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BACKGROUND: Neoadjuvant short-course radiotherapy (SCRT) followed by CAPOX and camrelizumab (a programmed cell death protein 1 monoclonal antibody) has shown potential clinical activity for locally advanced rectal cancer (LARC) in a phase II trial. This study aimed to further confirm the efficacy and safety of SCRT followed by CAPOX and camrelizumab compared to long-course chemoradiotherapy (LCRT) followed by CAPOX alone as neoadjuvant treatment for LARC. PATIENTS AND METHODS: In this randomized, phase III trial, patients with T3-4/N+ rectal adenocarcinoma were randomly assigned (1 : 1) to receive SCRT or long-course chemoradiotherapy (LCRT), followed by two cycles of camrelizumab and CAPOX or CAPOX alone, respectively. After surgery, each arm underwent either six cycles of camrelizumab and CAPOX, followed by up to 17 doses of camrelizumab, or six cycles of CAPOX. The primary endpoint was pathological complete response (pCR) rate (ypT0N0) assessed by a blinded independent review committee. Key secondary endpoints tested hierarchically were 3-year event-free survival (EFS) rate and overall survival (OS). RESULTS: Between July 2021 and March 2023, the intention-to-treat population comprised 113 patients in the experimental arm and 118 patients in the control arm, with surgery carried out in 92% and 83.9%, respectively. At data cut-off (11 July 2023), the pCR rates were 39.8% [95% confidence interval (CI) 30.7% to 49.5%] in the experimental arm compared to 15.3% (95% CI 9.3% to 23.0%) in the control arm (difference, 24.6%; odds ratio, 3.7; 95% CI 2.0-6.9; P < 0.001). In each arm, surgical complication rates were 40.0% and 40.8%, and grade ≥3 treatment-related adverse events were 29.2% and 27.2%. Three-year EFS rate and OS continue to mature. CONCLUSIONS: In LARC patients, neoadjuvant SCRT followed by camrelizumab plus CAPOX demonstrated a significantly higher pCR rate than LCRT followed by CAPOX, with a well-tolerated safety profile. SCRT followed by camrelizumab and chemotherapy can be recommended as a neoadjuvant treatment modality for these patients.
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Since 1986, the WHO has held ten global health promotion conferences covering various health promotion issues and sustainable development worldwide. These sessions have formed a series of consensus and actions that guide promoting health globally. This study analyzed the declarations, reports, and news materials from the ten conferences that studied health promotion action areas, focal topics, actor networks, partnership relationships, and other significant outcomes. It also explored how these conferences contributed to the construction and advancement of global health promotion consensus and actions. The first Global Conference on Health Promotion identified the concept of health promotion and five key action areas, laying the foundation for subsequent conferences and health promotion actions. Over the years, the ten conferences continuously expanded the essence of health promotion, developed partnership relationships, formulated public health promotion policies, and called for health promotion actions. This process culminated in the formation of global consensus and collective actions. The latter conferences have gained significant attention and influence. The conferences offer valuable insights for future global health promotion endeavors and provide global perspectives and pathways for the development of Healthy China.
