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1.
J Cancer Res Clin Oncol ; 150(3): 143, 2024 Mar 20.
Artigo em Inglês | MEDLINE | ID: mdl-38504073

RESUMO

OBJECTIVE: To develop and validate a radiomics nomogram based on computed tomography (CT) to distinguish appendiceal mucinous neoplasms (AMNs) from appendicitis with intraluminal fluid (AWIF). METHOD: A total of 211 patients from two medical institutions were retrospectively analysed, of which 109 were pathologically confirmed as having appendicitis with concomitant CT signs of intraluminal fluid and 102 as having AMN. All patients were randomly assigned to a training (147 patients) or validation cohort (64 patients) at a 7:3 ratio. Radiomics features of the cystic fluid area of the appendiceal lesions were extracted from nonenhanced CT images using 3D Slicer software. Minimum redundancy maximum relevance and least absolute shrinkage and selection operator regression methods were employed to screen the radiomics features and develop a radiomics model. Combined radiomics nomogram and clinical-CT models were further developed based on the corresponding features selected after multivariate analysis. Lastly, receiver operating characteristic curves, and decision curve analysis (DCA) were used to assess the models' performances in the training and validation cohorts. RESULTS: A total of 851 radiomics features were acquired from the nonenhanced CT images. Subsequently, a radiomics model consisting of eight selected features was developed. The combined radiomics nomogram model comprised rad-score, age, and mural calcification, while the clinical-CT model contained age and mural calcification. The combined model achieved area under the curves (AUCs) of 0.945 (95% confidence interval [CI]: 0.895, 0.976) and 0.933 (95% CI: 0.841, 0.980) in the training and validation cohorts, respectively, which were larger than those obtained by the radiomics (training cohort: AUC, 0.915 [95% CI: 0.865, 0.964]; validation cohort: AUC, 0.912 [95% CI: 0.843, 0.981]) and clinical-CT models (training cohort: AUC, 0.884 [95% CI: 0.820, 0.931]; validation cohort: AUC, 0.767 [95% CI: 0.644, 0.863]). Finally, DCA showed that the clinical utility of the combined model was superior to that of the clinical CT and radiomics models. CONCLUSION: Our combined radiomics nomogram model constituting radiomics, clinical, and CT features exhibited good performance for differentiating AMN from AWIF, indicating its potential application in clinical decision-making.


Assuntos
Apendicite , Neoplasias Císticas, Mucinosas e Serosas , Neoplasias , Humanos , Apendicite/diagnóstico por imagem , Nomogramas , Radiômica , Estudos Retrospectivos , Tomografia Computadorizada por Raios X
2.
BMC Med Imaging ; 23(1): 131, 2023 09 15.
Artigo em Inglês | MEDLINE | ID: mdl-37715139

RESUMO

OBJECTIVE: To identify CT features and establish a nomogram, compared with a machine learning-based model for distinguishing gastrointestinal heterotopic pancreas (HP) from gastrointestinal stromal tumor (GIST). MATERIALS AND METHODS: This retrospective study included 148 patients with pathologically confirmed HP (n = 48) and GIST (n = 100) in the stomach or small intestine that were less than 3 cm in size. Clinical information and CT characteristics were collected. A nomogram on account of lasso regression and multivariate logistic regression, and a RandomForest (RF) model based on significant variables in univariate analyses were established. Receiver operating characteristic (ROC) curve, mean area under the curve (AUC), calibration curve and decision curve analysis (DCA) were carried out to evaluate and compare the diagnostic ability of models. RESULTS: The nomogram identified five CT features as independent predictors of HP diagnosis: age, location, LD/SD ratio, duct-like structure, and HU lesion/pancreas A. Five features were included in RF model and ranked according to their relevance to the differential diagnosis: LD/SD ratio, HU lesion/pancreas A, location, peritumoral hypodensity line and age. The nomogram and RF model yielded AUC of 0.951 (95% CI: 0.842-0.993) and 0.894 (95% CI: 0.766-0.966), respectively. The DeLong test found no statistically significant difference in diagnostic performance (p > 0.05), but DCA revealed that the nomogram surpassed the RF model in clinical usefulness. CONCLUSION: Two diagnostic prediction models based on a nomogram as well as RF method were reliable and easy-to-use for distinguishing between HP and GIST, which might also assist treatment planning.


