Publications by authors named "Yifan Zhong"

30 Publications

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The learning curve of video-assisted thoracoscopic sleeve lobectomy in a high-volume pulmonary center.

JTCVS Tech 2021 Oct 20;9:143-152. Epub 2021 Jul 20.

Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China.

Objectives: To evaluate the time course and caseload required to achieve proficiency by plotting the learning curve of video-assisted thoracoscopic sleeve lobectomy.

Methods: We reviewed 127 cases of video-assisted thoracoscopic sleeve lobectomy by a single surgeon at Shanghai Pulmonary Hospital to evaluate its learning curve using the cumulative sum (CUSUM) analysis. The changes of perioperative outcomes were assessed.

Results: The inflection points of the CUSUM curve were around case 30 and 90, according to which 3 phases were identified: Phase I, Phase II, and Phase III. Significant downtrends were observed regarding operative time (Phase I, 194 [173-233 minutes] vs Phase II, 172 [142-215 minutes] vs Phase III, 138 [117-164 minutes],  < .05, all), blood loss (Phase I, 200 [100-238 mL] vs Phase II, 100 [50-200 mL] vs Phase III, 50 [50-100 mL];  < .05, all), drainage duration (Phase I [5.53 ± 1.11 days] vs Phase II [4.52 ± 1.38 days];  < .05), and length of postoperative stays (Phase I [6.60 ± 1.13 days] vs Phase II [5.68 ± 1.47 days],  < .05). The rate of severe complications significantly decreased from Phase I to Phase II ( = .03).

Conclusions: Thirty cases should be accumulated to lay the technical foundation, and 90 cases were required to achieve proficiency. The focus should now shift to providing sufficient training opportunities for centers wanting to implement this technique.
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http://dx.doi.org/10.1016/j.xjtc.2021.07.006DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8501212PMC
October 2021

L. reuteri ZJ617 inhibits inflammatory and autophagy signaling pathways in gut-liver axis in piglet induced by lipopolysaccharide.

J Anim Sci Biotechnol 2021 Oct 13;12(1):110. Epub 2021 Oct 13.

The Key Laboratory of Molecular Animal Nutrition, Ministry of Education, College of Animal Science, Zhejiang University, Hangzhou, 310058, China.

Background: This study investigated the protective effects of L. reuteri ZJ617 on intestinal and liver injury and the underlying mechanisms in modulating inflammatory, autophagy, and apoptosis signaling pathways in a piglet challenged with lipopolysaccharide (LPS).

Methods: Duroc × Landrace × Large White piglets were assigned to 3 groups (n = 6/group): control (CON) and LPS groups received oral phosphate-buffered saline for 2 weeks before intraperitoneal injection (i.p.) of physiological saline or LPS (25 μg/kg body weight), respectively, while the ZJ617 + LPS group was orally inoculated with ZJ617 for 2 weeks before i.p. of LPS. Piglets were sacrificed 4 h after LPS injection to determine intestinal integrity, serum biochemical parameters, inflammatory signaling involved in molecular and liver injury pathways.

Results: Compared with controls, LPS stimulation significantly increased intestinal phosphorylated-p38 MAPK, phosphorylated-ERK and JNK protein levels and decreased IκBα protein expression, while serum LPS, TNF-α, and IL-6 concentrations (P < 0.05) increased. ZJ617 pretreatment significantly countered the effects induced by LPS alone, with the exception of p-JNK protein levels. Compared with controls, LPS stimulation significantly increased LC3, Atg5, and Beclin-1 protein expression (P < 0.05) but decreased ZO-1, claudin-3, and occludin protein expression (P < 0.05) and increased serum DAO and D-xylose levels, effects that were all countered by ZJ617 pretreatment. LPS induced significantly higher hepatic LC3, Atg5, Beclin-1, SOD-2, and Bax protein expression (P < 0.05) and lower hepatic total bile acid (TBA) levels (P < 0.05) compared with controls. ZJ617 pretreatment significantly decreased hepatic Beclin-1, SOD2, and Bax protein expression (P < 0.05) and showed a tendency to decrease hepatic TBA (P = 0.0743) induced by LPS treatment. Pretreatment of ZJ617 before LPS injection induced the production of 5 significant metabolites in the intestinal contents: capric acid, isoleucine 1TMS, glycerol-1-phosphate byproduct, linoleic acid, alanine-alanine (P < 0.05).

Conclusions: These results demonstrated that ZJ617 pretreatment alleviated LPS-induced intestinal tight junction protein destruction, and intestinal and hepatic inflammatory and autophagy signal activation in the piglets.
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http://dx.doi.org/10.1186/s40104-021-00624-9DOI Listing
October 2021

Global Incidence, Progression, and Risk Factors of Age-Related Macular Degeneration and Projection of Disease Statistics in 30 Years: A Modeling Study.

Gerontology 2021 Sep 21:1-15. Epub 2021 Sep 21.

Department of Ophthalmology, The First affiliated Hospital of China Medical University, Shenyang, China.

Objective: Age-related macular degeneration(AMD) has become a major cause of visual impairment worldwide, especially in the elderly. Estimates of incidence, progression rates, and risk factors of AMD vary among studies, complicating the understanding of its epidemiology.

Methods: For this systematic review and meta-analysis, literature published up to March 1, 2021, was searched in both English and Chinese databases. Hierarchical Bayesian approaches were used to estimate pooled incidence, progression, and 95% credible intervals (CrIs).

Results: Thirty studies were included. The pooled annual early and late AMD incidence rates were 1.59 (95% CrI: 1.18-2.11) and 0.23 (95% CrI: 0.14-0.34) per 100 person-years, respectively. The annual progression rate of AMD was 5.5 (95% CrI: 2.3-8.8) per 100 person-years. Smoking was an independent risk factor for both early and late AMD, whereas age, high-density lipoprotein cholesterol, and alcohol consumption were risk factors for early AMD incidence only. The projected number of new cases of early and late AMD in 2050 would be 39.05 million (95% CrI: 23.12-63.57) and 6.41 million (95% CrI: 3.37-13.22), respectively.

Conclusion: The prediction the number of new cases of AMD is not equal across the globe. Our findings indicate the need for more rigorous control and prevention measures in AMD focus on its risk factors for early intervention. The epidemiological estimates reported in this study could inform to identify effective strategies for preventing AMD worldwide.
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http://dx.doi.org/10.1159/000518822DOI Listing
September 2021

A novel protein encoded by circASK1 ameliorates gefitinib resistance in lung adenocarcinoma by competitively activating ASK1-dependent apoptosis.

Cancer Lett 2021 Nov 11;520:321-331. Epub 2021 Aug 11.

Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China. Electronic address:

Acquired resistance to growth factor receptor tyrosine kinase inhibitors limits the therapeutic benefits gained by EGFR-mutant lung adenocarcinoma (LUAD) patients treated with gefitinib. Circular RNAs (circRNAs) are novel noncoding RNAs implicated in the regulation of chemoresistance in malignancies. However, whether circRNAs participate in the development of EGFR-TKI resistance in LUAD remains to be clarified. Here, we report that circASK1 (hsa_circ_0007798) is significantly downregulated in gefitinib-resistant cells and enhances the gefitinib sensitivity of LUAD cells. Mechanistically, we identified a novel protein encoded by circASK1, ASK1-272a.a, which is essential for ASK1/JNK/p38 signaling activation and mediates the chemosensitivity-inducing effect of circASK1 in LUAD. Importantly, this novel isoform competes with ASK1 for binding to Akt1, therefore antagonizing Akt1-induced ASK1 phosphorylation and inactivation, leading to the activation of ASK1-induced apoptosis and alleviating gefitinib resistance. Moreover, increased YTHDF2-mediated endoribonucleolytic cleavage of mA-modified circASK1 accounts for its downregulation in gefitinib-resistant cells. The clinical data and in vivo model further corroborated the suppressive effect of circASK1 and its encoded protein on gefitinib resistance. Our study provides a novel therapeutic target to overcome gefitinib resistance in LUAD patients.
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http://dx.doi.org/10.1016/j.canlet.2021.08.007DOI Listing
November 2021

Multi-omics analyses on Kandelia obovata reveal its response to transplanting and genetic differentiation among populations.

BMC Plant Biol 2021 Jul 19;21(1):341. Epub 2021 Jul 19.

Key Laboratory of the Ministry of E, ducation for Coastal and Wetland Ecosystems, College of the Environment and Ecology, Xiamen University, Xiamen, 361102, Fujian, China.

Background: Restoration through planting is the dominant strategy to conserve mangrove ecosystems. However, many of the plantations fail to survive. Site and seeding selection matters for planting. The process of afforestation, where individuals were planted in a novel environment, is essentially human-controlled transplanting events. Trying to deepen and expand the understanding of the effects of transplanting on plants, we have performed a seven-year-long reciprocal transplant experiment on Kandelia obovata along a latitudinal gradient.

Results: Combined phenotypic analyses and next-generation sequencing, we found phenotypic discrepancies among individuals from different populations in the common garden and genetic differentiation among populations. The central population with abundant genetic diversity and high phenotypic plasticity had a wide plantable range. But its biomass was reduced after being transferred to other latitudes. The suppressed expression of lignin biosynthesis genes revealed by RNA-seq was responsible for the biomass reduction. Moreover, using whole-genome bisulfite sequencing, we observed modification of DNA methylation in MADS-box genes that involved in the regulation of flowering time, which might contribute to the adaptation to new environments.

Conclusions: Taking advantage of classical ecological experiments as well as multi-omics analyses, our work observed morphology differences and genetic differentiation among different populations of K. obovata, offering scientific advice for the development of restoration strategy with long-term efficacy, also explored phenotypic, transcript, and epigenetic responses of plants to transplanting events between latitudes.
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http://dx.doi.org/10.1186/s12870-021-03123-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8287808PMC
July 2021

Does environmental and renewable energy R&D help to achieve carbon neutrality target? A case of the US economy.

J Environ Manage 2021 Oct 13;296:113229. Epub 2021 Jul 13.

Nisantasi University, Faculty of Economics, Administrative and Social Sciences, Department of Economics, Turkey. Electronic address:

The current study investigates carbon neutrality targets for the US's case while analyzing the role of environmental-related research and development (ERR&D) and renewable energy research and development (RER&D). This study also considered economic growth (GDP) and energy productivity (EP) as controlled variables. Utilizing the time series data over the period from 1990 to 2019, this study used various econometric approaches, such as unit root tests and cointegration tests for stationarity and the long-run association between variables, respectively. This study's main econometric regression tools, such as dynamic ordinary least square (DOLS) and fully modified ordinary least square (FMOLS), are utilized. The empirical findings reveal that economic growth played a negative role in achieving carbon neutrality targets. However, EP, RER&D, and ERR&D positively contribute to carbon neutrality target achievement by reducing atmospheric CO emissions. Moreover, this study found a cointegration relationship between the study variables. The bidirectional causality is found between ERR&D and CO emissions, while a unidirectional causality is observed, running from exogenous variables towards CO emissions. Based on the empirical findings, this study recommends expanding the investment and expenditures in both ERR&D and RER&D sectors to attain carbon neutrality.
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http://dx.doi.org/10.1016/j.jenvman.2021.113229DOI Listing
October 2021

Modeling the effect of green technology innovation and renewable energy on carbon neutrality in N-11 countries? Evidence from advance panel estimations.

J Environ Manage 2021 Oct 2;296:113189. Epub 2021 Jul 2.

Sustainable Real Estate Research Center / Department of Economics and Finance, Hong Kong Shue Yan University, Hong Kong. Electronic address:

After the Paris Climate Conference (Conference of the Paris COP: 21), most developing countries face challenges to attain a sustainable economy and carbon neutrality targets with minimum CO emission. The next eleven (N-11) economies are in line with the global phenomena of environmental degradation; very few studies have analyzed the effects of green technology innovation on environmental degradation in N-11 countries. Therefore, the present study addresses the gap and examines green technology innovation and renewable energy with CO emission from 1980 to 2018. The present study considers all the issues related to panel data analysis, such as cross-sectional dependence, stationarity, heterogeneity in slope parameters, and structural break with advanced panel estimators. Moreover, the cross-sectional augmented autoregressive distributed lags (CS-ARDL) test results show the negative and significant impact of green technology innovation and renewable energy with CO emission in the long run. However, the short-run association of green technology innovation is not significant-further, the results endorsed by the robustness tests such as AMG and CCEMG. To reduce environmental deterioration in N-11 countries, governments are suggested implementing some policies to support green innovation technologies and renewable energy resources.
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http://dx.doi.org/10.1016/j.jenvman.2021.113189DOI Listing
October 2021

A newly identified linear epitope on non-RBD region of SARS-CoV-2 spike protein improves the serological detection rate of COVID-19 patients.

BMC Microbiol 2021 06 26;21(1):194. Epub 2021 Jun 26.

Shenzhen Center for Disease Control and Prevention, Shenzhen, China.

Background: Serological test is helpful in confirming and tracking infectious diseases in large population with the advantage of fast and convenience. Using the specific epitope peptides identified from the whole antigen as the detection antigen is sensitive and relatively economical. The development of epitope peptide-based detection kits for COVID-19 patients requires comprehensive information about epitope peptides. But the data on B cell epitope of SARS-CoV-2 spike protein is still limited. More importantly, there is a lack of serological data on the peptides in the population. In this study, we aimed to identify the B cell epitope peptides of spike protein and detect the reactivity in serum samples, for further providing data support for their subsequent serological applications.

