Search

Background: This study aimed to evaluate the long-term survival outcomes of esophagectomy with off-pump coronary artery bypass grafting (OPCABG) vs. esophagectomy alone. Methods: A total of 1798 patients who received esophagectomy between January 2010 and February 2020 were included and divided into the 38 patients who underwent OPCABG followed by esophagectomy (OP + ES group) and 1760 patients had only esophagectomy (ES group). Propensity score matching (PSM) and Cox multivariable analyses were performed to compare postoperative complications, disease-free survival (DFS), and overall survival (OS) between the two groups. Results: There were 37 patients in the OP + ES group matched with 74 in the ES group. The matched OP + ES group had higher total postoperative complications than the ES group, especially more pulmonary infections (P = 0.001) and arrhythmias (P = 0.018), but no other postoperative complications were the difference. The DFS was similar and the OS was a significant difference between the matching 2 groups (log-rank, P = 0.132 and 0.04, respectively). Although pT 3/4 stage, pN (+), and tumor length > 3.0 cm were independently associated with worse OS and DFS in multivariable analysis, CAD and EF < 55% were also found to be a predictive factor for OS and DFS in univariate analysis. Conclusion: OPCABG followed by esophagectomy for esophageal cancer associated with coronary artery disease has equivalent DFS and recurrence pattern to esophagectomy for esophageal cancer alone, but with a disadvantage in OS. [ABSTRACT FROM AUTHOR]

Objective: To explore whether the different phases of the nasal cycle have a significant effect on nasal temperature, the nasal mucosal clearance rate, and levels of nasal nitric oxide (nNO) and to investigate the correlation between these nasal conditions. Methods: The study participants were divided into 2 groups: the control group and the rhinitis group. The participants' nasal temperature, cilia clearance rate, and nNO levels were measured during different phases of the nasal cycle (the congestion phase and decongestion phase) in the control group and before and after undergoing inferior turbinate ablation in the rhinitis group. Results: The temperature of the nasal cavity in the control group was significantly higher in the congestion phase than in the decongestion phase (P =.0025), while in the rhinitis group, the temperature of the nasal cavity decreased significantly after inferior turbinate ablation (P =.001). In the control group, the nasal mucosa clearance time was significantly shorter in the congestion phase than in the decongestion phase (P =.001), and in the rhinitis group, the clearance time of the nasal mucosa was significantly shortened after the operation (P =.0025). In the control group, the levels of nNO were significantly higher in the congestion phase than in the decongestion phase (P =.025), while in the rhinitis group, nNO levels decreased significantly after the operation (P =.005). Conclusion: The function of the nasal cavity changes in different phases of the nasal cycle. Therefore, when evaluating the impact of various factors on nasal function, factors associated with the nasal cycle should also be considered. Inferior turbinate plasma ablation can improve the ciliary function of the nasal mucosa, reduce the temperature of the nasal cavity, and reduce nNO levels. [ABSTRACT FROM AUTHOR]