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Congressos como Assunto , Saúde Global , Promoção da Saúde , Promoção da Saúde/métodos , Humanos , China , Saúde Pública , Organização Mundial da SaúdeRESUMO
Objective: To compare the efficacy of lower extremity three dimensional CT venography (CTV) and lower extremity ascending phlebography in evaluating recurrent varicose veins. Methods: A retrospective analysis was conducted on clinical data from 235 patients with unilateral recurrent varicose veins who were treated at the Department of Vascular Surgery,Beijing Shijitan Hospital,Capital Medical University, between January 2015 and December 2020.There were 112 males and 123 females, with an age of (62.5±11.4)years (range:24 to 75 years).Patients were stratified into two groups based on preoperative imaging examination:the CTV group (utilizing lower extremity venous ultrasound+lower extremity CTV) and the control group (employing lower extremity venous ultrasound+lower extremity ascending phlebography).The two groups were matched in a 1â¶1 ratio using propensity score matching, resulting in 43 cases per group.Comparative analyses between the groups at the one-year postoperative follow-up were performed using independent sample t tests, Wilcoxon rank-sum tests, χ2 tests, and linear regression analysis. Results: One year post-surgery,the CTV group exhibited a lower venous clinical severity score (VCSS) compared to the control group(M(IQR),3.0(4.3) vs.4.0(5.8),Z=-2.038,P=0.040).Additionally, the chronic venous insufficiency patients' quality of life questionnaire (CIVIQ-20) scores were significantly higher in the CTV group than in the control group (89.0(8.0) vs.82.5(17.0), Z=-2.627, P=0.010).Patients in the CTV group also experienced a shorter ulcer healing time compared to the control group (4.0(4.0) weeks vs.12.0(7.0) weeks, Z=-3.217,P<0.01).Both groups showed no clinically symptomatic recurrent varicose veins or ulcers.However, they exhibited ultrasound-detectable varicose vein recurrence, with no statistically significant difference (χ2=0.453,P=0.500).The number of diseased vessels requiring management based on ultrasound supplemented by CTV was 16, while the number supplemented by ascending phlebography was 7,with a statistically significant difference (χ2=4.800,P=0.030).Linear regression analysis demonstrated that clinical-etiology-anatomy-pathology clinical grading and the preoperative imaging examination method exerted independent influences on VCSS and CIVIQ-20 during the one-year postoperative assessment. Conclusions: CTV-assisted ultrasound enables a direct and comprehensive evaluation and localization of diseased veins in patients with recurrent varicose veins.The utilization of lower extremity vein ultrasound combined with CTV-guided management of lower extremity vessels in minimally invasive treatment significantly improves patient prognosis, surpassing the assessment provided by ascending phlebography.
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Varizes , Insuficiência Venosa , Masculino , Feminino , Humanos , Flebografia/métodos , Estudos Retrospectivos , Pontuação de Propensão , Qualidade de Vida , Varizes/diagnóstico por imagem , Varizes/cirurgia , Tomografia Computadorizada por Raios X/métodos , Insuficiência Venosa/diagnósticoRESUMO
Prey animals modify their behaviour and physiology in the presence of predators. Domestic animals differ from wild animals in having less exposure to wild predators, but whether they still retain an antipredator instinct is frequently unknown. In this study, we used domesticated Small Tail Han sheep as a model prey animal to gauge their response to the presence of predators, in the form of odours from the faeces of lion, tiger, and leopard. The faeces of male sheep and male rabbit (as a heterogeneous non-predator) were used as control. We found that the frequency and time of feeding, exploration, moving, watching, and lying down behaviours were significantly affected by predator odour, and that there was an interaction between odour sources and sex. When exposed to predator odour, sheep reduced their frequency and time of feeding, and increased their exploratory, moving, and watching behaviours. Female sheep showed greater motivation towards frequent and lengthy exploration, moving, watching, and lying down behaviours than male sheep, and less motivation towards feeding and drinking behaviours. Serum cortisol levels were lowest in response to tiger stimuli. These results illustrated that Small Tail Han sheep could recognise predator odour and adjust their behaviour to display antipredator strategies, and displayed some physiological responses, although only changing in serum cortisol could be significantly attributed to the odour of predators.
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Hidrocortisona , Tigres , Ovinos , Animais , Feminino , Masculino , Coelhos , Cauda , Comportamento Predatório/fisiologia , OdorantesRESUMO
OBJECTIVE: This study aimed to analyze the potential correlation between chronic endometritis (CE) and intrauterine adhesions (IUA) with its associated risk factors. PATIENTS AND METHODS: We retrospectively analyzed data from 131 patients who underwent hysteroscopic transcervical resection of adhesions (TCRA) for intrauterine adhesions at our hospital between February 2020 and February 2021. General clinical data were collected and analyzed using univariate, multifactorial, and logistic regression analyses. Patients with mild, moderate, and severe IUA were divided into two groups based on whether they coincided with CE (CE group) or not (NCE group). Logistic regression analysis of the factors associated with IUA was performed, and the recurrence rates of IUA after TCRA in the CE and NCE groups were registered. RESULTS: The risk of severe IUA was higher in patients with a higher number of abortions, higher number of indolent abortions, and CD138 positivity. In addition, the incidence of IUA combined with chronic CE varied when comparing the different IUA stages: 10.70% (3/28) for patients with mild IUA, 25.00% (7/28) for patients with moderate IUA, and 64.30% (18/28) for patients with severe IUA. The recurrence rates of IUA after TCRA in the CE and NCE groups were 69.20% (9/26) and 30.08% (4/67), respectively, in patients with moderate to severe IUA, and the differences were statistically significant (χ2=12.782, p=0.001). CONCLUSIONS: A correlation was observed between CE and IUA. Patients presenting both conditions had more severe IUA stage and higher recurrence rates after TCRA.
