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1.
Liver Int ; 41(2): 288-294, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33043567

RESUMO

BACKGROUND & AIMS: Nucleos(t)ide analogue (NA) therapy in chronic hepatitis B (CHB) patients reduces liver-related mortality. However, long-term outcomes after pegylated interferon (PEG-IFN) therapy remain to be elucidated. Therefore, we aimed to investigate the long-term effectiveness and clinical outcomes of PEG-IFN therapy. METHODS: A total of 190 patients treated with PEG-IFN for CHB or compensated cirrhosis were consecutively enrolled between 2005 and 2014, and 122 patients who completed the treatment were analysed. The initial response was assessed at 6 months post-treatment and defined as achieving both <2000 IU/mL HBV DNA and HBeAg loss or seroconversion in the HBeAg-positive group, and <2000 IU/mL HBV DNA in the HBeAg-negative group. The rates of HBsAg loss, disease progression to cirrhosis or HCC, and sustained off-therapy response, defined as not requiring further NAs because of low viremia and liver enzymes, were analysed. RESULTS: The median follow-up period was 7.2 years. Forty-three (35.2%) patients achieved an initial response and 53 patients (43.4%) achieved a sustained response. Initial responders displayed higher rates of sustained response than noninitial responders (69.6% vs 32.5%, P < .001). A higher rate of HBsAg loss was observed in patients who achieved a sustained response than in non-sustained responders (16.2% vs 2.5%, P = .01). Disease progression to cirrhosis or HCC was observed in eight patients (6.6%) who were nonsustained responders. CONCLUSIONS: During long-term follow-up after PEG-IFN treatment, nearly half of patients achieved sustained response without the need of further NA and these patients displayed favourable outcomes, including HBsAg loss and no disease progression.


Assuntos
Carcinoma Hepatocelular , Hepatite B Crônica , Neoplasias Hepáticas , Antivirais/uso terapêutico , Carcinoma Hepatocelular/tratamento farmacológico , Progressão da Doença , Antígenos de Superfície da Hepatite B , Antígenos E da Hepatite B , Hepatite B Crônica/tratamento farmacológico , Humanos , Interferon-alfa/uso terapêutico , Neoplasias Hepáticas/tratamento farmacológico , Polietilenoglicóis/uso terapêutico , Proteínas Recombinantes/uso terapêutico , Resultado do Tratamento
2.
J Nanobiotechnology ; 17(1): 6, 2019 Jan 19.
Artigo em Inglês | MEDLINE | ID: mdl-30660182

RESUMO

BACKGROUND: Helicobacter pylori (H. pylori) infection remains a global public health issue, especially in Asia. Due to the emergence of antibiotic-resistant strains and the complexity of H. pylori infection, conventional vaccination is the best way to control the disease. Our previous study found that the N-acetyl-neuroaminyllactose-binding hemagglutinin protein (HpaA) is an effective protective antigen for vaccination against H. pylori infection, and intranasal immunization with the immunodominant HpaA epitope peptide (HpaA 154-171, P22, MEGVLIPAGFIKVTILEP) in conjunction with a CpG adjuvant decreased bacterial colonization in H. pylori-infected mice. However, to confer more robust and effective protection against H. pylori infection, an optimized delivery system is needed to enhance the P22-specific memory T cell response. RESULTS: In this study, an intranasal nanoemulsion (NE) delivery system offering high vaccine efficacy without obvious cytotoxicity was designed and produced. We found that this highly stable system significantly prolonged the nasal residence time and enhanced the cellular uptake of the epitope peptide, which powerfully boosted the specific Th1 responses of the NE-P22 vaccine, thus reducing bacterial colonization without CpG. Furthermore, the protection efficacy was further enhanced by combining the NE-P22 vaccine with CpG. CONCLUSION: This epitope-loaded nanoemulsion delivery system was shown to extend antigen release and elicit potent Th1 response, it is an applicable delivery system for intranasal vaccine against H. pylori.


