ObjectiveObservational studies have shown that plasma lipids are associated with the development of neurodegenerative diseases (NDD), but the causal relationship is unclear. This study investigated the causal relationship between 179 liposomes and NDD using a two-sample Mendelian randomization (MR). MethodsA two-sample MR method was used to comprehensively analyze the causal relationship between liposomes and major NDD such as Alzheimer's disease (AD), Parkinson's disease (PD), amyotrophic lateral sclerosis (ALS) and multiple sclerosis (MS). The two sample software package and Phenoscanner database were used to screen for appropriate instrumental variables (TV). In this study, inverse variance weighting (IVW) was used as the primary measure of MR analysis, and various sensitivity tests were performed. ResultsMR-IVW results showed that phosphatidylethanolamine (PE) (OR=0.90, 95%CI 0.83 to 0.99, P=0.03), phosphatidylcholine (PC) (OR=0.92, 95%CI 0.85 to 0.99, P=0.02) and phosphatidylinositol (PI) (OR=0.90, 95%CI 0.83 to 0.99, P=0.03) were protective factors for AD. Sterol ester (OR=1.18, 95%CI 1.04 to 1.34, P=0.01) and cholesterol (OR=1.26, 95%CI 1.02 to 1.56, P=0.03) increased the risk of PD. PE (OR=0.79, 95%CI 0.64 to 0.98, P=0.03) and PC (OR=0.83, 95%CI 0.69 to 0.98, P=0.03) reduced the risk of PD. Diacylglycerol (DAG) (OR=1.24, 95%CI 1.01 to 1.54, P=0.04) and sphingomyelin (SM) (OR=1.13, 95%CI 1.08 to 1.58, P=0.01) were the risk factors for MS. PI (OR=0.77, 95%CI 0.62 to 0.95, P=0.02) and PC (OR=0.74, 95%CI 0.88 to 0.95, P=0.02) were protective factors for MS. PI (OR=1.02, 95%CI 1.01 to 1.04, P=0.02) and triglyceride (TG) (OR=1.03, 95%CI 1.01 to 1.05, P=0.02) increased the risk of ALS, PC (OR=0.98, 95%CI 0.97 to 0.99, P=0.03) decreased the risk of ALS. ConclusionThere is a causal relationship between sterol ester, cholesterol, PC, PE, PI, DAG, SM, TG and different NDD, which provides a theoretical basis and support for further clinical studies.
Objective To systematically review the prognostic and clinicopathological value of plasma fibrinogen in renal cell carcinoma (RCC). Methods An electronic search of the PubMed, EMbase, The Cochrane Library (Issue 5, 2016), CNKI, CBM and WanFang Data databases was performed to collect cohort studies about the prognostic value of plasma fibrinogen in RCC from inception to May 2016. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then meta-analysis was performed by using RevMan 5.3 software. Results A total of 3 744 RCC patients from 7 cohort studies were included. The results of meta-analysis showed that the lower plasma fibrinogen expression group was superior to the higher expression group in overall survival (HR=2.13, 95%CI 1.74 to 2.61,P<0.00 001) and cancer-specific survival (HR=3.12, 95%CI 2.19 to 4.44,P<0.00 001). Subgroup analysis showed that plasma fibrinogen expression was higher in stage Ⅲ to Ⅳ than stage ⅠtoⅡ (OR=0.27, 95%CI 0.13 to 0.55,P=0.000 3) and was higher in Fuhrman grading G3+G4 than grading G1+G2 (OR=0.49, 95%CI 0.40 to 0.59,P<0.000 01). However, the level of plasma fibrinogen was not found to be associated with gender (OR=0.85, 95%CI 0.69 to 1.05,P=0.14). Conclusion Current evidence shows plasma fibrinogen expression is associated with the prognostic and clinicopathological value of RCC. Due to limited quantity and quality of included studies, the above conclusions are still needed to be verified by more high quality studies.
