AIM　A series of 4-piperidinylthioether and sulfone derivatives of 4-［1-hydroxy-1-(2,3-dimethoxyphenyl) methyl］-N-2-(4-fluorophenylethyl) piperidine (MDL 100907) were synthesized in order to find new 5-HT2A selective ligands. METHODS　Title compounds 2a-2c were synthesized from 2,3-dimethoxythiophenol and tested for their affinities to 5-HT2A, 5-HT2C, 5-HT6 and 5-HT7 receptors and some other nervous transmitter receptors in vitro. RESULTS　Compounds 2a-2c are new compounds. The results of the binding assay demonstrated that they have relatively high selectivity for 5-HT2A receptor in vitro. CONCLUSION　Some sulfur containing analogues of MDL 100907 showed selective affinity to 5-HT2A receptor and are worth further study.

OBJECTIVE: To summarize the clinical effect of TPF regimen in the treatment of hypopharyngeal carcinoma and explore various clinical factors affecting treatment efficacy. METHOD: The clinical data of 20 cases with hypopharyngeal carcinoma, who received TPF treatment, were analyzed retrospectively. After two courses of chemotherapy, based on radiographic outcomes, next treatment plan was developed. To sum up the clinical information, including the clinical type, patterns of tumor growth, pathologic type, tumor stage, lymph node metastasis, age and so on. To analyze possible influencing factors affecting curative effect. RESULT: (1) After 20 cases with hypopharyngeal carcinoma received two courses of TPF treatment, the effect was evaluated. Objective response rate was 65%. (2) In patients with hypopharyngeal carcinoma, the efficacy of TPF therapy was significantly related to the clinical type, patterns of tumor growth and pathologic type; there was no statistical significance in tumor stage, lymph node metastasis and age. CONCLUSION According to the clinical type, patterns of tumor growth and pathologic type of hypopharyngeal carcinoma, resistance to chemotherapy in hypopharyngeal carcinoma can be assessed, which provides important basis for designing individualized treatment plan.
Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Cisplatin ; therapeutic use ; Fluorouracil ; therapeutic use ; Humans ; Hypopharyngeal Neoplasms ; therapy ; Lymphatic Metastasis ; Retrospective Studies ; Taxoids ; therapeutic use ; Treatment Outcome

Glioblastoma is a malignant tumor in central nervous system, which has strong invasion, poor prognosis and short survival time. At present, the main treatment strategy of glioblastoma is surgical excision, supplemented by radiotherapy and chemotherapy. However, due to incomplete resection and high recurrence rate, it is urgent to find novel therapeutic method for glioblastoma. Photodynamic therapy, as a promising non-surgical treatment, provides a new strategy for postoperative adjuvant therapy of glioblastoma. This review summarizes the mechanism and clinical application of photodynamic therapy mediated by various photosensitizers in glioblastoma, in order to provide help for the treatment of glioblastoma.

Purpose: Emerging evidence from animal models suggests that intermittent hypoxia due to obstructive sleep apnea (OSA) is a risk factor for breast cancer. Despite their biological plausibility, human epidemiological studies have reported conflicting results. Therefore, we conducted a meta-analysis to delineate this relationship. Methods: We searched the PubMed, Embase, Scopus, and Cochrane Library databases for eligible studies from inception until June 6, 2021. Two reviewers selected randomized trials or observational studies reporting the association between OSA and breast cancer incidence compared with those without OSA. Two reviewers extracted relevant data and assessed the quality of evidence using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework and Newcastle-Ottawa Scale (NOS). We pooled the maximally covariate-adjusted hazard ratios (HRs) using a random-effects inverse varianceweighted meta-analysis and performed pre-specified subgroup analyses. Results: We included six studies out of 1,707 records, comprising a combined cohort of 5,165,200 patients. All studies used the International Classification of Diseases codes to classify OSA and breast cancer. OSA patients had a 36% increased breast cancer risk (HR, 1.36; 95% confidence interval [CI], 1.03–1.80; N = 6, I 2 = 96%) compared to those without OSA. Most studies adjusted for confounders, such as age, sex, obesity, diabetes mellitus, alcohol use, and hypertension. Subgroup analyses for studies with (1) multivariate adjustment and (2) at least five years of follow-up yielded HRs of 1.35 (95% CI, 0.98–1.87; N = 5, I 2 = 96%) and 1.57 (95% CI, 1.14–2.18; N = 4; I 2 = 90%), respectively. One Mendelian randomization study suggested a causal relationship, with a two-fold increase in the odds of breast cancer in patients with OSA. Conclusion This meta-analysis suggested that OSA is a risk factor for breast cancer. Future studies should explore the dose-response relationship between OSA and breast cancer, and whether treatment may mitigate breast cancer risk or progression.

