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1.
Gastroenterology ; 2024 Jun 19.
Artigo em Inglês | MEDLINE | ID: mdl-38906512

RESUMO

BACKGROUNDS & AIMS: Portal hypertension (PH) is one of the most frequent complications of chronic liver disease. The peripheral 5-hydroxytryptamine (5-HT) level was increased in cirrhotic patients. We aimed to elucidate the function and mechanism of 5-HT receptor 1A (HTR1A) in the portal vein (PV) on PH. METHODS: PH models were induced by thioacetamide injection, bile duct ligation, or partial PV ligation. HTR1A expression was detected using real-time polymerase chain reaction, in situ hybridization, and immunofluorescence staining. In situ intraportal infusion was used to assess the effects of 5-HT, the HTR1A agonist 8-OH-DPAT, and the HTR1A antagonist WAY-100635 on portal pressure (PP). Htr1a-knockout (Htr1a-/-) rats and vascular smooth muscle cell (VSMC)-specific Htr1a-knockout (Htr1aΔVSMC) mice were used to confirm the regulatory role of HTR1A on PP. RESULTS: HTR1A expression was significantly increased in the hypertensive PV of PH model rats and cirrhotic patients. Additionally, 8-OH-DPAT increased, but WAY-100635 decreased, the PP in rats without affecting liver fibrosis and systemic hemodynamics. Furthermore, 5-HT or 8-OH-DPAT directly induced the contraction of isolated PVs. Genetic deletion of Htr1a in rats and VSMC-specific Htr1a knockout in mice prevented the development of PH. Moreover, 5-HT triggered adenosine 3',5'-cyclic monophosphate pathway-mediated PV smooth muscle cell contraction via HTR1A in the PV. We also confirmed alverine as an HTR1A antagonist and demonstrated its capacity to decrease PP in rats with thioacetamide-, bile duct ligation-, and partial PV ligation-induced PH. CONCLUSIONS: Our findings reveal that 5-HT promotes PH by inducing the contraction of the PV and identify HTR1A as a promising therapeutic target for attenuating PH. As an HTR1A antagonist, alverine is expected to become a candidate for clinical PH treatment.

2.
Rev Med Virol ; 33(6): e2476, 2023 11.
Artigo em Inglês | MEDLINE | ID: mdl-37578892

RESUMO

This study aimed to clarify the beneficial effect and the clinical application value of Paxlovid in the treatment of coronavirus disease-19 (COVID-19) through a systematic review. Databases including PubMed, Cochrane Library, Chinese Clinical Trial Registry, and ClinicalTrials.gov were systematically searched for interventional or observational studies on the efficacy and safety of Paxlovid in the treatment of SARS-COV-2. The relative and absolute effect sizes for the outcomes were calculated based on the data reported in the original intervention literature. The external applicability of the evidence was analysed in terms of clinical application scenarios, patient willingness, and cost utility. One interventional and three observational studies were conducted. Four studies published in 2022, had participation sample sizes ranging 1780-109,254. Based on the randomised controlled trial data, the risk of all-cause mortality, all-cause death, and hospitalisation was significantly reduced in the Paxlovid group. Serious adverse events were reduced during the study. Based on observational studies, Paxlovid can significantly reduce the risk of death and hospitalisation in older patients with COVID-19 (moderate certainty) and improve in-hospital disease progression, composite disease progression, and viral load (low certainty). Paxlovid did not improve the outcomes of death and hospitalisation (low certainty) in patients aged <65 years. As per the economic utility analysis, the economic cost of reducing one death dramatically decreased with increasing age. Early use of Paxlovid in the older adult population with COVID-19 is beneficial. However, in the setting of limited resources, Paxlovid should be prioritised for older patients.


Assuntos
COVID-19 , Humanos , Idoso , SARS-CoV-2 , Reprodutibilidade dos Testes , Progressão da Doença
3.
Ren Fail ; 46(1): 2310081, 2024 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38321925

RESUMO

Background and purpose: Acute kidney injury (AKI) is a common serious complication in sepsis patients with a high mortality rate. This study aimed to develop and validate a predictive model for sepsis associated acute kidney injury (SA-AKI). Methods: In our study, we retrospectively constructed a development cohort comprising 733 septic patients admitted to eight Grade-A tertiary hospitals in Shanghai from January 2021 to October 2022. Additionally, we established an external validation cohort consisting of 336 septic patients admitted to our hospital from January 2017 to December 2019. Risk predictors were selected by LASSO regression, and a corresponding nomogram was constructed. We evaluated the model's discrimination, precision and clinical benefit through receiver operating characteristic (ROC) curves, calibration plots, decision curve analysis (DCA) and clinical impact curves (CIC) in both internal and external validation. Results: AKI incidence was 53.2% in the development cohort and 48.2% in the external validation cohort. The model included five independent indicators: chronic kidney disease stages 1 to 3, blood urea nitrogen, procalcitonin, D-dimer and creatine kinase isoenzyme. The AUC of the model in the development and validation cohorts was 0.914 (95% CI, 0.894-0.934) and 0.923 (95% CI, 0.895-0.952), respectively. The calibration plot, DCA, and CIC demonstrated the model's favorable clinical applicability. Conclusion: We developed and validated a robust nomogram model, which might identify patients at risk of SA-AKI and promising for clinical applications.


