Journal of Huazhong University of Science and Technology [Medical Sciences]最新文献

This study aims to explore the efficacy of interferon-α (IFN-α) combined with either entecavir (ETV) or adefovir (ADV) therapy versus IFN-α mono-therapy for chronic hepatitis B (CHB) patients, and to identify the factors associated with treatment outcomes. Totally, 159 CHB patients receiving interferon-based treatment for 48 weeks were enrolled in this retrospective study, including IFN-α mono-therapy group (group A, n=44), IFN-α plus ADV group (group B, n=53) and IFN-α plus ETV group (group C, n=62). The primary measures of efficacy assessments were the changes in HBsAg. Cox regression analysis was used to identify the predictors of treatment outcomes. The predictive values of the factors were assessed by ROC analysis. For patients with baseline hepatitis B surface antigen (HBsAg) level <1000 IU/mL, the reductions in mean HBsAg levels at week 48 were greater in group C than that in group A (P<0.05). Higher rate of HBeAg seroconversion was achieved in the combined therapy group than in IFN-α mono-therapy group at week 48 (P<0.05). Two factors were independently associated with HBeAg seroconversion: baseline HBeAg level <2.215 log10 index/mL and ΔHBeAg (decline in HBeAg from baseline) >0.175 log10 at week 12. In conclusion, interferon-α plus ETV therapy can accelerate HBsAg decline as compared with interferon-α mono-therapy in CHB patients with lower baseline HBsAg levels, and the combination therapy was superior to IFN-α mono-therapy in increasing the rate of HBeAg seroconversion. Baseline HBeAg and ΔHBeAg at week 12 can independently predict HBeAg seroconversion in patients subject to interferon-based therapy for 48 weeks.

Rational nutritional support shall be based on nutritional screening and nutritional assessment. This study is aimed to explore nutritional risk screening and its influencing factors of hospitalized patients in central urban area. It is helpful for the early detection of problems in nutritional supports, nutrition management and the implementation of intervention measures, which will contribute a lot to improving the patient's poor clinical outcome. A total of three tertiary medical institutions were enrolled in this study. From October 2015 to June 2016, 1202 hospitalized patients aged ≥18 years were enrolled in Nutrition Risk Screening 2002 (NRS2002) for nutritional risk screening, including 8 cases who refused to participate, 5 cases of same-day surgery and 5 cases of coma. A single-factor chi-square test was performed on 312 patients with nutritional risk and 872 hospitalized patients without nutritional risk. Logistic regression analysis was performed with univariate analysis (P<0.05), to investigate the incidence of nutritional risk and influencing factors. The incidence of nutritional risk was 26.35% in the inpatients, 25.90% in male and 26.84% in female, respectively. The single-factor analysis showed that the age ≥60, sleeping disorder, fasting, intraoperative bleeding, the surgery in recent month, digestive diseases, metabolic diseases and endocrine system diseases had significant effects on nutritional risk (P<0.05). Having considered the above-mentioned factors as independent variables and nutritional risk (Y=1, N=0) as dependent variable, logistic regression analysis revealed that the age ≥60, fasting, sleeping disorders, the surgery in recent month and digestive diseases are hazardous factors for nutritional risk. Nutritional risk exists in hospitalized patients in central urban areas. Nutritional risk screening should be conducted for inpatients. Nutritional intervention programs should be formulated in consideration of those influencing factors, which enable to reduce the nutritional risk and to promote the rehabilitation of inpatients.

Survival after pancreatic cancer surgery is extremely unfavorable even after curative resection. Prognostic factors have been explored but remain largely undefined. The present study was to identify the role of clinical and laboratory variables in the prognostic significance of resectable pancreatic adenocarcinoma. A total of 96 patients who underwent curative resection for pancreatic cancer were included. Survival was evaluated based on complete follow-up visits and was associated with potential prognostic factors using the Kaplan-Meier method and Cox proportional hazard model survival analyses. The results showed that prognostic variables significantly reduced survival, including old age, poorly differentiated tumors, elevated tumor markers and positive lymph node metastasis (LNM). Age of older than 60 years (HR=1.83, P=0.04), LNM (HR=2.22, P=0.01), lymph node ratio (00.2, HR=1.92, P=0.017), initial CA199 (HR=4.80, P=0.004), and CEA level (HR=2.59, P=0.019) were identified as independent prognostic factors by multivariate analysis. It was concluded that LNR may be potent predictor of survival and suggests that surgeons and the pathologists should thoroughly assess lymph nodes prior to surgery.

