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Trial Registration
ClinicalTrials.gov Identifier:
PMC10394570
Introduction
aggressive disease
PROSTATE CANCER
Black patients present with more aggressive disease and experience higher mortality than White patients with prostate cancer.
PMC10394570
Methods
death, Prostate Cancer
SECONDARY, PROSTATE CANCER
This is a secondary analysis of a multicenter randomized, open-label, phase 3 study in which patients with mCSPC, enrolled between March 1, 2013, and July 15, 2017, were randomly assigned in a 1:1 ratio to receive either androgen deprivation therapy (ADT) with orteronel 300 mg orally twice daily (experimental group) or...
PMC10394570
Statistical Analysis
Baseline demographic and clinical characteristics were summarized using descriptive statistics, median (with IQR) for continuous characteristics and count and percentage for categorical characteristics. To test differences in baseline characteristics by race, a χ
PMC10394570
Results
Of 1313 patients enrolled, 135 (10.3%) self-identified as Black and 1077 (82%) as White (
PMC10394570
Baseline Characteristics and PSA Responses
Abbreviation: PSA, prostate-specific antigen.Defined as greater than minimal involvement of vertebrae, pelvic bones, and/or lymph nodes.At a median follow-up of 4.9 years, the median OS for Black patients was 5.5 years (95% CI, 4.8 to not reached), compared with 6.3 years (95% CI, 5.7 to not reached) for White patients...
PMC10394570
Kaplan-Meier Estimates of Overall Survival (OS) and Progression-Free Survival (PFS) by Race in the Overall Population
Dashed lines indicate median time participants experienced OS (panel A) or PFS (panel B).
PMC10394570
Multivariable Analysis of Progression-Free Survival (PFS) and Overall Survival (OS)
Abbreviations: NA, not applicable; PSA, prostate-specific antigen.Defined as greater than minimal involvement of vertebrae, pelvic bones, and/or lymph nodes.Among Black patients, 63 of 135 (55.8%) had a complete PSA response at 7 months and 16 (14.2%) had no PSA response at 7 months, compared with 558 (62.8%) and 94 (1...
PMC10394570
Discussion
prostate cancer, aggressive disease
SECONDARY, METASTATIC PROSTATE CANCER, PROSTATE CANCER, PROSTATE
This secondary analysis of the SWOG 1216 trial found that ADT plus bicalutamide or ADT plus a novel androgen receptor pathway inhibitor (ARPI) elicited similar PFS, PSA response, and OS in Black and White patients with mCSPC, despite Black patients presenting with more aggressive disease features (younger age and highe...
PMC10394570
Limitations
SECONDARY
This study had several limitations. In the SWOG 1216 trial, orteronel improved PFS but not OS, and therefore is not being used in the current practice, which may have limited the generalizability of this study in the clinical setting compared with other ARPIs. Also, while to our knowledge this trial enrolled the larges...
PMC10394570
Conclusions
SECONDARY
In this secondary analysis of a large randomized, multicenter phase 3 clinical trial, we showed using high-quality patient-level data that Black patients had similar survival outcomes to White patients with mCSPC. These results support the hypothesis that equitable access to care as available in a clinical trial settin...
PMC10394570
Abstract
PMC10636424
Objective
aMCI, amnestic mild, cognitive impairment
We aim to develop a radiomics model based on 3‐dimensional (3D)‐T1WI images to discriminate amnestic mild cognitive impairment (aMCI) patients from the normal population by measuring changes in frontal white matter.
PMC10636424
Methods
aMCI
In this study, 126 patients with aMCI and 174 normal controls (NC) were recruited from the local community. All subjects underwent routine magnetic resonance imaging examination (including 3D‐T1WI ). Participants were randomly divided into a training set (
PMC10636424
Results
A total of 108 frontal lobe texture features were extracted from 3D‐T1WI images. LASSO selected 58 radiomic features for the final model, including log‐sigma (
PMC10636424
Conclusions
amnestic, aMCI, cognitive impairment
Textural features of white matter in the frontal lobe showed potential for distinguishing aMCI from the normal population, which could be a surrogate protocol to aid aMCI screening in clinical setting.(a) Drawing regions of interest in frontal lobe using ITK‐SNAP. (b) Strategy for frontal lobe extraction from high‐reso...