Assuntos
Injúria Renal Aguda , Sepse , Humanos , Nomogramas , Estudos Retrospectivos , China
4.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao ; 46(3): 377-383, 2024 Jun.
Artigo em Zh | MEDLINE | ID: mdl-38953261

RESUMO

Objective To analyze the research progress and hot topics in hypertrophic cardiomyopathy from 2018 to 2022.Methods The publications in the field of hypertrophic cardiomyopathy from January 1,2018 to December 31,2022 were retrieved from Web of Science core collection database and included for a bibliometric analysis.Results A total of 6355 publications were included,with an average citation frequency of 7 times.The year 2021 witnessed the most publications (1406).The analysis with VOSviewer showed that the research on sudden death related to hypertrophic cardiomyopathy,especially the predictive value of late gadolinium-enhanced cardiac MRI in sudden death,was a hot topic.In addition,gene detection and the new drug mavacamten became hot research topics.The United States was the country with the largest number of publications and the highest citation frequency in this field.Chinese scholars produced the second largest number of publications,which,however,included few high-quality research results.Conclusions Risk stratification and prevention of sudden death is still an important and hot research content in the field of hypertrophic cardiomyopathy.Chinese scholars should carry out multi-center cooperation in the future to improve the research results.


Assuntos
Bibliometria , Cardiomiopatia Hipertrófica , Cardiomiopatia Hipertrófica/epidemiologia , Cardiomiopatia Hipertrófica/diagnóstico por imagem , Cardiomiopatia Hipertrófica/diagnóstico , Humanos , Morte Súbita Cardíaca/epidemiologia , Publicações/estatística & dados numéricos , China/epidemiologia
5.
Small ; 19(35): e2301338, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-37183302

RESUMO

Electroreduction of CO2 to CO is a promising route for greenhouse gas resource utilization, but it still suffers from impractical current density and poor durability. Here, a nanosheet shell (NS) vertically standing on the Ag hollow fiber (NS@Ag HF) surface formed by electrochemical surface reconstruction is reported. As-prepared NS@Ag HF as a gas penetration electrode exhibited a high CO faradaic efficiency of 97% at an ultra-high current density of 2.0 A cm-2 with a sustained performance for continuous >200 h operation. The experimental and theoretical studies reveal that promoted surface electronic structures of NS@Ag HF by the nanosheets not only suppress the competitive hydrogen evolution reaction but also facilitate the CO2 reduction kinetics. This work provides a feasible strategy for fabricating robust catalysts for highly efficient and stable CO2 reduction.

6.
Gastrointest Endosc ; 97(5): 859-870.e5, 2023 05.
Artigo em Inglês | MEDLINE | ID: mdl-36572125

RESUMO

BACKGROUND AND AIMS: Upper GI-tracheobronchial fistula is a morbid condition with high mortality. It is a challenge for endoscopists because currently available treatments have severe limitations. In this study we assessed the efficacy and safety of an occluder we invented for endoscopic closure of refractory upper GI-tracheobronchial fistulas. METHODS: This was a prospective, single-arm, single-center trial conducted between September 2020 and March 2022. All patients undergoing occluder placement were eligible to enroll. The primary endpoints were clinical success rate (CSR) and complete closure rate (CCR) at 3 months and safety. Secondary efficacy endpoints were technical success rates, CSRs and CCRs at 1 and 6 months, near-complete closure rates, change from baseline in body mass index (BMI), and health-related quality of life (HRQoL) at 1, 3, and 6 months. RESULTS: Twenty-eight patients (mean age, 63.2 years; 23 men) were enrolled. Eighteen through-the-scope occluders (TTSOs) and 10 through-the-overtube occluders (TTOOs) were implanted, with a technical success rate of 100%. The mean procedure time for the TTSO and TTOO groups were 28.0 ± 8.0 minutes and 31.8 ± 7.7 minutes, respectively. The CSRs at 1, 3, and 6 months were 92.9%, 96.4%, and 92.0% and the CCRs were 60.7%, 60.7%, and 60.0%, respectively. The mean BMI at 3 and 6 months and HRQoL at 1, 3, and 6 months were significantly increased compared with baseline (P < .05). Two completely occluded fistulas had 1-sided or complete healing by coverage of granulation tissue and re-epithelialized mucosa at a follow-up of 6 and 12 months. All 14 adverse events were either mild and transient or easily corrected. CONCLUSIONS: Our clinical outcomes suggest that this novel GI occluder is a safe and effective salvage option for patients with refractory upper GI-tracheobronchial fistulas. (Clinical trial registration number: ChiCTR2000038566.).


