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Intravenous thrombolysis for acute ischemic stroke with extended time window

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Chinese Medical Journal 2021年第22期134卷 2666-2674页

作者： Xue Jia Wen Wang Bo Wu Xin Sun Chinese Evidence-based medicine Center West China School of MedicineWest China HospitalSichuan UniversityChengduSichuan 610041China Department of Postgraduate West China School of MedicineWest China HospitalSichuan UniversityChengduSichuan 610041China Department of Neurology West China School of MedicineWest China HospitalSichuan UniversityChengduSichuan 610041China.

Background:Intravenous thrombolysis(IVT)is an effective way for treating acute ischemic stroke(AIS).However,its effects have not been established among AIS patients with unclear stroke symptoms or with stroke onset for>4.5 h.Methods:We searched PubMed,Embase,Web of Science,Cochrane Central Register of Controlled Trials and Google Scholar databases for randomized controlled trials that compared IVT(IVT group)and placebo or usual care(control group[CG])in AIS patients with disease onset for>4.5 h.The outcomes of interest included the favorable functional outcome(defined as modified Rankin Scale[mRS]scores 0–1)at 90 days,the functional independence(defined as mRS scores 0–2)at 90 days,proportion of patients with symptomatic intracerebral hemorrhage(sICH)and death at 90 days.We assessed the risk of bias using the Cochrane tool.Pre-specified subgroup analyses were performed by age(70 years or>70 years),National Institute of Health Stroke Scale(NIHSS,10 or>10)and time window(4.5–9.0 h or>9.0 h).Results:Four trials involving 848 patients were eligible.The risk of bias of included trials was low.Patients in the IVT group were more likely to achieve favorable functional outcomes(45.8%vs.36.7%;OR 1.48,95%CI 1.12–1.96)and functional independence(63.8%vs.55.7%;OR 1.43,95%CI 1.08–1.90)at 90 days,but had higher risk of sICH(3.0%vs.0.5%;OR 5.28,95%CI 1.35–20.68)at 90 days than those in the CG.No significant difference in death at 90 days was found between the two groups(7.0%vs.4.1%;OR 1.80;95%CI 0.97–3.34).Conclusions:Use of IVT in patients with extended time window may improve their functional outcomes at 90 days,although IVT may induce increased risk of sICH.Care of these patients should well balance the potential benefits and harms of IVT.

关键词： Intravenous thrombolysis Acute ischemic stroke Time window Meta-analysis

Delineating asthma according to inflammation phenotypes with a focus on paucigranulocytic asthma

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Chinese Medical Journal 2023年第13期136卷 1513-1522页

作者： Yinhe Feng Xiaoyin Liu Yubin Wang Rao Du Hui Mao Department of Respiratory and Critical Care medicine West China HospitalSichuan UniversityChengduSichuan 610041China west china Hospital West China Medical SchoolSichuan UniversityChengduSichuan 610041China

Asthma is characterized by chronic airway inflammation and airway hyper-responsiveness.However,the differences in pathophysiology and phenotypic symptomology make a diagnosis of"asthma"too broad hindering individualized treatment.Four asthmatic inflammatory phenotypes have been identified based on inflammatory cell profiles in sputum:eosinophilic,neutrophilic,paucigranulocytic,and mixed-granulocytic.Paucigranulocytic asthma may be one of the most common phenotypes in stable asthmatic patients,yet it remains much less studied than the other inflammatory phenotypes.Understanding of paucigranulocytic asthma in terms of phenotypic discrimination,distribution,stability,surrogate biomarkers,underlying pathophysiology,clinical characteristics,and current therapies is fragmented,which impedes clinical management of patients.This review brings together existing knowledge and ongoing research about asthma phenotypes,with a focus on paucigranulocytic asthma,in order to present a comprehensive picture that may clarify specific inflammatory phenotypes and thus improve clinical diagnoses and disease management.