Assuntos
Tumores do Estroma Gastrointestinal , Humanos , Tumores do Estroma Gastrointestinal/diagnóstico por imagem , Nomogramas , Estudos Retrospectivos , Pâncreas/diagnóstico por imagem , Aprendizado de Máquina , Tomografia Computadorizada por Raios X
3.
J Int Med Res ; 51(9): 3000605231202140, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37773731

RESUMO

Various immunity-related adverse events have been reported to be associated with the inhibition of programmed cell death receptor 1. We report a rare case of a relapse of lupus nephritis (LN), involving rapidly progressive glomerulonephritis, which was induced by nivolumab treatment in a patient with oral cancer. The patient had a history of systemic lupus erythematosus and underwent treatment with steroids, rituximab, and plasmapheresis. However, her renal function did not improve, and she died of multiple organ failure. To our knowledge, this is the first description of severe LN induced by nivolumab.


Assuntos
Lúpus Eritematoso Sistêmico , Nefrite Lúpica , Neoplasias Bucais , Humanos , Feminino , Idoso de 80 Anos ou mais , Nefrite Lúpica/tratamento farmacológico , Nivolumabe/efeitos adversos , Recidiva Local de Neoplasia/tratamento farmacológico , Lúpus Eritematoso Sistêmico/complicações , Doença Crônica
4.
J Cancer Res Clin Oncol ; 149(16): 15143-15157, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37634206

RESUMO

OBJECTIVE: To identify CT features and establish a diagnostic model for distinguishing non-ampullary duodenal neuroendocrine neoplasms (dNENs) from non-ampullary duodenal gastrointestinal stromal tumors (dGISTs) and to analyze overall survival outcomes of all dNENs patients. MATERIALS AND METHODS: This retrospective study included 98 patients with pathologically confirmed dNENs (n = 44) and dGISTs (n = 54). Clinical data and CT characteristics were collected. Univariate analyses and binary logistic regression analyses were performed to identify independent factors and establish a diagnostic model between non-ampullary dNENs (n = 22) and dGISTs (n = 54). The ROC curve was created to determine diagnostic ability. Cox proportional hazards models were created and Kaplan-Meier survival analyses were performed for survival analysis of dNENs (n = 44). RESULTS: Three CT features were identified as independent predictors of non-ampullary dNENs, including intraluminal growth pattern (OR 0.450; 95% CI 0.206-0.983), absence of intratumoral vessels (OR 0.207; 95% CI 0.053-0.807) and unenhanced lesion > 40.76 HU (OR 5.720; 95% CI 1.575-20.774). The AUC was 0.866 (95% CI 0.765-0.968), with a sensitivity of 90.91% (95% CI 70.8-98.9%), specificity of 77.78% (95% CI 64.4-88.0%), and total accuracy rate of 81.58%. Lymph node metastases (HR: 21.60), obstructive biliary and/or pancreatic duct dilation (HR: 5.82) and portal lesion enhancement ≤ 99.79 HU (HR: 3.02) were independent prognostic factors related to poor outcomes. CONCLUSION: We established a diagnostic model to differentiate non-ampullary dNENs from dGISTs. Besides, we found that imaging features on enhanced CT can predict OS of patients with dNENs.


Assuntos
Neoplasias Duodenais , Tumores do Estroma Gastrointestinal , Tumores Neuroendócrinos , Humanos , Tumores do Estroma Gastrointestinal/diagnóstico por imagem , Estudos Retrospectivos , Tumores Neuroendócrinos/diagnóstico por imagem , Prognóstico , Neoplasias Duodenais/diagnóstico por imagem , Neoplasias Duodenais/patologia , Tomografia Computadorizada por Raios X/métodos
5.
J Cancer Res Clin Oncol ; 149(12): 10519-10530, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37289235