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Aborto Induzido , Endometrite , Doenças Uterinas , Gravidez , Feminino , Humanos , Estudos Retrospectivos , Endometrite/epidemiologia , Endometrite/complicações , Histeroscopia , Doenças Uterinas/epidemiologia , Doenças Uterinas/cirurgia , Aborto Induzido/efeitos adversos , Aderências Teciduais/cirurgia , Aderências Teciduais/complicações , Doença CrônicaRESUMO
Peritoneal metastasis is one of the most frequent patterns of metastasis in gastric cancer, and remains a major unmet clinical problem. Thus, systemic chemotherapy remains the mainstay of treatment for gastric cancer with peritoneal metastasis. In well-selected patients, the reasonable combination of cytoreductive surgery, hyperthermic intraperitoneal chemotherapy (HIPEC), and neoadjuvant intraperitoneal chemotherapy with systemic chemotherapy will bring significant survival benefits to patients with gastric cancer peritoneal metastasis. In patients with high-risk factors, prophylactic therapy may reduce the risk of peritoneal recurrence, and improves survival after radical gastrectomy. However, high-quality randomized controlled trials will be needed to determine which modality is better. The safety and efficacy of intraoperative extensive intraperitoneal lavage as a preventive measure has not been proven. The safety of HIPEC also requires further evaluation. HIPEC and neoadjuvant intraperitoneal and systemic chemotherapy have achieved good results in conversion therapy, and it is necessary to find more efficient and low-toxicity therapeutic modalities and screen out the potential benefit population. The efficacy of CRS combined with HIPEC on peritoneal metastasis in gastric cancer has been preliminarily validated, and with the completion of clinical studies such as PERISCOPE II, more evidence will be available.
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Hipertermia Induzida , Neoplasias Peritoneais , Neoplasias Gástricas , Humanos , Neoplasias Gástricas/patologia , Neoplasias Peritoneais/secundário , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Hipertermia Induzida/métodos , Peritônio/patologia , Terapia Combinada , Procedimentos Cirúrgicos de Citorredução/métodos , Taxa de SobrevidaRESUMO
The incidence of Siewert type II adenocarcinoma of the esophagogastric junction (AEG) is increasing year by year. Due to its special anatomical location and biological behavior, the treatment of AEG is still controversial in terms of lymph node dissection, the esophageal resection margin, range of gastrectomy, and the choice of reconstruction modality for postoperative gastrointestinal tract. The advent of the minimally invasive era has brought the treatment of Siewert type II AEG to a stage of gradual improvement and standardization. Experts of China are also actively exploring the value of minimally invasive surgery in the treatment of AEG through multicenter trials (CLASS-10, etc.). It is believed that based on the active development of many clinical studies, basic experimental studies and large prospective clinical studies, the strengthening of communication and cooperation among various disciplines and the innovative application of new technologies can bring greater survival benefits to patients.
