Covid-19, Coronavirus disease 2019; ARDS, Acute respiratory distress syndrome; ECMO, Extracorporeal Membrane Oxygenation; WHO, World Health Organization; ICUs, Intensive care units. Acute respiratory distress syndrome (ARDS) is a fatal comorbidity of critically ill patients with COVID-19, who often end up on respiratory support. However, the safety and effectiveness of Extracorporeal Membrane Oxygenation (ECMO) in the treatment of COVID-19 remains to be elucidated at present. Here, we report on nine patients who received ECMO due to severe SARS-CoV-2 infection in Wuhan, China. Our initial experiences suggest that carefully selecting patients, as well as management by a well-trained team, are critical to implementing ECMO in patients with COVID-19. More randomized controlled trials with larger sample sizes are needed to evaluate the usefulness of ECMO in patients with COVID-19.
OBJECTIVE To evaluate the curative effect of the Feng's manipulation on patient with thoracic postjoint disorder accompanied by symptoms of coronary artery disease. METHODS A total of 180 cases with thoracic postjoint disorder accompanied by symptoms of coronary artery disease were retrospective analyzed from Jan. 2005 to June 2008, included 86 males and 94 females, aged from 18 to 82 years with and average of 43.7 years. The disease course was from 1 d to 40 years with the average of 20.6 months. These patients were divided into 2 groups according to the method of manipulation (group A, n=90) and hot herb (group B, n=90). The patients of group A were treated by manipulation for 1 to 2 times per week. The other group was treated by hot herb for 2 times (20 minutes each time) per day for a month. The symptom and signs (chest distress, precordium pain, cardiopalmus, nape pain, spinous tenderness, tuberculum dolorosum) were compared before and after treatment. RESULTS All 180 cases were followed up for from 4 to 36 months with an average of 12.7 months. After 1 months of treatment, the chi2 test showed that there was a significant differences between the manipulation therapy group and the hot herb therapy group, including chest distress (chi2 = 8.9322, P = 0.0028 < 0.05); precordium pain (chi2 = 20.6527, P < 0.0001); cardiopalmus (chi2 = 24.2804, P < 0.0001); nape pain (chi2 = 23.5917, P < 0.0001); spinous tenderness (chi2 = 12.2062, P = 0.0005 < 0.01) and tuberculum dolorosum (chi2 = 4.0261, P = 0.0440 < 0.05). CONCLUSION Manipulation is an effective treatment method for the thoracic post joint disorders.
To observe the in vitro growth inhibitory and apoptosis-inducing effects of paclitaxel on the human osteosarcoma cell line U-2 OS.U-2 OS cells were treated with various concentrations of paclitaxel. Proliferation was determined by cell count in a neubauer cytometer chamber. Viability was assessed by trypan blue dye exclusion. Paclitaxel-induced morphologic alterations were visualized using light and transmission electron microscopy. The extent of paclitaxel-induced apoptosis was determined by flow cytometry and immunohistochemical detection (TdT-mediated dUTP nick end labeling technique, TUNEL).The cells treated with paclitaxel initially showed G(2)/M arrest, which was followed by apoptosis. The characteristic apoptotic changes, including nuclear disintegration and chromatin agglomeration, were displayed. Large amounts of micronuclei cells appeared, something not observed in those cells treated with cisplatin and adriamycin for contrast. Also, extensive DNA-cleavage was detected using TUNEL.This study demonstrates that paclitaxel has an apoptotic-inducing effect on osteosarcoma cells through the initiation of G(2)/M arrest and inhibiting mitosis in both a time-dependent and dose-dependent manner.
To find out the status of the sub healthy state in Xinjiang and the relationship with Northwest Dryness syndrome from characteristic area , to draft strategy of prevention and cure of Northwest Dryness Syndrome.