关键词： Asthma Inflammatory phenotype Paucigranulocytic asthma

Fas-670 A/G polymorphism predicts prognosis of hepatocellular carcinoma after curative resection in Chinese Han population

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Hepatobiliary & Pancreatic Diseases International 2022年第1期21卷 33-40页

作者： Xin-Yi Guo Yi-Lin Xia Zhi-Yang Li Ran Li Yang Fan Wen-Mo Yao Fei Liu West China School of Medicine West China HospitalSichuan UniversityChengdu 610041China Department of Liver Surgery&Liver Transplantation Center West China HospitalSichuan UniversityChengdu 610041China

Background:Apoptosis,also called programmed cell death,is a genetically controlled process against hyperproliferation and malignancy.The Fas-Fas ligand(FasL)system is considered a major pathway for apoptosis in cells and tissues.Thus,this study aimed to investigate whether single nucleotide polymor-phisms(SNPs)in Fas and FasL gene may have effects on the recurrence and survival of patients with hepatocellular carcinoma(HCC)after curative hepatectomy.Methods:We investigated the relationship between Fas rs1800682,rs2234767 and FasL rs763110 poly-morphisms and recurrence-free survival(RFS)as well as overall survival(OS)in 117 Chinese Han patients with HCC who underwent hepatectomy.Results:In Kaplan-Meier survival analysis,only Fas rs1800682(-670 A/G)was associated with RFS and OS.Compared with AA genotype,the AG/GG genotype was significantly associated with better RFS(P=0.008)and OS(P=0.020).Moreover,multivariate Cox regression analysis showed that Fas rs1800682 remained as a significant independent predictor of RFS for HCC patients with hepatectomy[AG/GG vs.AA:adjusted hazard ratio=0.464,95%confidence interval:0.275-0.782,P=0.004],but was not an independent predictor of OS(P=0.395).Conclusions:This study demonstrated that Fas-670 G allele may play a protective role in the recurrence and survival of HCC patients with hepatectomy.Furthermore,Fas rs1800682 polymorphism might be a promising biomarker for HCC patients after hepatectomy.

关键词： Hepatocellular carcinoma Single nucleotide polymorphism Cell apoptosis Prognosis Resection

Genetic diversity and phylogenetic analysis of Chinese Han and Li ethnic populations from Hainan Island by 30 autosomal insertion/deletion polymorphisms

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Forensic Sciences Research 2022年第2期7卷 189-195页

作者： Jing Liu Ziwei Ye Zheng Wang Xing Zou Guanglin He Mengge Wang Shouyu Wang Yiping Hou Institute of Forensic medicine West China School of Basic Medical Sciences&Forensic MedicineSichuan UniversityChengduChina

With the characteristics of low mutation rate,length variation and short amplicon size,insertion/deletion polymorphisms(InDels)have the advantages of both short tandem repeats(STRs)and single nucleotide polymorphisms(SNPs).Herein,people of two ethnicities from Hainan Island were genotyped for the first time using the Investigator DIPplex kit.We investigated the forensic parameters of the 30 InDels and the phylogenetic relationships among different populations.The accumulated powers of discrimination and powers of exclusion were 0.9999999999646 and 0.9897 in the Hainan Han population and 0.9999999999292 and 0.9861 in the Hainan Li population,respectively.Additionally,population comparisons among geographically,ethnically and linguistically diverse populations via cluster heatmap,multidimensional scaling,principal component analysis,phylogenetic tree and STRUCTURE analyses demonstrated that the Hainan Han population had genetic similarities to the other Han,She and Tujia populations,while the Hainan Li population had close genetic relationships to the Zhuang and Miao groups;both populations had a high degree of genetic differentiation from most Turkic-speaking populations.Aforementioned results suggested that the 30 autosomal InDels are highly polymorphic and informative,which are suitable for human identification and population genetics.

关键词： Forensic sciences forensic genetics InDels Investigator DIPplex kit Hainan Han Hainan Li

Clinical characteristics and in-hospital outcomes of patients receiving contemporary intensive cardiac care:retrospective study from a large centre in china

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Journal of Geriatric Cardiology 2021年第2期18卷 94-103页

作者： Fei CHEN Yi-Ming LI Qi LIU Bao-Tao HUANG Fang-Yang HUANG Yong PENG Mao CHEN Department of Cardiology West China HospitalSichuan UniversityChengduChina West China School of Medicine Sichuan UniversityChengduChina

