Lack of association between lymphotoxin-α, galectin-2 polymorphisms and coronary artery disease: A meta-analysis

ObjectivePrevious case–control studies suggested the single nucleotide polymorphisms of lymphotoxin-α (LTA) gene and galectin-2 (LGASL2) gene are associated with coronary artery disease and myocardial infarction. However, other studies did not confirm this relationship. The objective was to assess the relationship of LTA gene, LGALS2 gene and coronary artery disease, using a meta-analysis.MethodsDatabases, including PubMed, EMbase, CBM and CNKI, were searched to get the genetic association studies. Data were extracted by two authors and pooled odds ratio (OR) and 95% confidence interval (CI) were calculated.ResultThe meta-analysis included 20640 (LTA-A252G) and 10552 (LGALS2-C3279T) cases, 15388 (A252G) and 10545 (C3279T) controls. The pooled OR of 252G was 1.02 (95%CI: 0.97–1.07) compared to wild type allele in dominant model, and was 1.00 (95%CI: 0.94–1.07) in recessive model. The pooled OR of 3279T was 0.95 (95%CI: 0.89–1.01) compared to wild type allele in dominant model, and was 0.89 (95%CI: 0.78–1.00) in recessive model. None of the polymorphisms was found to associate with coronary artery disease.ConclusionIn present study, the LTA gene and LGALS2-C3279T are not associated with coronary artery disease.     

非酒精性脂肪性肝病与急性胰腺炎的关系

急性胰腺炎是临床常见的急腹症之一。非酒精性脂肪性肝病作为代谢综合征的肝脏表现,与急性胰腺炎的严重程度及预后密切相关。阐述了非酒精性脂肪性肝病在急性胰腺炎发生发展过程中的作用机制,指出非酒精性脂肪性肝病可通过多种途径诱发急性胰腺炎并加重其病情严重程度。     

Effect of arginine vasopressin on the cortex edema in the ischemic stroke of Mongolian gerbils

Brain edema formation is one of the most important mechanisms of ischemia-evoked cerebral edema. It has been demonstrated that arginine vasopressin (AVP) receptors are involved in the pathophysiology of secondary brain damage after focal cerebral ischemia. In a well-characterized animal model of ischemic stroke of Mongolian gerbils, the present study was undertaken to clear the effect of AVP on cortex edema in cerebral ischemia. The results showed that (1) occluding the left carotid artery of Mongolian gerbils not only decreased the cortex specific gravity (cortex edema) but also increased AVP levels in the ipsilateral cortex (ischemic area) including left prefrontal lobe, left parietal lobe, left temporal lobe, left occipital lobe and left hippocampus for the first 6 hours, and did not change of the cortex specific gravity and AVP concentration in the right cortex (non-ischemic area); (2) there were many negative relationships between the specific gravity and AVP levels in the ischemic cortex; (3) intranasal AVP (50 ng or 200 ng), which could pass through the blood–brain barrier to the brain, aggravated the focal cortex edema, whereas intranasal AVP receptor antagonist-D(CH₂)₅Tyr(ET)DAVP (2 µg) mitigated the cortex edema in the ischemic area after occluding the left carotid artery of Mongolian gerbils; and (4) either intranasal AVP or AVP receptor antagonist did not evoke that edema in the non-ischemic cortex. The data indicated that AVP participated in the process of ischemia-evoked cortex edema, and the cerebral AVP receptor might serve as an important therapeutic target for the ischemia-evoked cortex edema.     

Toripalimab plus chemotherapy in treatment-naïve,advanced esophageal squamous cell carcinoma (JUPITER-06): A multi-center phase 3 trial

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Soluble serum Klotho in diabetic nephropathy: Relationship to VEGF-A

ObjectivesBoth kidney expression and soluble serum Klotho are influenced by chronic kidney disease (CKD) and diabetes. Serum Klotho is a yet poorly explored biomarker. We describe, for the first time to our knowledge, serum Klotho in diabetic patients with CKD and its relationship to vascular endothelial growth factor A (VEGF-A).Design and methodsWe included 43 controls and 146 diabetic patients with different stages of CKD. Laboratory evaluation, urinary albumin/creatinine ratio (UACR), Klotho (ELISA), VEGF-A (ELISA) were performed.ResultsKlotho was 0.40(0.10–1.30) ng/mL in diabetic patients without CKD and 0.80(0.30–1.30) ng/mL in controls, p = 0.20; VEGF-A was higher in diabetic patients 73.85(57.32–119.00) pg/mL than in controls 43.20(30.1–65.9) pg/mL, p < 0.0001. Klotho increased with CKD stage: 0.2(0.10–0.40) ng/mL in CKD 1/2, 0.60(0.20–1.1) ng/mL in CKD 3/4 and 1.45(0.425–2.90) ng/mL in dialysis patients, p < 0.0001; it also increased with decreasing glomerular filtration rate (GFR). Klotho was lower in albuminuric (UACR > 30 mg/g) patients 0.20(0.10–0.70) ng/mL than in normoalbuminuric (UACR < 30 mg/g) ones 0.50(0.20–1.30) ng/mL, p = 0.03; lowest Klotho was found in microalbuminuric (UACR 30–300 mg/g) patients, p = 0.07. VEGF was lower in microalbuminuric patients but was not influenced by GFR. In diabetic patients but not in controls, Klotho correlated to VEGF-A (r = 0.29, p = 0.0003); in multiple regression VEGF-A was the only significant predictor of Klotho: b = 0.27, 95%CI (0.01–0.04), p = 0.001.ConclusionsIn diabetic patients, Klotho is decreased in early CKD and increases thereafter, paralleling reduced GFR. VEGF-A is higher in diabetic patients than in controls. Both Klotho and VEGF-A are decreased in the presence of microalbuminuria. In diabetes, Klotho strongly correlates to VEGF-A.     

Leukoaraiosis and earlier neurological outcome after mechanical thrombectomy in acute ischemic stroke

Background and purposeThe aim of the study was to evaluate whether leukoaraiosis (LA) severity is associated with earlier neurological outcome in acute stroke patients undergoing mechanical thrombectomy.Materials and methodsIn this retrospective multicenter study, we evaluated 273 acute stroke patients treated with mechanical thrombectomy. LA severity was graded as 0–2 (absent-to-moderate) versus 3–4 (severe) according to the van Swieten scale. The main clinical outcome was the proportion of early neurological improvement and early neurological deterioration. Early neurological improvement was defined as a decrease of ≥ 4 points on the NIHSS, or an NIHSS score of zero 24 hours after baseline assessment. Early neurological deterioration was defined as an increase of ≥ 4 points on the NIHSS 24 hours after baseline assessment.ResultsThere was a significantly lower early neurological improvement rate (17.1% versus 39.2%; P = 0.006) and non-significantly higher early neurological deterioration rate (29.3% versus 17.7%; P = 0.084) in patients with severe LA (sLA) compared with patients with absent-to-moderate LA. In multivariable analysis, sLA was inversely associated with early neurological improvement (OR, 0.31; 95% CI, 0.13–0.78; P = 0.012). There was no significant association of sLA with early neurological deterioration. However, in patients without symptomatic intracranial hemorrhage, sLA was an independent predictor of early neurological deterioration (OR, 2.65; 95% CI, 1.09–6.45; P = 0.032).ConclusionssLA is a significant negative predictor of early neurological improvement and is an independent predictor of early neurological deterioration in patients without symptomatic intracranial hemorrhage.