Background: To investigate whether interleukin (IL)-6 could predict the post-operative complications of elective pancreatectomy early. Patients and Methods: Overall, 122 patients who underwent elective pancreatectomy from June 2020 to May 2021 in our hospital were enrolled. Interleukin-6 was measured on the day before and at six hours after surgery, and on post-operative day one, three, and five. The associations between IL-6 level and post-operative complications were analyzed, and the predictive value of IL-6 for complications was assessed. Results: Sixty-three patients developed post-operative complications. Higher IL-6 was observed in patients with post-operative complications on post-operative day one, post-operative day three, and post-operative day five, with odd ratios of 1.43, 1.68, and 2.54 (p = 0.01, p = 0.01, and p = 0.01), respectively. These trends were also observed in patients with infectious complications preoperatively, on post-operative day one, post-operative day three, and post-operative day five, with ORs of 2.46, 1.95, 2.01, and 2.49 (p = 0.00, 0.00, 0.01, 0.00) respectively. Multivariate regression revealed that IL-6 is the only predictor for infectious complications on post-operative day one (p = 0.016). Based on the optimal cutoffs, pre-operative IL-6, IL-6 on post-operative day one and post-operative day three for predicting infectious complications yielded area under the curve (AUC) of 0.73, 0.70, and 0.70, with high negative predictive value of 82.7%, 92.2%, and of 91.3%, respectively. Conclusions: This study validated the early predictive value of IL-6 on infectious complications after pancreatectomy. Because of the performance of serum IL-6 in predicting infectious complications and high NPV, we endorse that IL-6 could be a potential biomarker for early prediction and antibiotic optimization after pancreatectomy.
Acute myelogenous leukemia (AML) is a common pediatric malignancy in children younger than 15 years old. Although the overall survival (OS) has been improved in recent years, the mechanisms of AML remain largely unknown. Hence, the purpose of this study is to explore the differentially methylated genes and to investigate the underlying mechanism in AML initiation and progression based on the bioinformatic analysis.Methylation array data and gene expression data were obtained from TARGET Data Matrix. The consensus clustering analysis was performed using ConsensusClusterPlus R package. The global DNA methylation was analyzed using methylationArrayAnalysis R package and differentially methylated genes (DMGs), and differentially expressed genes (DEGs) were identified using Limma R package. Besides, the biological function was analyzed using clusterProfiler R package. The correlation between DMGs and DEGs was determined using psych R package. Moreover, the correlation between DMGs and AML was assessed using varElect online tool. And the overall survival and progression-free survival were analyzed using survival R package.All AML samples in this study were divided into three clusters at k = 3. Based on consensus clustering, we identified 1,146 CpGs, including 40 hypermethylated and 1,106 hypomethylated CpGs in AML. Besides, a total 529 DEGs were identified, including 270 upregulated and 259 downregulated DEGs in AML. The function analysis showed that DEGs significantly enriched in AML related biological process. Moreover, the correlation between DMGs and DEGs indicated that seven DMGs directly interacted with AML. CD34, HOXA7, and CD96 showed the strongest correlation with AML. Further, we explored three CpG sites cg03583857, cg26511321, cg04039397 of CD34, HOXA7, and CD96 which acted as the clinical prognostic biomarkers.Our study identified three novel methylated genes in AML and also explored the mechanism of methylated genes in AML. Our finding may provide novel potential prognostic markers for AML.