BACKGROUND Few studies from developed countries have quantitatively characterized the clinical characteristics and outcomes of patients receiving contemporary intensive cardiac care.We sought to investigate these data in patients admitted to a Chinese intensive cardiac care unit(ICCU).METHODS We conducted a retrospective study using data from 2,337 consecutive admissions to the ICCU at a large centre in china from June 2016 to May 2017.Data were captured after systematic inspection of individual medical records regarding current demographics,primary diagnosis,comorbidities,illnesses severity,and in-hospital outcomes.RESULTS The mean age was 65.6±14.2 years,and females accounted for 32.0%of patients.The Charlson Comorbidity Index and Oxford Acute Severity of Illness Score were 2.4±1.8 and 22.5±10.4,respectively.The top reason for admission was ST-segment elevation myocardial infarction(32.0%),and nonischaemic heart diseases accounted for 31.2%of all primary diagnoses.Noncardiovascular diseases were prevalent in the ICCU population,including chronic illnesses and acute noncardiovascular critical illnesses(ANCIs);in particular,21.7%of patients were marked by acute respiratory failure(14.6%),acute kidney injury(13.7%),sepsis(4.2%),or gastrointestinal bleeding(3.3%).The median length of stay in the ICCU and hospital were 1.1 days[interquartile range(IQR):0.8–2.6 days]and 6.3 days(IQR:3.8−10.9 days),respectively.The overall incidence of in-hospital death or discharge against medical advice under extremely critical conditions was 7.6%(n=177).Multivariate logistic regression analysis showed that the complexity of chronic illnesses and incident ANCIs were strong independent determinants for in-hospital outcomes.CONCLUSIONS Remarkable patient diversity and breadth of critical illnesses were observed in a Chinese ICCU population.Particularly,noncardiovascular diseases were prevalent and associated with adverse outcomes.Reformation of organization and staffing practices may be considered to adapt to the changed landscape.

关键词： patients admitted centre

Population genetics and forensic efficiency of 30 InDel markers in four Chinese ethnic groups residing in Sichuan

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Forensic Sciences Research 2022年第3期7卷 498-502页

作者： Fei Wang Guanglin He Zheng Wang Mengge Wang Jing Liu Xing Zou Shouyu Wang Mengyuan Song Ziwei Ye Mingkun Xie Yiping Hou Institute of Forensic medicine West China School of Basic Medical Sciences&Forensic MedicineSichuan UniversityChengduChina

Sichuan Province is located at the transitional junction regions of the Qinghai-Tibet Plateau and the low-altitude plains.It also serves as the corridor of Sino Tibetan-speaking population migration and expansion since neolithic expansion of Proto-Tibeto-Burman populations from Middle/Upper Yellow River during Majiayao period(3300-2000 BC).However,the population structure and the corresponding genetic diversity of forensic-related markers in this region remain unclear.Thus,we genotyped 30 insertion-deletion(InDel)markers in 444 samples from four ethnic groups(Han,Tibetan,Hui and Yi)from Sichuan Province using the Investigator■ DIPplex kit to explore the characteristics of population genetics and forensic genetic focuses.All the loci were found to be in Hardy-Weinberg Equlibrium(HWE)after applying a Bonferroni correction and no pairwise loci showed prominent linkage disequilibrium.The combined matching probability(CMP)and the combined power of discrimination(CPD)are larger than 1.8089×10^(11)and 0.9999999995,respectively.Principal component analysis,multi-dimen-sional scaling plots and Neighbour-Joining tree among 65 worldwide populations indicated that Sichuan Hui and Han are genetically close to Hmong-Mien and Tai-Kadai-speaking popula-tions,and Sichuan Tibetan and Yi bear a strong genetic affinity with Tibeto-Burman-speaking populations.The model-based genetic structure further supports the genetic affinity between the studied populations and linguistically close populations.

关键词： Forensic sciences InDel population genetics Sichuan Han Sichuan Yi Sichuan Tibetan Sichuan Hui

Farnesoid X receptor regulators from natural products and their biological function

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Journal of Traditional Chinese medicine 2023年第3期43卷 618-626页

作者： PENG Wan NI Hengfan GUO Dale DENG Yun DAI Manyun Institute of Rare Diseases West China HospitalSichuan UniversityChengdu 610065China Department of Pharmacy West China HospitalSichuan UniversityChengdu 610041China school of Pharmacy Chengdu University of Traditional Chinese MedicineState Key Laboratory of Southwestern Chinese Medicine ResourcesChengdu 611137China school of medicine Ningbo UniversityNingbo 315000China