RESUMO

OBJECTIVE: To predict the existence of micropapillary or solid components in invasive adenocarcinoma, a model was constructed using qualitative and quantitative features in high-resolution computed tomography (HRCT). METHODS: Through pathological examinations, 176 lesions were divided into two groups depending on the presence or absence of micropapillary and/or solid components (MP/S): MP/S- group (n = 128) and MP/S + group (n = 48). Multivariate logistic regression analyses were used to identify independent predictors of the MP/S. Artificial intelligence (AI)-assisted diagnostic software was used to automatically identify the lesions and extract corresponding quantitative parameters on CT images. The qualitative, quantitative, and combined models were constructed according to the results of multivariate logistic regression analysis. The receiver operating characteristic (ROC) analysis was conducted to evaluate the discrimination capacity of the models with the area under the curve (AUC), sensitivity, and specificity calculated. The calibration and clinical utility of the three models were determined using the calibration curve and decision curve analysis (DCA), respectively. The combined model was visualized in a nomogram. RESULTS: The multivariate logistic regression analysis using both qualitative and quantitative features indicated that tumor shape (P = 0.029 OR = 4.89; 95% CI 1.175-20.379), pleural indentation (P = 0.039 OR = 1.91; 95% CI 0.791-4.631), and consolidation tumor ratios (CTR) (P < 0.001; OR = 1.05; 95% CI 1.036-1.070) were independent predictors for MP/S + . The areas under the curve (AUC) of the qualitative, quantitative, and combined models in predicting MP/S + were 0.844 (95% CI 0.778-0.909), 0.863 (95% CI 0.803-0.923), and 0.880 (95% CI 0.824-0.937). The combined model of AUC was the most superior and statistically better than qualitative model. CONCLUSION: The combined model could assist doctors to evaluate patient's prognoses and devise personalized diagnostic and treatment protocols for patients.


Assuntos
Adenocarcinoma de Pulmão , Adenocarcinoma , Neoplasias Pulmonares , Humanos , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/patologia , Inteligência Artificial , Adenocarcinoma de Pulmão/diagnóstico por imagem , Adenocarcinoma de Pulmão/patologia , Adenocarcinoma/diagnóstico por imagem , Adenocarcinoma/patologia , Tomografia Computadorizada por Raios X/métodos , Estudos Retrospectivos
6.
Eur Radiol ; 33(6): 3931-3940, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-36600124

RESUMO

OBJECTIVES: This study aims to predict the high-grade pattern (HGP) of stage IA lung invasive adenocarcinoma (IAC) based on the high-resolution CT (HRCT) features. METHODS: The clinical, pathological, and HRCT imaging data of 457 patients (from bicentric) with pathologically confirmed stage IA IAC (459 lesions in total) were retrospectively analyzed. The 459 lesions were classified into high-grade pattern (HGP) (n = 101) and non-high-grade pattern (n-HGP) (n = 358) groups depending on the presence of HGP (micropapillary and solid) in pathological results. The clinical and pathological data contained age, gender, smoking history, tumor stage, pathological type, and presence or absence of tumor spread through air spaces (STAS). CT features consisted of lesion location, size, density, shape, spiculation, lobulation, vacuole, air bronchogram, and pleural indentation. The independent predictors for HGP were screened by univariable and multivariable logistic regression analyses. The clinical, CT, and clinical-CT models were constructed according to the multivariable analysis results. RESULTS: The multivariate analysis suggested the independent predictors of HGP, encompassing tumor size (p = 0.001; OR = 1.090, 95% CI 1.035-1.148), density (p < 0.001; OR = 9.454, 95% CI 4.911-18.199), and lobulation (p = 0.002; OR = 2.722, 95% CI 1.438-5.154). The AUC values of clinical, CT, and clinical-CT models for predicting HGP were 0.641 (95% CI 0.583-0.699) (sensitivity = 69.3%, specificity = 79.2%), 0.851 (95% CI 0.806-0.896) (sensitivity = 79.2%, specificity = 79.6%), and 0.852 (95% CI 0.808-0.896) (sensitivity = 74.3%, specificity = 85.8%). CONCLUSION: The logistic regression model based on HRCT features has a good diagnostic performance for the high-grade pattern of stage IA IAC. KEY POINTS: • The AUC values of clinical, CT, and clinical-CT models for predicting high-grade patterns were 0.641 (95% CI 0.583-0.699), 0.851 (95% CI 0.806-0.896), and 0.852 (95% CI 0.808-0.896). • Tumor size, density, and lobulation were independent predictive markers for high-grade patterns. • The logistic regression model based on HRCT features has a good diagnostic performance for the high-grade patterns of invasive adenocarcinoma.