PMC10636424
INTRODUCTION
cognitive impairment, MCI, dementia, Alzheimer's disease, dementia disorders, AD
ALZHEIMER'S DISEASE
Mild cognitive impairment (MCI) is a transitional state between normal aging and dementia disorders, especially Alzheimer's disease (AD; Petersen et al., MCI differs from dementia in many ways, and previous studies support better outcomes for early treatment or prevention of MCI (Pilipovich & Vorob'eva, Radiomics, as a...
PMC10636424
MATERIALS AND METHODS
This prospective study was approved by the local ethics committee, all recruited participants have signed informed consent.
PMC10636424
Subjects
aMCI
From October 2020 to February 2021, 146 patients with aMCI and 189 healthy volunteers were recruited, all subjects were distributed a label that did not identify the group assignment. The gender, age, education, systolic pressure, and diastolic pressure of all subjects were collected for both groups. Body mass index (B...
PMC10636424
MRI data acquisition
MR
All MRI protocols were performed using a 3.0T Magnetic Resonance (MR) scanner (Ingenia CX, Philips Healthcare) with a 32‐channel head coil. Scan sequences were listed below: three‐dimensional(3D) T1 fast field echo, repeat time (TR) = 6.4 ms, echo time (TE) = 3.0 ms, field of view (FOV) = 240 × 240 × 180 mm, reconstruc...
PMC10636424
(ROI) delineated
amnestic, aMCI, cognitive impairment
The ROIs were manually delineated on the horizontal T1 images for segmentation using the ITK‐SNAP software (Version 3.6.0, Wikodeling for aMCI patients. (a) Drawing ROIs in frontal lobe using ITK‐SNAP. (b) Strategy for frontal lobe extraction from high‐resolution structural MRI. (c) Intensity features and textural feat...
PMC10636424
Radiomic features extraction
In this study, radiomic features were extracted using pyradiomics, and 108 features were obtained from 3D MRI T1‐weighted images. Before feature selection, each feature value for all frontal lobes was normalized with Z‐scores ((
PMC10636424
Features selection
REGRESSION
Due to the high complexity of the extracted features, there was a risk of overfitting in the analysis. Hence, the dimensions presented by these quantitative features needed to be reduced by prioritizing the features. The least absolute shrinkage and selection operator (LASSO) is a popular high‐dimensional data analysis...
PMC10636424
Prediction build and diagnostic validation
MCI
REGRESSION
A nomogram was formulated to predict MCI based on the results of LASSO regression. The sensitivity, specificity, accuracy, positive‐predictive value, and negative‐predictive value were obtained from the models. The predictive performance of the radiomics model was assessed using receiver operating characteristic (ROC) ...
PMC10636424
Clinical usefulness
cognitive impairment, x‐axis, amnestic, y‐axis, aMCI
Decision curve analysis (DCA) was applied to justify the clinical usefulness of this study. The prediction model provided clinical consequences regarding the choice of the threshold probability from which the net benefit could be derived. DCA was performed to estimate the clinical value of the radiomics nomogram by qua...
PMC10636424
Calibration curves of the radiomics model
cognitive impairment, x‐axis, amnestic, y‐axis, aMCI
Calibration curves were plotted to evaluate the calibration of the radiomics model. Additionally, the Hosmer–Lemeshow test was conducted. Calibration curves show how well each model is calibrated by comparing the predicted risks of aMCI to the observed outcomes of aMCI (Figure Calibration curves of the radiomics model....
