversely, there were no significant (P > 0.05) differences in ATP and ADP hydrolyses between all the groups (AC, EB, AC + EB and CT groups). Likewise, there were no significant (P > 0.05) changes in E-ADA activity and percentage platelet aggregation among all groups studied. Similarly, no significant (P > 0.05) change was observed in the expression of E-NTPDase 1, 2 and 3 in all the groups tested.ConclusionsOur study revealed that chlorogenic acid may modulate the hydrolysis of adenine nucleotides in platelets of rats demyelinated and treated with chlorogenic acid via alteration of E-NPP and ecto-5′-nucleotidase activities.     

Effect of individualized coaching at home on walking capacity in subacute stroke patients: A randomized controlled trial (Ticaa’dom)

BackgroundThe gains in walking capacity achieved during rehabilitation often plateau, or are lost, when the patient returns home. Moreover, maintaining or increasing the patient's daily physical activity level after a stroke remains challenging. We aimed to evaluate the effectiveness of a six-month individualized coaching program at home on walking capacity, as evaluated by the six-minute walk test in subacute stroke patients.MethodsStroke patients in the physical medicine and rehabilitation service participated in a monocentric observer blinded randomized controlled trial with two groups, intervention versus usual care control. The inclusion criteria were: age ≥ 18 years, first ischemic or hemorrhagic stroke, and stroke within < 6 months. Participants were randomly assigned (blocks of variable size) to an intervention group (EG) receiving individualized coaching on physical activity, or to a control group (CG) receiving standard care. The six-month program was composed of monitored physical activity, home visits and a weekly phone call. Participants were evaluated after hospital discharge (T0), at the end of the six-month program (T1) and six months later(follow-up; T2). The primary outcome was the walking distance performance, as evaluated with the six-minute walk test at T1.ResultsEighty-three participants (age: 61y [IQR = 22]; time post-stroke: 2.4 month [IQR = 1.7]; Barthel index: 100[IQR = 5]) were included in the study: (EG, n = 41; CG, n = 42). The difference between the two groups was not significant at T1(418 m [IQR = 165] for the EG and 389 m [IQR = 188] for the CG; P = 0.168) and at T2(425 m [IQR = 121] for the EG vs. 382 m [IQR = 219] for the CG; P = 0.208).ConclusionOur study shows no difference in the six-minute walk test between the two groups of subacute stroke patients after 6 months of the individualized coaching program, combining home visits, feedback on daily performance and weekly telephone calls. http://ClinicalTrials.gov (NCT01822938).     

An evaluation of a nurse-led rehabilitation programme (the ProBalance Programme) to improve balance and reduce fall risk of community-dwelling older people: A randomised controlled trial

ObjectiveThis study aims to assess the effect of a nurse-led rehabilitation programme (the ProBalance Programme) on balance and fall risk of community-dwelling older people from Madeira Island, Portugal.DesignSingle-blind, randomised controlled trial.SettingUniversity laboratory.Participants: Community-dwelling older people, aged 65–85, with balance impairments. Participants were randomly allocated to an intervention group (IG; n = 27) or a wait-list control group (CG; n = 25).InterventionA rehabilitation nursing programme included gait, balance, functional training, strengthening, flexibility, and 3D training. One trained rehabilitation nurse administered the group-based intervention over a period of 12 weeks (90 min sessions, 2 days per week). A wait-list control group was instructed to maintain their usual activities during the same time period.OutcomeBalance was assessed using the Fullerton Advanced Balance (FAB) scale. The time points for assessment were at zero (pre-test), 12 (post-test), and 24 weeks (follow up).ResultsChanges in the mean (SD) FAB scale scores immediately following the 12-week intervention were 5.15 (2.81) for the IG and −1.45 (2.80) for the CG. At follow-up, the mean (SD) change scores were −1.88 (1.84) and 0.75 (2.99) for the IG and CG, respectively. The results of a mixed between-within subjects analysis of variance, controlling for physical activity levels at baseline, revealed a significant interaction between group and time (F (2, 42) = 27.89, p < 0.001, Partial Eta Squared = 0.57) and a main effect for time (F (2, 43) = 3.76, p = 0.03, Partial Eta Squared = 0.15), with both groups showing changes in the mean FAB scale scores across the three time periods. A significant main effect comparing the two groups (F (1, 43) = 21.90, p < 0.001, Partial Eta Squared = 0.34) confirmed a clear positive effect of the intervention when compared to the control.ConclusionThis study demonstrated that the rehabilitation nursing programme was effective in improving balance and reducing fall risk in a group of older people with balance impairment, immediately after the intervention. A decline in balance was observed for the IG after a period of no intervention.Clinical Trial Registration NumberACTRN12612000301864.     

