Publications by authors named "He Zhu"

334 Publications

Synthesis, Electronic Structure, and Electrochemical Properties of the Cubic MgMnO Spinel with Porous-Spongy Structure.

Nanomaterials (Basel) 2021 Apr 27;11(5). Epub 2021 Apr 27.

State Key Laboratory of Crystal Materials, Institute of Crystal Materials, Shandong University, Jinan 250100, China.

MgMnO nanoparticles with cubic spinel structure were synthesized by the sol-gel method using polyvinyl alcohol (PVA) as a chelating agent. X-ray powder diffraction, infrared spectrum (IR), scanning electron microscope (SEM), and transmission electron microscope (TEM) were used to characterize the crystalline phase and particle size of as-synthesized nanoparticles. The electronic structure of MgMnO spinel was studied by X-ray photoelectron spectroscopy (XPS). The results showed that pure cubic MgMnO spinel nanoparticles were obtained when the annealing temperature was 500-700 °C. The samples had a porous-spongy structure assembled by nanoparticles. XPS studies indicated that MgMnO nanoparticles were mixed spinel structures and the degree of cation inversion decreased with increasing annealing temperature. Furthermore, the performance of MgMnO as lithium anode material was studied. The results showed that MgMnO samples had good cycle stability except for the slight decay in the capacity at 50 cycles. The coulombic efficiency (ratio of discharge and charge capacity) in most cycles was near 100%. The sample annealed at 600 °C exhibited good electrochemical properties, the first discharge capacity was 771.5 mAh/g, and the capacity remained 340 mAh/g after 100 cycles. The effect of calcination temperature on the charge-discharge performance of the samples was studied and discussed.
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http://dx.doi.org/10.3390/nano11051122DOI Listing
April 2021

Off-Label Use of Antineoplastic Drugs to Treat Malignancies: Evidence From China Based on a Nationwide Medical Insurance Data Analysis.

Front Pharmacol 2021 8;12:616453. Epub 2021 Apr 8.

Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, China.

Cancer is a leading cause of morbidity and mortality worldwide. Off-label (OL) use of antineoplastic drugs to treat malignancies is prevalent. In this study, we quantified and characterized OL use of antineoplastic drugs to treat malignancies in China. This was a retrospective study using nationwide data collected from 2008 to 2010. Use of antineoplastic drugs was considered OL if they were used for indications not reflected in the package insert published by the National Medical Products Administration at the time of prescription. Descriptive analysis and Spearman rank correlation were used to evaluate the frequency and pattern of OL drug use. In total, 51,382 patients with malignancies, 24 categories of antineoplastic drugs, and 77 types of malignancies treated with OL drugs were included in this study. Twenty commonly used antineoplastic drugs (ICD encoded as L01) were used OL in 10-61% of cases, and four commonly used endocrine therapy antineoplastic drugs (ICD encoded as L02) were used OL in 10-19% of cases. There was a significant negative correlation between the disease constituent ratio and the average OL use rate of antineoplastic drugs for various malignancies. In contrast, there was a significant positive correlation between the average OL use rate of antineoplastic drugs and the number of malignancies treated with OL drugs. This study provided information regarding OL use of antineoplastic drugs for treatment of malignancies, and showed that OL use was prevalent. In addition, uncommon malignancies were more likely to be treated with OL antineoplastic drugs. Furthermore, more commonly used antineoplastic drugs were more likely to be used OL.
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http://dx.doi.org/10.3389/fphar.2021.616453DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8060556PMC
April 2021

Bleeding after endoscopic resection between direct oral anticoagulants or warfarin: Systematic review and meta-analysis.

J Gastroenterol Hepatol 2021 Apr 24. Epub 2021 Apr 24.

Department of Gastroenterology, The First Hospital of Jilin University, Changchun, China.

Background And Aim: Oral anticoagulants are risk factors for post-endoscopic resection bleeding. We aimed to conduct a systematic review and meta-analysis for the risks of post-procedural bleeding (PPB) for direct oral anticoagulants (DOACs) and warfarin following endoscopic resection.

Methods: Two independent reviewers searched PubMed, Web of Science, Embase, and Cochrane Library. The Newcastle-Ottawa Scale score was used to assess the quality of the studies, the pooled odds ratio (OR) to present PPB results, and the funnel plots to assess publication bias. The Higgins I statistic was employed to determine the variation across studies due to heterogeneity.

Results: We reviewed 30 articles. PPB occurred in 586 patients on DOACs and 1782 on warfarin. The patients on DOACs had a significantly lower overall risk of PPB compared with those on warfarin (OR, 0.867, 95% confidence interval, 0.771-0.975; P = 0.017, I  = 1.6%). Cumulative meta-analysis showed that the PPB rate of DOACs has the trend to be lower than that of warfarin with publication year and sample size. For the subgroup of endoscopic submucosal dissection, the PPB of DOACs was significantly lower than that of warfarin (OR, 0.786; 95% confidence interval, 0.633-0.976; P = 0.029, I  = 0%). No significant difference was observed between DOACs and warfarin for anticoagulant strategies, endoscopic procedures, and lesion location.

Conclusions: Compared with warfarin, DOACs have the possibility to significantly decrease the risk of PPB following endoscopic resection, especially for endoscopic submucosal dissection.
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http://dx.doi.org/10.1111/jgh.15527DOI Listing
April 2021

Investigating the Underlying Mechanisms of Circular RNAs and Their Application in Clinical Research of Cervical Cancer.

Front Genet 2021 25;12:653051. Epub 2021 Mar 25.

Department of Gynaecology and Obstetrics, The Second Hospital of Jilin University, Changchun, China.

Circular RNAs (circRNAs) are non-coding RNA molecules, and these are differentially expressed in various diseases, including cancer, suggesting that circRNAs can regulate certain diseases. CircRNAs can act as miRNAs sponges, RNA-binding protein (RBP) sponges, and translation regulators, and they can become an important part of the regulation of gene expression. Furthermore, because of their biomedical features in body fluids, such as high abundance, conservation, and stability, circRNAs are seen as potential biomarkers for various cancers. Cervical cancer (CC) is one of the main causes of cancer-related death in women, and there have been a large number of studies that analyze circRNAs as a new object to be evaluated in CC. Therefore, this review, by understanding the role of circRNAs in CC, may create innovative strategies in the future clinical diagnosis, treatment, and prognosis of CC and promote the development of personalized and highly accurate cancer therapy.
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http://dx.doi.org/10.3389/fgene.2021.653051DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8027469PMC
March 2021

Effects of Preoperative Anxiety on Postoperative Delirium in Elderly Patients Undergoing Elective Orthopedic Surgery: A Prospective Observational Cohort Study.

