Cyanidin-3-rutinoside increases glucose uptake by activating the PI3K/Akt pathway in 3T3-L1 adipocytes

In this study, the effect of cyanidin-3-rutinoside (C3R) on glucose uptake by 3T3-L1 adipocytes was studied. C3R significantly increased glucose uptake, which was associated with enhanced plasma membrane glucose transporter type 4 (PM-GLUT4) expression in 3T3-L1 adipocytes. The potentiating effect of C3R on glucose uptake and PM-GLUT4 expression was related to enhanced phosphorylation of insulin receptor substrate 1 (IRS-1) and Akt, as well as augmented activation of phosphatidylinositol-3-kinase (PI3K) in the insulin signaling pathway. C3R induced glucose uptake was inhibited only by the PI3K inhibitor, but not by an AMPK inhibitor in 3T3-L1 adipocytes. Therefore, C3R likely up-regulates glucose uptake and PM-GLUT4 expression in 3T3-L1 adipocytes by activating the PI3K/Akt pathways.     

Clinical value of normal saline injection for expansion of the anterior perirectal space during prostate cryoablation

BackgroundThe objective of this study is to describe the technique and evaluate the clinical value of normal saline (NS) injection for expanding the anterior perirectal space during prostate cryoablation for prostate cancer (PCa) patients.MethodsPCa patients who received cryoablation between August 2014 and December 2019 were enrolled, and the technique of NS injection was adopted. The complications were evaluated. The prostate-specific antigen (PSA) nadir and biochemical progression-free survival (bPFS) were measured in localized PCa patients who received cryoablation as the primary treatment.ResultsA total of 159 PCa patients were included. Among 147 patients with the data of anterior perirectal space, the median (interquartile range [IQR]) distance of estimated iceball edge beyond the prostatic capsule was 8.3 (7.0–10.0) mm. No cases of urethrorectal fistula were reported; 29 patients developed urinary retention and 25 patients presented scrotal edema. All complications below Clavien-Dindo grade IIIb disappeared within 7 weeks after surgery. Urinary incontinence was reported in 6 patients. Among localized PCa patients, the median (IQR) follow-up time was 56.5 (36.0–73.5) months. The estimated 5-year bPFS was 82.3% overall, 82.8% for low-to intermediate-risk PCa patients, and 82.1% for high-risk PCa patients. For 52 patients received cryoablation alone, the median (IQR) PSA nadir was 0.147 (0.027–0.381) ng/mL.ConclusionsThe technique of NS injection for expanding the anterior perirectal space during cryoablation surgery could avoid urethrorectal fistula and might benefit localized PCa patients with lower PSA nadir and longer bPFS.     

C-反应蛋白/白蛋白与脓毒性休克患者90d预后价值的研究

目的:评估CRP/ALB比值在预测脓毒性休克患者90d死亡率中的作用。方法:收集在EICU入院的成人脓毒性休克患者共136例,按随访90d是否存活分为存活组与死亡组,记录两组患者基线特征、CRP、ALB数值,并计算CRP/ALB比值。采用统计学分析,确定各生物标记物对出院患者90d死亡率的诊断价值。结果:CRP dis及CRP/ALB dis较其他数据的AUC高,特异度亦较高,对出院后90d死亡有相对较好的诊断价值,二者比较差异有统计学意义,P=0.043。结论:CRP/ALB dis可作为脓毒性休克患者的长期预后指标。     

原因不明的顽固性咳嗽病因学诊断

本文通过对原因不明的顽固性咳嗽的病因学诊断进行归纳总结,阐述顽固性咳嗽的7个重要的病因诊断,包括鼻后滴漏综合征、咳嗽变异型哮喘、胃食管返流、肝癌、血管紧张素转换酶抑制剂（ACEI）药源性、室性早搏（心源性）和癔症,明确病因诊断可以使大多数患者得到病因学治疗而痊愈。临床诊疗工作中需注意鉴别诊断,不断提高临床诊断的准确性。     

Intravenous umbilical cord mesenchymal stem cell infusion for the treatment of combined malnutrition nonunion of the humerus and radial nerve injury

Nonunion and nerve injury are the most severe and common complications of bone fracture treatments. There is still no ideal therapy for these two complications. In this report, we first applied umbilical cord mesenchymal stem cell (UC-MSC) therapy to one patient with both nonunion and nerve injury, and observed the therapeutic effects. UC-MSCs were produced and expanded according to a clinical-grade technique using serum-free medium enriched in human platelet lysate. Flow cytometry was performed to evaluate the purity of UC-MSCs, which were then intravenously injected. At 60 days postinjection, clinical examinations were performed to evaluate the therapeutic effects. Compared with before treatment, the patient's nerve reflex was present, and their muscle tone and strength increased, and x-ray and electromyography analysis further showed that the fracture gap disappeared and the nerve conduction velocity increased with shorter latency and higher amplitude. Furthermore, the clinical evolution was favorable and no side effects were observed during the 1-year follow-up. Overall, this novel treatment might open up a new strategy for the treatment of bone fracture complications.     