Assuntos
Adenocarcinoma de Pulmão , Adenocarcinoma , Neoplasias Pulmonares , Humanos , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/patologia , Estudos Retrospectivos , Tomografia Computadorizada por Raios X/métodos , Adenocarcinoma de Pulmão/diagnóstico por imagem , Adenocarcinoma de Pulmão/patologia , Adenocarcinoma/diagnóstico por imagem , Adenocarcinoma/patologia , Pulmão/patologia , Invasividade Neoplásica/patologia
7.
Eur J Med Res ; 28(1): 52, 2023 Jan 27.
Artigo em Inglês | MEDLINE | ID: mdl-36707848

RESUMO

BACKGROUND: Glomerular damage is a common clinical indicator of nephrotic syndrome. High-dose hormone treatment often leads to hormone resistance in patients. How to avoid resistance and improve the efficiency of hormone therapy draws much attention to clinicians. METHODS: Adriamycin (ADR) was used to induce nephropathy model in SD rats. The rats were treated with dexamethasone (DEX), icariin (ICA), and DEX + ICA combination therapy. The changes in urinary protein (UP), urea nitrogen (BUN), and serum creatinine (SCR) contents in rats were detected by enzyme-linked immunosorbent assay (ELISA), and the degree of pathological injury and the expression level of podocin were detected by HE staining and immunohistochemistry, to test the success of the model and the therapeutic effects of three different ways. The effect of treatments on podocytes autophagy was evaluated via transfection of mRFP-GFP-LC3 tandem adenovirus in vitro. RESULTS: The contents of UP, SCR, and BUN were significantly increased, the glomerulus was seriously damaged, and the expression of Nephrosis2 (NPHS2) was significantly decreased in the ADR-induced nephrotic syndrome rat model compared to that of the control group. DEX, ICA, and the DEX + ICA combined treatment significantly alleviated these above changes induced by ADR. The combined treatment of DEX + ICA exhibited better outcome than single treatment. The combined treatment also restored the podocyte autophagy, increased the expression of microtubule-associated protein light-chain 3II (LC3II), and reduced the expression of p62 in vitro. The combined treatment protects podocytes by mediating the PI3K/AKT/mTOR (rapamycin complex) signaling pathway. CONCLUSION: ICA enhances the therapeutic effect of DEX on the nephrotic syndrome.


Assuntos
Nefropatias , Síndrome Nefrótica , Animais , Ratos , Dexametasona , Doxorrubicina , Hormônios , Síndrome Nefrótica/induzido quimicamente , Síndrome Nefrótica/tratamento farmacológico , Síndrome Nefrótica/patologia , Fosfatidilinositol 3-Quinases/genética , Ratos Sprague-Dawley
8.
Front Neurol ; 13: 955378, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36237620