Clin Interv Aging 2021 26;16:549-557. Epub 2021 Mar 26.

Department of Anesthesiology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, People's Republic of China.

Background: Postoperative delirium (POD) is common and has negative effects on elderly patients. There is a critical need to identify patients at high risk of POD so that providers can better offer targeted interventions in the preoperative and intraoperative periods. We aimed to characterize the prevalence of preoperative anxiety and investigate whether preoperative anxiety predicted the onset of POD in elderly patients undergoing elective orthopedic surgery.

Methods: We conducted a prospective observational cohort study of elderly patients (aged 65 years or older) undergoing elective orthopedic surgery. Preoperative anxiety was assessed using the Hospital Anxiety and Depression Scale-Anxiety (HADS-A), with clinically significant values defined as HADS-A>7. POD was diagnosed according to the Confusion Assessment Method (CAM) criteria on the 5 postoperative days. To determine the independent risk factors for POD, multivariable logistic regression was conducted, including those variables with a p-value <0.05 at univariate analysis.

Results: There were 263 patients included in the study. Seventy-three (27.8%) patients were diagnosed to be POD. Median duration of delirium was 2 days. Forty (15.2%) patients were assessed to experience preoperative anxiety. The occurrence of preoperative anxiety in total hip arthroplasty (THA), proximal femoral nail antirotation (PFNA), and total knee arthroplasty (TKA) was 12.5%, 16.1%, and 19.5%, respectively. Based on multivariable analysis, only age (odds ratio [OR]= 1.099, 95% Confidence Interval [CI]: 1.013-1.192; =0.023), Mini Mental State Examination (MMSE) (OR= 0.603, 95% CI: 0.432-0.842; =0.003) and preoperative anxiety (OR= 3.119, 95% CI: 1.144-8.500; =0.026) were independently associated with POD.

Conclusion: In conclusion, the current study reveals that preoperative anxiety helps to predict the risk of POD in elderly patients undergoing elective orthopedic surgery. Relieving preoperative anxiety could be a new target for preventive interventions to reduce POD.
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http://dx.doi.org/10.2147/CIA.S300639DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8009348PMC
March 2021

Recent and active problematic substance use among primary care patients: Results from the alcohol, smoking, and substance involvement screening test in a multisite study.

Subst Abus 2021 Apr 2:1-6. Epub 2021 Apr 2.

Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA.

Primary care settings provide salient opportunities for identifying patients with problematic substance use and addressing unmet treatment need. The aim of this study was to examine the extent and correlates of problematic substance use by substance-specific risk categories among primary care patients to inform screening/intervention efforts. Data were analyzed from 2000 adult primary care patients aged ≥18 years (56% female) across 5 clinics in the eastern U.S. Participants completed the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST). Prevalence and ASSIST-defined risk-level of tobacco use, alcohol use, and nonmedical/illicit drug use was examined. Multinomial logistic regression models analyzed the demographic correlates of substance use risk-levels. Among the total sample, the prevalence of any past 3-month use was 53.9% for alcohol, 42.0% for tobacco, 24.2% for any illicit/Rx drug, and 5.3% for opioids; the prevalence of ASSIST-defined moderate/high-risk use was 45.1% for tobacco, 29.0% for any illicit/Rx drug, 14.2% for alcohol, and 9.1% for opioids. Differences in the extent and risk-levels of substance use by sex, race/ethnicity, and age group were observed. Adjusted logistic regression showed that male sex, white race, not being married, and having less education were associated with increased odds of moderate/high-risk use scores for each substance category; older ages (versus ages 18-25 years) were associated with increased odds of moderate/high-risk opioid use. Intervention need for problematic substance use was prevalent in this sample. Providers should maintain awareness and screen for problematic substance use more consistently in identified high risk populations.
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http://dx.doi.org/10.1080/08897077.2021.1901176DOI Listing
April 2021

Insight into the capacity decay mechanism of cycled LiNiCoMnOcathodes viax-ray diffraction.

Nanotechnology 2021 Apr 27;32(29). Epub 2021 Apr 27.

Department of Physics, City University of Hong Kong, Hong Kong 999077, People's Republic of China.

Layered LiNiCoMnO(NCM) is expected to dominate the future cathode technology of the automotive industry, due to its high energy density and low cost. Despite its excellent prospects, however, the severe capacity decay of NCM cathodes has prevented this promising material from achieving further success. The mechanism underlying this phenomenon is controversial and has been generally understood as arising from the complex structural changes that take place upon Li-(de)intercalation. However, deeper insight has not been available due to unclear structural kinetics, in particular, in cycled NCM cathodes. For this study, we conductedhigh-energy synchrotron x-ray diffraction (XRD) measurements on a typical LiNiCoMnO(NCM523) cathode that had been operated for 90 cycles, then compared the results with those collected from a fresh NCM532 electrode. It was revealed that the H1-H2 phase transition that only occurs at the first cycle is irreversible. Remarkably, the-contraction triggered by the H2-H3 transition, which is expected to be the major cause of intergranular cracks in electrodes, became even more profound after cycling. Combining the above results with electrochemical testing and microscopic imaging, we discuss the interplay between structural dynamics and performance degradation in NCM532 in detail. This study provides key evidence for a mechanically induced capacity decay mechanism, which is expected to be extended to NCM materials with various compositions.
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http://dx.doi.org/10.1088/1361-6528/abf2ffDOI Listing
April 2021

Molecular basis of cross-resistance to acetohydroxy acid synthase-inhibiting herbicides in Sagittaria trifolia L.

Pestic Biochem Physiol 2021 Mar 29;173:104795. Epub 2021 Jan 29.

