Frigid Zone Medicine

Advances in the research field of osteoporosis in cold areas

Ping Zhou, Hanlu Zhang, Yizhen Nie, Yimeng Zhang, Yongchen Wang

2022, 2(1): 1-9. doi: 10.2478/fzm-2022-0001

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Abstract:
While osteoporosis is a chronic disease caused by multiple factors, it is also a risk factor for fractures. At present, numerous risk factors for osteoporosis and secondary fractures have been identified, including sunlight, physical fitness, gender, age, trauma, dietary habits, tobacco, alcohol, drugs, air quality, and genetics. Despite that factors such as long winters, short daylight hours, less daily physical activity, air pollution, low calcium and high salt diet, and sedentary lifestyle could negatively impact the bones of residents in the alpine regions of northern China, the direct effect of low-temperature stimulation on bone growth and development remains unclear. In this study, by reviewing current research progress related to osteoporosis and fracture risk in northern China, we proposed appropriate preventive measures for different risk factors to reduce the occurrence of osteoporosis and fracture in cold areas of northern China.

Therapeutic potential of gasotransmitters for cold stress-related cardiovascular disease

Haijian Sun, Xiaowei Nie, Kangying Yu, Jinsong Bian

2022, 2(1): 10-24. doi: 10.2478/fzm-2022-0002

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Abstract:
Growing evidence has shown that exposure to low ambient temperature poses a huge challenge to human health globally. Actually, cold stress is closely associated with a higher incidence of cardiovascular morbidity and mortality in winter or in cold regions. Cellular and molecular mechanisms underlying cardiovascular complications in response to cold exposure have yet to be fully clarified. Considering that cold exposure is an important risk of cardiovascular complications, it is necessary to clarify the molecular mechanism of cold stress-induced cardiovascular diseases and to develop effective intervention strategies. Hydrogen sulfide (H₂S), nitric oxide (NO), and carbon monoxide (CO) are wellknown gasotransmitters that are endogenously produced in many biological systems. Accumulating studies have demonstrated that these gasotransmitters play a critical role in a wide spectrum of physiological and/or pathophysiological processes by regulating numerous signaling pathways. These gas signal molecules are emerging as important players in cardiovascular homeostasis, and disruption of these gasotransmitters is critically implicated in cardiovascular anomalies, such as hypertension, atherosclerosis, myocardial ischemia, heart failure, and stroke. Also, evidence is emerging that H₂S, NO, and CO may be involved in the pathologies of cold stress-induced cardiovascular ailments. In this review, we aim to highlight and discuss the recent advances towards the development of gasotransmitters-based therapeutics for cold stressrelated cardiovascular pathogenesis. We believe that the effects of H₂S, NO, and CO on cardiovascular regulation under cold environment will attract tremendous interest in the near future as they serve as novel regulators of cardiovascular biology in cold environment.

Advances on pathogenesis of migraine in cold regions

Qihui Chen, Yonghui Pan, Dan Yao, Yongchen Wang

2022, 2(1): 25-29. doi: 10.2478/fzm-2022-0003

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Abstract:
Migraine is a common primary headache which seriously affects the quality of patients' life due to the high prevalence and disability rate. Recent years a large number of studies have found that temperature is directly bound to migraine and migraine patients in cold regions have higher prevalence, different manifestations and poor response to the conventional therapy. We propose in this review article a new concept of migraine in cold regions on the basis of geography and summarize the research advances on the pathogenesis of migraine in cold regions to provide conceptual basis for the clinical diagnosis and treatment of this disease entity.

Ticagrelor versus clopidogrel in East Asian patients with acute coronary syndrome: A meta-analysis

Meijiao He, Yanxiang Zang, Danghui Sun, Jianqiang Li, Guangzhong Liu, Jing Shi, Yue Li

2022, 2(1): 30-40. doi: 10.2478/fzm-2022-0004

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Abstract:
Objective There exist conflicting data on the efficacy and safety of ticagrelor and clopidogrel in East Asian patients with acute coronary syndrome (ACS). We performed a meta-analysis to evaluate whether ticagrelor or clopidogrel produces better outcomes for East Asian patients with ACS. Methods We searched for randomized controlled trials reporting associations between ticagrelor and clopidogrel in East Asian patients with acute coronary syndrome in PubMed, EMBASE, web of science and Cochrane central register of controlled trials. Results Ten studies involving 3 715 participants were qualified for our analysis. The major adverse cardiovascular events (MACE) were significantly decreased in patients with ticagrelor treatment compared to those with clopidogrel (risk ratio [RR]: 0.61; 95% confidence interval [CI]: 0.38-0.98; P = 0.042). There was no significant difference in all-cause death (RR: 0.89; 95% CI: 0.61-1.29; P = 0.540), cardiovascular death (RR: 0.86; 95% CI: 0.58-1.27; P = 0.451), myocardial infarction (RR: 0.91; 95% CI: 0.65-1.27; P = 0.575) and stroke (RR: 0.77; 95% CI: 0.44-1.36; P = 0.372) between ticagrelor and clopidogrel. Ticagrelor was associated with a significantly higher risk of bleeding compared to clopidogrel (RR: 1.71; 95% CI: 1.37-2.13; P = 0.000). Conclusion The present meta-analysis demonstrates that ticagrelor reduced the incidence of MACE in ACS patients from East Asia compared with clopidogrel. However, it increased the risk of bleeding.