Assuntos
Portadores de Fármacos , Epitopos , Infecções por Helicobacter , Helicobacter pylori/imunologia , Fatores de Transcrição/imunologia , Administração Intranasal , Animais , Antígenos de Bactérias/imunologia , Sistemas de Liberação de Medicamentos , Emulsões , Epitopos/administração & dosagem , Epitopos/imunologia , Feminino , Infecções por Helicobacter/imunologia , Infecções por Helicobacter/prevenção & controle , Humanos , Camundongos , Camundongos Endogâmicos BALB C , Nanopartículas , Vacinas
5.
Lasers Med Sci ; 32(4): 895-901, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-28293871

RESUMO

The purpose of this study is to assess the safety and efficacy of GreenLight laser photoselective vaporization of the prostate (PVP) for the treatment of benign prostate hyperplasia/lower urinary tract symptoms (BPH/LUTS) in patients with different post-void residual urine (PVR). BPH/LUTS patients treated with PVP from January 2014 to January 2016 were enrolled in the present study. All patients were divided into PVR > 50, 50 ≤ PVR < 400, and PVR ≥ 400 ml groups, and standard general and urological methods for BPH/LUTS were carried out. PVP surgery was performed, and the follow-up outcome was investigated 6 months after surgery. A total of 429 patients were included, and there were no significant differences in comorbid diseases or habits among the three groups. The maximum urinary flow rate (Qmax) differed significantly among the groups (P < 0.001), while patients in the PVR < 50 ml group had higher maximum detrusor pressure (Pdet.max) level than the other two groups (P < 0.001). Patients in 50 ≤ PVR < 400 (P < 0.001) and PVR ≥ 400 (P < 0.001) ml groups were more likely to develop detrusor underactivity than those in the PVR < 50 ml group. All patients were treated with PVP, and there were no severe complications requiring rehospitalization or reoperation except nine designed re-treatments. Follow-up data of 387 patients were available. Significant improvement in outcome parameters (International Prostate Symptom Score [IPSS], Qmax, and PVR) was observed in comparison with baseline measurements for the three groups. PVP significantly improved the IPSS, Qmax, and PVR in patients with different PVR; PVP is a safe and effective procedure for BPH/LUTS patients.


Assuntos
Terapia a Laser/métodos , Sintomas do Trato Urinário Inferior/cirurgia , Hiperplasia Prostática/cirurgia , Retenção Urinária/cirurgia , Idoso , Humanos , Masculino , Pessoa de Meia-Idade , Cuidados Pré-Operatórios , Ressecção Transuretral da Próstata/métodos , Resultado do Tratamento , Retenção Urinária/etiologia
6.
Zhongguo Zhong Xi Yi Jie He Za Zhi ; 34(9): 1064-8, 2014 Sep.
Artigo em Chinês | MEDLINE | ID: mdl-25335329

RESUMO

OBJECTIVE: To study the effect of Shugan Jiangu Recipe (SJR) on bone mineral density (BMD) and serum bone metabolic biochemical markers in postmenopausal breast cancer patients with osteopenia. METHODS: Totally 38 patients of postmenopausal women with breast cancer, who received aromatase inhibitors (AIs), were assigned to the treatment group (21 cases) and the control group (17 cases) by using random digit table. All patients took Caltrate D Tablet (containing Ca 600 mg and Vit D3 125 IU), one tablet daily. Patients in the treatment group took SJR, 6 g each time, twice daily for 6 successive months. The bone mineral density (BMD) level was detected before treatment and at months 6 after treatment. Levels of bone alkaline phosphatase (BALP), bone gla protein (BGP), tartrate-resistant acid phosphatase (TRAP), and C-terminal telopeptide of type II collagen (CTX-II) were detected by enzyme linked immunosorbent assay (ELISA). The drug safety was also assessed. RESULTS: Compared with before treatment, BMD of L2-4 and femur neck obviously increased in the treatment group at month 6 after treatment (P < 0.01), serum BALP and TRAP decreased (P < 0.05). Compared with before treatment, BMD of L2-4 and femur neck obviously decreased in the control group at month 6 after treatment (P < 0.05), serum BALP and TRAP increased (P < 0.01). Compared with the control group, lumbar and femur neck BMD obviously increased, serum levels of BGP and BALP obviously decreased, and serum levels of CTX-II and TRAP obviously increased in the treatment group at month 6 after treatment (P < 0.01). No serious adverse event occurred during the treatment period. Bone fracture occurred in one case of the control group (5.8%). CONCLUSION: SJR could attenuate bone loss of postmenopausal women with breast cancer who received AIs, increase BMD and improve abnormal bone metabolism.