College of Plant Protection, Shenyang Agricultural University, Shenyang, Liaoning 110866, China. Electronic address:

Acetohydroxy acid synthase (AHAS)-inhibiting herbicides are one of the most commonly used herbicides for controlling the growth of Sagittaria trifolia L. in paddy fields in Northeastern China. In this study, we collected five suspected resistant populations of S. trifolia (R1-R5) from three different provinces of Northeastern China. The results of whole-plant bioassays revealed that those populations showed high level of resistance to bensulfuron-methyl with resistance index (GR R/S) ranging from 39.90 to 88.50. The results of AHAS-activity assays were consistent with the results of the whole-plant bioassays. The AHAS gene analysis showed that R2 and R3 populations contained Pro-197-Leu mutations that were highly resistant to penoxsulam; R1 and R4 populations contained Pro-197-Ser mutations that were highly resistant to bispyribac‑sodium; R5 population contained Trp-574-Leu mutation that showed high resistance to IMI, PT, PTB and SU herbicides. The AHAS with resistance mutations showed less sensitivity to feedback inhibition by BCAAs and R genotypes had increased free BCAAs.
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http://dx.doi.org/10.1016/j.pestbp.2021.104795DOI Listing
March 2021

Co-transfection with and via chitosan nanoparticles potentiates osteogenesis in human adipose-derived stromal cells .

J Int Med Res 2021 Mar;49(3):300060521997679

Department of Plastic Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, PR China.

Objective: To investigate if co-transfection of human bone morphogenetic protein 2 (BMP-2, ) and human fibroblast growth factor 2 (FGF2, ) via chitosan nanoparticles promotes osteogenesis in human adipose tissue-derived stem cells (ADSCs) .

Materials And Methods: Recombinant and/or expression vectors were constructed and packaged into chitosan nanoparticles. The chitosan nanoparticles were characterized by atomic force microscopy. Gene and protein expression levels of BMP-2 and FGF2 in ADSCs were evaluated by real-time polymerase chain reaction (PCR), western blot, and enzyme-linked immunosorbent assay. Osteocalcin (OCN) and bone sialoprotein (BSP) gene expression were also evaluated by real-time PCR to assess osteogenesis.

Results: The prepared chitosan nanoparticles were spherical with a relatively homogenous size distribution. The and vectors were successfully transfected into ADSCs. BMP-2 and FGF2 mRNA and protein levels were significantly up-regulated in the co-transfection group compared with the control group. OCN and BSP mRNA levels were also significantly increased in the co-transfection group compared with cells transfected with or alone, suggesting that co-transfection significantly enhanced osteogenesis.

Conclusions: Co-transfection of human ADSCs with via chitosan nanoparticles efficiently promotes the osteogenic properties of ADSCs .
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http://dx.doi.org/10.1177/0300060521997679DOI Listing
March 2021

Effects of long-term fertilization without phosphorus on greenhouse gas emissions from paddy fields.

Ying Yong Sheng Tai Xue Bao 2021 Mar;32(3):942-950

Institute of Agricultural Resources and Environment, Jiangsu Academy of Agricultural Sciences, Nanjing 210014, China.

The strategy of few or no-phosphorus fertilization in rice season but more in wheat season can effectively increase phosphorus use efficiency and reduce phosphorus loss through runoff and leaching. It remains unknown whether the lack of phosphorus will affect greenhouse gas emission in the rice season. We monitored the CH and NO emission fluxes during the growth period of rice treated with normal phosphorus application (NPK) and no-phosphorus application (NK) in two long-term experimental fields in Suzhou and Yixing. The results showed that long-term no-phosphorus application promoted CH and NO emission in both fields. Compared with the NPK treatment, CH and NO emissions from the NK treatment significantly increased by 57% and 25% in Suzhou experi-mental field, respectively, while those in Yixing experimental field were also significantly increased by 221% and 70%, respectively. The contents of organic acid, dissolved organic carbon and available phosphorus in soil were reduced under long-term NK treatment, and they were closely related to CH emission. Soil available phosphorus content was significantly negatively correlated with CH emission (=-0.987). The global warming potential (GWP) was greater in NK treatment than NPK treatment in both fields. Therefore, long-term no-phosphorus application could decrease the contents of organic acid, soluble organic carbon, and available phosphorus in soils, resulting in more CH and NO emission in rice field.
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http://dx.doi.org/10.13287/j.1001-9332.202103.028DOI Listing
March 2021

Bridging Structural Inhomogeneity to Functionality: Pair Distribution Function Methods for Functional Materials Development.

Adv Sci (Weinh) 2021 Mar 22;8(6):2003534. Epub 2021 Jan 22.

Department of Physics City University of Hong Kong Hong Kong 999077 P. R. China.

The correlation between structure and function lies at the heart of materials science and engineering. Especially, modern functional materials usually contain inhomogeneities at an atomic level, endowing them with interesting properties regarding electrons, phonons, and magnetic moments. Over the past few decades, many of the key developments in functional materials have been driven by the rapid advances in short-range crystallographic techniques. Among them, pair distribution function (PDF) technique, capable of utilizing the entire Bragg and diffuse scattering signals, stands out as a powerful tool for detecting local structure away from average. With the advent of synchrotron X-rays, spallation neutrons, and advanced computing power, the PDF can quantitatively encode a local structure and in turn guide atomic-scale engineering in the functional materials. Here, the PDF investigations in a range of functional materials are reviewed, including ferroelectrics/thermoelectrics, colossal magnetoresistance (CMR) magnets, high-temperature superconductors (HTSC), quantum dots (QDs), nano-catalysts, and energy storage materials, where the links between functions and structural inhomogeneities are prominent. For each application, a brief description of the structure-function coupling will be given, followed by selected cases of PDF investigations. Before that, an overview of the theory, methodology, and unique power of the PDF method will be also presented.
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http://dx.doi.org/10.1002/advs.202003534DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7967088PMC
March 2021

FeARH: Federated machine learning with anonymous random hybridization on electronic medical records.

J Biomed Inform 2021 Mar 9;117:103735. Epub 2021 Mar 9.

