Erythropoiesis-stimulating agents in the management of cancer patients with anemia: a meta-analysis

Background: Erythropoiesis-stimulating agents(ESAs) are widely used in the management of anemia in cancer patients. Despite their apparent effectiveness, recent studies have suggested that ESAs could result in serious adverse events and even higher mortality. The aim of the current study was to evaluate the benefits and risks of ESAs in the management of cancer patients with anemia using a meta-analysis.Methods: The initial literature search covered Medline, PubMed, Embase, and the Cochrane Center Register of Controlled Trials, and identified 1,569 articles. The final meta-analysis included eight randomized controlled trials(n=2,387) in cancer patients with <11 g/dL hemoglobin(Hb) at the baseline and target Hb(for stopping ESA treatment) at no more than 13 g/dL. The assessment measures included Hb response, blood transfusion rate and adverse events that included venous thromboemblism(VTE), hypertension, and on-study mortality. The results are expressed as pooled odds ratio(OR). Publication bias was assessed using funnel plot analysis.Results: ESAs significantly increased the Hb concentration [OR 7.85, 95% confidence interval(CI): 5.85 to 10.53, P<0.001] and reduced the red blood cell(RBC) transfusion rate(OR 0.52, 95% CI: 0.42 to 0.65, P<0.001). ESAs did not increase the accumulated adverse events(OR 0.95, P=0.82), or the on-study mortality(OR 1.09, P=0.47).Conclusions: ESAs are not associated with increased frequency of severe adverse events in anemic cancer patients when the target Hb value is no more than 13 g/dL.

Influence of Aging Trend on Consumption Rate of Rural Residents--Empirical Analysis Based on Provincial Panel Data

Population is a basic factor that affects consumption of residents. In China,insufficient demand of residents,especially low consumption demand of rural residents,directly weakens the promotion of consumption for economic growth. This drives the study on the relationship between the aging trend and consumption of rural residents. In this paper,the current situation of population aging in China was firstly analyzed. Then a dynamic macroeconomic model was established using the cointegration theory and selecting related time series data such as per capita consumption expenditure of rural residents( Con),per capita net income of rural residents( Rev),urban-rural income gap( RU),children dependency ratio( CDR),and old-age dependency ratio( ODR),to test the correlation between variables. The results show that the decline in the children dependency ratio promotes the increase of consumption willingness of rural residents,while the rise in the old-age dependency ratio inhibits the consumption willingness of rural residents. Finally,it came up with pertinent recommendations for guiding and promoting the consumption level of rural residents in China.

Treatment of tiny intracranial aneurysms with guidewire manipulation

Background:Tiny false intracranial rupture aneurysms are particularly rare. It is challenged both to neurosurgery and endovascular treatment.Methods:We present here five rare cases of perforator tiny aneurysms that were diagnosed based on DSA. These patients were found due to SAH, and they decided to treat these aneurysms with endovascular therapy. After numerous attempts, the coiling microcatheter failed to access the aneurysms. As a result, the aneurysms finally were treated with guidewire manipulation.Results:Mean follow-up time was about 10.4 months. The outcomes of the 5 cases were all surprisingly excel ent. The patients were followed up with angiography and telephone till now. No revascularization of aneurysm was found.Conclusions:This paper demonstrated for the first time to our knowledge that tiny false intracranial aneurysm may be treated with guidewire manipulation. While larger studies with long-term follow-up are required to validate these promising results, guidewire manipulation is a new approach worth considering when microcatheter cannot enter aneurysm.

Cell-free microRNA-21: biomarker for intracranial aneurysm rupture

Background:Deregulation of miRNA-21 expression has been reported to be associated with vascular smooth muscle behavior and cytoskeletal stability.This study is aimed to investigate the density of serum miRNA-21 in patients with different phases of intracranial aneurysms(IAs)and explore its warning function for IA rupture.Methods:A total of 16 in 200 IA patients were selected and categorized into 4 groups based on the phase of IA.Microarray study was carried out using serum miRNA and differentially expressed miRNAs were identified.Another 24 samples from a cohort of 360 patients were added and real-time polymerase chain reaction(RT-PCR)was performed on expanded sample size(n=40)for miRNA-21 validation.Potential gene targets of miRNA-21 were screened out from Gene Ontology(GO)database and literatures.Results:Microarray study identified 77 miRNAs with significantly different expression levels between experimental groups and the control group.RT-PCR assays validated significant downregulation of miRNA-21 in experimental groups,among which miRNA-21 expression level of daughter aneurysm group decreased the most.Bioinformatic analyses revealed that several target genes related with miRNA-21 may be involved in IA formation and rupture.Conclusions:This study suggested that miRNA-21 had a protective effect for intracranial vascular wall against remodeling and warning function for intracranial aneurysm rupture.Significant suppression of serum miRNA-21 in IA patients may provide diagnostic clues for aneurysm rupture and guide clinical intervention.

Advances in research of intracranial vascular stent

In recent years, China's population has shown an obvious aging trend. This trend has been accompanied by an increased incidence of cardiovascular disease and death.Intracranial stenting has become an important treatment modality for intracranial vascular disease because it is effective, safe, and widely approved. In this paper,we review the literature concerning the classification, structure, preparation, and performance of intracranial stents. We also summarize problems and future prospects in the context of intracranial stents. This paper will serve as a reference for the future research and development of intracranial stents.