RESUMO
Objective: To analyze the occurrence of recompensation conditions in patients with chronic hepatitis B virus-related decompensated cirrhosis after entecavir antiviral therapy. Methods: Patients with hepatitis B virus-related decompensated cirrhosis with ascites as the initial manifestation were prospectively enrolled. Patients who received entecavir treatment for 120 weeks and were followed up every 24 weeks (including clinical endpoint events, hematological and imaging indicators, and others) were calculated for recompensation rates according to the Baveno VII criteria. Measurement data were compared using the Student t-test or Mann-Whitney U test between groups. Categorical data were compared by the χ (2) test or Fisher's exact probability method between groups. Results: 283 of the 320 enrolled cases completed the 120-week follow-up, and 92.2% (261/283) achieved a virological response (HBV DNA 20 IU/ml). Child-Pugh and MELD scores were significantly improved after treatment (8.33 ± 1.90 vs. 5.77 ± 1.37, t = 12.70, P < 0.001; 13.37 ± 4.44 vs. 10.45 ± 4.58, t = 5.963, P < 0.001). During the 120-week follow-up period, 14 cases died, two received liver transplants, 19 developed hepatocellular cancer, 11 developed gastroesophageal variceal bleeding, and four developed hepatic encephalopathy. 60.4% (171/283) (no decompensation events occurred for 12 months) and 56.2% (159/283) (no decompensation events occurred for 12 months and improved liver function) of the patients had achieved clinical recompensation within 120 weeks. Patients with baseline MELD scores > 15 after active antiviral therapy achieved higher recompensation than patients with baseline MELD scores ≤15 [50/74 (67.6%) vs. 109/209 (52.2%), χ (2) = 5.275, P = 0.029]. Conclusion: Antiviral therapy can significantly improve the prognosis of patients with hepatitis B virus-related decompensated cirrhosis. The majority of patients (56.2%) had achieved recompensation. Patients with severe disease did not have a lower probability of recompensation at baseline than other patients.
Assuntos
Varizes Esofágicas e Gástricas , Hepatite B Crônica , Hepatite B , Humanos , Antivirais/efeitos adversos , Varizes Esofágicas e Gástricas/complicações , Hemorragia Gastrointestinal/complicações , Hepatite B/tratamento farmacológico , Vírus da Hepatite B/genética , Hepatite B Crônica/complicações , Hepatite B Crônica/tratamento farmacológico , Cirrose Hepática/complicações , Resultado do TratamentoRESUMO
Objective: To investigate the regulatory effect of blue light on the expression of brain derived neurotrophic factor (BDNF) in the habenula nucleus of depression-like rats induced by light deprivation. Methods: male SD rats were exposed to white light (white light control group, 20 rats) and constant darkness (depression model group, 60 rats), respectively. 18 days later rats in depression model group were randomly divided into three groups: depression model group (treated with constant darkness), blue light group (treated with blue light) and red light group (treated with red light). Rats in white light control group were kept in white light. All rats exposed to light were in a standard 12â¶12 h Light/Dark condition at 20 lx for 36 days. Sucrose preference test was applied to evaluate depression-like symptoms of rats. The c-fos+cells in the habenula nucleus, intergeniculate leaflet and ventral lateral geniculate nucleus were detected. The phosphoylation of cAMP-response element binding protein (CREB) and the relative BDNF protein level in the habenula nucleus were measured. Results: Sucrose intake per kg body weight increased in rats exposed to blue light and returned to the level of control group (P>0.05). Sucrose intake per kg body weight in red light group and depression model group were lower than control group (P<0.05). More c-fos+cells were detected in the habenula nucleus, intergeniculate leaflet and ventral lateral geniculate nucleus from blue light group than those from depression model group (P<0.05). The relative BDNF protein level and the phosphoylation of CREB in the habenula nucleus from blue light group were higher than those from depression model group (P<0.05). Conclusion: Blue light could relieve depression-like symptoms in light-deprived rats. Exposure to blue light could activate neurons in the habenula nucleus to which intrinsically photosensitive retinal ganglion cells projected. Blue-light-mediated antidepressant effect might involve in the activation of CREB/BDNF signal transduction pathways in the habenula nucleus.