Assuntos
Fístula , Qualidade de Vida , Masculino , Humanos , Pessoa de Meia-Idade , Estudos Prospectivos , Endoscopia , Resultado do Tratamento , Estudos Retrospectivos
7.
BMC Infect Dis ; 23(1): 53, 2023 Jan 24.
Artigo em Inglês | MEDLINE | ID: mdl-36694122

RESUMO

BACKGROUND: The effect of angiotensin-converting enzyme inhibitors (ACEIs)/angiotensin receptor blockers (ARBs) on mortality was preliminarily explored through the comparison of ACEIs/ARBs with non-ACEIs/ARBs in patients with coronavirus disease 2019 (COVID-19). Reaching a conclusion on whether previous ACEI/ARB treatment should be continued in view of the different ACE2 levels in the comparison groups was not unimpeachable. Therefore, this study aimed to further elucidate the effect of ACEI/ARB continuation on hospital mortality, intensive care unit (ICU) admission, and invasive mechanical ventilation (IMV) in the same patient population. METHODS: We searched PubMed, the Cochrane Library, Ovid, and Embase for relevant articles published between December 1, 2019 and April 30, 2022. Continuation of ACEI/ARB use after hospitalization due to COVID-19 was considered as an exposure and discontinuation of ACEI/ARB considered as a control. The primary outcome was hospital mortality, and the secondary outcomes included 30-day mortality, rate of ICU admission, IMV, and other clinical outcomes. RESULTS: Seven observational studies and four randomized controlled trials involving 2823 patients were included. The pooled hospital mortality in the continuation group (13.04%, 158/1212) was significantly lower than that (22.15%, 278/1255) in the discontinuation group (risk ratio [RR] = 0.45; 95% confidence interval [CI], 0.28-0.72; P = 0.001). Continuation of ACEI/ARB use was associated with lower rates of ICU admission (10.5% versus 16.2%, RR = 0.63; 95% CI 0.5-0.79; P < 0.0001) and IMV (8.2% versus 12.5%, RR = 0.62; 95% CI 0.46-0.83, P = 0.001). Nevertheless, the effect was mainly demonstrated in the observational study subgroup (P < 0.05). Continuing ACEI/ARB had no significant effect on 30-day mortality (P = 0.34), acute myocardial infarction (P = 0.08), heart failure (P = 0.82), and acute kidney injury after hospitalization (P = 0.98). CONCLUSION: Previous ACEI/ARB treatment could be continued since it was associated with lower hospital deaths, ICU admission, and IMV in patients with COVID-19, although the benefits of continuing use were mainly shown in observational studies. More evidence from multicenter RCTs are still needed to increase the robustness of the data. Trial registration PROSPERO (CRD42022341169). Registered 27 June 2022.


Assuntos
Inibidores da Enzima Conversora de Angiotensina , COVID-19 , Humanos , Inibidores da Enzima Conversora de Angiotensina/uso terapêutico , Antagonistas de Receptores de Angiotensina/uso terapêutico , Sistema Renina-Angiotensina , Anti-Hipertensivos/uso terapêutico , Análise de Regressão , Ensaios Clínicos Controlados Aleatórios como Assunto , Estudos Observacionais como Assunto , Estudos Multicêntricos como Assunto
8.
Phys Chem Chem Phys ; 25(12): 8532-8543, 2023 Mar 22.
Artigo em Inglês | MEDLINE | ID: mdl-36883610

RESUMO

Although introducing an alkoxy group is one of the most popular methods to suppress the interfacial charge recombination process of dye-sensitized solar cells, understanding of its effects is still limited and a microscopic picture of the alkoxy effects is lacking. Two ullazine dyes with distinct alkoxy chains at the donor part are used to investigate the effects of the alkoxy group on the adsorption, dye aggregation and charge recombination process in our study. Different from the usual assumption, we find that alkoxy chains can not only play a shielding role, but can also assist dye adsorption and inhibit the charge recombination process more effectively by covering the TiO2 surface. We also find that the existence of alkyl chains can well inhibit the aggregation of dyes and reduce intermolecular electron transfer. Furthermore, an important structural feature at the interface, the Ti-O interaction between the oxygen atom of the alkoxy group and the Ti atom of the surface is also found to contribute substantially to the interface stability. New insights into the effects of the alkoxy group on auxiliary adsorption and inhibiting charge recombination through reducing the recombination sites pave the way for rational design of sensitizers with high performance.

