Publications by authors named "Di Jia"

68 Publications

Efficacy and safety of abdominal paracentesis drainage on patients with acute pancreatitis: a systematic review and meta-analysis.

BMJ Open 2021 08 9;11(8):e045031. Epub 2021 Aug 9.

The 2nd Department of Intensive Care Unit, Second Affiliated Hospital of Anhui Medical University, Hefei, China

Objectives: To conduct a systematic review and meta-analysis of the efficacy and safety of abdominal paracentesis drainage (APD) in patients with acute pancreatitis (AP) when compared with conventional 'step-up' strategy based on percutaneous catheter drainage (PCD).

Design: Systematic review and meta-analysis.

Methods: PubMed, EMBASE, Cochrane Library, MEDLINE (OVID), China National Knowledge Infrastructure and Wanfang Database were electronically searched to collect cohort studies and randomised controlled trials (RCTs) from inception to 25 July 2020. Studies related to comparing APD with conventional 'step-up' strategy based on PCD were included.

Outcomes: The primary outcome was all-cause mortality. The secondary outcomes were the rate of organ dysfunction, infectious complications, hospitalisation expenses and length of hospital stay.

Results: Five cohort studies and three RCTs were included in the analysis. Compared with the conventional 'step-up' method, pooled results suggested APD significantly decreased all-cause mortality during hospitalisation (cohort studies: OR 0.48, 95% CI 0.26 to 0.89 and p=0.02), length of hospital stay (cohort studies: standard mean difference (SMD) -0.31, 95% CI -0.53 to -0.10 and p=0.005; RCTs: SMD -0.45, 95% CI -0.64 to -0.26 and p<0.001) and hospitalisation expenses (cohort studies: SMD -2.49, 95% CI -4.46 to -0.51 and p<0.001; RCTs: SMD -0.67, 95% CI -0.89 to -0.44 and p<0.001). There was no evidence to prove that APD was associated with a higher incidence of infectious complications. However, the incidence of organ dysfunction between cohort studies and RCTs subgroup slightly differed (cohort studies: OR 0.66, 95% CI 0.34 to 1.28 and p=0.22; RCTs: OR 0.58, 95% CI 0.35 to 0.98 and p=0.04).

Conclusions: The findings suggest that early application of APD in patients with AP is associated with reduced all-cause mortality, expenses during hospitalisation and the length of stay compared with the 'step-up' strategy without significantly increasing the risk of infectious complications. These results must be interpreted with caution because of the limited number of included studies as well as a larger dependence on observational trials.

Prospero Registration Number: CRD42020168537.
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http://dx.doi.org/10.1136/bmjopen-2020-045031DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8354272PMC
August 2021

{BiW O } Exerts Antitumor Effect by Triggering Pyroptosis and Upregulating Reactive Oxygen Species.

Angew Chem Int Ed Engl 2021 09 20;60(39):21449-21456. Epub 2021 Aug 20.

Department of Biochemistry and Molecular Biology, Harbin Medical University, Harbin, 150081, China.

We successfully synthesized {BiW }, a 10-nuclear heteroatom cluster modified {BiW O }. At 24 h post-incubation, the IC values of {BiW } against HUVEC, MG63, RD, Hep3B, HepG2, and MCF7 cells were 895.8, 127.3, 344.3, 455.0, 781.3, and 206.3 μM, respectively. The IC value of {BiW } on the MG63 cells was more than 2-fold lower than that of the other raw materials. Through morphological and functional features, we demonstrated pyroptosis as a newly identified mechanism of cell death induced by {BiW }. {BiW } increased 2-fold reactive oxygen species (ROS) levels in MG63 cells at 24 h post-incubation. Compared with 0 h, the glutathione (GSH) content decreased by 59, 65, 75, 94, and 97 % at 6, 12, 24, 36 and 48 h post-incubation, respectively. Furthermore, multiple antitumor mechanisms of {BiW } were identified via transcriptome analysis and chemical simulation, including activation of pyroptosis, suppression of GSH generation, depletion of GSH, and inhibition of DNA repair.
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http://dx.doi.org/10.1002/anie.202107265DOI Listing
September 2021

[Comparative study on effectiveness of posterior-posterior triangulation technique and anteroposterior approach for arthroscopic posterior cruciate ligament reconstruction].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2021 Jul;35(7):823-828

Department of Sports Medicine, the First Affiliated Hospital of Kunming Medical University, Kunming Yunnan, 650032, P.R.China.

Objective: To investigate the effectiveness of the posterior-posterior triangulation technique for arthroscopic posterior cruciate ligament (PCL) reconstruction by comparing with the anteroposterior approach.

Methods: Retrospective analysis was performed on 40 patients who underwent arthroscopic PCL reconstruction between February 2016 and February 2020. The PCLs were reconstructed via anteroposterior approach in 20 patients (anteroposterior approach group) and posterior-posterior triangulation technique in 20 patients (posterior-posterior triangulation technique group). There was no significant difference in gender, age, cause of injury, injury side, disease duration, preoperative International Knee Documentary Committee (IKDC) score, and Lysholm score between the two groups ( >0.05). The operation time, surgical complications, and postoperative posterior drawer test, Lysholm score, and IKDC score were recorded and compared between the two groups.

Results: The operation time was (65.25±10.05) minutes in the anteroposterior approach group and (56.15±8.15) minutes in the posterior-posterior triangulation technique group, and the difference was significant ( =3.145, =0.003). All incisions healed by first intention, and there was no complication such as vascular and nerve injuries or infection. Patients were followed up (27.05±11.95) months in the anteroposterior approach group and (21.40±7.82) months in the posterior-posterior triangulation technique group, with no significant difference ( =1.770, =0.085). At last follow-up, the posterior drawer tests were positive in 4 cases (3 cases of stageⅠand 1 case of stage Ⅱ) of the anteroposterior approach group and in 1 case (stageⅠ) of the posterior-posterior triangulation technique group, showing no significant difference between the two groups ( =0.342). At last follow-up, Lysholm score and IKDC score in both groups were significantly higher than those before operation ( <0.05). The above functional scores in the posterior-posterior triangulation technique group were significantly higher than those in the anteroposterior approach group ( <0.05). Imaging reexamination showed that the position, shape, and tension of the grafts were well in both groups, and the grafts were covered with the synovium in the posterior-posterior triangulation technique group, the meniscofemoral ligaments were well preserved. There was no re-rupture of the reconstructed ligament during follow-up.

