RESUMO
Objective: This study aims to compare the antiviral treatment similarities and differences in the population covered by the 2024 version of the World Health Organization's (WHO) hepatitis B prevention and treatment guidelines and the current Chinese hepatitis B prevention and treatment guidelines, so as to explore their impact on the indications for antiviral therapy in Chinese patients with chronic hepatitis B (CHB). Methods: The information of patients with chronic hepatitis B virus infection who did not receive antiviral treatment was collected through the registration database of the China Clinical Research Platform for Hepatitis B Elimination. Descriptive statistics were conducted on the demographic, blood, biochemical, and virological levels of patients according to the treatment recommendations of the two versions of the guidelines. The Mann-Whitney U test and χ2 test were used to compare the differences and proportional distribution of the treatment populations covered by the two guidelines. The χ2 test was used to analyze the coverage rate of different antiviral treatment indications. Results: A total of 21,134 CHB patients without antiviral treatment were enrolled. 69.4% of patients met the 2024 versions of the WHO guidelines' recommendations. 85.0% of patients met the current Chinese hepatitis B prevention and treatment guidelines. The WHO guidelines for antiviral therapy indications were met in younger patients with higher levels of ALT, AST, and APRI scores, as well as greater proportion of patients with higher viral loads (P<0.001). The WHO guidelines recommended a cut-off value of APRI>0.5, which raised the proportion of patients on antiviral therapy from 6.6% to 30.9%. 45.7% of patients met the antiviral indications for HBV DNA >2000 IU/ml with abnormal transaminase (ALT>30 U/L for males and ALT>19 U/L for females). The reduced APRI diagnostic cut-off value and ALT treatment threshold had further increased the treatment coverage rate by 91.6% in patients with chronic HBV infection in line with the 2024 versions of WHO guidelines. Conclusion: The reduction of the APRI diagnostic cut-off value and the ALT treatment threshold, based on the current hepatitis B guidelines of China, will further improve the treatment coverage of CHB patients.
Assuntos
Antivirais , Hepatite B Crônica , Guias de Prática Clínica como Assunto , Organização Mundial da Saúde , Humanos , Antivirais/uso terapêutico , Hepatite B Crônica/tratamento farmacológico , Adulto , Feminino , Masculino , China/epidemiologia , Pessoa de Meia-Idade , Adulto Jovem , Adolescente , Idoso , População do Leste AsiáticoRESUMO
Cleft palate is one of the most common maxillofacial birth defects, which can occur alone or accompany with many known deformities. Palatal selves need to complete the process of vertical growth, elevation, adhesion and fusion in a specific time window of embryo development. Any abnormality in this process will lead to cleft palate. Although previous studies have identified many molecular networks that regulate the growth, location and fusion of palatal selves, there are still many unknown mechanisms for palatal development. The pathogenesis of cleft palate has not been clarified so far. In recent years, the molecular research on palate development has been deepened continuously. Here we summarize major recent advances and integrate the genes and molecular pathways with the cellular and morphogenetic processes of palatal shelf growth, patterning, elevation, adhesion, and fusion, in order to comprehensively understand the genotype-phenotype functional relationship and provide assistance in formulating effective prevention strategies for cleft palate disease.