PMC10636424
Statistical analysis
aMCI
Statistical analyses were conducted with python software (Version 3.7; Variables for the normal control group and aMCI group were tested for normal distribution. In a two‐tailed analysis, a 
PMC10636424
RESULTS
PMC10636424
Baseline characteristics of the patients
amnestic, aMCI, cognitive impairment
Fourteen subjects were excluded from the study because they could not cooperate for a normal examination; 19 subjects were excluded because their image quality did not meet the diagnostic requirements. Finally, 126 patients with aMCI and 176 normal controls (NC) were included in this study. Table Clinical characteristi...
PMC10636424
Feature selection and LASSO logistic regression results
REGRESSION
A total of 108 radiomic features were extracted from 3D‐T1WI imaging. Among the 108 extracted features, an ICC to or higher than 0.84 were included. To identify the relevant predictors, all explanatory features extracted from MR images of the training set were included in LASSO logistic regression. Features with regres...
PMC10636424
Diagnostic performance of the radiomics model
aMCI
The diagnostic performance of the radiomics model to distinguish aMCI from normal subjects was evaluated using ROC analysis in both the training set and the test set. In the training set, the area under the ROC curve (AUC) was 1.00, and the accuracy, sensitivity, and specificity were 100%, 98%, and 100%, respectively. ...
PMC10636424
Clinical usefulness
The DCA of the radiomics model is shown in Figure 
PMC10636424
Calibration curves of the radiomics model
y‐axis, aMCI, x‐axis
The y‐axis represents the incidence rate of aMCI. The x‐axis represents the predicted risk of aMCI. The diagonal dotted line represents the prediction of an ideal model. The blue solid line represents the performance of the radiomics model. A closer fit to the diagonal dotted line indicates a more accurate prediction. ...
PMC10636424
DISCUSSION
decline of cognitive function, MCI, aMCI, MR, AD
DISEASE, PATHOGENESIS, PATHOLOGY, DISEASES
Early diagnosis of MCI and timely clinical intervention may slow down further decline of cognitive function and progression to AD (Livingston et al., Radiomics is a promising technology that emerged in recent years, which improves the diagnosis and prediction efficiency of diseases by extracting a large number of radio...
PMC10636424
CONCLUSION
aMCI
In this study, we identified significant alterations in radiomic features related to aMCI within the frontal lobe white matter. These alterations demonstrated the ability to discriminate aMCI from NC with a relatively high diagnostic efficacy as evidenced by an AUC of 0.82. The calibration curve of the radiomics model ...
PMC10636424
AUTHOR CONTRIBUTIONS
Wei Zheng and Xiqi Zhu designed the study. Wei Zheng, Xiaoyan Qin, Ronghua Mu, and Xiaoyan Qin conducted the MRI data processing and statistical analyses. Wei Zheng, Ronghua Mu, Xin Li, JL, PY and Fuzhen Liu contributed to data collection and analyses. Wei Zheng and Ronghua Mu wrote the paper. Xiqi Zhu and Wei Zheng cr...
PMC10636424
CONFLICT OF INTEREST STATEMENT
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
PMC10636424
PEER REVIEW
The peer review history for this article is available at
PMC10636424
ACKNOWLEDGMENTS
We thank the Department of neurology, Nanxishan Hospital of Guangxi Zhuang Autonomous Region, for their help and discussion.
PMC10636424
DATA AVAILABILITY STATEMENT
The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.
PMC10636424
REFERENCES
PMC10636424
Abstract
Xin-Yi Gao and Yue-Ming Liu contributed equally to this work.Supplemental data for this article can be accessed online at
PMC9848225
Purpose
bleeding
THROMBOEMBOLIC EVENT, NEPHROTIC SYNDROME, BLEEDING
The risk of thromboembolic events is elevated in patients with nephrotic syndrome, and warfarin use has been associated with an increased risk of bleeding. Indobufen, a selective cyclooxygenase-1 inhibitor, is currently being evaluated for the prevention of thromboembolic events in nephrotic syndrome. This study aimed ...
