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BACKGROUND: Nearly half of bronchiectasis patients receiving bronchial artery embolization (BAE) still have recurrent hemoptysis, which may be life-threatening. Worse still, the underlying risk factors of recurrence remain unknown. METHODS: A retrospective cohort was conducted of patients with idiopathic bronchiectasis who received BAE from 2015 to 2019 at eight centers. Patients were followed up for at least 24 months post BAE. Based on the outcomes of recurrent hemoptysis and recurrent severe hemoptysis, a Cox regression model was used to identify risk factors for recurrence. RESULTS: A total of 588 individuals were included. The median follow-up period was 34.0 months (interquartile range: 24.3-53.3 months). The 1-month, 1-year, 2-year, and 5-year cumulative recurrent hemoptysis-free rates were 87.2%, 67.5%, 57.6%, and 49.4%, respectively. The following factors were relative to recurrent hemoptysis: 24-h sputum volume (hazard ratio [HR] = 1.99 [95% confidence interval [95% CI]: 1.25-3.15, p = 0.015]), isolation of Pseudomonas aeruginosa (HR = 1.50 [95% CI: 1.13-2.00, p = 0.003]), extensive bronchiectasis (HR = 2.00 [95% CI: 1.29-3.09, p = 0.002]), and aberrant bronchial arteries (AbBAs) (HR = 1.45 [95% CI: 1.09-1.93, p = 0.014]). The area under the receiver operating characteristic curve of the nomogram was 0.728 [95% CI: 0.688-0.769]. CONCLUSIONS: Isolation of Pseudomonas aeruginosa is an important independent predictor of recurrent hemoptysis. The clearance of Pseudomonas aeruginosa might effectively reduce the hemoptysis recurrence rate.
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Bronquiectasia , Embolização Terapêutica , Humanos , Artérias Brônquicas , Pseudomonas aeruginosa , Estudos Retrospectivos , Recidiva , Hemoptise/diagnóstico , Hemoptise/terapia , Embolização Terapêutica/efeitos adversos , Bronquiectasia/diagnóstico , Bronquiectasia/terapia , Resultado do TratamentoRESUMO
OBJECTIVE: To investigate the correlation of effect of bronchial arterial embolization (BAE) in the treatment of hemoptysis and relative factors. METHODS: From December 2007 to August 2011, 105 patients with hemoptysis were admitted. BAE was carried out after bronchial artery arteriography and ensured bronchial artery anomaly. Patients were followed up 3 to 24 months. RESULTS: All 105 cases were confirmed abnormal bronchial artery. And 101 cases (96.2%) were completed BAE, and among them, 91 cases (86.7%) were stop bleeding , and 7 cases (6.7%) were excellence. The total effective rate was 93.4%.In follow-up period, there were 69 cases (65.7%) without recurrence, and 8 cases (7.6%) were recent recurrence and 10 cases (9.5%) were long-term recurrence, respectively. All factors were no obvious correlation to effect of BAE. CONCLUSION: BAE is an effective treatment for hemoptysis.Effect of the BAE was irrespective to related factors.
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Artérias Brônquicas , Embolização Terapêutica/métodos , Hemoptise/terapia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Adulto JovemRESUMO
The mismatch between the supply and demand of ecosystem services has become a critical cause of the decline of urban ecological security. Studying the supply-demand matching of ecosystem services and exploring its association with urban spatial governance are imperative for ensuring sustainable urbanization. Taking Suzhou City as a case, the supply and demand values and matching degrees of five selected ecosystem services were assessed. Additionally, we explored the relationship between ecosystem services and urban spatial governance, with a focus on urban functional zoning. The findings indicate that first, the supply value of water production, food production, carbon sequestration, and tourism and leisure fall short of the demand value, while the supply value of air purification exceeds the demand value. The spatial matching of supply and demand shows a typical circular structure, with areas in short supply predominantly located in the downtown area and its vicinity. Second, the degree of coupling coordination between the supply-demand ratio of selected ecosystem services and the intensity of ecological control is low. Urban functional zoning can affect the supply-demand relationship of selected ecosystem services, and intensified development efforts can exacerbate the mismatch between supply and demand. Third, research on the supply-demand matching of selected ecosystem services can facilitate the assessment and regulation of urban functional zoning. Urban spatial governance can be regulated based on land use, industry, and population, with a focus on achieving a better supply-demand matching of ecosystem services. Through the analysis, this paper is aimed to provide reference for mitigating urban environmental problems and formulating sustainable urban development strategies.