Assuntos
Fissura Palatina , Humanos , Fissura Palatina/genética , Palato , Morfogênese/genéticaRESUMO
Objective: To explore the safety and reliability of retrosigmoid approach BONEBRIDGE implantation in patients with auricle reconstruction using skin expansion flap. Methods: A retrospective analysis was conducted on 43 congenital aural atresia cases (43 ears) who underwent BONEBRIDGE implantation from September 2019 to January 2023 in Beijing Tongren Hospital. 30 males and 13 females were included in this work. The implantation age was 9-36 years old (median age=10 y/o). All cases underwent auricle reconstruction surgery using the posterior ear flap expansion method, with 36 cases using the single expanded postauricular flap method and 7 cases using two-flap method. BONEBRIDGE implant surgery was performed during the third stage of auricle reconstruction or after all stages. The hearing improvements were evaluated by comparing the changes in pure tone hearing threshold and speech recognition rate of patients before and after BONEBRIDGE implantation. Routine follow-up was conducted to observe the hearing results and complications. SPSS 14.0 software was applied for data statistical analysis. Results: All 43 patients healed well and had no surgical complications when discharge. The average bone conduction hearing threshold after surgery was (8.2±6.6) dBHL, and there was no statistically significant difference compared to the preoperative [(8.1±5.7) dBHL] (P=0.95). After surgery, the threshold of hearing assistance with power on was significantly lower than that without hearing assistance [(32.8±4.6) dBHL vs (60.5±5.5) dBHL], and the difference was statistically significant (P<0.001). The speech recognition rate of monosyllable words, disyllabic words and short sentences in quiet environment increased to 72%, 84%, and 98% respectively. The differences were statistically significant (P<0.001). The speech recognition rate of monosyllabic words, disyllabic words, and short sentences in noise environment was significantly increased by 70%, 80%, and 92% respectively (P<0.001). After a follow-up of 4 to 47 months (median=24 months), the hearing results were stable and the aesthetic outcomes were satisfying. One patient had delayed hematoma around coil of the implant. After aspiration and compressed dressing for one week, hematoma was not recurrent. Conclusion: For patients after auricle reconstruction using expanded postauricular flap, the preference of retrosigmoid approach is a good choice in terms of safety and reliability of operation, as well as aesthetic appearance.
Assuntos
Anormalidades Congênitas , Pavilhão Auricular , Auxiliares de Audição , Procedimentos Cirúrgicos Otológicos , Procedimentos de Cirurgia Plástica , Retalhos Cirúrgicos , Adolescente , Adulto , Criança , Feminino , Humanos , Masculino , Adulto Jovem , Audiometria de Tons Puros , Condução Óssea , Anormalidades Congênitas/cirurgia , Pavilhão Auricular/anormalidades , Pavilhão Auricular/cirurgia , Perda Auditiva Condutiva/diagnóstico , Perda Auditiva Condutiva/etiologia , Perda Auditiva Condutiva/cirurgia , Procedimentos Cirúrgicos Otológicos/métodos , Procedimentos de Cirurgia Plástica/métodos , Implantação de Prótese/métodos , Reprodutibilidade dos Testes , Estudos Retrospectivos , Pele , Teste do Limiar de Recepção da Fala , Expansão de Tecido , Resultado do TratamentoRESUMO
Hyperbaric oxygen (HBO) therapy is of clinical utility in patients with transient cerebral ischemia. The investigatory study was to identify the potential regulatory mechanism of HBO treatment on neuronal injury and neurological function recovery in rats with intracerebral hemorrhage (ICH). Firstly, the rat model of ICH was established by collagenase, and the experimental rats were treated with HBO at 2.5 absolute atmospheres for 60 min each time. Next, lentivirus interfering with microRNA (miR)-204-5p or chloride channel protein 3 (CLCN3) expression was injected via the tail vein. Afterward, neurological function assessment was conducted, serum S100ß and NSE contents were detected by enzymer-linked immunosorbent assay, and pathological conditions of brain tissue were observed by hematoxylin-eosin staining. Terminal deoxynucleotidyl transferase mediated dUTP nick end labeling staining was used to detect neuronal apoptosis. The results showed that HBO alleviated neuronal injury and neurological function recovery in ICH rats and reduced serum S100ß and NSE content (all P<0.05). At the same time, overexpressing miR-204-5p or depleting CLCN3 further promoted the therapeutic effect of HBO on ICH rats (all P<0.05), while silencing miR-204-5p or elevating CLCN3 did oppositely (all P<0.05). In conclusion, HBO alleviates neuronal injury and neurological function recovery in ICH rats by silencing miR-204-5p-targeted CLCN3.