PMC9848225
Materials and methods
thromboembolic, nephrotic syndrome, bleeding
BLEEDING, ADVERSE EVENTS, NEPHROTIC SYNDROME, SECONDARY, EVENTS
This multicenter, randomized, three-arm, open-label, parallel controlled trial involved a total of 180 adult patients with nephrotic syndrome from four centers in China. Patients were randomly assigned to receive 100 mg indobufen (bid), 200 mg indobufen (bid), and 3 mg warfarin (qd) daily for 12 weeks. The primary endp...
PMC9848225
Results
bleeding
MINOR, THROMBOEMBOLIC EVENT, EVENTS, BLEEDING
No thromboembolic events occurred in the high-/low-dose indobufen and warfarin groups. Moreover, the use of a low dose of indobufen significantly reduced the risk of minor bleeding events compared with warfarin use (2% versus 18%,
PMC9848225
Conclusions
bleeding
EVENTS, THROMBOEMBOLIC EVENT, NEPHROTIC SYNDROME, BLEEDING
This study found that indobufen therapy provided equivalent effects in preventing thromboembolic events compared with warfarin therapy, while low dose of indobufen was associated with a reduced risk of bleeding events, thus it should be recommended for the prevention of thromboembolic events in clinical practice in pat...
PMC9848225
Trial registration number
ChiCTR-IPR-17013428.
PMC9848225
Keywords
PMC9848225
Introduction
hypoalbuminemia, bleeding, edema, Nephrotic syndrome
HYPOALBUMINEMIA, BLEEDING, EDEMA, NEPHROTIC SYNDROME, EVENTS
Nephrotic syndrome is characterized by a urine protein loss > 3.5 g/24 h, accompanied by hypoalbuminemia and edema, with an annual incidence of 1–3 per 100,000 adults [Currently, warfarin is widely used as a prophylactic anticoagulant; however, its risk of bleeding events is significantly high [
PMC9848225
Methods
PMC9848225
Trial design and oversight
This prospective, multicenter, randomized clinical trial was conducted at four centers in China. All patients provided written informed consent before participation, and the institutional review board of each center approved the protocol before the initiation of the study. The coauthors contributed to the first draft o...
PMC9848225
Trial population
thrombosis, nephrotic syndrome
THROMBOSIS, HEART FAILURE, NEPHROTIC SYNDROME
Adult patients with nephrotic syndrome were eligible for inclusion in this study, and the inclusion criteria were as follows: (1) age between 18 and 75 years; (2) 24-h urinary protein excretion > 3.5 g and/or serum albumin < 30 g/L; and (3) exposure to thrombosis risk factors, such as recent abdominal surgery, prolonge...
PMC9848225
Randomization and treatment protocol
thrombosis, nephrotic syndrome
THROMBOSIS, GROUP B, ADVERSE EVENTS, NEPHROTIC SYNDROME, REMISSION
After enrollment, patients were randomly assigned to three groups in a 1:1:1 ratio, and an observer-blinded approach was followed. Randomization was performed using a random number table with a central computerized system. Group A was administered an oral dose of 100 mg of indobufen twice daily. Group B was administere...
PMC9848225
Collected variables
Baseline data included age, sex, weight, BMI, and pathological diagnosis from kidney biopsy samples. BMI is the weight in kilograms divided by the square of the height in meters. Baseline laboratory data obtained from the central laboratory included the following: hemoglobin (Hb), platelet count, serum albumin (Salb), ...
PMC9848225
Endpoints
thrombosis, bleeding
THROMBOSIS, PULMONARY EMBOLISM, BLEEDING, DEEP VEIN THROMBOSIS, THROMBOEMBOLIC EVENTS, RENAL VEIN THROMBOSIS, EVENTS
The primary outcomes were the incidence rates of thrombosis and bleeding. Thromboembolic events were confirmed by ultrasound (for deep vein thrombosis), renal magnetic resonance venography (for renal vein thrombosis), or computed tomography pulmonary ventilation-perfusion scan (for pulmonary embolism). Major bleeding r...
