Effects of Shenqi Xiangyi granules in advanced gastric cancer chemotherapy

BACKGROUND Owing to the absence of specific symptoms in early-stage gastric cancer,most patients are diagnosed at intermediate or advanced stages.As a result,treatment often shifts from surgery to other therapies,with chemotherapy and targeted therapies being the primary options for advanced gastric cancer treatment.A total of 116 patients with advanced gastric cancer,admitted from January 2021 to December 2023,were selected and divided into two groups of 58 each using the random number table method.The control group received FOLFOX4 chemothe-rapy(oxaliplatin+calcium+folinate+5-fluorouracil)combined with intravenous sindilizumab.The observation group received the same treatment as the control group,supplemented by oral administration of Senqi Shiyiwei granules.Both groups underwent treatment cycles of 3 weeks,with a minimum of two cycles.The therapeutic efficacy,immune mechanisms,and treatment-related toxicity and side effects were compared between the groups.The objective remission rate in the observation group(55.17%)was higher than that of the control group(36.21%)(P<0.05).After two treatment cycle,CD3+,CD4+,and CD4+/CD8+levels were higher in the observation group compared to the control group,while CD8+,regulatory T cells,and natural killer cells were lower(P<0.05).Additionally,the incidence of leukopenia,nausea,and vomiting was lower in observed group(P<0.05).No significant differences were observed in the incidence of other adverse reactions(P>0.05).CONCLUSION Adjuvant therapy with Shenqixian granules may enhance the efficacy of simudizumab combined with FOLFOX4 chemotherapy in advanced gastric cancer and the immune function by increasing immune cell counts,making it a valuable option in clinical treatment.

Comparison of clinical outcomes of Chinese men and women after coronary stenting for coronary artery disease:a multi-center retrospective analysis of 4,334 patients

The outcome differences between Chinese male and female patients within one-year follow-up after percutaneous coronary intervention（PCI） with stent remain unclear.The present study was aimed to compare clinical outcomes in such two populations.From May 1999 to December 2009,4,334 patients with acute myocardial infarction（MI）,unstable angina,stable angina,or silent ischemia,who underwent PCI,were registered at our centers.Among these,3,089 were men and 1,245 were women.We compared these groups with respect to the primary outcomes of MI and secondary outcomes including a composite of major adverse cardiac events（MACE） including cardiac death,MI,target lesion revascularization,target vessel revascularization（TVR）,stent thrombosis（ST）,definite ST and probable ST at one-year follow-up.Chinese male patients had a higher MACE rate（13%vs.10.7%,P =0.039）,mainly led by TVR（9.09%vs.6.98%,P=0.024） at one year,which was significantly different than female patients.Chinese male and female patients showed a significant difference on MACEs.However,there was no significant difference with respect to MI between these groups.

Effect of acupuncture intervention on the intestinal mucosal inflammatory response and immune response balance in animals with ulcerative colitis

Objective:To study the effect of acupuncture intervention on the intestinal mucosal inflammatory response and immune response balance in animals with ulcerative colitis (UC).Methods:Adult, male SPF SD rats were selected and randomly divided into the control group, UC group and acupuncture group, and then the acupuncture intervention was established after the UC animal model was established. 14 d after intervention, the expression of inflammatory mediators and Th1/Th2/Th17/Treg cytokines in intestinal mucosa, and the levels of inflammatory mediators and Th1/Th2/Th17/Treg cytokines in serum were detected. Results:NF-kB, HMGB-1, TNF-α, IL-1β, IFN-γ and IL-17 mRNA expression in intestinal mucosa as well as HMGB-1, TNF-α, IL-1β, IFN-γ and IL-17 levels in serum of UC group were significantly higher than those of control group while IL-4, IL-5 and TGF-β1 mRNA expression in intestinal mucosa as well as IL-4, IL-5 and TGF-β1 levels in serum were significantly lower than those of control group;NF-kB, HMGB-1, TNF-α, IL-1β, IFN-γ and IL-17 mRNA expression in intestinal mucosa as well as HMGB-1, TNF-α, IL-1β, IFN-γ and IL-17 levels in serum of acupuncture group were significantly lower than those of UC group while IL-4, IL-5 and TGF-β1 mRNA expression in intestinal mucosa as well as IL-4, IL-5 and TGF-β1 levels in serum were significantly higher than those of UC group. Conclusions: Acupuncture intervention can regulate the intestinal mucosal inflammatory response and immune response of animals with ulcerative colitis.