Harvard Medical School, Boston, MA 02115, United States; Massachusetts General Hospital, Boston, MA 02115, United States; The Broad institute of MIT and Harvard, Cambridge, MA 02115, United States; Computer Science & Artificial Intelligence Laboratory, Massachusetts Institute of Technology, Cambridge, MA 02139, United States. Electronic address:

Electrical medical records are restricted and difficult to centralize for machine learning model training due to privacy and regulatory issues. One solution is to train models in a distributed manner that involves many parties in the process. However, sometimes certain parties are not trustable, and in this project, we aim to propose an alternative method to traditional federated learning with central analyzer in order to conduct training in a situation without a trustable central analyzer. The proposed algorithm is called "federated machine learning with anonymous random hybridization (abbreviated as 'FeARH')", using mainly hybridization algorithm to degenerate the integration of connections between medical record data and models' parameters by adding randomization into the parameter sets shared to other parties. Based on our experiment, our new algorithm has similar AUCROC and AUCPR results compared with machine learning in a centralized manner and original federated machine learning.
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http://dx.doi.org/10.1016/j.jbi.2021.103735DOI Listing
March 2021

100 Hz Electroacupuncture Alleviated Chronic Itch and GRPR Expression Through Activation of Kappa Opioid Receptors in Spinal Dorsal Horn.

Front Neurosci 2021 16;15:625471. Epub 2021 Feb 16.

Department of Neurobiology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Background: Clinical studies have shown that electroacupuncture (EA) alleviates chronic itch. Gastrin-releasing peptide receptor (GRPR) and dynorphin (DYN) in the spinal dorsal horn positively or negatively regulate itch, respectively. However, which frequency of EA is effective on relieving chronic itch and reducing the expression of GRPR, whether DYN-A in the spinal cord is involved in the underlying mechanism of the antipruritus effect of EA remains unknown.

Methods: The mixture of acetone and diethyl ether (1:1) [designated as AEW (acetone/diethyl ether and water) treatment] was used to induce the dry skin model of chronic itch. EA was applied to Quchi (LI11) and Hegu (LI4). Western blot was used to detect the expression of GRPR and DYN-A. Immunofluorescence was used to detect the expression of DYN-A.

Results: The AEW administration induced remarkable spontaneous scratching, enhanced the expression of GRPR, and reduced the expression of DYN-A. Compared with the sham EA, 2 Hz EA, or 15 Hz EA group, 100 Hz EA was the most effective frequency for relieving chronic itch, reducing the expression of GRPR, and increasing the expression of DYN-A in the cervical dorsal horn. Furthermore, intraperitoneal injection of kappa opioid receptors (KORs) antagonist nor-Binaltorphimine dihydrochloride (nor-BNI) significantly reversed the effect of 100 Hz EA on the inhibition of both itching behavior and GRPR expression.

Conclusion: EA at 100 Hz is the most effective frequency that inhibits chronic itch and GRPR expression through activation of KORs in the spinal dorsal horn, which can effectively guide the clinical treatment and improve the antipruritic effect of acupuncture.
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http://dx.doi.org/10.3389/fnins.2021.625471DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7921323PMC
February 2021

Streamlined Subclass-Specific Absolute Quantification of Serum IgG Glycopeptides Using Synthetic Isotope-Labeled Standards.

Anal Chem 2021 03 25;93(10):4449-4455. Epub 2021 Feb 25.

Department of Chemistry, Georgia State University, Atlanta, Georgia 30303, United States.

Absolute glycoproteomics quantification has drawn tremendous attention owing to its prospects in biomarker discovery and clinical implementation but is impeded by a general lack of suitable heavy isotope-labeled glycopeptide standards. In this study, we devised a facile chemoenzymatic strategy to synthesize a total of 36 human IgG glycopeptides attached with well-defined glycoforms, including 15 isotope-labeled ones with a mass increment of 6 Da to their native counterparts. Spiking of these standards into human sera enabled simplified, robust, and precise absolute quantification of IgG glycopeptides in a subclass-specific fashion. Additionally, the implementation of the absolute quantification approach revealed subclass-dependent alteration of serum IgG galactosylation and sialylation in colon cancer samples.
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http://dx.doi.org/10.1021/acs.analchem.0c04462DOI Listing
March 2021

Efficacy of ginseng and its ingredients as adjuvants to chemotherapy in non-small cell lung cancer.

Food Funct 2021 Mar;12(5):2225-2241

Department of Pharmaceutical Analysis, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing 210028, China. and Department of Metabolomics, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing 210028, China.

Chemotherapy is applied to treat non-small cell lung cancer (NSCLC), but often limited due to its unstable therapeutic effects and adverse reactions (ADRs). Ginseng and its main ingredients (ginsenosides and polysaccharides) have been clinically used as adjuvants to chemotherapy. However, their efficacies were based on individual trials with relatively small sample sizes, and it is difficult to draw a valid conclusion. In this study, eligible randomized controlled trials (RCTs) were searched in six international and Chinese databases (PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, Chinese VIP Information and Wanfang). The outcomes of the objective response rate (ORR), disease control rate (DCR), ADRs, quality of life (QOL), survival rates and immunity were extracted using standard data extraction forms. The efficacies of ginseng and its ingredients as adjuvants to chemotherapy in NSCLC were investigated and compared by meta-analysis and subgroup meta-analysis, respectively. A total of 28 RCTs including 2503 subjects were enrolled, and most of the eligible studies were of low-to-moderate quality. For the evaluation of ginseng and its ingredients as adjuvants to chemotherapy, the risk ratio (RR) or standardized mean difference (SMD) and 95% confidence intervals (CI) of the ORR, DCR, leucopenia, thrombocytopenia, myelosuppression, hepatotoxicity, nausea and vomiting, diarrhea, CD4+/CD8+ and one- and two-year survival rates, and QOL were 1.35 (1.21,1.50), 1.20 (1.14,1.28), 0.59 (0.50, 0.70), 0.53 (0.37, 0.76), 0.30 (0.17, 0.53), 0.67 (0.52, 0.87), 0.67 (0.53, 0.86), 0.42 (0.19, 0.96), 1.39 (0.63, 2.16), 1.35 (1.13, 1.60), 3.21 (1.51, 6.81) and 1.31 (1.22, 1.41) with significant differences. Subgroup analysis showed that ginseng enhanced nausea and vomiting and QOL, ginsenosides increased ORR, DCR, QOL, leucopenia, thrombocytopenia, myelosuppression, hepatotoxicity, diarrhea, CD4+/CD8+, and one- and two-year survival rates, while polysaccharides improved ORR, DCR, leucopenia, thrombocytopenia, myelosuppression, hepatotoxicity and nausea and vomiting during chemotherapy. In conclusion, ginseng and its ingredients facilitated the therapeutic effects of chemotherapy on NSCLC patients. Ginseng had beneficial effects on alleviating ADRs and enhancing QOL, ginsenosides demonstrated beneficial effects on enhancing therapeutic effects, reducing ADRs, improving immunity, prolonging survival rates and promoting QOL, while polysaccharides showed beneficial effects on promoting therapeutic effects and reducing ADRs.
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http://dx.doi.org/10.1039/d0fo03341cDOI Listing
March 2021

The emerging roles of IDO2 in cancer and its potential as a therapeutic target.