PMC9848225
Statistical analysis
REGRESSION
Patient demographic, clinical, and laboratory data are described using (1) the mean (±SD) or median (range), depending on the underlying distribution, for continuous variables and (2) frequencies (percentages) for categorical variables. Continuous variables were compared using analysis of variance, while categorical va...
PMC9848225
Results
PMC9848225
Patients
Between December 2017 and December 2020, 180 patients from four different centers were randomly assigned (59 in group A, 61 in group B, and 60 in group C) and followed up until February 2021. Nine patients discontinued treatment early during the COVID-19 lockdown. Of the 180 patients, 36 (20%) had missing primary-outco...
PMC9848225
Discussion
sudden cardiac arrest, thrombosis, bleeding, death, nephrotic syndrome, venous thromboembolism
SUDDEN CARDIAC ARREST, THROMBOSIS, THROMBOEMBOLIC EVENT, BLEEDING, HYPERCOAGULABILITY, MINOR, NEPHROTIC SYNDROME, EVENTS
Hypercoagulability, the main pathological change in nephrotic syndrome, is possibly caused by reduced anticoagulants (antithrombin III), increased liver procoagulant synthesis (FIB, factor V, and factor VIII), increased platelet activation and aggregability, and decreased fibrinolytic activity in the kidney [The curren...
PMC9848225
Supplementary Material
PMC9848225
Supplemental Material
Click here for additional data file.
PMC9848225
Ethical approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
PMC9848225
Author contributions
Research idea and study design: Li YW; data acquisition and centralized laboratory measurements: Zheng DN, Liu YM, Li H, Xiong XL, Chen HY, Wang H, Yu XY, Qu K; data analysis, statistical analysis, and manuscript drafting: Gao XY, Liu YM; supervision of the study or mentorship: Lin B, Jin J, He Q.
PMC9848225
Disclosure statement
No potential conflict of interest was reported by the author(s).
PMC9848225
Data availability statement
The datasets used and analyzed during the current study are available from the corresponding author on reasonable request.
PMC9848225
References
PMC9848225
Objective
non-alcoholic fatty liver disease, NAFLD, TCM
METABOLIC DISEASE, NON-ALCOHOLIC FATTY LIVER DISEASE
Edited by: Xinhua Shu, Glasgow Caledonian University, United KingdomReviewed by: Tianhao Liu, Affiliated Hospital of Jiangnan University, China; Kangxiao Guo, Central South University Forestry and Technology, China; Haoqing Shao, Hunan University of Medicine, China†These authors have contributed equally to this workThi...
PMC9892935
Methods
NAFLD
A prospective, randomized, controlled clinical study was designed to observe the efficacy and safety of SLF in the treatment of NAFLD. The study participants were randomly and evenly divided into control group and treatment group (SLF group). The control group made lifestyle adjustments, while the SLF group was treated...
PMC9892935
Results
NAFLD, liver stiffness
INSULIN RESISTANCE
Compared with the control group, the SLF group showed significant improvements in liver function, controlled attenuation parameter (CAP), and liver stiffness measurement (LSM), meanwhile, patients had significantly lower lipid and homeostasis model assessment of insulin resistance (HOMA-IR) with better security. Intest...
PMC9892935
Conclusions
NAFLD
SLF can improve liver function and glucolipid metabolism in patients with NAFLD and lower down liver fat content to some extent. SLF could be carried out by regulating the disturbance of intestinal flora, especially
PMC9892935
Introduction
NAFLD, Radix glehniae, obesity, Paeoniae Radix Alba, Radix Bupleuri, Fuling, metabolic diseases, liver reaction, Atractylodis Macrocephalae Rhizoma, metabolic syndrome, steatosis, TCM, diabetes
OBESITY, DISEASE, NON-ALCOHOLIC FATTY LIVER DISEASE, METABOLIC DISEASES, METABOLIC SYNDROME, STEATOSIS, DIABETES
Non-alcoholic fatty liver disease (NAFLD), is common disease characterized by steatosis in more than 5% of hepatocytes with no excessive alcohol consumption, and is a form of liver reaction to a metabolic syndrome (In recent years, Traditional Chinese Medicine (TCM) has been favored by a growing number of patients beca...
