Aging is a major risk factor for prostate cancer （PCa）, and prostatic stromal cells may also promote PCa progression. Accordingly, stromal cells do not equally promote PCa in older males and younger males. Therefore...Aging is a major risk factor for prostate cancer （PCa）, and prostatic stromal cells may also promote PCa progression. Accordingly, stromal cells do not equally promote PCa in older males and younger males. Therefore, it is also possible that the expression of androgen receptors （ARs） by prostatic stromal cells in older versus younger males plays different roles in PCa progression. Using a gene knockdown technique and coculture system, we found that the knockdown of the AR in prostatic stromal cells obtained from younger males could promote the invasiveness and metastasis of cocultured PC3/LNCaP cells in vitro. By contrast, the invasiveness and metastasis of LNCaP cells was inhibited when cocultured with prostatic stromal cells from older males that when AR expression was knocked down. Moreover, after targeting AR expression with small hairpin RNA （shRNA）, matrix metalloproteinase （MMP） expression in stromal cells was observed to increase in the younger group, but decreased or remained unchanged in the older group. One exception, however, was observed with MMP9. In vivo, after knocking down AR expression in prostatic stromal cells, the incidence of metastatic lymph nodes was observed to increase in the younger age group, but decreased in the older age group. Together, these data suggest that the AR in prostatic stromal cells played opposite roles in PCa metastasis for older versus younger males. Therefore, collectively, the function of the AR in prostatic stromal cells appears to change with age, and this may account for the increased incidence of PCa in older males.展开更多
We investigated the usage of secondary prevention drugs and traditional Chinese medicine （TCM） products in individuals with cardiovascular diseases （CVDs） at the community level in China. Among 2,407 participants ...We investigated the usage of secondary prevention drugs and traditional Chinese medicine （TCM） products in individuals with cardiovascular diseases （CVDs） at the community level in China. Among 2,407 participants with self-reported coronary heart disease （CHD） and 872 with stroke, nearly 80% of individuals with CHD and 73% of individuals with stroke were not taking any proven secondary prevention drug. However, 32.9% of them took TCM products. Patients with CVDs in rural areas used less secondary prevention treatment, but more TCM products than their counterparts in the urban regions. After adjusting for confounding factors, lower rates of secondary prevention treatment were evident in Western China compared with Eastern China, which was more developed. Systematic change is needed to promote the development of evidence-based medicine at the community level in China.展开更多
Background Previous studies indicated that the time to positivity （TTP） of blood culture is a parameter correlating with degree of the bacteremia and outcome in patients with bloodstream infections caused by Escheri...Background Previous studies indicated that the time to positivity （TTP） of blood culture is a parameter correlating with degree of the bacteremia and outcome in patients with bloodstream infections caused by Escherichia coli （E.co/i）. The objective of this study was to further investigate the diagnostic and prognostic power of using TTP to predict E. coli bacteremia.Methods A retrospective cohort study at two university hospitals was conducted. We retrieved all the medical records of those with E. coli bloodstream infection according to the records generated by their microbiology departments.Univariate and multivariate analyses were applied to identify clinical factors correlating with fast bacterial growth and significant prognostic factors for hospital mortality.Results Medical records of 353 episodes of E. coli bacteremia diagnosed between January 1,2007 and December 31,2009 were retrieved in the investigation. Univariate analysis demonstrated that the TTP≤7 hours group is associated with higher incidence of active malignancies （41.7% vs. 27.2%, P=0.010）, neutropenia （30% vs.14.3%, P=0.007）, primary bacteremia （55.0% vs. 33.4%, P=0.002）, and poorer outcome （hospital mortality 43.3% vs.11.9%, P=0.000） than the TTP 〉7 hours group. Multivariate analysis revealed that the significant predictors of hospital mortality, in rank order from high to low, were TTP （for TTP 〈7 hours, odds ratio （OR）： 4.886; 95% confidence interval （CI）： 2.572-9.283; P=0.000）,neutropenia （OR： 2.800; 95% CI：1.428-5.490; P=0.003）, comedication of steroids or immunosuppressive agents （OR：2.670; 95% CI： 0.971-7.342; P=0.057）.Conclusions Incidence of malignancies, neutropenia and primary bacterernia correlates with fast bacterial growth in patients with E. coli bacteremia. The parameter of TTP has been identified as a variable of highest correlation to hospital mortality and therefore can be potentially utilized as a mortality prognostic marker.展开更多
基金This work was supported by the Innovation Program of the Shanghai Municipal Education Commission （No. 102216） and by the National Natural Science Foundation of China （No. 81072096 and No. 81072114）.