Metabolic syndrome(Met S)has been a growing public health concern worldwide without specific medicine.Through summarizing the chemical structure type and effect mechanisms of natural products targeted on farnesoid X receptor(FXR),to provide the research basis for exploring the treatment of Met S.The following databases were searched for natural products which targeting FXR:Pub Med,Embase,the Cochrane Library,Web of Science,china National Knowledge Infrastructure Database,Wanfang Database,china Science and Technology Journal Database,and Chinese Biomedical Literature Database.Totally 120 natural products were summarized,including terpenoids(51 compounds),steroidal saponins(27 compounds),phenylpropanolds(19 compounds),flavonoids(13 compounds),alkaloids(3 compounds)and others(7 compounds),most researches focus on terpenoids and part of synthetic FXR regulators were based on the structure of terpenoids.FXR regulators could improve cholestasis and liver injury,hyperlipidemia,diabetes and atherosclerosis.FXR is a potential target of treating Met S.Natural products are characteristics with unique novel structures and special biological activity,and they are important sources of bioactive precursor compounds and drug discovery.Exploring the effects and mechanism of natural products and its derivative on Met S by targeting FXR may be a new way to develop the new drugs of treating Met S.

关键词： farnesoid X receptor metabolic syndrome biological products molecular docking simulation biological activity

Enhanced recovery after surgery in transurethral surgery for benign prostatic hyperplasia

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Asian Journal of Andrology 2023年第3期25卷 356-360页

作者： Jing Zhou Zhu-Feng Peng Pan Song Lu-Chen Yang Zheng-Huan Liu Shuai-Ke Shi Lin-Chun Wang Jun-Hao Chen Liang-Ren Liu Qiang Dong Department of Urology/Institute of Urology West China HospitalSichuan UniversityChengdu 610041China West China School of Medicine Sichuan UniversityChengdu 610000ChinaJing ZhouThese author

Enhanced recovery after surgery(ERAS)measures have not been systematically applied in transurethral surgery for benign prostatic hyperplasia(BPH).This study was performed on patients with BPH who required surgical intervention.From July 2019 to June 2020,the ERAS program was applied to 248 patients,and the conventional program was applied to 238 patients.After 1 year of follow-up,the differences between the ERAS group and the conventional group were evaluated.The ERAS group had a shorter time of urinary catheterization compared with the conventional group(mean±standard deviation[s.d.]:1.0±0.4 days vs 2.7±0.8 days,P<0.01),and the pain(mean±s.d.)was significantly reduced through postoperative hospitalization days(PODs)0-2(POD 0:1.7±0.8 vs 2.4±1.0,P<0.01;POD 1:1.6±0.9 vs 3.5±1.3,P<0.01;POD 2:1.2±0.7 vs 3.0±1.3,P<0.01).No statistically significant difference was found in the rate of postoperative complications,such as postoperative bleeding(P=0.79),urinary retention(P=0.40),fever(P=0.55),and readmission(P=0.71).The hospitalization cost of the ERAS group was similar to that of the conventional group(mean±s.d.:16927.8±5808.1 Chinese Yuan[CNY]vs 17044.1±5830.7 CNY,P=0.85).The International Prostate Symptom Scores(IPSS)and quality of life(QoL)scores in the two groups were also similar when compared at 1 month,3 months,6 months,and 12 months after discharge.The ERAS program we conducted was safe,repeatable,and efficient.In conclusion,patients undergoing the ERAS program experienced less postoperative stress than those undergoing the conventional program.

关键词： aging male benign prostatic hyperplasia enhanced recovery after surgery prostate transurethral surgery

Hypoxia-induced reactive oxygen species in organ and tissue fibrosis

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BIOCELL 2023年第2期47卷 261-267页

作者： LINSHEN XIE QIAOLAN WANG JINGXUAN MA YE ZENG west china school of Public Health and west china Fourth Hospital Sichuan UniversityChengdu610041China Institute of Biomedical Engineering West China School of Basic Medical Sciences and Forensic MedicineSichuan UniversityChengdu610041China

Fibrosis is the end-stage change of damaged tissues in various human diseases,which can lead to permanent scarring or organ malfunction.Hypoxia leads to oxidative stress,mitochondrial dysfunction,and inflammation in dysfunctional organs and tissues.Oxidative stress resulting from the overproduction of reactive oxygen species plays a central role in the fibrosis of injured organs.This review addresses the updated knowledge of the relationship between hypoxia and tissue fibrosis mediated by the reactive oxygen species pathway.Moreover,novel anti-fibrotic strategies are discussed,which may suppress reactive oxygen species and organ fibrosis.

关键词： Fibrosis Oxidative stress Hypoxia