Objective:To search for and screen evidence related to perioperative nutrition management in cardiac surgery patients and summarize the best available evidence.Methods:Computerized searches were conducted in BMJ Best Practice, UpToDate, Guidelines International Network, National Institute for Health and Care Excellence website, National Guideline Clearinghouse, Scottish Intercollegiate Guideline Network, Registered Nurses' Association of Ontario, Canadian Medical Association Clinical Practice Guidelines Library, Medlive, Joanna Briggs Institute (JBI) Evidence-Based Health Care Centre Database, Cochrane Library, American College of Physicians Journal Club, PubMed, Web of Science, Embase, China National Knowledge Infrastructure, China Biology Medicine disc, Wanfang Data, VIP and other database and professional association websites for literature related to perioperative nutrition management in cardiac surgery patients. The search time limit is from the establishment of the database to April 30, 2024. Two researchers independently screened the literature based on quality standards, performed quality assessments, and extracted and synthesized the evidence.Results:A total of 17 articles were included, including four clinical decisions, five guidelines, five expert consensuses, two systematic reviews, and one randomized controlled trial. The final best evidence was summarized into 35 key recommendations across eight areas: multidisciplinary team formation, nutritional assessment and monitoring, dietary management, caloric requirements, nutrient intake, preoperative nutritional support therapy, postoperative nutritional support therapy, and health education.Conclusions:The best evidence summarized in this study for perioperative nutrition management in cardiac surgery patients is scientifically rigorous and comprehensive. It provides evidence-based support and decision-making guidance for clinical healthcare providers in managing perioperative nutrition for cardiac surgery patients.

Objective:To search for and screen evidence related to perioperative nutrition management in cardiac surgery patients and summarize the best available evidence.Methods:Computerized searches were conducted in BMJ Best Practice, UpToDate, Guidelines International Network, National Institute for Health and Care Excellence website, National Guideline Clearinghouse, Scottish Intercollegiate Guideline Network, Registered Nurses' Association of Ontario, Canadian Medical Association Clinical Practice Guidelines Library, Medlive, Joanna Briggs Institute (JBI) Evidence-Based Health Care Centre Database, Cochrane Library, American College of Physicians Journal Club, PubMed, Web of Science, Embase, China National Knowledge Infrastructure, China Biology Medicine disc, Wanfang Data, VIP and other database and professional association websites for literature related to perioperative nutrition management in cardiac surgery patients. The search time limit is from the establishment of the database to April 30, 2024. Two researchers independently screened the literature based on quality standards, performed quality assessments, and extracted and synthesized the evidence.Results:A total of 17 articles were included, including four clinical decisions, five guidelines, five expert consensuses, two systematic reviews, and one randomized controlled trial. The final best evidence was summarized into 35 key recommendations across eight areas: multidisciplinary team formation, nutritional assessment and monitoring, dietary management, caloric requirements, nutrient intake, preoperative nutritional support therapy, postoperative nutritional support therapy, and health education.Conclusions:The best evidence summarized in this study for perioperative nutrition management in cardiac surgery patients is scientifically rigorous and comprehensive. It provides evidence-based support and decision-making guidance for clinical healthcare providers in managing perioperative nutrition for cardiac surgery patients.

Objective:To analyze the short-term clinical efficacy and safety of arsenic trioxide (ATO) combined with a modified N7 induction regimen in the treatment of children with high-risk neuroblastoma (NB).Methods:This study was a prospective, single-arm, multicenter phase Ⅱ clinical study. Sixty-seven high-risk NB children from eight units of Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Wuhan Children′s Hospital of Tongji Medical College of Huazhong University of Science and Technology, First Affiliated Hospital of Guangxi Medical University, Hainan General Hospital, Affiliated Hospital of Guangdong Medical University, Kunming Children′s Hospital, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, and Guangdong Provincial Agricultural Reclamation Center Hospital were enrolled from January 2019 to August 2023 and were treated with ATO combined with a modified N7 induction regimen. The efficacy and adverse effects at the end of induction chemotherapy were assessed and analyzed, and the differences in the clinical characteristics were further compared between the treatment-responsive and treatment-unresponsive groups by using the Fisher′s exact test.Results:Among 67 high-risk NB children, there were 40 males (60%) and 27 females (40%), with the age of disease onset of 3.5 (2.6, 4.8) years. Primary NB sites were mostly in retroperitoneum (including adrenal gland) (56/67, 84%) and the common metastases sites at initial diagnosis were distant lymph node in 25 cases (37%),bone in 48 cases (72%),bone marrow in 56 cases (84%) and intracalvarium in 3 cases (4%). MYCN gene amplification were detected in 28 cases (42%). At the end of induction, 33 cases (49%) achieved complete remission, 29 cases (43%) achieved partial remission, 1 case (1%) with stable disease, and 4 cases (6%) were assessed as progressive disease (PD). The objective remission rate was 93% (62/67) and the disease control rate was 94% (63/67). The percentage of central system metastases at the initial diagnosis was higher in the treatment-unresponsive group than in the treatment-responsive group (2/5 vs. 2% (1/62), P=0.013), whereas the difference in MYCN gene amplification was not statistically significant between two groups (3/5 vs.40% (25/62), P=0.786). Grade Ⅲ or higher adverse reactions during the induction chemotherapy period were myelosuppression occurred in 60 cases (90%), gastrointestinal symptoms occurred in 33 cases (49%), infections occurred in 20 cases (30%), hepatotoxicity occurred in 4 cases (6%), and cardiovascular toxicity occurred in 1 case (2%). There were no chemotherapy-related deaths. Conclusion:ATO combined with N7-modified induction regimen had a superiority in efficacy and safety, which deserved further promotion in clinical practice.