Assuntos
Oxigenoterapia Hiperbárica , MicroRNAs , Animais , Ratos , Recuperação de Função Fisiológica , Oxigênio , Hemorragia Cerebral/genética , Hemorragia Cerebral/terapia , Canais de Cloreto/genética , MicroRNAs/genéticaRESUMO
The performances of energy storage devices are strongly dependent on the electrode materials. Owing to the high theoretical capacity, NiCoO2 is a promising transition metal oxide for supercapacitors. Despite many efforts have been devoted, it still lacks of effective methods to overcome its shortcomings such as low conductivity and poor stability, in order to achieve its theoretical capacity. Herein, utilizing the thermal reducibility of trisodium citrate and its hydrolyzate, a series of NiCoO2@NiCo/CNT ternary composites in which NiCoO2@NiCo core-shell nanospheres deposited on CNT surface with adjustable metal contents are synthesized. Benefiting from the enhanced synergistic effect of both metallic core and CNTs, the optimized composite exhibits an extremely high specific capacitance (2660 F g-1 at 1 A g-1, the effective specific capacitance of the loaded metal oxide is 4199 F g-1, close to the theoretical value), an excellent rate performance and stability, when the metal content is about 37%. After depolarized calculation, the energy storage mechanism of the composite is reasonably analyzed. By controlling the contents of hexamethylenetetramine, trisodium citrate and CNTs in the reactant, the roles of them are distinguished. This study reveals an efficient novel strategy for transition metal oxides to maximize the electrochemical performances.
RESUMO
OBJECTIVE: To identify the clinical characteristics, treatment, and prognosis of relapsing polychondritis patients with airway involvement. METHODS: Twenty-eight patients with relapsing polychondritis, hospitalised in the First Hospital of Shanxi Medical University between April 2011 and April 2021, were retrospectively analysed. RESULTS: Fifty per cent of relapsing polychondritis patients with airway involvement had a lower risk of ear and ocular involvement. Relapsing polychondritis patients with airway involvement had a longer time-to-diagnosis (p < 0.001), a poorer outcome following glucocorticoid combined with immunosuppressant treatment (p = 0.004), and a higher recurrence rate than those without airway involvement (p = 0.004). The rates of positive findings on chest computed tomography and bronchoscopy in relapsing polychondritis patients with airway involvement were 88.9 per cent and 85.7 per cent, respectively. Laryngoscopy analysis showed that 66.7 per cent of relapsing polychondritis patients had varying degrees of mucosal lesions. CONCLUSION: For relapsing polychondritis patients with airway involvement, drug treatment should be combined with local airway management.
Assuntos
Policondrite Recidivante , Humanos , Estudos Retrospectivos , Policondrite Recidivante/complicações , Policondrite Recidivante/diagnóstico , Policondrite Recidivante/terapia , Sistema Respiratório , Broncoscopia/métodos , PrognósticoRESUMO
Objective: To clarify the effect and related factors of antiviral therapy on the change of esophageal varices in patients with hepatitis B virus-related cirrhosis. Methods: Fifty-two cases with hepatitis B virus-related cirrhosis who underwent endoscopy before and after antiviral therapy were selected from prospective cohorts. Patients were divided into three groups: no, mild, and moderate-severe based on the degree of esophageal varices. The changes in the severity of esophageal varices in each group were compared after antiviral therapy. Clinical characteristics (platelet, liver and kidney function, liver stiffness, and virological response) of patients with different regressions were analyzed. Measurement data were analyzed by independent sample t-test, one-way ANOVA, Mann-Whitney U test and Kruskal-Wallis H test, and Chi-Square test was used for count data. Results: All patients received entecavir-based antiviral therapy. The median treatment time was 3.1 (2.5-4.4) years. The proportion of patients without esophageal varices increased from 30.8% to 51.9%, the proportion of mild esophageal varices decreased from 40.4% to 30.8%, and the proportion of patients with moderate-to-severe esophageal varices decreased from 28.8% to 17.3% (χ2=14.067, P=0.001). A total of 40.4% of patients had esophageal varices regression, and 13.5% had esophageal varices progression. The progression rate was significantly higher in patients with moderate-severe esophageal varices than patients with mild and no esophageal varices (χ2=28.126, P<0.001), and 60.0% of patients with moderate-severe esophageal varices still remained in moderate-severe state after antiviral treatment. Baseline platelet count and 5-year mean change rates were significantly lower in patients with progressive moderate-to-severe esophageal varices than in those without progression (+3.3% vs. +34.1%, Z=7.00, P=0.027). Conclusion: After effective antiviral treatment, 40.4% of patients with hepatitis B virus-related cirrhosis combined with esophageal varices has obtained esophageal varices regression, but those with moderate to severe esophageal varices still have a considerable risk of progression while receiving mono antiviral treatment only. Thrombocytopenia and without significant improving are the clinical signs of progression risk after receiving antiviral treatment.
