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1.
Zhonghua Liu Xing Bing Xue Za Zhi ; 45(3): 353-357, 2024 Mar 10.
Artigo em Chinês | MEDLINE | ID: mdl-38514311

RESUMO

Objective: To understand the baseline viral load (VL) of newly reported HIV- infected patients before antiretroviral therapy and related factors in Tianjin. Methods: Data were obtained from the China Disease Control and Prevention Information System, and the study subjects were HIV-infected patients before the first antiretroviral therapy in Tianjin from 2019 to 2022, and the information about their socio-demographic characteristics, baseline CD4+T lymphocyte (CD4) counts before antiretroviral therapy and baseline VL test results were collected, the baseline high VL was defined as ≥100 000 copies/ml. The effect of different factors on viral load were analyzed. Software SPSS 24.0 was used for statistical analysis. Results: A total of 1 296 newly reported HIV-infected patients were included in the study, in whom 15.89% (206/1 296) had high baseline VL, and multifactorial logistic regression analysis showed that those with history of STD (aOR=1.45, 95%CI:1.00-2.08) were more likely to have high baseline VL. Compared with those with baseline CD4 counts <200 cells/µl, those with baseline CD4 counts 200-350 cells/µl (aOR=0.40, 95%CI: 0.27-0.57), 351-500 cells/µl (aOR=0.32, 95%CI: 0.20-0.49), and >500 cells/µl (aOR=0.30, 95%CI: 0.18-0.49) were less likely to have high baseline VL. Conclusions: The proportion of HIV-infected patients with high baseline VL before antiretroviral therapy was low in Tianjin during 2019-2022. History of STD and baseline CD4 counts <200 cells/µl were associated with high baseline VL in HIV-infected patients, to which close attention needs to be paid in AIDS prevention and control.


Assuntos
Síndrome da Imunodeficiência Adquirida , Infecções por HIV , Humanos , Carga Viral , Contagem de Linfócito CD4 , China/epidemiologia , Terapia Antirretroviral de Alta Atividade
2.
Zhonghua Shao Shang Za Zhi ; 38(8): 767-777, 2022 Aug 20.
Artigo em Chinês | MEDLINE | ID: mdl-36058700