Objective:To explore whether cytoplasmic linker protein 170(CLIP170)affects papillary thyroid cancer(PTC)cell metastasis and invasion and clarify the underlying mechanisms.Methods:We analyzed CLIP170 expression levels in PTC using GEO and TCGA data and con-structed CLIP170 knockdown(CLIP170KD)cells using lentiviral transfection.Then,we evaluated their functions through Transwell transfer and invasion assays.We assessed how CLIP170 affected the cellular actin structure via immunofluorescence analysis.We detected transforming growth factor-β 1(TGF-β1)release in the cell culture medium using enzyme-linked immunosorbent assay(ELISA).We also assessed epithelial-mesenchymal transition(EMT)and TGF-β signaling pathway molecule expression using immunoblotting and reverse-transcription quantitat-ive fluorescence PCR and validated the results in a nude mouse lung metastasis model.Results:CLIP170 expression level in PTC was lower than that in normal thyroid tissue.Regarding the function,CLIP170KD significantly enhanced PTC cell metastasis both in vitro and in vivo.Re-garding the underlying mechanism,CLIP170KD triggered TGF-β pathway activation,subsequently promoted tumor cell migration and invasion.The inhibitor of TGF-β effectively inhibited TGF-β activation,and this inhibition significantly reversed the CLIP170KD-induced tumor metastasis.Conclusions:CLIP170 could be a promising therapeutic target to mitigate metastatic tendencies in PTC.

Objective To explore the effect of traditional Chinese medicine enema combined with acupoint massage on postoperative intestinal function recovery.Methods A total of 80 patients with abdominal surgery admitted to First Affiliated Hospital of Huzhou University from January 2022 to June 2023 were selected and divided into study group and control group according to random number table method,with 40 cases in each group.The control group was treated with conventional Western medicine,while the study group was treated with traditional Chinese medicine enema combined with acupoint massage on the basis of conventional Western medicine treatment.The therapeutic effect,postoperative recovery time,gastrointestinal hormone level,abdominal distension pain and gastrointestinal reaction score were compared between two groups.Results Postoperative bowel sound recovery time,first anal defecation time and full-flow diet recovery time in study group were significantly shorter than those in control group(P<0.05).At 5 days after surgery,the levels of motilin(MTL),gastrin(GAS)and gastric inhibitory peptide(GIP)in two groups were significantly higher than those in this group at 1 day after surgery(P<0.05).The levels of MTL,GAS and GIP in study group were significantly higher than those in control group(P<0.05).At 5 days after surgery,abdominal distension score and gastrointestinal reaction score in two groups were significantly lower than those in this group 1 day after surgery(P<0.05),and abdominal distension score and gastrointestinal reaction score in study group were significantly lower than those in control group(P<0.05).The total effective rate of study group was significantly higher than that of control group(χ2=3.914,P=0.048).Conclusion Traditional Chinese medicine enema combined with acupoint massage can effectively shorten the recovery time of intestinal function,improve the level of gastrointestinal hormone,relieve abdominal distension pain and gastrointestinal reaction after abdominal operation,and the effect is significant,worthy of clinical application.