Assuntos
Inibidores da Aromatase/efeitos adversos , Densidade Óssea/efeitos dos fármacos , Medicamentos de Ervas Chinesas/uso terapêutico , Osteoporose Pós-Menopausa/prevenção & controle , Fosfatase Ácida/sangue , Idoso , Fosfatase Alcalina/sangue , Osso e Ossos/efeitos dos fármacos , Osso e Ossos/metabolismo , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/metabolismo , Colágeno Tipo II/sangue , Feminino , Humanos , Isoenzimas/sangue , Pessoa de Meia-Idade , Osteocalcina/sangue , Osteoporose Pós-Menopausa/induzido quimicamente , Fragmentos de Peptídeos/sangue , Fosfatase Ácida Resistente a Tartarato
7.
Immun Inflamm Dis ; 11(7): e938, 2023 07.
Artigo em Inglês | MEDLINE | ID: mdl-37506146

RESUMO

BACKGROUND: Vaccination is an important method for the prevention of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission. There is currently a lack of real-world clinical data regarding the safety and efficacy of coronavirus disease 2019 (COVID-19) vaccines with respect to plaque psoriasis treatment involving tumor necrosis factor-α (TNF-α) and interleukin-17A (IL-17A) inhibitors. METHODS: We longitudinally analyzed 152 patients with plaque psoriasis, 86 of whom received two doses of inactivated COVID-19 vaccine (either BBIBP-CorV or CoronaVac). Comparisons were made between patients undergoing treatment with biologics (TNF- α inhibitors or IL-17A inhibitors) or acitretin. Routine blood tests were used to assess safety; the psoriasis area and severity index (PASI) and dermatology life quality index (DLQI) were used to assess efficacy. RESULTS: After inactivated COVID-19 vaccination, biologics retained considerable advantages in terms of improving skin lesions (measured by PASI) and quality of life (measured by DLQI), compared with conventional treatment (p < 0.05 and p < 0.01, respectively). Routine blood tests and hepatorenal function analyses suggested that inactivated SARS-CoV-2 vaccines did not alter the safety of biologics treatment (p > 0.05). CONCLUSIONS: Inactivated SARS-CoV-2 vaccines do not have significant impacts on the safety and efficacy of biologics (TNF-α inhibitors or IL-17A inhibitors) in patients with moderate to severe plaque psoriasis.


Assuntos
Produtos Biológicos , COVID-19 , Psoríase , Humanos , Vacinas contra COVID-19/efeitos adversos , Fator de Necrose Tumoral alfa , Interleucina-17 , Inibidores de Interleucina , Produtos Biológicos/uso terapêutico , Qualidade de Vida , COVID-19/prevenção & controle , SARS-CoV-2 , Resultado do Tratamento , Psoríase/tratamento farmacológico
8.
J Huazhong Univ Sci Technolog Med Sci ; 32(2): 205-209, 2012 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-22528221

RESUMO

This study retrospectively reviewed 9 cases of complicated hepatic cystic hydatidosis with intrabiliary rupture who were surgically treated with pericystectomy in combination with Roux-en-Y hepaticojejunostomy in our hospital from 2004 to 2010. The clinical features, results of laboratory tests, B-mode ultrasonography and CT, post-operative recovery, days of hospital stay after the operation and post-operative complications were statistically analyzed and the patients were followed up. The subjects in our series included 7 males and 2 females, whose average age was 50.78±7.58 years. Before operation, 9 patients suffered from pain of the right upper quadrant and jaundice, which, in 4 cases (44.45%), were accompanied with fever and chills. Preoperative B-mode ultrosonography and CT showed that all the 9 patients had single hydatid cyst, with their diameter being 9.33±1.58 cm on average. The lesions involved segments V, VI in 6 cases, and segment IV in 3 cases. By WHO classification, 7 cases were classified as CE3 and 2 cases as CE4. They all had choledochectasia. The subjects underwent the surgery uneventfully. Intraoperatively, 2-4 biliary fistula orifices were found, with the average of the orifice being (0.79±0.20) cm. After the operation, one patient developed incision infection, one had pulmonary infection and one suffered from reflux cholangitis. No anastomotic leaks or peri-operative deaths took place and follow-up revealed no recurrence and implantative metastasis. We are led to conclude that pericystectomy in combination with Roux-en-Y hepaticojejunostomy can achieve satisfactory results for the treatment of complicated hepatic cystic hydatidosis with intrabiliary rupture.


Assuntos
Anastomose em-Y de Roux/métodos , Cistectomia/métodos , Equinococose Hepática/cirurgia , Jejunostomia/métodos , Adulto , Terapia Combinada/métodos , Equinococose Hepática/diagnóstico , Feminino , Hepatectomia/métodos , Humanos , Masculino , Ruptura Espontânea/diagnóstico , Ruptura Espontânea/cirurgia , Resultado do Tratamento
9.
Front Public Health ; 10: 1072137, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36457318