9.
Surg Endosc ; 37(3): 1863-1869, 2023 03.
Artigo em Inglês | MEDLINE | ID: mdl-36253627

RESUMO

BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP) is a major option for common bile duct (CBD) stones. Endoscopic sphincterotomy (EST), endoscopic papillary balloon dilatation (EPBD), and endoscopic sphincterotomy plus balloon dilatation (ESBD) are procedures for opening the bile duct orifice to extract CBD stones during ERCP. The optimal method for extracting small CBD stones (≤ 10 mm) has not yet been proposed. We aimed to compare the efficacy and safety of these three techniques in extracting small CBD stones. METHODS: ERCP for small stones was performed between January 2009 and November 2020 at three tertiary care centers. The incidence of post-ERCP pancreatitis (PEP) was compared among EST, EPBD, and ESBD groups. First and overall success rates of stone extraction, utilization rate of mechanical lithotripsy, and other ERCP complications such as bleeding, perforation, infection, and hyperamylasemia were compared. RESULTS: A total of 2181 patients were enrolled between January 2009 and November 2020. The proportion of young patients (≤ 45 years) in EPBD group was more than those in EST and ESBD group. Stone size in ESBD group was much larger than EST and EPBD group. After propensity score matching, the success rates of first and overall stone extraction in the three groups were high, and the rates of mechanical lithotripsy were low, with no significant difference. The PEP incidences showed no differences among the three groups. The incidence of bleeding complication in EST group was higher than that in EPBD group. No significant differences were observed in other complications between EPBD group and ESBD group. ESBD group had higher incidence of overall, infection, and hyperamylasemia complications than EST group. CONCLUSION: EPBD is equivalent to ESBD in stone removal efficiency and complication rate, but brings a lower bleeding risk than EST. Therefore, we recommend EPBD as the first choice for small CBD stones.


Assuntos
Cálculos Biliares , Hiperamilassemia , Humanos , Estudos Retrospectivos , Estudos de Coortes , Pontuação de Propensão , Colangiopancreatografia Retrógrada Endoscópica/efeitos adversos , Colangiopancreatografia Retrógrada Endoscópica/métodos , Cálculos Biliares/cirurgia , Esfinterotomia Endoscópica/efeitos adversos , Esfinterotomia Endoscópica/métodos , Resultado do Tratamento , Ducto Colédoco , Dilatação/efeitos adversos , Dilatação/métodos
10.
Arch Biochem Biophys ; 731: 109423, 2022 11 30.
Artigo em Inglês | MEDLINE | ID: mdl-36183846

RESUMO

This work firstly scrutinized the effect of KIF4 on the progression of CRC. KIF4 expression in CRC clinical tissues and cells was evaluated by real-time quantitative reverse transcription-polymerase chain reaction (qRT-PCR) and Western blot. Cell counting kit-8 assay, Transwell invasion and migration assay were implemented to research the function of KIF4 on the proliferation, invasion and migration of CRC cells. The effect of KIF4 on the autophagy and the Hedgehog pathway activityavtivity in CRC cells was explored in the presence or absence of rapamycin and ring propylamine. The expression of autophagy-related proteins was scrutinized by qRT-PCR, Western blot and immunofluorescence. Autophagosomes in CRC cells was observed by transmission electron microscopy. In vivo xenograft experiment was executed. Immunohistochemistry of xenograft tumor tissues was executed to investigate the Hedgehog pathway activityactivtiy. KIF4 was abundantly expressed in CRC clinical tissues and cells. KIF4 enforced the proliferation, invasion, migration of CRC cells, repressed the autophagy and activated the Hedgehog pathway in CRC cells. Rapamycin and ring propylamine treatment reversed the inhibition of KIF4 on the autophagy and the promotion of KIF4 on the Hedgehog pathway activity in CRC cells. Ring propylamine treatment reversed the inhibition of KIF4 on the autophagy in CRC cells. KIF4 intensified the in vivo growth of CRC cells and activated the Hedgehog pathway in xenograft tumor tissues. KIF4 acted as an oncogene in CRC by inhibiting the autophagy via activating the Hedgehog pathway. It might be a potential target for CRC treatment.