Results: Two B cell linear epitopes, P104 and P82, located in non-RBD region of SARS-CoV-2 S protein were identified by indirect ELISA screening of an overlapping peptide library of the S protein with COVID-19 patients' convalescent serum. And the peptides were verified by testing with 165 serum samples. P104 has not been reported previously; P82 is contained in peptide S21P2 reported before. The positive reaction rates of epitope peptides S14P5 and S21P2, the two non-RBD region epitopes identified by Poh et al., and P82 and P104 were 77.0%, 73.9%, 61.2% and 30.3%, respectively, for 165 convalescent sera, including 30 asymptomatic patients. Although P104 had the lowest positive rate for total patients (30.3%), it exhibited slight advantage for detection of asymptomatic infections (36.7%). Combination of epitopes significantly improved the positive reaction rate. Among all combination patterns, (S14P5 + S21P2 + P104) pattern exhibited the highest positive reaction rate for all patients (92.7%), as well as for asymptomatic infections (86.7%), confirming the feasibility of P104 as supplementary antigen for serological detection. In addition, we analyzed the correlation between epitopes with neutralizing antibody, but only S14P5 had a medium positive correlation with neutralizing antibody titre (r = 0.510, P < 0.01).

Conclusion: Our research proved that epitopes on non-RBD region are of value in serological detection especially when combination more than one epitope, thus providing serological reaction information about the four epitopes, which has valuable references for their usage.
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http://dx.doi.org/10.1186/s12866-021-02241-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8234764PMC
June 2021

Comparison of uniportal video-assisted thoracoscopic versus thoracotomy bronchial sleeve lobectomy with pulmonary arterioplasty for centrally located non-small-cell lung cancer.

Eur J Cardiothorac Surg 2021 05;59(5):978-986

Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China.

Objectives: This study aimed to investigate the efficacy of bronchial sleeve lobectomy with pulmonary arterioplasty by uniportal video-assisted thoracoscopic surgery (UniVATS) in centrally located non-small-cell lung cancer.

Methods: One hundred and two thoracotomy and 31 UniVATS cases were included in this retrospective, single-centre study. Baseline characteristics, perioperative performance and survival outcomes were compared between the 2 groups.

Results: Compared with the thoracotomy group, the UniVATS group was associated with lower postoperative blood transfusion rate (P = 0.043), decreased postoperative hospital stays (P = 0.008), shorter drainage duration (P = 0.003) and less drainage volume during the first postoperative 24 h (P = 0.005). Besides, the 3-year overall survival and recurrence-free survival were comparable between the 2 groups (log-rank, P = 0.81 and P = 0.78, respectively). In addition, squamous cell carcinoma was proved to be the independent favourable predictor for overall survival [hazard ratio (HR) 0.44, 95% confidence interval (CI) 0.24-0.80; P = 0.008], and advanced pathological stage was found to be independently associated with worse overall survival (IIIB stage: HR 3.21, 95% CI 1.13-9.12; P = 0.028) and recurrence-free survival (IIIB stage: HR 3.54, 95% CI 1.32-9.51; P = 0.012).

Conclusions: With appropriate patient selection, UniVATS sleeve lobectomy with pulmonary arterioplasty is feasible and safe for centrally located lung cancer in the hands of thoracic surgeons with extensive thoracoscopy experience.
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http://dx.doi.org/10.1093/ejcts/ezaa404DOI Listing
May 2021

Molecular surveillance of HIV-1 newly diagnosed infections in Shenzhen, China from 2011 to 2018.

J Infect 2021 07 28;83(1):76-83. Epub 2021 Apr 28.

Department of AIDS Research, State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences, Beijing, 100071 China. Electronic address:

Objectives: Shenzhen is suffering severe HIV epidemic. No systematic surveillance on high risk populations, HIV genetic diversity, transmitted drug resistance (TDR) and molecular transmission clusters (MTCs) have been reported yet. In this study, we described them based on newly diagnosed HIV positive cases from 2011 to 2018 in Shenzhen city, China.

Methods: Plasma samples of newly reported HIV positive cases in Shenzhen, China were collected from 2011 to 2018. The HIV pol gene was amplified and sequenced for subtyping, genetic characterization, TDR and phylogenetic analysis. Demographic and risk characteristics associated with transmitted drug resistance-associated mutations (TDRAMs) and MTCs were explored by using logistic regression analyses.

Results: 10,378 HIV pol sequences were successfully obtained from newly diagnosed patients with available background information. The most prevalent HIV-1 subtype was CRF07_BC (40.92%). CRF07_BC, CRF55_01B and URFs increased across years. Total TDR was 6.02% during 2011 to 2018. CRF01_AE, CRF08_BC, CRF55_01B and subtype B were more likely to be associated with TDRAMs than CRF07_BC. 4460 (42.98%) patients were infected with strains included in MTCs. Patients younger than 30 and over 50 years were more likely to cluster.

Conclusions: The prevalence of HIV-1 drug resistance and molecular transmission clusters in Shenzhen should raise a high alert. Interventions targeting on patients with strains locating in MTCs should be considered to improve prevention effect in Shenzhen.
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http://dx.doi.org/10.1016/j.jinf.2021.04.021DOI Listing
July 2021

Comparison of Bronchial Sleeve Lobectomy with Pulmonary Arterioplasty versus Pneumonectomy.

Ann Thorac Surg 2021 Apr 16. Epub 2021 Apr 16.

Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University. Electronic address:

Background: To evaluate the efficacy of bronchial sleeve lobectomy with pulmonary arterioplasty by comparing to pneumonectomy in centrally located non-small cell lung cancer (NSCLC) with bronchovascular invasion.

Methods: The entire cohort consisted of 212 patients receiving pneumonectomy and 156 patients undergoing bronchial sleeve lobectomy with pulmonary arterioplasty. Propensity score matching was adopted to create a fully balanced cohort, after which, baseline characteristics, perioperative performance and oncological results were compared between two groups.

Results: Totally 139 pneumonectomy cases were matched with 139 sleeve lobectomy cases. In the matched cohort, bronchial sleeve lobectomy with pulmonary arterioplasty was associated with longer operative time (p<0.001), decreased perioperative transfusion rate (p=0.002), shorter postoperative hospital stays (p<0.001), shorter intensive care unit stays (p=0.040) and lower Clavien-dindo Classification (p=0.016). In respect to survival outcomes, Log-rank test revealed no significant difference in OS (p= 0.381) and RFS (p=0.619) between two surgical procedures.

Conclusions: Bronchial sleeve lobectomy with pulmonary arterioplasty could achieve superior perioperative outcomes and equivalent oncological efficacy in comparison with pneumonectomy, indicating that this complex procedure is safe and reliable for centrally located NSCLC concurrently involving the pulmonary artery and bronchus.
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http://dx.doi.org/10.1016/j.athoracsur.2021.04.007DOI Listing
April 2021

The Triglyceride-Glucose Index is Associated with Diabetic Retinopathy in Chinese Patients with Type 2 Diabetes: A Hospital-Based, Nested, Case-Control Study.

Diabetes Metab Syndr Obes 2021 9;14:1547-1555. Epub 2021 Apr 9.

Department of Ophthalmology, First Affiliated Hospital of China Medical University, Shenyang, 110001, People's Republic of China.