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Adenocarcinoma , Neoplasias Esofágicas , Neoplasias Gástricas , Adenocarcinoma/patologia , Neoplasias Esofágicas/patologia , Neoplasias Esofágicas/cirurgia , Junção Esofagogástrica/patologia , Junção Esofagogástrica/cirurgia , Gastrectomia , Humanos , Excisão de Linfonodo , Procedimentos Cirúrgicos Minimamente Invasivos , Estudos Prospectivos , Estudos Retrospectivos , Neoplasias Gástricas/patologiaRESUMO
A questionnaire was used to investigate the emergency training needs of novel coronavirus pneumonia of disease prevention and control institutions in provinces, deputy provincial level regions and cities specifically designated in the state plan, and the effect evaluation of emergency training activities conducted by Chinese Center for Disease Control and Prevention (China CDC). The results showed that 67.4% of 47 disease prevention and control institutions (31/46) believed that the emergency training at the initial stage of the epidemic should be conducted as soon as possible, and the form of network training should be given priority. The training should focus on the urgently needed technologies such as epidemiological investigation, formulation and response of prevention and control strategies, laboratory testing, etc. The teaching materials should highlight pertinence and practicability and be presented in the form of electronic video. The average satisfaction score of the video training conducted by China CDC was (8.81±1.125) and the score of audio-video courseware was (8.97±0.893). The needs analysis and evaluation of novel coronavirus pneumonia prevention and control in disease prevention and control institutions could provide reference for the follow-up training and improve the emergency training management.
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COVID-19 , Pneumonia , China/epidemiologia , Humanos , Pneumonia/prevenção & controle , SARS-CoV-2 , Inquéritos e QuestionáriosRESUMO
OBJECTIVE: To investigate how nuclear factor-E2-related factor 2 (Nrf2) involved in the protective effect of isoflurane (Iso) preconditioning in oxygen glucose deprivation (OGD)-induced cortical neuron injury. METHODS: Primary mouse cortical neurons were divided into Control, ML385 (an Nrf2 inhibitor), Iso, Iso + ML385, OGD, ML385 + OGD, Iso + OGD, and Iso + ML385 + OGD groups. Lactate dehydrogenase activity (LDH) release and oxidative stress indexes were quantified. 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay was used to detect cell viability, Annexin V-FITC/propidium iodide (PI) staining to measure cell apoptosis, dichloro-dihydro-fluorescein diacetate (DCFH-DA) method to test reactive oxygen species (ROS), and quantitative reverse-transcription polymerase chain reaction (qRT-PCR) and Western blotting to evaluate genes and protein expression. RESULTS: Iso preconditioning reduced LDH release and inhibited cell cytotoxicity in OGD-induced cortical neurons, which was abolished by ML385. Iso preconditioning increased the Nrf2 nuclear translocation in cortical neurons. Meanwhile, Iso decreased the OGD-induced apoptosis with the down-regulations of Bax and Caspase-3 and the up-regulation of Bcl-2, which was reversed by ML385. OGD enhanced the level of ROS and malondialdehyde (MDA) in cortical neurons, but reduced the activities of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px), which were aggravated in ML385 + OGD group and mitigated in Iso + OGD group. No observable difference was found between OGD group and Iso + ML385 + OGD group regarding apoptosis-related proteins and oxidative stress-related indexes. CONCLUSION: Iso preconditioning up-regulated Nrf2 level to play its protective role in OGD-induced mouse cortical neuron injury.
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Isquemia Encefálica/tratamento farmacológico , Encéfalo/efeitos dos fármacos , Glucose/deficiência , Hipóxia/tratamento farmacológico , Isoflurano/farmacologia , Fator 2 Relacionado a NF-E2/farmacologia , Neurônios/efeitos dos fármacos , Anestésicos Inalatórios/metabolismo , Anestésicos Inalatórios/farmacologia , Animais , Sobrevivência Celular/efeitos dos fármacos , Humanos , Hipóxia/fisiopatologia , Isoflurano/metabolismo , Redes e Vias Metabólicas , Camundongos , Modelos Animais , Fator 2 Relacionado a NF-E2/metabolismo , Fármacos NeuroprotetoresRESUMO
OBJECTIVE: This study aims to investigate the regulatory effect of circRNA_010763 on the growth and invasion of non-small cell lung cancer (NSCLC). PATIENTS AND METHODS: qRT-PCR was performed to detect the expressions of circRNA_010763 and c-Myc in human NSCLC tissues and cells. CCK-8 assay was performed to evaluate the A549 cells proliferation and transwell assay was performed to evaluate the A549 cells migration. The correlation between miR-715 and circRNA_010763 was detected by statistical analysis. Bioinformatics prediction and Luciferase assay were performed to explore the interaction and binding site of circRNA_010763 and miR-715, miR-715 and c-Myc, respectively. RESULTS: We found that both circRNA_010763 and c-Myc were upregulated in human NSCLC tissues and cells. qRT-PCR and CCK-8 assay showed that circRNA_010763 expression is associated with the proliferation of NSCLC cells. Transwell assay showed that circRNA_010763 regulated the migration ability of NSCLC cells. The bioinformatics prediction and Luciferase assay demonstrated that circRNA_010763 can sponge with miR-715, serving as a molecular sponge to further regulate the expression of c-Myc. CONCLUSIONS: In this study, we found that circRNA_010763 was highly expressed in human NSCLC tissues, which could promote tumor proliferation, migration and invasion through serving as a molecular sponge by modulating the inhibitory effect of miR-715 on oncogene c-Myc.