Conclusion: Compared to the anteroposterior approach, the posterior-posterior triangulation technique provides a clearer view under arthroscopy, no blind spot, sufficient operating space, and relative safety. Moreover, it is easier to retain the remnant and the meniscofemoral ligaments, and can obtain good short-term effectiveness.
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http://dx.doi.org/10.7507/1002-1892.202101101DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8311221PMC
July 2021

Investigating the Atomic and Mesoscale Interactions that Facilitate Spider Silk Protein Pre-Assembly.

Biomacromolecules 2021 Aug 12;22(8):3377-3385. Epub 2021 Jul 12.

Department of Chemistry and Biochemistry, San Diego State University, 5500 Campanile Drive, San Diego, California 92182-1030, United States.

Black widow spider dragline silk is one of nature's high-performance biological polymers, exceeding the strength and toughness of most man-made materials including high tensile steel and Kevlar. Major ampullate (Ma), or dragline silk, is primarily comprised of two spidroin proteins (Sp) stored within the Ma gland. In the native gland environment, the MaSp1 and MaSp2 proteins self-associate to form hierarchical 200-300 nm superstructures despite being intrinsically disordered proteins (IDPs). Here, dynamic light scattering (DLS), three-dimensional (3D) triple resonance solution NMR, and diffusion NMR is utilized to probe the MaSp size, molecular structure, and dynamics of these protein pre-assemblies diluted in 4 M urea and identify specific regions of the proteins important for silk protein pre-assembly. 3D NMR indicates that the Gly-Ala-Ala and Ala-Ala-Gly motifs flanking the poly(Ala) runs, which comprise the β-sheet forming domains in fibers, are perturbed by urea, suggesting that these regions may be important for silk protein pre-assembly stabilization.
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http://dx.doi.org/10.1021/acs.biomac.1c00473DOI Listing
August 2021

Vitamin E succinate exerts anti-tumour effects on human cervical cancer cells via the CD47-SIRPɑ pathway both and .

J Cancer 2021 5;12(13):3877-3886. Epub 2021 May 5.

Institute of Basic Medical Sciences, Qilu Hospital of Shandong University, School of Medicine, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.

Vitamin E succinate (RRR-a-tocopheryl succinate, VES) acts as a potent agent for cancer therapy and has no toxic and side effects on normal tissue cells. However, the mechanism by which VES mediates the effects are not yet fully understood. Here, we hypothesised that VES mediates antitumour activity on human cervical cancer cells via the CD47-SIRPɑ pathway and . Results indicated that the human cervical cancer HeLa cells treated with VES were more efficiently engulfed by THP-1-derived macrophages. In response to VES, the protein expression of CD47 on cell membranes and the mRNA level of CD47 in different human cervical cancer cells significantly decreased. And the level of calreticulin (CRT) mRNA in the VES-treated cells increased. By contrast, CRT protein expression was not altered. miRNA-155, miRNA-133 and miRNA-326 were up-regulated in the VES-treated HeLa cells. Knocking down miRNA-155 and miRNA-133 by RNA interference increased CD47 protein expression in the VES-treated cells. efficacy was determined in BALB/C nude mice with HeLa xenografts. Results showed that VES reduced tumour growth, increased overall survival and inhibited CD47 in the tumour transcriptionally and translationally. Furthermore, inflammatory factors (TNF-α, IL-12, IFN-γ, IL-2 and IL-10) in the spleen were altered because of VES treatment. Our results suggest that VES-induced antitumour activity is coupled to the CD47-SIRPɑ pathway in human cervical HeLa cancer cells.
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http://dx.doi.org/10.7150/jca.52315DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8176246PMC
May 2021

Meta-analysis: Interleukin 6 gene -174G/C polymorphism associated with type 2 diabetes mellitus and interleukin 6 changes.

J Cell Mol Med 2021 06 7;25(12):5628-5639. Epub 2021 May 7.

Department of Biochemistry and Molecular Biology, Qiqihar Medical University, Qiqihar, China.

The gene coding interleukin 6 (IL-6) is a promising candidate in predisposition to type 2 diabetes mellitus (T2DM). This study aimed to meta-analytically examine the association of IL-6 gene -174G/C polymorphism with T2DM and circulating IL-6 changes across -174G/C genotypes. Odds ratio (OR) and standard mean difference (SMD) with 95% confidence interval (CI) were calculated. Twenty-five articles were meta-analysed, with 20 articles for T2DM risk and 9 articles for circulating IL-6 changes. Overall, there was no detectable significance for the association between -174G/C polymorphism and T2DM, and this association was relatively obvious under dominant model (OR: 0.82, 95% CI: 0.56-1.21). Improved heterogeneity was seen in some subgroups, with statistical significance found in studies involving subjects of mixed races (OR: 0.63, 95% CI: 0.46-0.86). Begg's and filled funnel plots, along with Egger's tests revealed week evidence of publication bias. In genotype-phenotype analyses, carriers of -174CC and -174CG genotypes separately had 0.10 and 0.03 lower concentrations (pg/mL) of circulating IL-6 than -174GG carriers. Albeit no detectable significance for the association of -174G/C with T2DM, our findings provided suggestive evidence on a dose-dependent relation between -174G/C mutant alleles and circulating IL-6 concentrations, indicating possible implication of this polymorphism in the pathogenesis of T2DM.
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http://dx.doi.org/10.1111/jcmm.16575DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8184671PMC
June 2021

Theory of Charged Gels: Swelling, Elasticity, and Dynamics.

Gels 2021 Apr 21;7(2). Epub 2021 Apr 21.

Department of Polymer Science and Engineering, University of Massachusetts, Amherst, MA 01003, USA.

The fundamental attributes of charged hydrogels containing predominantly water and controllable amounts of low molar mass electrolytes are of tremendous significance in biological context and applications in healthcare. However, a rigorous theoretical formulation of gel behavior continues to be a challenge due to the presence of multiple length and time scales in the system which operate simultaneously. Furthermore, chain connectivity, the electrostatic interaction, and the hydrodynamic interaction all lead to long-range interactions. In spite of these complications, considerable progress has been achieved over the past several decades in generating theories of variable complexity. The present review presents an analytically tractable theory by accounting for correlations emerging from topological, electrostatic, and hydrodynamic interactions. Closed-form formulas are derived for charged hydrogels to describe their swelling equilibrium, elastic moduli, and the relationship between microscopic properties such as gel diffusion and macroscopic properties such as elasticity. In addition, electrostatic coupling between charged moieties and their ion clouds, which significantly modifies the elastic diffusion coefficient of gels, and various scaling laws are presented. The theoretical formulas summarized here are useful to adequately capture the essentials of the physics of charged gels and to design new hydrogels with specified elastic and dynamical properties.
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http://dx.doi.org/10.3390/gels7020049DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8167639PMC
April 2021

Susceptibility of six polymorphisms in the receptor for advanced glycation end products to type 2 diabetes: a systematic review and meta-analysis.