Assuntos
Varizes Esofágicas e Gástricas , Varizes , Antivirais/uso terapêutico , Varizes Esofágicas e Gástricas/tratamento farmacológico , Varizes Esofágicas e Gástricas/etiologia , Vírus da Hepatite B , Humanos , Cirrose Hepática/diagnóstico , Estudos ProspectivosRESUMO
Objective: Our study aims to determine histological regression and clinical improvement after long-term antiviral therapy in hepatitis B virus-related cirrhosis patients. Methods: Treatment-naïve chronic hepatitis B patients with histologically or clinically diagnosed liver cirrhosis were enrolled. Liver biopsies were performed after 5 years entecavir-based antiviral treatment. Patients were followed up every 6 months. Cirrhosis regression was evaluated based on Metavir system and P-I-R score. Clinical improvement was evaluated before and after the long-term treatment. Kruskal Wallis test and Wilcoxon signed-rank test were used for continuous variables, Fisher's exact test was used for categorical variables and multivariate analysis was performed using logistic regression analysis. Results: Totals of 73 patients with HBV-related liver cirrhosis were enrolled. Among them, 30 (41.1%) patients were biopsy proved liver cirrhosis and the remaining 43 (58.9%) cirrhotic patients were diagnosed by clinical features. Based on Metavir system and P-I-R score, 72.6% (53/73) patients attained histological regression. Furthermore, 30.1% (22/73) were defined as significant regression (Metavir decrease ≥2 stage), 42.5% (31/73) were mild regression (Metavir decrease 1 stage or predominantly regressive by P-I-R system if still cirrhosis after treatment) and 27.4% (20/73) were the non-regression. Compared to levels of clinical characteristics at baseline, HBV DNA, ALT, AST, liver stiffness(decreased from 12.7 to 6.4 kPa in significant regression, from 18.1 to 7.3 kPa in mild regression and from 21.4 to 11.2 kPa in non-regression)and Ishak-HAI score significantly decreased after 5 years of anti-HBV treatment, while serum levels of platelets and albumin improved remarkably (P<0.05). In multivariate analysis, only the pre-treatment liver stiffness level was associated with significant regression (OR=0.887, 95%CI: 0.802-0.981, P=0.020). Conclusions: After long-term antiviral therapy, patients with HBV-related cirrhosis are easily to attain improvements in clinical parameters, while a certain percentage of these patients still cannot achieve histological reversal.
Assuntos
Hepatite B Crônica , Fígado , Antivirais/uso terapêutico , Vírus da Hepatite B/genética , Hepatite B Crônica/complicações , Humanos , Fígado/patologia , Cirrose Hepática/patologiaRESUMO
Designing optimized nano-sized architecture is a promising approach to prepare high-performance electrode materials for supercapacitors. In this work, a hierarchical multi-shelled structure has been successfully synthesized, which consists of a 3D carbon nanofiber network as a supporting scaffold prepared by carbonization of aramid nanofiber aerogel, an intermediate polypyrrole (PPy) bonding layer and a NiCoO2 outer shell, just like a coaxial cable in the structure. The intermediate PPy layer facilitates the uniform deposition of NiCoO2 by providing more anchor sites, and enhances the electrical contact between carbon nanofiber network and NiCoO2 shell due to its high conductivity and good compatibility with two different substances. The synergistic effect of the hierarchical configuration endows the electrode material with a high specific capacitance of 1037 F g-1at 1 A g-1and excellent cycling stability (â¼89% of initial capacitance after 7000 cycles). Moreover, an asymmetric supercapacitor based on the composite and activated carbon achieves a high energy density of 37.7 Wh kg-1 at a power density of 465 W kg-1 in 1.65 V. This work may provide a feasible strategy to design high-performance hybrid electrodes for energy storage devices.