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Conservação dos Recursos Naturais , Ecossistema , Urbanização , Cidades , ChinaRESUMO
In breast conserving surgery (BCS), specimen mammography is one of the most widely used intraoperative methods of assessing margin status. We performed a meta-analysis to evaluate the diagnostic accuracy of specimen mammography. Literature databases including PubMed, Cochrane Library, Web of Science, and EMBASE were searched prior to Jun 2022. A total of 1967 patients were included from 20 studies. A pooled analysis, heterogeneity testing, threshold effect testing, publication bias analysis, and subgroup analyses were performed from extracted data. The pooled weighted values were a sensitivity of 0.55 (95% confidence interval [CI], 0.47-0.63), a specificity of 0.85 (95% CI, 0.78-0.90), a diagnostic odds ratio of 7 (95% CI, 4-12), and a pooled positive likelihood ratio of 3.7 (95% CI 2.6-5.5). The area under the receiver operator characteristic curve was 0.75 (95% CI 0.71-0.78). In the subgroup analysis, the pooled specificity in the positive margin defined as tumor at margin subgroup was lower than the other positive margin definition subgroup (0.82 [95% CI: 0.71, 0.92] vs. 0.87 [95% CI: 0.80, 0.94], p = 0.01). Our findings indicated that specimen mammography was an accurate intraoperative imaging technique for margin assessment in BCS.
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Neoplasias da Mama , Neoplasias , Humanos , Feminino , Mastectomia Segmentar , Mamografia , Margens de Excisão , Sensibilidade e Especificidade , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/cirurgiaRESUMO
Background: Periodontal disease is very common worldwide and is one of the main causes of tooth loss in adults. Periodontal disease is characterized by chronic inflammation that can destroy adjacent alveolar bone and lead to a loss of periodontal ligaments. Although previous studies have found that a daily diet can influence the development of periodontal disease (e.g., a diet low in carbohydrates and rich in vitamins C and D and fiber can have a protective effect). Periodontal disease may present as gingivitis or periodontitis. However, studies on the role of healthy eating index in periodontitis are lacking. The purpose of this study was to assess the association between healthy eating index and periodontitis. Methods: We analyzed data collected from participants in the National Health and Nutrition Examination Survey (NHANES), a nationally representative survey conducted in 2-year cycles from 2013 to 2014. As part of our analysis, we developed multivariate logistic regression models to examine the independent association between the healthy eating index and periodontitis. We evaluated the significance of association using odds ratios (OR) with 95% confidence intervals (95%CI). Results: Individuals with a lower total healthy eating index had a higher prevalence of periodontitis. Adjusted multivariate regression models showed that a higher healthy diet index was associated with a lower prevalence of periodontitis (OR = 0.69, 95% CI: 0.55-0.86, P < 0.05). Conclusion: The results of the study showed that dietary structure was associated with the prevalence of periodontitis. Patients with a higher healthy eating index had a lower prevalence of periodontitis. These findings will need to be confirmed by longitudinal, prospective studies in the future.
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Arsenic trioxide (As2O3, ATO) has limited therapeutic benefit to treat solid tumors, whether used alone or in combination. Nanoscale drug delivery vehicles have great potential to overcome the limitation of the utility of ATO by rapid renal clearance and dose-limiting toxicity. Polymeric materials ranging from gelatin foam to synthetic polymers such as poly(vinyl alcohol) were developed for vascular embolic or chemoembolic applications. Recently, we have introduced sevelamer, an oral phosphate binder, as a new polymeric embolic for vascular interventional therapy. In this paper, sevelamer arsenite nanoparticle with a polygonal shape and a size of 50-300 nm, synthesized by anionic exchange from sevelamer chloride, was developed as a Pi-responsive bifunctional drug carrier and embolic agent for chemoembolization therapy. At the same arsenic dosage, sevelamer arsenite-induced severer tumor necrosis than ATO on the VX2 cancer model. In vitro tests evidenced that Pi deprivation by sevelamer could enhance ATO's anticancer effect. The results showed that ATO in Pi starvation reduced cell viability, induced more apoptosis, and diminished the mitochondrial membrane potential (Δψm) of cells since Pi starvation helps ATO to further down-regulate Bcl-2 expression, up-regulate Bax expression, enhance the activation of caspase-3 and increase the release of cytochrome c, and the production of excessive reactive oxygen species (ROS). Sevelamer arsenite not only plays a Pi-activated nano-drug delivery system but also integrated anticancer drug with embolic for interventional therapy. Therefore, our results presented a new administration route of ATO as well as an alternative chemoembolization therapy.
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Antineoplásicos , Arsenicais , Arsenitos , Nanopartículas , Antineoplásicos/farmacologia , Antineoplásicos/uso terapêutico , Apoptose , Arsenicais/farmacologia , Arsenitos/farmacologia , Linhagem Celular Tumoral , Portadores de Fármacos/farmacologia , Sinergismo Farmacológico , Óxidos , Sevelamer/farmacologiaRESUMO
It is a decade-long controversy that transarterial chemoembolization (TACE) has definite priority over transarterial embolization (TAE) in treating patients with hepatocellular carcinoma (HCC), since HCC cells are regularly resistant to chemotherapy by enhanced expression of proteins that confer drug resistance, and ABC transporters pump the intracellular drug out of the cell. We addressed this issue by modulating the chemo-environment. In an animal model, sevelamer, a polymeric phosphate binder, was introduced as an embolic agent to induce intratumoral inorganic phosphate (Pi) starvation, and trans-arterially co-delivered with doxorubicin (DOX). The new type of TACE was named as DOX-TASE. This Pi-starved environment enhanced DOX tumoral accumulation and retention, and DOX-TASE thereby induced more severe tumor necrosis than that induced by conventional TACE (C-TACE) and drug-eluting bead TACE (D-TACE) at the same dose. In vitro tests showed that Pi starvation increased the cellular accumulation of DOX in an irreversible manner and enhanced cytotoxicity and cell apoptosis by suppressing the expression of ABC transporters (P-glycoprotein (P-gp), BCRP, and MRP1) and the production of intracellular ATP. Our results are indicative of an alternative interventional therapy combining chemotherapy with embolization more effectively.