Endocr J 2021 Aug 9;68(8):993-1010. Epub 2021 Apr 9.

Department of Biochemistry and Molecular Biology, Qiqihar Medical University, Qiqihar, Heilongjiang, 161006, China.

We did a systematic review and meta-analysis, aiming to examine the association of available polymorphisms in the receptor for advanced glycation end products (AGER) gene with the risk of type 2 diabetes. Literature search, eligibility assessment, and data extraction were independently performed by two authors. Risk was expressed as by odds ratio (OR) and 95% confidence interval (CI) under the random-effects model. A total of 26 publications, involving 29 independent studies (8,318 patients with type 2 diabetes and 5,589 healthy or orthoglycemic controls) were included in this meta-analysis. Six polymorphisms in AGER gene, rs2070600, rs1800624, rs1800625, rs184003, rs3134940, and rs55640627, were eligible for inclusion. Overall analyses indicated that the mutations of rs1800624 (-374A) and rs55640627 (2245A) were associated with a significantly increased risk of type 2 diabetes (OR = 1.17 and 1.55, 95% CI: 1.00 to 1.38 and 1.21 to 1.98, respectively). Subsidiary analyses revealed that the mutation of rs2070600 was associated with 2.13-folded increased risk of type 2 diabetes in Caucasians (95% CI: 1.28 to 3.55), and the mutation of rs1800624 was associated with 1.57-folded increased risk in South Asians (95% CI: 1.09 to 2.25), with no evidence of heterogeneity (I: 42.5% and 44.5%). There were low probabilities of publication bias for all studied polymorphisms. Taken together, our findings indicate an ethnicity-dependent contribution of AGER gene in the pathogenesis of type 2 diabetes, that is, rs2070600 was a susceptibility locus in Caucasians, yet rs1800624 in South Asians.
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http://dx.doi.org/10.1507/endocrj.EJ21-0130DOI Listing
August 2021

MicroRNA-21-containing microvesicles from tubular epithelial cells promote cardiomyocyte hypertrophy.

Ren Fail 2021 Dec;43(1):391-400

Department of Pathology, The Second People's Hospital of Changzhou, Changzhou, China.

Background: Cardiomyocyte hypertrophy has been reported as one of the important mechanisms for cardiovascular disease (CVD) in patients with chronic kidney disease (CKD). MiroRNA-21(miR-21) was determined to play an important role in myocardial hypertrophy. However, the role of microvesicles (MVs) containing miR-21 in CKD-related cardiomyocyte hypertrophy remains largely unexplored.

Methods: Renal tubular epithelial cells were stimulated by transforming growth factor (TGF-β1), and the conditioned medium was extracted by differential centrifugation. Renal tubular epithelial cells were labeled with Dil-C18 dye and the recipient cardiomyocytes were observed by fluorescence microscope. MiR-21 level in MVs was detected by qRT-PCR, and the length and diameter of cardiomyocytes were measured by microscope. BCA protein kit and ANP kit were used to detect the content of cell protein and the level of ANP. MiR-21 inhibitor was transfected into cardiomyocytes to observe the effect of miR-21 on myocardial hypertrophy.

Results: TGF-β1 could induce donor renal tubular epithelial cells to produce MVs and delivered into cardiomyocytes, followed by the diameter, protein concentration and ANP content of cardiomyocytes significantly increased. Meanwhile, MiR-21 levels were markedly increased in MVs isolated from donor renal tubular epithelial cells and recipient cardiomyocytes. Pre-transfection of miR-21 inhibitors could inhibit MV-induced cardiomyocyte hypertrophy.

Conclusion: Tubular cells could secrete miR-21 by MVs and deliver it into recipient cardiomyocytes to induce cardiomyocyte hypertrophy. It might shed a new light on the mechanism and treatment of CKD-related cardiac dysfunction.
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http://dx.doi.org/10.1080/0886022X.2021.1891098DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7919913PMC
December 2021

Electrostatically Driven Topological Freezing of Polymer Diffusion at Intermediate Confinements.

Phys Rev Lett 2021 Feb;126(5):057802

Department of Polymer Science and Engineering, University of Massachusetts, Amherst, Massachusetts 01003, USA.

Breaking the paradigm that polymers in crowded aqueous media obey Einstein's law of diffusion, we report a localized nondiffusive hierarchical metastable state at intermediate confinements. Combining electrostatic and topological effects, we can tune the propensity of this new universality class in a quasicoacervate gel system consisting of guest polyamino acid chains inside an oppositely charged host hydrogel. Our observations offer strategies for controlled release and retention of macromolecules in aqueous crowded media, while opening a new direction for understanding topologically frustrated dynamics in polymers and other soft matter systems.
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http://dx.doi.org/10.1103/PhysRevLett.126.057802DOI Listing
February 2021

Susceptibility weighted imaging (SWI) for evaluating renal dysfunction in type 2 diabetes mellitus: a preliminary study using SWI parameters and SWI-based texture features.

Ann Transl Med 2020 Dec;8(24):1673

Department of Radiology, The Third Affiliated Hospital of Soochow University, Changzhou, China.

Background: Susceptibility weighted imaging (SWI) could reflect tissue blood oxygen levels, and then whether it could be used to evaluate renal injury remains to be further studied. This study aimed to examine the performance of SWI parameters and SWI-based texture features in evaluating renal dysfunction of type 2 diabetes mellitus (T2DM).

Methods: Forty-five patients with T2DM were included. With the estimated glomerular filtration rate (eGFR), the patients were divided into non-moderate-severe renal injured group (non-msRI, eGFR >60 mL/min/1.73 m) and moderate-severe renal injured group (msRI, eGFR ≤60 mL/min/1.73 m). The 3 SWI parameters and 16 SWI-based texture features between non-msRI and msRI were compared. The correlation between the parameters and BUN, Scr was analyzed.

Results: The signal intensity ratio of the medulla to psoas muscle (MPswi) was significantly lower than the signal intensity ratio of the cortex to psoas muscle (CPswi) in non-msRI and msRI group (t=8.619, 3.483, respectively, P<0.05). MPswi was higher, and the signal intensity ratio of the cortex to the medulla (CMswi), Skewness, Correlation were lower in msRI than in non-msRI (P<0.05). These parameters showed similar diagnostic efficacies for msRI (P>0.05), and AUCs were 0.7030.854. CMswi was an independent protective factor for msRI (OR =0.026, P=0.003). MPswi and CMswi were correlated with BUN (r=0.416, -0.545, P<0.05). CMswi and Correlation were correlated with Scr (r=-0.645, -0.411, P<0.05).