RESUMO
Objective: To investigate the curative effect of rib cartilage framework supporting combined with local flap grafting for correction of cryptotia. Methods: Fourteen cases (nineteen ears) were corrected by rib cartilage framework supporting combined with local flap grafting method from January 2017 to March 2019. Part of the 7th rib cartilage was carved into a scalloped cartilage piece, which was implanted on the retroauricular cartilage to release and expand the deformed cartilage. A "M" incision was designed on the retroauricular skin to make the local flap grafting. Results: All corrected auricles were followed up for four months to three year and abtained satisfactory and stable appearance. In one case, the edge of the helix was broken two weeks after the operation, and well healed after repairing. Conclusions: The rib cartilage framework supporting combined with local flap grafting method can fully correct the deformity of cryptotia, and the long-term effect is satisfied. It can be an important complement to the classic methods.
Assuntos
Orelha Externa , Procedimentos de Cirurgia Plástica , Cartilagem , Orelha Externa/cirurgia , Humanos , Costelas , Retalhos CirúrgicosRESUMO
Objective: To investigate the feasibility and safety of auricle reconstruction combined with Bonebridge implantation for bilateral aural atresia patients. Methods: A retrospective analysis was conducted for 36 cases(72 ears) who underwent Bonebridge implantation combined with bilateral auricle reconstruction from February 1, 2017 to January 15, 2020. All cases were bilateral congenital aural atresia and underwent Nagata auricle reconstruction for both sides simultaneously. Bonebridge implantations were performed during the second stage of auricle reconstruction. Results: All 36 patients healed well and had no surgical complications when discharged. The preoperative average bone conduction threshold of the patients was(8.5±5.8) dB HL and postoperative bone conduction threshold was (8.4±5.2) dB HL. There was no significant change after the implantation (P=0.724). The preoperative average air conduction threshold of was(64.9±7.4)dB HL and postoperative air conduction threshold was (24.0±5.3) dB HL, which had a significant change after the implantation (P<0.001). The hearing threshold with Bonebridge significantly decreased by 40.9 dB HL compared with the preoperative air conduction threshold(P<0.001). The speech recognition rate of monosyllable words, disyllabic words and short sentences in quiet environment increased by 62.5%, 63.5% and 72.2% respectively. The differences were statistically significant (P<0.001). The speech recognition rate of monosyllabic words, disyllabic words and short sentences in noise environment were significantly increased by 55.9%, 58.9% and 69.9% respectively (P<0.001). After a follow-up of 18.3 months in average, the hearing results were stable and the aesthetic outcomes were satisfied. One patient had implant rupture and healed after revision surgery. Conclusions: With an integrated surgical procedure, patients with bilateral congenital aural atresia can complete bilateral auricle reconstruction and hearing implantation within six months. This integrated surgical procedure is safe and efficient, with a stable hearing improvement and good appearance.
Assuntos
Auxiliares de Audição , Perda Auditiva Condutiva , Condução Óssea , Orelha Externa , Humanos , Estudos Retrospectivos , Resultado do TratamentoRESUMO
OBJECTIVE: The aim of this study was to determine serum level of long non-coding RNA (lncRNA)-AWPPH in coronary artery disease (CAD) patients and its clinical significance as a serum marker. PATIENTS AND METHODS: Serum levels of lncRNA-AWPPH in 132 CAD patients and 50 controls were detected by quantitative Real Time-Polymerase Chain Reaction (qRT-PCR). Based on medical history of statin therapy, differential expressions of lncRNA-AWPPH in CAD patients were examined. Then, the correlation between lncRNA-AWPPH level and clinical data of CAD patients was analyzed. Moreover, risk factors influencing prognosis of CAD were assessed by multivariate logistic regression analysis. RESULTS: It was found that lncRNA-AWPPH was highly expressed in serum of CAD patients, especially those receiving rosuvastatin therapy. LDL-C, hs-CRP, and serum lncRNA-AWPPH were independent risk factors for CAD, while HDL-C was favorable to CAD. CONCLUSIONS: LncRNA-AWPPH is highly expressed in serum of CAD patients, which can be reduced by statin therapy, and it may be a potential serum marker for predicting the prognosis of CAD.