Biomed Pharmacother 2021 May 4;137:111295. Epub 2021 Feb 4.

Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. Electronic address:

During the past decades, tryptophan metabolism disorder was discovered to play a vital and complex role in the development of cancer. Indoleamine 2,3-dioxygenase 2 (IDO2) is one of the initial and rate-limiting enzymes of the kynurenine pathway of tryptophan catabolism. Increasing evidence indicates that IDO2 is upregulated in some tumors and plays a role in the development of cancer. In spite of the growing body of research, few reviews focused on the role of IDO2 in cancer. Here, we review the emerging knowledge on the roles of IDO2 in cancer and its potential as a therapeutic target. Firstly, the main biological features and regulatory mechanisms are reviewed, after which we focus on the expression and roles of IDO2 in cancer. Finally, we discuss the potential of IDO2 as a therapeutic target for cancer treatment.
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http://dx.doi.org/10.1016/j.biopha.2021.111295DOI Listing
May 2021

Long non-coding RNA CCDC183-AS1 acts AS a miR-589-5p sponge to promote the progression of hepatocellular carcinoma through regulating SKP1 expression.

J Exp Clin Cancer Res 2021 Feb 4;40(1):57. Epub 2021 Feb 4.

Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, P.R. China.

Background: Hepatocellular carcinoma (HCC) is a common type of malignant human cancer with high morbidity and poor prognosis, causing numerous deaths per year worldwide. Growing evidence has been demonstrated that long non-coding RNAs (lncRNAs) are closely associated with hepatocarcinogenesis and metastasis. However, the roles, functions, and working mechanisms of most lncRNAs in HCC remain poorly defined.

Methods: Real-time quantitative polymerase chain reaction (qRT-PCR) was used to detect the expression level of CCDC183-AS1 in HCC tissues and cell lines. Cell proliferation, migration and invasion ability were evaluated by CCK-8 and transwell assay, respectively. Animal experiments were used to explore the role of CCDC183-AS1 and miR-589-5p in vivo. Bioinformatic analysis, dual-luciferase reporter assay and RNA immunoprecipitation (RIP) assay were performed to confirm the regulatory relationship between CCDC183-AS1, miR-589-5p and SKP1.

Results: Significantly upregulated expression of CCDC183-AS1 was observed in both HCC tissues and cell lines. HCC patients with higher expression of CCDC183-AS1 had a poorer overall survival rate. Functionally, overexpression of CCDC183-AS1 markedly promoted HCC cell proliferation, migration and invasion in vitro and tumor growth and metastasis in vivo, whereas the downregulation of CCDC183-AS1 exerted opposite effects. MiR-589-5p inhibitor counteracted the proliferation, migration and invasion inhibitory effects induced by CCDC183-AS1 silencing. Mechanistically, CCDC183-AS1 acted as a ceRNA through sponging miR-589-5p to offset its inhibitory effect on the target gene SKP1, then promoted the tumorigenesis of HCC.

Conclusions: CCDC183-AS1 functions as an oncogene to promote HCC progression through the CCDC183-AS1/miR-589-5p/SKP1 axis. Our study provided a novel potential therapeutic target for HCC patients.
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http://dx.doi.org/10.1186/s13046-021-01861-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7863448PMC
February 2021

Impact of house price growth on mental health: Evidence from China.

SSM Popul Health 2021 Mar 19;13:100696. Epub 2020 Nov 19.

Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, 100191, China.

Background: Housing boom has raised global attention in the past two decades. A number of studies attempted to analyse the effect of house price increase. However, little is known about the health consequence as a result of housing boom, likely due to the scarcity of the data. The objective of this paper is to investigate the relationship between housing affordability and mental health as a result of house price increase.

Methods: Based on a panel dataset of 32 Chinese cities from January 2013 to December 2017, we used a fixed effect model adjusting for per capita disposable income to estimate the impact of house price growth rate on mental health, and applied the Instrumental Variable (IV) method to address the endogeneity problem.

Results: From both Ordinary Least Squares (OLS) and IV estimations, the results suggested that a one standard deviation increase in house price increase rate in the past three months is associated with a 0.443 standard deviation increase in people consulting with doctors about their mental disorders in the city. This effect does not vary by gender, but was more pronounced in residents older than 40 years.

Conclusion: These results revealed the potential negative consequences in people's mental health due to house price increase, necessitate appropriate policy responses.
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http://dx.doi.org/10.1016/j.ssmph.2020.100696DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7823040PMC
March 2021

Chrysophanol protects human bronchial epithelial cells from cigarette smoke extract (CSE)-induced apoptosis.

Int J Mol Epidemiol Genet 2020 15;11(3):39-45. Epub 2020 Dec 15.

The Center for Biomedical Research, Tongji Hospital Research Building, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan, China.

Objective: Chronic obstructive pulmonary disease (COPD) is a common respiratory disease characterized by the persistent airflow obstruction. Chrysophanol, an anthraquinone derivative isolated from the rhizomes of , has been reported to be protective for some inflammatory diseases. The present report aimed to dissect its effect on cigarette smoke extract (CSE)-induced apoptosis in 16HBECs, a human bronchial epithelial cell line.

Methods: CCK8 cell viability assay was conducted to evaluate the protective effect of chrysophanol on 16HBECs after CSE induction. Western blot analysis, Annexin V/PI staining and TUNEL assay were conducted to test the effect of chrysophanol on 16HBECs apoptosis induced by CSE. Then the western blot assay measured associated molecular pathways to dissect the mechanisms underlying protective effect of chrysophanol on 16HBECs.

Results: Chrysophanol protects 16HBECs against CSE-induced apoptosis in a dose dependent manner. Specifically, pre-treatment of 16HBECs with 20 mmol/l of chrysophanol, reduced CSE-induced apoptosis by almost 10%. Mechanistically, chrysophanol manifested high potency to attenuate CSE-induced expression of apoptotic markers, Bax and cleaved caspase 3. In particular, chrysophanol not only represses CSE-induced oxidative stress by inhibiting CYP1A1 expression, but also suppresses CSE-induced ER stress by inhibiting pPERK, ATF4 and ATF6 expression.

