No abstract

Abstract. During liver surgery, hepatic blood flow needs to be blocked in order to reduce bleeding, which inevitably results in hepatic ischemia/reperfusion injury (HI/R). Paeoniflorin (PF) is the main active ingredient of the traditional Chinese herbal medicine peony, which has been shown to exert anti-oxidative and anti-apoptotic properties. In the present study, a mouse model of HI/R was generated by clamping the hepatoportal vein, hepatic artery, and hepatic duct of BALB/c mice with a vascular clamp for 30 min, followed by reperfusion for 6 h under anesthesia. Six mice in the three PF treatment groups (5, 10 and 20 mg/kg) were then injected with PF, via the tail vein. A sham group, consisting of six mice that did not undergo the procedure, and a vehicle group, consisting of 6 mice that underwent the procedure but subsequently received injections of physiological saline only, were used as controls. Liver injury was indicated by serum levels of the enzymes alanine transaminase (ALT) and aspartate transaminase (AST). The activities of oxidative stress biomarkers, including superoxide dismutase (SOD), glutathione (GSH), glutathione peroxidase (GSH-PX) and malondialdehyde (MDA), were also measured. Furthermore, the activity of caspase-3 was analyzed in hepatic tissue using a commercial kit. Treatment with PF significantly attenuated HI/R injury histologically, as compared with the vehicle group. In addition, significant reductions in the serum levels of ALT and AST were observed in the PF-treated ischemic mice. Furthermore, treatment with PF enhanced the activities of hepatic tissue SOD, GSH and GSH-PX, but decreased the MDA content. Treatment of ischemic mice with PF markedly reduced the expression levels of inflammatory mediators, including nuclear factor-κB, tumor necrosis factor-α, interleukin (IL)-6, and IL-1β, and decreased the HI/R injury-induced expression of caspase-3. The results of the present study suggest that PF attenuates the HI/R injury of mice via anti-oxidative, anti-inflammatory and anti-apoptotic activities.

Background: To assess the changes to left ventricular (LV) function of patients with coronary slow flow (CSF) in response to stress induced by low dose dobutamine. Methods: Based on coronary angiography (CAG) results, total of 186 patients undergoing CAG for chest pain and suspected coronary heart disease were assigned to the CSF group (n = 142) and control group (n = 44). Patients in the CSF group underwent two-dimensional speckle-tracking echocardiography (STE) during the dobutamine stress test to evaluate LV systolic and diastolic functions. Results: At rest, there were no statistically significant differences in LV peak systolic longitudinal strain (LS), LV peak systolic longitudinal strain rate (LSRs), LV peak early diastolic longitudinal strain rate (LSRed), LV circumferential strain (CS), or LV circumferential strain rate (CSRed) between the CSF and control groups. In the CSF group, LS and LSRs first increased as the infusion rate was increased to 10 µg/kg/min (all, p < 0.05), before decreasing at infusion rates of 15 and 20 g/kg/min (all, p < 0.05). CS and CSRed increased in the CSF group at infusion rates of 5, 10, and 15 µg/kg/min, (all, p < 0.05), but decreased significantly at 20 g/kg/min (all, p < 0.05). Conclusions: At rest, LV systolic and diastolic functions were comparable between the CSF and control groups. However, when blood flow to the heart muscles was insufficient, LSRed decreased first, followed by LS. In terms of sensitivity to myocardial ischemia, LS is a better strain parameter than CS.

Sulodexide is a heterogeneous group of sulfated glycosaminoglycans (GAGs) that is mainly composed of low-molecular-weight heparin. Clinical studies have demonstrated that sulodexide is capable of reducing urinary albumin excretion rates in patients with type 1 and type 2 diabetes, suggesting that sulodexide has renal protection. However, this efficacy remains inconclusive. In this article, we used meta-analysis to summarize the clinical results of all prospective clinical studies in order to determine the clinical efficacy and safety of sulodexide in diabetic patients with nephropathy. Overall, sulodexide therapy was associated with a significant reduction in urinary protein excretion. In the sulodexide group, 220 (17.7%) achieved at least a 50% decrease in albumin excretion rate compared with only 141 (11.5%) in the placebo. The odds ratio comparing proportions of patients with therapeutic success between the sulodexide and placebo groups was 3.28 (95% confidence interval, 1.34–8.06; P=0.01). These data suggest a renoprotective benefit of sulodexide in patients with diabetes and micro- and macroalbuminuria, which will provide important information for clinical use of this drug as a potential modality for diabetic nephropathy, specifically, the prevention of end-stage renal disease that is often caused by diabetes.

Purpose The objective of this research was to develop and validate an ultrasound‐based radiomics nomogram for the pre‐operative assessment of Ki‐67 in breast cancer (BC). Materials and Methods From December 2016 to December 2018, 515 patients with invasive ductal breast cancer who received two‐dimensional (2D) ultrasound and Ki‐67 examination were studied and analyzed retrospectively. The dataset was distributed at random into a training cohort (n = 360) and a test cohort (n = 155) in the ratio of 7:3. Each tumor region of interest was defined based on 2D ultrasound images and radiomics features were extracted. ANOVA, maximum correlation minimum redundancy (mRMR) algorithm, and minimum absolute shrinkage and selection operator (LASSO) were performed to pick features, and independent clinical predictors were integrated with radscore to construct the nomogram for predicting Ki‐67 index by univariate and multivariate logistic regression analysis. The performance and utility of the models were evaluated by plotting receiver operating characteristic (ROC) curves, decision curve analysis (DCA), and calibration curves. Results In the testing cohort, the area under the receiver characteristic curve (AUC) of the nomogram was 0.770 (95% confidence interval, 0.690–0.860). In both cohorts, the nomogram outperformed both the clinical model and the radiomics model (P < .05 according to the DeLong test). The analysis of DCA proved that the model has clinical utility. Conclusions The nomogram based on 2D ultrasound images offered an approach for predicting Ki‐67 in BC.