Brown-Sequard Syndrome ; diagnosis ; diagnostic imaging ; etiology ; surgery ; Cervical Vertebrae ; Humans ; Intervertebral Disc Displacement ; complications ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Tomography, X-Ray Computed

7,8-Dihydro-7,8-dihydroxybenzo(a)pyrene 9,10-oxide ; toxicity ; Carcinogens ; toxicity ; Cell Line, Tumor ; DNA Damage ; drug effects ; Dose-Response Relationship, Drug ; HSP70 Heat-Shock Proteins ; biosynthesis ; Humans

Objective: To compare the risk angle and safety angle of needling Yamen (GV 15) between the atlanto-axial dislocation (AAD) patients and healthy subjects. Methods: A total of 177 AAD patients diagnosed and treated at the Center of Upper Cervical Vertebra of Beijing China-Japan Friendship Hospital between January 2010 and January 2018 were included in the AAD group. Another 207 healthy subjects were included in the normal group. There were totally 191 males and 193 females. The MRI scan was performed for the cervical vertebrae to measure the risk angle and safety angle of acupuncture at Yamen (GV 15) on the sagittal image. Results: In the AAD group, the risk angle was (13.14±3.99)° and the relative safety angle was (10.31±3.23)° for the perpendicular needling, while the oblique needling risk angle was (9.09±3.09)° for the male; the risk angle was (12.12±2.74)° and the relative safety angle was (10.56±2.09)° for the perpendicular needling, while the oblique needling risk angle was (9.70±2.95)° for the female. In the normal group, the risk angle was (7.89±1.59)° and the relative safety angle was (10.21±3.55)° for the perpendicular needling, while the oblique needling risk angle was (16.07±1.77)° for the male; the risk angle was (6.93±1.45)° and the relative safety angle was (10.70±2.94)° for the perpendicular needling, while the oblique needling risk angle was (14.89±2.18)° for the female. The perpendicular needling risk angles for the males and females in the AAD group were larger than those in the normal group, and the differences were statistically significant (bothP<0.01); for the inner-group comparison, there was no significant difference in the perpendicular needling risk angle between the male and the female in the AAD group (P>0.05); however, the perpendicular needling risk angle for the male was larger than the female, and the difference was statistically significant in the normal group (P<0.01). There were no significant differences in the relative safety angle for both the male and the female between the AAD group and the normal group (bothP>0.05). For the inner-group comparison, there was no significant difference in the relative safety angle between the male and the female (P>0.05). The oblique needling risk angles for both the males and females were smaller in the AAD group than those in the normal group, and the differences were statistically significant (bothP<0.01); the oblique needling risk angle for the male was not significantly different from that for the female in the AAD group (P>0.05); in the normal group, the oblique needling risk angle for the male was larger than that for the female, and the difference was statistically significant (P<0.01). Conclusion: Under the AAD condition, the risk angle and safety angle of acupuncture at Yamen (GV 15) change significantly, perpendicular needling should be better if performed slightly lower than the horizontal direction, and the oblique needling should be safer across the occipital foramen toward the occipital bone.