RESUMO

Objective: To investigate the effects of deferoxamine on macrophage polarization and wound healing in mice with deep tissue injury (DTI) and its mechanism. Methods: The experimental research methods were adopted. Fifty-four male C57BL/6J mice of 6-8 weeks old were divided into DTI control group, 2 mg/mL deferoxamine group, and 20 mg/mL deferoxamine group according to random number table, with 18 mice in each group. DTI was established on the back of mice by magnet compression method. From post injury day (PID) 1, mice were injected subcutaneously with 100 µL normal saline or the corresponding mass concentration of deferoxamine solution every other day at the wound edge until the samples were collected. Another 6 mice without any treatment were selected as normal control group. Six mice in each of the three DTI groups were collected on PID 3, 7, and 14 to observe the wound changes and calculate the wound healing rate. Normal skin tissue of mice in normal control group was collected on PID 3 in other groups (the same below) and wound tissue of mice in the other three groups on PID 7 and 14 was collected for hematoxylin-eosin (HE) staining to observe the tissue morphology. Normal skin tissue of mice in normal control group and wound tissue of mice in the other three groups on PID 7 were collected, and the percentages of CD206 and CD11c positive area were observed and measured by immunohistochemical staining, and the mRNA and protein expressions of CD206, CD11c, and inducible nitric oxide synthase (iNOS) were detected by real-time fluorescence quantitative reverse transcription polymerase chain reaction and Western blotting, respectively. Normal skin tissue of mice in normal control group and wound tissue of mice in DTI control group and 20 mg/mL deferoxamine group were collected on PID 3, 7, and 14, and the protein expressions of signal transducer and activator of transcription 3 (STAT3) and interleukin-10 (IL-10) were detected by Western blotting. The sample number in each group at each time point in the above experiments. The RAW264.7 cells were divided into 50 µmol/L deferoxamine group, 100 µmol/L deferoxamine group, 200 µmol/L deferoxamine group, and blank control group, which were treated correspondingly, with 3 wells in each group. The positive cell percentages of CD206 and CD86 after 48 h of culture were detected by flow cytometry. Data were statistically analyzed with analysis of variance for repeated measurement, one-way analysis of variance, and least significant difference test. Results: On PID 7, the wound healing rates of mice in 2 mg/mL and 20 mg/mL deferoamine groups were (17.7±3.7)% and (21.5±5.0)%, respectively, which were significantly higher than (5.1±2.3)% in DTI control group (P<0.01). On PID 14, the wound healing rates of mice in 2 mg/mL and 20 mg/mL deferoamine groups were (51.1±3.8)% and (57.4±4.4)%, respectively, which were significantly higher than (25.2±3.8)% in DTI control group (P<0.01). HE staining showed that the normal skin tissue layer of mice in normal control group was clear, the epidermis thickness was uniform, and skin appendages such as hair follicles and sweat glands were visible in the dermis. On PID 7, inflammation in wound tissue was obvious, the epidermis was incomplete, and blood vessels and skin appendages were rare in mice in DTI control group; inflammatory cells in wound tissue were reduced in mice in 2 mg/mL and 20 mg/mL deferoxamine groups, and a few of blood vessels and skin appendages could be seen. On PID 14, inflammation was significantly alleviated and blood vessels and skin appendages were increased in wound tissue of mice in 2 mg/mL and 20 mg/mL deferoxamine groups compared with those in DTI control group. On PID 7, the percentages of CD206 positive area in wound tissue of mice in 2 mg/mL and 20 mg/mL deferoxamine groups were significantly higher than that in DTI control group (P<0.01), the percentage of CD206 positive area in wound tissue of mice in DTI control group was significantly lower than that in normal skin tissue of mice in normal control group (P<0.01), the percentage of CD206 positive area in wound tissue of mice in 20 mg/mL deferoxamine group was significantly higher than that in normal skin tissue of mice in normal control group (P<0.01). The percentages of CD11c positive area in wound tissue of mice in 2 mg/mL and 20 mg/mL deferoxamine groups were significantly lower than those in DTI control group and normal skin tissue in normal control group (P<0.05 or P<0.01), and the percentage of CD11c positive area in normal skin tissue of mice in normal control group was significantly higher than that in DTI control group (P<0.05). On PID 7, the CD206 mRNA expressions in the wound tissue of mice in 2 mg/mL and 20 mg/mL deferoxamine groups were significantly higher than that in DTI control group (P<0.01), but significantly lower than that in normal skin tissue in normal control group (P<0.01); the CD206 mRNA expression in wound tissue of mice in DTI control group was significantly lower than that in normal skin tissue in normal control group (P<0.01). The mRNA expressions of CD11c and iNOS in wound tissue of mice in 2 mg/mL and 20 mg/mL deferoamine groups were significantly lower than those in DTI control group (P<0.01). The mRNA expressions of CD11c in the wound tissue of mice in DTI control group, 2 mg/mL and 20 mg/mL deferoamine groups were significantly higher than that in normal skin tissue in normal control group (P<0.01). Compared with that in normal skin tissue in normal control group, the mRNA expressions of iNOS in wound tissue of mice in 2 mg/mL and 20 mg/mL deferoamine groups were significantly decreased (P<0.01), and the mRNA expression of iNOS in wound tissue of mice in DTI control group was significantly increased (P<0.01). On PID 7, the protein expressions of CD206 in the wound tissue of mice in 2 mg/mL and 20 mg/mL deferoamine groups were significantly higher than those in DTI control group and normal skin tissue in normal control group (P<0.01), and the protein expression of CD206 in wound tissue of mice in DTI control group was significantly lower than that in normal skin tissue in normal control group (P<0.01). The protein expressions of CD11c and iNOS in wound tissue of mice in 2 mg/mL and 20 mg/mL deferoamine groups were significantly lower than those in DTI control group (P<0.01). The protein expressions of CD11c and iNOS in wound tissue of mice in DTI control group were significantly higher than those in normal skin tissue in normal control group (P<0.01). The CD11c protein expressions in wound tissue of mice in 2 mg/mL and 20 mg/mL deferoamine groups were significantly higher than those in normal skin tissue in normal control group (P<0.05 or P<0.01). The protein expression of iNOS in wound tissue of mice in 2 mg/mL deferoamine group was significantly lower than that in 20 mg/mL deferoamine group and normal skin tissue in normal control group (P<0.05). On PID 3, 7, and 14, the protein expressions of STAT3 and IL-10 in wound tissue of mice in 20 mg/mL deferoxamine group were significantly higher than those in DTI control group (P<0.05 or P<0.01), and the protein expressions of STAT3 were significantly higher than those in normal skin tissue in normal control group (P<0.05 or P<0.01). On PID 7 and 14, the protein expressions of IL-10 in wound tissue of mice in 20 mg/mL deferoxamine group were significantly higher than those in normal skin tissue in normal control group (P<0.01). On PID 3, 7, and 14, the protein expressions of IL-10 in wound tissue of mice in DTI control group were significantly lower than those in normal skin tissue in normal control group (P<0.05 or P<0.01). After 48 h of culture, compared with those in blank control group, the CD206 positive cell percentages in 100 µmol/L and 200 µmol/L deferoamine groups were significantly increased (P<0.01), while the CD86 positive cell percentages in 100 µmol/L and 200 µmol/L deferoamine groups were significantly decreased (P<0.01). Conclusions: Deferoxamine can promote the polarization of macrophages toward the anti-inflammatory M2 phenotype and improve wound healing by enhancing the STAT3/IL-10 signaling pathway in DTI mice.