This study was to determine the protective effect of ω-3 polyunsaturated fatty acids (ω-3PUFAs) on MK-801-induced cognitive impairment in schizophrenia (SZ) rats and the underlying mechanism. A rat model of schizophrenia was induced by MK-801. The cognitive function of rats was assessed using a Morris water maze. The number of hippocampal neurons was measured by Nissl staining. The expression of CREB, p-CREB, BDNF, TrkB, p-TrkB, AKT, p-AKT, ERK, and p-ERK in the hippocampus of rats was detected by Western blotting. The results showed that ω-3PUFAs attenuated MK-801-induced cognitive impairment and hippocampal neurons loss, reversed the injury of the CREB/BDNF/TrkB pathway induced by MK-801, and antagonized MK-801-induced down-regulation of p-AKT and p-ERK in the hippocampus of rats. In conclusion, ω-3PUFAs enhances the CREB/BDNF/TrkB pathway by activating ERK and AKT, thereby increasing the synaptic plasticity and decreasing neuron loss, and antagonizing MK-801-induced cognitive impairment in schizophrenic rats.

Accurate prenatal diagnosis of complex congenital cardiovascular anomalies, vascular ones in particular, is still challenging. A fetal cardiovascular cast model can provide a copy of the cardiac chambers and great vessels with normal or pathological structures. This study was aimed to demonstrate three-dimensional anatomy of complex congenital cardiovascular anomalies in fetuses by means of corrosion casting. Twenty fetuses with prenatal-ultrasound-diagnosed complex cardiovascular anomalies were enrolled in this study (19 to 35 gestational weeks). Fetal cardiovascular cast models were made by a corrosion casting technique. The specimens were injected with casting material via the umbilical vein, and then immersed in strong acid after casting fluid was solidified, to disclose the geometries of cardiovascular cavities. Nineteen cast models were successfully made from 20 specimens. The casts distinctly showed the morphological malformations and spatial relationship between cardiac chambers and great vessels. One hundred and eleven abnormalities were revealed by casting in the 19 specimens, including 34 abnormalities located in the cardiac chambers (3, 4 and 27 anomalies in the atria, atrioventricular valves and ventricles, respectively), and 77 in the great vessels (28, 20, 24 and 5 anomalies in the aorta and its branches, the pulmonary artery, the ductus arteriosus and the major veins, respectively). Corrosion casting can display three-dimensional anatomy of fetal complex cardiovascular anomalies. This improves our understanding of related pathomorphology and prenatal diagnosis.

This study evaluated the effects of sodium hypochlorite (NaOCl) with different concentrations and exposure time on the structural, compositional and mechanical properties of human dentin in vitro. Sixty dentin slabs were obtained from freshly extracted premolars, randomly distributed into four groups (n=15), and treated with 1%, 5%, 10% NaOCl and distilled water (control group), respectively, for a total of 60 min. Attenuated total reflection infrared (ATR-IR) spectroscopy, Raman spectroscopy and X-ray diffraction (XRD) were carried out before, 10 min and 60 min after the treatment. Scanning electron microscopy (SEM) and flexural strength test were conducted as well. The results showed that dentins experienced morphological alterations in the NaOCl groups, but not in the control group. Two-way repeated-measures analysis of variance revealed that the carbonate:mineral ratio (C:M), Raman relative intensity (RRI), a-axis, c-axis length and full width at half maximum (FWHM) with the increase of time and concentration in the NaOCl groups were not significantly different from those in the control group (P>0.05). Nevertheless, the mineral:matrix ratio (M:M) increased and the flexural strength declined with the increase of concentration and the extension of time in the NaOCl groups (P<0.05). Additionally, it was found that the M:M and the flexural strength remained unchanged after 1% NaOCl treatment (P>0.05), and the morphology changes were unnoticeable within 10 min in 1% NaOCl group. These results indicated that NaOCl has no significant effects on the inorganic mineral of human dentin; but it undermines and eliminates the organic content concentration- and time-dependently, which in turn influences the flexural strength and toughness of dentins. In addition, an irrigation of 1% NaOCl within 10 min can minimize the effects of NaOCl on the structural and mechanical properties of dentin during root canal treatment.

