RESUMEN

Prostate adenocarcinoma (PRAD) is the most frequent malignancy, and is the second leading cause of death due to cancer in men. Thus, new prognostic biomarkers and drug targets for PRAD are urgently needed. As we know, nuclear receptor Nur77 is important in cancer development and changes in the tumor microenvironment; whereas, the function of Nur77 in PRAD remains to be elucidated. The TCGA database was used to explore the Nur77 expression and its role in the prognosis of PRAD. It was shown that Nur77 was down regulated in PRAD, and low Nur77 expression was correlated with advanced clinical pathologic characteristics (high grade, histological type, age) and poor prognosis. Furthermore, key genes screening was examined by univariate Cox analysis and Kaplan-Meier survival. Additionally, Nur77 was closely related to immune infiltration and some anti-tumor immune functions. The differentially expressed genes (DEGs) were presented by protein-protein interaction (PPI) network analysis. Therefore, the expression level of Nur77 might help predict the survival of PRAD cases, which presents a new insight and a new target for the treatment of PRAD. In vitro experiments verified that natural product malayoside targeting Nur77 exhibited significant therapeutic effects on PRAD and largely induced cell apoptosis by up-regulating the expression of Nur77 and its mitochondrial localization. Taken together, Nur77 is a prognostic biomarker for patients with PRAD, which may refresh the profound understanding of PRAD individualized treatment.

Asunto(s)

RESUMEN

BACKGROUND: The spatiotemporal trend of renal involvement in coronavirus disease 2019 (COVID-19) patients is still unclear. Therefore, the aim of this study was to reveal the dynamics of renal involvement superimposed COVID-19 according to time and space. METHODS: COVID-19 patients reporting renal involvement were included in this study. The following information was collected from relevant articles: first author, patient demographics, patient enrollment period, location, definition of acute kidney injury (AKI), prevalence of AKI, and use of renal replacement therapy (RRT). RESULTS: A total of 17 134 patients were finally included. The overall prevalence of AKI in COVID-19 patients was 19%, with 7% of them undergoing RRT. The overall risk of AKI in patients enrolled before March 1, 2020 (9%) was significantly lower than that after March 1, 2020 (36%) (P < 0.00001). Moreover, the overall risk of AKI outside Asia (35%) was significantly higher than that in Asia (10%) (P < 0.00001). Additionally, similar to patients requiring RRT, AKI patients were more likely to become seriously ill or even to die (P < 0.00001). CONCLUSIONS: This study found that renal involvement superimposed COVID-19, a comorbidity portending a poor prognosis, has become an increasingly serious problem over time and is more common outside Asia. Thus, more attention should be paid to the management of this specific group of patients.

Asunto(s)

RESUMEN

Objective To explore the clinical characteristics and treatment of cerebral arteriovenous malformations (AVMs) in elderly patients to improve their prognoses.Methods Such clinical data as clinical manifestations,angioarchitecture features,location and therapy of 28 elderly patients (≥60 years old) with AVMs,admitted to our hospital from January 2000 to December 2011,were retrospectively analyzed.Results The elderly patients had 5.4％ (28/511) morbidity of AVMs,with mean age of (62.25±3.46) years; the male patients were slightly more than the female patients.The clinical presentations included hemorrhage in 20 patients,seizure in 4,headache in 2,facial tic in 1 and tinnitus in 1.Supratentorial and infratentorial lesions were noted in 22 and 6,respectively.The maximum diameter of AVMs was smaller than 3 centimeters in 11 patients,ranged from 3 to 6 centimeters in 16,and larger than 6 centimeters in 1.Twenty-one AVMs were located in the functional areas and 7 in non-functional areas.Deep vein drainage was noted in 15,two-way drainage in 1 and superficial drainage in 11.Spetzeler-Martin grading showed grade Ⅰ in 1,grade Ⅱ in 7,grade Ⅲ in 13,grade Ⅳ in 6 and grade V in 1.After operation,endovascular embolization,27 patients had significantly improved symptoms; one patient had no effect on any treatments.Conclusion The elderly patients with cAVMs have low morbidity with hemorrhage as its most common symptom; and the lesions mostly locate in the supratentorial region; active intervention therapy (resection,endovascular embolization and radiotherapy)can obviously improve the prognosis and quality of lives.