PMC9892935
Material and methods
PMC9892935
Ethical approval
The study was conducted in conformity with the guidelines set out in the declaration of Helsinki. The study protocol and informed consent were approved by the Institutional Review Board of Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine (Ethics No. 2020-863-72-01). All the patients w...
PMC9892935
Study design and participants
NAFLD, fatty liver disease
DRUG-INDUCED LIVER DISEASE, VIRUS, AUTOIMMUNE LIVER DISEASE, METABOLIC DISEASE, HEPATITIS B, DISEASES
This study was designed as a randomized, controlled trial. Participants were recruited from Shuguang Hospital Affiliated to the Shanghai University of Traditional Chinese Medicine from September 2020 to September 2021 who meet the diagnostic of NAFLD. The diagnostic criteria are as follows: (1) No history of alcohol co...
PMC9892935
Interventions description
DISEASE
A screening test had to be conducted for all patients who meet the inclusion criteria during the screening period in clinic. It included the general status of patients, symptoms, and signs associated with the disease, and laboratory detection, including the following: liver function, HOMA-IR, hemorrheologic, FibroTouch...
PMC9892935
Outcomes evaluation
ADVERSE EVENTS
The outcomes included liver function, hepatic fat, blood glucose and lipids, and HOMA-IR. In addition, we recorded the compliance and adverse events of participants, and monitored participants’ health status through blood and urine tests, including kidney function checks and electrocardiogram.
PMC9892935
Stool sample collection
Stool samples were collected from all patients who were recruited with genetic testing sample collectors before and after treatment. Samples were collected only once from HC. All patients were required not to take antibiotics or probiotic preparations in the two weeks preceding the study, and they had to stop eating af...
PMC9892935
16S rRNA gene sequencing analysis
When the raw sequencing data were completed, FastQC was used to check the length and quality of sequencing data control, and errors and low-quality sequences was removed simultaneously. After that, DADA2 (
PMC9892935
Statistical analysis
All data were statistically analyzed using Graphpad Prism 9.4.0 and R 4.2.1. Measurement data followed a normal distribution, with mean ± standard deviation (
PMC9892935
Results
PMC9892935
Baseline comparison
NAFLD
After strict inclusion and exclusion criteria, a total of 88 patients were enrolled in this study, with 44 in each group, which made up the intent-to-treat population. In the control group 4 patients were lost to follow up and 2 patients in the treatment group. The final 82 patients (40 in the control group and 42 in t...
PMC9892935
SLF had a clinical efficacy on improving the liver function and FibroTouch, as well as relieving symptoms of fatigue
NAFLD, fatigue
LIVER
Liver function was tested for normality in both groups, and ALT, AST, and gamma glutamyl transpeptidase (GGT) did not conform to a normal distribution (SLF had a clinical efficacy on improving the liver function and FibroTouch, as well as relieving symptoms of fatigue. ALT, AST, GGT, CAP, LSM and FS-14 was compared in ...
PMC9892935
SLF could improve glycolipid metabolism with a good security
NAFLD, TG
In order to investigate the effects of SLF on blood lipids, we conducted a statistical analysis of total cholesterol (TC) and triglyceride (TG) of the two groups. After treatment in the control group, TC (SLF could improve glycolipid metabolism. TC, TG, FPG, HOMA-IR, and BMI were compared to evaluate the efficacy of SL...