Background: This study aimed to investigate the association between the triglyceride-glucose (TyG) index and diabetic retinopathy (DR) in Chinese patients with type 2 diabetes.

Methods: In this nested case-control study, all diabetic participants were registered hospitalizations during 2012-2018, including 596 with DR as cases and three matching controls per case. DR was assessed using Early Treatment Diabetic Retinopathy Study criteria. The TyG index was calculated: Ln (fasting blood glucose [mg/dL] × fasting triglycerides [mg/dL] ÷ 2). Multivariate logistic regression, a receiver-operating characteristic (ROC) curve, linear regression models, and mediation analysis were used to explore associations.

Results: The TyG index was lower in DR and decreased as its severity advanced among 2,112 subjects (=0.005). After confounders (sex, duration of diabetes, use of antidiabetic agents, heart rate, systolic blood pressure, pulse pressure, height, weight, body-mass index, and glycated hemoglobin) had been accounted for, there were significant associations between the TyG index and any-severity DR (OR 0.83, 95% CI 0.73-0.95; =0.006), as well as vision-threatening DR (VTDR; OR 0.53, 95% CI 0.36-0.76; =0.001). ROC analysis indicated that the TyG index showed significant discriminatory ability in any-severity DR (area under curve [AUC] 0.534, =0.015) and VTDR (AUC 0.624, =0.001).

Conclusion: The TyG index was associated with the presence and severity of DR. Our findings suggest that the TyG index may become a useful biomarker in evaluating and following the presence of DR and VTDR.
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http://dx.doi.org/10.2147/DMSO.S294408DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8043781PMC
April 2021

Prevention of non-recurrent laryngeal nerve injury in robotic thyroidectomy: imaging and technique.

Surg Endosc 2021 Aug 15;35(8):4865-4872. Epub 2021 Mar 15.

Division of Thyroid Surgery, Jilin Provincial Key Laboratory of Surgical Translational Medicine, Jilin Provincial Precision Medicine Laboratory of Molecular Biology and Translational Medicine On Differentiated Thyroid Carcinoma, China-Japan Union Hospital Of Jilin University, Changchun, 130000, People's Republic of China.

Introduction: The aim of this report was to summarize observations, evaluate the feasibility, provide detailed information concerning proper techniques, and address limitations for non-recurrent laryngeal nerve (NRLN) dissection and release during the robotic bilateral axillo-breast approach (BABA) for thyroidectomy.

Materials And Methods: The BABA approach was used in two cases of thyroidectomy in the setting of NRLN. Preoperative CT imaging findings suggesting the aberrant anatomy are reviewed and technical planning, inclusive of intraoperative nerve monitoring, was employed. Intraoperative videos with narrative discussion of technique for safe dissection are provided, along with supplementary video of additional technical guidance.

Results: In both cases, the NRLNs were identified, dissected, and preserved. We dissected the proximal segment of each NRLN to its origin. We determined that the use of only the NRLN proximal to distal robotic dissection jeopardized the nerve. The BABA approach with the Type I NRLN is similar to the dissection of the recurrent laryngeal nerve (RLN) in transoral thyroidectomy. Due to interference with endoscopic viewing caused by the thyroid cartilage, the Type I NRLN is more challenging to manage both at the laryngeal entry point and its origin from the vagus nerve (VN). For the Type II NRLN, it is essential to identify its point of origin and the reflection of the nerve from the VN. Therefore, modification of nerve dissection to mirror open surgery with bidirectional nerve dissection assisted in avoidance of traction injury to the nerve.

Conclusions: We presented a video, a detailed description of methods, and discussed limits for NRLN management in robotic BABA. This report included (i) a description of the aberrant anatomy and CT scans to inform surgeons of the possible NRLN locations, (ii) a description of a technique for using the nerve monitor in the robotic surgeries, and (iii) a description of the techniques used to isolate and protect the NRLN during the robotic surgery. In robotic BABA, our NRLN-sparing technique and degree included mainly a multi-directional nerve dissection (i.e., medial-grade, later-grade approach together with proximal to/from distal) using athermal technique. The NRLN-sparing technique is predominantly carried out in an anterior dissection plane.
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http://dx.doi.org/10.1007/s00464-021-08421-1DOI Listing
August 2021

Current Understanding on Perioperative Management in Lung Cancer: Implications for Anesthetic Considerations.

Drug Des Devel Ther 2021 25;15:835-842. Epub 2021 Feb 25.

Department of Ophthalmology, First Hospital of China Medical University, Shenyang, Liaoning, 110001, People's Republic of China.

Narcotic drugs are often used to treat perioperative pain for patients with lung cancer. However, anesthetic management and narcotic substance use may have significant impacts on patients with lung cancer, including anti-cancer or promoting cancer effects. In this study, we summarize the effects of anesthetic management and its related substances on lung cancer. An evidence-based review of the influence of anesthetic techniques and narcotic substances used on lung cancer was performed. The effects of perioperative pain management and the method of choosing anesthesia for patients with lung cancer were explored. Different management techniques of anesthesia have been indicated to suppress both cell-mediated immunity and humoral immunity and have effects on the recurrence and metastasis of lung cancer. Evidence suggests that the effects of narcotic substances used on lung cancer were still inconsistent. However, the mechanisms by which anesthetics and analgesics inhibit the tumor are complicated. Perioperative management leads to decreased immunity in patients with lung cancer, which to some extent contributes to recurrence and metastasis. Various narcotic substances used may modulate signal pathways, including the mitochondrial pathway, and appear to exert different effects on the recurrence and metastasis of lung cancer. The anesthesiologists should consider these effects on perioperative management with lung cancer.
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http://dx.doi.org/10.2147/DDDT.S297200DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7920500PMC
October 2021

Rumen and Hindgut Bacteria Are Potential Indicators for Mastitis of Mid-Lactating Holstein Dairy Cows.

Microorganisms 2020 Dec 20;8(12). Epub 2020 Dec 20.

Institute of Diary Science, College of Animal Sciences, Zhejiang University, Hangzhou 310058, China.

Mastitis is one of the major problems for the productivity of dairy cows and its classifications have usually been based on milk somatic cell counts (SCCs). In this study, we investigated the differences in milk production, rumen fermentation parameters, and diversity and composition of rumen and hindgut bacteria in cows with similar SCCs with the aim to identify whether they can be potential microbial biomarkers to improve the diagnostics of mastitis. A total of 20 dairy cows with SCCs over 500 × 10 cells/mL in milk but without clinical symptoms of mastitis were selected in this study. Random forest modeling revealed that UCG 004 and the [] group in the rumen, as well as the Family XIII AD3011 group and in the hindgut, were the most influential candidates as key bacterial markers for differentiating "true" mastitis from cows with high SCCs. Mastitis statuses of 334 dairy cows were evaluated, and 96 in 101 cows with high SCCs were defined as healthy rather than mastitis according to the rumen bacteria. Our findings suggested that bacteria in the rumen and hindgut can be a new approach and provide an opportunity to reduce common errors in the detection of mastitis.
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http://dx.doi.org/10.3390/microorganisms8122042DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7767203PMC
December 2020

Development and validation of a risk perception scale of medical help-seeking behavior in Chinese adults.