Assuntos
Desferroxamina , Interleucina-10 , Animais , Desferroxamina/farmacologia , Inflamação , Macrófagos , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Cicatrização
3.
BJOG ; 129(5): 777-784, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34651411

RESUMO

OBJECTIVE: While there are a number of benefits to minimally invasive surgery (MIS) for women with ovarian cysts, there is an increased risk of ovarian capsule rupture during the procedure, which could potentially seed the abdominal cavity with malignant cells. We developed a decision model to compare the risks, benefits, effectiveness and cost of MIS versus laparotomy in women with ovarian masses. DESIGN: Cost-effectiveness study POPULATION: Hypothetical cohort of 10 000 women with ovarian masses who were undergoing surgical management. METHODS: The initial decision point in the model was performance of surgery via laparotomy or a MIS approach. Model probabilities, costs and utility values were derived from published literature and administrative data sources. Extensive sensitivity analyses were conducted to assess the robustness of the findings. MAIN OUTCOME MEASURES: The primary outcome was the cost-effectiveness of MIS versus laparotomy for women with a pelvic mass measured by incremental cost-effectiveness ratios (ICERs). RESULTS: MIS was the least costly strategy at $7,732 per women on average, compared with $17,899 for laparotomy. In our hypothetical cohort of 10 000 women, there were 64 cases of ovarian rupture in the MIS group and 53 in the laparotomy group, while there were 26 cancer-related deaths in the MIS group and 25 in the laparotomy group. MIS was more effective than laparotomy (188 462 QALYs for MIS versus 187 631 quality adjusted life years [QALYs] for laparotomy). Thus, MIS was a dominant strategy, being both less costly and more effective than laparotomy. These results were robust in a variety of sensitivity analyses. CONCLUSION: MIS constitutes a cost-effective management strategy for women with suspicious ovarian masses. TWEETABLE ABSTRACT: MIS is a cost-effective management strategy for women with suspicious ovarian masses.


Assuntos
Procedimentos Cirúrgicos Minimamente Invasivos , Neoplasias Ovarianas , Análise Custo-Benefício , Feminino , Humanos , Laparotomia/efeitos adversos , Laparotomia/métodos , Procedimentos Cirúrgicos Minimamente Invasivos/efeitos adversos , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Neoplasias Ovarianas/patologia , Anos de Vida Ajustados por Qualidade de Vida
5.
Zhonghua Liu Xing Bing Xue Za Zhi ; 41(11): 1871-1875, 2020 Nov 10.
Artigo em Chinês | MEDLINE | ID: mdl-33297653

RESUMO

Objective: To analyze the characteristics of newly reported HIV/AIDS cases in medical institutions in Tianjin from 2005 to 2017 and provide evidence for the improvement of AIDS prevention and treatment in medical institutions. Methods: The data of the newly reported cases of HIV/AIDS in medical institutions in Tianjin from 2005 to 2017 were analyzed. Meanwhile a retrospective survey was conducted on the source department of medical institutions and the main disease for treatment of HIV/AIDS cases. Results: A total of 3 035 HIV/AIDS cases were reported in medical institutions in Tianjin from 2005 to 2017 with an annual increase of 24.8%, among these cases, 49.2% (1 343/2 728) were reported from inpatients and 50.8% (1 385/2 728) were reported from outpatients. There was an increasing trend in the HIV positive detection rate in STD outpatients from 2011 to 2017 (χ(2)=18.469, P=0.005). The counts of the first CD(4)(+) T cell counts (CD(4)) (χ(2)=17.189, P=0.000) among the cases from inpatients and outpatients and the proportions of deaths in the year when the cases were found differed (χ(2)=61.198, P=0.000), the differences were significant. And the statistically significant differences in the counts of the first CD(4) (χ(2)=16.751, P=0.000) and the proportions of deaths in the year when the cases were found (χ(2)=18.926, P=0.000) existed among the cases in grade Ⅲ hospitals and in grade Ⅱ hospitals; meanwhile the differences in the counts of the first CD(4) (χ(2)=37.620, P=0.000) and the proportions of deaths in the year when the cases was found ( χ(2)=95.489, P=0.000) among the cases from different departments were significant. Conclusion: The timeliness of HIV/AIDS case reporting by outpatient departments was better in medical institutions in Tianjin, and the case reporting in grade Ⅱ hospitals were more timely than in grade Ⅲ hospitals; so it is suggested to provide active HIV test in key departments of medical institutions for the better HIV/AIDS prevention and control in Tianjin.