Conclusions: SWI was valuable for assessing renal dysfunction, which may be helpful for the evaluation of moderate-severe renal injured patients with T2DM.
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http://dx.doi.org/10.21037/atm-20-7121DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7812222PMC
December 2020

High-efficiency chirped grating couplers on lithium niobate on insulator.

Opt Lett 2020 Dec;45(24):6651-6654

High-efficiency chirped grating couplers (GCs) with coupling efficiencies (CE) approaching 90%/coupler were designed by using a particle swarm optimization algorithm. These GCs were fabricated on $z$-cut lithium niobate on insulator (LNOI) with an Au layer on the lithium niobate substrate. The maximum CEs for transverse electric and transverse magnetic polarization input were measured up to ${\sim}{72.0}\%$/coupler and ${\sim}{61.6}\%$/coupler, respectively, which are the state-of-the-art values for LNOI GCs as far as we know. These GCs contribute to the realization of high-efficiency LNOI on-chip integrated optics.
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http://dx.doi.org/10.1364/OL.412902DOI Listing
December 2020

[Esophageal pH-impedance monitoring of reflux patterns in non-erosive reflux disease, reflux hypersensitivity and functional heartburn].

Nan Fang Yi Ke Da Xue Xue Bao 2020 Oct;40(10):1507-1512

Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710003, China.

Objective: To analyze the differences in reflux patterns in 24-hour esophageal pH-impedance monitoring in patients with non-erosive reflux disease (NERD), reflux hypersensitivity (RH) and functional heartburn (FH) and explore the possible mechanism of symptoms in patients with heartburn and negative endoscopic findings.

Methods: Seventy-nine patients with heartburn as the main symptoms but negative endoscopic findings, including 35 with NERD, 16 with RH and 28 with FH, were enrolled in this study.All the patients underwent 24-h esophageal pH-impedance monitoring and esophagogastroscopy, and the results were compared among the 3 groups.

Results: Acid reflux episode was significantly increased and weakly alkaline reflux episode was significantly decreased in NERD group in comparison with RH group and FH group ( < 0.05).The patients in NERD group showed significantly increased total reflux episode, mixed reflux episode, proximal acid reflux episode, proximal weak acid reflux episode, total proximal reflux episode, percentage of proximal acid reflux, percentage of proximal weak acid reflux, and percentage of total proximal reflux as compared with the other two groups (all < 0.05).Bolus clear time was significantly prolonged in NERD group compared with that in the other two groups ( < 0.05).Analysis of the reflux acidity showed that the percentages of different reflux episodes differed significantly among the 3 groups ( < 0.05);acid reflux was the main reflux in NERD, while weak acid reflux was the main reflux in RH and FH groups, which had also significantly increased weakly alkaline reflux episodes compared with NERD group.

Conclusions: Patients with NERD, RH and FH had different reflux patterns.Acid reflux is predominant in the NERD, while weakly alkaline reflux is significantly increased RH and FH.In patients with normal esophageal acid exposure but without symptoms or without recorded symptoms during esophageal pH-impedance monitoring, analysis of the total reflux episode, mixed reflux episode, proximal acid reflux episode and percentage can help in the differential diagnosis between RH and FH.
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http://dx.doi.org/10.12122/j.issn.1673-4254.2020.10.18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7606246PMC
October 2020

Risk factors of hyperkalemia after total parathyroidectomy in patients with secondary hyperparathyroidism.

Ren Fail 2020 Nov;42(1):1029-1031

Department of Nephrology, The Third Affiliated Hospital of Soochow University, Changzhou, China.

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http://dx.doi.org/10.1080/0886022X.2020.1803088DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7580569PMC
November 2020

Correlation between single nucleotide polymorphisms in CXCR4 microRNA binding site and the susceptibility to knee osteoarthritis in Han Chinese population.

J Clin Lab Anal 2021 Feb 25;35(2):e23600. Epub 2020 Sep 25.

Department of Sports Medicine, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China.

Background: This study aimed to investigate the relationship between single nucleotide polymorphisms (SNPs) at the microRNA target sequence in CXCR4 and the susceptibility to knee osteoarthritis (KOA).

Methods: A total of 305 patients with KOA and 305 healthy controls were recruited into this study. The genotypes of CXCR4 rs1804029 and rs17848060 loci were analyzed.

Results: The susceptibility to KOA of CXCR4 rs1804029 G allele carriers was 1.33 times (95% CI: 1.09-1.54, P = .006) that of T allele carriers. The KOA susceptibility in individuals carrying T allele at CXCR4 rs17848060 locus was 1.38 times that of individuals carrying A allele (95% CI: 1.17-1.57, P < .001). The G allele at CXCR4 rs1804029 locus was the target of hsa-miR-146a-3p, while the A allele at CXCR4 rs17848060 locus could be targeted by hsa-miR-20a-3p. The plasma level of hsa-miR-146a-3p was lower in rs1804029 G allele carriers than T allele carriers (P < .001), whereas plasma level of hsa-miR-20a-3p was higher in rs17848060 T allele carriers than A allele carriers (P < .001).

Conclusion: The SNPs at rs1804029 and rs17848060 loci in CXCR4 were significantly associated with the susceptibility to KOA in Han Chinese population.
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http://dx.doi.org/10.1002/jcla.23600DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7891528PMC
February 2021

Surveillance strategy of Barrett's esophagus in the Asian region with particular reference to its locoregional epidemiology.

JGH Open 2020 Aug 12;4(4):565-568. Epub 2020 May 12.

Department of Medicine, Yong Loo Lin School of Medicine National University of Singapore Singapore Singapore.

Barrett's esophagus (BE) is a premalignant condition associated with the development of esophageal adenocarcinoma (EAC). Over the past decade, BE and its associated neoplasia has increased in prevalence globally. Current surveillance guidelines aimed to detect and treat BE-associated dysplasia early in the hope of improving the morbidity and mortality of the condition. However, due to the lack of long-term data and the proven benefit that surveillance actually improves mortality from EAC, the guidelines of the United States and Europe are slightly different. This review will focus on discussing the surveillance strategy for BE appropriate for the Asian region, taking into account the unique epidemiologic features of this disease in the Asian region.
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http://dx.doi.org/10.1002/jgh3.12350DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7411646PMC
August 2020

[Interpretation of International consensus on electroencephalogram reactivity testing after cardiac arrest on 2018].

Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 2020 Apr;32(4):392-396

The Laboratory of Cardiopulmonary Resuscitation and Critical Care Medicine, the Second Affiliated Hospital of Anhui Medical University, Hefei 230601, Anhui, China.

In patients being resuscitated successfully after cardiac arrest, electroencephalogram reactivity (EEG-R) is considered as a prognostic indicator. However, there are no clear guidelines on how to test EEG-R and exact definition of EEG-R. The International consensus on electroencephalogram reactivity testing after cardiac arrest on 2018, which is jointly developed by expert in relevant fields from many countries, reach a partial consensus on the test stimulation plan and definition of EEG-R. This paper interprets the main points of the consensus to provide reference for doctors majored in relevant fields in China.
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http://dx.doi.org/10.3760/cma.j.cn121430-20200305-00209DOI Listing
April 2020

A Case of Early Calciphylaxis Diagnosed by Bone Scan.

Case Rep Med 2020 17;2020:9526836. Epub 2020 Mar 17.

Nephrology, Department of Nephrology, Changzhou First People's Hospital, Changzhou, China.

Calcium uremic aortic disease (calciphylaxis) has long been considered as a rare, life-threatening small vessel disease. The diagnosis of calciphylaxis depends mainly on clinical symptoms and high risk factors, and skin biopsy can be used to confirm the diagnosis. However, noninvasive testing methods are still the focus of exploration currently. There is increasing evidence that bone scintigraphy is helpful in the diagnosis of calciphylaxis, especially for assessing the involvement of muscles and internal organs. Here, we describe a pathology-proven case of calciphylaxis case and the corresponding imaging findings on Tc-99 m MDP bone scan imaging.
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http://dx.doi.org/10.1155/2020/9526836DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7103050PMC
March 2020

Hydrogen Peroxide-Mediated Oxygen Enrichment Eradicates Helicobacter pylori and .

Antimicrob Agents Chemother 2020 04 21;64(5). Epub 2020 Apr 21.

Department of Pharmacology, School of Basic Medical Science, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China

is an important risk factor for gastric ulcers. However, antibacterial therapies increase the resistance rate and decrease the eradication rate of Inspired by the microaerophilic characteristics of , we aimed at effectively establishing an oxygen-enriched environment to eradicate and prevent the recurrence of The effect and the mechanism of an oxygen-enriched environment in eradicating and preventing the recurrence were explored and During oral administration and after drug withdrawal, counts were evaluated by Giemsa staining in animal cohorts. An oxygen-enriched environment in which could not survive was successfully established by adding hydrogen peroxide into several solutions and rabbit gastric juice. Hydrogen peroxide effectively killed in Columbia blood agar and special peptone broth. Minimum inhibition concentrations and minimum bactericidal concentrations of hydrogen peroxide were both relatively stable after promotion of resistance for 30 generations, indicating that hydrogen peroxide did not easily promote resistance in In models of Mongolian gerbils and Kunming mice, hydrogen peroxide has been shown to significantly eradicate and effectively prevent the recurrence of without toxicity and damage to the gastric mucosa. The mechanism of hydrogen peroxide causing death was related to the disruption of bacterial cell membranes. The oxygen-enriched environment achieved by hydrogen peroxide eradicates and prevents the recurrence of by damaging bacterial cell membranes. Hydrogen peroxide thus provides an attractive candidate for anti- treatment.
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http://dx.doi.org/10.1128/AAC.02192-19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7179623PMC
April 2020

miR-142-5p as a CXCR4-Targeted MicroRNA Attenuates SDF-1-Induced Chondrocyte Apoptosis and Cartilage Degradation via Inactivating MAPK Signaling Pathway.

Biochem Res Int 2020 24;2020:4508108. Epub 2020 Jan 24.

Department of Pharmacy, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650000, China.

Osteoarthritis (OA) is a chronic joint function disorder with characteristics of chondrocytes reduction and extracellular matrix (ECM) components destruction. MicroRNAs (miRNAs) and the SDF-1/CXCR4 axis are essential factors of chondrocyte apoptosis and ECM degeneration. However, very few studies have investigated the correlation between miRNAs and the SDF-1/CXCR4 axis in osteoarthritis so far. Here, through miRNAs microarray and bioinformatics analyses, we identified miR-142-5p as a CXCR4-targeted and dramatically downregulated miRNA in cartilage from OA patients, as well as in SDF-1-induced OA chondrocytes . In SDF-1-treated primary human OA chondrocytes that were transfected with a miR-142-5p mimic or inhibitor, the expression of CXCR4 was found to be inversely correlated with the expression of miR-142-5p. The dual luciferase reporter assay further verified the target relationship between miR-142-5p and CXCR4. Overexpression of miR-142-5p alleviated OA pathology by suppressing chondrocyte apoptosis, even in CXCR4 overexpressed OA chondrocytes. This was associated with decreased cartilage matrix degradation, reduced cartilage inflammation, and inactivated MAPK signaling pathway. Our study suggests that upregulated expression of CXCR4-targeted miR-142-5p can inhibit apoptosis, inflammation, and matrix catabolism and inactivate the MAPK signaling pathway in OA chondrocytes. Our work provides important insight into targeting miR-142-5p and the SDF-1/CXCR4 axis in OA therapy.
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http://dx.doi.org/10.1155/2020/4508108DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7003277PMC
January 2020

Label-Free Quantitative Proteomic Profiling of LAD2 Mast Cell Releasates Reveals the Mechanism of Tween-80-Induced Anaphylactoid Reaction.

Proteomics Clin Appl 2020 07 7;14(4):e1900065. Epub 2020 Feb 7.

Department of Pharmacology, School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center, 76 Yanta West Road, Xi'an, 710061, China.

Purpose: Tween-80 is one of the most important causes resulting in anaphylactoid reaction. However, its mechanism remains unclear. Proteomic characterizations of mast cells' excreta in response to Tween-80 are assayed to investigate the mechanism of anaphylactoid reaction.

Experimental Design: A label-free LCMS/MS-based proteomics is used to analyze Tween-80-stimulated Laboratory of Allergic Diseases 2 (LAD2) mast cells releasates. The results of proteomic are analyzed by bioinformatics analysis. Western blotting is used to verify the expression of proteins.