Ann Transl Med 2020 Nov;8(21):1352

Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China.

Background: When people require medical treatment, many risk factors including adverse medical events, economic burdens, and social-psychological consequences may contribute to their hesitation to seek medical help. Therefore, a reliable and valid instrument that can comprehensively assess the risk perception of medical help-seeking behavior among ordinary Chinese adults should be developed.

Methods: The basic dimensions of the scale were determined based on literature review and in-depth interviews with patients. Then, an item pool with 32 items and six dimensions was developed. After the item reduction process based on item and factor analyses, a three-factor, 16-item scale was established. From March 2019, this scale was distributed among 639 healthy adults, outpatients, or inpatients in 20 provinces and municipalities in the mainland of China by convenience sampling. Then, the reliability and validity of the scale were examined.

Results: The scale consists of three dimensions (treatment risks, burden risks, and stigma risks) and 16 items. The root-mean-square error of approximation, comparative fit index, and Tucker-Lewis index of this model were 0.069, 0.925, and 0.910, respectively. The internal consistency reliability of the scale was 0.893, and the test-retest reliability was 0.784. The criterion-related validity was 0.720 (P<0.01).

Conclusions: The risk perception scale of medical help-seeking behavior is a reliable and valid instrument to measure Chinese adults' perception for potential risks in the process of medical treatment.
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http://dx.doi.org/10.21037/atm-20-1656DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7723601PMC
November 2020

A systematic review and meta-analysis of thoracoscopic versus thoracotomy sleeve lobectomy.

J Thorac Dis 2020 Oct;12(10):5678-5690

Department of Thoracic Surgery, Tongji University Affiliated Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.

Background: Operative safety and oncologic adequacy of thoracoscopic sleeve lobectomy remain controversial. As such, the purpose of this meta-analysis was to evaluate evidence comparing thoracoscopy and thoracotomy in sleeve lobectomy for centrally located non-small cell lung cancer (NSCLC).

Methods: Electronic searches of PubMed and Web of Science databases were undertaken from inception to March 2020. Comparative studies about thoracoscopic and thoracotomy sleeve lobectomy, with evaluation for perioperative outcomes and oncological results were identified. The following outcomes were measured in this meta-analysis: operating time, blood loss, numbers of lymph node, postoperative hospital stay, chest drainage time, postoperative complication rate, mortality, overall survival (OS). The standardized difference (SMD), relative risk (RR) and hazard ratio (HR) with 95% confidence intervals (CI) were pooled using Stata software.

Results: Six studies generating 281 thoracoscopy and 369 thoracotomy cases were finally included. There was no significant difference in intraoperative blood loss, number of resected lymph nodes, chest drainage time, postoperative complication rate and mortality between two groups. However, thoracoscopic sleeve lobectomy was associated with longer operation time (SMD 0.59, 95% CI: 0.14 to 1.03, P=0.010). And shorter postoperative hospital stays (SMD -0.24, 95% CI: -0.51 to 0.03, P=0.078) were observed in the thoracoscopy group with marginal significance. Furthermore, sleeve lobectomy via thoracoscopy could achieve comparable OS compared to that via thoracotomy (HR 0.69, 95% CI: 0.38 to 1.00; P<0.001). In addition, there were no evident publication bias in all observational outcomes.

Conclusions: Current evidence suggests that thoracoscopic sleeve lobectomy is a safe and efficient surgical procedure for centrally located NSCLC, with comparable perioperative outcomes and equivalent oncological results compared to thoracotomy sleeve lobectomy.
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http://dx.doi.org/10.21037/jtd-20-1855DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7656351PMC
October 2020

Prognostic impact of tumour spread through air space in radiological subsolid and pure solid lung adenocarcinoma.

Eur J Cardiothorac Surg 2021 04;59(3):624-632

Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.

Objectives: The aim of the study was to investigate the relationship between ground-glass opacity (GGO) and tumour spread through air space (STAS), as well as their joint influence on the prognosis of stage I lung adenocarcinoma.

Methods: A total of 620 consecutive patients with surgically resected lung adenocarcinoma between January 2011 and December 2012 were reviewed retrospectively. The relevance of STAS and GGO was analysed by logistic regression, and their prognostic significance was investigated via the Kaplan-Meier method and Cox regression models. Furthermore, to determine the magnitude of the prognostic impact of GGO and STAS, we respectively performed survival analysis in subgroups according to the presence of STAS and GGO.

Results: Of all 620 cases, 26.7% were positive for STAS, and 32.9% had a GGO component. STAS was present in 10.8% of part-solid lesions and 34.9% of pure solid nodules (P < 0.001). Lepidic-predominant histologic subtype, GGO component and pathological T stage exhibited significant relevance to the presence of STAS. For the whole population, STAS and GGO component were each revealed as independent predictors for overall survival and recurrence-free survival (each with P < 0.001). Interestingly, in the GGO-present subgroup, STAS failed to significantly stratify prognosis. However, in the STAS-positive subgroup, the presence of a GGO component was independently associated with favourable oncological results.

Conclusions: STAS is associated with a GGO component, and each factor was a significant predictor for the prognosis of stage I lung adenocarcinoma. Moreover, the favourable prognostic impact of a GGO component was greater than the adverse prognostic influence of STAS, indicating that GGO is a more reliable prognostic predictor in stage I lung adenocarcinoma.
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http://dx.doi.org/10.1093/ejcts/ezaa361DOI Listing
April 2021

Viral RNA level, serum antibody responses, and transmission risk in recovered COVID-19 patients with recurrent positive SARS-CoV-2 RNA test results: a population-based observational cohort study.

Emerg Microbes Infect 2020 Dec;9(1):2368-2378

State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, People's Republic of China.

Managing recovered COVID-19 patients with recurrent-positive SARS-CoV-2 RNA test results is challenging. We performed a population-based observational study to characterize the viral RNA level and serum antibody responses in recurrent-positive patients and evaluate their viral transmission risk. Of 479 recovered COVID-19 patients, 93 (19%) recurrent-positive patients were identified, characterized by younger age, with a median discharge-to-recurrent-positive length of 8 days. After readmission, recurrent-positive patients exhibited mild (28%) or absent (72%) symptoms, with no disease progression. The viral RNA level in recurrent-positive patients ranged from 1.8 to 5.7 log10 copies/mL (median: 3.2), which was significantly lower than the corresponding values at disease onset. There are generally no significant differences in antibody levels between recurrent-positive and non-recurrent-positive patients, or in recurrent-positive patients over time (before, during, or after recurrent-positive detection). Virus isolation of nine representative specimens returned negative results. Whole genome sequencing of six specimens yielded only genomic fragments. 96 close contacts and 1,200 candidate contacts of 23 recurrent-positive patients showed no clinical symptoms; their viral RNA (1,296/1,296) and antibody (20/20) tests were negative. After full recovery (no longer/never recurrent-positive), 60% (98/162) patients had neutralizing antibody titers of ≥1:32. Our findings suggested that an intermittent, non-stable excretion of low-level viral RNA may result in recurrent-positive occurrence, rather than re-infection. Recurrent-positive patients pose a low transmission risk, a relatively relaxed management of recovered COVID-19 patients is recommended.
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http://dx.doi.org/10.1080/22221751.2020.1837018DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7655076PMC
December 2020

Global, national and regional prevalence, and associated factors of ocular trauma: A protocol for systematic review and meta-analysis.