Objective:To investigate the occurrence and risk factors of intravenous polymyxin B-associated acute kidney injury (AKI) in patients with severe infection.Methods:Electronic medical records of patients with severe infection treated with intravenous polymyxin B during hospitalization in the First Affiliated Hospital, Sun Yat-sen University from October 2017 to October 2020 were collected and analyzed retrospectively. Patients with polymyxin B-induced acute kidney injury were screened out. The occurrence time, clinical stage, and outcome of AKI were statistically analyzed, and the incidence of polymyxin B-induced AKI and the cumulative incidence of AKI on the 3rd, 6th, 12th, and 15th days of administration were calculated. Patients were divided into AKI and non-AKI groups according to whether polymyxin B-associated AKI occurred. The clinical characteristics in patients of the 2 groups were compared. The risk factors of AKI were analyzed by multivariate logistic regression, and the odds ratio ( OR) and 95% confidence interval ( CI) were calculated. Results:A total of 311 patients were entered in the analysis, including 237 males (76.2%) and 74 (23.8%) females, with a median age of 58 (46, 70) years. Fifty-two patients (16.7%) developed polymyxin B-associated AKI, and the time from medication to onset of AKI was (4±2) days, ranging from 2 to 13 days. The cumulative incidence (%) of AKI and its 95 %CI on the 3rd, 6th, 12th, and 15th days of polymyxin B administration were 9.1(3.0-19.4), 15.4(7.9-25.2), 21.5(12.8-31.6), and 21.5(12.8-31.6), respectively. After developing AKI, polymyxin B was discontinued in 17 of 52 patients (32.7%), and 7 of them were given continuous renal replacement therapy (CRRT). The other 35 patients (53.8%) needed to continue medication because of the infection condition, and 25 of them were given CRRT and 10 received diuretics additionally. After the above treatments, 22 (42.3%) of 52 patients had Scr returning to normal, 6 patients (11.5%) were improved, 15 (28.9%) died due to primary diseases, and 9 (17.3%) were discharged under their own request. Multivariate logistic regression analysis showed that daily dose ≥150.0 mg ( OR=5.588, 95 %CI: 2.258-13.833, P<0.001) and high acute physiology and chronic health evaluation Ⅱ (APACHE-Ⅱ) score ( OR=1.063, 95 %CI: 1.021-1.106, P=0.003) were independent risk factors for polymyxin B-associated AKI. Conclusions:AKI may occur in a short time in patients with severe infection after intravenous administration of polymyxin B. The daily dose of polymyxin B ≥150.0 mg and high APACHE-Ⅱscore may increase the risk of AKI.

Objective:To investigate the occurrence and risk factors of intravenous polymyxin B-associated acute kidney injury (AKI) in patients with severe infection.Methods:Electronic medical records of patients with severe infection treated with intravenous polymyxin B during hospitalization in the First Affiliated Hospital, Sun Yat-sen University from October 2017 to October 2020 were collected and analyzed retrospectively. Patients with polymyxin B-induced acute kidney injury were screened out. The occurrence time, clinical stage, and outcome of AKI were statistically analyzed, and the incidence of polymyxin B-induced AKI and the cumulative incidence of AKI on the 3rd, 6th, 12th, and 15th days of administration were calculated. Patients were divided into AKI and non-AKI groups according to whether polymyxin B-associated AKI occurred. The clinical characteristics in patients of the 2 groups were compared. The risk factors of AKI were analyzed by multivariate logistic regression, and the odds ratio ( OR) and 95% confidence interval ( CI) were calculated. Results:A total of 311 patients were entered in the analysis, including 237 males (76.2%) and 74 (23.8%) females, with a median age of 58 (46, 70) years. Fifty-two patients (16.7%) developed polymyxin B-associated AKI, and the time from medication to onset of AKI was (4±2) days, ranging from 2 to 13 days. The cumulative incidence (%) of AKI and its 95 %CI on the 3rd, 6th, 12th, and 15th days of polymyxin B administration were 9.1(3.0-19.4), 15.4(7.9-25.2), 21.5(12.8-31.6), and 21.5(12.8-31.6), respectively. After developing AKI, polymyxin B was discontinued in 17 of 52 patients (32.7%), and 7 of them were given continuous renal replacement therapy (CRRT). The other 35 patients (53.8%) needed to continue medication because of the infection condition, and 25 of them were given CRRT and 10 received diuretics additionally. After the above treatments, 22 (42.3%) of 52 patients had Scr returning to normal, 6 patients (11.5%) were improved, 15 (28.9%) died due to primary diseases, and 9 (17.3%) were discharged under their own request. Multivariate logistic regression analysis showed that daily dose ≥150.0 mg ( OR=5.588, 95 %CI: 2.258-13.833, P<0.001) and high acute physiology and chronic health evaluation Ⅱ (APACHE-Ⅱ) score ( OR=1.063, 95 %CI: 1.021-1.106, P=0.003) were independent risk factors for polymyxin B-associated AKI. Conclusions:AKI may occur in a short time in patients with severe infection after intravenous administration of polymyxin B. The daily dose of polymyxin B ≥150.0 mg and high APACHE-Ⅱscore may increase the risk of AKI.