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Carcinoma Pulmonar de Células não Pequenas/metabolismo , Movimento Celular , Proliferação de Células , Neoplasias Pulmonares/metabolismo , MicroRNAs/metabolismo , Proteínas Proto-Oncogênicas c-myc/metabolismo , RNA Circular/metabolismo , Células A549 , Adulto , Carcinoma Pulmonar de Células não Pequenas/genética , Carcinoma Pulmonar de Células não Pequenas/patologia , Feminino , Regulação Neoplásica da Expressão Gênica , Humanos , Neoplasias Pulmonares/genética , Neoplasias Pulmonares/patologia , Masculino , MicroRNAs/genética , Pessoa de Meia-Idade , Invasividade Neoplásica , Proteínas Proto-Oncogênicas c-myc/genética , RNA Circular/genética , Transdução de SinaisRESUMO
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.
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Metilação de DNA , Adulto , Glicemia , Ilhas de CpG , Epigênese Genética , Jejum , Feminino , Hemoglobinas Glicadas , Humanos , Masculino , Pessoa de Meia-Idade , Gêmeos MonozigóticosRESUMO
This article provides comprehensive experimental data of two water-swelling materials, water swelling rubber (WSR) and water-swelling polyurethane (WSP). Swelling tests, Dynamic Mechanical Analyzer (DMA) and Scanning Electron Microscope (SEM) were performed. Sealing properties of WSR and WSP were characterized by the data of swelling ratios (Sw and Sa), storage moduli (E') and images of micro-damage morphologies. These data can be useful for the prediction of the long-term waterproof performance of water-swelling materials and provide reference for material selection. The data presented herein was used for the article, titled "Laboratory evaluation of long-term sealing behaviors of two water-swelling materials for shield tunnel gasket" [1].
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Laryngomalacia is defined as a supraglottic collapse of the glottis, resulting in intermittent airflow obstruction and associated wheezing. This disease is the most common cause of stridor in neonates and infants. Associated feeding difficulties are present in approximately half of the children. A definitive diagnosis can generally be made with flexible fiberoptic laryngoscopy. The disorder is most often self-limited with resolution of symptoms within the first 24 months of life, and the majority of children can thus be managed conservatively. The approximately 5%-20% of children with severe or refractory disease may require more aggressive intervention, most commonly in the form of transoral supraglottoplasty. High success rates and a low rate of complications have been reported for this procedure in otherwise healthy children. Children with syndromes or medical comorbidities are more likely to have complications or persistent symptoms after supraglottoplasty and may require additional interventions.
