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Calciphylaxis is a rare disease with severe pain and high-mortality due to cutaneous ischemic necrosis and infection that currently lacks proved effective therapies. The occurrence of calciphylaxis in end stage kidney disease (ESKD) patients is known as calcific uremic arteriolopathy (CUA), which is characterized histologically by dermal microvessel calcification, intimal fibroplasia and microthrombosis. Here we innovatively treated a severe CUA patient with human amnion-derived mesenchymal stem cells (hAMSCs). A 34-year-old uremic woman was presented with progressive, painful malodorous ulcers in buttocks and mummified lower limbs. Skin pathological features supported the diagnosis of calciphylaxis. The patient was refractory to conventional multidisciplinary symptomatic therapies. With the approval of our hospital ethics committee, she was treated with hAMSCs including intravenous and local intramuscular injection, and external application of hAMSC culture supernatant to the wound area. During 15-month follow-up, the patient had regeneration of skin and soft tissues, with improved blood biochemical, inflammatory, mineral and bone metabolic indices and immunoregulation effects. After 15-month hAMSC treatment, the score of pain visual analog scale (VAS) decreased from 10 to 0, Bates-Jensen wound assessment tool (BWAT) score decreased from 65 to 13, and wound-quality of life (Wound-QoL) questionnaire score decreased from 68 to 0. We propose that hAMSC treatment is promising for CUA patients. The therapy is potentially involved in the multiple beneficial effects of inhibiting vascular calcification, stimulating angiogenesis and myogenesis, modulating adverse inflammatory and immunologic responses, promoting re-epithelialization and restoring skin integrity.
Assuntos
Calciofilaxia , Falência Renal Crônica , Células-Tronco Mesenquimais , Adulto , Âmnio , Calciofilaxia/diagnóstico , Calciofilaxia/terapia , Feminino , Humanos , Dor , Qualidade de VidaRESUMO
Objective: To investigate the effect of hourly ambient temperature exposure on emergency calls in Xuchang city and Zhengzhou city. Methods: The hourly meteorological data, air pollution data and emergency calls of Xuchang city and Zhengzhou city were collected from January 1, 2017 to October 31, 2019. A distributed lag non-linear model was used to calculate the excess relative risk (ERR). The lag effect and cumulative effect of extreme temperature exposure on emergency calls were evaluated. Results: The relationship between hourly temperature exposure and emergency calls was a U-shaped curve. In Xuchang city and Zhengzhou city, both low and high temperatures would increase the number of hourly emergency calls. The earliest effect of low temperature occurred at a lag of 22 h and 52 h, with ERR values (95%CI) about 0.20% (0.00%, 0.39%) and 0.11% (0.00%, 0.22%), respectively. The earliest effect of high temperature occurred at a lag of 0 h with ERR values about 1.59% (1.09%, 2.09%) and 1.45% (1.22%, 1.69%), respectively. High temperature had the greatest impact on the number of emergency calls of cardiovascular disease at a lag of 4-8 h. The cumulative ERR values (95%CI) of the two cities were 8.70% (4.98%, 12.75%) and 3.89% (2.61%, 5.22%), respectively. Conclusion: High temperature exposure could increase the number of emergency calls within a few hours, while the effect of low temperature would not occur until 22 hours later.
Assuntos
Poluentes Atmosféricos , Poluição do Ar , Poluentes Atmosféricos/análise , Poluição do Ar/análise , China , Cidades , Serviço Hospitalar de Emergência , Humanos , TemperaturaRESUMO
Objective: To investigate the clinicopathological features of hepatic vascular tumors in children. Methods The clinical characteristics, histology and immunohistochemical staining results were summarized and analyzed in 22 cases of hepatic vascular tumors in children at Guangzhou Women and Children's Medical Center from September 2007 to November 2020. Results: The 22 patients aged from 1.0 month to 2.5 years (mean age 9 months). There were 10 males and 12 females. Five cases were found in premature and had low birth weight infants; three cases were discovered in the antenatal period; one patient also had cutanous hemangioma; six patients had associated anemia; Kasabach-Merritt phenomenon was not seen in any patient. CT examination showed 17 tumors were solitary and five were multifocal lesions. Macroscopically, the tumors size ranged from was 0.6 cm to 11.0 cm; the cut surface was solid, gray red and brown in color, and in six cases there were hemorrhage and necrosis in the central area. Microscopically,15 cases of solitary congenital hepatic hemangiomas showed characteristic necrosis in the central area, with loose fibrous tissues at periphery. Proliferation of capillaries, residual bile ducts between the vascular lumens, and dilated thrombosed vascular channels were seen, and contained extramedullary hematopoietic foci and calcification. Five cases of multiple hepatic infantile hemangiomas showed capillaries of different sizes composing of plump endothelium and pericytes and were arranged in lobular or diffuse patterns. Two cases of cavernous hemangioma (venous malformation) consisted of dilated thin-walled blood vessels with branch-like pattern lined with flat endothelial cells. Immunohistochemically, all 22 case expressed vascular endothelial markers CD31 and CD34, but D2-40 was negative. Glut1 was positive in five cases of multiple hepatic infantile hemangiomas, and the other cases were negative. Conclusion: Hepatic vascular tumors in children are rare, and their classification is different from that of adults. It is of great significance to make clear pathologic diagnosis.