Assuntos
Síndrome da Imunodeficiência Adquirida , Infecções por HIV , Hospitais , Síndrome da Imunodeficiência Adquirida/diagnóstico , Síndrome da Imunodeficiência Adquirida/epidemiologia , China/epidemiologia , Infecções por HIV/diagnóstico , Infecções por HIV/epidemiologia , Teste de HIV , Hospitais/estatística & dados numéricos , Humanos , Estudos Retrospectivos
6.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 55(7): 488-493, 2020 Jul 09.
Artigo em Chinês | MEDLINE | ID: mdl-32634888

RESUMO

Objective: To measure the proximal enamel thickness (PET) at the mesial and distal contact areas of the permanent teeth and to provide a reference for interproximal enamel reduction (IPR). Methods: From May 2016 to February 2018, 182 isolated permanent teeth were collected and screened from patients who underwent extraction at Department of Oral and Maxillofacial Surgery, Capital Medical University School of Stomatology. These teeth were extracted for orthodontic purpose or due to severe periodontitis. The patients having teeth extracted were all Beijing residents, Han nationality, and aged (39.5±10.6) years. Ninety percent of the teeth came from patients under 50 years old. These teeth were classified according to different tooth type. The mesial and distal contact areas of these teeth were marked with fluid resin. The isolated teeth were scanned using micro-CT and the enamel thickness was measured and analyzed. The parameters measured included mesial PET (PETm), distal PET (PETd), the distance from mesial contact area to occlusal plane (CAm-OP), the distance from distal contact area to occlusal plane (CAd-OP), the distance from mesial contact area to the cementoenamel junction (CAm-CEJ), the distance from distal contact area to cementoenamel junction (CAd-CEJ) and tooth width (TWmd). Results: The PET gradually increased from the anterior tooth area [(0.63±0.16) mm] to the molar area [(1.46±0.25) mm]. The sum of the PET from the second molar to the contralateral second molar in the maxillary dentition was 31.60 mm, and that of the PET from the second molar to the contralateral second molar in the mandibular dentition was 29.68 mm. The contact areas were located on the occlusal third of the proximal walls of anterior teeth and the middle third of the proximal walls of posterior teeth. The PET were positively correlated with the tooth width between the mesial and distal contact areas (P<0.05). Conclusions: The PET was thinner in the incisor area and thicker in the molar area. IPR should be carried out close to the occlusal side of the proximal walls in anterior teeth and the cementoenamel junction side of the proximal walls in posterior teeth.


Assuntos
Esmalte Dentário , Dentição Permanente , Adulto , Pequim , Humanos , Incisivo/diagnóstico por imagem , Pessoa de Meia-Idade , Dente Molar
8.
Zhonghua Liu Xing Bing Xue Za Zhi ; 39(12): 1655-1659, 2018 Dec 10.
Artigo em Chinês | MEDLINE | ID: mdl-30572395

RESUMO

When facing the worldwide abuse of opioid substance, one of the effective responses is opioid substitution therapy (OST). However, different OST service patterns may affect the therapeutic outcome. Using the System Engineering Initiative for Patient Safety (SEIPS) model, we can analyze the factors that affecting the outcomes of patients from the perspective work system. In this paper, SEIPS model is used to describe the existing OST service model. According to the operation mechanism of the methadone maintenance treatment in China and the existing OST service model, some suggestions are put forward to carry out effective OST service in the country.