Assuntos
Doença da Artéria Coronariana/metabolismo , RNA Longo não Codificante/metabolismo , Adulto , Idoso , Idoso de 80 Anos ou mais , Doença da Artéria Coronariana/sangue , Doença da Artéria Coronariana/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , RNA Longo não Codificante/sangue , RNA Longo não Codificante/genéticaRESUMO
Objective: To study the effects on learning and memory, mitochondrial energy metabolism and ATPase activity of hippocampus in mice with subacute exposure to n-hexane. Methods: The SPF 40 Kunming mice were randomly divided into low, middle and high dose groups and control groups according to different dosages. Each group consisted of 10 mice. The mice were given n-hexane by gavage, the mice in the low, middle and high dose groups were given 0.2 ml/d of n-hexane at concentrations of 500, 1000 and 2000 mg/kg respectively, while the mice in the control group were given 0.2 ml/d of cooking oil once a day for 28 days. The y-type maze test, the activity of ATP Enzyme, mitochondrial respiratory chain enzyme complex â -IV, the mrna of mitochondrial fusion gene (MFn1, Mfn2) and fission gene (FIs1) in brain tissues were performed. Results: Except for the wrong reaction times of low-dose exposure group in the first test, there existed significantly different in the first and second Y-maze tests in exposure groups and control group (P<0.05) ; in low, middle and high-dose group, the Na(+)-K(+)-ATPase activities were (8.27±2.65) , (5.38±1.55) , (3.55±1.69) µmol/gprot/h, and Ca(2+)-Mg(2+)-ATPase activities were (10.32±2.96) , (7.19±1.94) and (4.49±1.33) µmol/gprot/h, respectively. Compared with those in control group, the activities of Na(+)-K(+)-ATPase and Ca(2+)-Mg(2+)-ATPase decreased significantly in middle-dose group and high-dose group (P<0.05) . Compared with those in control group, the activities of mitochondrial respiratory chain enzyme complex I-IV in each dose group were significantly decreased (P<0.05) . The expressions of Mfn1mRNA and Mfn2mRNA in each dose group was significantly lower than those in control group (P<0.05) . Conclusion: Subacute exposure to n-hexane can result in the decrease of activities of mitochondrial respiratory chain enzyme complex in hippocampus of mice, which may lead to the disorder of mitochondrial energy metabolism by the decrease of ATPase activity and the imbalance of mitochondrial fusion-division, which must be one of the mechanisms of impairment of learning and memory of mice induced by n-hexane.
Assuntos
Hipocampo , Memória , Animais , Metabolismo Energético , Hexanos , CamundongosRESUMO
The composites of NiCo2O4 with unique structures are extensively explored as promising electrodes. In this work, core-shell structured nanowires anchored on nickel foam are synthesized by the hydrothermal synthesis of NiCo2O4 as core and subsequent electrodeposition of α-Co(OH)2 as shell. The core-shell composites exhibit enhanced electrochemical performances ascribing to the synergistic reactions from both materials, showing higher specific capacitance than any single component. By changing the deposition time, the mass loading of α-Co(OH)2 can be easily controlled. The electrochemical performances of the hybrid electrodes are diverse with the mass loading of Co(OH)2. The optimized hybrid electrode with 3 mins electrodeposition exhibits the highest specific capacitance (1298 F g-1 at 1 A g-1) among all electrodes. The redox reaction is a main contributor to the total specific capacitance through electrochemical kinetics analysis. An asymmetric supercapacitor assembled by the optimized material as positive electrode and activated carbon as negative electrode can achieve a relatively high energy density of 39.7 Wh kg-1 at a power density of 387.5 W kg-1 (at 0.5 A g-1) in a voltage of 1.55 V.