Assuntos
Fator Neurotrófico Derivado do Encéfalo , Habenula , Animais , Depressão , Modelos Animais de Doenças , Habenula/metabolismo , Masculino , Ratos , Ratos Sprague-DawleyRESUMO
Objective: To screen the different microRNAs in the serum exosomes of patients with malignant glioma, to explore the effect of non-coding microRNA-376b-3p (miR-376b-3p) on the proliferation, invasion and tumor vasculogenic mimicry of glioma cells, and to verify its targeting effect on HOXD10. Methods: HiSeq/MiSeq high-throughput sequencing was used to screen the different microRNA expression profiles, target genes and action pathways in the serum exosomes of patients with malignant glioma. Samples were used to evaluate the expression of candidate microRNAs in serum exosomes of high-grade gliomas. The effects of miR-376b-3p on the proliferation, invasion and angiogenesis of glioma cells were detected by MTT assay, Transwell migration assay and Matrigel vasculogenic mimicry assay. The mRNA and protein expression of HOXD10 were detected to evaluate the regulatory effect of miR-376b-3p on it. Results: There were 144 different expression microRNAs in the serum exosomes between malignant glioma and the normal control. Focal adhesion and tumor protein polysaccharides were involved in the regulation of glioma enriched by KEGG(Kyoto Encyclopedia of Genes and Genomes). MiR-376b-3p was down regulated in malignant glioma, and AUC of malignant glioma was 0.85 (P<0.01). MTT test showed that the proliferation ability of miR-376b-3p inhibitor group was higher than that of the control group, and that of miR-376b-3p mimic group was lower than that of the control group. Transwell migration test showed that the number of transmembrane cells in miR-376b-3p inhibitor group was higher than that in NC inhibitor group, and the number of transmembrane cells in miR-376b-3p mimic group was lower than that in NC mimic group. The number of tubes of vasculogenic mimicry in miR-376b-3p mimic group was lower than that in NC mimic group. MiR-376b-3p inhibitor decreased the expression level of HOXD10 mRNA and protein, and miR-376b-3p mimic increased the expression level of HOXD10 mRNA and protein. Conclusions: MiR-376b-3p is down-regulated in the serum exosomes of malignant glioma patients. The up-regulated miR-376b-3p can reduce the proliferation and invasion of glioma cells, inhibit the formation of vasculogenic mimicry, and increase the expression of HOXD10, which is expected to inhibit the formation of two forms of angiogenesis at the same time. MiR-376b-3p may be a new therapeutic target of anti-angiogenesis for malignant glioma.
Assuntos
Exossomos , Glioma , MicroRNAs/genética , Linhagem Celular Tumoral , Movimento Celular , Proliferação de Células , Regulação Neoplásica da Expressão Gênica , Glioma/genética , Humanos , RNA MensageiroRESUMO
OBJECTIVE: This study aims to investigate the role of solute transport family 5 member 8 (SLC5A8) in the progress of cervical cancer (CC) to provide a theoretical basis for the treatment of CC. PATIENTS AND METHODS: Tissues were obtained from 58 patients diagnosed with CC in our hospital. Real Time-quantitative Polymerase Chain Reaction (RT-qPCR) analysis was used to detect the expression level of SLC5A8 in CC tissues and cell lines. SLC5A8 level was up-regulated by transfection of SLC5A8 overexpression plasmid. MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide) assay and flow analysis were designed to measure the cell proliferation, cell cycle, and apoptosis of CC cells. RESULTS: The mRNA expression of SLC5A8 was down-regulated in CC tissues and cell lines. Transfection of SLC5A8 overexpression plasmid successfully over-expressed SLC5A8. In addition, an inhibited activation of Wnt signaling pathway was detected in CC cells after over-expression of SLC5A8. Besides, decreased proliferation activity and increased apoptosis were also observed in CC cells overexpressing SLC5A8 plasmid. Moreover, the impaired proliferation activity and increased apoptosis proportion of CC cells induced by SLC5A8 over-expression could be counteracted by the Wnt signaling pathway activator LiCl. CONCLUSIONS: SLC5A8 alleviates the progression of CC by regulating the Wnt signaling pathway.
Assuntos
Proliferação de Células/fisiologia , Transportadores de Ácidos Monocarboxílicos/biossíntese , Neoplasias do Colo do Útero/metabolismo , Via de Sinalização Wnt/fisiologia , Feminino , Células HeLa , Humanos , Neoplasias do Colo do Útero/patologiaRESUMO
Many studies in modern times claim that the name " 100-day cough" is from traditional Chinese medicine, and even think that there is a description of pertussis as early as the Sui Dynasty classics. By reviewing the original texts of the classics, we found that these interpretations are not exactly. The description of the pertussis and the chronological distribution of the literature in traditional Chinese books are similar to those of Western medicine. They started about 500 years ago, and then become more detailed and specific. The domestic medical community has a variety of nomenclature for this disease, and there is no sign or evidence to uniformly use "100-day cough" as the disease name. The literature records suggest that "100-day cough" first became a more recognized disease name in Japan, and through the direct input of medical education, entered the modern medical textbooks of western medicine in China.