Medicine (Baltimore) 2020 Aug;99(35):e21870

Department of Ophthalmology, The First Affiliated Hospital of China Medical University, Shenyang, China.

Background: Ocular trauma is a common eye disease and one of the main causes of blindness. There is a dearth of data on a summary and meta-analysis on the global epidemiology of the disease. Therefore, this systematic review protocol aims to propose the first systematic review and meta-analysis to synthesize existing evidence on the global prevalence and associated factors of ocular trauma worldwide.

Methods: A systematic search will be performed according to the following databases: PubMed, Web of Science, Chinese National Knowledge Infrastructure (CNKI), Weipu, and Wanfang. Cross-sectional, case-control, and cohort studies reporting on the prevalence and risk factors of ocular trauma will be included. The primary outcome will be the prevalence in global, regional, and national ocular trauma. Study searching, data extraction, and quality evaluation will be performed by 2 reviewers, independently. Appropriate meta-analysis will then be used to pool studies. STATA software package v 12.0 (Stata Corporation, College Station, TX) and R (version 3.4.1; R Foundation for Statistical Computing, Vienna, Austria) software will be used for all statistical analyses.

Results: This study will provide a high-quality synthesis to examine the prevalence and associated factors of ocular trauma worldwide. Furthermore, current study will project disease estimates in the next 50 years.

Conclusion: This systematic review and meta-analysis will provide first evidence to evaluate the burden of ocular trauma in the general population.

Ethics And Dissemination: This systematic review and meta-analysis of randomized controlled trials does not require ethical recognition, and the results of this paper will be published in an open access, internationally influential academic journal.

Trial Registration Number: CRD42020189166.
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http://dx.doi.org/10.1097/MD.0000000000021870DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7458182PMC
August 2020

Serum CA125 Level Is Associated with Diabetic Retinopathy in Chinese Patients with Type 2 Diabetes.

Diabetes Metab Syndr Obes 2020 22;13:1803-1812. Epub 2020 May 22.

Department of Ophthalmology, The First Hospital of China Medical University, Shenyang 110001, People's Republic of China.

Background: To investigate the association between serum carbohydrate antigen 125 (CA125) and the presence as well as severity of diabetes retinopathy (DR) in Chinese adult patients with type 2 diabetes.

Methods: A hospital-based cross-sectional study was conducted from February 2012 to November 2018. DR was assessed using Early Treatment Diabetic Retinopathy Study criteria. Vision-threatening DR (VTDR) was diagnosed if subjects had severe non-proliferative DR (NPDR), proliferative DR (PDR), or clinically significant macular edema (CSME). Multivariate logistic regression models were applied to explore the associations.

Results: Among the 2696 participants, the overall prevalence of DR was 25.1%, of which the prevalence of mild NPDR, moderate NPDR, and VTDR was 10.8%, 4.5%, and 9.9%, respectively. Serum CA125 level was significantly higher in participants with DR and increased with the severity of DR ( = 0.013). After accounting for age, gender, smoking, drinking, duration of diabetes, anti-diabetic agents use, systolic blood pressure, pulse pressure, weight, hemoglobin A1c and fasting plasma glucose levels, CA125 level was significantly associated with subjects in any-severity DR (odds ratio [OR] 1.006 [95% confidence interval CI: 1.002-1.010], = 0.006) and VTDR (1.008 [1.003-1.013], = 0.001). When CA125 was treated as categorized variables, the prevalence of VTDR might increase as improving CA125 quartiles ( value for trend = 0.017).

Conclusion: In this study, serum CA125 level was associated with the presence and severity of DR in Chinese patients with type 2 diabetes. Further prospective studies should be warranted to validate the feasible role of CA125 as well as other biomarkers.
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http://dx.doi.org/10.2147/DMSO.S250928DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7250309PMC
May 2020

Aqueous Humor Mediator and Cytokine Aberrations in Diabetic Retinopathy and Diabetic Macular Edema: A Systematic Review and Meta-Analysis.

Dis Markers 2019 23;2019:6928524. Epub 2019 Nov 23.

Department of Ophthalmology, The First Hospital of China Medical University, Shenyang 110001, China.

Purpose: To evaluate the relationship between the aqueous humor levels of VEGF, TNF-, IL-10, IL-6, IL-12, MCP-1, and IP-10 with DR/DME.

Methods: PubMed, Web of Science, Embase, China National Knowledge Infrastructure (CNKI), and Wanfang databases were searched up to October 2018. Systematic review and meta-analysis were conducted.

Results: 18 studies comprising 362 cases with DR (100 with DME) and 620 controls without DR were included in this meta-analysis. There was a significant association between VEGF levels in the aqueous humor and DR (standardized mean difference (SMD) 1.94 (95% CI 1.05-2.83)) and DME (1.07 (0.71, 1.42)). Furthermore, a significant correlation was observed between levels of IL-6 and DR (3.53 (0.37, 6.69)), and similarly correlation with DME (1.26 (0.30, 2.21)). The relationship between MCP-1 and DR and DME was significant, in which the SMD was (0.49 (0.09, 0.89)) and (1.49 (0.78, 2.20)), respectively. However, IL-12, IP-10, and TNF- had no correlation with DR and DME, whereas there was a significant relationship between IL-8 and DME (1.68 (0.97, 2.40)).

Conclusion: Elevated levels of VEGF, IL-6, and MCP-1 in the aqueous humor were associated with the risk for the presence of DR, and levels of VEGF, IL-6, IL-8, and MCP-1 were associated with the risk of DME. Furthermore, these biomarkers may be used as potential predictors or therapeutic targets for DR/DME.
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http://dx.doi.org/10.1155/2019/6928524DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6906842PMC
May 2020

Multivariable Logistic Regression And Back Propagation Artificial Neural Network To Predict Diabetic Retinopathy.

Diabetes Metab Syndr Obes 2019 25;12:1943-1951. Epub 2019 Sep 25.

Department of Ophthalmology, The First Affiliated Hospital of China Medical University, Shenyang 110001, People's Republic of China.

Background: Monitoring and prediction of diabetic retinopathy (DR) is necessary in patients with diabetes for early discovery and timely treatment of disease. We aimed to analyze the association between DR and biochemical and metabolic parameters, and develop a predictive model for DR.

