腹腔镜下囊肿去顶减压术治疗多囊肾的临床疗效评价

目的：比较腹腔镜肾囊肿去顶减压术和开放肾囊肿去顶减压术两种手术方式治疗多囊肾的临床疗效。方法对108例多囊肾患者的临床资料进行回顾性分析,其中腹腔镜手术60例,开放手术48例,对两组手术时间、术中出血量、术后引流量、术后肠道功能恢复时间、术后住院天数、并发症发生率、肾功能情况、血压情况和临床疗效等指标进行比较。结果腹腔镜组手术时间为（57．7±13．2）min,术中出血量为（35．9±17．3）mL,术后排气时间为（1．6±0．7）d,术后引流量为（23．2±4．3）mL,术后住院天数为（5．1±0．8）d,均显著少于开放手术组;腹腔镜组出现3例皮下气肿、腹膜后血肿及尿瘘并发症,并发症发生率为5．0％,开放手术组出现8例腹膜后血肿、切口感染、尿瘘并发症,并发症发生率为16．7％,两组间并发症差异有统计学意义（ P＜0．05）。腹腔镜组和开放手术组患者术后3月时肌酐、尿素氮水平及收缩压水平均较术前显著下降,两组之间差异无统计学意义（P＞0．05）。开放手术组48例中治愈率和有效率分别为81．2％和18．8％,腹腔镜组治愈率和有效率分别为85．0％和15.0％,两组疗效差异无统计学意义（ P＞0．05）。结论腹腔镜下囊肿去顶减压术在手术时间、术中失血量、并发症、术后恢复情况方面均优于开放手术,具有疗效可靠,损伤小,恢复快等优点,可以作为治疗多囊肾的首选方式。     

Treatments of unruptured brain arteriovenous malformations: A systematic review and meta-analysis

Background:The best therapeutic option for unruptured brain arteriovenous malformations (bAVMs) patients is disputed.Objective:To assess the occurrence of obliteration and complications of patients with unruptured bAVMs after various treatments.Methods:A systematic literature search was performed in PubMed, EMBASE, Web of Science, and so on to identify studies fulfilling predefined inclusion criteria. Baseline, treatment, and outcomes data were extracted for statistical analysis.Results:We identified 28 eligible studies totaling 5852 patients. The obliteration rates were 98% in microsurgery group (95% confidence interval (CI): 96%–99%, I² = 74.5%), 97% in surgery group (95%CI: 95%–99%, I² = 18.3%), 87% in endovascular treatment group (95%CI: 80%–93%, I² = 0.0%), and 68% in radiosurgery group (95%CI: 66%–69%, I² = 92.0%). The stroke or death rates were 1% in microsurgery group (95%CI: 0%–2%, I² = 0.0%), 0% in surgery group (95%CI: 0%–1%, I² = 0.0%), 4% in endovascular treatment group (95%CI: 0%–8%, I² = 85.8%), and 3% in radiosurgery group (95%CI: 3%–4%, I² = 82.9%). In addition, the proportions of hemorrhage were 2% in microsurgery group (95%CI: 1%–4%, I² = 0.0%), 23% in endovascular treatment group (95%CI: 7%–39%), and 12% in radiosurgery group (95%CI: 12%–13%, I² = 99.2%). As to neurological deficit, the occurrence was 9% in microsurgery group (95%CI: 6%–11%, I² = 94.1%), 20% in surgery group (95%CI: 13%–27%, I² = 0.0%), 14% in endovascular treatment group (95%CI: 10%–18%, I² = 64.0%), and 8% in radiosurgery group (95%CI: 7%–9%, I² = 66.6%).Conclusions:We found that microsurgery might provide lasting clinical benefits in some unruptured bAVMs patients for its high obliteration rates and low hemorrhage. These findings are helpful to provide a reference basis for neurosurgeons to choose the treatment of patients with unruptured bAVMs.     

Acupuncture and related therapies for poststroke insomnia: A protocol for systematic review and network meta-analysis

Objective:To compare and evaluate the clinical effects on patients with poststroke insomnia of various acupuncture and acupuncture-related therapies.Methods:In order to analyze the direct and indirect evidence from related studies, we used network meta-analysis (NMA). In order to collect randomized controlled trials (RCTs) of acupuncture and related therapies in the treatment of poststroke insomnia, 3 English and 4 Chinese databases were searched. After 2 researchers independently screened the literature, extracted the information, and assessed the probability of bias in the included studies, the data was analyzed using Stata15.0 and WinBUGS1.4.3 software.Results:Based on the existing data, the pros and cons of different acupuncture-related therapies are compared extensively, the effectiveness of different acupuncture-related therapies is ranked compared to drugs with hypnotic effect in poststroke insomnia care, and the best methods or combinations of acupuncture intervention are summarized.Conclusion:This study will provide new evidence for the safety and effectiveness of acupuncture-related therapies in the treatment of poststroke insomnia, and may be helpful for clinicians, poststroke insomnia patients, and clinical guideline makers to choose the optimal combination of acupuncture for the treatment of poststroke insomnia.Registration Number:INPLASY202120028.     

