Ethnicity might be associated with treatment outcomes in advanced prostate cancer. This study aimed to evaluate the efficacy and safety of androgen deprivation therapy (ADT) combined with apalutamide in East Asians with metastatic castration-sensitive prostate cancer (mCSPC). The original phase 3 Targeted Investigational Treatment Analysis of Novel Anti-androgen (TITAN) trial was conducted at 260 sites in 23 countries. This subgroup analysis included patients enrolled in 62 participating centers in China, Japan, and Korea. Radiographic progression-free survival (PFS), time to prostate-specific antigen (PSA) progression, and PSA changes from baseline were compared between groups in the East Asian population. The intent-to-treat East Asian population included 111 and 110 participants in the apalutamide and placebo groups, respectively. The 24-month radiographic PFS rates were 76.1% and 52.3% in the apalutamide and placebo groups, respectively (apalutamide vs placebo: hazard ratio [HR] = 0.506; 95% confidence interval [CI], 0.302-0.849; P = 0.009). Median time to PSA progression was more favorable with apalutamide than placebo (HR = 0.210; 95% CI, 0.124-0.357; P < 0.001). Median maximum percentages of PSA decline from baseline were 99.0% and 73.9% in the apalutamide and placebo groups, respectively. The most common adverse event (AE) was rash in the apalutamide group, with a higher rate than that in the placebo group (37.3% vs 9.1%). The most common grade 3 or 4 AEs were rash (12 [10.9%]) and hypertension (12 [10.9%]) for apalutamide. The efficacy and safety of apalutamide in the East Asian subgroup of the TITAN trial are consistent with the global results.
Androgen Antagonists/adverse effects* ; Exanthema/chemically induced* ; Far East ; Humans ; Male ; Prostate-Specific Antigen ; Prostatic Neoplasms, Castration-Resistant/pathology* ; Thiohydantoins/adverse effects*

Objective: To explore the improvement influence of three combined exercise programs on sleep quality among college students with sleep disorders, so as to provide reference for the construction of exercise intervention programs for sleep disorder. Methods: A total of 35 college students with sleep disorders were randomly divided into AR group ( n =10), AM group ( n =8), RM group ( n =9) and CG group ( n =8). The three exercise groups were provided with exercise intervention for 8 weeks, 3 times/week , 60 min/time, and the CG group maintained previous lifestyle.Before and after the intervention,evaluation of subjective sleep quality and reduction rate of sleep disorder by PSQI, and Actigraph GT3X+ was used to monitor the changes in the objective sleep quality. Results: After the intervention,the total score of PSQI ( t =3.49, 2.31, 2.73), sleep quality score ( t =2.71, 3.00 , 5.29),sleep duration of AR group ( t =2.74), daytime dysfunction of AM group ( t =2.64) and sleep duration of RM group ( t = 2.29) significantly decreased ( P ＜0.05); The scores of sleep duration in AM group were significantly lower than those in AR group, and the scores of PSQI,sleep quality and daytime dysfunction in AM group were significantly lower than those in CG group (P<0.05). After intervention,TST ( t =-4.41, -8.37, -6.79) and SE ( t =-4.40, -5.86, -4.91) of AR group, AM group and RM group significantly increased( P <0.05), SOL ( t =4.18, 9.93), WASO ( t =2.91, 3.46) and NA ( t =4.80, 3.37) of AM group and RM group significantly decreased ( P <0.05). The changes of TST,SE and WASO in RM group were significantly higher than those in CG group, and SOL was significantly lower than those in CG group ( P <0.05). Conclusion The three kinds of combined exercise programs can improve the subjective and objective sleep quality of college students with sleep disorders, and reduce the incidence of sleep disorders; different combined exercise programs have different influence on the improvement of sleep quality of college students with sleep disorders, aerobic combined meditative movement exercise program has a prominent influence on the improvement of subjective sleep quality, and resistance combined meditative movement exercise program has a prominent influence on the improvement of objective sleep quality.

Abstract As the largest human microecosystem, intestinal microorganisms participate in human material and energy metabolisms and pose a significant impact on human health. Diabetes mellitus is likely to cause imbalance of abundance and component alterations in intestinal microorganisms, and reduce the diversity and balance, leading to intestinal microflora dysregulation. It has been shown that intestinal microflora dysregulation may promote diabetes development and progression through the reduction of intestinal microbial metabolites, inflammatory reaction and insulin resistance. This review summarizes the involvement of intestinal microorganisms in the pathogenesis of diabetes through metabolites including short-chain fatty acid, bile acid and lipopolysaccharide, and describes the current status of intestinal microorganisms-mediated treatments for diabetes, so as to provide the theoretical basis for the researches on diabetes and intestinal microorganisms.