Results: Overall, endocytosis, nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB), and calcium signaling pathways play important roles in Tween-80-induced LAD2 cells activation by bioinformatics analysis. The expressions of relative proteins including actin-related protein 2/3 complexes, vacuolar protein sorting-associated protein, phosphorylation of transcription factor of P105 and P65, phosphorylation of inositol 1,4,5-trisphosphate receptor (IP R), phosphoinositide phospholipase Cγ (PLCγ), and protein kinase C (PKC), are significantly increased in Tween-80 group compared to control. Tween-80 might be internalized via endocytosis, which induces degranulation by PLCγ/PKC pathways mediated calcium influx, and promotes the generation of inflammatory mediators via NF-κB pathway resulting in anaphylactoid reaction.
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http://dx.doi.org/10.1002/prca.201900065DOI Listing
July 2020

Characterization of silk-hyaluronic acid composite hydrogels towards vitreous humor substitutes.

Biomaterials 2020 03 27;233:119729. Epub 2019 Dec 27.

Department of Biomedical Engineering, Tufts University, 4 Colby St., Medford, MA, 02155, USA. Electronic address:

Multiple ophthalmic pathologies, such as retinal detachment and diabetic retinopathy, require the removal and replacement of the vitreous humor. Clinical tamponades such as silicone oil and fluorinated gases are utilized but limited due to complications and toxicity. Therefore, there is a need for biocompatible, stable, vitreous humor substitutes. In this study, enzymatically crosslinked silk-hyaluronic acid (HA) hydrogels formed using horseradish peroxidase and HO were characterized for use as vitreous humor substitutes. The composite network structure was characterized with dynamic light scattering. In addition, the rheological, optical, and swelling properties of hydrogels with varying silk to HA ratios and crosslinking densities controlled via HO were determined over time. Hydrogels had refractive indexes of 1.336 and were clear with 75-91% light transmission. Hydrogel shear storage modulus ranged between ~6 and 240 Pa where increased HO increased the modulus. After 1 month of aging, there were no changes in modulus for hydrogels with lower silk ratios, while those with higher silk ratios exhibited a significant increase in modulus. Decreasing HO concentration in the reactions led to increased hydrogel volume during swelling, with higher silk ratios returning to their original size after 15 days. Dynamic light scattering results show three diffusive modes, revealing the possible structures of the hydrogel composite and are consistent with the mechanical properties and swelling results. The normalized intraocular pressure of ex vivo porcine eyes after injecting hydrogels were comparable with those treated with silicone oil showing the potential clinical utility of the hydrogels as vitreous substitutes. The versatility of the silk-HA hydrogel system, the tunable swelling properties, and the stability of hydrogels with lower silk ratios show the benefit of utilizing silk-HA hydrogels as vitreous substitutes.
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http://dx.doi.org/10.1016/j.biomaterials.2019.119729DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7007602PMC
March 2020

A Meta-Analysis of the Impact of Obesity, Metabolic Syndrome, Insulin Resistance, and Microbiome on the Diagnosis of Barrett's Esophagus.

Dig Dis 2020 18;38(3):165-177. Epub 2019 Oct 18.

Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.

Background And Aim: The etiology and pathogenesis of Barrett's esophagus (BE) have been widely studied during recent decades. However, the association between BE and possible risk factors, including abdominal obesity (AO), metabolic syndrome (MetS), insulin resistance (IR), and the microbiome has not reached a consensus and lacks a systematic assessment. The purpose of our study is to evaluate, quantify, and summarize the association between these factors and BE risk.

Methods: A systematic search of Pubmed, Embase, and Cochrane Library databases was performed to identify relevant studies before September 2018. Studies were estimated with the OR, the weighted mean difference (WMD), and the 95% CI by using a random effects model. Subgroup analysis and publication bias were also performed.

Results: A total of 46 citations were included in the analysis, and 119,273 subjects were analyzed (AO 13, MetS 15, IR 9, and microbiome: 9). The pooled results showed that AO (p < 0.01, OR 1.30, 95% CI 1.11-1.52, I2 = 31.9%), MetS (p < 0.01, OR 1.68, 95% CI 1.40-2.01, I2 = 87.6%), and IR (p < 0.01, WMD 0.23, 95% CI 0.11-0.35, I2 = 55.8%) were all significantly associated with an increased risk of BE, but except for the microbiome (p > 0.05, OR 1.27, 95% CI 0.66-2.43, I2 = 46.7%). In addition, subgroup analyses were stratified by waist-to-hip ratio, waist circumference, body mass index, diagnosis criteria, strain type, geographical region, and study design, respectively. Moreover, we observed no evidence of publication bias in Egger's and Begg's tests.

Conclusions: Our study reveals that AO, MetS, and IR are significantly associated with BE risk, except for the microbiome. The mechanism of BE induced by 3 risk factors should be further explored.
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http://dx.doi.org/10.1159/000502376DOI Listing
July 2020

miR‑146a‑5p expression is upregulated by the CXCR4 antagonist TN14003 and attenuates SDF‑1‑induced cartilage degradation.

Mol Med Rep 2019 May 21;19(5):4388-4400. Epub 2019 Mar 21.

Department of Sports Medicine, The First Affiliated Hospital, Kunming Medical University, Kunming, Yunnan 650000, P.R. China.

Osteoarthritis (OA) is an aseptic inflammatory disease which is associated with the stromal cell‑derived factor 1/C‑X‑C chemokine receptor type 4 (SDF‑1/CXCR4) axis. Accumulating studies have identified numbers of microRNAs (miRNAs) that serve important roles in the pathogenesis of OA. However, whether and how the inhibition of the SDF‑1/CXCR4 axis induces alterations in miRNA expression remains largely unclear. miRNA profiling was performed in OA chondrocytes stimulated with SDF‑1 alone, or SDF‑1 with the CXCR4 antagonist TN14003 by miRNA microarray. Candidate miRNAs were verified by reverse transcription quantitative polymerase chain reaction. Bioinformatic analyses including target prediction, gene ontology (GO) and pathway analysis were performed to explore the potential functions of candidate miRNAs. Notably, 7 miRNAs (miR‑146a‑5p, miR‑221‑3p, miR‑126‑3p, miR‑185‑5p, miR‑155‑5p, miR‑124‑3p and miR‑130a‑3p) were significantly differentially expressed. GO analysis indicated that miR‑146a‑5p and its associated genes were enriched in receptor regulatory activity, nuclear factor‑kappa‑light‑chain‑enhancer of activated B cells (NF‑κB)‑inducing kinase activity, cellular response to interleukin‑1, cytokine‑cytokine receptor interaction, NF‑κB signaling pathway and osteoclast differentiation pathways. CXCR4 was predicted to be a target of miR‑146a‑5p with high importance. The mRNA and protein levels of key factors involved in cartilage degeneration were measured following manipulation of the expression levels of miR‑146a‑5p in OA chondrocytes. CXCR4 and MMP‑3 levels were negatively associated with miR‑146a‑5p expression, while the levels of type II collagen and aggrecan were positively associated. These data reveal that TN14003 upregulates miR‑146a‑5p expression, and also pinpoints a novel role of miR‑146a‑5p in inhibiting cartilage degeneration by directly targeting the SDF‑1/CXCR4 axis.
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http://dx.doi.org/10.3892/mmr.2019.10076DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6472139PMC
May 2019

Effect of Salt on the Ordinary-Extraordinary Transition in Solutions of Charged Macromolecules.