Methods: A total of 530 Chinese residents including 423 with type 2 diabetes (T2D) aged 18 years or older participated in this study. The association between DR and biochemical and metabolic parameters was analyzed by the univariate and multivariable logistic regression (MLR). According to the MLR results, we developed a back propagation artificial neural network (BP-ANN) model by selecting tan-sigmoid as the transfer function of the hidden layers nodes, and pure-line of the output layer nodes, with training goal of 0.5×10.

Results: There were 51 (9.6%) diabetic participants with DR. After univariate and MLR analysis, duration of diabetes, waist to hip ratio, HbAc and family history of diabetes were independently associated with the presence of DR (all < 0.05). Based on these parameters, the area under the receiver operating characteristic (ROC) curve for the BP-ANN model was significantly higher than that by MLR (0.84 vs. 0.77, < 0.001).

Conclusion: Our evaluation demonstrated the potential role of BP-ANN model to identify DR in screening practice. The presence of DR was well predictable using the proposed BP-ANN model based on four related parameters (duration of diabetes, waist to hip ratio, HbAc and family history of diabetes).
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http://dx.doi.org/10.2147/DMSO.S219842DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6768122PMC
September 2019

Association between lipid accumulation product and diabetic retinopathy based on a community-based survey in Chinese with type 2 diabetes.

Diabetes Metab Syndr Obes 2019 16;12:513-518. Epub 2019 Apr 16.

Department of Ophthalmology, The First Affiliated Hospital of China Medical University, Shenyang, 110001, People's Republic of China.

Abnormal levels of lipid accumulation product (LAP) have been associated with risk of cardiovascular disease and diabetes. However, it is not clear whether LAP index is associated with diabetic retinopathy (DR). We investigated the association between LAP index and DR in Chinese adults with diabetes. We included 427 Chinese patients with type 2 diabetes aged 18-year over who participated in a community-based cross-sectional study in Shenyang. DR was addressed on retinal photographs graded using the modified Airlie House classification. LAP was defined as (waist circumference [cm]-65) × (triglycerides [mmol/L]) in men, and (waist circumference [cm]-58) × (triglycerides [mmol/L]) in women and analyzed continuously (per SD change) and categorically (quartile 1, <30; quartile 2, 30-50; and quartile 3, >50). Prevalence of DR among the study population was 17.8%. The mean level of LAP was 52.96±44.01. Compared to quartile 1 level, both quartile 2 and 3 levels were associated with DR with multivariable odds ratio (95% CI) of 0.23 (0.12-0.46) and 0.27 (0.14-0.54), respectively. These associations persisted when LAP was analyzed continuously (0.57 [0.35-0.92]). Higher central lipid accumulation in Chinese diabetics is related to the lower risk of DR, suggesting that LAP may be useful for identifying type 2 diabetes mellitus patients who are at risk for DR.
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http://dx.doi.org/10.2147/DMSO.S195578DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6490235PMC
April 2019

Association of the Serum Total Cholesterol to Triglyceride Ratio with Diabetic Retinopathy in Chinese Patients with Type 2 Diabetes: A Community-Based Study.

Diabetes Ther 2019 Apr 13;10(2):597-604. Epub 2019 Feb 13.

Department of Ophthalmology, The First Affiliated Hospital of China Medical University, Shenyang, 110001, China.

Introduction: The relationship of total cholesterol (TC) or triglyceride (TG) to diabetic retinopathy (DR) has proven difficult to determine. In addition, there is no report of any study of the correlation between the TC/TG ratio and DR. This study was therefore undertaken to investigate the relationship between the TC/TG ratio and DR in Chinese adults with type 2 diabetes mellitus.

Methods: A community-based study was conducted from August to October 2014 in Fengyutan, Shenyang, China. DR was assessed based on the modified Airlie House classification of DR. Multivariable logistic regression models were used to evaluate the association between the TC/TG ratio and the presence of DR.

Results: Among the 420 diabetic participants in the study (157 men; mean (SD) age 61.7 (10.0) years), 76 (18.1%) presented with DR. When the TC/TG ratio was analyzed categorically, participants with T2DM in tertile 2 (i.e., TC/TG 2.91-4.00) were more likely (OR 2.01; 95% CI 1.01-3.99) to suffer from DR than patients in tertile 1 (i.e., TC/TG < 2.91) in multivariable models. Similarly, participants in tertile 3 (TC/TG > 4.00) were more likely (OR 2.59; 95% CI 1.11-3.14; P = 0.011) to suffer from DR than patients in tertile 1. This association persisted when the TC/TG ratio was analyzed continuously (P = 0.014).

Conclusion: We found a novel positive association between TC/TG ratio and presence of DR in Chinese individuals with T2DM. Although longitudinal data are needed, this finding contributes to the accumulating evidence that a high TC/TG ratio may be implicated in DR.
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http://dx.doi.org/10.1007/s13300-019-0579-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6437234PMC
April 2019

Composition of Rumen Bacterial Community in Dairy Cows With Different Levels of Somatic Cell Counts.

Front Microbiol 2018 24;9:3217. Epub 2018 Dec 24.

MoE Key Laboratory of Molecular Animal Nutrition, College of Animal Sciences, Institute of Diary Science, Zhejiang University, Hangzhou, China.

Mastitis is an inflammatory disease, affects the dairy industry and has a severe economic impact. During subclinical mastitis, milk production and milk quality deteriorates. Recently, rumen microbial composition has been linked to rumen health, but few studies have investigated the effect of rumen microbiota on mammary health in cows. This study was undertaken to identify the rumen microbial composition and associated microbial fermentation in cows with different somatic cell counts (SCC), with the speculation that cows with different health statuses of the mammary gland have different rumen bacterial composition and diversity. A total of 319 Holstein dairy cows fed the same diet and under the same management were selected and divided into four groups as SCC1 ( = 175), SCC2 ( = 49), SCC3 ( = 49), and SCC4 ( = 46) with < 200,000, 200,001-500,000, 500,001-1,000,000, and >1,000,000 somatic cells/mL, respectively. Further, 20 cows with the lowest SCC and 20 cows with the highest SCC were identified. The rumen microbial composition was profiled using 16S rRNA sequencing, along with measurement of rumen fermentation parameters and milking performance. Compared to low SCC, cows with high SCC showed poorer milk yield, milk composition, and rumen volatile fatty acids concentration, but higher rumen bacterial diversity. Although the predominant rumen bacterial taxa did not vary among the SCC groups, the relative abundance of phyla SR1 and , unclassified family and genus were significantly different. In addition, and family were enriched in cows with low SCC. Our results suggest that specific rumen microbes are altered in cows with high SCC.
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http://dx.doi.org/10.3389/fmicb.2018.03217DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6312127PMC
December 2018

Burden of diabetic retinopathy in mainland China: Protocol for an updated systematic review and meta-analysis of prevalence and risk factors to identify prevention policies.

Medicine (Baltimore) 2018 Dec;97(50):e13678

Department of Ophthalmology, The First Hospital of China Medical University.