MUC1 568 A/G genotype-dependent Cancer Antigen 15-3 levels in breast cancer patients

ObjectivesCA 15-3 is a widely used tumor marker for breast cancer. We have investigated whether the MUC1 568 A/G polymorphism can influence CA 15-3 levels in healthy women and patients with breast tumors.Design and methodsCA 15-3 was measured in 208 healthy women, in 67 with benign disease, and in 162 women with breast cancer. All subjects were genotyped for the MUC1 568 A/G polymorphism.ResultsSignificant differences were observed between mean CA 15-3 levels of control subjects grouped according to the MUC1 568 genotype (mean ± SD): AA (10.3 ± 3.8), AG (15.9 ± 5.0) and GG (19.0 ± 5.6) U/mL, p < 0.0001. Similar (median) results were observed in women with benign breast disease: AA (10.2), AG (14.2) and GG (16.6) U/mL, p < 0.0001, and those with breast cancer: AA (10.4), AG (17.1) and GG (23.9) U/mL, p < 0.0001.ConclusionsThe MUC1 568 A/G polymorphism strongly influences CA 15-3 levels in healthy women and women with either benign or malignant breast tumors.     

Cerebral energy failure following experimental cardiac arrest: Hypothermia treatment reduces secondary lactate/pyruvate-ratio increase

AimThis was an experimental study performed to investigate cerebral metabolism during hypothermia treatment and rewarming after resuscitation from cardiac arrest (CA).Materials and methodsSixteen pigs underwent CA followed by cardiopulmonary resuscitation (CPR). After randomisation into one hypothermic (n = 8) and one normothermic group (n = 8) the animals received infusion of 4 or 38 °C saline, respectively. Following restoration of spontaneous circulation (ROSC) both groups were observed for 360 min. The hypothermic group was cooled for 180 min and then rewarmed. Temperature was not modulated in the normothermic group.Cerebral microdialysis was conducted and lactate/pyruvate (L/P)-ratio and glutamate were analysed. Intracranial pressure probe was inserted. Oxygen saturation in venous jugular bulb blood (SjO₂) was analysed.ResultsAll animals initially had increased L/P-ratio (>30). A total of nine animals developed secondary increase. In the hypothermic group this was observed in 2/7 animals and in the normothermic group in 7/8 (p = 0.04). Glutamate increased initially in all animals with secondary increases in two animals in each group. No differences in L/P-ratio or glutamate were detected during the rewarming phase compared to the hypothermic phase. The hypothermic group had higher SjO₂ (p = 0.04). In both groups intracranial pressure increased after ROSC.ConclusionAfter resuscitation from CA there was a risk of cerebral secondary energy failure (reflected as an increased L/P-ratio) but hypothermia treatment seemed to counteract this effect. Cerebral oxygen extraction, measured by SjO_2, was increased in the hypothermic group probably due to reduced metabolism. Rewarming did not reveal any obvious harmful events.     