Assuntos
Tosse , Medicina Tradicional Chinesa , Livros , China , História do Século XV , Humanos , JapãoRESUMO
In this paper, a novel energy-based signal, the removal energy density $e_{b}$, is proposed as the detecting signal to determine the breakthrough instances in bone drilling based on the energy approach during the process. The proposed signal is derived from the energy conversion and conservation in drilling process. And the relationship between the signal and the drilling parameter, e.g., drilling speed, feed rate and drill bit radius, is derived. Recursive least square with time forgetting factor is used to estimate $e_{b}$ from the drilling parameters and drilling torque information. Unlike the traditional force profile, this proposed signal profile is similar under different drilling parameters including drilling speed and feed rate, hence reducing the difficulty in setting a threshold for the detection. Experiment on porcine bone is performed. The results show that the proposed signal profile is more consistent than the commonly used force profile, verifying the effectiveness of the proposed method.
Assuntos
Osso e Ossos , Fenômenos Mecânicos , Animais , Suínos , TorqueRESUMO
Objective: To evaluate the incidence, and the characteristics of organ failure in relationship to prognosis in hepatitis B virus-associated acute-on-chronic liver failure (HBV-ACLF) patients using chronic liver failure-sequential organ failure assessment (CLIF-SOFA) score for judgments of clinical treatment and prognosis. Methods: Clinical data of 316 patients who were diagnosed as HBV-ACLF during hospitalization from February 2015 to February 2016 were retrospectively analyzed. Intrahepatic and extrahepatic organ failures were assessed according to CLIF-SOFA score, and the relationship between clinical characteristics and prognosis was analyzed. Continuity variables were analyzed by analysis of variance, or Kruskal-Wallis H test. Comparison of the categorical data were done using χ (2) or Fisher's exact test, and the predictive efficacy of various prognostic scores was compared using the area under the receiver operating characteristic curve (AUROC) and Z-test. Results: Of 316 cases (87.3% men) of HBV-ACLF, the mean age was (45 ± 11) years old. 78.8% of patients with underlying liver disease had hepatitis B virus induced cirrhosis. Mortality rates in patients without liver transplantation at 28 days, 90 days and 180 days were 20.5% (63/307), 36.7% (110/300) and 39.2% (116/296), respectively. According to the CLIF-SOFA score, 89.9% (284 patients) had organ failure at baseline, of which 97.5% had liver failure (Total bilirubin ≥ 12 mg/dl) and only 2.5% had coagulation, kidney, circulation or respiratory failure without liver failure. Besides liver failure, the incidence of extrahepatic organ failure was coagulation (23.1%), kidney (5.7%), brain (3.8%), circulation (1.3%) and respiratory failure (0.3%). With increasing number of organ failure, the mortality rate of two and three or more organ failures were 69.6% and 69.2%, respectively, which was significantly higher than that of single organ failure and non-organ failure patients (27% and 6.9%, respectively; P < 0.001). Liver failure with coagulation failure (International normalized ratio≥2.5 or platelet count≤20×10(9)/L) had worst prognosis with a mortality rate of up to 75% at 90 days. Conclusion: According to the CLIF-SOFA score, the main organ failure in patients with HBV-ACLF in China is liver failure. The mortality rate in patients with two or more organ failures is as high as 70% within 3 months. Therefore, timely manner liver transplantation should be considered.
Assuntos
Insuficiência Hepática Crônica Agudizada/diagnóstico , Vírus da Hepatite B , Hepatite B/diagnóstico , Cirrose Hepática/diagnóstico , Insuficiência Hepática Crônica Agudizada/complicações , Insuficiência Hepática Crônica Agudizada/etnologia , Insuficiência Hepática Crônica Agudizada/mortalidade , Adulto , Povo Asiático , China/epidemiologia , Feminino , Hepatite B/complicações , Hepatite B/etnologia , Hepatite B/mortalidade , Humanos , Incidência , Cirrose Hepática/complicações , Cirrose Hepática/etnologia , Cirrose Hepática/mortalidade , Masculino , Pessoa de Meia-Idade , Escores de Disfunção Orgânica , Prognóstico , Estudos RetrospectivosRESUMO
Currently, continuous renal replacement therapy (CRRT) is one of the most important means of organ support methods in critical care medicine. Anticoagulation is an essential part of the treatment process due to its prolonged duration. Patients with liver failure often have coagulation dysfunction and heparin anticoagulant can increase the risk of bleeding, but without heparin anticoagulant, coagulation can easily occur. In addition, an increased volumetric load, hemodynamic instability, nursing workload and other problems are major issues. Therefore, regional citrate anticoagulation (RCA) is the main anticoagulant method for CRRT therapy in patients with liver failure. This article reviews the mechanism, indications, advantages and disadvantages of using RCA to CRRT in hepatic failure.