RESUMEN

Objective To explore the factors that may influence the prognosis of patients with multiple intracranial aneurysms (MIA) in subarachnoid hemorrhage (SAH). Methods A retrospective review was performed to analyze the medical records of 93 patients who had been managed in our department from January 2000 through January 2011 for MIA in SAH. Results The single factor analysis showed that the gender, preoperative Hunt-Hess grade, treatment protocol and a history of hypertension had significant influences on the prognosis of the patients (P＜0.05). The multiple linear regression analysis revealed that the preoperative Hunt-Hess grade and treatment protocol were 2 independent risk factors of the prognosis of the patients (P＜0.05). Conclusions The preoperative Hunt-Hess grade and the treatment protocol appear to be related to the prognosis of patients with MIA in SAH. Early diagnosis and treatment of ruptured aneurysms, as well as careful observation and proper intervention ofunruptured aneurysms,can result in a satisfactory prognosis in most patients with MIA in SAH.

RESUMEN

Objective To observe the expression of growth factors (vascular endothelial growth factor [VEGF],stromal cell-derived factor-1 [SDF-1 ],basic fibroblast growth factor [bFGF],insulin-like growth factor [IGF-1],transforming growth factor-β [TGF-β],platelet-derived growth factor [PDGF],brain derived neurotrophic factor [BDNF],glial cell line-derived neurotrophic factor [GDNF] and nerve growth factor [NGF]) in rat ischemic brain tissues after intravenous implantation of bone marrow stromal cells (BMSCs) and/or endothelial progenitor cells (EPCs). Methods Healthy adult Wistar rats were randomly divided into 4 groups:vehicle group,BMSCs transplantation group,EPCs transplantation group and BMSCs combined with EPCs transplantation group (n=20). The rats were subjected to middle cerebral artery occlusion (MCAO),and 24 h after that,they were intravenously transplanted with either 3×106 BMSCs,EPCs,BMSCs/EPCs or 1 mL physiological saline.Seven d after transplantation,real time-PCR and Western blotting were employed to detect the expressions of VEGF,SDF-1,bFGF,IGF-1,TGF-β,PDGF-BB,BDNF,GDNF and NGF. Results The mRNA expressions of bFGF,VEGF and BNDF in the BMSCs/EPCs transplantation group were significantly higher as compared with those in the other groups (P＜0.05).BMSCs transplantation group enjoyed the highest mRNA levels of NGF,GDNF and TGF-β among all the groups, significantly higher as compared with those in the other groups (P＜0.05),followed by BMSCs/EPCs transplantation group.EPCs transplantation group enjoyed the highest mRNA levels of PDGF,IGF-1 and SDF-1,significantly higher as compared with those in the other groups (P＜ 0.05), followed by BMSCs/EPCs transplantation group. Conclusion BMSCs combined with EPCs implantation can promote the functional rehabilitation in rats after focal cerebral ischemia, which provides new way for improving the transplantation success rate.

RESUMEN

Objective To explore the clinical skills and curative efficacy of endovascular embolization on dural arteriovenous fistula (DAVF). Methods A total of 50 patients with DAVF,admitted to our hospital from 2000 to 2009, underwent endovascular embolization with different materials through a microcatheter under DSA. After embolization, imaging examination was applied and clinical manifestations were noted during the clinical follow-up to evaluate the clinical efficacies.Results Immediate postoperative angiography indicated that the fistulas were totally occluded in 43patients, occluded evidently in 6 and occluded partially in 1. The 6-84 months follow-up found that clinical symptoms of 34 patients disappeared, 6 alleviated evidently, 7 relapsed, and 3 worsened; no complications were noted. Conclusion The endovascular embolization for DAVF is effective; and choosing the right embolic approach and material and improving the technology are the keys of successful treatment.