Assuntos
Neoplasias Colorretais , Proteínas Hedgehog , Humanos , Autofagia , Linhagem Celular Tumoral , Movimento Celular/fisiologia , Proliferação de Células/fisiologia , Neoplasias Colorretais/patologia , Invasividade Neoplásica , Propilaminas , Sirolimo , Cinesinas/metabolismo
11.
J Clin Microbiol ; 59(4)2021 03 19.
Artigo em Inglês | MEDLINE | ID: mdl-33177121

RESUMO

The performance of Xpert MTB/RIF using bronchoalveolar lavage fluid (BAL) for the diagnosis of pulmonary tuberculosis (PTB) remains unclear. Therefore, a systematic review/meta-analysis was conducted. Studies published before 31 December 2019 were retrieved from the PubMed, Embase, and Web of Science databases using the keywords "pulmonary tuberculosis," "Xpert MTB/RIF," and "BAL." Two independent evaluators extracted the data and assessed the bias risk of the included studies. A random-effects model was used to calculate the overall sensitivity, specificity, positive and negative likelihood ratios (PLR and NLR, respectively), diagnostic odds ratio (DOR), and the area under the curve (AUC), as well as the respective 95% confidence intervals (CIs). Nineteen trials involving 3,019 participants met the inclusion criteria. Compared to the culture method, the pooled sensitivity, specificity, PLR, NLR, DOR, and the AUC with 95% CIs of Xpert MTB/RIF were 0.87 (0.84 to 0.90), 0.92 (0.91 to 0.93), 10.21 (5.78 to 18.02), 0.16 (0.12 to 0.22), 78.95 (38.59 to 161.53), and 0.9467 (0.9462 to 0.9472), respectively. Relative to the composite reference standard, the observed values were 0.69 (0.65 to 0.72), 0.98 (0.98 to 0.99), 37.50 (18.59 to 75.62), 0.30 (0.21 to 0.43), 171.98 (80.82 to 365.96), and 0.9691 (0.9683 to 0.9699), respectively. All subgroups, except children, showed high sensitivity and specificity. In conclusion, the use of Xpert MTB/RIF in the context of BAL samples has a high diagnostic performance for PTB (except for children) and may serve as an alternative rapid diagnostic tool.


Assuntos
Antibióticos Antituberculose , Mycobacterium tuberculosis , Tuberculose Pulmonar , Antibióticos Antituberculose/farmacologia , Líquido da Lavagem Broncoalveolar , Criança , Farmacorresistência Bacteriana , Humanos , Mycobacterium tuberculosis/genética , Rifampina , Sensibilidade e Especificidade , Tuberculose Pulmonar/diagnóstico , Tuberculose Pulmonar/tratamento farmacológico
12.
Respir Res ; 22(1): 130, 2021 Apr 28.
Artigo em Inglês | MEDLINE | ID: mdl-33910578

RESUMO

BACKGROUND: Fibrinogen is the first qualified prognostic/predictive biomarker for exacerbations in patients with chronic obstructive pulmonary disease (COPD). The IMPACT trial investigated fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) triple therapy versus FF/VI and UMEC/VI in patients with symptomatic COPD at risk of exacerbations. This analysis used IMPACT trial data to examine the relationship between fibrinogen levels and exacerbation outcomes in patients with COPD. METHODS: 8094 patients with a fibrinogen assessment at Week 16 were included, baseline fibrinogen data were not measured. Post hoc analyses were performed by fibrinogen quartiles and by 3.5 g/L threshold. Endpoints included on-treatment exacerbations and adverse events of special interest (AESIs). RESULTS: Rates of moderate, moderate/severe, and severe exacerbations were higher in the highest versus lowest fibrinogen quartile (0.75, 0.92 and 0.15 vs 0.67, 0.79 and 0.10, respectively). The rate ratios (95% confidence interval [CI]) for exacerbations in patients with fibrinogen levels ≥ 3.5 g/L versus those with fibrinogen levels < 3.5 g/L were 1.03 (0.95, 1.11) for moderate exacerbations, 1.08 (1.00, 1.15) for moderate/severe exacerbations, and 1.30 (1.10, 1.54) for severe exacerbations. There was an increased risk of moderate/severe exacerbation (hazard ratio [95% CI]: highest vs lowest quartile 1.16 [1.04, 1.228]; ≥ 3.5 g/L vs < 3.5 g/L: 1.09 [1.00, 1.16]) and severe exacerbation (1.35 [1.09, 1.69]; 1.27 [1.08, 1.47], respectively) with increasing fibrinogen level. Cardiovascular AESIs were highest in patients in the highest fibrinogen quartile. CONCLUSIONS: Rate and risk of exacerbations was higher in patients with higher fibrinogen levels. This supports the validity of fibrinogen as a predictive biomarker for COPD exacerbations, and highlights the potential use of fibrinogen as an enrichment strategy in trials examining exacerbation outcomes. TRIAL REGISTRATION: NCT02164513.


