No abstract

Marital status has been demonstrated to be related to the survival of patients in various cancer types, but the relationship in the large population of non-small cell lung cancer (NSCLC) has rarely been studied. In this study, we retrospectively extracted 70006 eligible NSCLC patients from the Surveillance, Epidemiology, and End Results (SEER) database in the period from 2004 to 2012. Marital status was categorized as married, divorced/separated, widowed, and never married. Chi-square tests were used to investigate the association between marital status and other variables. The Kaplan-Meier test was adopted to compare survival curves of different groups. Multivariate Cox regression analyses were conducted to estimate the effect of marital status on overall survival (OS) and NSCLC cause-specific survival (CSS). We further performed subgroup analyses according to TNM stage and surgery condition. The results showed that marital status was an independent prognostic factor for OS and CSS of NSCLC patients. Subgroup analyses showed that the relationship between marital status and prognosis varies according to different conditions. Widowed patients with surgery were at greater risk of death across all stages and non-surgical unmarried patients at advanced stages suffered poorer prognosis than the married. To conclude, in the NSCLC patients, married patients had advantage over the unmarried in both OS and CSS.

Neuropathic pain remains a prevalent and persistent clinical problem because it is often poorly responsive to the currently used analgesics. It is very urgent to develop novel drugs to alleviate neuropathic pain. Galectin-3 (gal3) is a multifunctional protein belonging to the carbohydrate-ligand lectin family, which is expressed by different cells. Emerging studies showed that gal3 elicits a pro-inflammatory response by recruiting and activating lymphocytes, macrophages and microglia. In the study we investigated whether gal3 inhibition could suppress neuroinflammation and alleviate neuropathic pain following peripheral nerve injury. We found that L5 spinal nerve ligation (SNL) increases the expression of gal3 in dorsal root ganglions at the mRNA and protein level. Intrathecal administration of modified citrus pectin (MCP), a gal3 inhibitor, reduces gal3 expression in dorsal root ganglions. MCP treatment also inhibits SNL-induced gal3 expression in primary rat microglia. SNL results in an increased activation of autophagy that contributes to microglial activation and subsequent inflammatory response. Intrathecal administration of MCP significantly suppresses SNL-induced autophagy activation. MCP also inhibits lipopolysaccharide (LPS)-induced autophagy in cultured microglia in vitro. MCP further decreases LPS-induced expression of proinflammatory mediators including IL-1β, TNF-α and IL-6 by regulating autophagy. Intrathecal administration of MCP results in adecreased mechanical and cold hypersensitivity following SNL. These results demonstrated that gal3 inhibition is associated with the suppression of SNL-induced inflammatory process andneurophathic pain attenuation.

The in-hospital mortality of severe pulmonary hypertension (PH) with right heart failure (RHF) is high despite the use of vasoactive and PH-specific therapies. We conducted a prospective analysis evaluating the safety and outcomes of fasudil hydrochloride (Chuan Wei) therapy in acute RHF. PH patients hospitalized between April 2009 and November 2010 were treated with 30 mg of i.v. fasudil three times daily over 30 min, until they experienced relief of RHF symptoms. Adverse and serious adverse events were recorded. Odds ratios (ORs) and 95% confidence intervals were calculated for both in-hospital mortality and re-hospitalization. Multivariate adjustments were made for age, gender and World Health Organization functional class. There were no significant differences between the fasudil group and the control group in demographics, hemodynamics, and PH-specific and vasoactive therapies. Of the 209 study patients, 3 of the 74 patients (4.1%) in the fasudil arm died, and 19 of the 135 patients (14.1%) in the control arm died (P=0.005). Fasudil decreased both in-hospital mortality (OR=0.258 (0.074-0.903); P=0.034) and 30-day re-hospitalization (OR=0.200 (0.059-0.681); P=0.010). Fasudil was well tolerated; one patient discontinued treatment. Intravenous fasudil may be given safely in patients with PH and acute RHF, and may reduce the rates of both in-hospital mortality and 30-day re-hospitalization.