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Glote/fisiopatologia , Laringomalácia/diagnóstico , Laringomalácia/terapia , Laringoscopia , Sons Respiratórios/etiologia , Obstrução das Vias Respiratórias/etiologia , Criança , Humanos , Lactente , Laringomalácia/complicações , LaringoplastiaRESUMO
WHAT IS KNOWN AND OBJECTIVE: Anticoagulation management services are well known to improve the quality of patient care and to reduce the rates of hospitalization and emergency department visits following adverse events related to anticoagulation therapy. The complexity of managing warfarin has led to the development of a variety of specialized models managed by pharmacists, physicians, nurses, and self-managed care. The aim of the study is to compare the effectiveness of pharmacist-managed anticoagulation control of warfarin with other models. METHODS: We performed a systematic literature search of the PubMed, Medline@Web of Knowledge, EMBASE, Cochrane Library and Cumulative Index to Nursing and Allied Health Literature to identify randomized controlled trials (RCTs) from database inception up to July 2015. The search terms used for the study were 'warfarin', 'pharmacists', 'Vitamin K antagonist', 'anticoagulation' and 'management model.' We used the Cochrane Collaboration's tool from the Cochrane Handbook to assess the risk of bias of RCTs. We performed statistical analyses using RevMan 5.3 and used the Grading of Recommendations, Assessment, Development, and Evaluations profiler to rate the quality of evidence of the outcomes. The anticoagulation control outcomes were the percentage of time within the standard and expanded therapeutic range and thrombosis events; the safety outcomes were bleeding events and mortality, and patients' satisfaction of anticoagulation service. RESULTS AND DISCUSSION: Eight RCTs from 981 potentially relevant publications with a total of 1493 patients were included. Meta-analysis of the RCTs showed that a significant difference existed between pharmacist-managed care and other models for satisfaction (mean difference (MD) = 0·41, 95% CI, 0·01-0·81, P = 0·04, low-quality evidence) with heterogeneity, and the percentage of time within the standard therapeutic range (MD = 3·66, 95% CI 2·20-5·11, P < 0·00001, high-quality evidence) without heterogeneity. However, the pharmacist-managed group demonstrated no significant improvement on the percentage of time within the expanded therapeutic range (MD = 2·85, 95% CI -0·56 to 6·26, P = 0·10, moderate-quality evidence) with heterogeneity, mortality [odds ratio (OR) = 0·97, 95% CI, 0·44-2·11, P = 0·09, high-quality evidence] without heterogeneity, the prevention of bleeding events (OR = 0·89, 95% CI, 0·56-1·44, P = 0·64, high-quality evidence) without heterogeneity, and thrombosis events (OR = 0·81, 95% CI, 0·34-1·92, P = 0·64, high-quality evidence) without heterogeneity. WHAT IS NEW AND CONCLUSION: The advantage of pharmacist-managed warfarin anticoagulation therapy in terms of anticoagulation control, safety and mortality are unclear, but resulted in significantly better patient satisfaction. Compared with other models, the superiority of pharmacist-managed warfarin anticoagulation needs to be further evaluated and validated in future research.
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Anticoagulantes/uso terapêutico , Coagulação Sanguínea/efeitos dos fármacos , Varfarina/uso terapêutico , Serviço Hospitalar de Emergência , Hemorragia/induzido quimicamente , Hemorragia/tratamento farmacológico , Hospitalização , Humanos , Enfermeiras e Enfermeiros , Satisfação do Paciente , Farmacêuticos , Médicos , Autocuidado/métodos , Varfarina/efeitos adversosRESUMO
Objective: To characterize the metabolic " fingerprint" of fecal extracts for diagnosis of early-stage colorectal cancer(CRC)using proton nuclear magnetic resonance spectroscopy(1H-NMR)-based metabolomics coupled with pattern recognition. Methods: From January 2014 to December 2014, we collected fecal samples at the Second Affiliated Hospital of Shantou University Medical College, from 25 patients with colorectal adenomas(CR-Ad), 20 with stage â /â ¡ CRC, and 32 healthy controls(HCs). The patients were diagnosed by histopathology. No subjects had any complicating diseases. HCs showed no abnormalities from blood tests, endoscopic examination, diagnostic imaging, and/or medical interviews. We excluded participants who used antibiotics, NSAIDS, statins, or probiotics within two months of study participation, and