PMC9892935
Reduced species diversity and altered intestinal flora abundance were observed in NAFLD
NAFLD
We randomly selected 11 patients, each from the control group and SLF group, and stool specimens were collected from these patients before and after treatment and sent for examination. A total of 53 stool samples (44 NAFLD and 9 HC) were detected utilizing 16S rRNA gene sequencing to analyze the changes of intestinal f...
PMC9892935
Intestinal flora correlated with clinical indicators of NAFLD, and SLF might play a role in regulating
NAFLD
To further investigate whether intestinal flora affected the severity of NAFLD, we investigated the correlation between Intestinal flora were correlated with clinical indicators of NAFLD, and SLF might play a role in regulating Our clinical trial results showed that SLF ameliorated the condition of NAFLD patients. Whet...
PMC9892935
SLF exerted its effect by regulating the disturbance of specific intestinal flora genera
At the genus level, some of the intestinal flora abundances altered. In our study, we found SLF exerted its effect by regulating the disturbance of specific intestinal flora genera. We applied PICRUSt2 to predict the metabolic function of intestinal flora. Metacyc pathway enrichment analysis showed enhanced super pathw...
PMC9892935
Discussion
NAFLD, metabolic diseases, HC
DISORDER, DISORDERS, METABOLIC DISEASES, HOT SPOT, PATHOGENESIS
NAFLD is often accompanied with disorders of glucolipid metabolism (The study of intestinal flora has become a hot spot in the study of metabolic diseases and microorganisms has grown rapidly in the past few decades. The intestinal flora participates in the absorption and metabolism of nutrients (including the metaboli...
PMC9892935
Conclusion
NAFLD
Our study suggested that NAFLD had relations with disturbances in the intestinal flora, which manifested as the levels of
PMC9892935
Data availability statement
The data presented in the study are deposited in the NCBI repository, accession number PRJNA921570.
PMC9892935
Ethics statement
The studies involving human participants were reviewed and approved by the Institutional Review Board of Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine (Ethics No. 2020-863-72-01). The patients/participants provided their written informed consent to participate in this study.
PMC9892935
Author contributions
DH: Project management, Methodology, Writing manuscript. LL: Conceptualization, Investigation, Methodology. NA:Conceptualization, Revision. JS, YH and WX: Visualization. CW,DX and YJ: Revision. YB: Supervision, Methodology. MS: Funding acquisition, Writing – review and editing. All authors contributed to the article an...
PMC9892935
Conflict of interest
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
PMC9892935
Publisher’s note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or ...
PMC9892935
Supplementary material
NAFLD
The Supplementary Material for this article can be found online at: Click here for additional data file.Differentially abundant taxa between HC and NAFLD samples analyzed by linear discriminant analysis effect size (LEfSe).Click here for additional data file.
PMC9892935
References
PMC9892935
Background
UEs
Umbilical artery serum-derived exosomes (UEs) serve as messengers for maternal–fetal information exchange and cellular regulation. Intravenous remifentanil could be considered as an effective adjunct to epidural anesthesia in providing a favorable analgesia effect for cesarean section (C-section), but its effects on UE...
PMC9840320
Methods
visceral pain
NEONATAL ASPHYXIA, COMPLICATIONS
From 01/12/2021 to 30/06/2022, eligible parturients scheduled for repeated C-section at the First Affiliated Hospital of Wenzhou Medical University were randomized to receive either an intravenous bolus (0.15 μg/kg) followed by a continuous infusion (0.075 μg/kg/min) of remifentanil or normal saline throughout the proc...
PMC9840320
Results
Nanoparticle tracking analysis indicated similar size of UEs between the two groups, but the number and protein amount of UEs were increased in the remifentanil group  compared to the control group (
PMC9840320
Conclusion
COMPLICATIONS
The intravenous administration of remifentanil increased the number of UEs in parturients undergoing repeated C-section under epidural anesthesia, with improved birth experience and minimal neonatal complications.
PMC9840320
Supplementary Information
The online version contains supplementary material available at 10.1186/s12884-023-05360-8.
PMC9840320