Functional constipation (FC), characterized by chronic constipation, significantly impacts physiological function and induces psychological stress in patients. However, current clinical treatment options for FC are currently limited. Cistanche deserticola , a traditional Chinese medicine that promotes intestinal moisture and bowel relaxation, contains cistanche total alditol extract (CTAE) as its primary active extract. However, the production of CTAE, its overall efficacy, and potential mechanisms for treating FC have yet to been investigated. This study aimed to reveal the overall efficacy and potential mechanism of action of CTAE in rats with FC using a combination of stable preparation, pharmacodynamics, non-targeted metabolomics, bile acid metabolomics, and western blotting. Fourteen batches of CTAE underwent quality testing. A rat model of FC was developed using diphenoxylate tablets. The comprehensive pharmacodynamic effects of CTAE on FC were evaluated using fecal characteristics (wet weight, dry weight, and water content), intestinal transmission (colonic EMG amplitude, colonic EMG frequency, propulsion length, and propulsion rate), serum and colon biochemical indicators, distribution of interstitial cells of Cajal (ICC), and pathological examination. Non-targeted metabolomics was performed to assess the changes in endogenous metabolite profiles induced by CTAE. Bile acid metabolomics and western blotting analyses were employed to validate the potential mechanisms of action of CTAE. CTAE, with a total content of betaine, mannitol, D-fructose, glucose, and sucrose of (75.67 ± 3.73) %, significantly enhanced intestinal transit, regulated neurotransmitters, increased the expression of c-kit in ICC, and alleviated intestinal inflammation in rats with FC. Non-targeted metabolomics revealed that CTAE significantly alleviated FC-induced metabolic disorders, mainly the biosynthesis of primary bile acids. Targeted metabolomic analysis confirmed that CTAE regulated FC-induced bile acid disorders. Western-blotting results confirmed that CTAE increased the expression of CYP8B1, FGF15, TGR5, and FXR, thereby modulating bile acid synthesis and enterohepatic circulation. CTAE demonstrates significant therapeutic effects on FC, primarily through the regulation of bile acid synthesis and enterohepatic circulation. These findings provide a promising foundation for the development and clinical application of novel CATE-based drugs. [Display omitted] • Producing high-quality and stable CTAE. • CTAE exerts significant therapeutic effects on rat with FC. • Metabolomics reveals that CTAE mainly regulates bile acid metabolism. • BA metabolomics and western-blot confirms the anti-FC mechanism of CTAE. [ABSTRACT FROM AUTHOR]

Objective. To study the clinical efficacy of integrated traditional Chinese medicine (TCM) and Western medicine (WM) in treating endometrial cancer and the influence on ultrasound, magnetic resonance imaging (MRI), tumor markers, human epididymis protein 4 (HE4) and carbohydrate antigen 125 (CA125). Method. A total of 152 cases of patients with endometrial carcinoma were randomly divided into two groups: the TCM + WM group and the WM group. The WM group was treated with megestrol acetate tablets, and the TCM + WM group was treated with Radix Astragali injection on the basis of the control group. The levels of inflammatory factors, HE4 and CA125 in serum, were detected using enzyme-linked immunosorbent assay (ELISA) or radioimmunoassay. The characteristics of ultrasound images and MRI images were observed and recorded. Toxicity, side effects, and the 3-year cumulative survival rate after treatment were assessed. Results. After treatment, the levels of interleukin-4 (IL-4), tumor necrosis factor-alpha (TNF-α), and high-sensitivity C-reactive protein (hs-CRP) in both groups decreased, and the decrease in the TCM + WM group was more obvious than that in the WM group. There were statistically significant differences between the two groups in lesion shape, boundary, blood flow signal, lesion diameter, resistance index (RI), echo, intima thickness, and muscle layer infiltration from transvaginal ultrasound images after treatment. The diameter, echo, boundary, shape, composition, and enhancement degree of lesions between the two groups have a significant difference. Moreover, the levels of serum HE4 and CA125 in both groups decreased after treatment, and the decrease in the TCM + WM group was more obvious than that in the WM group. There were statistically significant differences between the two groups in the occurrence of myelosuppression, abnormal liver function, decreased platelet number, gastrointestinal reactions, leukopenia, and cardiotoxicity. After three years of follow-up, the cumulative survival rate of the TCM + WM group was 76.32%, and the cumulative survival rate of the WM group was 57.89%. Conclusion. Radix Astragali injection combined with megestrol acetate tablets has obvious therapeutic effects against endometrial cancer. Through vaginal ultrasonography and MRI, it can significantly improve the size, shape, and blood flow signals of patients' lesions, reduce the level of serum inflammatory factors and tumor markers HE4 and CA125, reduce the incidence of toxic and side reactions, improve the patient's immunity, improve the patient's condition significantly, and prolong the survival time of patients. [ABSTRACT FROM AUTHOR]