Assuntos
Analgésicos Opioides/efeitos adversos , Metadona/uso terapêutico , Tratamento de Substituição de Opiáceos , Transtornos Relacionados ao Uso de Opioides/terapia , Analgésicos Opioides/administração & dosagem , China , Atenção à Saúde , Humanos , Resultado do Tratamento
9.
Zhonghua Nei Ke Za Zhi ; 57(5): 335-339, 2018 May 01.
Artigo em Chinês | MEDLINE | ID: mdl-29747288

RESUMO

Objective: To analyze the prevalence and risk factors of anemia in a general population in Kailuan. Methods: Working and retired employees in Kailuan Company who had participated in biennial physical examination from 2006-2014 were investigated by questionnaire and blood test. Hemoglobin levels<120 g/L in male and<110 g/L in female are defined as anemia. The trend of prevalence of anemia was analyzed by chi square test. Multivariable logistic regression was used to analyze the factors associated with anemia. Results: (1) The biennial prevalence of anemia in Kailuan during 2006-2014 were 3.7%, 3.1%, 2.4%, 1.3%, 1.5%. The corresponding proportion were 3.3%, 2.3%, 1.9%, 0.8%, 1.0% in males and 5.3%, 5.9%, 4.2%, 3.1% and 3.3% in females, respectively. The differences between males and females were statistically significant (all P<0.05). The prevalence of anemia declined over time (P for trend<0.05). (2) The results of multivariable logistic regression showed that aging and elevated hs-CRP were positively associated with anemia, with OR= 1.01 (95%CI 1.01-1.02) and 1.03 (95%CI 1.02-1.03) , respectively. While male, BMI, physical exercise, smoking, hyperlipidemia were negatively associated with anemia with OR= 0.60 (95%CI 0.55-0.65) , 0.99 (95%CI 0.98-0.99) , 0.91 (95%CI 0.82-0.98) , 0.87 (95%CI 0.81-0.95) and 0.87 (95%CI 0.81-0.94) , respectively. Conclusions: The prevalence of anemia in a large general population in Kailuan has been analyzed. Prevalence of anemia is higher in males than females and declines over time. Several demographic and clinical characteristics are associated with anemia.


Assuntos
Anemia/epidemiologia , China/epidemiologia , Feminino , Humanos , Modelos Logísticos , Masculino , Prevalência , Fatores de Risco , Distribuição por Sexo , Fumar
10.
BJOG ; 125(3): 309-315, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-28278350

RESUMO

Human microbiome research has shown commensal bacteria to be a major factor in both wellness and disease pathogenesis. Interest in the microbiome has recently expanded beyond the gut to include a multitude of other organ systems for which the microbiome may have health implications. Here, we review the role of the vaginal microbiome in health and disease, with a particular focus on gynaecologic malignancies. Further, we suggest that it may be possible to expand the use of probiotics in the treatment of gynaecological cancers. TWEETABLE ABSTRACT: A review of the research to date on the relation between the vaginal microbiome and gynaecological cancers.


Assuntos
Neoplasias dos Genitais Femininos , Microbiota/fisiologia , Probióticos , Vagina , Feminino , Neoplasias dos Genitais Femininos/microbiologia , Neoplasias dos Genitais Femininos/patologia , Humanos , Vagina/microbiologia , Vagina/fisiologia , Vagina/fisiopatologia , Saúde da Mulher
11.
BJOG ; 124(7): 1028-1037, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28128524

RESUMO

Uterine leiomyosarcoma (LMS) are rare but aggressive tumours with poor clinical outcomes regardless of stage. Most tumours are identified by histopathology at time of surgery, and pre-operative diagnosis remains a clinical challenge. Management of early-stage LMS relies on surgical resection. Cytotoxic chemotherapy remains the mainstay of therapy for advanced-stage, recurrent or metastatic LMS, and includes single or combination doxorubicin-, ifosfamide- or gemcitabine-based regimens. Recent interest in genetic biomarkers led to developments of targeted therapies for LMS, although more research is needed to understand the molecular complexities underlying LMS to guide the development of novel treatment strategies. TWEETABLE ABSTRACT: The diagnosis and treatment of uterine LMS is challenging. Novel biomarkers offer hope for future therapies.