RESUMEN

Objective To explore the influencing factors of bleeding in patients with cerebral arteriovenous malformation (AVM) through observing the angioarchitecture of AVM with cerebral DSA.Methods The clinical and imaging data of 199 patients with AVM, including 107 with bleeding and 92without bleeding, were retrospectively analyzed. The relationships between bleeding and such factors as the site and size of masses, the type and site of supplying arteries, the number and pathway of venous drainage, having vascular tumor-like changes or not, the relation between AVM and aneurysm in terms of location, and the number and size of concurrent aneurysms were determined by univariate analyses and Binary logistic regression with SPSS13.0. Results Univariate analysis indicated that such factors as micro-sized (0.5-1.0 cra) and small-sized (1.0-2.0 cra) masses ofAVM, AVM underdeep location,having exclusively deep draining veins, fewer draining veins and deep feeding arteries, concurrent small aneurysms (＜5 mm), aneurysms at the end of the blood-supply artery were positively correlated to hemorrhagic presentation. The number of feeding arteries and the number of concurrent aneurysms were not correlated with hemorrhagic presentation. Having vascular tumor-like changes can decreased the risk of bleeding. When stepwise multiple logistic regression analysis was employed, only micro-sized and small-sized masses of AVM, having deep feeding arteries, and aneurysms at the end of the blood-supply artery were dependent predictors of hemorrhagic presentation. Conclusion Micro-sized and small-sized masses of AVM, having deep draining veins and aneurysms at the end of the blood-supply artery are the most powerful risk predictors for hemorrhagic AVM presentation.

RESUMEN

Objective To explore the risk factors and the prognosis of chronic hydrocephalus following aneurysmal subarachnoid hemorrhage (SAH) treated by endovaseular embolization with Guglielmi detachable coils (GDCs). Methods Endovascular embolization with GDCs were performed in 132 patients with aneurysmal subarachnoid hemorrhage that satisfied our research standard. After endovascular embolization, ventricular drainage was conventionally performed in patients who occurred intraventricular hemorrhage combined with obstruction in the ventricular system, while cerebrospinal fluid permutation was performed in other patients. Chronic hydrocephalus was evaluated by CT 1 month after SAH. Ventricle-peritoneal shunt was carried out for patients with severe chronic hydrocephalus while only clinical observation was needed for patients with mild chronic hydrocephalus. Clinical follow-up evaluation was carried out 6 months after SAIl according to the modified Rankin scale score. The risk factors related to chronic hydrocephalus were noted through the statistical analysis of the patients' data and the relation between the appearing of chronic hydrocephalus and clinical prognosis of SAH was analyzed. Results The overall incidence rate of chronic hydrocephalus following aneurysmal subarachnoid hemorrhage was 12.12% and age, Fisher grade and Hunt-Hess grade had important value in the prognosis of chronic hydrocephalus. Clinical prognosis of SAH was not significantly related to chronic hydrocephalus following SAH (P >0.05). Conclusion Chronic hydrocephalus following aneurysmal subarachnoid hemorrhage is not only resulted from one single risk factor and good clinical prognosis can be achieved by promptly performing ventricle-peritoneal shunt in patients with severe chronic hydrocephalus.