Clinical outcomes of percutaneous coronary intervention for chronic total occlusion lesions in remote hospitals without on-site surgical support

Background The safety of percutaneous coronary intervention （PCI） for chronic total occlusion （CTO） lesions in remote hospitals without surgical facilities remains unknown. This study aimed to evaluate three-year outcomes after CTO for PCI in ten centers around China where no on-site coronary artery bypass grafting （CABG） support was available. Methods A total of 152 patients from 10 Chinese hospitals without on-site surgical facilities were prospectively studied. Intra-procedural and in-hospital events were assessed. Angiographic follow-up was indexed eight months after the initial procedure. Clinical follow-up was extended to three years. The primary outcome was the rate of major adverse cardiac events （MACE）, defined as cardiac death, myocardial infarction and target-vessel revascularization （TVR）. Results The incidence of CTO was 7.9% in patients who underwent PCI, Successful recanalization was achieved in 132 patients （86.8%）. Compared with patients in the PCI success group, patients with PCI procedural failure had longer lesion lengths （（42.32±22.08） mm vs （27.61±22.85） mm, P=0.023）, a higher rate of perforation （25.0% vs 0, P=0.014）, and a greater need for pericardial puncture. There were significant differences in MACE in-hospital and at one year and three years between the failure （10.0%, 30.0% and 35.0%） and the success （3.0%, 12.1% and 14.4%） groups （P=0.037, 0.034 and 0.040, respectively）. These led to a significant decrease in the MACE-free survival rate at one and three years in the failure group, compared with the success group （P=0.031 and 0.023, respectively）. Stump was the only predictor of recanalization success （HR 0.158, 95% Cl 0.041-0.612, P=0.008）, whereas procedural failure （OR 13.023, 95% CI 6.67-13.69, P=0.002）, incomplete revascularization （OR 9.71, 95% CI 2.93-5.59, P=0.005）, and total stent length （OR 6.02, 95% Cl 1.55-11.93, P=0.027） were three independent predictors of MACE. Conclusions PCI for CTO was unsafe in remote hospitals without CABG facilities. Paying attention to coronary perforation is important for successful procedures.

Mechanisms and clinical significance of quality of final kissing balloon inflation in patients with true bifurcation lesions treated by crush stenting technique

Background The mechanisms responsible for the occurrence of a kissing unsatisfied （KUS） result after classical crush stenting remain unclear. The present study aimed at analyzing the mechanisms and clinical significance of KUS. Methods Two hundred and thirteen patients with true bifurcation lesions treated with classical crush stenting and final kissing balloon inflation （FKBI） were assigned to upper, middle, and lower groups according to the position of the side branch re-wiring assessed by visual estimation, quantitative coronary analysis （QCA） and intravascular ultrasound （IVUS）. Angiographic follow-up was indexed at 12 months. Results The upper group was characterized by a larger bifurcation angle of 55.53°±25.25° （P=0,030） and a longer procedural time （42.43±23.92） minutes （P=0.015）. The overall rate of KUS by visual estimation was 10.48%, with 5.4% in the upper group, 3.9% in middle group, and 36.1% in lower group （P 〈0.001）. For the diagnosis of KUS, visual inspection demonstrated a good correlation with both QCA and IVUS. Smaller stent diameter was the main reason for KUS in the upper group, while extra-stent side wire location, or re-wire in a low position was the main mechanism attributed to KUS in the lower group. The Lower group had more restenosis, with most restenotic lesions at a lower position of the side branch ostium. KUS （HR 1.652, 95% Cl 1.332-2.088, P 〈0.001） and re-wiring position （HR 2.341, 95% Cl 1.780-4.329, P 〈0.001） were two independent predictors of side branch restenosis. Re-wiring position （OR 0.458, 95%C/0.336-0.874, P=0.001） and side stent expansion （OR 3.122, 95%C/2.883-5.061, P=0.014） were factors predicting the findings of KUS. Conclusions Side wire outside side stents resulted in more KUS and restenosis. Different restenotic lesion types reflected individual mechanisms contributing to the development of plaque proliferation.