Assuntos
Biomarcadores Tumorais/genética , Leiomiossarcoma/terapia , Terapia de Alvo Molecular/métodos , Neoplasias Uterinas/terapia , Antineoplásicos/uso terapêutico , Antineoplásicos Hormonais/uso terapêutico , Feminino , Predisposição Genética para Doença , Humanos , Leiomiossarcoma/genética , Biologia Molecular , Mutação , Neoplasias Uterinas/genética , Útero/patologia
12.
Actas Urol Esp ; 41(3): 162-171, 2017 Apr.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-27522521

RESUMO

INTRODUCTION: To assess the risk factors of Gleason sum upgrading between biopsy and radical prostatectomy (RP) and update the nomogram for the prediction of Gleason sum upgrading. METHODS: The study cohort consisted of 237 Chinese prostate adenocarcinoma patients who underwent 10-core prostate biopsy and subsequently received RP in Huashan Hospital from February 2011 to May 2015. The main outcome of our study was Gleason sum upgrading between biopsy and RP pathology. Univariate and multivariate logistic regression models were conducted to explore the potential predictors, and ultimately to build the nomograms. The prediction model was further evaluated for its ability to predict significant upgrading in patients with biopsy Gleason sum<8. RESULTS: In the main cohort of all the patients, Gleason sum upgrading was observed in 62 (26.16%) patients. The pre-operative prostate-specific antigen (PSA) level, biopsy Gleason sum, and digital rectal examination were used in building the nomogram, which was validated internally with a bootstrap-corrected concordance index of 0.787. In the sub-cohort of 115 patients with standardized biopsy details, Gleason sum upgrading was observed in 31 (26.96%) patients. The pre-operative PSA level, biopsy Gleason sum, and number of positive cores were used in the nomogram, which was also validated internally with a bootstrap-corrected concordance index of 0.833. These two nomograms both demonstrated satisfactory statistical performance for predicting significant upgrading. CONCLUSIONS: Updated nomograms to predict Gleason sum upgrading in Chinese population between biopsy and RP were developed, demonstrating good statistical performance upon internal validation.


Assuntos
Adenocarcinoma/patologia , Nomogramas , Próstata/patologia , Prostatectomia , Neoplasias da Próstata/patologia , Idoso , Idoso de 80 Anos ou mais , Povo Asiático , Biópsia , Estudos de Coortes , Humanos , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Prostatectomia/métodos , Estudos Retrospectivos , Medição de Risco , Fatores de Risco
13.
BJOG ; 123(3): 455-61, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26301606

RESUMO

OBJECTIVE: Frailty is the loss of physical or mental reserve that impairs function, often in the absence of a defined comorbidity. Our aim was to determine whether a modified frailty index (mFI) correlates with morbidity and mortality in patients undergoing hysterectomy. DESIGN: Retrospective cohort study. SETTING: Hospitals across the USA participating in the National Surgical Quality Improvement Program (NSQIP). SAMPLE: Patients who underwent hysterectomy from 2008 to 2012. METHODS: An mFI was calculated using 11 variables in NSQIP. The associations between mFI and morbidity and mortality were assessed. Model fit statistics (c-statistics) were utilised to evaluate the ability of mFI to distinguish outcomes. MAIN OUTCOME MEASURE: Wound infection, severe complications and mortality. RESULTS: A total of 66 105 patients were identified. Wound complications increased from 2.4% in patients with an mFI of zero to 4.8% in those with mFI ≥ 0.5 (P < 0.0001). Similarly, severe complications increased from 0.98% to 7.3% (P < 0.0001), overall complications rose from 3.7% to 14.5% (P < 0.0001) and mortality increased from 0.06% to 3.2% (P < 0.0001) for patients with a frailty index of zero compared with those with an index of ≥ 0.5. Versus chance, the goodness-of-fit c-statistics suggested that mFI increases the ability to detect wound complications by 11.4%, severe complications by 22.0% and overall complications by 11.0%. CONCLUSIONS: The mFI is easily reproducible from routinely collected clinical data and predictive of outcomes in patients undergoing hysterectomy. Frailty may be useful in the preoperative risk assessment of women undergoing gynaecological surgery. TWEETABLE ABSTRACT: Frailty may be useful in the preoperative risk assessment of women undergoing gynaecological surgery.


Assuntos
Histerectomia , Complicações Pós-Operatórias/epidemiologia , Adulto , Idoso , Estudos de Coortes , Feminino , Idoso Fragilizado , Humanos , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Medição de Risco , Resultado do Tratamento
14.
Tissue Antigens ; 60(3): 262-5, 2002 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-12445310

RESUMO

A new HLA-B null allele has been identified within the B*51 group by combined serological and molecular typing of an Italian Caucasoid family. Serological data indicated that the proband typed homozygous for A2 and B60. Confirmatory typing using sequence specific oligonucleotide hybridization (SSPOH) detected a second B allele within the B*51 group. Allele specific typing (SSP) for B*51 subtypes, including the known B*5111N allele, was performed, and typing results were consistent with B*5101, suggesting the presence of a new null variant. Cloning and sequencing of this allele identified a B*5101 variant with a nonsense mutation in exon 3. This new null allele has been designated B*5127N. The combined use of serologic and DNA-based typing methods facilitates the identification of null and low-expression alleles. An overview of null alleles of class I HLA is presented.