Objective To investigate the early diagnosis of lower l imb deep vein thrombosis (DVT) after major orthopedic surgeries. Methods From October 2005 to June 2009, color doppler sonography and hemorheology detection were carried out for 62 cases undergoing first total hip arthroplasty (THA), 14 cases undergoing total knee arthroplasty (TKA), and 86 cases undergoing hip fractures surgery (HFS) before operation and 1, 7, 14 days after operation. The plasma D-dimerlevels of the DVT were also examined for the THA patients before operation and 3 days after operation. Of all cases, therewere 89 males and 73 females, aged from 34 to 74 years (51.5 years on average). After operation, all the patients were treated with the regular low molecular weight heparin sodium against DVT. Results After operation, 17 cases (10.5%) developed DVT, including 8 THA cases, 1 TKA case, and 8 HFS cases. Preoperative color doppler sonography showed no abnormal echo, normal b blood flow signal, and normal periodical variation in vein blood flow without regurgitation. Postoperative examinations showed that the vascular occlusion of common femoral vein and popl iteal vein occurred in DVT patients. There were significant differences (P lt; 0.05) in whole blood viscosity between patients with DVT and without DVT after 1, 14 days and no significant difference (P gt; 0.05) before operation and 7 days after operation. There was no significant difference (P gt; 0.05) in plasma viscosity and erythrocyte aggregation index, between patients with DVT and without DVT pre- and postoperation. There was significant difference (P lt; 0.05) in erythrocyte deformation index between patients with DVT and without DVT 14 days after operation. The preoperative plasma D-dimer levels of patients with DVT and without DVT were (372.00 ± 148.62) ng/mL and (369.00 ± 141.03) ng/mL, respectively, showing no significant difference (P gt; 0.05); the 3 days postoperatively levels were (574.00 ± 217.29) ng/mL and (391.00 ± 120.16) ng/mL, respectively, showing significant difference (P lt; 0.05). Conclusion Color doppler sonography in combination of hemorheology and plasma D-dimer examination can be beneficial for the early diagnosis of DVT in major orthopedic surgeries.
Objective To explore the effectiveness of plasma-mediated bipolar radiofrequency ablation debridement (Coblation debridement) in treatment with retention of internal fixation for early postoperative infection of fractures of extremities. Methods Between January 2012 and May 2015, 16 patients (12 males and 4 females) with early postoperative infection of internal fixation for extremity fracture were treated, with an average age of 41.6 years (range, 19-61 years). The fractures included tibia and fibula fracture in 5 cases, femoral fractures in 5 cases, distal humeral fractures in 3 cases, ulna and radius fractures in 2 cases, and patellar fracture in 1 case. Two cases were open fractures and 14 cases were closed fractures. All fractures were fixed non-intramedullarily. Postoperative infection occurred at 5-10 days (mean, 7 days) after operation, with bacteria cultured from wound secretion in all cases. Type EIC5872 70 Coblation knife and Coblator Ⅱ plasma surgery system were conducted to debride the foci of infection in ablating pattern with sterile saline used as the conductive fluid and the magnitude of power from 6 to 9. After pulse irrigating with sterile saline, irrigating tube and draining tube were placed beside the fixation. Postoperative continuous irrigation and drainage and systemic antibiotic therapy would be conducted. The effectiveness was evaluated by bone infection effectiveness evaluation criteria. Results All the 16 patients were followed up 12-36 months (mean, 15 months) after operation. All the infected wounds were cured and healed by first intention without recurrence in all the patients, and the fracture healing time was 3-7 months (mean, 4.8 months) without limb dysfunction or nonunion. Internal fixation was removed at 1-2 years after operation in 4 cases, whom with good fracture healing and without recurrence of infection after operation. Conclusion The effectiveness of Coblation debridement in treatment with retention of internal fixation for early postoperative infection of extremity fractures are satisfactory, which can avoid the second stage operation, infectious nonunion, and osteomyelitis.
Objective To evaluate the effect of methylation determination about the peripheral plasma DNA in diagnose of hepatocellular carcinoma （HCC） and select the highly sensitive and specific methylated cancer suppressor genes. Methods Methylation-specific PCR （MSP） was used to detect the degree of methylation about SLIT2 and DAPK genes in peripheral plasma and associated cancer tissues of 34 patients with HCC confirmed by pathology, then analyzed their relationship to clinicopathologic feature. Results The positive rate of the promoter methylation of SLIT2 and DAPK genes in cancer tissues in 34 cases were 70.6% （24/34） and 79.4% （27/34）, while the relevant promoter methylation rate in plasma were 44.1% （15/34） and 50.0% （17/34） correspondingly. The sensitivity of detection of DNA methylation about SLIT2 and DAPK genes in plasma was 62.5% and 63.0%, respectively；both of the specificity for them were 100%. The negative predicted value was 52.6% and 41.2%, respectively；while both of the positive predicted value were 100%. There were no significant correlation between the clinicopathologic features and the methylation rate in cancer tissues and plasma （P＞0.05）. In plasma of patients whose AFP＜400 μg/L, the positive rate of combined detection of DNA methylation of SLIT2 and DAPK was 61.1% （11/18）. Conclusions The detection rate of DNA methylation of SLIT2 and DAPK genes in plasma is higher, and there is a significant correlation between the DNA methylation in HCC tissue and plasma, based on MSP method. DNA methylation in plasma, as an non-invasive method, could be used to diagnose HCC, especially for the patients whose AFP is negative. HBV infection may be only associate with DNA methylation of part gene.