J Am Chem Soc 2019 04 1;141(14):5886-5896. Epub 2019 Apr 1.

Department of Polymer Science and Engineering , University of Massachusetts , Amherst , Massachusetts 01003 , United States.

Using dynamic light scattering technique, we address the role of added salt at higher concentrations on the "ordinary-extraordinary" transition in solutions of charged macromolecules. The "ordinary" behavior has previously been associated with a "fast" diffusion coefficient which is independent of salt concentration C and polymer concentration C if the ratio C/ C is above a threshold value. The "extraordinary" transition is associated with formation of aggregates, with a "slow" diffusion coefficient, formed from similarly charged macromolecules. By investigating aqueous solutions of sodium poly(styrenesulfonate) and sodium chloride with variations in C, C, and polymer molecular weight, M, we report the emergence of a new diffusive "fast" relaxation mode at higher values of C, C, and M, in addition to the previously known "fast" and "slow" relaxation modes. Furthermore, we find that M plays a crucial role on the collective dynamics of polyelectrolyte solutions with salt, instead of just the C/ C ratio as previously postulated. As M is progressively decreased, the salty solution exhibits dynamical transitions from three modes to two modes and then to one mode of relaxation. The emergence of the new fast mode and the dynamical transitions are in marked departure from the general premise of the ordinary-extraordinary transition developed over several decades. In an effort to rationalize our experimental findings we present a theory for the collective dynamics of polyelectrolyte solutions with salt by addressing the coupling between the relaxations of polyelectrolyte chains, counterions from the polymer and added salt, and co-ions from the salt. The predictions are in qualitative agreement with experimental findings. The present combined work of experiments and theory forms the basis for accurately characterizing dynamics of charged macromolecules in salty solutions, which are ubiquitous in biological systems and polyelectrolyte-based technologies.
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http://dx.doi.org/10.1021/jacs.9b00562DOI Listing
April 2019

Clinical efficacy of celecoxib for osteoarthritis and bone anchor assisted knee extensor reconstruction.

Pak J Pharm Sci 2019 Jan;32(1(Special)):439-444

Department of Sports Medicine, the First Affiliated Hospital of Kunming Medical University, Kunming Yunnan, China.

Celecoxib is the most recent non steroidal anti-inflammatory analgesic, and has been gradually used in the treatment of acute pain, rheumatism and osteoarthritis. This paper analyzes the analgesic effect of celecoxib in the treatment of knee osteoarthritis and put forward a new mechanism of knee joint extensor reconstruction assisted by bone anchor. The experimental group was given celecoxib 200 mg/ time and 1 time /d. The results showed that VAS (Visual Analogue Scale) decreased gradually in both groups on the 1st, 3rd and 7th day of treatment and VAS in experimental group was lower than that in control group at the same time point (P<0.05). At the 1 year follow-up, experience group had a significant improvement on the Lysholm (69.33 ± 8.38 preoperatively and 88.65 ± 12.93 postoperatively) and Kujula (69.33 ± 8.38 preoperatively and 88.65 ±12.93 postoperatively) knee scores (P<0.05). The results showed that celecoxib had a good analgesic effect in patients with knee osteoarthritis and reducing the release of inflammatory factors may be its mechanism..
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January 2019

Evaluation of renal dysfunction using texture analysis based on DWI, BOLD, and susceptibility-weighted imaging.

Eur Radiol 2019 May 17;29(5):2293-2301. Epub 2018 Dec 17.

Department of Radiology, Third Affiliated Hospital of Soochow University, Changzhou, 213003, Jiangsu, China.

Objective: To explore the value of texture analysis based on diffusion-weighted imaging (DWI), blood oxygen level-dependent MRI (BOLD), and susceptibility-weighted imaging (SWI) in evaluating renal dysfunction.

Methods: Seventy-two patients (mean age 53.72 ± 13.46 years) underwent MRI consisting of DWI, BOLD, and SWI. According to their estimated glomerular filtration rate (eGFR), the patients were classified into either severe renal function impairment (sRI, eGFR < 30 mL/min/1.73 m), non-severe renal function impairment (non-sRI, eGFR ≥ 30 mL/min/1.73 m, and < 80 mL/min/1.73 m), or control (CG, eGFR ≥ 80 mL/min/1.73 m) groups. Thirteen texture features were extracted and then were analyzed to select the most valuable for discerning the three groups with each imaging method. A ROC curve was performed to compare the capacities of the features to differentiate non-sRI from sRI or CG.

Results: Six features proved to be the most valuable for assessing renal dysfunction: 0.25Quantile, 0.5Quantile, Homogeneity, Entropy, Skewness, and Correlation. Three features derived from DWI (0.25Quantile, 0.5Quantile, and Homogeneity) were smaller in sRI than in non-sRI; Entropy and Correlation were smaller in non-sRI than in CG (p < 0.05). 0.25Quantile, 0.5Quantile, and Homogeneity showed similar capacities for differentiating sRI from non-sRI. Similarly, Entropy and Correlation showed equal capacities for differentiating non-sRI from CG.

Conclusion: Texture analysis based on DWI, BOLD, and SWI can assist in assessing renal dysfunction, and texture features based on BOLD and SWI may be suitable for assessing renal dysfunction during early stages.

Key Points: • Texture analysis based on MRI techniques allowed for assessing renal dysfunction. • Texture features based on BOLD and SWI, but not DWI, may be suitable for assessing renal function impairment during early stages. • SWI exhibited a similar capacity to BOLD for assessing renal dysfunction.
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http://dx.doi.org/10.1007/s00330-018-5911-3DOI Listing
May 2019

[Short-term effectiveness of total knee arthroplasty assisted by three-dimensional printing osteotomy navigation template].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2018 07;32(7):899-905

Department of Sports Medicine, the First Affiliated Hospital of Kunming Medical University, Kunming Yunnan, 650032, P.R.China.

Objective: To investigate the short-term effectiveness of total knee arthroplasty (TKA) assisted by three-dimensional (3D) printing osteotomy navigation template.