Assuntos
Injúria Renal Aguda/terapia , Anticoagulantes/uso terapêutico , Ácido Cítrico/uso terapêutico , Falência Hepática/tratamento farmacológico , Terapia de Substituição Renal/efeitos adversos , Anticoagulantes/efeitos adversos , Citratos , Ácido Cítrico/efeitos adversos , Humanos , Falência Hepática/metabolismoRESUMO
Chinese soft-shelled turtle Pelodiscus sinensis has been an important aquaculture species in Southeast Asian countries. To breed a new variety of soft-shelled turtle with excellent properties and to evaluate the effect of hybridization of two turtle strains with a highly different trait phenotype, inheritance, microsatellite loci, and transcriptome analysis were studied in the hybrid turtles and their parents of P. sinensis Japanese strain and Qingxi black turtle. The genotypic characteristics and economic trait of the hybrid turtles were analyzed and compared to the two parents, showing significant growth vigor. The chromosome number of the hybrid turtle was diploid (2N = 66). The karyotype formulae were 8m+10sm+26t+22mc, with little differences between the two parents. Genotypic segregations of 241 microsatellite loci were screened in 3 populations including 90 species and showed that the specific allele numbers and polymorphic fragments increased in hybrid turtles indicating genetic diversity increased by hybridization. The liver transcriptome analysis of the hybrids and two parents showed similar distribution abundance in the parental and hybrid groups, but the transcripts with high abundance appeared in the hybrid group. There were 274 significant differentially expressed transcripts in the hybrid group compared to the two parental groups, among them 7 differentially expressed genes indicating super-parent expression, and only 2 genes showing low-parent expression. In the differentially expressed genes, expression changes were mainly contributed to regulatory region changes rather than coding region sequences. These results would be important for facilitating successful breeding strategies by hybridization in P. sinensis.
Assuntos
Genótipo , Hibridização Genética , Polimorfismo Genético , Tartarugas/genética , Animais , Cromossomos/genética , Feminino , Cariótipo , Fígado/metabolismo , Masculino , Repetições de Microssatélites , Característica Quantitativa Herdável , Transcriptoma , Tartarugas/crescimento & desenvolvimentoRESUMO
Objective: To investigate the clinical effect and safety of long-acting pegylated interferon-α-2b (Peg-IFN-α-2b) (Y shape, 40 kD) injection (180 µg/week) in the treatment of HBeAg-positive chronic hepatitis B (CHB) patients, with standard-dose Peg-IFN-α-2a as positive control. Methods: This study was a multicenter, randomized, open-label, and positive-controlled phase III clinical trial. Eligible HBeAg-positive CHB patients were screened out and randomized to Peg-IFN-α-2b (Y shape, 40 kD) trial group and Peg-IFN-α-2a control group at a ratio of 2:1. The course of treatment was 48 weeks and the patients were followed up for 24 weeks after drug withdrawal. Plasma samples were collected at screening, baseline, and 12, 24, 36, 48, 60, and 72 weeks for centralized detection. COBAS® Ampliprep/COBAS® TaqMan® HBV Test was used to measure HBV DNA level by quantitative real-time PCR. Electrochemiluminescence immunoassay with Elecsys kit was used to measure HBV markers (HBsAg, anti-HBs, HBeAg, anti-HBe). Adverse events were recorded in detail. The primary outcome measure was HBeAg seroconversion rate after the 24-week follow-up, and non-inferiority was also tested. The difference in HBeAg seroconversion rate after treatment between the trial group and the control group and two-sided confidence interval (CI) were calculated, and non-inferiority was demonstrated if the lower limit of 95% CI was > -10%. The t-test, chi-square test, or rank sum test was used according to the types and features of data. Results: A total of 855 HBeAg-positive CHB patients were enrolled and 820 of them received treatment (538 in the trial group and 282 in the control group). The data of the full analysis set showed that HBeAg seroconversion rate at week 72 was 27.32% in the trial group and 22.70% in the control group with a rate difference of 4.63% (95% CI -1.54% to 10.80%, P = 0.1493). The data of the per-protocol set showed that HBeAg seroconversion rate at week 72 was 30.75% in the trial group and 27.14% in the control group with a rate difference of 3.61% (95% CI -3.87% to 11.09%, P = 0.3436). 95% CI met the non-inferiority criteria, and the trial group was non-inferior to the control group. The two groups had similar incidence rates of adverse events, serious adverse events, and common adverse events. Conclusion: In Peg-IFN-α regimen for HBeAg-positive CHB patients, the new drug Peg-IFN-α-2b (Y shape, 40 kD) has comparable effect and safety to the control drug Peg-IFN-α-2a.