Conclusion: Chrysophanol showed protective effect on CSE-induced epithelial injuries in cell line 16HBECs. And our data support that chrysophanol could be employed to reduce the toxicity of cigarette smoke in bronchial epithelial cells, which may have the potential to decrease the risk for developing COPD in smoking subjects.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7811954PMC
December 2020

Long noncoding RNA SNHG14 promotes hepatocellular carcinoma progression by regulating miR-876-5p/SSR2 axis.

J Exp Clin Cancer Res 2021 Jan 23;40(1):36. Epub 2021 Jan 23.

Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, P. R. China.

Background: Aberrant expressions of long noncoding RNAs (lncRNAs) have been demonstrated to be related to the progress of HCC. The mechanisms that SNHG14 has participated in the development of HCC are obscure.

Methods: Quantitative real-time PCR (qRT-PCR) was used to measure the lncRNA, microRNA and mRNA expression level. Cell migration, invasion and proliferation ability were evaluated by transwell and CCK8 assays. The ceRNA regulatory mechanism of SNHG14 was evaluated by RNA immunoprecipitation (RIP) and dual luciferase reporter assay. Tumorigenesis mouse model was used to explore the roles of miR-876-5p in vivo. The protein levels of SSR2 were measured by western blot assay.

Results: In this study, we demonstrated that SNHG14 was highly expressed in HCC tissues, meanwhile, the elevated expression of SNHG14 predicted poor prognosis in patients with HCC. SNHG14 promoted proliferation and metastasis of HCC cells. We further revealed that SNHG14 functioned as a competing endogenous RNA (ceRNA) for miR-876-5p and that SSR2 was a downstream target of miR-876-5p in HCC. Transwell, CCK8 and animal experiments exhibited miR-876-5p inhibited HCC progression in vitro and in vivo. By conducting rescue experiments, we found the overexpression of SSR2 or knocking down the level of miR-876-5p could reverse the suppressive roles of SNHG14 depletion in HCC.

Conclusion: SNHG14 promotes HCC progress by acting as a sponge of miR-876-5p to regulate the expression of SSR2 in HCC.
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http://dx.doi.org/10.1186/s13046-021-01838-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7824933PMC
January 2021

Fractions, Contamination and Health Risk of Cadmium in Alpine Soils on the Gongga Mountain, Eastern Tibetan Plateau.

Bull Environ Contam Toxicol 2021 Jan 21;106(1):86-91. Epub 2021 Jan 21.

The Key Laboratory of Mountain Surface Processes and Ecological Regulation, Institute of Mountain Hazards and Environment, Chinese Academy of Sciences, Chengdu, 610041, China.

Anthropogenic cadmium (Cd) in alpine soils is mainly from long-range atmospheric transport. Because of the high toxicity and mobility, whether the accumulation of Cd in the soils threats to ecosystem safety remains unclear. The fractions of soil Cd along three altitudinal transects on Gongga Mountain were analyzed to decipher the drivers on its mobility, and its contamination and health risk were assessed. The concentrations of Cd in the organic (O) and mineral (A) horizons were significantly higher on the eastern and southern transects than the western transect. The Cd fractions in the two horizons dominated by acid-soluble and reducible Cd. Soil organic matter and pH modulated the mobilization of soil Cd. Cadmium reached a moderate contamination level on the eastern and southern transects, but no or slight contamination on the western transect. The soil Cd had a low non-carcinogenic risk and no carcinogenic risk despite of adults or children.
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http://dx.doi.org/10.1007/s00128-020-03073-8DOI Listing
January 2021

Primary malignant melanomas of the female lower genital tract: clinicopathological characteristics and management.

Am J Cancer Res 2020 1;10(12):4017-4037. Epub 2020 Dec 1.

Department of Obstetrics and Gynecology, Second Hospital of Jilin University Changchun, Jilin, P. R. China.

The female lower genital tract melanomas mainly include vulvar, vaginal and cervical melanoma. There is little clinical data on the melanomas thus making them highly lethal with their prognosis being worse than for cutaneous melanoma and other gynecological malignancies. Surgery is still the primary treatment for gynecological melanomas with wide local resection (WLE) of tumors with adequate margins being preferred for early-stage vulvar melanoma while complete resection of the primary tumor is the standard treatment for early-stage cervical and vaginal melanoma. Sentinel lymph node biopsy seems to avoid unnecessary complete regional lymphadenectomy. However, it should be chosen cautiously. Recently discovered molecular changes have provided new hopes for effective systemic treatment of female genital tract melanomas. In this review, we summarize the pathogenesis and clinicopathological characteristics of these rare melanomas with particular emphasis on new therapies and clinical management methods that may affect prognosis. The review aims to provide a viable direction for clinicians to diagnose and treat female lower genital tract melanomas.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7783736PMC
December 2020

Extrinsic Photoconduction Induced Short-Wavelength Infrared Photodetectors Based on Ge-Based Chalcogenides.

Small 2021 Jan 20;17(4):e2006765. Epub 2020 Dec 20.

State Key Laboratory of Infrared Physics, Shanghai Institute of Technical Physics, Chinese Academy of Sciences, 500 Yutian Road, Shanghai, 200083, China.

2D layered photodetectors have been widely researched for intriguing optoelectronic properties but their application fields are limited by the bandgap. Extending the detection waveband can significantly enrich functionalities and applications of photodetectors. For example, after breaking through bandgap limitation, extrinsic Si photodetectors are used for short-wavelength infrared or even long-wavelength infrared detection. Utilizing extrinsic photoconduction to extend the detection waveband of 2D layered photodetectors is attractive and desirable. However, extrinsic photoconduction has yet not been observed in 2D layered materials. Here, extrinsic photoconduction-induced short-wavelength infrared photodetectors based on Ge-based chalcogenides are reported for the first time and the effectiveness of intrinsic point defects are demonstrated. The detection waveband of room-temperature extrinsic GeSe photodetectors with the assistance of Ge vacancies is broadened to 1.6 µm. Extrinsic GeSe photodetectors have an excellent external quantum efficiency (0.5%) at the communication band of 1.31 µm and polarization-resolved capability to subwaveband radiation. Moreover, room-temperature extrinsic GeS photodetectors with a detection waveband to the communication band of 1.55 µm further verify the versatility of intrinsic point defects. This approach provides design strategies to enrich the functionalities of 2D layered photodetectors.
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http://dx.doi.org/10.1002/smll.202006765DOI Listing
January 2021

Dysfunction of VIPR2 leads to myopia in humans and mice.