RESUMO

Background: To date, the COVID-19 pandemic does not appear to be overcome with new variants continuously emerging. The vaccination against COVID-19 has been the trend, but there are multiple systematic reviews on COVID-19 vaccines in patients with cancer, resulting in redundant and sub-optimal systematic reviews. There are still some doubts about efficacy and safety of the COVID-19 vaccine in cancer patients. Purpose: To identify, summarize and synthesize the available evidence of systematic reviews on response and COVID-19 vaccine safety in patients with cancer. Methods: Multiple databases were searched from their inception to May 1, 2022 to fetch the relevant articles. Study quality was assessed by AMSTAR2. The protocol of this study was registered on PROSPERO (CRD42022327931). Results: A total of 18 articles were finally included. The seroconversion rates after first dose were ranged from 37.30-54.20% in all cancers, 49.60-62.00% in solid cancers and 33.30-56.00% in hematological malignancies. The seroconversion rates after second dose were ranged from 65.30-87.70% in all cancers, 91.60-96.00% in solid cancers and 58.00-72.60% in hematological malignancies. Cancer types and types of therapy could influence vaccine response. COVID-19 vaccines were safe and well-tolerated. Conclusions: This study suggests COVID-19 vaccine response is significantly lower in cancer patients. Number of received doses, cancer types and treatment strategies could influence response of COVID-19 vaccine in cancer patients. COVID-19 vaccines are safe and well-tolerated. Considering the emergence of several new variants of SARS-CoV-2 with potential influence on ongoing vaccination programs, there is a need for booster doses to increase the effectiveness of COVID-19 vaccines. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022327931, identifier CRD42022327931.


Assuntos
COVID-19 , Neoplasias Hematológicas , Neoplasias , Humanos , Vacinas contra COVID-19 , Pandemias , COVID-19/prevenção & controle , SARS-CoV-2 , Revisões Sistemáticas como Assunto , Neoplasias/terapia
10.
Artigo em Inglês | MEDLINE | ID: mdl-35682349

RESUMO

Following the outbreak of the COVID-19 pandemic, the continued emergence of major variant viruses has caused enormous damage worldwide by generating social and economic ripple effects, and the importance of PHSMs (Public Health and Social Measures) is being highlighted to cope with this severe situation. Accordingly, there has also been an increase in research related to a decision support system based on simulation approaches used as a basis for PHSMs. However, previous studies showed limitations impeding utilization as a decision support system for policy establishment and implementation, such as the failure to reflect changes in the effectiveness of PHSMs and the restriction to short-term forecasts. Therefore, this study proposes an LSTM-Autoencoder-based decision support system for establishing and implementing PHSMs. To overcome the limitations of existing studies, the proposed decision support system used a methodology for predicting the number of daily confirmed cases over multiple periods based on multiple output strategies and a methodology for rapidly identifying varies in policy effects based on anomaly detection. It was confirmed that the proposed decision support system demonstrated excellent performance compared to models used for time series analysis such as statistical models and deep learning models. In addition, we endeavored to increase the usability of the proposed decision support system by suggesting a transfer learning-based methodology that can efficiently reflect variations in policy effects. Finally, the decision support system proposed in this study provides a methodology that provides multi-period forecasts, identifying variations in policy effects, and efficiently reflects the effects of variation policies. It was intended to provide reasonable and realistic information for the establishment and implementation of PHSMs and, through this, to yield information expected to be highly useful, which had not been provided in the decision support systems presented in previous studies.


Assuntos
COVID-19 , Aprendizado Profundo , COVID-19/epidemiologia , Surtos de Doenças , Humanos , Pandemias/prevenção & controle
11.
Artigo em Inglês | MEDLINE | ID: mdl-34745301

RESUMO

OBJECTIVE: To explore the effect of acupoint application of Chinese medicine on children's height and bone age. METHODS: Altogether, 120 children with a short stature treated in our hospital from September 2017 to September 2018 were divided into the control group (CG, n = 60) and the observation group (OG, n = 60) according to the random number table method. The children in CG were given healthy diet and exercise plans and supplemented with daily vitamin intake. The OG was treated with acupoint application of Chinese medicine on the basis of the CG. The clinical efficacy of the CG and the OG of children after treatment was observed. The height increment, growth rate, and bone age of children were compared before and after treatment. The levels of IGF-1 and 25-(OH)D in the serum of children before and after treatment were tested. According to the clinical curative effect after treatment, the children were divided into good curative effect group (markedly effective + effective) and poor curative effect group (ineffective). Logistics regression analysis was applied to analyze the risk factors. RESULTS: Compared with the CG, the curative effect on the OG was evidently improved (P < 0.05). In addition, the height increment, the growth speed, and the bone age of the OG increased evidently (P < 0.05). Compared with the CG, the expression of IGF-1 and 25-(OH)D of the OG elevated (P < 0.05). Serum IGF-1 and 25-(OH)D concentrations were positively correlated with growth rate and bone age (P < 0.05). Risk factors analysis showed that disease course, IGF-1, 25-(OH)D expression, and heredity were the risk factors affecting the curative effect on children. CONCLUSION: Acupoint application of Chinese medicine has effect on the height and bone age of children with short stature, which is worthy of clinical promotion. In addition, early treatment should be carried out to improve the clinical efficacy of children.