Assuntos
Antivirais/uso terapêutico , Antígenos de Superfície da Hepatite B/efeitos dos fármacos , Antígenos E da Hepatite B/sangue , Hepatite B Crônica/tratamento farmacológico , Interferon-alfa/uso terapêutico , Antivirais/efeitos adversos , DNA Viral , Feminino , Hepatite B Crônica/imunologia , Humanos , Injeções , Interferon-alfa/efeitos adversos , Polietilenoglicóis , Proteínas Recombinantes , Resultado do TratamentoRESUMO
Objective: To explore the safety and efficiency of lateral supraorbital (LSO) approach for the ruptured anterior circulation aneurysm. Methods: The clinical data of 23 patients with grade â -â ¢ ruptured anterior circulation aneurysm via LSO at the Second Hospital of Shandong University from February 2016 to December 2016 were retrospectively analyzed. The clinical data included their clinical manifestations, radiological finding, microsurgical techniques and follow-up results. Results: All patients were diagnosed as anterior circulation aneurysm by preoperative CT angiography (CTA) or Digital Subtraction Angiography (DSA). They all accepted aneurysm clipping via LSO. The operations carried out smoothly, with no operation related complications. They were followed up for 2 to 12 months, and the Glasgow outcome scales (GOS) were 5 in 18 patients (78.3%), 4 in 2 patients (8.7%), 3 in 2 patients (8.7%), and 1 in 1 patient (4.3%). Conclusion: LSO could provide adequate exposure for the anterior circulation aneurysm, so the clipping could be carried out safely and effectively. LSO is a simple and minimally invasive surgical approach, and when it is used by the skilled master of pterion approach, its advantage could be fully played.
Assuntos
Aneurisma Roto , Aneurisma Intracraniano , Procedimentos Neurocirúrgicos , Humanos , Microcirurgia , Estudos Retrospectivos , Resultado do TratamentoRESUMO
Mineral salt bricks are often used in cow raising as compensation for mineral losses to improve milk yield, growth, and metabolic activity. Generally, effects of minerals are partially thought to result from improvement of microbial metabolism, but their influence on the rumen microbiota has rarely been documented to date. In this study, we investigated the response of microbiota to mineral salt in heifer and adult cows and evaluated ruminal fermentation and enteric methane emissions of cows fed mineral salts. Twelve lactating Holstein cows and twelve heifers fed a total mixed ration (TMR) diet were randomly allocated into two groups, respectively: a treatment group comprising half of the adults and heifers that were fed mineral salt and a control group containing the other half fed a diet with no mineral salt supplement. Enteric methane emissions were reduced by 9.6% (P < 0.05) in adults ingesting a mineral salt diet, while concentrations of ruminal ammonia, butyrate, and propionate were increased to a significant extent (P < 0.05). Enteric methane emissions were also reduced in heifers ingesting a mineral salt diet, but not to a significant extent (P > 0.05). Moreover, the concentrations of ammonia and volatile fatty acids (VFAs) were not significantly altered in heifers (P > 0.05). Based on these results, we performed high-throughput sequencing to explore the bacterial and archaeal communities of the rumen samples. Succiniclasticum and Prevotella, two propionate-producing bacteria, were predominant in samples of both adults and heifers. At the phylotype level, mineral salt intake led to a significant shift from Succiniclasticum to Prevotella and Prevotellaceae populations in adults. In contrast, reduced abundance of Succiniclasticum and Prevotella phylotypes was observed, with no marked shift in propionate-producing bacteria in heifers. Methanogenic archaea were not significantly abundant between groups, either in adult cows or heifers. The shift of Succiniclasticum to Prevotella and Prevotellaceae in adults suggests a response of microbiota to mineral salt that contributes to higher propionate production, which competes for hydrogen utilized by methanogens. Our data collectively indicate that a mineral salt diet can alter interactions of bacterial taxa that result in enteric methane reduction, and this effect is also influenced in an age-dependent manner.