Effects of cryolipolysis on lower abdomen fat thickness of healthy women and patient satisfaction: a randomized controlled trial

ObjectiveTo analyze the effects of cryolipolysis on the fat thickness of the lower abdomen of healthy women and patient's satisfaction.MethodsDesign and setting: a randomized controlled trial, with concealed allocation and blinded assessor. Participants: 34 healthy women between 18 and 48 years, skinfold in the lower abdomen ≥3 cm, BMI between 18.5 and 27 kg/m², low level of physical activity, and no contraindication to cryolipolysis were allocated to intervention group (IG, n = 17) or control group (CG, n = 17). Interventions: The IG received one session of cryolipolysis with −10 °C of temperature for 50 min. The CG was not submitted to any kind of intervention. Both groups did the evaluation protocols at baseline, 30, 60 and 90 days after the intervention. Main outcome measures: fat thickness was measured by ultrasonography (US), skinfold (SF) and abdominal circumference (AC1 and AC2).ResultsNo significant differences between the IG and CG were demonstrated at any evaluation at any time of follow up for the variables US (30 days: 0.05 cm (95%CI: −0.12; 0.22), 60 days: 0.05 cm (95%CI: −0.11; 0.20) and 90 days: 0.04 cm (95%CI: −0.7; 0.25)), SF (30 days: −0.09 cm (95%CI: −0.25; 0.08), 60 days: −0.14 cm (95%CI: −0.36; 0.09) and 90 days: −0.001 cm (95%CI: −0.237; 0.234)), AC1 (30 days: 0.42 cm (95%CI: −1.1; 1.9), 60 days: −0.1 cm (95%CI: −1.74; 1.54) and 90 days: −0.007 cm (−1.9; 1.9)) and AC2 (30 days: 0.183 cm (95%CI: −0.84; 1.20), 60 days: −0.13 cm (95%CI: −1.61; 1.35) and 90 days: −0.31 cm (95%CI: −1.61; 1.00)).ConclusionsThe current study showed that a single application of the utilized protocol of cryolipolysis does not produce any significant effect on fat thickness of the lower abdomen of healthy women.Clinical Trial Registration number: NCT03160976 (https://clinicaltrials.gov/ct2/show/NCT03160976).Contribution of the Paper: the study is one of the first studies in the literature with methodological rigor to report an unfavorable result for localized abdominal fat treatment with a single session of cryolipolysis.     

The effects of gait retraining in runners with patellofemoral pain: A randomized trial

BackgroundRunning popularity has increased resulting in a concomitant increase in running-related injuries with patellofemoral pain most commonly reported. The purpose of this study was to determine whether gait retraining by modifying footstrike patterns from rearfoot strike to forefoot strike reduces patellofemoral pain and improves associated biomechanical measures, and whether the modification influences risk of ankle injuries.MethodsSixteen subjects (n = 16) were randomly placed in the control (n = 8) or experimental (n = 8) group. The experimental group performed eight gait retraining running sessions over two weeks where footstrike pattern was switched from rearfoot strike to forefoot strike, while the control group performed running sessions with no intervention. Variables were recorded pre-, post-, and one-month post-running trials.FindingsKnee pain was significantly reduced post-retraining (P < 0.05; effect size = 0.294) and one-month follow-up (P < 0.05; effect size = 0.294). Knee abduction was significantly improved post-retraining (P < 0.05; effect size = 0.291) and one-month follow-up (P < 0.05; effect size = 0.291). Ankle flexion was significantly different post-retraining (P < 0.05; effect size = 0.547), as well as ankle range of motion post-retraining (P < 0.05; effect size = 0.425) and one-month follow-up (P < 0.05; effect size = 0.425).InterpretationFindings suggest running with a forefoot strike pattern leads to reduced knee pain, and should be considered a possible strategy for management of patellofemoral pain in recreational runners.This trial is registered at the US National Institutes of Health (clinicaltrials.gov) #NCT02567123.     