Assuntos
Códon sem Sentido/genética , Antígenos HLA-B/genética , Sequência de Bases , Transplante de Medula Óssea/imunologia , Éxons/genética , Saúde da Família , Frequência do Gene , Humanos , Dados de Sequência Molecular
15.
Biochem Biophys Res Commun ; 284(1): 83-9, 2001 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-11374874

RESUMO

Albumin is the major transport protein in blood and intramolecular movement contributes to this function. Nonenzymatic glycosylation (NEG) of albumin occurs in diabetes and, in this study, fluorometric methods were used to determine the effect of increasing levels of NEG upon intramolecular movement in human serum albumin. Low levels of NEG significantly reduced and left-shifted Trp fluorescence, reduced quenching by acrylamide and inhibited penetration of bis-ANS, while these changes became only modestly more pronounced at higher levels of NEG. Mass spectrometry of tryptic and CNBr NEG-HSA fragments identified potential glycosylation sites and demonstrated only late glycosylation of the C- and N-terminal regions of the protein. Similar changes in diabetes may contribute to altered transport function in these patients.


Assuntos
Glucose/química , Glicosilação , Albumina Sérica/química , Acrilamida/química , Naftalenossulfonato de Anilina/química , Sítios de Ligação/fisiologia , Brometo de Cianogênio/química , Corantes Fluorescentes/química , Fluorometria , Produtos Finais de Glicação Avançada/química , Humanos , Modelos Moleculares , Fragmentos de Peptídeos/análise , Mapeamento de Peptídeos , Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por Matriz , Tripsina/química , Triptofano/química
16.
Nucleic Acids Res ; 27(24): e36, 1999 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-10572188

RESUMO

A five-capillary system has been developed for DNA sequencing and analysis. The post-column fluorescence detector is based on a sheath-flow cuvette. The instrument provides uniform and continuous illumination of the samples. The cuvette virtually eliminates cross-talk in the fluorescence signal between capillaries. Discrete single-photon counting avalanche photodiodes provide high efficiency light detection. The instrument has detection limits (3sigma) of 130 +/- 30 fluorescein molecules injected onto each capillary. Over 650 bases of sequence at 98.8% accuracy were generated in 100 min at 50 degrees C from M13mp18. Separation and detection of short tandem repeats proved efficient and accurate with the use of internal standards for direct comparison of migration times between capillaries.


Assuntos
Eletroforese Capilar/instrumentação , Análise de Sequência de DNA/instrumentação , Adulto , Criança , Cromossomos Humanos Par 7 , Eletroforese Capilar/métodos , Desenho de Equipamento , Feminino , Tecnologia de Fibra Óptica , Fluorescência , Humanos , Masculino , Repetições de Microssatélites , Microscopia , Óptica e Fotônica , Reação em Cadeia da Polimerase , Sensibilidade e Especificidade , Análise de Sequência de DNA/métodos , Sequências de Repetição em Tandem , Temperatura
17.
Microvasc Res ; 57(2): 162-73, 1999 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-10049664

RESUMO

Plasma factors appear to inhibit endothelial cell (EC) apoptosis in vivo so that flow influences microvascular form. The identity of these factors has not, however, been established. Earlier, we reported that apoptosis in isolated, serum-deprived human EC is inhibited by albumin (Alb). Here, we demonstrate likely biological relevance of this to vascular remodelling in experiments with tissue explants. Rat skin explants were incubated in medium M199 with or without serum, bovine Alb, or human Alb. EC in paraffin sections of explants were labelled by lectin histochemistry and the relative proportion of apoptotic was EC determined. Apoptosis was confirmed by transmission electron microscopy and terminal deoxynucleotidyl transferase labelling. Serum-free culture induced EC apoptosis (P < 0.02) and this was strongly inhibited by Alb at physiological concentrations (P < 0.01). This was not a nonspecific protein effect, as mercaptoethanol denaturation destroyed the activity and ovalbumin was not protective. Also, protection was not due to serum contaminants, as recombinant human Alb had activity identical to that of native material. The dose response was identical for all Alb preparations tested, with maximal activity at physiological concentrations. Protection was not limited to rat tissue as similar results were obtained with human gingival explants. These data support a role for Alb as a plasma antiapoptotic factor for EC in tissues.