Methods: A retrospective study was performed on 60 patients with osteoarthritis bewteen January 2016 and June 2017. Thirty cases underwent TKA assisted by 3D printing osteotomy navigation template (3D printing group) and 30 cases underwent the conventional TKA (conventional TKA group). There was no significant difference in gender, age, body mass index, surgical side, and disease duration between 2 groups ( >0.05). The operation time, the pre- and post-operative hemoglobin values, the amount of drainage, the Hospital for Special Surgery (HSS) score and Knee Society Score (KSS) of knee joint before operation and at 3 months after operation were observed. And 6 freedom degrees of knee (the varus and valgus angle, the internal and external rotation angle, the antero-posterior displacement, the proximal-distal displacement, the flexion and extension angle, and the internal and external displacement) before operation and at 3 months after operation were recorded by Opti-Knee (the knee 3D motion analysis system). The values of 2 groups were compared with 30 healthy adults (<60 years).

Results: The operation time was shorter in 3D printing group than that in conventional TKA group ( =5.833, =0.000). The hemoglobin values at 1 and 3 days after operation were higher in 3D printing group than those in conventional TKA group ( <0.05). The amount of drainage was less in 3D printing group than that in conventional TKA group ( =5.468, =0.000). All patients were followed up 6-9 months (mean, 7.3 months). There was no significant difference in pre- and post-operative HSS score and KSS clinical score between 2 groups ( >0.05). There was no significant difference in preoperative KSS function score between 2 groups ( >0.05), but the KSS function score of 3D printing group at 3 months after operation was higher than that of conventional TKA group ( <0.05). Before operation, the varus and valgus angle, the internal and external rotation angle, the antero-posterior displacement, the proximal-distal displacement of 3D printing group and conventional TKA group were larger than that of the healthy adults ( <0.05); there was no significant difference in the flexion and extension angle and the internal and external displacement between 2 groups and healthy adults ( >0.05). At 3 months after operation, compared with healthy adults, the varus and valgus angle of conventional TKA group was increased, the flexion and extension angle of conventional TKA group was decreased ( <0.05); the proximal-distal displacement and the internal and external displacement of 2 groups were decreased ( <0.05); there was no significant difference in other freedom degrees between groups ( >0.05). No sign of prosthesis loosening was observed by X-ray examination.

Conclusion: Compared with the traditional TKA, TKA assisted by the 3D printing osteotomy navigation template had such advantages as shorter operation time, less postoperative blood loss, and well postoperative recovery.
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http://dx.doi.org/10.7507/1002-1892.201802013DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8435961PMC
July 2018

Efficacy and safety of long-course tacrolimus treatment for idiopathic membranous nephropathy.

Exp Ther Med 2018 Aug 23;16(2):979-984. Epub 2018 May 23.

Department of Nephrology, The First People's Hospital of Changzhou, Changzhou, Jiangsu 213003, P.R. China.

The aim of the present study was to observe the efficacy and safety of long-course treatment with tacrolimus combined with low-dose corticosteroids for idiopathic membranous nephropathy (IMN). A total of 76 patients with IMN diagnosed by renal biopsy between March 2012 and January 2016 form The First People's Hospital of Changzhou (Changzhou, China) were selected and randomly divided into a short-course group and a long-course group (each, n=38). Patients in the short-course group were treated with hormone combined with tacrolimus for 12 months, whereas those in the long-course group received the same treatment for 24 months. The efficacy, safety and recurrence of the two groups of patients were observed, and serum ALB, urine protein, Scr and blood glucose were assessed once a month for 24 months by measuring blood biochemistry. A total of 11 patients exhibited adverse effects, 6 of whom were serious and as such were excluded from the study. In the short-course group, 8 of 35 patients demonstrated complete remission (CR), 17 patients exhibited partial remission (PR) and the remaining 10 patients had no remission (NR); however the disease recurred in 8 patients following treatment. In the long-course group, 16 of 35 patients exhibited CR, 14 patients demonstrated PR and the remaining 5 patients had NR. Furthermore, the disease recurred in 4 patients following treatment. Significant differences were observed in urine protein and serum ALB at 18 and 24 months following treatment between the two groups while Scr and blood glucose had no significant differences at any time point. It was concluded that long-course tacrolimus combined with low-dose hormone effectively treats idiopathic membranous nephropathy and that therapy demonstrated a relatively high remission rate, and the recurrence rate of the disease is low.
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http://dx.doi.org/10.3892/etm.2018.6211DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6090310PMC
August 2018

Renal Hypoxia: An Important Prognostic Marker in Patients with Chronic Kidney Disease.

Am J Nephrol 2018 26;48(1):46-55. Epub 2018 Jul 26.

Department of Urology, The Third Affiliated Hospital of Soochow University, Changzhou, China.

Background: Blood oxygen level-dependent (BOLD)-MRI is a novel and noninvasive tool that can assess renal oxygenation. The R2* value is a parameter of tissue deoxyhemoglobin concentration detected by BOLD-MRI. The purpose of the current study was to determine the relationships between renal R2* values and clinical parameters and to determine whether renal R2* values were associated with the risk for progression of chronic kidney disease (CKD).

Methods: Sixty patients with CKD were enrolled in this prospective observational study in China from March 2013 to August 2014. A region of interest-based BOLD-MRI was performed to obtain cortical and medullary R2* (CR2* and MR2*) values. Data on demographics and clinical characteristics were collected. The primary end point (CKD progression) was defined as an absolute 30% decline in the estimated glomerular filtration rates (eGFR; CKD-Epidemiology Collaboration equations) or initiation of dialysis during follow-up.

Results: The CR2* and MR2* values in patients with CKD were significantly higher compared with those of healthy controls. The CR2* levels were positively associated with 24-h urinary protein excretion, blood urea nitrogen, creatinine, and uric acid but negatively associated with baseline eGFR, 24-h creatinine clearance, eGFR slope, serum albumin, and the use of angiotensin II type 1 receptor blockade. The CR2* levels had the highest areas under the curve during follow-up compared with the MR2* levels and medullary cortical ratios. The Kaplan-Meier survival analysis showed that patients with CKD in the lowest tertile of the CR2* levels had the best prognosis compared with the other 2 tertiles. Moreover, baseline eGFR and CR2* tertiles were associated with the progression of CKD in Cox proportional hazard regression models. Only CR2* tertiles correlated negatively with the eGFR slope.

Conclusion: We have demonstrated that the clinical feasibility of BOLD-MRI to evaluate renal oxygenation and cortex hypoxia aggravates with the decline of renal function, and cortex hypoxia was a prognostic marker in the progression of CKD.
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http://dx.doi.org/10.1159/000491551DOI Listing
December 2019
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