Deep involvement in the negative mood over long periods of time likely results in emotional disturbances/disorders and poor mental health. Tai Chi Chuan (TCC) is regarded as a typical mind-body practice combining aerobic exercise and meditation to prevent and treat negative mood. Although there are an increasing number of TCC studies examining anxiety, depression, and mental stress, the mechanisms underlying these negative emotions are not fully understood. This review study examined TCC studies related to emotional health from both clinical patients and healthy individuals. Next, several potential mechanisms from physiological, psychological, and neurological perspectives were evaluated based on direct and indirect research evidence. We reviewed recent functional magnetic resonance imaging studies, which demonstrated changes in brain anatomy and function, mainly in the prefrontal cortex, following TCC practice. Finally, the effects of TCC on emotion/mental health is depicted with a prefrontal cortex hypothesis that proposed "an immune system of the mind" indicating the role of the prefrontal cortex as a flexible hub in regulating an individual's mental health. The prefrontal cortex is likely a key biomarker among the multiple complex neural correlates to help an individual manage negative emotions/mental health. Future research is needed to examine TCC effects on mental health by examining the relationship between the executive control system (mainly prefrontal cortex) and limbic network (including amygdala, insula, and hippocampal gyrus). [ABSTRACT FROM AUTHOR]

Background: The posterior tympanum approach of cochlear implantation is easy to damage the facial nerve and cord tympanic nerve. Therefore, we need to improve the safety of cochlear implantation. Objectives: To discuss the safety and feasibility of active and adequate transparent exposure of the facial nerve and chorda tympani nerve during the surgery. Methods: A retrospective analysis was performed on all 945 patients who underwent cochlear implantation from January 2011 to September 2017. All patients have been followed up for 14 months to 5 years postoperatively and postoperative complications have been observed. Results: All 945 patients received artificial cochlear implantation. The facial nerves of 76 cases were above the horizontal semicircular canal plane, while narrow facial recess was observed in 44 cases. Serious chorda tympani nerve variation was found in 1 case. No facial paralysis and facial nerve irritation and abnormal taste occurred after operation. Conclusions: Cochlear implantation with initiative and adequate exposure of facial nerve and the chorda tympani nerve can improve the safety of the cochlear implant surgery. Our study provide a safe and effective method for clinical cochlear implantation to reduce facial nerve and tympanic cord nerve injury. [ABSTRACT FROM AUTHOR]

Purpose: To investigate using magnetic resonance imaging (MRI) myocardial injuries and cardiac function in patients with newly diagnosed severe primary overt hypothyroidism (HT) before and after achieving euthyroidism by short-term levothyroxine treatment. Levothyroxine treatment improves cardiovascular performance and ventricular remodeling in patients with HT, but diffuse myocardial injuries induced by HT are difficult to detect clinically.Materials and Methods: Myocardial longitudinal relaxation time (T1 ) mapping using the modified Look-Locker inversion-recovery (MOLLI) sequences at 3.0T was performed before and after euthyroidism was achieved by levothyroxine treatment in 24 patients with Hashimoto's thyroiditis, and compared to 17 healthy controls. Subjects underwent measurements of T1 values and left ventricular stroke volume (SV), ejection fraction (EF), cardiac index (CI), and peak filling rate (PFR). Cardiac data were expressed as an index, as per body surface area, except for heart rate and EF.Results: Patients with untreated HT exhibited significantly longer native myocardial T1 values (all P < 0.05) accompanied by reduced SV (30.7 ± 5.6 vs. 34.9 ± 6.8 mL/m2 , P < 0.05), CI (2.1 ± 0.4 vs. 2.4 ± 0.4 L/min/m2 , P < 0.05), and PFR (3.5 ± 0.9 vs. 4.2 ± 1.1 EDV/s, P < 0.05) compared to healthy controls at baseline. Achieving euthyroidism resulted in a significant decrease in T1 values and improved SV, CI, and PFR values (all P < 0.05) in the patients with HT. Negative correlations of the T1 values with free triiodothyronine (r = -0.55, P < 0.001) and PFR (r = -0.46, P = 0.0016) were observed.Conclusion: We suggest that the negative effect induced by severe overt HT on the cardiovascular system can be significantly improved by restoring euthyroidism with short-term levothyroxine therapy.Level Of Evidence: 1 Technical Efficacy: Stage 2 J. MAGN. RESON. IMAGING 2017;46:897-904. [ABSTRACT FROM AUTHOR]