Placebo was defined as any therapy that is used for its nonspecific psychological and physiologic effect but has no specific pharmacologic impact on the condition being treated. Besides medication therapies, studies have found that the optimal dietary approach as well as physical activity and education are useful to control hyperglycemia in patients with type 2 diabetes (T2DM). The aim of this study was to evaluate the placebo effects of antidiabetic therapies in Asian and Caucasian T2DM patients and make a comparison between the two ethnicities.A search using the MEDLINE database, EMBASE, and Cochrane Database was performed, from when recording began until December 2016. The main concepts searched in English were sulfonylurea (SU); alpha glucosidase inhibitors (AGI); metformin (MET); thiazolidinediones (TZD); dipeptidyl peptidase-4 inhibitors (DPP-4i); sodium-glucose cotransporter 2 inhibitors (SGLT2i); glucagon-like peptide-1 receptor agonist (GLP-1RA); type 2 diabetes (T2DM); placebo controlled; and randomized controlled trials. Using the Cochrane instrument, we evaluated the adequacy of randomization, allocation concealment procedures, and blinding.This study included 63 studies with a total of 7096 Asian patients involved and 262 studies with a total of 27,477 Caucasian patients involved. In Caucasian population, the use of placebo led to significant reductions of glycosylated hemoglobin (HbA1c), -0.683% (P = 0.008) in SU monotherapy treatment, -0.193% (P = 0.001) in DPP-4i treatment, and -0.230% (P < 0.001) in SGLT2i treatment, respectively. In Asian population, the use of placebo resulted in significant decreases of HbA1c, -0.162% (P = 0.012) in DPP-4i treatment and -0.269% (P = 0.028) in GLP-1RA add-on therapy, respectively. The placebo also significantly reduced body weight. In Caucasian population, placebo use resulted in 0.833 kg (P = 0.006) weight loss by SU treatment and 0.953 kg (P = 0.006) weight loss by GLP-1RA treatment. In Asian population, the placebo led to a weight change of 0.612 kg (P < 0.001) by GLP-1RA analog treatment. The changes of HbA1c and weight due to the placebo effect in other treatments were not significant in both Asian and Caucasian population. Comparisons of the placebo effect on HbA1c change and weight change in each treatment group indicated that no significant difference was found between Asian and Caucasian population.The overall differences of the placebo effect on HbA1c changes as well as on body weight changes were not significant between Asian and Caucasian T2DM patients. The placebo effect on HbA1c changes and weight changes was not associated with baseline age, gender, baseline body mass index, baseline HbA1c, duration of diabetes, or study duration.亚洲与欧美人群2型糖尿病患者的安慰剂效应比较摘要背景：安慰剂效应被理解为非特定心理及生理效应，而无特定药理学效应。有证据显示，在2型糖尿病治疗方面，安慰剂效应源自于减少总热量的摄入以及减轻体重。本荟萃分析的目的是系统评价在亚洲与欧美2型糖尿病患者人群中的安慰剂效应，并比较安慰剂效应在两人种之间的差异。 方法：在MEDLINE、EMBASE、Cochrane等数据库中进行文献检索，检索截止时间2016年11月。检索关键词为英文，包括：磺脲类(SU)、α-糖苷酶抑制剂(AGI)、二甲双胍(MET)、噻唑烷二酮类(TZD)、二肽基肽酶-4抑制剂(DPP-4i)、钠葡萄糖协同转运蛋白2抑制剂(SGLT2i)、胰高血糖素样肽受体激动剂(GLP-1RA)、2型糖尿病(T2DM)、空白对照、随机对照试验。应用Cochrane协作网对临床随机分组、对照、双盲研究进行质量评估。 结果：本荟萃分析共纳入63项亚洲人群研究（7096名患者）和262项欧美人群研究（27477名患者）。在欧美人群中，安慰剂的使用带来了糖化血红蛋白（HbA1c）的显著下降，其中SU单药治疗组-0.683% (P=0.008)、DPP-4i组-0.193% (P=0.001)及SGLT2i组-0.230%(P=0.000)。在亚洲人群中，安慰剂的使用在DPP-4i组及GLP-1RA联合治疗组也带来了HbA1c的显著下降，分别为-0.162% (P=0.012)、-0.269% (P=0.028)。安慰剂效应同时带来了显著的体重减轻，在欧美人群中，安慰剂所致的体重下降在SU组为-0.833kg (P=0.006)、GLP-1RA组为-0.953kg (P=0.006)。在亚洲人群中，安慰剂所致的体重下降在GLP-1RA组为-0.612kg (P=0.000)。安慰剂效应对HbA1c变化及体重变化的影响在两个人群中的其它治疗组均无显著变化。各治疗组间的比较显示，安慰剂所致的HbA1c及体重变化在亚洲与欧美2型糖尿病人群中无明显差异。 结论：安慰剂效应对HbA1c变化及体重变化的影响在亚洲与欧美2型糖尿病人群中无显著差异，且与年龄、性别、基线体重指数（BMI）、基线HbA1c、糖尿病病程及研究时长无明显相关性。.
Objective To observe the curative effects of low dose of β-receptor blocking agent on early angina pectoris after the occurrence of myocardiac infarction.Methods 130 cases were randomly divided into three groups.Group A(50 cases) was treated with Betaloc Group B(40 cases) was treated with Bisoprolol,and the contrast group was treated with nitroglycerin and aspirin.The treatments lasted 4 weeks,and then the changes in electrocardiogram(ECG) and the controls of symptoms were observed and analyzed.Results The rates of curative effects according to ECG were both 80% and the rats of symptom control were both 100% in Group A and Group B.No significant differences were found between the two groups(P0.05).The rates of curative effects and symptom control were 60% and 75% respectively.There existed significant differences between the contrast group and Group A and Group B(P0.05).Conclusion Low doses of β-receptor blocking agents have good curative effects on angina pectoris after the occurrence of myocardial infarction.
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