12.
Laryngoscope ; 131(1): 54-58, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32034959

RESUMO

OBJECTIVES: Although lateral osteotomy is an important part of rhinoplasty, it is known to be closely associated with postoperative eyelid edema and ecchymosis after rhinoplasty. There is no consensus on which osteotomy methods are effective in reducing morbidity from rhinoplasty. This study compared the effects of different osteotomy methods on edema and ecchymosis after lateral osteotomy using a meta-analysis. STUDY DESIGN: A literature search using MEDLINE, SCOPUS, and Cochrane databases. METHODS: Two authors independently reviewed the databases published until May 2019. Randomized controlled trials that compared lateral osteotomy methods (external approach) with different methods (internal approach), for which the outcomes of interest were mucosal injury, edema, and ecchymosis on postoperative days, were included. Sufficient data for meta-analysis was found in six studies with a total of 224 patients. RESULTS: In a comparison of the external approach with the internal approach, mucosal injury was significantly lower in the external approach (odds ratio = 0.41; 95% confidence interval = [0.11; 0.99], I2 = 29%). There were significant differences between the external and internal approach in eyelid ecchymosis and edema, except for eyelid ecchymosis at 7 days postoperatively. However, all significant results showed a small effect size with a standardized mean difference near 0.2. CONCLUSIONS: The external approach during lateral osteotomy had no significant advantage in edema and ecchymosis compared to the internal approach. Further studies with good research methodology should be carried out to determine the effect on the postoperative complications of different lateral osteotomy methods. Laryngoscope, 131:54-58, 2021.


Assuntos
Equimose/prevenção & controle , Edema/prevenção & controle , Osteotomia/métodos , Complicações Pós-Operatórias/prevenção & controle , Rinoplastia/métodos , Equimose/etiologia , Edema/etiologia , Humanos , Complicações Pós-Operatórias/etiologia
13.
Respir Care ; 55(6): 725-8, 2010 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-20507655

RESUMO

OBJECTIVE: To evaluate the effects of educational and psychological intervention on the quality of life and psychological status of patients with asthma. METHODS: Asthmatic patients were randomized to study (n = 228) and control (n = 146) groups. Both groups received conventional pharmacotherapy for asthma. The study group also received education and psychological counseling. We assessed quality of life, mood states, and asthma knowledge before and after the educational and psychological interventions. RESULTS: The study group's mean quality-of-life score was higher than that of the control group immediately after the intervention (130.2 +/- 25.1 vs 111.6 +/- 27.4, P < .001) and 3 months after the intervention (144.4 +/- 16.9 vs 121.5 +/- 25.6, P < .001). The study group's mean asthma-knowledge score was higher immediately after the intervention (9.0 +/- 1.2 vs 7.5 +/- 1.8, P < .001) and 3 months after the intervention (9.4 +/- 0.8 vs 7.5 +/- 1.5, P < .001). Two weeks after the intervention the mean increment of the asthma-knowledge score in the study group was greater than that in the control group (1.8 +/- 1.6 vs 0.6 +/- 1.7, P = or < .01). The study group's mean Profile of Mood States score was lower than that of the control group immediately after the intervention (12.0 +/- 18.5 vs 23.0 +/- 22.7, P < .001) and 3 months following the intervention (10.2 +/- 7.5 vs 22.8 +/- 11.4, P < .001). CONCLUSIONS: Education and psychological counseling improves the quality of life and alleviates the psychological distress in patients with asthma. These interventions also enhance patient's understanding of this chronic disease.