Background:Benign paroxysmal positional vertigo (BPPV) is the most common type of peripheral vertigo. This study aimed to evaluate the effects of the Semont maneuver (SM) for BPPV treatment, compared with other methods. Methods:Studies were selected in relevant databases under pre-defined criteria up to June 2015. The Cochrane evaluation system was used to assess the quality of the studies. Effect size was indicated as a risk-ratio (RR) with corresponding 95% confidential interval (CI). Statistical analysis was conducted under a randomized- or fixed-effects model. Sub-group analysis was performed. Results:Ten studies were included in the meta-analysis. All of the studies presented a low attrition bias, but a high selection and reporting bias. SM had a much higher recovery rate (SM vs no treatment: RR = 2.60, 95% CI = 1.97–3.44,p < 0.01; SM vs sham: RR = 4.89, 95% CI = 3.01–7.94,p < 0.01), and lower recurrence rate than those from controls (SM vs no treatment: RR = 0.11, 95% CI = 0.04–0.31,p < 0.01). Overall, SM had similar outcomes with Epley maneuver (EM) and Brandt-Daroff exercise (BDE) in terms of recovery rate, recurrence rate, and side-effects. Conclusion:SM is as effective as EM and BDE for BPPV treatment. [ABSTRACT FROM PUBLISHER]

[Display omitted] • Metabolomics revealed the treatment mechanism of Qiwei Tongbi oral liquid on rheumatoid arthritis at the metabolic level. • The pharmacological effects of QWTB were related to its activity against inflammation, kidney deficiency, and bone loss. • The reliability and biological significance of biomarkers was verified by the correlation with pharmacodynamic indicators. Qiwei Tongbi oral liquid (QWTB), a classical traditional Chinese medicine (TCM) formula, has a good therapeutic effect on rheumatoid arthritis (RA) and is widely used in China. To comprehensively elucidate the therapeutic mechanism of QWTB in the treatment of RA, the effects of QWTB on biomarkers and metabolic pathways in a rat model of kidney deficiency arthritis were investigated in this study. The effects of QWTB on pharmacodynamic indicators, including paw swelling, arthritis score; interleukin-1β, interleukin-6, interleukin-17 F, tumor necrosis factor-α, tartrate-resistant acid phosphatase 5b, bone alkaline phosphatase, bone-specific alkaline phosphatase, bone glaprotein, urea, and creatinine levels; and histopathology, suggested that QWTB significantly improved renal function, inhibited the inflammatory response, and reduced bone loss. In total, 39 differential metabolites were screened by comparing the endogenous components between blank and model rat plasma, among which 16 metabolites were altered by QWTB. The metabolism pathway analysis revealed that α-linolenic acid metabolism, phenylalanine metabolism, sphingolipid metabolism, histidine metabolism and glycerophospholipid metabolism were greatly disturbed. Thus, the biomarkers investigated included (1) α-linolenic acid, (2) hippuric acid, (3) phosphatidylethanolamine (15:0/22:2(13Z,16Z)), (4) phenylpyruvic acid, (5) sphinganine, and (6) urocanic acid. QWTB affected three abnormal biomarkers: (3), (4), and (6). Phenylphruvic acid, sphinganine and urocanic acid were significantly associated with pharmacodynamic indicators, as shown by Pearson correlation analysis. These results indicated that RA-related biomarkers had certain reliability and biological significance. In summary, QWTB regulated the metabolic disorders in rats with RA. Its therapeutic mechanism may involve the regulation of phenylalanine metabolism, histidine metabolism, and glycerophospholipid metabolism. The results of this study are useful for understanding the therapeutic mechanisms of TCM. [ABSTRACT FROM AUTHOR]