C-erbB-2和EGFR及nm23-H1在膀胱癌中的表达及临床意义

目的：探讨C-erbB-2、表皮生长因子受体（EGFR）和nm23-H1在膀胱癌中的表达及临床意义。方法：应用免疫组织化学S-P法检测69例膀胱癌和12例正常膀胱黏膜中C-erbB-2,EGFR和nm23-H1的表达情况。结果：C-erbB-2,EGFR和nm23-H1在膀胱癌中的阳性表达率分别是44.9%,56.5%和60.9%,在正常膀胱黏膜中的阳性表达率分别为0.00%,0.00%和100%,两两比较差异均有显著性（P〈0.01）,其中C-erbB-2和EGFR的阳性表达率随着膀胱癌病理分级和临床分期的增高而增高,nm23-H1的阳性表达率随着膀胱癌病理分级和临床分期的增高而降低。结论：C-erbB-2,EGFR和nm23-H1的异常表达在膀胱癌的发生及发展过程中起着重要作用。     

Efficacy and Safety of Rezivertinib (BPI-7711) in Patients With Locally Advanced or Metastatic/Recurrent EGFR T790M-Mutated NSCLC: A Phase 2b Study

IntroductionRezivertinib (BPI-7711) is a novel third-generation EGFR tyrosine kinase inhibitor (TKI) targeting both EGFR-sensitizing mutations and EGFR T790M mutation. This study aimed to evaluate the efficacy and safety of rezivertinib in patients with locally advanced or metastatic/recurrent EGFR T790M-mutated NSCLC.MethodsPatients with locally advanced or metastatic/recurrent NSCLC with confirmed EGFR T790M mutation who progressed after first-/second-generation EGFR TKI therapy or primary EGFR T790M mutation were enrolled. Patients received rezivertinib at 180 mg orally once daily until disease progression, unacceptable toxicity, or withdrawal of consent. The primary end point was objective response rate (ORR) assessed by blinded independent central review per Response Evaluation Criteria in Solid Tumors version 1.1. Secondary end points included disease control rate (DCR), duration of response, progression-free survival (PFS), overall survival, and safety. This study is registered with Clinical Trials.gov (NCT03812809).ResultsA total of 226 patients were enrolled from July 5, 2019, to January 22, 2020. By the data cutoff date on January 24, 2022, the median duration of follow-up was 23.3 months (95% confidence interval [CI]: 22.8–24.0). The ORR by blinded independent central review was 64.6% (95% CI: 58.0%–70.8%), and DCR was 89.8% (95% CI: 85.1%–93.4%). The median duration of response was 12.5 months (95% CI: 10.0–13.9), and median PFS was 12.2 months (95% CI: 9.6–13.9). The median overall survival was 23.9 months (95% CI: 20.0–not calculated [NC]). Among 91 (40.3%) patients with central nervous system (CNS) metastases, the median CNS PFS was 16.6 months (95% CI: 11.1–NC). In 29 patients with more than or equal to one brain target lesion at baseline, the CNS ORR and CNS DCR were 69.0% (95% CI: 49.2%–84.7%) and 100% (95% CI: 88.1%–100%), respectively. Time to progression of CNS was 16.5 months (95% CI: 9.7–NC). Of 226 patients, 188 (83.2%) had at least one treatment-related adverse event, whereas grade more than or equal to 3 occurred in 45 (19.9%) patients. No interstitial lung disease was reported.ConclusionsRezivertinib was found to have promising efficacy and favorable safety profile for patients with locally advanced or metastatic/recurrent NSCLC with EGFR T790M mutation.     

血清肿瘤相关性胰蛋白酶原2检测在胰腺癌初筛中的意义

目的研究血清中肿瘤相关胰蛋白酶原2在胰腺癌初筛中的意义。方法收集中国人民解放军北京军区总医院内、外科诊为胰腺癌患者23例治疗前的血清标本,35例正常健康人的血清。采用酶联免疫法半定量检测血清中肿瘤相关胰蛋白酶原2的含量。结果血清肿瘤相关性胰蛋白酶原2含量在健康人的中位数为0.8μg/L,四分位间距为0.6～1.2μg/L;胰腺癌患者中位数为13.8μg/L,四分位间距为2.3～60.7μg/L。胰腺癌患者和健康人血清肿瘤相关胰蛋白酶原2水平有差异(P<0.01)。以1.85μg/L为临界值,诊断胰腺癌的敏感度为91.4%,特异度为95.7%。结论血清肿瘤胰蛋白酶原2检测可作为胰腺癌的一种初筛试验,敏感性、特异性均较高。     

灯盏细辛注射液与灯盏生脉胶囊治疗缺血性中风上市后临床再评价

目的:验证灯盏细辛注射液和灯盏生脉胶囊(以下称灯盏组)上市后治疗缺血性中风的疗效和安全性。方法:采用多中心、前瞻性、实用性随机对照研究设计,应用"临床研究中央随机系统",对678例患者进行随机分组,灯盏组343例,西医组335例。灯盏组急性期以灯盏细辛注射液治疗为主,恢复期以口服灯盏生脉胶囊为主。疗效评价指标主要为随访360 d的重要临床结局事件(病死率、复发率、致残率、生存质量)。安全性评价主要观察实验室检查指标、不良事件及发生率。结果:随访360 d,灯盏组病死4例,病死率为1.17%,西医组病死16例,病死率为4.78%,灯盏组病死率显著低于西医组(P<0.05);灯盏组复发11例,复发率为3.21%,西医组复发12例,复发率为3.59%,灯盏组复发率略低于西医组;灯盏组致残率为39.53%,其中严重致残率为1.49%,西医组的致残率为40.13%,其中严重致残率为3.13%,灯盏组致残率与残疾严重程度均低于西医组;生存质量比较,灯盏组对脑卒中患者活动能力、上肢功能评分方面显著优于西医组(P<0.05)。安全性分析显示,灯盏组发生不良事件11例,与药物治疗相关为4例,不良反应发生率1.17%,主要表现为发热寒战、皮疹、恶心、头晕心慌,全部为使用灯盏细辛注射液后出现,停药后1～2 d症状消失。灯盏组中发生13例肝功能异常,2例肾功能异常,临床医生判断3例ALT异常可能与药物使用有关,其余均与药物无关。结论:灯盏细辛注射液与灯盏生脉胶囊是治疗缺血性中风安全有效的中药。