Objective:To explore the risk signals of edoxaban-related adverse reactions and provide reference for the clinical safety of edoxaban.Method:The US FDA adverse Event Reporting System database was searched and the adverse event (AE) reports on edoxaban as the suspicious drug from the second quarter of 2011 to the first quarter of 2022 were collected. An AE with reports>3, 95% confidence interval ( CI) lower limit of ROR>1, PRR>2, and χ2>4 was defined as a positive signal. AEs were counted and classified using the preferred term (PT) and system organ class of Medical Dictionary for Regulatory Activities 25.0. The PTs of top 50 in AE report amount and signal intensity were selected and analyzed. Results:A total of 4 113 AE reports on edoxaban as the suspicious drug were collected and 996 PTs were involved. After calculation using ROR and PRR methods, 158 positive risk signals were obtained, involving 1 898 AE reports. PTs of the top 50 in AE report amount and signal intensity were merged 89 PTs were selected after screening out duplicates, involving 1 468 AE reports. The top 5 PTs in report amount were dyspnea, anemia, atrial fibrillation, melena, and cardiac failure; the top 5 PTs in signal intensity were angiodysplasia, urogenital haemorrhage, cardiac amyloidosis, chorea, and ischaemic cerebral infarction/cardioactive drug level increased. Fourty-five PTs were not included in the drug labels. Of them, acute renal injury, renal impairment, and interstitial lung disease were with more AE reports and stronger signals. Conclusions:Bleeding-related events are still the key AEs that need to be monitored during the use of edoxaban. Edoxaban may also lead to renal injury and interstitial lung disease, which requires special attention.

Objective:To explore the risk signals of edoxaban-related adverse reactions and provide reference for the clinical safety of edoxaban.Method:The US FDA adverse Event Reporting System database was searched and the adverse event (AE) reports on edoxaban as the suspicious drug from the second quarter of 2011 to the first quarter of 2022 were collected. An AE with reports>3, 95% confidence interval ( CI) lower limit of ROR>1, PRR>2, and χ2>4 was defined as a positive signal. AEs were counted and classified using the preferred term (PT) and system organ class of Medical Dictionary for Regulatory Activities 25.0. The PTs of top 50 in AE report amount and signal intensity were selected and analyzed. Results:A total of 4 113 AE reports on edoxaban as the suspicious drug were collected and 996 PTs were involved. After calculation using ROR and PRR methods, 158 positive risk signals were obtained, involving 1 898 AE reports. PTs of the top 50 in AE report amount and signal intensity were merged 89 PTs were selected after screening out duplicates, involving 1 468 AE reports. The top 5 PTs in report amount were dyspnea, anemia, atrial fibrillation, melena, and cardiac failure; the top 5 PTs in signal intensity were angiodysplasia, urogenital haemorrhage, cardiac amyloidosis, chorea, and ischaemic cerebral infarction/cardioactive drug level increased. Fourty-five PTs were not included in the drug labels. Of them, acute renal injury, renal impairment, and interstitial lung disease were with more AE reports and stronger signals. Conclusions:Bleeding-related events are still the key AEs that need to be monitored during the use of edoxaban. Edoxaban may also lead to renal injury and interstitial lung disease, which requires special attention.

OBJECTIVE: To explore the pathogenesis of gastric cancer through a bioinformatic approach to provide evidence for the prevention and treatment of gastric cancer. METHODS: The differentially expressed genes (DEGs) in gastric cancer and normal gastric mucosa in GSE79973 dataset were analyzed using GEO2R online tool. GO analysis and KEGG pathway enrichment analysis of the DEGs in DAVID database were performed. The protein interaction network was constructed using STRING database, and the key genes (Hub genes) were screened and their functional modules were analyzed using Cytoscape software. The GEPIA database was used to validate the Hub genes, and the Target Scan database was used to predict the microRNAs that regulate the target genes; OncomiR was used to analyze the expressions of the microRNAs in gastric cancer tissues and their relationship with the survival outcomes of the patients. RESULTS: A total of 181 DEGs were identified in gastric cancer, and 10 hub genes were screened by the protein- protein interaction network. Functional analysis showed that these DEGs were involved mainly in protein digestion and absorption, PI3K-Akt signaling pathway, ECM-receptor interaction and platelet activation signal pathway. GEPIA database validation showed that COL1A1 was highly expressed in gastric cancer tissues and was associated with a poor prognosis of patients with gastric cancer. MiR-129-5p was found to bind to the 3'UTR of COL1A1 mRNA, and compared with that in normal tissues, miR-129-5p expression was obviously down-regulated in gastric cancer tissues, and was correlated with the prognosis of the patients. CONCLUSIONS COL1A1 under regulation by MiR-129-5p is a potential therapeutic target for gastric cancer.
Collagen Type I ; drug effects ; Computational Biology ; Gene Expression Profiling ; Gene Expression Regulation, Neoplastic ; Humans ; MicroRNAs ; therapeutic use ; Phosphatidylinositol 3-Kinases ; Stomach Neoplasms ; drug therapy