Background: Diabetic retinopathy (DR) is the leading cause of vision loss in adults of working age. Although existing systematic reviews of the prevalence of DR for mainland China have been reported, but several studies have been newly reported. Further some potential factors for DR are still discrepant and inconclusive. The aim of current research is to identify relevant literature regarding the prevalence of DR and DR-related factors in mainland China. In addition, we will project the number of individuals affected with DR in mainland China in years 2030 and 2050.

Methods: This systematic review will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. To identify publications in English or Chinese languages on the prevalence of DR in mainland China, a comprehensive step-by-step search of the PubMed, Embase, Web of Science, VIP Chinese Periodical, and China National Knowledge Infrastructure (CNKI) databases will be performed. Two reviewers will independently review the studies for eligibility according to the predefined inclusion and exclusion criteria. The quality of the included studies will be evaluated according to the National Health Institute Quality Assessment tool and Quality Assessment Manual. A random-effect model (DerSimonian-Laird method) will be used for the meta-analysis. Heterogeneity and publication bias among studies will be estimated by the I statistic and Begg funnel plot, respectively.

Results: This systematic review study will provide an evidence of prevalence, risk factors, and national burden for DR in mainland China.

Conclusion: The study will give an explicit evidence to provide preventative measures of DR.PROSPERO registration number: CRD42018094565.
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http://dx.doi.org/10.1097/MD.0000000000013678DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6320130PMC
December 2018

Ghrelin projection from the lateral hypothalamus area to the dorsal vagal complex and its regulation of gastric motility in cisplatin-treated rats.

Neuropeptides 2017 Dec 28;66:69-80. Epub 2017 Sep 28.

Department of Pathophysiology, Medical College of Qingdao University, Qingdao, Shandong, China.

Objective: To investigate ghrelin projection from the lateral hypothalamus area (LHA) to the dorsal vagal complex (DVC) and its regulation of gastric motility in cisplatin-treated rats.

Materials And Methods: In the present study, the protein and mRNA expression of ghrelin and its receptor GHSR-1a were measured by Western blot and PCR, respectively. The ghrelin fiber projections arising from the LHA and projecting to the DVC were investigated by retrograde tracing combined with fluoro-immunohistochemical staining. The effects of ghrelin in the DVC, electrical stimulation of the LHA, and electrical lesion of the DVC on gastric motility were measured in cisplatin-treated rats.

Results: Ghrelin fibers originating in the LHA projected to the DVC. The protein and mRNA expression of GHSR-1a was greater in cisplatin-treated rats than in saline-treated rats. Conversely, the expression of ghrelin in the LHA and DVC was reduced in cisplatin-treated rats. Cisplatin treatment also reduced gastric contractions. Ghrelin administrated into the DVC significantly promoted gastric motility, an effect completely blocked by treatment with the ghrelin receptor antagonist [D-Lys-3]-GHRP-6. In addition, electrical stimulation of the LHA promoted gastric motility, though this effect was much weaker in cisplatin-treated rats than in control rats. The excitatory effect of electrical stimulation of the LHA on gastric motility was partially blocked by pretreatment of the DVC with [D-Lys-3]-GHRP-6. Electrical lesion of the DVC diminished the excitatory effect that was induced by electrical stimulation of the LHA.

Conclusions: DVC, especially AP, may have a role for gastric contraction induced by the stimulation of the LHA. This regulation on gastric motility was weaker in cisplatin-treated rats than in saline-treated rats, possibly due to reduced ghrelin expression in the LHA and ghrelin projection from the LHA to the DVC.
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http://dx.doi.org/10.1016/j.npep.2017.09.003DOI Listing
December 2017

Design, Synthesis, Antifungal Activity and Molecular Docking of Thiochroman-4-one Derivatives.

Chem Pharm Bull (Tokyo) 2017 ;65(10):904-910

Key Laboratory of Pharmaceutical Quality Control of Hebei Province, College of Pharmaceutical Sciences, Hebei University.

N-Myristoyltransferase (NMT) has been validated pre-clinically as a target for treatment of fungal infections. Various substituted thiochroman-4-one derivatives have been synthesized by an efficient method. The synthesized compounds 7a-y and 8a-t were evaluated for their in vitro antifungal activity against the Canidia albicans, Cryptococcus neoformans, Epidermophyton floccosum, Mucor racemosus, Microsporum gypseum and Aspergillus nigerstrain. A series of compounds exhibited significant activity (minimal inhibitory concentrotion (MIC)=0.5-16 µg/mL) against Canidia albicans and Cryptococcus neoformans. The antifungal activity of compound 7b was reached to that of fluconazole, which can serve as a good starting point for further studies of structural diversity of the NMT inhibitors. The molecular docking studies revealed an interesting binding profile with very high receptor affinity for NMT of Canidia albicans.
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http://dx.doi.org/10.1248/cpb.c17-00274DOI Listing
October 2017

Synthesis and biological evaluation of N-(carbobenzyloxy)-l-phenylalanine and N-(carbobenzyloxy)-l-aspartic acid-β-benzyl ester derivatives as potent topoisomerase IIα inhibitors.

Bioorg Med Chem 2017 06 3;25(12):3116-3126. Epub 2017 Apr 3.

Key Laboratory of Pharmaceutical Quality Control of Hebei Province, College of Pharmaceutical Sciences, Hebei University, Baoding 071002, China; Key Laboratory of Medicinal Chemistry and Molecular Diagnosis of Ministry of Education, College of Chemistry and Environmental Science, Hebei University, Baoding 071002, China. Electronic address:

A new series of thirteen N-(carbobenzyloxy)-l-phenylalanine and N-(carbobenzyloxy)-l-aspartic acid-β-benzyl ester compounds were synthesized and evaluated for antiproliferative activity against four different human cancer cell lines: cervical cancer (HeLa), lung cancer (A549), gastric cancer (MGC-803) and breast cancer (MCF-7) as well as topoisomerase I and IIα inhibitory activity. Compounds (5a, 5b, 5e, 8a, 8b) showed significant antiproliferative activity with low IC values against the four cancer cell lines. Equally, compounds 5a, 5b, 5e, 5f, 8a, 8d, 8e and 8f showed topoisomerase IIα inhibitory activity at 100μM with 5b, 5e, 8f exhibiting potential topoisomerase IIα inhibitory activity compared to positive control at 100μM and 20μM, respectively. Conversely compounds 5e, 5f, 5g and 8a showed weaker topoisomerase I inhibitory activity compared to positive control at 100μM. Compound 5b exhibited the most potent topoisomerase IIα inhibitory activity at low concentration and better antiproliferative activity against the four human cancer cell lines. The molecular interactions between compounds 5a-5g, 8a-8f and the topoisomerase IIα (PDB ID: 1ZXM) were further investigated through molecular docking. The results indicated that these compounds could serve as promising leads for further optimization as novel antitumor agents.
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http://dx.doi.org/10.1016/j.bmc.2017.03.065DOI Listing
June 2017
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