RESUMO
OBJECTIVE: To explore the cytidine-phosphate-guanosine (CPG) sites associated with fas-ting plasma glucose (FPG) and glycated haemoglobin (HbA1c) in twins. METHODS: In the study, 169 pairs of monozygotic twins were recruited in Qingdao, Zhejiang, Jiangsu, Sichuan and Heilongjiang in June to December of 2013 and June 2017 to October 2018. The methylation was detected by Illumina Infinium HumanMethylation450 BeadChip and Illumina Infinium MethylationEPIC BeadChip. According to the Linear Mixed Effect model (LME model), fasting plasma glucose and HbA1c were taken as the main effects, the methylation level (ß value) was taken as the dependent variable, continuous variables, such as age, body mass index (BMI), blood pressure, components of blood cells, surrogate variables generated by SVA, and categorical variables, such as gender, smoking and drinking status, hypoglycemic drugs taking, were included in the fixed effect model as covariates, and the identity numbers (ID) of the twins was included in the random effect model. The intercept was set as a random. Regression analysis was carried out to find out the CpG sites related to fasting blood glucose or HbA1c, respectively. RESULTS: In this study, 338 monozygotic twins (169 pairs) were included, with 412 459 CpG loci. Among them, 114 pairs were male, and 55 pairs were female, with an average age of (48.2±11.9) years. After adjustment of age, gender, BMI, blood pressure, smoking, drinking, blood cell composition, and other covariates, and multiple comparison test, 7 CpG sites (cg19693031, cg01538969, cg08501915, cg04816311, ch.8.1820050F, cg06721411, cg26608667) were found related to fasting blood glucose, 3 of which (cg08501915, ch.8.1820050f, cg26608667) were the newly found sites in this study; whereas 10 CpG sites (cg19693031, cg04816311, cg01538969, cg01339781, cg01676795, cg24667115, cg09029192, cg20697417, ch.4.1528651F, cg16097041) were found related to HbA1c, and 4 of which(cg01339781, cg24667115, cg20697417, and ch.4.1528651f) were new. We found that cg19693031 in TXNIP gene was the lowest P-value site in the association analysis between DNA methylation and fas-ting plasma glucose and HbA1c (PFPG=2.42×10-19, FDRFPG<0.001; PHbA1c=1.72×10-19, FDRHbA1c<0.001). CONCLUSION: In this twin study, we found new CpG sites related to fasting blood glucose and HbA1c, and provided some clues that partly revealed the potential mechanism of blood glucose metabolism in terms of DNA methylation, but it needed further verification in external larger samples.
Assuntos
Metilação de DNA , Adulto , Glicemia , Ilhas de CpG , Epigênese Genética , Jejum , Feminino , Hemoglobinas Glicadas , Humanos , Masculino , Pessoa de Meia-Idade , Gêmeos MonozigóticosRESUMO
Objective: Meta-analysis was used to compare the long-term efficacy and laryngeal function preservation rate of patients with advanced hypopharyngeal cancer treated with surgery plus radio(chemo)therapy (SRT) or non-surgery chemoradiotherapy (CRT). Methods: We searched publicly published articles on case-control studies of surgical and non-surgical comprehensive treatment of advanced hypopharyngeal cancer in PubMed, the Cochrane Library, Wanfang Database, Chinese Journal Full-text Database, and Chinese Science and Technology Periodical Database. The search language was limited to Chinese and English, and the period was from 1990 to 2018. These literatures were rigorously screened by inclusion and exclusion criteria. The data needed for this study were extracted and the Meta analysis was performed using RevMan 5.3 software. Results: A total of 13 literatures were included, and the overall quality of the literature was relatively high, and no significant publication bias was suggested. A total of 1 994 subjects, including 720 in the SRT group and 1 274 in the CRT group. The average 3-year overall survival rates were 42.9% in SRT group and 44.8% in CRT group,with no significant difference (OR=1.14, 95%CI: 0.62-2.06, P=0.68). The average 5-year overall survival rate (OR=1.42, 95%CI: 1.10-1.84, P<0.01), 5-year local recurrence-free survival rate (OR=1.68, 95%CI: 1.11-2.55, P=0.01) and 5-year local control rate (OR=2.17, 95%CI: 1.52-3.12, P<0.01) of SRT group were 46.4%, 47.4% and 71.2%, respectively, which were higher than those of non-surgical group (37.9%, 32.0%, and 52.2% respectively). The average laryngeal function preservation rate was 19.8%,being significantly lower than 80.6% of the non-surgical group(OR=0.03, 95%CI: 0.01-0.07, P<0.01). Conclusions: SRT has better long-term efficacy, while CRT has better preservation of laryngeal function.