Efficacy and safety of immunosuppressive therapies in the treatment of high-risk IgA nephropathy: A network meta-analysis

Background:IgA nephropathy (IgAN) is one of the significant contributing factors of end-stage renal disease (ESRD). It is reported that over half of patients with IgAN accompany multiple high-risk factors, which increase the risk of ESRD progression. Studies have shown that immunosuppressive agents were beneficial in high-risk IgAN, but the efficacy and safety have not been fully demonstrated yet. The present study aims to elucidate the efficacy of commonly used immunosuppressants in high-risk IgAN and their relative safety profiles via a network meta-analysis strategy.Methods:Randomized controlled trials (RCTs) eligible for this network meta-analysis were included to evaluate the efficacy and safety of different immunosuppressants for high-risk IgAN. Main outcomes and measures include incidence of renal composite end point, the rate of total remission, adverse events, and proteinuria. Besides, subgroup analysis and cluster analysis were carried out.Results:This network meta-analysis of 37 RCTs involving 3012 participants found that Mycophenolate mofetil (MMF) combined with corticosteroids (CS) was superior to other interventions in end point events and proteinuria. Cyclosporine A (CsA) plus CS was the best option for clinical remission rate, and supportive care (SC) was the safest treatment. Cluster analysis showed that MMF+CS and Leflunomide (LEF)+CS were best protocols in efficacy and safety. Subgroup analysis indicated the best benefits of MMF were presented among the Asian population, and the benefits increased with the increase of follow-up duration. The effect of Cyclophosphamide (CTX) +CS on crescent IgAN was better than that of other risk factors. Moreover, the increasing follow-up duration was negatively associated with the effect.Conclusions:MMF+CS and LEF+CS appear to serve as the best choice for treating high-risk IgAN than other immunosuppressive therapies.     

LncRNA SNHG14 Sponges miR-206 to Affect Proliferation,Apoptosis, and Metastasis of Hepatocellular Carcinoma Cells by Regulating SOX9

Digestive Diseases and Sciences - To explore how lncRNA SNHG14 modulates the biological features of hepatocellular carcinoma (HCC) cells by regulating SOX9 via mediating miR-206. HCC tissues were...     

Mirabegron Ameliorated Atherosclerosis of ApoE−/− Mice in Chronic Intermittent Hypoxia but Not in Normoxia

Cardiovascular Drugs and Therapy - It has been established that obstructive sleep apnea (OSA) is an independent risk factor for atherosclerosis. Chronic intermittent hypoxia (CIH) activates...     

Benzothiadiazole‐Containing Conjugated Polyelectrolytes for Biological Sensing and Imaging

This article summarizes the recent advances of benzothiadiazole (BT)‐containing conjugated polyelectrolytes (CPEs) for biological sensing and imaging. After a brief introduction of the molecular design principles, the application of linear BT‐containing CPEs as multicolor or light‐up probes for visual sensing of biomolecules is reviewed. Then, linear, grafted, and hyperbranched BT‐containing CPEs that can self‐assemble into nanoparticles or have intrinsic 3D structures for in vitro and in vivo imaging are summarized. The future outlook of BT‐containing CPEs for biomedical applications is also discussed at the end.

     

Overexpression and involvement in migration by the metastasis-associated phosphatase PRL-3 in human myeloma cells

Multiple myeloma (MM) is characterized by accumulation and dissemination of malignant plasma cells (PCs) in the bone marrow (BM). Gene expression profiling of 2 MM cell lines (OH-2 and IH-1) indicated that expression of PRL-3, a metastasis-associated tyrosine phosphatase, was induced by several mitogenic cytokines. Cytokine-driven PRL-3 expression could be shown in several myeloma cell lines at both the mRNA and protein levels. There was significantly higher expression of the PRL-3 gene in PCs from patients with monoclonal gammopathy of undetermined significance (MGUS), smoldering myeloma (SMM), and myeloma than in PCs from healthy persons. Among 7 MM subgroups identified by unsupervised hierarchical cluster analysis, PRL-3 gene expression was significantly higher in the 3 groups denoted as "proliferation," "low bone disease," and "MMSET/FGFR3." PRL-3 protein was detected in 18 of 20 BM biopsies from patients with MM. Silencing of the PRL-3 gene by siRNA reduced cell migration in the MM cell line INA-6, but had no detectable effect on proliferation and cell-cycle phase distribution of the cells. In conclusion, PRL-3 is a gene product specifically expressed in malignant plasma cells and may have a role in migration of these cells.     

Gene expression profiling of human plasma cell differentiation and classification of multiple myeloma based on similarities to distinct stages of late-stage B-cell development

To identify genes linked to normal plasma cell (PC) differentiation and to classify multiple myeloma (MM) with respect to the expression patterns of these genes, we analyzed global mRNA expression in CD19-enriched B cells (BCs) from 7 tonsils, CD138-enriched PCs from 11 tonsils, 31 normal bone marrow samples, and 74 MM bone marrow samples using microarrays interrogating 6800 genes. Hierarchical clustering analyses with 3288 genes clearly segregated the 4 cell types, and chi-square and Wilcoxin rank sum tests (P <.0005) identified 359 and 500 previously defined and novel genes that distinguish tonsil BCs from tonsil PCs (early differentiation genes [EDGs]), and tonsil PCs from bone marrow PCs (late differentiation genes [LDGs]), respectively. MM as a whole was found to have dramatically variable expression of EDGs and LDGs, and one-way analysis of variance (ANOVA) was used to identify the most variable EDGs (vEDGs) and LDGs (v1LDG and v2LDG). Hierarchical cluster analysis with these genes revealed that previously defined MM gene expression subgroups (MM1-MM4) could be linked to one of the 3 normal cell types. Clustering with 30 vEDGs revealed that 13 of 18 MM4 cases clustered with tonsil BCs (P =.000 05), whereas 14 of 15 MM3 cases clustered with tonsil PCs when using 50 v1LDG (P =.000 008), and 14 of 20 MM2 cases clustered with bone marrow PCs when using 50 v2LDG (P =.000 09). MM1 showed no significant linkage with normal cell types studied. Thus, genes whose expression is linked to distinct transitions in late-stage B-cell differentiation can be used to classify MM.