Altitude ; Diabetes Mellitus, Type 2 ; Endothelial Progenitor Cells ; Glycated Hemoglobin A ; Humans ; Hypoxia-Inducible Factor 1, alpha Subunit/metabolism*

BACKGROUND: Many domestic and foreign literatures have reported that half hip replacement for unstable intertrochanteric fractures in the elderly has achieved good results, but the unstable intertrochanteric fracture with hemiarthroplasty is difficult to reconstruct the greater trochanter, and its reconstruction method is still controversial. OBJECTIVE: To discuss short-term effect of bipolar hemiarthroplasty and reconstruction of the femoral greater trochanter with cerclage band in the treatment of intertrochanteric fracture in elderly patients. METHODS: Clinical data of 15 elderly patients with intertrochanteric fracture undergoing bipolar hemiarthroplasty, and reconstruction of the femoral greater trochanter with cerclage band in the Xinjiang Uygur Autonomous Region People's Hospital were retrospectively analyzed. Posterolateral approach was selected. The patients were followed up in out-patient clinic yearly at postoperative 1, 3, 6 and 12 months. Fracture healing was judged using X-ray films, and the possibility of infection was observed. Hip function was evaluated using Harris scoring. Subjective satisfaction of patients was recorded. RESULTS AND CONCLUSION: (1) All patients walked within 3 days after operation. All patients were reviewed on time within a year. Postoperative X-ray revealed that the sample achieved initial stability, and had achieved fracture healing of greater trochanter. Blood examination did not show infection index. (2) The Harris score was (86.3±5.8) in final follow-up. Subjective satisfaction of patients was good. (3) In summary, bipolar hemiarthroplasty and reconstruction of the femoral greater trochanter with cerclage band in the treatment of intertrochanteric fracture in elderly patients can obtain good therapeutic effect, and it can achieve good prosthesis stability and large trochanter fracture reduction and fixation.

Toxoplasma gondii is an apicomplexan zoonotic protozoan parasite that infects most species of warm-blooded animals, including humans. The heavy incidence and severe or lethal damage caused by T. gondii infection clearly indicate a need for the development of an effective vaccine. T. gondii GRA8 is a member of the dense granules protein family and is used as a marker of acute infection. In the present study, we evaluated the protective immunity induced by DNA vaccination based on a recombinant eukaryotic plasmid, pDsRed2-GRA8, against acute toxoplasmosis in mice. BALB/c mice were intramuscularly immunized with the pDsRed2-GRA8 plasmid and then challenged by infection with the highly virulent GFP-RH strain of T. gondii. The specific immune responses and protective efficacy against T. gondii of this vaccine were analyzed by measuring cytokine and serum antibody titers, splenocyte proliferation assays, and the survival times of mice after challenge. Our results showed that mice immunized with pDsRed2-GRA8 demonstrated specific humoral and cellular responses, induced higher IgG antibody titers with predominant IgG2a production; increased levels of IL-10, IL-12 (p70), IFN-γ, TNF-α, and splenocyte proliferation; and prolonged survival times compared to those of control mice. The present study showed that DNA immunization with pDsRed2-GRA8 induced humoral and cellular immune responses, and all immunized mice showed greater Th1-type immune responses and longer survival times than those of control mice. These results indicated that T. gondii GRA8 DNA immunization induces a partial protective effect against acute toxoplasmosis.
Animals ; DNA ; Humans ; Immunity, Cellular ; Immunization ; Immunoglobulin G ; Incidence ; Interleukin-10 ; Interleukin-12 ; Mice ; Parasites ; Plasmids ; Toxoplasma ; Toxoplasmosis ; Vaccination