This study investigated the accuracy of MRI features in differentiating the pathological grades of pancreatic neuroendocrine neoplasms (PNENs). A total of 31 PNENs patients were retrospectively evaluated, including 19 cases in grade 1, 5 in grade 2, and 7 in grade 3. Plain and contrastenhanced MRI was performed on all patients. MRI features including tumor size, margin, signal intensity, enhancement patterns, degenerative changes, duct dilatation and metastasis were analyzed. Chi square tests, Fisher's exact tests, one-way ANOVA and ROC analysis were conducted to assess the associations between MRI features and different tumor grades. It was found that patients with older age, tumors with higher TNM stage and without hormonal syndrome had higher grade of PNETs (all P<0.05). Tumor size, shape, margin and growth pattern, tumor pattern, pancreatic and bile duct dilatation and presence of lymphatic and distant metastasis as well as MR enhancement pattern and tumor-topancreas contrast during arterial phase were the key features differentiating tumors of all grades (all P<0.05). ROC analysis revealed that the tumor size with threshold of 2.8 cm, irregular shape, pancreatic duct dilatation and lymphadenopathy showed satisfactory sensitivity and specificity in distinguishing grade 3 from grade 1 and grade 2 tumors. Features of peripancreatic tissue or vascular invasion, and distant metastasis showed high specificity but relatively low sensitivity. In conclusion, larger size, poorlydefined margin, heterogeneous enhanced pattern during arterial phase, duct dilatation and the presence of metastases are common features of higher grade PNENs. Plain and contrast-enhanced MRI provides the ability to differentiate tumors with different pathological grades.

Erythroderma with complicated etiology is one of the severe skin diseases and has high mortality, of which the incidence was 0.5‰-1.5‰ in skin diseases. Erythrodermic psoriasis (EP) is the commonest type of erythroderma. In addition, there are drug-induced erythroderma, erythroderma secondary to preexisting dermatoses, malignancy-related erythroderma, and idiopathic erythroderma of unknown etiology. Erythroderma of different etiologies has various clinical manifestations, resulting in relevant curative effects and outcomes. In this article, we retrospectively investigated 205 erythroderma patients about clinical symptoms, auxiliary examination and treatments, and evaluated the efficacy and prognosis. There were 84 cases of EP among 205 patients, 10 cases of erythroderma caused by specific drugs, 77 cases of erythroderma secondary to preexisting dermatoses (excluding psoriasis), 7 cases of erythroderma patients suffering from malignancy and 27 cases with unknown causes. We concluded that the etiology of male patients in different age groups had significant difference. The incidence of EP was the highest among all types. The EP was commonly accompanied with hypoproteinemia, and changed into psoriasis vulgaris after treatment. Drug-induced erythroderma was commonly accompanied with fever, and mostly cured by systematic steroid therapy. For erythroderma secondary to preexisting dermatoses, the original dermatoses must be actively treated to achieve a satisfying prognosis. Erythroderma with malignancy or unknown causes had long-term duration, poor response to the treatment, and high potential to relapse. Therefore, clarifying the etiology, providing an appropiate and individual regimen, and regular follow-up are crucial for the successful treatment of erythroderma with unknown causes.

The post-operative patellar tendon length was studied to evaluate the possible tendon length change after anterior cruciate ligament (ACL) reconstruction with hamstring autografts. The Insall-Salvati index, modified Insall-Salvati index, curved modified Insall-Salvati index and Caton-Deschamps index were observed by MRI during a follow-up period of 12 weeks on 20 ACL reconstructed knees. The results showed no patellar baja or alta pre-existed on those ACL injured patients. After a follow-up period of 12 weeks, no patellar tendon length change was observed. It is suggested that the change of patella was not the primary reason that may contribute to the premature patellofemoral joint osteoarthritis after ACL reconstruction.

Adipose-derived stem cells (ASCs) induce therapeutic angiogenesis due to pro-angiogenic cytokines secretion. Superparamagnetic iron oxide (SPIO) nanoparticles are critical for magnetic resonance (MR) tracking of implanted cells. Hypoxia is a powerful stimulus for angiogenic activity of ASCs. In this study, we investigated whether therapeutic potency could be enhanced by implantation of hypoxia-preconditioned SPIO-labeled ASCs (_SPIOASCs) into the infarcted myocardium. ASCs and _SPIOASCs were cultured under 2% O₂ (hypoxia) or 95% air (normoxia). Cells were intramyocardially injected into the infarcted myocardium after 48-h culture. We found that hypoxia culture increased the mRNA expression of hypoxia-inducible factor-1 alpha (HIF-1α) and vascular endothelial growth factor (VEGF) in ASCs and _SPIOASCs. The VEGF protein in the conditioned medium was significantly higher in hypoxic ASCs and _SPIOASCs than in normoxic ASCs and _SPIOASCs. The capillary density and left ventricular contractile function in the infarcted myocardium were significantly higher 4 weeks after implantation with hypoxic ASCs and _SPIOASCs than with normoxic ASCs and _SPIOASCs. Improvement in the capillary density and left ventricle function didn't differ between hypoxic ASCs-transplanted rats and hypoxic _SPIOASCs-transplanted rats. Hypoxic culture enhanced the angiogenic efficiency of ASCs. It was concluded that implantation of hypoxic ASCs or _SPIOASCs promotes therapeutic angiogenesis and cardiac function recovery in the infarcted myocardium. SPIO labeling does not impact the beneficial effect of hypoxic ASCs.