Obstructive Sleep Apnea Affecting Platelet Reactivity in Patients Undergoing Percutaneous Coronary Intervention

Background：The relationship between obstructive sleep apnea （OSA） and platelet reactivity in patients undergoing percutaneous coronary intervention （PCI） has not been defined.The present prospective,single-center study explored the relationship between platelet reactivity and OSA in patients with PCI.Methods：A total of 242 patients were finally included in the study.OSA was screened overnight by polysomnography.Platelet reactivity was assessed with a sequential platelet counting method,and the platelet maximum aggregation ratio （MAR） and average aggregation ratio were calculated.All patients were assigned per apnea-hypopnea index （AHI） to non-OSA （n =128） and OSA （n =l 14） groups.The receiver operating characteristic curve analysis was used to evaluate the accuracy of AHI for high platelet reactivity （HPR） on aspirin and clopidogrel,and multivariable logistic regression was used to determine the independent predictors of HPR on aspirin and clopidogrel.Results：Median AHI was significantly higher in the OSA group than in the non-OSA group （34.5 events/h vs.8.1 events/h,Z =-13.422,P 〈 0.001）.Likewise,median arachidonic acid-and adenosine diphosphate-induced maximum aggregation rate （MAR） in the OSA group was significantly higher than those in the non-OSA group （21.1% vs.17.7%,Z=-3.525,P 〈 0.001 and 45.8% vs.32.2%,Z =-5.708,P 〈 0.001,respectively）.Multivariable logistic regression showed that OSA was the only independent predictor for HPR on aspirin （odds ratio [OR]：1.055,95% confidence interval [CI]：1.033-1.077,P 〈 0.001） and clopidogrel （OR：1.036,95% CI：1.017-1.056,P 〈 0.001）.The cutoffvalue of AHI for HPR on aspirin was 45.2 events/h （sensitivity 47.1% and specificity 91.3%）,whereas cutoffvalue of AHI for HPR on clopidogrel was 21.3 events/h （sensitivity 68.3% and specificity 67.7%）.

Comparison of paclitaxal vs. sirolimus eluting stents with bio-degradable polymer for the treatment of coronary bifurcation lesions： subgroup analysis from DKCRUSH-I and DKCRUSH-II studies

Background The difference in clinical outcome between paclitaxal-eluting stents （PES） and sirolimus-eluting stents with bio-degradable polymer （SES-BDP） for bifurcation lesions remains unclear. The present study aimed to investigate the one-year clinical outcome after DK crush stenting using PES （maxusTM） MS. SES-BDP （ExcelTM） from our database. Methods A total of 275 patients （90 from the DKCRUSH-I and 185 from the DKCRUSH-II study） were studied. The primary endpoint was the occurrence of major adverse cardiac events （MACE） at 12 months; including cardiac death, myocardial infarction （MI）, or target vessel revascularization （TVR）. The rate of binary restenosis and stent thrombosis served as secondary endpoints. Results At follow-up, minimal luminal diameter （MLD） in the Taxus group was （2.11＋0.66） mm, with resultant increased target lesion revascularization （TLR） 12.2% and TVR 14.4%, significantly different from the Excel group; （2.47±0.56） mm, P 〈0.001, 3.2%, P=0.006, 4.9%, P=0.019, respectively. As a result there was a significant difference in MACE between the Taxus （20.0%） and Excel （10.3%, P=0.038） groups. Overall stent thrombosis was monitored in 11 patients （4.0%）, with five in the Excel group （2.7%） and six in the Taxus group （6.7%）. All stent thrombosis in the Excel group was classified as early, and all were defined as late in the Taxus group. Conclusion The Excel stent had lower rate of stent thrombosis, TLR, TVR, and composite MACE at 12-month after an indexed stenting procedure, compared to the Taxus stent.