any patients who underwent chemotherapy or radiation treatments prior to surgery. We used orthogonal partial least-squares-discriminant analysis(OPLS-DA)for pattern recognition(dimension reduction)on 1H-NMR processed data(1H frequency of 400.13 MHz), to find metabolic differences among CR-Ad, carcinoma and HC fecal samples; and receiver operating characteristic(ROC)analysis to determine the diagnostic value of the fecal metabolic biomarkers. Results: Fecal samples were collected from 20 patients with Stage â /â ¡ CRC(11 M, 9 F, median age(52±13)years), 25 with CR-Ad(14 M, 11 F, median age(53 ± 11)years)and 32 HCs(15 M, 17 F, median age(53 ± 14)years). OPLS-DA clearly distinguished CR-Ad and stage â /â ¡ CRC from HC samples, based on their metabolomic profiles. Relative signal intensities in HCs were significantly lower than in the cancer patients for butyrate(HC: 23.0±6.0; CR-Ad: 18.0±5.0; CRC: 14.0±6.0; Z=-2.07, P=0.008), acetate(HC: 45.0±11.0; CR-Ad: 31.0±11.0; CRC: 24.0±8.0; Z=- 2.32, P=0.011), propionate(HC: 26.0 ± 7.0; CR-Ad: 22.0 ± 6.0; CRC: 19.0 ± 5.0; Z=- 2.43, P=0.032), glucose(HC: 37.0±7.0; CR-Ad: 31.0±7.0; CRC: 26.0±8.0; Z=-2.07, P=0.044)and glutamine(HC: 4.5±2.0; CR-Ad: 4.9 ± 1.0; CRC: 5.4 ± 1.0; Z=2.21, P=0.044). However, relative signal intensities in HCs were significantly higher than in patients for lactate(HC: 4.8±1.0; CR-Ad: 6.9±2.0; CRC: 4.8± 1.0; Z=2.02, P= 0.038), glutamate(HC: 3.2 ± 2.0; CR-Ad: 4.9 ± 1.0; CRC: 3.2 ± 2.0; Z=2.21, P=0.044)and succinate(HC: 12.0±2.0; CR-Ad: 15.0±3.0; CRC: 12.0± 2.0; Z=2.25, P=0.011). Among the potential biomarkers, acetate at 1.92 ppm, and succinate at 2.41 ppm displayed relatively high area under ROC, with sensitivity and specificity both >90%, to distinguish early-stage CRC patients from HCs. Conclusion: Fecal metabolic profiles distinguish of HCs from patients with CRC patients, even in the early stages(stage â /â ¡), highlighting the potential of NMR-based fecal metabolomic fingerprinting as tools for early CRC diagnosis.
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Adenoma/patologia , Neoplasias Colorretais/patologia , Detecção Precoce de Câncer , Fezes/química , Espectroscopia de Ressonância Magnética , Metabolômica/métodos , Adenoma/metabolismo , Adulto , Idoso , Biomarcadores Tumorais/análise , Neoplasias Colorretais/metabolismo , Feminino , Humanos , Mucosa Intestinal/metabolismo , Intestinos/efeitos da radiação , Análise dos Mínimos Quadrados , Masculino , Metaboloma , Pessoa de Meia-Idade , Prótons , Curva ROC , Sensibilidade e EspecificidadeRESUMO
OBJECTIVE: To establish the criteria for screening macroprolactinemia (MP) after Polyethylene glycol (PEG) treatment plus different assays of Prolactin (PRL) in a clinical setting. PATIENTS AND METHODS: This study recruited 122 patients, and their PRL-elevated serum samples were collected. Twenty-two of the 122 serum samples were treated by gel filtration chromatography (GFC) and PEG precipitation. The PRL content in the eluent and supernatant were tested separately by two analyzers: i2000sr (Abbott Laboratories, Chicago, IL, USA) and E170 (Roche Diagnostics, Basel, Switzerland). The GFC-method (the gold standard) was applied, in order to establish the criteria of screening MP after PEG-method. The MP positive rate and PRL concentrations in 100 PRL-elevated patients were compared between the literature criteria (a PRL recovery of < 40%) and the new criteria. RESULTS: The detected value of macroprolactin with the new criteria in the i2000sr (a PRL recovery of < 50%) was higher than in the E170 (a PRL recovery of < 60%). The E170 analyzer detected 38 cases of MP in 100 PRL-elevated samples by using new criteria, which was higher than the literature criteria (24 cases) (p < 0.05). Therefore, there were 15 samples could not be judged consistently using the literature criteria by the i2000sr and E170 analyzers. There was also a significant difference in PRL concentrations between the two groups (p < 0.01). If using the new criteria, the inconsistency between the two analyzers was reduced to 2 samples. There was a very significant difference in the inconsistency between two criteria (p < 0.01). The reported values of PRL from the i2000sr and E170 were 27.8 (16.2-42.6) ng/ml and 32.0 (19.6-49.9) ng/ml. There were no significant differences between two analyzers. CONCLUSIONS: Establishment of different criteria for screening MP by using PEG-method is helpful for the accuracy of PRL determination and its comparability.