Assuntos
Hemangioma , Síndrome de Kasabach-Merritt , Neoplasias Vasculares , Criança , Células Endoteliais , Feminino , Humanos , Lactente , Fígado , Masculino , GravidezRESUMO
Thermotherapy has been proven to be effective for the treatment of various tumors, including glioma. We determined whether tumor necrosis factor-alpha (TNF-α) is involved in the regulation of the biological processes of glioma development. Reverse transcription-polymerase chain reaction (RT-PCR) and immunocytochemistry were used to investigate the levels of TNF-α mRNA and heat shock factor-1 (HSF1) protein, respectively, in glioma cells. Radioimmunoassay was used to dynamically monitor the contents of TNF-α in the nutrient fluid of C6 cells after thermotherapy treatment. Crystal violet staining was used to determine glioma invasiveness. The most obvious increases in HSF1 protein and TNF-α mRNA in C6 cells were observed at 30 and 60 min after thermotherapy, respectively. In addition, the radioactivity of TNF-α in the culture fluid of the C6 cells reached a peak after 120 min of thermotherapy. In addition, glioma invasiveness decreased and the concentration of TNF-α reached a maximum after 120 min of thermotherapy. Our results show that the decrease in thermotherapy-mediated glioma invasiveness is due to the accelerated release of TNF-α, which could promote the release of HSF1 from neurospongioma cells.
Assuntos
Neoplasias Encefálicas/terapia , Regulação Neoplásica da Expressão Gênica , Glioma/terapia , Hipertermia Induzida , Fator de Necrose Tumoral alfa/genética , Animais , Neoplasias Encefálicas/genética , Neoplasias Encefálicas/metabolismo , Neoplasias Encefálicas/patologia , Linhagem Celular Tumoral , Movimento Celular , Proteínas de Ligação a DNA/genética , Proteínas de Ligação a DNA/metabolismo , Glioma/genética , Glioma/metabolismo , Glioma/patologia , Fatores de Transcrição de Choque Térmico , Masculino , Invasividade Neoplásica , Transplante de Neoplasias , Ratos , Ratos Wistar , Fatores de Transcrição/genética , Fatores de Transcrição/metabolismo , Fator de Necrose Tumoral alfa/metabolismoRESUMO
KCNJ11 (potassium inwardly rectifying channel, subfamily J, member 11) and ABCC8 (ATP-binding cassette, subfamily C (CFTR/MRP), member 8) have been studied for association with type 2 diabetes in various ethnic populations with contradictory results. We performed a comprehensive meta-analysis for KCNJ11 rs5219, rs5210, rs5215, and ABCC8 rs757110 to evaluate the effect of these regions on genetic susceptibility for type 2 diabetes. Forty-one case-control association studies of KCNJ11 and ABCC8 polymorphisms with type 2 diabetes, including 61,879 subjects, were identified and used in our meta-analysis. Combined odds ratios (OR) of associations of this disease with the rs5219 T, rs5210 G, rs5215 G, and rs757110 G alleles were 1.15 [95% confidence interval (95%CI) = 1.10-1.21, P < 0.0001], 1.16 (95%CI = 1.08-1.24, P = 0.023), 1.08 (95%CI = 1.02-1.13, P = 0.006), and 1.12 (95%CI = 1.07-1.18, P < 0.0001), respectively. The effect of allele T of rs5219 was similar (OR = 1.16) in Europeans and Japanese. However, rs5219 was not associated with type 2 diabetes in the Chinese Han population. Our meta-analysis demonstrated that KCNJ11 and ABCC8 polymorphisms are associated with risk for type 2 diabetes in the global population. Comparative genomics and bioinformatics analyses revealed that rs5210 is located within a conserved 3'-UTR, and that allele A may abolish the binding site of hsa-miR-1910 that the risk allele G possesses.