Assuntos
Asma/psicologia , Aconselhamento Diretivo , Educação de Pacientes como Assunto , Qualidade de Vida , Estresse Psicológico/prevenção & controle , Adulto , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Estresse Psicológico/etiologia
14.
Pharmacol Ther ; 214: 107593, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32492512

RESUMO

Cell death plays a critical role in organism development and the pathogenesis of diseases. Necrosis is considered a non-programmed cell death in an extreme environment. Recent advances have provided solid evidence that necrosis could be programmed and quite a few types of programmed necrosis, such as necroptosis, ferroptosis, pyroptosis, paraptosis, mitochondrial permeability transition-driven necrosis, and oncosis, have been identified. The specific biomarkers, detailed signaling, and precise pathophysiological importance of programmed necrosis are yet to be clarified, but these forms of necrosis provide novel strategies for the treatment of various diseases, including cancer. Natural compounds are a unique source of lead compounds for the discovery of anti-cancer drugs. Natural compounds can induce both apoptosis and programmed necrosis. In this review, we summarized the recent progress of programmed necrosis and introduced their natural inducers. Noptosis, which is a novel type of programmed necrosis that is strictly dependent on NAD(P)H: quinone oxidoreductase 1-derived oxidative stress was proposed. Furthermore, the anti-cancer strategies that take advantage of programmed necrosis and the main concerns from the scientific community in this regard were discussed.


Assuntos
Antineoplásicos Fitogênicos/uso terapêutico , Produtos Biológicos/uso terapêutico , Neoplasias/tratamento farmacológico , Morte Celular Regulada/efeitos dos fármacos , Animais , Antineoplásicos Fitogênicos/efeitos adversos , Produtos Biológicos/efeitos adversos , Humanos , NAD(P)H Desidrogenase (Quinona)/metabolismo , Necrose , Neoplasias/metabolismo , Neoplasias/patologia , Estresse Oxidativo/efeitos dos fármacos , Transdução de Sinais
15.
PLoS Negl Trop Dis ; 14(3): e0008023, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32163408

RESUMO

BACKGROUND: Human cystic echinococcosis (CE) is one of the commonest zoonoses, and it is endemic in many parts of the world including China. Complications and recurrences after the surgical treatment of hepatic CE (HCE) incur a large personal, healthcare, and societal burden. There has been some progress in HCE prevention, diagnosis, and treatment, but there is no "one size fits all" approach, and surgery still remains the cornerstone of treatment for some cyst stages and locations or in areas with little knowledge or access to other treatment modalities. In 2009 we designed and implemented a program to improve surgical outcomes from HCE in Xinjiang province, China. METHODOLOGY/PRINCIPAL FINDINGS: A multimodal HCE training program was implemented in eleven primary hospitals in Xinjiang province, China, which provided education and training on HCE clinical knowledge and practice, the application of diagnostic and treatment options, and optimal surgery. The management of HCE cases was analyzed before and after program implementation. Contrast enhanced CT use, application of scoloicidal agents, removal of necrotic cyst wall remnants, appropriate perioperative drug use, and the use of optimal surgical approach increased after program implementation. Further, postoperative recurrences and residual cavity complications creased from 7.4% to 1.3% and 15.2% to 9.0% after program implementation, respectively. CONCLUSIONS/SIGNIFICANCE: Tis integrated surgical training program is useful for improving outcomes of patients with HCE and can be used in institutions in other endemic areas.


Assuntos
Equinococose Hepática/cirurgia , Educação/organização & administração , Procedimentos Cirúrgicos Operatórios/educação , Adulto , Anti-Helmínticos/uso terapêutico , China , Gerenciamento Clínico , Equinococose Hepática/diagnóstico , Equinococose Hepática/tratamento farmacológico , Feminino , Hospitais , Humanos , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Operatórios/métodos , Tomografia Computadorizada por Raios X/métodos
16.
Korean J Anesthesiol ; 73(1): 51-57, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31304694

RESUMO

BACKGROUND: This study was performed to evaluate the effect of a wagon as a transport vehicle instead of the standard stretcher car to reduce children's anxiety of separation from parents. The secondary goal was to evaluate whether this anxiolytic effect was related to age. METHODS: We divided 80 children (age 2-7 years) into two groups. The stretcher group was transferred to the operating room on a conventional stretcher car, whereas the wagon group was transferred using a wagon. The level of anxiety was evaluated three times using the Modified Yale Preoperative Anxiety Scale (mYPAS): in the waiting area (T0), in the hallway to the operating room (T1), and before induction of anesthesia (T2). RESULTS: The mYPAS score was significantly lower in the wagon group (36.7 [31.7, 51.7]) than in the stretcher group (51.7 [36.7, 83.3]) at T1 (P = 0.007). However, there was no difference in the mYPAS score between the two groups at T2 (46.7 [32.5, 54.2] vs. 51.7 [36.7, 75.0], respectively, P = 0.057). The baseline anxiety tended to be lower with increasing age (r = -0.248, P = 0.031). During transportation to the operating room, the increase in the mYPAS score (T1-T0) was greater as the age of children decreased in the stretcher group (r = -0.340, P = 0.034). However, no correlation was observed in the wagon group (r = -0.053, P = 0.756). CONCLUSION: The wagon method decreased preoperative anxiety, suggesting that it may be a good alternative for reducing preoperative anxiety in children.