Study of the incidence of hyperuricemia in young males' population with rapid entry into the plateau of 4 500m

Chang'e Liu, Yingyue Liu, Xiaoyang Hong, Zhichun Feng

2022, 2(1): 41-44. doi: 10.2478/fzm-2022-0005

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Abstract:
Objective To study the incidence and risk factors of hyperuricemia in young males who rapid entered into the plateau of 4 500 m. Methods The study contained 390 males aged 18-35 years (21.6 ± 2.5 years), who rapidly entered the plateau with an altitude of 4 500 m. According to their basic level of uric acid (UA), they were divided into two groups, high uric acid (HUA) group and normal uric acid (NUA) group. The characteristics and physiological index, such as the body weight and the height, of them were recorded. For the test of the biochemical indicators, the venous blood samples were collected at the altitude of 4 500 m in the morning. The count of blood cells, blood urea nitrogen (BUN), serum creatinine (SCR), lactate dehydrogenase (LDH), total bilirubin (TBIL), direct bilirubin (DBIL) and indirect bilirubin (IDBIL) were compared between the two groups. Results The incidence of hyperuricemia was 65.1% (254/390) at 4 500 m. At the altitude of 4 500 m, the mean hemoglobin concentration (MCHC) of red blood cells in the HUA group was significantly lower than that in the NUA group. Hemoglobin (HGB), mean red blood cell volume (MCV), TBIL, IDBIL, BUN, SCR and LDH in the HUA group were significantly higher than those in the NUA group, though without statistically significant differences in the other variables. Meanwhile, multivariate analysis showed at the altitude of 4 500 m, the risk of HUA increased by 0.982, 1.038 and 1.045 times when MCHC decreased by one unit and TBIL and SCR increased by one unit, respectively. Conclusion The incidence of hyperuricemia was high of 65.1% rush entry into the plateau of young male. Decreased MCHC and elevated TBIL and SCR were independent risk factors for hyperuricemia when rapid enter into 4 500 m.

Robot-assisted radical cystectomy for bladder cancer: single-center experience

Valentin Pavlov, Marat Urmantsev, Ruslan Safiullin, Anton Denejko, Rita Gilmanova, Ruslan Abdrakhimov

2022, 2(1): 45-52. doi: 10.2478/fzm-2022-0006

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Abstract:
Objective Radical cystectomy remains the most effective treatment for patients with localized, invasive bladder cancer and recurrent noninvasive disease. Recently some surgeons have begun to describe outcomes associated with less invasive surgical approaches to this disease, such as laparoscopic or robotic assisted techniques. We report our maturing experience with 100 consecutive cases of robotic assisted laparoscopic radical cystectomy regarding perioperative results, pathological outcomes, and surgical complications. Methods A total of 100 consecutive patients (73 male and 27 female) underwent robotic radical cystectomy with intracorporeal urinary diversion at our institution from February 2018 to February 2021 for clinically localized bladder cancer. Outcome measures evaluated included operative variables, hospital recovery, pathological outcomes, and complication rate. Results The mean age of this cohort was 60.4 years (range 38 to 82). Ninety-five patients underwent ileal conduit diversion, 5 received a neobladder). The mean operating room time for all patients was 184 min (min time was 160 min) and mean surgical blood loss was 286 ml. On surgical pathology, 2% of the cases were pT1, 35% were pT2, 51+12% were pT3/T4 disease and 17% were node positive. The mean number of lymph nodes removed was 16 (range 10 to 40). In no case was there a positive surgical margin. The mean days to flatus were 2.6, bowel movement 2.8 and discharge home 8.2. There were 21 postoperative complications in 20 patients with 4% having a major complication (Clavien grade 3 or higher) and 15% being readmitted within 30 days after surgery. At a mean follow-up of 12 months 3 patients had disease recurrence and died 4 of disease. Conclusions We report a relatively large cohort and maturing experience with robotic radical cystectomy for the treatment of bladder cancer, providing acceptable surgical and pathological outcomes. These results support continued efforts to refine the surgical management of muscle-invasive bladder cancer.

Apelin aggravates the migration and invasion of nonsmall cell lung cancer cells via YAP1

Wenchao Ma, Di Zhu, Tong Yu, Junwen Xue, Xiang Sun, Guofang Zhang, Yumeng Hou, Jinrui Li, Yingzhun Chen, Hongli Shan, Haihai Liang

2022, 2(1): 53-64. doi: 10.2478/fzm-2022-0007

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Abstract:
Background Apelin, an endogenous ligand of G-protein coupled receptor (GPCR), is a secreted peptide involved in the development of various tumors. However, the relationship between apelin and nonsmall cell lung cancer (NSCLC) is not quite clear. This study was designed to investigate the effect and mechanism of apelin on cell proliferation, migration and invasion of NSCLC cells. Methods Twelve NSCLC specimens were collected for hematoxylin-eosin (HE) staining and immunohistochemistry analyses. Cell proliferation was examined by 3-(4, 5-Dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide (MTT) and cell migration and invasion were assessed using wound-healing and transwell assays. The subcellular location of yes associated protein 1 (YAP1) in A549 cells was determined by immunofluorescence. The mRNA and protein levels in NSCLC tissues and cell lines were measured by qRT-PCR and western blot, respectively. Results Apelin was upregulated in tumor tissues compared with the adjacent tissues. Apelin promoted proliferation, migration, and invasion of A549 and H460 cells, which was reversed by competitive apelin receptor (APJ) antagonist ML221. Additionally, apelin upregulated YAP1 expression, whereas silence of YAP1 by small interfering RNA (siRNA) attenuated apelin-induced cell proliferation, migration and invasion and suppressed epithelial-mesenchymal transition progression. Conclusion Apelin promotes NSCLC cells proliferation, migration, and invasion by modulating YAP1 and might be a potential therapeutic target for NSCLC treatment.

2022 Vol. 2, No. 1

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