Assuntos
Diabetes Mellitus Tipo 2/genética , Estudos de Associação Genética , Canais de Potássio Corretores do Fluxo de Internalização/genética , Receptores de Sulfonilureias/genética , Alelos , Diabetes Mellitus Tipo 2/patologia , Etnicidade/genética , Feminino , Predisposição Genética para Doença , Humanos , Masculino , Polimorfismo Genético , Polimorfismo de Nucleotídeo ÚnicoRESUMO
Uncoupling protein 2 (UCP2) is a mitochondrial transporter protein and can affect the function of ß-cells. We investigated a possible association between functional UCP2 -866G/A and Ala55Val polymorphisms and type 2 diabetes in 715 Hubei Han Chinese. No significant association was found, either for the -866G/A polymorphism (allele, P = 0.254; genotype, P = 0.508) or for the Ala55Val polymorphism (allele, P = 0.250; genotype, P = 0.896). Then, we reviewed the association of UCP2 -866G/A and Ala55Val polymorphisms with type 2 diabetes susceptibility in the Chinese population with a meta-analysis. Our meta-analysis, which included 3643 Chinese, further confirmed a lack of association of -866G/A and Ala55Val with type 2 diabetes (additive model: -866G/A, odds ratio = 1.09, 95% confidence interval = 0.94-1.27, P = 0.25; Ala55Val, odds ratio = 1.21, 95% confidence interval = 0.85-1.72, P = 0.28). Based on our case-control study and meta-analysis, we conclude that UCP2 Ala55Val and -866G/A polymorphisms are not significantly associated with type 2 diabetes risk in the Chinese population.
Assuntos
Diabetes Mellitus Tipo 2/genética , Estudos de Associação Genética , Canais Iônicos/genética , Proteínas Mitocondriais/genética , Obesidade/genética , Estudos de Casos e Controles , China , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/patologia , Predisposição Genética para Doença , Genética Populacional , Humanos , Obesidade/complicações , Obesidade/patologia , Polimorfismo de Nucleotídeo Único , Regiões Promotoras Genéticas , Fatores de Risco , Proteína Desacopladora 2 , População BrancaRESUMO
Tumor necrosis factor-like weak inducer of apoptosis (TWEAK) has an important role in the promotion of cell proliferation, migration, and differentiation. However, very little is known about the role of TWEAK in modulating uterine natural killer (uNK) cells' comprehensive functions in ruminants. In the present study, the effects of TWEAK on goat uNK cells were investigated by measuring their cytotoxic function and phenotype as well as cytokine expression in vitro. The results showed that TWEAK protein could be detected in the goat endometrium during estrous cycle and pregnancy. However, a significant increase in ( < 0.05) TWEAK protein levels was observed during very early pregnancy when compared with that during mid pregnancy and later pregnancy as well as during different phases of estrous cycle. Tumor necrosis factor-like weak inducer of apoptosis did not affect proliferation but did decrease ( < 0.05) the cytotoxic activity of uNK cells in vitro. Furthermore, the percentage of CD56/NKp46 uNK cells incubated with TWEAK-containing medium was greater ( < 0.05) compared with those treated with control medium. In addition, uNK cells incubated with TWEAK medium were associated with lesser ( < 0.05) secretion levels and protein expression of interferon-γ (IFN-γ) compared to those incubated with control medium. However, no differences ( > 0.05) could be observed for the secretion levels and protein expression of vascular endothelial growth factor (VEGF) in the uNK cells incubated with TWEAK-containing medium compared with those incubated with control medium. The present preliminary observations indicate that TWEAK has a biological effect on phenotype of uNK cells as well as the secretion and expression of IFN-γ by uNK cells in goats. Moreover, TWEAK decreases the cytotoxicity of goat uNK cells in vitro.