Prognostic value of miR-26a and HMGA1 in urothelial bladder cancer

BackgroundMicroRNA-26a (miR-26a) functions as a tumor suppressor by regulating its direct target gene high mobility group AT-hook 1 (HMGA1). This study was aimed to investigate the associations of differential expression of miR-26a and HMGA1 with tumor progression and prognosis in urothelial bladder cancer (UBC) patients.Materials and methodsOne hundred and twenty-six UBC patients were selected and quantitative real-time PCR was performed to detect the expression of miR-26a and HMGA1 mRNA in the respective tumors.ResultsOur data showed the decreased expression of miR-26a and the increased expression of HMGA1 mRNA in UBC tissues compared with corresponding non-cancerous tissues (both P < 0.001). Then, the expression levels of miR-26a in UBC tissues were negatively correlated with those of HMGA1 mRNA significantly (r = –0.72, P < 0.001). In addition, UBC patients with combined miR-26a downregulation and HMGA1 upregulation (miR-26a-low/HMGA1-high) more frequently had advanced pathological stage (P < 0.001) and high tumor grade (P < 0.001). Moreover, miR-26a-low/HMGA1-high expression was associated with a significantly shortest disease-free survival (P < 0.001) and overall survival (P < 0.001) of all miR-26a/HMGA1 combined expression groups. Furthermore, multivariate analysis indicated that miR-26a/HMGA1 expression was an independent prognostic factor for both disease-free survival and overall survival (both P = 0.001) in UBC patients.ConclusionInteraction between miR-26a and its target gene HMGA1 may contribute to the malignant progression of human UBC. Tumors with miR-26a downregulation in combination with high expression of HMGA1 showed a worse prognosis than the other tumors. Combined detection of their expression might be particularly helpful for surveillance of disease progression and treatment stratification.     

Correlation between concentrations of 8-oxo-7,8-dihydro-2′-deoxyguanosine in urine,plasma and saliva measured by on-line solid-phase extraction LC-MS/MS

Background8-Oxo-7,8-dihydro-2′-deoxyguanosine (8-oxodGuo) is the most frequently measured biomarker of oxidative stress. Chromatographic-based methods for 8-oxodGuo in urine are well established; however, the 8-oxodGuo measurement in plasma and saliva has been problematic.MethodsWe firstly and successfully applied an on-line solid-phase extraction (SPE) LC-MS/MS following manual SPE pretreatment to quantify the 8-oxodGuo both in plasma and saliva. Urine, plasma and saliva specimens were simultaneously collected from 50 healthy adults and measured for 8-oxodGuo.ResultsMean baseline levels of 8-oxodGuo in plasma and saliva were 21.7 ± 9.2 and 5.1 ± 2.6 pg/ml, respectively, being far lower than that in urine (6.2 ± 4.8 ng/ml). The 8-oxodGuo levels obtained in this study for plasma and saliva were, however, up to several hundred times lower than those reported by commercial ELISA kit in the literature. Furthermore, the 8-oxodGuo levels in plasma and saliva were significantly correlated with the 8-oxodGuo levels in urine (Spearman correlation coefficients, r = 0.33, P = 0.02 for plasma and r = 0.56, P = 0.0015 for saliva). 8-OxodGuo in plasma was also correlated with the 8-oxodGuo in saliva (r = 0.52, P = 0.0041).ConclusionsSignificantly correlations were observed between plasma, saliva and urine, giving the possibility of using other body fluids in addition to urine for assessing whole body oxidative stress.     