Assuntos
Ansiedade de Separação/prevenção & controle , Ansiedade/prevenção & controle , Cuidados Pré-Operatórios/métodos , Transporte de Pacientes/métodos , Fatores Etários , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Pais
17.
J Neurosurg ; 110(3): 418-26, 2009 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-18847343

RESUMO

OBJECT: Utilization of covered stent grafts in treating neurovascular disorders has been reported, but their efficacy and safety in vertebral artery (VA) dissecting aneurysms needs further investigation. METHODS: Six cases are presented involving VA dissecting aneurysms that were treated by positioning a covered stent graft. Two aneurysms were located distal to the posterior inferior cerebellar artery, and 4 were located proximal to the posterior inferior cerebellar artery. Aspirin as well as ticlopidine or clopidogrel were administered after the procedure to prevent stent-related thrombosis. All patients were followed up both angiographically and clinically. RESULTS: Five of the 6 patients underwent successful placement of a covered stent graft. The covered stent could not reach the level of the aneurysm in 1 patient with serious vasospasm who died secondary to severe subarachnoid hemorrhage that occurred 3 days later. Patient follow-up ranged from 6 to 14 months (mean 10.4 months), and demonstrated complete stabilization of the obliterated aneurysms, and no obvious intimal hyperplasia. No procedure-related complications such as stenosis or embolization occurred in the 5 patients with successful stent graft placement. CONCLUSIONS: Although long-term follow-up studies using a greater number of patients is required for further validation of this technique, this preliminary assessment shows that covered stent graft placement is an efficient, safe, and microinvasive technique, and is a promising tool in treating intracranial VA dissecting aneurysms.


Assuntos
Dissecção Aórtica/terapia , Aneurisma Intracraniano/terapia , Artéria Vertebral , Adulto , Clopidogrel , Feminino , Fibrinolíticos/uso terapêutico , Humanos , Trombose Intracraniana/prevenção & controle , Masculino , Pessoa de Meia-Idade , Inibidores da Agregação Plaquetária/uso terapêutico , Stents , Ticlopidina/análogos & derivados , Ticlopidina/uso terapêutico , Resultado do Tratamento
18.
Zhonghua Yu Fang Yi Xue Za Zhi ; 43(7): 615-8, 2009 Jul.
Artigo em Chinês | MEDLINE | ID: mdl-19954075

RESUMO

OBJECTIVE: To evaluate the safety and immunological effect of domestic split influenza virus vaccine. METHODS: All 606 subjects were divided into three groups by under 6, 16-60 and above 60 years old. Each age group was divided as study group (n = 213), control group 1 (n = 195) and control group 2 (n= 198) by Table of Random Number, one domestic vaccine and two imported vaccines were respectively inoculated in three group people. The differences of clinical side effect rate, antibody positive rate, protective rate and geometric mean titer (GMT) of these three vaccines were compared by using the statistical software with statistical significance of P < 0.05. RESULTS: The side effect rate of study group, control group 1 and control group 2 was 3.76% (8/213), 4.10% (8/195), and 3.54% (7/198), respectively without statistical significance(chi2 = 0.87, P =0.93). The positive seroconversion rates of H1N1, H3N2 and B in these three groups were respectively 89.2% (190/213), 63.4% (135/213), 86.4% (184/213), 88.7% (173/195), 61.5% (120/195), 87.2% (170/195), 87.9% (174/198), 61.6% (122/198) and 84.8% (168/198). There were no statistical significance in the total positive seroconversion rate of each antibody type (chi2(H1N1) = 0.94, P(H1N1) = 0.63; chi2(H3N2) = 0.94, P(H3N2) = 0.63; chi2(B) = 0.75, P(B) = 0.69). The average growth multiple of H1N1, H3N2 and B in these three groups were 10.7, 7.3, 8.4, 10.5, 6.3, 8.3, 10.2, 7.1, 8.8 times. There were no statistical significances in the GMT growth multiple of each antibody type (F(H1N1) = 0.35, P(H1N1) = 0.70; F(H3N2) = 2.22, P(H3N2) = 0.11; F(B) = 1.51, P(B) = 0.35). The antibody protective rates of H1N1, H3N2 and B were 100% (213/213), 70.0% (149/213), 95.3% (203/213), 100% (195/195), 66.7% (130/195), 97.9% (191/195), 99.5% (197/198), 66.2% (131/198), 96.5% (191/198) respectively. There was no statistical difference among the three vaccines (chi2(H1N1) = 2.04, P(H1N1) = 0.36; chi2(H3N2) = 0.74, P(H3N2) = 0.69; chi2(B) = 0.42, P(B) = 0.82). CONCLUSION: The domestic influenza split vaccine might be suitable for colony vaccination for its having clinical safety and immunological effect.


