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   Table of Contents - Current issue
Coverpage
January-March 2019
Volume 5 | Issue 1
Page Nos. 1-23

Online since Thursday, March 28, 2019

Accessed 1,221 times.

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META-ANALYSIS  

The prognostic role of lactate in patients who achieved return of spontaneous circulation after cardiac arrest: A systematic review and meta-analysis p. 1
Dongni Ren, Xin Wang, Yanyang Tu
DOI:10.4103/ctm.ctm_6_19  
Aim: The aim of the study is to conduct a systematic review and meta-analysis of data showing the association of lactate levels with mortality and neurologic outcome in patients who achieved return of spontaneous circulation (ROSC) after cardiac arrest. Methods: An electronic search of PubMed, Embase, Web of Science, and Cochrane Library databases was conducted. Lactate levels at 0, 6, 12, 24, and 48 h after ROSC in survivors versus nonsurvivors and in good versus poor neurologic outcome patients were extracted. Continuous variable and odds ratio were applied for data analysis. Inverse-variance fixed effects model with 95% confidence interval (CI) was used depending on interstudy heterogeneity. Results: A total of 18 articles meeting the study criteria were included for systematic review and 15 for meta-analysis. The results showed that initial serum lactate levels in nonsurvivors were significantly higher than survivors (standardized mean difference [SMD] = −0.43; 95% CI = [−0.52, −0.33]; P < 0.00001), and a higher lactate level at admission was associated with increased hospital mortality. In addition, initial serum lactate levels were significantly higher in poor neurologic outcome patients than good neurologic outcome patients (SMD = −0.44; 95% CI = [−0.54, −0.34]; P < 0.00001), and initial higher lactate level was associated with poor neurologic outcome. There was a statistically significant difference in lactate levels at 6, 12, 24, and 48 h after ROSC, among survivors versus nonsurvivors and among patients presenting good neurologic outcome versus poor neurologic outcome. However, the included studies had small sample size and highly inconsistent data. Conclusions: Higher lactate levels were associated with increased mortality and poor neurologic outcome. Lower lactate levels or faster lactate clearance was associated with higher survival and good neurologic outcome.
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ORIGINAL ARTICLE Top

Inhibitory effect of hyaluronidase-4 in a rat spinal cord hemisection model p. 10
Xipeng Wang, Mitsuteru Yokoyama, Ping Liu
DOI:10.4103/ctm.ctm_30_18  
Objective: In this study, the effects of anti-hyaluronidase-4 (Hyal-4) antibody on the histological changes of Hyal-4 and the corresponding chondroitin sulfate proteoglycan (CSPG) expression in the rat spinal cord hemisection model were examined. Methods: After creating a rat spinal cord hemisection injury, experiments were conducted by administering anti-Hyal-4 antibody or control immunoglobulin G by intraspinal injection as a single dose, or intrathecal administration, using osmotic pumps, as multiple doses. Frozen sections of the injured spinal cord were made after a single-dose administration on days 1 and 4 and 1 week or at 1, 2, 3, and 4 weeks after the start of pump-aided injections. Immunofluorescence studies were then conducted using CS56 for CSPGs and anti-glial fibrillary acidic protein antibody for reactive astrocytes. Results: No difference was observed between the test and control groups in the single-dose administration of the antibody. In pump-aided administration, CSPGs in the control group decreased at 4 weeks, but those in the anti-Hyal-4 antibody administered group did not. Conclusion: Persistent suppression of Hyal-4 allowed CSPGs to remain and also increase in the rat spinal cord hemisection model, confirming Hyal-4 as an endogenous digestive enzyme of CSPGs.
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MINI REVIEW Top

Research and development of anticancer agents under the guidance of biomarkers p. 17
Xiaohui Xu, Guoyu Qiu, Lupeng Ji, Ruiping Ma, Zilong Dang, Ruling Jia, Bo Zhao
DOI:10.4103/ctm.ctm_2_19  
At present, cancer ranks first as the cause of death in the world, necessitating the need to develop new anticancer agents. As a probe, biomarkers can indicate the biological and pharmacological activity of anticancer agents and are thus valuable in predicting their effectiveness during the research and development phase. This paper reviews the research on the biomarker-guided prediction of the efficacy of anticancer agents. We infer that, in the process of the development of anticancer agents, reasonable selection of biomarkers can improve the accuracy of the development of anticancer agents.
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LETTER TO EDITOR Top

Idiopathic hypereosinophilic syndrome and disseminated intravascular coagulation p. 22
Mansoor C Abdulla
DOI:10.4103/ctm.ctm_3_19  
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