RESUMO

Background: Cerebral microbleeds (CMBs) are common in the hypertensive population and can only be detected with magnetic resonance imaging (MRI). The anticoagulation and thrombolytic regimens for patients with >5 CMBs are different from those for patients with ≤ 5 CMBs. However, MRI is not suitable for evaluating CMBs in patients with MRI contraindications or acute ischemic stroke urgently requiring thrombolysis. We aimed to develop and validate a nomogram combining clinical and brain computed tomography (CT) characteristics for predicting >5 CMBs in a hypertensive population. Materials and methods: In total, 160 hypertensive patients from 2016 to 2020 who were confirmed by MRI to have >5 (77 patients) and ≤ 5 CMBs (83) were retrospectively analyzed as the training cohort. Sixty-four hypertensive patients from January 2021 to February 2022 were included in the validation cohort. Multivariate logistic regression was used to evaluate >5 CMBs. A combined nomogram was constructed based on the results, while clinical and CT models were established according to the corresponding characteristics. Receiver operating characteristic (ROC) and calibration curves and decision curve analysis (DCA) were used to verify the models. Results: In the multivariable analysis, the duration of hypertension, level of homocysteine, the number of lacunar infarcts (LIs), and leukoaraiosis (LA) score were included as factors associated with >5 CMBs. The clinical model consisted of the duration of hypertension and level of homocysteine, while the CT model consisted of the number of LIs and LA. The combined model consisted of the duration of hypertension, level of homocysteine, LI, and LA. The combined model achieved an area under the curve (AUC) of 0.915 (95% confidence interval [CI]: 0.860-0.953) with the training cohort and 0.887 (95% CI: 0.783-0.953) with the validation cohort, which were higher than those of the clinical model [training cohort: AUC, 0.797 (95% CI: 0.726, 0.857); validation cohort: AUC, 0.812 (95% CI: 0.695, 0.899)] and CT model [training cohort: AUC, 0.884 (95% CI: 0.824, 0.929); validation cohort: AUC, 0.868 (95% CI: 0.760, 0.940)]. DCA showed that the clinical value of the combined model was superior to that of the clinical model and CT model. Conclusion: A combined model based on clinical and CT characteristics showed good diagnostic performance for predicting >5 CMBs in hypertensive patients.

9.
Biomed Res Int ; 2022: 6447407, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36246990

RESUMO

The effects of different doses of dexmedetomidine (Dex) anesthesia on inflammatory factors and hemodynamics in patients undergoing neurosurgery and its relationship with RSS scores are analyzed. A total of 102 patients who received neurosurgery in our hospital from March 2021 to March 2022 are selected. According to different intraoperative Dex dose, the enrolled patients are randomly divided into low-, medium-, and high-dose groups, 34 patients in each group. In this study, hemodynamic indexes, inflammatory factors, anesthesia effect, and the Ramsay sedation scale (RSS) score are compared in each groups. The experimental results show that in neurosurgery, compared with low-dose Dex, high-dose Dex can better maintain patients' intraoperative hemodynamic parameters and effectively inhibit postoperative inflammatory response, but postoperative awakening time is also relatively prolonged, while medium-dose Dex can effectively control patients' awakening time.


Assuntos
Anestesia , Dexmedetomidina , Neurocirurgia , Anestesia/métodos , Relação Dose-Resposta a Droga , Hemodinâmica , Humanos , Hipnóticos e Sedativos/farmacologia
10.
Medicine (Baltimore) ; 101(25): e29373, 2022 Jun 24.
Artigo em Inglês | MEDLINE | ID: mdl-35758369

RESUMO

ABSTRACT: The purpose of the study is to investigate the correlation of computed tomography (CT) quantitative parameters with tumor invasion and Ki-67 expression in early lung adenocarcinoma.The study involved 141 lesions in 141 patients with early lung adenocarcinoma. According to the degree of tumor invasion, the lesions were assigned into (adenocarcinoma in situ + minimally invasive adenocarcinoma) group and invasive adenocarcinoma (IAC) group. Artificial intelligence-assisted diagnostic software was used to automatically outline the lesions and extract corresponding quantitative parameters on CT images. Statistical analysis was performed to explore the correlation of these parameters with tumor invasion and Ki-67 expression.The results of logistic regression analysis showed that the short diameter of the lesion and the average CT value were independent predictors of IAC. Receiver operating characteristic curve analysis identified the average CT value as an independent predictor of IAC with the best performance, with the area under the receiver operating characteristic curve of 0.893 (P < .001), and the threshold of -450 HU. Besides, the predicted probability of logistic regression analysis model was detected to have the area under the curve of 0.931 (P < .001). The results of Spearman correlation analysis showed that the expression level of Ki-67 had the highest correlation with the average CT value of the lesion (r = 0.403, P < .001).The short diameter of the lesion and the average CT value are independent predictors of IAC, and the average CT value is significantly positively correlated with the expression of tumor Ki-67.