INTRODUCTION: There is paucity of data on the occurrence of cardiovascular events (CVEs) in critically ill patients with sepsis. We aimed to describe the incidence, risk factors and impact on mortality of CVEs in these patients. METHODS: This was a retrospective cohort study of critically ill patients admitted to the medical intensive care unit (ICU) between July 2015 and October 2016. The primary outcome was intra-hospital CVEs, while the secondary outcomes were in-hospital mortality, ICU and hospital length of stay. RESULTS: Patients with sepsis (n=662) had significantly more CVEs compared to those without (52.9% versus 23.0%, P<0.001). Among sepsis patients, 350 (52.9%) had 1 or more CVEs: 59 (8.9%) acute coronary syndrome; 198 (29.9%) type 2 myocardial infarction; 124 (18.7%) incident atrial fibrillation; 76 (11.5%) new or worsening heart failure; 32 (4.8%) cerebrovascular accident; and 33 (5.0%) cardiovascular death. Factors associated with an increased risk of CVEs (adjusted relative risk [95% confidence interval]) included age (1.013 [1.007-1.019]); ethnicity-Malay (1.214 [1.005-1.465]) and Indian (1.240 [1.030-1.494]) when compared to Chinese; and comorbidity of ischaemic heart disease (1.317 [1.137-1.527]). There were 278 patients (79.4%) who developed CVEs within the first week of hospitalisation. Sepsis patients with CVEs had a longer median (interquartile range [IQR]) length of stay in the ICU (6 [3-12] vs 4 [2-9] days, P<0.001), and hospital (21 [10-42] vs 15 [7-30] days, P<0.001) compared to sepsis patients without CVEs. There was no difference in in-hospital mortality between the 2 groups (46.9% vs 45.8%, P=0.792). CONCLUSION CVEs complicate half of the critically ill patients with sepsis, with 79.4% of patients developing CVEs within the first week of hospitalisation, resulting in longer ICU and hospital length of stay.
Cardiovascular Diseases/epidemiology* ; Critical Illness/epidemiology* ; Hospital Mortality ; Humans ; Intensive Care Units ; Length of Stay ; Retrospective Studies ; Risk Factors ; Sepsis/epidemiology*

OBJECTIVETo assess the value of preoperative serum albumin level in predicting the survival of patients with non-muscle-invasive bladder cancer (NMIBC) undergoing transurethral resection of bladder tumor (TURBT).

METHODSTwo hundred and sixteen newly diagnosed patients with NMIBC who underwent TURBT between January, 2007 and April, 2012 were retrospectively analyzed. The patients were categorized into low albumin (<40 g/L) and normal albumin (≥40 g/L) groups. The patient survival was estimated using the Kaplan-Meier method, and univariate and multivariate Cox proportional analyses were used to determine the hazard ratios (HRs) for the overall survival (OS).

RESULTSOf the patients with available data, 82 (39%) and 127 (61%) patients were classified into low albumin (<40 g/L) and normal albumin (≥40 g/L) groups, respectively. Kaplan-Meier analysis showed a significantly worse 5-year OS in low albumin group than in normal albumin group (P=0.017). In the multivariate Cox regression analysis, after adjusting for confounding variables, the preoperative albumin level remained as an independent predictor for 5-year OS (HR: 3.102, 95%CI: 1.200-8.020, P=0.020).

CONCLUSIONA low preoperative albumin level predicts a poor 5-year OS in patients with NMIBC who underwent TURBT. Preoperative serum albumin can be a good prognostic factor for predicting survival of the patients with NMIBC treated with TURBT.

Objective To compare the platelet-leukocyte-aggregates (PLAs)level among patients with acute coronary syndrome (ACS) and stable angina pectoris (SAP).Methods Hospitalized patients were divided into three groups [ ACS group ( n =86 ),SAP group ( n =54 ),the control group with 46patients without coronary artery disease ].PLAs were measured by flow cytometry at admission before coronary angiography.ACS patients were further divided into low-risk group (0 - 108 points) and high-risk group ( ＞ 109 points ) according to GRACE scores at admission.PLA,platelet-monocyte aggregations ( PMA),platelet-neutrophile aggregations ( PNA ),platelet-lymphocyte aggregations ( PlyA ) and hs-CRP values were compared among groups.Results PLA (4.40％ ± 3.08％ ),PMA (33.6％ ± 21.5％ ),PNA(3.76％ ±5.06％),PLyA (2.03％ ± 1.27％) and hs-CRP [5.75(3.49,9.15)] levels in ACS group were significantly higher than those in SAP and control groups ( all P ＜ 0.05 ).PLA was also significantly higher in high-risk group than in the low-risk group (44.8％ ± 18.0％ vs.13.0％ ± 6.3％,P ＜ 0.01 ).Spearman correlation analysis showed that hs-CRP was positively correlated with PMA ( r =0.547,P ＜0.01 ) and GRACE score is positively correlated with PMA,PLA,PNA and PlyA ( r =0.746,0.652,0.460,respectively,all P＜0.01).Conclusion PLAs is increased in ACS patients and higher PMA level is related with the unstable coronary syndrome in ACS patients.Increased PMA,PLA,PNA and PlyA levels is associated with higher GRACE score in ACS patients.