Assuntos
Fibrinogênio/metabolismo , Pulmão/fisiopatologia , Doença Pulmonar Obstrutiva Crônica/sangue , Idoso , Biomarcadores/sangue , Broncodilatadores/uso terapêutico , Progressão da Doença , Método Duplo-Cego , Combinação de Medicamentos , Feminino , Humanos , Pulmão/efeitos dos fármacos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Doença Pulmonar Obstrutiva Crônica/tratamento farmacológico , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Índice de Gravidade de Doença , Fatores de Tempo , Resultado do Tratamento , Regulação para Cima
13.
Gastrointest Endosc ; 93(6): 1261-1272.e2, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33065026

RESUMO

BACKGROUND AND AIMS: Recent advances in deep convolutional neural networks (CNNs) have led to remarkable results in digestive endoscopy. In this study, we aimed to develop CNN-based models for the differential diagnosis of benign esophageal protruded lesions using endoscopic images acquired during real clinical settings. METHODS: We retrospectively reviewed the images from 1217 patients who underwent white-light endoscopy (WLE) and EUS between January 2015 and April 2020. Three deep CNN models were developed to accomplish the following tasks: (1) identification of esophageal benign lesions from healthy controls using WLE images; (2) differentiation of 3 subtypes of esophageal protruded lesions (including esophageal leiomyoma [EL], esophageal cyst (EC], and esophageal papilloma [EP]) using WLE images; and (3) discrimination between EL and EC using EUS images. Six endoscopists blinded to the patients' clinical status were enrolled to interpret all images independently. Their diagnostic performances were evaluated and compared with the CNN models using the area under the receiver operating characteristic curve (AUC). RESULTS: For task 1, the CNN model achieved an AUC of 0.751 (95% confidence interval [CI], 0.652-0.850) in identifying benign esophageal lesions. For task 2, the proposed model using WLE images for differentiation of esophageal protruded lesions achieved an AUC of 0.907 (95% CI, 0.835-0.979), 0.897 (95% CI, 0.841-0.953), and 0.868 (95% CI, 0.769-0.968) for EP, EL, and EC, respectively. The CNN model achieved equivalent or higher identification accuracy for EL and EC compared with skilled endoscopists. In the task of discriminating EL from EC (task 3), the proposed CNN model had AUC values of 0.739 (EL, 95% CI, 0.600-0.878) and 0.724 (EC, 95% CI, 0.567-0.881), which outperformed seniors and novices. Attempts to combine the CNN and endoscopist predictions led to significantly improved diagnostic accuracy compared with endoscopists interpretations alone. CONCLUSIONS: Our team established CNN-based methodologies to recognize benign esophageal protruded lesions using routinely obtained WLE and EUS images. Preliminary results combining the results from the models and the endoscopists underscored the potential of ensemble models for improved differentiation of lesions in real endoscopic settings.


Assuntos
Neoplasias Esofágicas , Redes Neurais de Computação , Diagnóstico Diferencial , Neoplasias Esofágicas/diagnóstico por imagem , Humanos , Curva ROC , Estudos Retrospectivos
14.
Appl Opt ; 60(24): 7362-7370, 2021 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-34613025

RESUMO

Floodlight quantum key distribution (FL-QKD) is a new QKD protocol that can achieve a 2 Gbps secret key rate (SKR) in a 50 km fiber link without multiplexing technology [Q. Zhuang et al., Phys. Rev. A94, 012322 (2016)PLRAAN1050-294710.1103/PhysRevA.94.012322]. In this paper, we propose a wireless FL-QKD at terahertz bands (THz-FL-QKD) in inter-satellite links. THz-FL-QKD is the two-way protocol that sends quantum signals in the forward channel, modulates and amplifies the received signals at the receiver, and then returns to the transmitter through the backward channel for homodyne detection and decoding. We analyze the security of THz-FL-QKD against individual attacks and optimum collective attacks. Numerical simulations show that THz-FL-QKD is capable of a 50 Mbps SKR at 10 THz frequency in a 200 km inter-satellite wireless link. We expect this work will provide an efficient path to build a high-speed global quantum communication network.

15.
Appl Opt ; 60(25): 7731, 2021 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-34613243

RESUMO

This publisher's note serves to identify a correction in Appl. Opt.60, 7362 (2021)APOPAI0003-693510.1364/AO.430898.