Assuntos
Adenocarcinoma de Pulmão , Adenocarcinoma , Neoplasias Pulmonares , Adenocarcinoma/diagnóstico por imagem , Adenocarcinoma/patologia , Adenocarcinoma de Pulmão/diagnóstico por imagem , Adenocarcinoma de Pulmão/patologia , Inteligência Artificial , Diagnóstico Diferencial , Humanos , Antígeno Ki-67 , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/patologia , Invasividade Neoplásica , Estudos Retrospectivos , Tomografia Computadorizada por Raios X/métodos
11.
Medicine (Baltimore) ; 100(4): e24533, 2021 Jan 29.
Artigo em Inglês | MEDLINE | ID: mdl-33530282

RESUMO

BACKGROUND: Evidence suggesting a role for including calcineurin inhibitors(CNIs) in early therapy remains limited for low quality and mainly based on small observation cohort study. We will conduct a systematic reviews to explore the effect and adverse effect of calcineurin inhibitors compared with other interventions in the treatment of primary focal segmental glomerulosclerosis (FSGS). METHODS: A comprehensive literature search of MEDLINE (through PubMed), EMBASE, The Cochrane Library, Cochrane Central Register of Controlled Trials (CENTRAL) will be conducted. Two investigators will independently select studies, extract data and assess the quality of the included study. Extracted information will include study characteristics, the contents of included randomized controlled trials, outcomes, the quality of randomized controlled trials and etc. A risk of bias tool will be used to assess the methodological quality. Any disagreement will be resolved by the third investigator. There is no requirement of ethical approval and informed consent. RESULTS: This study will provide high-quality evidence for treatment of FSGS in terms of effectiveness and safety. CONCLUSION: This systematic review aims to provide evidence for treatment of FSGS in different CNIs. REGISTRATION: The systematic review and meta-analysis is registered in the OSF REGISTERS (10.17605/OSF.IO/3B7DE) international prospective register of systematic review.


Assuntos
Inibidores de Calcineurina/uso terapêutico , Glomerulosclerose Segmentar e Focal/tratamento farmacológico , Humanos , Metanálise como Assunto , Ensaios Clínicos Controlados Aleatórios como Assunto , Revisões Sistemáticas como Assunto
12.
Medicine (Baltimore) ; 97(27): e11282, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29979395

RESUMO

BACKGROUND: The present study aims to comprehensively determine the efficacy of different therapy regimens based on Tripterygium wilfordii Hook F (TwHF) for patients with primary nephrotic syndrome (PNS) using network meta-analysis method. METHODS: Seven electronic databases were searched to identify randomized controlled trials (RCTs) that compared the differences between different therapy regimens based on TwHF for patients with PNS. The risk of bias in included RCTs was evaluated according to the Cochrane Handbook version 5.2.0. Network meta-analysis was performed to compare different regimens. Primary outcomes were complete remission rate and total remission rate. The secondary outcomes were hr urinary protein excretion, serum albumin, serum creatinine, and urea nitrogen. Data analysis was performed using R software. RESULTS: A total of 40 studies involving 2846 patients with PNS were included. Compared with prednisone, the improvement in total remission rate and complete remission rate was associated with TwHF alone (odds ratio [OR] = 4.80, 95% credible intervals [CrI]: 2.20-10.00; OR = 6.30, 95% CrI: 2.90-13.00, respectively), TwHF+prednisone (OR = 2.10, 95% CrI: 1.30-3.50; OR = 2.40, 95% CrI: 1.50-3.80, respectively), TwHF+CPA (OR = 12.00, 95% CrI: 1.10-150.00; OR = 16.00, 95% CrI: 1.60-170.00, respectively), and TwHF+Cyclosporine A (OR = 28.00, 95% CrI: 3.20-250.00; OR = 35.00, 95% CrI: 4.50-270.00, respectively). Compared with TwHF alone, TwHF+prednisone showed less benefit in improving total remission rate and complete remission rate (OR = 0.44, 95% CrI: 0.21-0.91; OR = 0.38, 95% CrI: 0.19-0.77, respectively). TwHF alone, TwHF+prednisone could significantly reduce hr urinary protein excretion (MD = -0.69, 95% CrI: -1.30 to -0.14; MD = -1.00, 95% CrI: -1.90 to -0.14, respectively) and increase serum albumin (MD = 5.90, 95% CrI: 2.50-9.30; MD = 3.40, 95% CrI: 1.30-5.50, respectively) when compared to prednisone alone. TwHF alone showed significant reduction in serum creatinine when compared to CPA (MD = -19.00, 95% CrI: -37.00 to -0.56). CONCLUSIONS: TwHF alone, the addition TwHF to prednisone showed more benefit in improving total and complete remission rate, hr urinary protein excretion, serum albumin, and serum creatinine.