Effect of Aidi injection plus transarterial chemoembolization on primary hepatic carcinoma： a systematic review and Meta-analysis

OBJECTIVE: To assess the efficacy and safety of Aidi injection plus transarterial chemoembolization(TACE) in patients with primary hepatic carcinoma.METHODS: A comprehensive research of seven electronic databases was performed for comparative studies evaluating Aidi injection combined with TACE for primary hepatic carcinoma until September 2016. Two authors independently extracted data and assessed the methodological quality of the included trials using the Cochrane risk of bias tool from the Cochrane Handbook version 5.1.0. Data was synthesized by using Rev Man 5.3 software.RESULTS: Forty-nine studies involving 3435 patients met the inclusion criteria, most of which were low methodological quality. Compared with TACE alone, Aidi injection plus TACE can significantly improve the efficiency rate [RR = 1.33, 95% CI(1.24, 1.43), P < 0.000 01], clinical beneficial rate[RR = 1.25, 95% CI(1.17, 1.33), P < 0.000 01], survival rate [6 months, RR = 1.19, 95% CI(1.09, 1.29), P <0.0001], 12 months, [RR = 1.37, 95% CI(1.24, 1.52),P < 0.000 01], 18 months, [RR = 2.00, 95% CI(1.26,3.20), P < 0.004], 24 months, [RR = 1.44, 95% CI(1.22, 1.70), P < 0.0001], 36 months, [RR = 1.50, 95%CI(1.07, 2.11), P = 0.02 < 0.05], quality of life [RR =1.84, 95% CI(1.64, 2.05), P < 0.000 01] and immune function [CD3+, MD = 11.12, 95% CI(7.93, 14.30),P < 0.000 01], CD4 +, [MD = 10.37, 95% CI(7.29,13.45), P < 0.000 01], CD4+/CD8+, [MD = 0.30, 95%CI(0.07, 0.53), P = 0.01 < 0.05], NK, [MD = 7.49, 95%CI(6.64, 8.34), P < 0.000 01]. A significant improvement was also found in improvement of symptoms[RR = 1.64, 95%CI(1.38, 1.94), P < 0.000 01], leukopenia [RR = 0.60, 95% CI(0.54, 0.66), P < 0.000 01],thrombocytopenia [RR = 0.46, 95% CI(0.34, 0.61),P < 0.000 01], nausea and vomiting incidence [RR =0.66, 95% CI(0.54, 0.81), P < 0.0001), liver damage rate [RR = 0.57, 95% CI(0.42, 0.77), P = 0.0003 <0.05), and kidney damage rate [RR = 0.18, 95% CI(0.05, 0.68), P = 0.01 < 0.05].CONCLUSION: The results suggested that Aidi injection plus TACE significantly improve the clinical effect of TACE, and reduce the incidence of adverse events. However, rigorous multicenter trials with larger size are warranted to further confirm the findings.

Different edge effects of paclitaxel- and sirolimus-eluting stents on proximal and distal edges in patients with unstable angina： serial intravascular ultrasound analysis

Background It is unclear whether edge segments have different responses to paclitaxel eluting stent （PES） and sirolimus eluting stent （SES） implantation in patients with unstable angina. This study aimed to compare the different vascular edge responses in patients with unstable angina and single de novo coronary lesion treated with SES and PES. Methods Two hundred and fifty-five patients with unstable angina and single de novo lesion were randomly assigned to PES and SES groups. Serial volumetric intravascular ultrasound （IVUS） images were taken immediately after stenting and at an eight-month follow-up. Five-mm edge segments proximal and distal to the stents were analyzed. Results Baseline characteristics were comparable between the two groups. At proximal-edge segment, the vessel area decreased and the plaque area increased significantly in the PES group as compared with the SES group. A significant net loss of lumen area was found in the PES group （from （11.10±3.12） mm^2 at baseline to （9.92±3.59） mm^2 at the follow-up, P 〈0.001）. At the distal-edge segment, the net loss of lumen area in the PES group （from （7.71±2.81） mm^2 at baseline to （6.66±2.29） mm^2 at the follow-up, P 〈0.001） was attributed to a significant increase of plaque area. Proximal-edge stenosis was commonly seen in the PES group （20.0%） as compared with the SES group （5.0%, P=0.001）. This correlated with the higher incidence of target lesion revascularization in the PES group （P=0.03）. Subsegmentally, the smallest A lumen area was located at 2 mm proximally in both groups, at 0 mm distally in the PES group, and at 1 mm distally in the SES group. Conclusions The two groups demonstrated negative remodeling of edge segments. PES was less effective than SES in inhibiting the growth of plaque within the first 1-mm length proximal to the stent.