RESUMEN

<p><b>OBJECTIVE</b>To study the expression of signal transducer and activator of transcription 5b (STAT5b) mRNA and interleukin-4 (IL-4) mRNA in blood mononuclearcells in a rat model of asthma and the effect of montelukast (MK) and BCG-polysaccharide and nucleic acid injection (BCG-PSN) on STAT5b mRNA and IL-4 mRNA expression.</p><p><b>METHODS</b>Fifty-two male Sprague-Dawley rats (weight:140-200 g) were randomly divided into four groups: asthma, MK treated and BCG-PSN-treated and control groups. Rat model of asthma was prepared by ovalbumin (OVA) sensitization. The rats were sacrificed 24 hrs after the last sensitization. Blood eosinophils (EOS) were counted. Plasma contens of IL-4 and interferon-gamma (IFN-gamma) were measured using ELISA. Expression of STAT5b mRNA and IL-4 mRNA in blood mononuclearcells was detected with SYBR GREEN I fluorescent quantitation PCR method.</p><p><b>RESULTS</b>Blood contents of STAT5b mRNA and IL-4 mRNA in the untreated asthma group were significantly higher than those in the other three groups (<0.01). Blood EOS count and plasma IL-4 contents in the untreated asthma group significantly increased, while plasma IFN-gamma contents significantly decreased compared with the other three groups (<0.01). There were no significant differences in the parameters measured among the MK-treated, the BCG-PSNjtreated and the control groups. STAT5b mRNA expression was positively correlated to IL-4 mRNA expression, IL-4 content and EOS count (r=0.730,0.650, 0.664, respectively; <0.01), but negatively correlated to IFN-gamma content (r=-0.798; <0.01).</p><p><b>CONCLUSIONS</b>STAT5b mRNA and IL-4 mRNA were strongly expressed in blood mononuclearcells in rats with asthma, and there was a positive correlation between them. MK and BCG-PSN had inhibitory effects on the expression of STAT5b mRNA and IL-4 mRNA, which might be contributed to suppression of airway inflammation in asthma.</p>

Asunto(s)

RESUMEN

Objective To analyze the effect of NexusTM coils for endovascular occlusion of intracranial aneurysms. Methods In 41 patients with intracranial aneurysms, endovascular occlusion of 43 aneurysms was performed using NexusTM coils. The follow-up data of the patients for 6 to 12 months were reviewed, and the imaging data from digital subtraction angiography (DSA), CT angiography (CTA) or magnetic resonance arthrography (MRA) alter the treatment were analyzed. Results In the 41 patients, 1 died, 1 had aneurysm recurrence, 3 had cerebral infarction, 1 showed ocular paralysis, and 2 developed hydrocephalus after the surgery. Evaluation with modified Rankin Scale showed grade 0 in 8 cases, grade 1 in 19 cases, grade 2 in 7 cases, grade 3 in 3 cases, grade 4 in 1 case, grade 5 in 1 ease and grade 6 in 1 case. Conclusion Endovascular embolization with NexusTM coils is effective for treatment of intracranial aneurysms especially in cases of small aneurysms and parent artery occlusion. Caution should be taken with the coil for endovascular occlusion of the neck of anterior and middle cerebral artery aneurysms with thin parent arteries, as the fibers in the coil may cause thrombosis and potential cerebral infarction.

RESUMEN

Objective To evaluate the effect ofendovascular embolization on intracranial aneurysms with detachable coil and detachable balloon and to emphasize the mainpoint of embolization technique.Methods 1328 patients underwent complete cerebral angiography using microcatheter under DSA imaging. 85 cases with 90 aneurysms were embolized by MDS, 825 cases with 847 aneurysms were embolized by GDC, 418 cases with 433 aneurysms were embolized by EDC. 37 of 67 giant aneurysms were embolized by detachable balloon, 18 aneurysms by GDC, 11 aneurysms by EDC, 1 by MDS. Results 1328 patients with 1370 aneurysms were cured successfully; 1 322 cases recovered clinically, 6 patients died. 1 281 aneurysms achieved 100 % occlusion, 65with 95 % occlusion, 20 with 90 % occlusion, and 4with 80 % embolization. 9 aneurysms reputured during the embolization, 5 patients had cerebral infarction, 1 patient died of intractable cerebral vasospasm for microcoil escape. 2 recurrent cases were cured by second GDC embolization. Conclusion The method of endovascular embolization to treat intracranial aneurysm is safe, reliable and effective. Those cases with giant aneurysms will have high recurrence. Patients who suffer from SAH repeatedly may have great possibility of aneurysm rupture during embolization.

RESUMEN

Objective To evaluate the treatment of aneurysms rupture during endovascular embolization.Methods Nine aneurysms ruptured during the embolization and were treated with endovascular embolization.The reasons of aneurysms rupture during embolization,the prevention and the first aid after aneurysms rupture were analysed.Results Seven patients recovered and 2 died.Conclusions The optimal treatment of aneurysms rupture during endovascular embolization is effective,(J Intervent Radiol,2007,16: 132-134)