Effects of a home-based rehabilitation program in obese type 2 diabetics

ObjectiveTo assess, in obese type 2 diabetics (T2D), the impact of a home-based effort training program and the barriers to physical activity (PA) practice.MethodTwenty-three obese T2D patients (52.7 ± 8.2 years, BMI = 38.5 ± 7.6 kg/m²) were randomized to either a control group (CG), or an intervention group (IG) performing home-based cyclergometer training during 3 months, 30 min/day, with a monthly-supervised session. The initial and final measurements included: maximal graded effort test on cyclergometer, 6-minute walk test (6MWT) and 200-meter fast walk test (200mFWT), quadriceps maximal isometric strength, blood tests and quality of life assessment (SF- 36). A long-term assessment of the amount of physical activity (PA) and the barriers to PA practice was conducted using a questionnaire by phone call.ResultsPatients in the CG significantly improved the maximal power developed at the peak of the cyclergometer effort test (P < 0.05) as well as the quadriceps strength (P < 0.01). There were no significant changes in the other physical and biological parameters, neither in quality of life. At a mean distance of 17 ± 6.4 months, the PA score remained low in the two groups. The main barriers to PA practice identified in both groups were the perception of a low exercise capacity and a poor tolerance to effort, lack of motivation, and the existence of pain associated to PA.ConclusionThis home-based intervention had a positive impact on biometrics and physical ability in the short term in obese T2D patients, but limited effects in the long term. The questionnaires completed at a distance suggest considering educational strategies to increase the motivation and compliance of these patients.     

Alu-based cell-free DNA: A potential complementary biomarker for diagnosis of colorectal cancer

ObjectivesMany patients with colorectal cancer (CRC) present with regional or widespread metastasis, partially reflecting limitations of the current screening programs. This study was aimed to find a complementary marker that can improve the diagnostic accuracy.Design and methodsConcentrations of cell-free DNA based on Alu (Alu‐based CFD) in 31 unselected CRC patients, 30 intestinal polyp patients and 92 healthy individuals were detected by branch DNA (bDNA). Concentrations of carcinoembryonic antigen (CEA) and carbohydrate antigen 19–9 (CA19-9) were detected by ARCHITECT assay.ResultsThere was significant difference in concentrations of CFD between CRC and intestinal polyp patients or healthy individuals (P < 0.0001). There was no statistically significant difference in CFD in different subgroups of CRC patients with respect to gender, age, tumor site and pathologic stage, suggesting that CFD might be an independent marker relative to CEA and CA19-9. There was a significant correlation between pathologic stage and CEA or CA19-9. Although no significant correlation was observed between pathologic stage and CFD, CFD (the area under the receiver operating characteristic curve (AUC) = 0.904) seemed to be a better indicator to distinguish CRC patients from intestinal polyp patients as compared with CEA (AUC = 0.681) or CA19-9 (AUC = 0.651). CFD was more accurate than CEA or CA19-9 in diagnosing CRC.ConclusionsCombination of CFD, CEA and CA19-9 may be a better option for the diagnosis of CRC than any of them used alone. Discrimination CRC from intestinal polyp patients with CFD and staging with CEA and CA19-9 may substantially improve the accuracy CRC diagnosis.     

Effect of a high-intensity interval training on serum microRNA levels in women with breast cancer undergoing hormone therapy. A single-blind randomized trial

BackgroundThe role of microRNAs (miRs) in hormone therapy (HT) is of keen interest in developing biomarkers and treatments for individuals with breast cancer. Although miRs are often moderate regulators under homeostatic conditions, their function is changed more in response to physical activity.ObjectiveThis single-blind randomized trial aimed to explore the effect of high-intensity interval training (HIIT) on serum levels of miRs in individuals with early-stage breast cancer undergoing HT.MethodsHormone receptor-positive women with breast cancer and healthy women were randomly assigned to a healthy control group (n = 15), healthy group with HIIT (n = 15), breast cancer group with HT (HT, n = 26), and breast cancer group with HT and HIIT (HT + HIIT, n = 26). The exercise groups underwent interval uphill walking training on a treadmill 3 times a week for 12 weeks. At the end of the study, we analyzed changes in levels of cancer-related miRs (oncomiRs) and tumour suppressor miRs (TSmiRs) in response to the HT and HIIT.ResultsIn women with breast cancer versus healthy controls, the expression of some oncomiRs was significantly increased — miR-21 (P < 0.001), miR-155 (P = 0.001), miR-221 (P = 0.008), miR-27a (P < 0.001), and miR-10b (P = 0.007) — and that of some TSmiRs was significantly decreased — miR-206 (P = 0.048), miR-145 (P = 0.011), miR-143 (P = 0.008), miR-9 (P = 0.020), and let-7a (P = 0.005). Moreover, HT considerably downregulated oncomiRs and upregulated TSmiRs. HIIT for 12 weeks with HT significantly decreased the expression of the oncomiRs and significantly increased that of the TSmiRs as compared with HT alone.ConclusionsHITT could amplify the decrease and/or increase in expression of miRs associated with HT in women with breast cancer. A prospective trial could determine whether the use of circulating miRs for monitoring treatment can be useful in therapy decisions.Trial registrationIranian Registry of Clinical Trials (No.: IRCT201202289171N1).     