Assuntos
Hiperprolactinemia/diagnóstico , Prolactina/sangue , Cromatografia em Gel , Humanos , Polietilenoglicóis/químicaRESUMO
Objective:To analysis the clinical features, diagnosis and treatment experience of nasopharyngeal neoplasm in infants.Method:Twenty infants cases of nasopharyngeal neoplasm, from June 2002 to March 2015, admitted in our department were retrospectively studied. Nasopharyngeal neoplasm in all cases were ablated with low temperature plasma radiofrequency ablation after anesthesia downlink preoperative 70 degrees endoscope, and new biological routine pathologic examination were done.Result:The low temperature plasma radiofrequency ablation has several advantages,such as simple and convenient operating, short operating time, intraoperative blood loss and clear vision.Five cases were diagnosed as postoperative pathological cyst,4 cases were teratoma, 4 cases were hairy polyps,3 cases were hamartoma, 2 cases were hyperplasia of lymphoid tissue, 1 case was glioma, and 1 case was rhabdomyosarcoma. Postoperative follow-up for 6 months to 12 years, recurrence were found in 2 cases, including 1 death case.Conclusion:Infants nasopharyngeal neoplasm are almost benign, clinical rare congenital nasopharyngeal tumor more than the early detection of an infant. CT and MRI examination has important significance to the diagnosis. Low temperature plasma radiofrequency ablation with Seventy degrees nasal endoscope is worth extending.
RESUMO
Pulse generation often requires a stabilized cavity and its corresponding mode structure for initial phase-locking. Contrastingly, modeless cavity-free random lasers provide new possibilities for high quantum efficiency lasing that could potentially be widely tunable spectrally and temporally. Pulse generation in random lasers, however, has remained elusive since the discovery of modeless gain lasing. Here we report coherent pulse generation with modeless random lasers based on the unique polarization selectivity and broadband saturable absorption of monolayer graphene. Simultaneous temporal compression of cavity-free pulses are observed with such a polarization modulation, along with a broadly-tunable pulsewidth across two orders of magnitude down to 900 ps, a broadly-tunable repetition rate across three orders of magnitude up to 3 MHz, and a singly-polarized pulse train at 41 dB extinction ratio, about an order of magnitude larger than conventional pulsed fiber lasers. Moreover, our graphene-based pulse formation also demonstrates robust pulse-to-pulse stability and wide-wavelength operation due to the cavity-less feature. Such a graphene-based architecture not only provides a tunable pulsed random laser for fiber-optic sensing, speckle-free imaging, and laser-material processing, but also a new way for the non-random CW fiber lasers to generate widely tunable and singly-polarized pulses.
RESUMO
We propose a long range, high precision optical time domain reflectometry (OTDR) based on an all-fiber supercontinuum source. The source simply consists of a CW pump laser with moderate power and a section of fiber, which has a zero dispersion wavelength near the laser's central wavelength. Spectrum and time domain properties of the source are investigated, showing that the source has great capability in nonlinear optics, such as correlation OTDR due to its ultra-wide-band chaotic behavior, and mm-scale spatial resolution is demonstrated. Then we analyze the key factors limiting the operational range of such an OTDR, e. g., integral Rayleigh backscattering and the fiber loss, which degrades the optical signal to noise ratio at the receiver side, and then the guideline for counter-act such signal fading is discussed. Finally, we experimentally demonstrate a correlation OTDR with 100km sensing range and 8.2cm spatial resolution (1.2 million resolved points), as a verification of theoretical analysis.