We aimed to summarize reliable medical evidence by the meta-analysis of all published clinical trials that investigated the safety, tolerability, and immunogenicity of vaccine candidates against coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The PubMed, Cochrane Library, EMBASE, and medRxiv databases were used to select the studies. 7094 articles were identified initially and 43 were retrieved for more detailed evaluation. 5 randomized, double-blind, placebo-controlled trials were selected. A total of 1604 subjects with either vaccines or placebo infections were included in the meta-analysis within the scope of these articles. According to the results, there is an increase in total adverse events for subjects with either low (95% CI: 1.90-4.29) or high (CI: 2.65-5.63) dose vaccination. The adverse effects of COVID-19 vaccine are mainly local ones including pain, itching, and redness, and no significant difference was identified in the systemic reactions. All adverse effects were transient and resolved within a few days. Moreover, the neutralizing and IgG antibody levels post different dose vaccinations were all significantly increased at day 14/21 (P = 0.0004 and P = 0.0003, respectively) and day 28/35 (P < 0.00001) in vaccine groups compared to placebo controls. Besides, the levels of neutralizing and IgG antibodies were also elevated significantly at from day 14 to 35, versus day 0 (All P < 0.001). In conclusion, our analysis suggests that the current COVID-19 vaccine candidates are safe, tolerated, and immunogenic, which provides important information for further development, evaluation, and clinical application of COVID-19 vaccine.

Objective. To compare ultrasound-guided miniscalpel-needle (UG-MSN) release versus ultrasound-guided dry needling (UG-DN) for chronic neck pain. Methods. A total of 169 patients with chronic neck pain were randomized to receive either UG-MSN release or UG-DN. Before treatment and at 3 and 6 months posttreatment, pain was measured using a 10-point visual analogue scale (VAS). Neck function was examined using the neck disability index. Health-related quality of life was examined using the physical component score (PCS) and mental component score (MCS) of the SF-36 health status scale. Results. Patients in the UG-MSN release had greater improvement on the VAS (by 2 points at 3 months and 0.9 points at 6 months) versus in the UG-DN arm; (both P < 0.0001). Patients receiving UG-MSN release also showed significantly lower scores on the adjusted neck disability index, as well as significantly lower PCS. No severe complications were observed. Conclusion. UG-MSN release was superior to UG-DN in reducing pain intensity and neck disability in patients with chronic neck pain and was not associated with severe complications. The procedural aspects in the two arms were identical; however, we did not verify the blinding success. As such, the results need to be interpreted with caution.

The present study was to analyze clinical outcome of Pauwels grade-3 femoral neck fractures treated by different surgical techniques. Potential risk factors associated with nonunion and osteonecrosis of the femoral head (ONFH) were investigated as well. The retrospective study comprised of 67 sequential patients treated between January 2008 and December 2011. Patients with Pauwels grade-3 femoral neck fractures were treated by operative reduction and internal fixation. Cannulated screws (CS) were used in 46 patients, dynamic hip screw plus CS (DHS+CS) in 14, and locking compression plate (LCP) for proximal femur in 7. Reduction quality was assessed according to Haidukewych criteria. Postoperative radiographic examinations were conducted to observe fracture healing. Fracture displacement, comminution, fashion of internal fixation, and the sliding effect were analyzed, regarding the incidence of nonunion and ONFH. All patients had a follow-up of 21.6 ± 6.0 months on average. The phenomenon of sliding effect was observed in 16 cases (23.9%). In terms of reduction quality, 64 cases were graded as excellent, 2 were good, and 1 was poor. ONFH was presented in 15 cases (22.4%) and nonunion was found in 8 (11.9%), with 1 patient had ONFH and nonunion concomitantly. Profound hip contour was preserved in 45 cases (67.2%). The fashion of internal fixation yielded different results regarding ONFH and nonunion, whereas the effects of fracture displacement, comminution, and the sliding effect were not significant. ONFH and nonunion were common complications following Pauwels grade-3 femoral neck fractures. Higher incidence of ONFH in DHS+CS and of nonunion in the LCP group should be noted.

Femoral head osteonecrosis (ON) is a serious complication of steroid administration. We examined whether implantation of autologous bone marrow-derived endothelial progenitor cells (EPCs) can augment neovascularization and bone regeneration in steroid-induced osteonecrosis of the femoral head. Forty 12-week-old male New-Zealand white rabbits were divided into group I (left untreated, n=12), group II (core decompression, n=12), and group III (core decompression + autologous EPCs implantation, n=16) after receiving an established inductive protocol for inducing steroid-associated ON. Four weeks later, these rabbits were euthanized, bilateral femora were dissected for Micro-CT-based microangiography to assess vascularization, and then the osteonecrotic changes and repair processes were examined histopathologically. Quantitative analysis showed that new vessel formation in group III was significantly greater compared with other groups at 4 weeks after treatment. The histologic and histomorphometric analyses revealed that the new bone volume was significantly higher in group III than in groups I and II 4 weeks after treatment. A combination of EPCs and core decompression enhances the neovascularization and bone regeneration in rabbit steroid-induced femoral head ON. Local implantation of EPCs may provide a novel and effective therapeutic option for early corticosteroid-induced ON.