Matrix metalloproteinase (MMP)-9 genotypes and haplotypes in preeclampsia and gestational hypertension

BackgroundAbnormal production of matrix metalloproteinases (MMPs), especially MMP-9, may play a role in hypertensive disorders of pregnancy. These alterations may result from functional genetic polymorphisms in the promoter region of MMP-9 gene, which are known to change MMP-9 expression. We examined whether 2 MMP-9 polymorphisms (C^? 1562 T and (CA)n) and haplotypes are associated with preeclampsia and/or gestational hypertension.MethodsWe studied 476 pregnant women: 176 healthy pregnant (HP), 146 pregnant with gestational hypertension (GH), and 154 pregnant with preeclampsia (PE). Genomic DNA was extracted from whole blood and genotypes for C^? 1562 T and (CA)n polymorphisms were determined by PCR-RFLP. Haplotype frequencies were inferred using the PHASE ver. 2.1 program.ResultsFor the g.?90(CA)13–25 polymorphism, no significant differences were found in genotype and allele distributions when PE or GH groups were compared with HP group. However, the CT genotype and T allele for g.?1562C > T polymorphism were more commonly found in GH subjects compared with the HP group (both P < 0.05). Conversely, we found no differences in genotypes or allele distributions for the g.?1562C > T polymorphism when the PE and the HP groups were compared. No significant differences were found in overall distributions of haplotype frequencies when the GH or the PE group was compared with the HP group.ConclusionsThe C^? 1562 T polymorphism in MMP-9 gene is associated with gestational hypertension, but not with preeclampsia. These findings may help to explain the higher plasma MMP-9 levels previously reported in GH compared with HP.     

High-level expression of early growth response-1 and association of polymorphism with total IgE and atopy in allergic rhinitis adults

BackgroundEarly growth response-1 (Egr-1) is expressed in human airways and its polymorphisms have been associated with total IgE and atopy in asthmatic patients. We investigated the effects of Chinese-tagging single nucleotide polymorphism (SNP) of Egr-1 and its mRNA expression on allergic rhinitis (AR) traits.MethodsAmong 214 Chinese AR adults and 259 controls, tag SNP ?4071 A → G was genotyped and mRNA expression in peripheral blood was quantified by real-time PCR.ResultsEgr-1 mRNA expression was significantly higher in patients than controls (median of 0.23 vs 0.15 fold GAPDH expression; p < 0.001). Its expression was not associated with ? 4071 polymorphism. However, significant correlations were found between ? 4071 A → G with increased plasma total IgE (p = 0.028) and atopy (p = 0.030) in patients. Logistic regression confirmed the association (p = 0.034) with age and gender adjusted. Patients homozygous for the A allele had a 2.3-fold and 1.9-fold risks, respectively of having increased plasma total IgE and atopy than those G allele carriers.ConclusionsWe showed high levels of Egr-1 mRNA expression and demonstrated a significant association of polymorphism with increased plasma total IgE and atopy in AR patients. It may be useful to explore the pharmacogenetics of Egr-1 inhibitors.     