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Carcinoma Hepatocelular , Quimioembolização Terapêutica , Neoplasias Hepáticas , Membro 2 da Subfamília G de Transportadores de Cassetes de Ligação de ATP , Animais , Carcinoma Hepatocelular/tratamento farmacológico , Quimioembolização Terapêutica/métodos , Doxorrubicina , Humanos , Neoplasias Hepáticas/tratamento farmacológico , Proteínas de NeoplasiasRESUMO
Commercially available drug-eluting embolization beads (100-500 µm) reduced the occurrence of adverse events related to an anticancer drug, but were unascertained to remarkably benefit the transcatheter arterial chemoembolization (TACE) treatment of intermediate-stage liver cancer. Dextran-coated arsenite nanoparticles with the size ranging from 400 to 600 nm were developed as a nanosized drug-eluting bead (NDEB) for chemoembolization therapy of the rabbit VX2 liver tumor. We fully characterized their relevant physicochemistry and drug release properties. Their hemolysis was investigated before vessel embolization. The introduction of the NDEB allowed continuous embolization of tumor feeding vessels and sustained release of arsenic trioxide, thereby causing severe tumor necrosis and reduced vascularity. Sonography including B mode ultrasound, color Doppler flow imaging (CDFI) and dynamic contrast-enhanced ultrasound (CEUS) were performed to evaluate the tumor vascularity and viability. Additionally, its hepatotoxicity was tolerable at a medium dose. NDEB-TACE might be an effective therapeutic strategy for interventional therapy.
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Trióxido de Arsênio/uso terapêutico , Portadores de Fármacos/química , Neoplasias Hepáticas/tratamento farmacológico , Nanopartículas/química , Animais , Trióxido de Arsênio/química , Arsenitos/química , Quimioembolização Terapêutica/métodos , Dextranos/química , Liberação Controlada de Fármacos , Gadolínio/química , Coelhos , Compostos de Sódio/químicaRESUMO
After the publication of the article, the authors have realized that the affiliation presented for the joint coauthor listed on the paper (JianRen Tu) was incorrect. The correct author list (and affiliations) should therefore have been published as follows: YuHua Xu1*, JianRen Tu2*, TianTian Zhao3, ShiGuang Xie3 and ShengBo Tang4. 1Department of Cardiovascular Medicine, Jiangxi Chest Hospital, Nanchang, Jiangxi 330006; 2Department of Oncology, Jiangxi Cancer Hospital, Nanchang, Jiangxi 330029; Departments of 3Respiratory Medicine and 4Medical Oncology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China. *Contributed equally. The authors apologize for their oversight, and for any inconvenience that this has caused. [the original article was published in International Journal of Oncology 54: 295305, 2019; DOI: 10.3892/ijo.2018.4629].
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Chemoresistance is one of the most important biological elements affecting the progression and prognosis of cancer. Long noncoding RNAs (lncRNAs) are important regulators and are aberrantly expressed in various types of cancer in humans, including nonsmall cell lung cancer (NSCLC). The present study aimed to investigate the effect of lncRNAs on NSCLC resistance to chemotherapy. The relative expression level of epidermal growth factor receptor antisense RNA 1 (EGFRAS1) was quantified by reverse transcription-quantitative polymerase chain reaction analysis in NSCLC tissues, paired adjacent normal tissues, patient plasma and NSCLC cell lines, and its association with prognosis was assessed by multivariate analysis. The biological functions of EGFRAS1 in NSCLC cells were determined in vitro. It was found that EGFRAS1 was abnormally upregulated in NSCLC tissues compared with adjacent normal lung tissues. Furthermore, patients with NSCLC with increased expression of EGFRAS1 had a poor prognosis. EGFRAS1 knockdown significantly inhibited NSCLC malignancy in vitro, including cell proliferation and chemoresistance. Furthermore, the expression levels of EGFRAS1 were increased in plasma samples from patients with cisplatin-based chemotherapy resistance. Bioinformatics analysis and a luciferase reporter assay confirmed that EGFRAS1 mediated cell proliferation and chemoresistance through directly binding to microRNA223. Therefore, EGFRAS1 overexpression-induced chemoresistance can contribute to poor prognosis in NSCLC.