Assuntos
Neoplasias Hipofaríngeas/terapia , Quimiorradioterapia , Terapia Combinada , Humanos , Neoplasias Hipofaríngeas/cirurgia , Hipofaringe , Laringe , Taxa de SobrevidaRESUMO
At present, there are many monitoring devices for vital signs parameters for clinical selection, but urine monitoring has not received enough attention. The traditional manual visual measurement, intermittent measurement of urine pH value, and other methods are still in use, so the authors designed a multifunctional urine bag. The urine bag can set up an alarm system per unit time according to patient's age and condition as well as set up urine pH value detection area in hard plastic measuring bottle. This device can not only accurately monitor urine volume per unit time, but also hopefully realize the alarm automation of abnormal urine volume per unit time, as well as real-time dynamic monitoring of urine pH value. It is helpful for medical staff to make accurate judgment on patients' condition changes, to guide the formulation and modification of clinical treatment plans, and to reduce the workload of clinical nursing staff to a certain extent.
Assuntos
Desenho de Equipamento , Coleta de Urina/instrumentação , Humanos , Monitorização FisiológicaRESUMO
Surgical margin principle is one of the central surgical principles for head and neck cancers. Negative surgical margin is the primary purpose of surgery for head and neck cancers. This paper is based on the current clinical application of surgical margins of head and neck cancers, and it is proposed that surgical margins of head and neck cancers may be classified into three types: surface margin, deep margin, and tissue interface margin in consideration of surgical exposure of tumors. The classification of surgical margins can make the clinical application and the research of surgical margins of head and neck cancers more systematic and clear.
Assuntos
Neoplasias de Cabeça e Pescoço , Margens de Excisão , Neoplasias de Cabeça e Pescoço/cirurgia , HumanosRESUMO
Most of the common dizziness/vertigo diseases in otology clinic are peripheral vertigo diseases, and while about 20% -30% of all vertigo diseases are caused by central nervous system diseases. Pseudo vestibular neuritis, acute ischemic stroke with audiovestibular loss, and central paroxysmal positional vertigo are the three types of central "malignant vertigo" diseases which are most easily misdiagnosed by otologists. This article described the clinical characteristics and bedside physical performance of these three diseases, and summarized the differential diagnosis points for clinical reference.
Assuntos
Programas de Rastreamento/métodos , Vertigem/diagnóstico , Vertigem/etiologia , Diagnóstico Diferencial , Humanos , Anamnese , Exame FísicoRESUMO
Summary Allergic rhinitisï¼ARï¼, a common and frequente disease, has attracted global attention in recent years. The imbalance between Th1 and Th2 cellular immune responses is the immunological basis of AR. Studies have found that vitamin D plays an important role in the occurrence of AR, and IL-33/ST2 is a newly discovered cytokine and signaling pathway in AR. There are certain specific associations between vitamin D and IL-33/ST2 in the pathogenesis of AR. This paper mainly analyzes the studies on the expression of vitamin D, IL-33/ST2 and Th1/Th2 cytokines in AR, so as to clarify the role of the above two factors in the pathogenesis of AR.