Assuntos
Vacinas contra Influenza/efeitos adversos , Vacinas contra Influenza/imunologia , Adolescente , Adulto , Criança , Humanos , Vírus da Influenza A Subtipo H1N1/imunologia , Vírus da Influenza A Subtipo H3N2/imunologia , Influenza Humana/prevenção & controle , Pessoa de Meia-Idade , Adulto Jovem
19.
Environ Int ; 122: 301-309, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30477816

RESUMO

BACKGROUND: Reducing cadmium (Cd) exposure in Cd-polluted areas in Asia is urgently needed given the toxic effects of Cd. The short-term and long-term benefits of lowering Cd exposure are unknown because of its long half-life in the body. OBJECTIVES: We aimed to investigate whether an intervention with low-Cd rice in a contaminated area of China reduced urinary Cd (UCd) levels and improved blood pressure and kidney function outcomes compared to no-intervention in consumers of high-Cd rice in the same region. METHODS: 106 non-smoking subjects were divided into three treatment groups: the intervention group (replacing homegrown high-Cd rice with market low-Cd rice, n = 34), the non-intervention group (continue eating high-Cd rice, n = 36) and the control group (continued eating low-Cd rice they have been eating for years, n = 36). The intervention period lasted for almost 8 months, during which participants were visited on up to 4 occasions and UCd, systolic and diastolic blood pressure (SBP, DBP), kidney function biomarkers (ß2-microglobulin and N-acetyl-ß-D-glucosaminidase) were measured. RESULTS: After 3 months, the geometric mean UCd in the intervention (Int) group decreased significantly by 0.32 µg/g (p = 0.007), while changes were not significant in the non-intervention (non-Int) group (0.13 µg/g, p = 0.95) or the control group (-0.01 µg/g, p = 0.52). UCd in the Int group remained lower than in the non-Int group but higher than in the Control group through the end of follow up. DBP in the Int group decreased significantly from 80 mm Hg at month three (p = 0.03) and stayed around 74 mm Hg for the remainder of the study. SBP also decreased in the Int group but with variations similar to those observed in the other two groups. The two kidney biomarkers showed variations without a clear pattern. CONCLUSION: This study suggested that UCd reflected both short-term (<3 months) and long-term Cd exposure. In addition, the low-Cd rice intervention showed initial benefits in lowering blood pressure levels, especially DBP, but not kidney biomarkers.


Assuntos
Cádmio/urina , Exposição Ambiental , Exposição Ambiental/análise , Exposição Ambiental/prevenção & controle , Exposição Ambiental/estatística & dados numéricos , Humanos , Oryza
20.
Chin J Integr Med ; 14(1): 61-4, 2008 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-18219451

RESUMO

OBJECTIVE: To observe the effect of transcutaneous electrical acupoint stimulation (TEAS) on nausea and vomiting (N&V) induced by patient controlled intravenous analgesia (PCIA) with Tramadol. METHODS: Sixty patients who were ready to receive scheduled operation for tumor in the head-neck region and post-operation PCIA, aged 39-65 years, with the physique grades I-II of ASA, were randomized into two groups, A and B, 30 in each group. The pre-operation medication, induction of analgesia and continuous anesthesia used in the two groups were the same. TEAS on bilateral Hegu (LI4) and Neiguan (PC6) points was intermittently applied to the patients in group A starting from 30 min before analgesia induction to 24 h after operation, and the incidence and score of nausea and vomiting, antiemetic used, visual analogue scores (VAS), and PCIA pressing times in 4 time segments (0-4, 4-8, 8-12 and 12-24 h after the operation was finished) were determined. The same management was applied to patients in Group B, with sham TEAS for control. RESULTS: The incidence and degree of N&V, as well as the number of patients who needed remedial antiemetic in Group A were less than those in Group B. The VAS score and PCIA pressing time were lower in Group A than those in Group B in the corresponding time segments respectively. CONCLUSION: TEAS could prevent N&V induced by PCIA with Tramadol.


Assuntos
Pontos de Acupuntura , Analgesia Controlada pelo Paciente , Analgésicos Opioides/efeitos adversos , Náusea/prevenção & controle , Tramadol/efeitos adversos , Estimulação Elétrica Nervosa Transcutânea , Vômito/prevenção & controle , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
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