Assuntos
Imunossupressores/uso terapêutico , Medicina Tradicional Chinesa/métodos , Síndrome Nefrótica/tratamento farmacológico , Fitoterapia/métodos , Tripterygium/efeitos dos fármacos , Glucocorticoides/uso terapêutico , Humanos , Testes de Função Renal , Metanálise em Rede , Prednisona/uso terapêutico , Albumina Sérica Humana/efeitos dos fármacos , Resultado do Tratamento
13.
BMC Neurol ; 16(1): 141, 2016 Aug 17.
Artigo em Inglês | MEDLINE | ID: mdl-27534852

RESUMO

BACKGROUND: Spinal muscular atrophy (SMA) is the most common autosomal recessive disease in children, and the diagnosis is complicated and difficult, especially at early stage. Early diagnosis of SMA is able to improve the outcome of SMA patients. In our study, Real-time PCR was developed to measure the gene mutation or deletion of key genes for SMA and to further analyse genotype-phenotype correlation. METHODS: The multiple real-time PCR for detecting the mutations of survival of motor neuron (SMN), apoptosis inhibitory protein (NAIP) and general transcription factor IIH, polypeptide 2 gene (GTF2H2) was established and confirmed by DNA sequencing and multiplex ligation-dependent probe amplification (MLPA). The diagnosis and prognosis of 141 hospitalized children, 100 normal children and further 2000 cases of dry blood spot (DBS) samples were analysed by this multiple real-time PCR. RESULTS: The multiple real-time PCR was established and the accuracy of it to detect the mutations of SMN, NAIP and GTF2H2 was at least 98.8 % comparing with DNA sequencing and MLPA. Among 141 limb movement disorders children, 75 cases were SMA. 71 cases of SMA (94.67 %) were with SMN c.840 mutation, 9 cases (12 %) with NAIP deletion and 3 cases (4 %) with GTF2H2 deletion. The multiple real-time PCR was able to diagnose and predict the prognosis of SMA patients. Simultaneously, the real-time PCR was applied to detect trace DNA from DBS and able to make an early diagnosis of SMA. CONCLUSION: The clinical and molecular characteristics of SMA in Southwest of China were presented. Our work provides a novel way for detecting SMA in children by using real-time PCR and the potential usage in newborn screening for early diagnosis of SMA.


Assuntos
Atrofia Muscular Espinal/diagnóstico , Atrofia Muscular Espinal/genética , Reação em Cadeia da Polimerase em Tempo Real/métodos , Criança , Pré-Escolar , China , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Triagem Neonatal/métodos , Proteínas do Tecido Nervoso/genética , Proteína Inibidora de Apoptose Neuronal/genética , Proteína 1 de Sobrevivência do Neurônio Motor/genética , Fatores de Transcrição/genética
14.
Opt Express ; 22(17): 19895-911, 2014 Aug 25.
Artigo em Inglês | MEDLINE | ID: mdl-25321200

RESUMO

A transparent reconfigurable optical interleaver module composed of cascaded AWGs-based wavelength-channel-selector/interleaver monolithically integrated with multimode interference (MMI) variable optical attenuators (VOAs) and Mach-Zehnder interferometer (MZI) switch arrays was designed and fabricated using polymer photonic lightwave circuits. Highly fluorinated photopolymer and grafting modified organic-inorganic hybrid material were synthesized as the waveguide core and caldding, respectively. Thermo-optic (TO) tunable wavelength transfer matrix (WTM) function of the module can be achieved for optical routing network. The one-chip transmission loss is ~ 6 dB and crosstalk is less than ~25 dB for transverse-magnetic (TM) mode. The crosstalk and extinction ratio of the MMI VOAs were measured as -15.2 dB and 17.5 dB with driving current 8 mA, respectively. The modulation depth of the TO switches is obtained as ~18.2 dB with 2.2 V bias. Proposed novel interleaver module could be well suited for DWDM optical communication systems.