Assuntos
Metano/metabolismo , Microbiota/efeitos dos fármacos , Minerais/farmacologia , Rúmen/microbiologia , Sais/farmacologia , Oligoelementos/farmacologia , Amônia/metabolismo , Animais , Bacteroides/isolamento & purificação , Bacteroides/metabolismo , Butiratos/metabolismo , Bovinos , Suplementos Nutricionais , Feminino , Fermentação/efeitos dos fármacos , Firmicutes/isolamento & purificação , Firmicutes/metabolismo , Prevotella/isolamento & purificação , Prevotella/metabolismo , Propionatos/metabolismoRESUMO
We hypothesized that IV busulfan (Bu) dosing could be safely intensified through pharmacokinetic (PK-) dose guidance to minimize the inter-patient variability in systemic exposure (SE) associated with body-sized dosing, and that this should improve outcome of AML/MDS patients undergoing allogeneic stem cell transplantation. To test this hypothesis, we treated 218 patients (median age 50.7 years, male/female 50/50%) with fludarabine 40 mg/m2 once daily x4, each dose followed by IV Bu, randomized to 130 mg/m2 (N=107) or PK-guided to average daily SE, AUC of 6000 µM min (N=111), stratified for remission status and allo-grafting from HLA-matched donors. Toxicity and GvHD rates in the groups were similar; the risk of relapse or treatment-related mortality remained higher in the fixed-dose group throughout the 80-month observation period. Further, PK-guidance yielded safer disease control, leading to improved overall and PFS, most prominently in MDS patients and in AML patients not in remission at allogeneic stem cell transplantation. We conclude that AML/MDS patients receiving pretransplant conditioning treatment with our 4-day regimen may benefit significantly from PK-guided Bu dosing. This could be considered an alternative to fixed-dose delivery since it provides the benefit of precise dose delivery to a predetermined SE without increasing risk(s) of serious toxicity and/or GvHD.
Assuntos
Bussulfano/administração & dosagem , Monitoramento de Medicamentos/métodos , Leucemia Mieloide Aguda/terapia , Síndromes Mielodisplásicas/terapia , Condicionamento Pré-Transplante/métodos , Transplante Homólogo/métodos , Vidarabina/análogos & derivados , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/toxicidade , Bussulfano/farmacocinética , Bussulfano/toxicidade , Feminino , Doença Enxerto-Hospedeiro/etiologia , Transplante de Células-Tronco Hematopoéticas/métodos , Transplante de Células-Tronco Hematopoéticas/mortalidade , Humanos , Leucemia Mieloide Aguda/mortalidade , Masculino , Pessoa de Meia-Idade , Síndromes Mielodisplásicas/mortalidade , Recidiva , Análise de Sobrevida , Condicionamento Pré-Transplante/mortalidade , Transplante Homólogo/mortalidade , Resultado do Tratamento , Vidarabina/administração & dosagemRESUMO
OBJECTIVE: To understand the clinical characteristics of patients with abnormal liver function as the first symptom of systemic lupus erythematosus (SLE). METHODS: Here, 15 patients admitted to a hospital from January 2010 to December 2013 with initial presentation of lupus-related hepatitis or cirrhosis were included. Their SLE-DAI scores and clinical and laboratory data were collected. All cases received liver protection therapy and active SLE controlling treatment with methylprednisolone combined with rapamycin. RESULTS: When hepatic abnormalities were the most prominent feature during the first visit, the patient was more likely to receive an incorrect diagnosis or be diagnosed with SLE late. Of the 15 cases, only 7 (46.7%) were identified as SLE within a week of presentation of abnormal liver functionâ¯; meanwhile, the 7 remaining patients (46.7%) were not correctly diagnosed until more than 2 weeks later and as late as 4 monthsâ¯; in addition, 1 patient was not diagnosed with SLE until 8 years after the initial presentation of abnormal liver function. In the 3-month follow-up after active treatment, liver function was completely restored in 10 cases with no cirrhosis and significantly improved in 3 patients who still had cirrhosis. Another case showed no improvement in liver function and was self-discharged, and another died from chronic liver failure. CONCLUSION: Liver injury caused by SLE is not uncommon, and it is easy to tentatively diagnose it as hepatitis, delaying the correct diagnosis of SLE. In such patients, physicians should perform a thorough differential diagnosis as soon as possible and administer proper treatment. Corticosteroid conjugated with immunosuppressants with no or little liver toxicity would be suitable for patients with SLE-induced liver injury. (Acta gastroenterol. belg., 2016, 79, 441-446).