ObjectiveTo explore the concentration of the plasma homocysteine (Hcy) and the relationship with TOAST subtypes in patients with acute cerebral infarction. MethodsA total of 120 patients with acute cerebral infarction (ACI) treated from April 2012 to April 2013 were enrolled into the ACI group.They were classified with Korean TOAST classification as five subtypes:atherothrombosis (AT) type,small artery disease (SAD) type,cardioembolism (CE) type,stroke of other disease (SOD) type,and stroke of undetermined etiology (SUE) type.The plasma Hcy concentrations in each group and in 60 heathy people who were selected into the control group were measured.Furthermore,the relationship between plasma Hcy concentration and their subtypes were analyzed. ResultsThe plasma Hcy level in ACI group was significant higher than that in the control group (P<0.01).The levels of plasma Hcy were much higher in patients with AT,SAD,SOD,and CE than those in the control groups (P<0.01).In different subtypes,AT and SAD subtypes had higher homocysteine concentration than SUD and CE subtypes did.The concentration of Hcy in AT and SAD group had no significant difference. ConclusionACI is related to hyperhomocysteinemia.The plasma Hcy level varies with different TOAST subtypes of ACI,specially elevating in the subtypes of AT and SAD,which may indicate that hyperhomocysteinemia may increase stroke risk through proatherogenic effect and endothelial dysfunction.
ObjectiveTo systematically review the efficacy and safety of plasma exchange (PE) versus routine medical therapy (RMT) for patients with chronic liver failure. MethodsWe electronically searched databases including PubMed, The Cochrane Library (Issue 7, 2014), CBM, CNKI, and VIP from inception to August 2014, to collect randomized controlled trials (RCTs) and clinical controlled trials (CCTs) of PE versus RMT for chronic liver failure patients. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data and assessed the methodological quality of included studies. Then, meta-analysis was performed using RevMan 5.0 software. ResultsA total of 7 RCTs and 9 CCTs involving 1 632 patients (822 in the PE group and 810 in the RMT group) were included. The results of meta-analysis showed that:compared with the RMT group, the PE group had lower mortality rate (RCT:OR=0.24, 95%CI 0.13 to 0.43; CCT:OR=0.48, 95%CI 0.30 to 0.78) and higher total effective rate (RCT:OR=4.04, 95%CI 2.80 to 5.85; CCT:OR=3.45, 95%CI 2.11 to 5.64). Subgroup analysis based on the stage of liver failure showed that the PE group was superior to the RMT group in early- and intermediate-stage patients with liver failure in total effective rate (early stage:OR=4.78, 95%CI 1.87 to 12.23; intermediate stage:OR=4.43, 95%CI 1.77 to 11.08), but this difference was not found in advanced liver failure patients (OR=1.61, 95%CI 0.35 to 7.38). Seven studies reported 187 cases of adverse reactions (11.46%), and most of them were pruritus and urticaria. ConclusionCurrent evidence shows, compared with the routine medical therapy, the PE therapy could be effective to early- and intermediate-stage liver failure patients, but not be effective to advanced liver failure patients. In addition, patients who received the PE therapy have risks of adverse reactions which mainly are allergic reaction. Due to limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.