J Med Genet 2020 Dec 14. Epub 2020 Dec 14.

School of Optometry and Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, China

Background: Myopia is the leading cause of refractive errors. As its pathogenesis is poorly understood, we determined if the retinal VIP-VIPR2 signalling pathway axis has a role in controlling signalling output that affects myopia development in mice.

Methods: Association analysis meta-study, single-cell transcriptome, bulk RNA sequencing, pharmacological manipulation and VIPR2 gene knockout studies were used to clarify if changes in the VIP-VIPR2 signalling pathway affect refractive development in mice.

Results: The SNP rs6979985 of the gene was associated with high myopia in a Chinese Han cohort (randomceffect model: p=0.013). After either 1 or 2 days' form deprivation (FD) retinal mRNA expression was downregulated. Retinal single-cell transcriptome sequencing showed that VIPR2 expressed mainly by bipolar cells. Furthermore, the cAMP signalling pathway axis was inhibited in some clusters after 2 days of FD. The selective VIPR2 antagonist PG99-465 induced relative myopia, whereas the selective VIPR2 agonist Ro25-1553 inhibited this response. In knockout (-KO) mice, refraction was significantly shifted towards myopia (p<0.05). The amplitudes of the bipolar cell derived b-waves in 7-week-old -KO mice were significantly larger than those in their WT littermates (p<0.05).

Conclusions: Loss of VIPR2 function likely compromises bipolar cell function based on presumed changes in signal transduction due to altered signature electrical wave activity output in these mice. As these effects correspond with increases in form deprivation myopia (FDM), the VIP-VIPR2 signalling pathway axis is a viable novel target to control the development of this condition.
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http://dx.doi.org/10.1136/jmedgenet-2020-107220DOI Listing
December 2020

Integration of the Extreme Gradient Boosting model with electronic health records to enable the early diagnosis of multiple sclerosis.

Mult Scler Relat Disord 2021 Jan 18;47:102632. Epub 2020 Nov 18.

Department of Neurology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China. Electronic address:

Background: Delayed multiple sclerosis (MS) diagnoses are not uncommon, an early diagnostic tool is urgently warranted. We aimed to develop an effective tool through electronic health records and machine learning techniques to early recognize MS patients from hospital visitors in China.

Methods: Two case sets were collected from January 2016 to December 2018. The training set had 239 MS and 1142 controls, and the test set had 23 MS and 92 controls. The utility of Extreme Gradient Boosting (XGBoost), Random Forest (RF), Naive Bayes, K-nearest-neighbor (KNN) and Support Vector Machine (SVM) in early diagnosis of MS was evaluated by the area under curve of receiver operating characteristic, precision, recall, specificity, accuracy and F1 score.

Results: The XGBoost performed the best and was used to generate the results. Thirty-four variables which were highly relevant to MS diagnosis were set for the XGBoost model, and their relative importance with MS were ranked. The training set recall was 0.632, with a precision of 0.576, and the test set recall was 0.609, with a precision of 0.609. Our study found that 61%, 51%, and 49% of the patients could be diagnosed with MS, 1, 2, and 3 years earlier than their real diagnostic time point, respectively.

Conclusions: A diagnostic tool for early MS recognition based on the XGBoost model and electronic health records were developed to help reduce diagnostic delays in MS.
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http://dx.doi.org/10.1016/j.msard.2020.102632DOI Listing
January 2021

N-Linked Glycosylation Prevents Deamidation of Glycopeptide and Glycoprotein.

ACS Chem Biol 2020 12 3;15(12):3197-3205. Epub 2020 Dec 3.

Department of Chemistry, Georgia State University, Atlanta, Georgia 30303, United States.

Deamidation has been recognized as a common spontaneous pathway of protein degradation and a prevalent concern in the pharmaceutical industry; deamidation caused the reduction of protein/peptide drug efficacy and shelf life in several cases. More importantly, deamidation of physiological proteins is related to several human diseases and considered a "timer" for the diseases. N-linked glycosylation has a variety of significant biological functions, and it interestingly occurs right on the deamidation site-asparagine. It has been perceived that N-glycosylation could prevent deamidation, but experimental support is still lacking for clearly understanding the role of N-glycosylation on deamidation. Our results presented that deamidation is prevented by naturally occurring N-linked glycosylation. Glycopeptides and corresponding nonglycosylated peptides were used to compare their deamidation rates. All the nonglycosylated peptides have different half-lives ranging from one to 20 days, for the corresponding glycosylated peptides; all the results showed that the deamidation reaction was significantly reduced by the introduction of N-linked glycosylation. A glycoprotein, RNase B, also showed a significantly elongated deamidation half-life compared to nonglycosylated protein RNase A. At last, N-linked glycosylation on INGAP-P, a therapeutic peptide, increased the deamidation half-life of INGAP-P as well as its therapeutic potency.
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http://dx.doi.org/10.1021/acschembio.0c00734DOI Listing
December 2020

Effects of Artificial Islands Construction on the Spatial Distribution and Risk Assessment of Heavy Metals in the Surface Sediments from a Semi-closed Bay (Longkou Bay), China.

Bull Environ Contam Toxicol 2021 Jan 19;106(1):44-50. Epub 2020 Nov 19.

Key Laboratory of Coastal Zone Environment Processes and Ecological Remediation, Yantai Institute of Coastal Zone Research, Chinese Academy of Sciences, Yantai, 264003, People's Republic of China.

Artificial islands construction can significantly influence the spatial distribution of heavy metals in inshore sediments. In this study, the distribution and contamination of heavy metals (Cd, Co, Cr, Cu, Ni, Pb, Zn, As and Hg) in inshore sediments of the Longkou Bay and artificial island adjacent areas were investigated in 2013 and 2014, respectively. Results showed that the contents of heavy metals increased in the Longkou Bay and decreased in the west of the artificial island in 2014 compared with 2013. The contamination and potential eco-risk of heavy metals in the sediments were higher in 2014 than those in 2013. Cd and Hg showed a high potential eco-risk in LK02, and other metals were in the lower level. The results indicated that after the construction of artificial islands in the Longkou Bay, the contamination and eco-risk of heavy metals in the sediments markedly increased in the Longkou Bay.
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http://dx.doi.org/10.1007/s00128-020-03032-3DOI Listing
January 2021

MiRNA-532-5p Regulates CUMS-Induced Depression-Like Behaviors and Modulates LPS-Induced Proinflammatory Cytokine Signaling by Targeting STAT3.