Hepatic ischemia/reperfusion (I/R) injury leads to oxidative stress and acute inflammatory responses that cause liver damage and have a considerable impact on the postoperative outcome. Much research has been performed to develop possible protective techniques. We aimed to investigate the efficacy of SPA0355, a synthetic thiourea analog, in an animal model of hepatic I/R injury. Male C57BL/6 mice underwent normothermic partial liver ischemia for 45 min followed by varying periods of reperfusion. The animals were divided into three groups: sham operated, I/R and SPA0355 pretreated. Pretreatment with SPA0355 protected against hepatic I/R injury, as indicated by the decreased levels of serum aminotransferase and reduced parenchymal necrosis and apoptosis. Liver synthetic function was also restored by SPA0355 as reflected by the prolonged prothrombin time. To gain insight into the mechanism involved in this protection, we measured the activity of nuclear factor-kappaB (NF-kappaB), which revealed that SPA0355 suppressed the nuclear translocation and DNA binding of NF-kappaB subunits. Concomitantly, the expression of NF-kappaB target genes such as IL-1beta, IL-6, TNF-alpha and iNOS was significantly downregulated. Lastly, the liver antioxidant enzymes superoxide dismutase, catalase and glutathione were upregulated by SPA0355 treatment, which correlated with the reduction in serum malondialdehyde. Our results suggest that SPA0355 pretreatment prior to I/R injury could be an effective method to reduce liver damage.
Animals ; Anti-Inflammatory Agents/*therapeutic use ; Benzoxazines/*therapeutic use ; Liver/*drug effects/immunology/*injuries/pathology ; Male ; Mice, Inbred C57BL ; NF-kappa B/immunology ; Reperfusion Injury/*drug therapy/immunology/pathology ; Signal Transduction/drug effects ; Thiourea/*analogs & derivatives/therapeutic use

Objective The expression of anti-inflammatory cytokine interleukin(IL)-10 in protrusion and extrusion tissue of intervertebral disc and its correlation with clinical features.Methods The specimens were from 30 cases of disc herniation in single level.The patients were enquired about the medical histories and evaluated by JOA index preoperation before operation,which were all completed by one trained doctor.The contents of IL-10 in the inter=43vertebral disc were detected by enzyme-linked immunosorbent assay after operation.Results The level of IL-10 had no statistical significance between protrusion and extrusion tissue of intervertebral disc (t =0.032,P =0.725).Patient's JOA index has negative correlation with IL-10(r =-0.377,P =0.040),and positive correlation with Patient's history (r =0.449,P =0.013).Conclusion Protrusion and extrusion tissue of intervertebral disc have abilities of excreting anti-inflammatory cytokine IL-10.The level of cytokine has correlation with patient's clinical features.

PURPOSE: To evaluate several risk factors related to re-ulceration of diabetic foot including psychosocial aspects such as familial support and degree of independence of patients' activity. MATERIALS AND METHODS: We reviewed medical records and performed telephone interview with eighty-five patients who had a history of hospitalization in our hospital due to diabetic foot ulceration from year 2002 to 2010. Based on the collected data, we analyzed several factors such as age, gender, prevalence duration, accompanying diseases, HbA1c level, degree of independence and familial support. RESULTS: The mean age was 61.4 years and most common in the 4th decade. There were 57 cases (67%) of recurrence, predominance of male. Eleven patients with recurrent diabetic foot ulceration had undergone major amputations. Psychosocial problems such as depression, insufficient familial support and mortality were more frequently observed in recurrent group. CONCLUSION: This study shows that psychosocial factor such as familial support for patient with diabetic foot could be important to reduce the recurrence rate of diabetic foot ulceration. Therefore, we should pay attention to strategic plans for prevention, screening, treatment, and aftercare through the prospective studies including psychosocial risk factor in diabetic foot ulceration.
Aftercare ; Amputation ; Depression ; Diabetic Foot ; Foot ; Hospitalization ; Humans ; Interviews as Topic ; Male ; Mass Screening ; Medical Records ; Prevalence ; Recurrence ; Retrospective Studies ; Risk Factors ; Ulcer

Ultrasound image has a lot of speckle noise, which brings great difficulties to the feature extraction, recognition and analysis. Especially in the edge extraction, the conventional extraction algorithms are difficult to achieve the desired results because of the speckle noise. To solve this problem, an algorithm based on the anisotropic diffusion equation is presented. The new algorithm combines the robust estimation and considers the characteristic of the speckle noise, so it can suppress the speckle noise effectively and be more robust, thus the edge details of the ultrasound image can be preserved even enhanced, which can provide effective safeguard for the following edge extraction. Furthermore, the paper proposes a new method to compute speckle scale coefficients automatically, which reduces the influence of the human beings, and enhances the stability of the algorithm.
Algorithms ; Artifacts ; Image Interpretation, Computer-Assisted ; Ultrasonography ; methods