Objective To detect traces of microRNAs (miRNAs) in plasma and assess the expression stability of two common reference genes by stem-loop and poly A polymerase (PAP) real-time quantitative polymerase chain reaction (PCR) method, as miRNAs are the new bio-markers of tumor diagnosis and molecular targeted therapy, and its quantitative research is very important. Methods We extracted miRNAs from plasma of adult Sprague Dawley (SD) rats’ plasma, and detected the expressions of rno-miR-200b-3p and rno-miR-126-3p with stem-loop and PAP real-time PCR quantitative method, with rno-miR-103a-3p and U6 as internal controls. All the results were evaluated by 2△Ct method. Results Compared with PAP method, the stem-loop method reduced Ct value by 2-4 cycles and improved sensitivity by 10 times. In PAP method, the melting curve showed two peaks, a main peak and a small non-specific peak. Yet the melting curve of stem-loop method demonstrated a single specific peak. Furthermore, we validated the stability of internal references in the two real time PCR methods. U6 presented a more stable Ct value than rno-miR-103 in adult SD rats’ plasma samples. Conclusions Stem-loop real-time PCR is recommended as a major way to detect some samples with a low concentration of miRNAs, owing to its high accuracy and sensitivity. However, if a large number of tissue samples is going to be detected, PAP real-time PCR is more suitable and convenient than stem-loop method. U6 is more stable and repeatable than rno-miR-103a-3p as the reference gene to evaluate the semi-quantitative consequence of miRNAs.
ObjectivesTo systematically review the prognostic value of plasma soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) level in predicting 28-day mortality in sepsis.MethodsPubMed, The Cochrane Library, EMbase, Web of Science, CBM, CNKI, VIP and WanFang Data databases were electronically searched to collect studies about the prognostic value of plasma sTREM-1 in early 28-day mortality in sepsis from inception to April 16th, 2018. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by using Stata 14.0 software.ResultsA total of 13 studies involving 1 115 patients were included. The results of meta-analysis showed that the sensitivity and specificity were 79% and 77%, respectively. The positive likelihood ratio and the negative likelihood ratio were 3.4 and 0.28, respectively. The diagnostic ratio was 12. The overall area under the summary receiver operator characteristic (SROC) curve was 0.80.ConclusionsCurrent evidence shows that plasma sTREM-1, as a single index, may play a prognostic role in the early 28-day mortality of sepsis in patients. Due to limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.
ObjectiveTo evaluate the safety and clinical efficacy of transurethral holmium laser enucleation of the prostate (HoLEP) versus transurethral plasma kinetic enucleation of the prostate (PKEP) in the treatment of benign prostate hyperplasia (BPH).MethodsRandomized controlled trials of HoLEP versus PKEP in the treatment of BPH published between January 2000 and March 2021 were searched in PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, Chongqing VIP database, and Wanfang database. Operative duration, estimated intraoperative blood loss, average duration of urinary catheterization, average duration of bladder irrigation, average length of hospital stay, and postoperative complications were used as safety evaluation indicators. Postoperative International Prostatic Symptomatic Score (IPSS), postoperative maximum urinary flow rate (Qmax), postoperative quality of life (QoL), and postvoid residual (PVR) were used as effective evaluation indicators.ResultsA total of 14 randomized controlled trials were included in this study, with a total of 1 478 patients (744 in the HoLEP group and 734 in the PKEP group). The results of the meta-analysis showed that the intraoperative blood loss in the HoLEP group was less than that in the PKEP group [weighted mean difference (WMD)=?25.95 mL, 95% confidence interval (CI) (?31.65, 20.25) mL, P=0.025], the average duration of urinary catheterization [WMD=?10.35 h, 95%CI (?18.25, ?2.45) h, P=0.042], average duration of bladder irrigation [WMD=?10.28 h, 95%CI (?17.52, ?3.04) h, P=0.038], and average length of hospital stay [WMD=?1.24 d, 95%CI (?1.85, ?0.62) d, P=0.033] in the HoLEP group were shorter than those in the PKEP group, and the incidence of postoperative complications [risk ratio=0.70, 95%CI (0.56, 0.87), P=0.047] and 6-month postoperative Qmax [WMD=?0.89 m/s, 95%CI (?1.74, ?0.05) m/s, P=0.037] in the HoLEP group were lower than those in the PKEP group. However, there was no significant difference in the operative duration, 3-month postoperative IPSS, 3-month postoperative Qmax, 3-month postoperative QoL, 3-month postoperative PVR, 6-month postoperative IPSS, 6-month postoperative QoL, or 6-month postoperative PVR between the two groups (P>0.05).ConclusionsIn the treatment of BPH, the effectiveness of HoLEP does not differ from that of PKEP, but HoLEP is safer. The conclusions of this study need to be verified in more precisely designed and larger sample-sized multi-center randomized controlled trials.