Neuropsychiatr Dis Treat 2020 12;16:2753-2764. Epub 2020 Nov 12.

Pharmaceutical Department, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province 510405, People's Republic of China.

Background: It is known that miR-532-5p is critical for neuronal differentiation. However, the role of miR-532-5p in depression remains unknown. This study aimed to investigate the role and mechanism of miR-532-5p in major depressive disorder (MDD).

Methods: The depression mice model was established by chronic unpredictable mild stress (CUMS) and confirmed by forced swimming test (FST) and sucrose preference test (SPT). The role of miR-532-5p in MDD was detected by tail suspension test (TST), FST, SPT and SIT. QRT-PCR was used to detect the expression of miR-139-5p in hippocampus and BV-2 microglia of mice. ELISA and Western blotting were used to detect the expression of the nitric oxide synthase (NOS), proinflammatory cytokines (IL-6, IL-1β, TNF-α, and MCP-1) and transcriptional activator 3 (STAT3). Luciferase reporter assay was used to verify the downstream target genes of miR-532-5p.

Results: MiR-532-5p was significantly reduced in the hippocampus of mice treated with CUMS. Overexpression of miR-532-5p significantly reduced CUMS-induced depression-like behaviors and suppressed the expression of IL-6, IL-1β, TNF-α and MCP-1. MiR-532-5p directly targeted signal transducers and STAT3 in BV2 cells. In addition, overexpression of miR-532-5p restrained the raise of inducible NOS and IL-6, IL-1 β, TNF-α and MCP-1 in LPS-exposed BV2 cells.

Conclusion: This study indicates that miR-532-5p plays an important role in CUMS-induced depression-like behaviors by targeting STAT3, and miR-532-5p may be a potential target for MDD therapy.
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http://dx.doi.org/10.2147/NDT.S251152DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7669525PMC
November 2020

Interaction of Analgesic Effects of Dezocine and Sufentanil for Relief of Postoperative Pain: A Pilot Study.

Drug Des Devel Ther 2020 3;14:4717-4724. Epub 2020 Nov 3.

Department of Anesthesiology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200093, People's Republic of China.

Purpose: The combination of dezocine and sufentanil is often used for postoperative analgesia in China and other areas, but the interaction of both two drugs is still unclear. The purpose of this study was to evaluate the interaction of the analgesic effects of dezocine and sufentanil in the patients after gynecological laparoscopic surgery.

Patients And Methods: We conducted a prospective, randomized, double-blinded clinical trial. A total of 150 patients were divided into 5 groups (30 in each group) in the post-anesthesia care unit, namely, dezocine group (Group D), sufentanil group (Group S) and dezocine mixed sufentanil groups (Group DS1-3). In group D and S, the initial dose of dezocine or sufentanil was 5mg and 5μg intravenously, respectively. In Group DS1, the initial dose was dezocine 5mg × 3/4 and sufentanil 5μg × 1/4. In Group DS2, the initial dose was dezocine 5mg × 1/2 and sufentanil 5μg × 1/2. In Group DS3, the initial dose was dezocine 5mg × 1/4 and sufentanil 5μg × 3/4.

Results: The median effective dose (ED50) of dezocine and sufentanil alone was 3.92 (95% confidence interval (CI) 3.01~4.64) mg and 3.71 (95% CI 2.78~4.39) μg, respectively. The isobolographic analysis showed that the combination of dezocine and sufentanil at 1:3, 1:1 or 3:1 appeared in the additive line.

Conclusion: In conclusion, when simultaneously administered intravenously, combined dezocine and sufentanil produce an additive effect for relieving the acute nociception after gynecological laparoscopic surgery.
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http://dx.doi.org/10.2147/DDDT.S270478DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7650029PMC
November 2020

Impact of Dexmedetomidine Infusion on Postoperative Acute Kidney Injury in Elderly Patients Undergoing Major Joint Replacement: A Retrospective Cohort Study.

Drug Des Devel Ther 2020 2;14:4695-4701. Epub 2020 Nov 2.

Department of Anesthesiology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, People's Republic of China.

Purpose: Postoperative acute kidney injury (AKI) is a frequent complication in elderly patients that increases morbidity and mortality. Approximately 1.7 million people die from AKI worldwide every year. Dexmedetomidine (Dex) is often used as an adjunct to multimodal analgesia. Our study investigated whether Dex could safely decrease the incidence of AKI in elderly patients undergoing major joint replacement.

Methods: A single-center retrospective study was conducted in patients aged >65 years undergoing major joint replacement. Propensity score-matching analysis was used, and a total of 1,006 patients were matched successfully. The primary outcome was the incidence of postoperative AKI. Secondary outcomes included perioperative adverse complications, opioid consumption, time to extubation, and length of hospital stay.

Results: Among the 1,006 patients included, postoperative AKI occurred in 9.3% (n=94). The Dex group (perioperative Dex infusion) had lower incidence of postoperative AKI than the control group (7.2% vs 11.5%, =0.017). Compared with the control group, the Dex group had less opioid consumption (<0.05), reduced time to extubation (=0.004), and shorter length of hospital stay (=0.001). The Dex group also showed higher incidence of bradycardia (20.1% vs 15.1%, =0.038). There were no differences in intraoperative hypotension (19.5% vs 17.5%), postoperative nausea and vomiting (4.2% vs 5.4%), time in PACU (45.0±6.4 vs 45.5±6.2 minutes), or rate of ICU admission (9.7% vs 11.1%) between the Dex group and control group (All >0.05).

Conclusion: This retrospective study showed Dex infusion in elderly patients undergoing major joint replacement was associated with lower incidence of postoperative AKI, less opioid consumption, and shorter extubation time and hospital stay. However, the Dex group had higher incidence of bradycardia. We found no statistical differences in other perioperative adverse complications between the groups.
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http://dx.doi.org/10.2147/DDDT.S278342DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7646437PMC
November 2020