Epidermal growth factor-like domain 7 promotes cell invasion and angiogenesis in pancreatic carcinoma

Epidermal growth factor-like domain 7 (EGFL7), also known as vascular endothelial stain, was firstly identified as a modulator of smooth muscle cell migration. Though the expression of EGFL7 was reported to be up-regulated during tumorigenesis, the clinical and biological functions of EGFL7 in pancreatic carcinoma (PC) were still not fully elucidated. In this study, we found that the serum EGFL7 level in PC tissues was statistically higher than that in normal subjects (p < 0.001), and its level in non-resectable patients was also higher than that in resectable ones (p = 0.013). Among these resectable PC patients, the postoperative EGFL7 expression was significantly down-regulated when tumors were resected (p = 0.018). Using the immunohistochemistry method, our results demonstrated that the positive expression of EGFL7 was significantly associated with the TNM stage (p = 0.024), lymph node metastasis (p = 0.003) and local invasion (p = 0.022), and the EGFL7 expression closely correlated to the micro-vessel density (MVD) in PC tissues by Spearman analysis (r = 0.941, p = 0.000). In vitro, EGFL7 was silenced by the small interference RNA in PC cells, and our data indicated that down-regulation of EGFL7 did not influence the cycle progression, proliferation, colony formation and apoptosis of PC cells (p > 0.05), whereas inhibition of EGFL7 expression could decrease PaCa-2 cell invasion (p < 0.05). More interestingly, by tubular formation, Chick embryo chorioallantoic membrane (CAM) and ELISA assays, our results revealed that silencing EGFL7 expression represented a strong inhibiting effect on tubular formation of micro-vessels through down-regulating the protein levels of VEGF and Ang-2 (p < 0.05). Our results raised the possibility of using EGFL7 as a potential prognostic biomarker and therapy target of PC, and down-regulation of EGFL7 might be considered to be a potentially important molecular treatment strategy for patients with PC.     

Cerebral effects of three resuscitation protocols in uncontrolled haemorrhagic shock: A randomised controlled experimental study

BackgroundTo compare haemodynamic and cerebral variables during aggressive fluid resuscitation vs. administration of a hypertonic starch solution (HS) combined with either noradrenaline [norepinephrine] or arginine vasopressin in an animal model of uncontrolled haemorrhagic shock.MethodsAfter Animal Investigational Committee approval, 24 anaesthetised pigs underwent a liver trauma. At haemodynamic decompensation, animals were randomly assigned to receive fluid resuscitation (6% HES 130/0.4, 20 mL/kg, and Ringer, 40 mL/kg; FR group, n = 8), or noradrenaline (bolus 20 μg/kg, continuously 1 μg/kg/min) combined with HS (7.2% NaCl/6% HES 200/0.5; 4 mL/kg) (n = 8; NA/HS group), or vasopressin (bolus 0.2 U/kg, continuously 0.04 U/kg/min) combined with HS (4 mL/kg) (n = 8; AVP/HS group), respectively. Thirty minutes after drug administration, bleeding was controlled manually.ResultsMean arterial blood pressure (MAP), cerebral perfusion pressure (CPP), and brain tissue oxygen pressure (P_btO₂) decreased significantly with haemorrhage in all groups (p < 0.05). AVP/HS resulted in a faster and higher increase of MAP and CPP compared to both NA/HS and FR (p < 0.001 vs. FR; p < 0.01 vs. NA/HS). Compared to FR, P_btO₂ increased faster with AVP/HS and NA/HS (p < 0.05) after therapy, and ICP was lower at the end of the study period (p < 0.05). All animals (8/8) of the AVP/HS group survived, compared to 4/8 and 4/8 in the NA/HS and FR group, respectively (p = 0.07).ConclusionsFollowing uncontrolled haemorrhagic shock in this animal model, combination of HS with arginine vasopressin increased CPP and cerebral oxygenation faster than aggressive fluid resuscitation, without re-increasing ICP.