15.
BMC Infect Dis ; 14: 245, 2014 May 08.
Artigo em Inglês | MEDLINE | ID: mdl-24884393

RESUMO

BACKGROUND: Human cytomegalovirus (HCMV) is an important pathogen of viral pneumonia in children. The diagnosis of acute HCMV infection is complicated and difficult. METHODS: Clinical and laboratory data of 6063 hospitalized children with respiratory infection and 509 with respiratory virus infection alone were retrospectively analyzed. Urine and respiratory specimens of 186 hospitalized children with pneumonia were also prospectively collected. Real-time polymerase chain reaction (PCR) and a chemiluminescent assay were used to detect HCMV DNA copy number, the pp65 gene, and HCMV IgM. RESULTS: The patients with respiratory virus infection alone and those with pulmonary HCMV infection (n = 422) were mostly children aged <6 months old (82.91%, 422/509). The accuracy of urine HCMV DNA (82.32%) was higher than that of HCMV IgM (67.78%), indicating that PCR of urine samples is suitable for determining pediatric acute pulmonary HCMV infection. There was no significant difference in detecting HCMV DNA or the pp65 gene between urinary and respiratory specimens (P > 0.05) in 186 pediatric pneumonia cases. The accuracy of the pp65 gene measured in urine for determining acute pulmonary HCMV infection was the highest (93.01%). CONCLUSIONS: Our study shows a novel method for investigating acute pulmonary HCMV infection in children by using real-time PCR and non-invasive samples. This study also highlights the superiority and potential use of the pp65 gene as an important target for the diagnosis of acute pulmonary HCMV infection.


Assuntos
Infecções por Citomegalovirus/diagnóstico , Citomegalovirus/isolamento & purificação , DNA Viral/urina , Pneumonia/virologia , Criança , Pré-Escolar , Citomegalovirus/genética , Infecções por Citomegalovirus/urina , Feminino , Humanos , Lactente , Recém-Nascido , Contagem de Leucócitos , Masculino , Fosfoproteínas/genética , Reação em Cadeia da Polimerase em Tempo Real , Estudos Retrospectivos , Proteínas da Matriz Viral/genética
16.
Opt Express ; 22(9): 10716-27, 2014 May 05.
Artigo em Inglês | MEDLINE | ID: mdl-24921773

RESUMO

A transparent reconfigurable optical add-drop multiplexer (ROADM) module composed of AWG-based wavelength-channel-selectors monolithically integrated with Mach-Zehnder interferometer (MZI) thermo-optic (TO) waveguide switch arrays and arrayed waveguide true-time-delay (TTD) lines is designed and fabricated using polymer photonic lightwave circuit technology. Negative-type fluorinated photoresist and grafting modified organic-inorganic hybrid materials were synthesized as the waveguide core and cladding, respectively. The one-chip transmission loss is ~6 dB and the crosstalk is less than ~30 dB for the transverse-magnetic (TM) mode. The actual maximum modulation depths of different thermo-optic switches are similar, ~15.5 dB with 1.9 V bias. The maximum power consumption of a single switch is less than 10 mW. The delay time basic increments are measured from 140 ps to 20 ps. Proposed novel ROADM is flexible and scalable for the dense wavelength division multiplexing network.

17.
Opt Express ; 16(22): 17542-53, 2008 Oct 27.
Artigo em Inglês | MEDLINE | ID: mdl-18958034

RESUMO

Molecular wave packets provide an alternative route to steer the high harmonic generation (HHG). Here we present a new method for isolated attosecond pulse generation from high harmonics in the plateau with asymmetric molecules. It is shown that the photoionization depends on the molecular structure. Through steering the ionization, HHG is controlled with the asymmetric molecule and supercontinuous high harmonics are produced in the plateau, from which an isolated 95-attosecond pulse is generated. In contrast to the cutoff which declines sharply, the plateau shows almost a constant intensity, indicating a higher yield. Moreover, the plateau covers a very broad bandwidth, thus is preferable to produce an isolated attosecond pulse with a rather short duration.

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