Assuntos
Hepatite Autoimune/etiologia , Lúpus Eritematoso Sistêmico/diagnóstico , Humanos , Hepatopatias , Lúpus Eritematoso Sistêmico/complicaçõesRESUMO
OBJECTIVE: This study was performed to evaluate the regulating effects of acetylpuerarin on inflammation in an Alzheimer's disease (AD) rat model and an inflammatory cell model. METHODS: Healthy female Wistar rats and mouse BV2 microglia cells were selected. AD rat models were established with the method of bilateral intrahippocampal amyloid-ß(Aß)1-42 injections and the inflammatory cell models were established using Aß25-35-induced mouse BV2 microglia cells. The cytotoxicity of acetylpuerarin on BV2 microglial cells was detected by MTT assay and the morphological changes of BV2 microglia cells were observed under inverted phase contrast microscope. As inflammatory parameters, the expressions of IL-1ß, iNOS, IL-6 and TNF-α were examined by Elisa, Immunohistochemistry, Quantitative real-time PCR (qRT-PCR), Western blot and Immunofluorescence analyses. We also examined the acetylpuerarin's effect on the activity of PKC-δ, IKKß and caspase-8/caspase-3 pathway. RESULTS: Acetylpuerarin exerted no significant cytotoxicity on BV2 microglia cells and was applied in all subsequent experiments. Acetylpuerarin treatment mitigated Aß25-35-induced morphological changes associated with microglia activation. Moreover, the expressions of caspase-8, cleaved caspase-3, PKC-δ, IKKß, iNOS, IL-1ß and TNF-α in Aß25-35-stimulated BV2 microglia cells were significantly suppressed by acetylpuerarin and in a dose-dependent manner. Additionally, the expression of IL-1ß in hippocampus and the level of IL-6 in serum of Aß1-42 treated rat were reduced by acetylpuerarin and in a concentration-dependent manner. CONCLUSION: Our results suggest that acetylpuerarin's anti-inflammation mechanism on AD may be mediated through the PKC-δ-dependent caspase signalling pathway.
Assuntos
Caspases/efeitos dos fármacos , Encefalite/tratamento farmacológico , Isoflavonas/farmacologia , Proteína Quinase C-delta/efeitos dos fármacos , Doença de Alzheimer/induzido quimicamente , Doença de Alzheimer/tratamento farmacológico , Doença de Alzheimer/patologia , Peptídeos beta-Amiloides , Animais , Sobrevivência Celular/efeitos dos fármacos , Citocinas/metabolismo , Encefalite/induzido quimicamente , Feminino , Ativação de Macrófagos/efeitos dos fármacos , Camundongos , Microglia/efeitos dos fármacos , Fragmentos de Peptídeos , Ratos , Ratos Wistar , Transdução de Sinais/efeitos dos fármacosRESUMO
In liver cirrhosis with bacterial infection, hepatoadrenal syndrome has been described recently as a progressive impairment in the adrenocortical reserve, with deficient production or action of glucocorticoids resulting in adrenal insufficiency. The aim of this study was to explore the characteristics of cortisol in hepatitis B virus (HBV) cirrhosis patients in the absence of bacterial infection. Fasting peripheral venous blood samples were collected from 107 patients with HBV cirrhosis in the absence of bacterial infection and 18 patients with chronic hepatitis B (CHB) infection at 7 a.m. in the morning. The carbohydrate, cortisol-binding globulin, routine chemistry, liver function, and hepatitis B indicators were tested, and free cortisol was calculated. Cortisol (COR) levels were 18.72 ± 6.60 µg/dL in the CHB group and 14.20 ± 7.55 µg/dL in the HBV cirrhosis group (P = 0.002). COR levels were 15.11 ± 5.56, 14.88 ± 6.96, and 12.68 ± 8.36 µg/dL in Child-Pugh class A, B, and C cirrhotic patients, respectively (P = 0.006). Adrenocorticotropic hormone levels were 35.42 ± 24.49, 26.57 ± 15.72, and 19.65 ± 10.72 pg/mL in Child-Pugh class A, B, and C cirrhotic patients, respectively (P = 0.000). Patients with HBV cirrhosis had significantly lower serum COR levels compared with those of CHB patients, even if they are in the absence of bacterial infection. COR levels negatively correlated with Child-Pugh scores. The hypothalamic-pituitary-adrenal axis might be damaged in patients with HBV cirrhosis.