16.
Hepatobiliary Pancreat Dis Int ; 20(5): 469-477, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34348873

RESUMO

BACKGROUND: Liver injury is one of the most common complications during sepsis. Macrophage migration inhibitory factor (MIF) is an important proinflammatory cytokine. This study explored the role of MIF in the lipopolysaccharide (LPS)-induced liver injury through genetically manipulated mouse strains. METHODS: The model of LPS-induced liver injury was established in wild-type and Mif-knockout C57/BL6 mice. Serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), and total bilirubin (TBil) were detected, and the expressions of MIF, tumor necrosis factor-α (TNF-α) and interleukin-1ß (IL-1ß) were measured. Liver histopathology was conducted to assess liver injury. Moreover, the inhibitions of MIF with (S,R)-3-(4-hydroxyphenyl)-4,5-dihydro-5-isoxazole acetic acid methyl ester (ISO-1) and 4-iodo-6-phenylpyrimidine (4-IPP) were used to evaluate their therapeutic potential of liver injury. RESULTS: Compared with wild-type mice, the liver function indices and inflammation factors presented no significant difference in the Mif-/- mice. After 72 h of the LPS-induced liver injury, serum levels of ALT, AST, and TBil as well as TNF-α and IL-1ß were significantly increased, but the knockout of Mif attenuated liver injury and inflammatory response. In liver tissue, mRNA levels of TNF-α, IL-1ß and NF-κB p65 were remarkably elevated in LPS-induced liver injury, while the knockout of Mif reduced these levels. Moreover, in LPS-induced liver injury, the inhibitions of MIF with ISO-1 and 4-IPP alleviated liver injury and slightly attenuated inflammatory response. Importantly, compared to mice with LPS-induced liver injury, Mif knockout or MIF inhibitions significantly prolonged the survival of the mice. CONCLUSIONS: In LPS-induced liver injury, the knockout of Mif or MIF inhibitions alleviated liver injury and slightly attenuated inflammatory response, thereby prolonged the survival of the mice. Targeting MIF may be an important strategy to protect the liver from injury during sepsis.


Assuntos
Doença Hepática Crônica Induzida por Substâncias e Drogas , Fatores Inibidores da Migração de Macrófagos , Sepse , Animais , Técnicas de Inativação de Genes , Lipopolissacarídeos/toxicidade , Fígado , Fatores Inibidores da Migração de Macrófagos/genética , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Fator de Necrose Tumoral alfa/genética
17.
Nano Lett ; 20(11): 8229-8235, 2020 Nov 11.
Artigo em Inglês | MEDLINE | ID: mdl-33054238

RESUMO

Probing and understanding the intrinsic active sites of electrocatalysts is crucial to unravel the underlying mechanism of CO2 electroreduction and provide a prospective for the rational design of high-performance electrocatalysts. However, their structure-activity relationships are not straightforward because electrocatalysts might reconstruct under realistic working conditions. Herein, we employ in-situ measurements to unveil the intrinsic origin of the InN nanosheets which served as an efficient electrocatalyst for CO2 reduction with a high faradaic efficiency of 95% for carbonaceous product. During the CO2 electroreduction, InN nanosheets reconstructed to form the In-rich surface. Density functional theory calculations revealed that the reconstruction of InN led to the redistribution of surface charge that significantly promoted the adsorption of HCOO* intermediates and thus benefited the formation of formate toward CO2 electroreduction. This work establishes a fundamental understanding on the mechanism associated with self-reconstruction of heterogeneous catalysts toward CO2 electroreduction.

18.
Gut ; 69(7): 1309-1321, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-31727683

RESUMO

OBJECTIVE: Autophagy participates in the progression of hepatocellular carcinoma (HCC) and the resistance of HCC cells to sorafenib. We investigated the feasibility of sensitising HCC cells to sorafenib by modulating miR-541-initiated microRNA-autophagy axis. DESIGN: Gain- and loss-of-function assays were performed to evaluate the effects of miR-541 on the malignant properties and autophagy of human HCC cells. Autophagy was quantified by western blotting of LC3, transmission electron microscopy analyses and confocal microscopy scanning of mRFP-GFP-LC3 reporter construct. Luciferase reporter assays were conducted to confirm the targets of miR-541. HCC xenograft tumours were established to analyse the role of miR-541 in sorafenib-induced lethality. RESULTS: The expression of miR-541 was downregulated in human HCC tissues and was associated with malignant clinicopathologic phenotypes, recurrence and survival of patients with HCC. miR-541 inhibited the growth, metastasis and autophagy of HCC cells both in vitro and in vivo. Prediction software and luciferase reporter assays identified autophagy-related gene 2A (ATG2A) and Ras-related protein Rab-1B (RAB1B) as the direct targets of miR-541. Consistent with the effects of the miR-541 mimic, inhibition of ATG2A or RAB1B suppressed the malignant phenotypes and autophagy of HCC cells. Furthermore, siATG2A and siRAB1B partially reversed the enhancement of the malignant properties and autophagy in HCC cells mediated by the miR-541 inhibitor. More interestingly, higher miR-541 expression predicted a better response to sorafenib treatment, and the combination of miR-541 and sorafenib further suppressed the growth of HCC cells in vivo compared with the single treatment. CONCLUSIONS: Dysregulation of miR-541-ATG2A/RAB1B axis plays a critical role in patients' responses to sorafenib treatment. Manipulation of this axis might benefit survival of patients with HCC, especially in the context of the highly pursued strategies to eliminate drug resistance.