Assuntos
Proteínas Reguladoras de Apoptose/metabolismo , Cabras/imunologia , Células Matadoras Naturais/citologia , Fatores de Necrose Tumoral/metabolismo , Útero/imunologia , Animais , Citocinas/metabolismo , Endométrio/metabolismo , Feminino , Interferon gama/metabolismo , Células Matadoras Naturais/metabolismo , Gravidez , Útero/citologia , Fator A de Crescimento do Endotélio Vascular/metabolismoRESUMO
By using the natural birefringence of an a-cut Nd:GdVO(4) crystal, we experimentally investigate laser operation under different light polarizations (pi- and sigma-polarized emissions) and compare their performance. The laser performance is further compared with a diode-pumped c-cut Nd:GdVO(4) laser of the same parameters. We show experimentally that the c-cut Nd:GdVO(4) laser could have good passively Q-switched performance in a low-pump-power region but is influenced by other intrinsic laser effects, such as the thermally induced cavity losses; its performance is severely degraded under high pump power. The best passively Q-switched performance obtained in our experiments is from the a-cut pi-polarized laser, which gives the narrowest pulse of 5.4 ns with the highest peak power of 20 kW. Our experimental results show that, to achieve the best performance of the passively Q-switched laser operation, an overall consideration of laser parameters is important.
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In order to understand the effects of relaxation training on surgical stress response, a study was conducted among patients with abdominal surgery. Fifty-one patients were randomly divided into two groups. Experimental group (n = 25): patients received preoperative instruction and relaxation training, control group (n = 26): patients received only preoperative instruction. Anxiety state (state anxiety and physical symptoms of anxiety), blood pressure, heart rate, serum cortisone and postoperative pain of two groups were assessed and compared respectively on the third preoperative day, operation day, the first and the fourth postoperative day. Results showed that (1) there were significant differences between two groups (P < 0.05) in state anxiety scores on each day, physical symptoms on the first and fourth day after operation and severity of pain on the first postoperative day. (2) responses of systolic pressure, diastolic pressure and heart rate decreased in the experimental group. (3) Serum cortisone level decreased significantly in the experimental group on the first postoperative day (P < 0.05). This study shows that relaxation training has positive effects on surgical stress responses, especially in reducing the psychological anxiety response. Relaxation training can be served as an easy and effective method in nursing practice.
Assuntos
Laparotomia/efeitos adversos , Educação de Pacientes como Assunto/normas , Cuidados Pré-Operatórios , Terapia de Relaxamento/normas , Estresse Psicológico/prevenção & controle , Humanos , Estresse Psicológico/etiologiaRESUMO
As the blood dialysis has been applied more widely, the hygenic state of air and furniture surfaces in blood dialysis room and that of dialysis fluid would diretly affect the incidence of nosocomial infections. The results of investigation in three hospital dialysis units showed that: With people walking around, the number of air microbes presented a kenetic variation, ranged from 410 to 1755CFU/m3. That number was positively related to the number of dust particles in the air, which carring certain amount pathogenic of conditional-pathogenic microbes, among which, fungi, Stap. aureus and Pseud. aruginosa acount for 8.38%, 2.99% and 1.39% respectively. Physical of chemical disinfection treatment showed prompt effects (P < 0.01). The thermogenic reaction and infections in dialysis patients were mainly due to microbes containminated in the water for dialysis. Some of these microbes may produce intracellular or and exo-toxin and thermogenic factors. The microbes in dialysis machines could 100% be killed immediately after disinfecting the dialysis tubes with 5% available chlorine. But the germ numer could rise again as the time streched. Our results suggested that certain monitoring and disinfectious procedures must be carried out in hospital critical departments so as to reduce nosocomial infection cases.
Assuntos
Microbiologia do Ar , Poluição do Ar em Ambientes Fechados/análise , Infecção Hospitalar/prevenção & controle , Unidades Hospitalares de Hemodiálise , Infecção Hospitalar/etiologia , Humanos , IncidênciaRESUMO
We report the experimental observation and numerical simulation of deterministic chaos in a diode-pumped Nd:YAG solid-state laser that is passively Q switched by a Cr4+:YAG crystal saturable absorber. We show that apart from the stable Q-switched operation the laser can also exhibit complicated nonlinear dynamics, including the period-doubling route to chaos and periodic windows.