文摘Aging is a major risk factor for prostate cancer （PCa）, and prostatic stromal cells may also promote PCa progression. Accordingly, stromal cells do not equally promote PCa in older males and younger males. Therefore, it is also possible that the expression of androgen receptors （ARs） by prostatic stromal cells in older versus younger males plays different roles in PCa progression. Using a gene knockdown technique and coculture system, we found that the knockdown of the AR in prostatic stromal cells obtained from younger males could promote the invasiveness and metastasis of cocultured PC3/LNCaP cells in vitro. By contrast, the invasiveness and metastasis of LNCaP cells was inhibited when cocultured with prostatic stromal cells from older males that when AR expression was knocked down. Moreover, after targeting AR expression with small hairpin RNA （shRNA）, matrix metalloproteinase （MMP） expression in stromal cells was observed to increase in the younger group, but decreased or remained unchanged in the older group. One exception, however, was observed with MMP9. In vivo, after knocking down AR expression in prostatic stromal cells, the incidence of metastatic lymph nodes was observed to increase in the younger age group, but decreased in the older age group. Together, these data suggest that the AR in prostatic stromal cells played opposite roles in PCa metastasis for older versus younger males. Therefore, collectively, the function of the AR in prostatic stromal cells appears to change with age, and this may account for the increased incidence of PCa in older males.
文摘We investigated the usage of secondary prevention drugs and traditional Chinese medicine （TCM） products in individuals with cardiovascular diseases （CVDs） at the community level in China. Among 2,407 participants with self-reported coronary heart disease （CHD） and 872 with stroke, nearly 80% of individuals with CHD and 73% of individuals with stroke were not taking any proven secondary prevention drug. However, 32.9% of them took TCM products. Patients with CVDs in rural areas used less secondary prevention treatment, but more TCM products than their counterparts in the urban regions. After adjusting for confounding factors, lower rates of secondary prevention treatment were evident in Western China compared with Eastern China, which was more developed. Systematic change is needed to promote the development of evidence-based medicine at the community level in China.
文摘Background Previous studies indicated that the time to positivity （TTP） of blood culture is a parameter correlating with degree of the bacteremia and outcome in patients with bloodstream infections caused by Escherichia coli （E.co/i）. The objective of this study was to further investigate the diagnostic and prognostic power of using TTP to predict E. coli bacteremia.Methods A retrospective cohort study at two university hospitals was conducted. We retrieved all the medical records of those with E. coli bloodstream infection according to the records generated by their microbiology departments.Univariate and multivariate analyses were applied to identify clinical factors correlating with fast bacterial growth and significant prognostic factors for hospital mortality.Results Medical records of 353 episodes of E. coli bacteremia diagnosed between January 1,2007 and December 31,2009 were retrieved in the investigation. Univariate analysis demonstrated that the TTP≤7 hours group is associated with higher incidence of active malignancies （41.7% vs. 27.2%, P=0.010）, neutropenia （30% vs.14.3%, P=0.007）, primary bacteremia （55.0% vs. 33.4%, P=0.002）, and poorer outcome （hospital mortality 43.3% vs.11.9%, P=0.000） than the TTP 〉7 hours group. Multivariate analysis revealed that the significant predictors of hospital mortality, in rank order from high to low, were TTP （for TTP 〈7 hours, odds ratio （OR）： 4.886; 95% confidence interval （CI）： 2.572-9.283; P=0.000）,neutropenia （OR： 2.800; 95% CI：1.428-5.490; P=0.003）, comedication of steroids or immunosuppressive agents （OR：2.670; 95% CI： 0.971-7.342; P=0.057）.Conclusions Incidence of malignancies, neutropenia and primary bacterernia correlates with fast bacterial growth in patients with E. coli bacteremia. The parameter of TTP has been identified as a variable of highest correlation to hospital mortality and therefore can be potentially utilized as a mortality prognostic marker.