Assuntos
Antineoplásicos/farmacologia , Autofagia/efeitos dos fármacos , Carcinoma Hepatocelular/tratamento farmacológico , Neoplasias Hepáticas/tratamento farmacológico , MicroRNAs/metabolismo , Sorafenibe/farmacologia , Animais , Carcinoma Hepatocelular/patologia , Linhagem Celular Tumoral , Proliferação de Células/efeitos dos fármacos , Sobrevivência Celular/efeitos dos fármacos , Resistencia a Medicamentos Antineoplásicos , Estudos de Viabilidade , Humanos , Neoplasias Hepáticas/patologia , Camundongos , Recidiva Local de Neoplasia , Fenótipo
19.
Biochem Biophys Res Commun ; 523(1): 117-122, 2020 02 26.
Artigo em Inglês | MEDLINE | ID: mdl-31836142

RESUMO

Osteoarthritis (OA) remains a challenge for clinicians and effective treatments are lacking. In this study, we investigated JNK/NF-κB signaling in knee OA patients. Rats were used to establish an OA model and were divided into six groups; (1) Control (sterile saline injection only); (2) Controls with treadmill exercise (treadmill); (3) Controls with wheel exercise (wheel); (4) OA (MIA injection); (5) OA with treadmill exercise (OA + treadmill); and (6) OA with wheel exercise (OA + wheel). The results showed that, compared to the OA group, the OA + treadmill and OA + wheel groups had lower levels of IL-1ß, IL-6 and TNF-α, and similar levels of p-P65, p-JNK, and P-IκBα. Furthermore, treatment with the JNK agonist anisomycin enhanced the damage to the joint cartilage and increased the levels of IL-1ß, IL-6 and TNF-α. Taken together, these data suggest that treadmill and wheel exercise protect against inflammation through the regulation of JNK/NF-κB signaling in experimental models of knee OA.


Assuntos
Modelos Animais de Doenças , Inflamação/prevenção & controle , Proteínas Quinases JNK Ativadas por Mitógeno/metabolismo , NF-kappa B/metabolismo , Osteoartrite do Joelho/prevenção & controle , Condicionamento Físico Animal/fisiologia , Animais , Inflamação/metabolismo , Masculino , Osteoartrite do Joelho/metabolismo , Ratos , Ratos Sprague-Dawley
20.
J Transl Med ; 18(1): 106, 2020 02 28.
Artigo em Inglês | MEDLINE | ID: mdl-32111248

RESUMO

BACKGROUND: Thiazide diuretics reduce the risk of recurrent kidney calculi in patients with kidney calculi or hypercalciuria. However, whether thiazide diuretics can definitely prevent recurrent kidney calculi remains unclear. We aimed to evaluate the effect and safety of thiazide diuretics on recurrent kidney calculi. METHODS: The PubMed, Cochrane Library, and EMBASE databases were systematically searched using the keywords thiazide diuretics and kidney calculi to identify randomized controlled trials (RCTs). The primary outcome was the incidence of recurrent kidney calculi, and the secondary outcome was the 24-h urinary calcium level. The pooled risk ratio (RR), risk difference (RD), standardized mean difference (SMD), and 95% confidence interval (CI) were calculated. The evidence quality was graded using the GRADE criteria, and recommendations for recurrent kidney calculus prevention using thiazide diuretics were reassessed. RESULTS: Eight RCTs involving 571 patients were included. The pooled RR for the incidence of kidney calculi in the thiazide diuretic groups was 0.44 (95% CI 0.33-0.58, P < 0.0001) compared to that in the placebo and untreated groups; the pooled RD was - 0.23 (95% CI - 0.30 to - 0.16, P < 0.0001). The pooled SMD for the 24-h urinary calcium level was - 18.59 (95% CI - 25.11 to - 12.08, P < 0.0001). The thiazide diuretic groups had a high incidence of adverse reactions and low tolerance. The evidence quality for decrease in kidney calculus incidence using thiazide diuretics was low, while that for the 24-h urinary calcium level decrease among those with recurrent kidney calculi was moderate, and that for the decrease in kidney calculus incidence using short-acting and long-acting thiazide diuretics was low. The overall strength of recommendation for prevention of recurrent renal calculi using thiazide diuretics was not recommended. The subgroup and sensitivity analysis findings were robust. CONCLUSIONS: Long-term use of thiazide diuretics reduces the incidence of recurrent renal calculi and 24-h urinary calcium level. However, the benefits are insufficient, and the evidence quality is low. Considering the adverse effects, poor patient compliance, and economic burden of long-term medication, their use in preventing recurrent kidney calculi is not recommended.


Assuntos
Cálculos Renais , Inibidores de Simportadores de Cloreto de Sódio , Diuréticos , Humanos , Hipercalciúria , Cálculos Renais/tratamento farmacológico , Cálculos Renais/prevenção & controle , Inibidores de Simportadores de Cloreto de Sódio/uso terapêutico
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