Assuntos
Apoptose , Endotélio Vascular/citologia , Animais , Animais Recém-Nascidos , Apoptose/efeitos dos fármacos , Bovinos , Meios de Cultura Livres de Soro , Endotélio Vascular/efeitos dos fármacos , Gengiva/irrigação sanguínea , Humanos , Técnicas In Vitro , Microcirculação/citologia , Microcirculação/efeitos dos fármacos , Microscopia Eletrônica , Ratos , Ratos Wistar , Proteínas Recombinantes/farmacologia , Albumina Sérica/farmacologia , Soroalbumina Bovina/farmacologia , Pele/irrigação sanguínea
18.
Electrophoresis ; 17(9): 1436-42, 1996 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-8905259

RESUMO

We present the mobility of DNA sequencing fragments as a function of temperature in 5%T, 0%C noncross-linked polyacrylamide and at an electric field of 150 V/cm. The mobility of the fragments follows the Arrhenius equation. The activation energy for migration of a fragment through the polymer decreases monotonically with fragment length. The data were also analyzed in terms of the biased reptation model; the onset of biased reptation with stretching occurs for longer fragments as the temperature increase. These results are quite different from those observed for separation of DNA in cross-linked gels and represent a fundamental difference in the physics of the cross-linked and noncross-linked polyacrylamide.


Assuntos
DNA/química , Eletroforese Capilar , Eletroforese em Gel de Poliacrilamida , Resinas Acrílicas/química , Desnaturação de Ácido Nucleico , Análise de Sequência de DNA , Temperatura , Termodinâmica
19.
Zhongguo Zhong Xi Yi Jie He Za Zhi ; 16(3): 164-6, 1996 Mar.
Artigo em Chinês | MEDLINE | ID: mdl-9208540

RESUMO

Effect of Shashen Maidong Decoction (SSMDD) on the gastric motility of mice and rats was observed in vivo. Results showed that the gastric phenol red excretion rate of mice could be reduced markedly by SSMDD given in various dosages (23 g.kg-1.d-1, 9 g.kg-1.d-1 or 23 g.kg-1.d-1 for 5 days successively), P < 0.05. By administration of 9 g.kg-1.d-1 or 23 g.kg-1.d-1 could antagonize the acceleration of gastric emptying induced by neostigmine in mice (P < 0.05, P < 0.01). 7 g/kg of SSMDD by gastrogavage could inhibit the frequency and amplitude of contraction of fundic longitudinal muscle using strain gauge transducer in rats, but the effect was not obvious on that of antral circular muscle. By water-ballon method, it was observed that SSMDD 3.5 g/kg or 7 g/kg intraduodenal perfusion could slow down the frequency and decrease the amplitude of gastric peristalsis, 7 g/kg could inhibit significantly the gastric hypermotility induced by subcutaneous injection of indomethacin (40 mg/kg), but had no obvious effect on the gastric hypermotility induced by intramuscular injection of reserpine (0.4 mg.kg-1.d-1 x 4 d).


Assuntos
Medicamentos de Ervas Chinesas/farmacologia , Esvaziamento Gástrico/efeitos dos fármacos , Fármacos Gastrointestinais/farmacologia , Motilidade Gastrointestinal/efeitos dos fármacos , Animais , Feminino , Indometacina/antagonistas & inibidores , Masculino , Camundongos , Contração Muscular/efeitos dos fármacos , Músculo Liso/efeitos dos fármacos , Neostigmina/antagonistas & inibidores , Ratos , Ratos Wistar
20.
Anal Chem ; 67(24): 4589-93, 1995 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-8633791

RESUMO

Four-color DNA cycle sequencing was performed on an M13mp18 template using dye-labeled primers. Sequencing fragments were separated by capillary electrophoresis at 60 degrees C and at an electric field of 150 V/cm. The sieving medium was 5%T, non-cross-linked polyacrylamide in 7 M urea. The use of high temperature for the separation reduces formation of secondary structures in the sequencing fragments, generating a sequence that is free of compressions without the use of strongly denaturing gels. The use of high temperatures also increases the separation rate compared with room-temperature operation. Fragments up to 640 bases are separated in less than 2 h.


Assuntos
DNA/química , Análise de Sequência de DNA/métodos , Sequência de Bases , Primers do DNA/química , Eletroforese em Gel de Poliacrilamida , Dados de Sequência Molecular , Padrões de Referência
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