Assuntos
Infecções Bacterianas/complicações , Vírus da Hepatite B/fisiologia , Hepatite B/sangue , Hepatite B/virologia , Hidrocortisona/sangue , Cirrose Hepática/sangue , Cirrose Hepática/virologia , Adolescente , Hormônio Adrenocorticotrópico/sangue , Adulto , Idoso , Infecções Bacterianas/sangue , Proteínas de Transporte/sangue , Demografia , Feminino , Hepatite B/complicações , Humanos , Cirrose Hepática/complicações , Masculino , Pessoa de Meia-Idade , Adulto JovemRESUMO
OBJECTIVE: Hemoglobin A(1c) (HbA(1c)) concentrations reflect glycemic control and diabetic complications. However, there is little evidence supporting the pathological role of HbA(1c) in the development and progression of diabetic complications. We investigated the impact of HbA(1c) on endothelial cell function and the potential mechanisms. METHODS: The effects of HbA(1c) on the viability and migration of human umbilical vein endothelial cells (HUVECs) were measured by the Cell Counting Kit-8 and a wound healing scratch assay, respectively. Production of nitric oxide (NO) and reactive oxygen species was measured by the nitrate reductase colorimetric method and flow cytometry, respectively. The expression of endothelial nitric oxide synthase (eNOS) mRNA was quantitated by reverse-transcriptase PCR. The expression of eNOS, p-AMPK, and NOX4 proteins was detected by Western blot. RESULTS: High concentrations of HbA(1c) reduced the viability and migration of HUVECs in a dose- and time-dependent manner. High concentrations of HbA(1c) inhibited production of NO but increased production of ROS. Incubation with increasing concentrations of HbA(1c) downregulated the expression of eNOS mRNA, decreased expression of eNOS and p-AMPK, and upregulated expression of NOX4. CONCLUSION: These findings provide direct evidence that HbA(1c) is involved in the development and progression of the cardiovascular complications of diabetes.
Assuntos
Hemoglobinas Glicadas/farmacologia , Células Endoteliais da Veia Umbilical Humana/metabolismo , Proteínas Quinases Ativadas por AMP/biossíntese , Sobrevivência Celular/efeitos dos fármacos , Feminino , Regulação da Expressão Gênica/efeitos dos fármacos , Células Endoteliais da Veia Umbilical Humana/patologia , Humanos , Masculino , NADPH Oxidase 4 , NADPH Oxidases/biossíntese , Óxido Nítrico/metabolismo , Óxido Nítrico Sintase Tipo III/biossíntese , Espécies Reativas de Oxigênio/metabolismo , Cicatrização/efeitos dos fármacosRESUMO
An efficient and eco-friendly copper(II) bromide-catalyzed intramolecular decarboxylative functionalization to form a C(sp(3))-O bond for the synthesis of furo[3,2-c]coumarins has been developed. In this reaction, a copper(II) bromide-catalyzed intramolecular decarboxylative functionalization of α-carbonyl is successfully realized to generate an α-bromo carbonyl compound as a key intermediate.
Assuntos
Brometos/química , Cobre/química , Cumarínicos/síntese química , Aldeídos/química , Catálise , Cumarínicos/química , DescarboxilaçãoRESUMO
Preliminary studies showed that miR-21 is overexpressed in some human cancers. However, the role of miR-21 in cancer is still unclear and even controversial. Our purpose was to investigate the biological effects of miR-21 on A549 non-small cell lung cancer (NSCLC) cells and the underlying mechanisms of those effects. The expression of miR-21 was quantified in serum samples from patients with NSCLC. A549 cells were transfected with miR-NC-sponge or miR-21-sponge only, or with miR-21-sponge plus PDCD4 small-interfering RNA (siRNA). The expression of miR-21 and PDCD4 mRNA in transfected cells was quantified by real-time polymerase chain reaction and the expression of PDCD4 protein by Western blot. Cell proliferation, apoptosis, migration, and invasion assays were performed to determine the biological effects of miR-21 expression and PDCD4 inhibition. miR-21 was overexpressed in serum from patients with NSCLC. Reduced miR-21 expression was observed following transfection with miR-21-sponge in A549 NSCLC cells. Co-transfection of miR-21-sponge with PDCD4 siRNA upregulated miR-21 expression in these cells. PDCD4 mRNA and protein levels were increased 2.14-fold and 2.16-fold, respectively, following inhibition of miR-21 expression. Inhibition of miR-21 expression following transfection of miR-21-sponge reduced cell proliferation, migration, and invasion of A549 cells. Depletion of PDCD4 by siRNA transfection reversed the reduction of cell proliferation, migration, and invasion induced by inhibition of miR-21 in A549 cells. It indicates that miR-21 is highly expressed in patients with NSCLC and inhibition of miR-21 expression reduces proliferation, migration, and invasion of A549 cells by upregulating PDCD4 expression. Modulation of miR-21 or PDCD4 expression may provide a potentially novel therapeutic approach for NSCLC.