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Objective: To assess the efficacy of neoadjuvant treatment with PD-1 (programmed cell death protein 1) inhibitors combined with paclitaxel (albumin-conjugated) and cisplatin (TP regimen) for locally advanced hypopharyngeal squamous cell carcinoma and laryngeal organ function preservation. Methods: Data of 53 patients, including 51 males and 2 females, aged 38-70 years old, who were diagnosed with locally advanced hypopharyngeal squamous carcinoma confirmed by histology and enhanced CT at the Cancer Prevention and Control Center of Sun Yat-sen University during the initial treatment from January 1, 2019 to January 15, 2023, were retrospectively analyzed. All patients received neoadjuvant therapy with PD-1 inhibitors combined with albumin-bound paclitaxel (260 mg/m2) and cisplatin (60 mg/m2) for 3 to 4 cycles. The main outcome measures were larynx dysfunction-free survival (LDFS), overall survival (OS), and progression-free survival (PFS). Survival curves were plotted using the Kaplan-Meier method, and Cox multifactorial analysis was further performed if Cox univariate analysis was statistically significant. Results: The overall efficiency was 90.6% (48/53). The 1-year and 2-year LDFS rates were 83.8% (95%CI: 74.0% to 94.8%) and 50.3% (95%CI: 22.1% to 91.6%), the 1-year and 2-year OS rates were 95.2% (95%CI: 88.9% to 100.0%) and 58.2% (95%CI: 25.6% to 81.8%), and the 1-year and 2-year PFS rates were 83.9% (95%CI: 74.2% to 94.9%) and 53.5% (95%CI: 32.1% to 89.1%). Adverse events associated with the neoadjuvant therapy were mainly myelosuppression (45.3%), gastrointestinal reactions (37.7%) and hypothyroidism (20.8%). Conclusion: The neoadjuvant treatment of locally advanced hypopharyngeal squamous cell carcinoma using PD-1 inhibitors combined with paclitaxel and cisplatin can provide with a higher survival rate with a improved laryngeal organ function preservation rate.
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Protocolos de Quimioterapia Combinada Antineoplásica , Cisplatino , Neoplasias Hipofaríngeas , Terapia Neoadjuvante , Paclitaxel , Humanos , Masculino , Pessoa de Meia-Idade , Feminino , Cisplatino/uso terapêutico , Paclitaxel/uso terapêutico , Paclitaxel/administração & dosagem , Adulto , Idoso , Neoplasias Hipofaríngeas/terapia , Neoplasias Hipofaríngeas/tratamento farmacológico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Estudos Retrospectivos , Albuminas/uso terapêutico , Albuminas/administração & dosagem , Carcinoma de Células Escamosas de Cabeça e Pescoço/tratamento farmacológico , Carcinoma de Células Escamosas de Cabeça e Pescoço/terapia , Carcinoma de Células Escamosas/tratamento farmacológico , Carcinoma de Células Escamosas/terapia , Carcinoma de Células Escamosas/patologia , Receptor de Morte Celular Programada 1/antagonistas & inibidoresRESUMO
Objective: To analyze survival data of cancer from 1970 to 2014 in Zhongshan City, Guangdong Province, and provide scientific basis for cancer prevention and control in Zhongshan City. Methods: The tumor incidence data of Zhongshan City, Guangdong Province from 1970 to 2014 were collected from Zhongshan Cancer Registry, and all patients were followed up to December 31, 2019. The standardized 5-year net survival rates and their annual percentage change (APC) and average annual percentage change (AAPC) for total and major cancers at different times were used to describe statistical analysis. The standardized survival rates were weighted using the International Cancer Survival Standard Age Coefficients. Results: There were 78 854 cancer patients eligible for the study in Zhongshan City of Guangdong Province from 1970 to 2014, among which lung cancer (13 466 cases, 17.08%), nasopharyngeal cancer (9715 cases, 12.32%) and liver cancer (9707 cases, 12.31%) were the main types of cancer. The morphology verification was 69.87% in the whole of cancers and the ranges were 21.07% to 97.00% in major cancers. From 2010 to 2014, the 5-year age-standardized net survival rates of cancers for all, males and females in Zhongshan City were 39.74%, 30.92% and 52.47%, in which were 97.98% for thyroid cancer, 74.29% for brain and central nervous system tumors, 73.92% for nasopharyngeal cancer, 50.23% for colorectal cancer, 81.38% for female breast cancer, 78.81% for uterine body cancer, 68.57% for cervical cancer, 49.33% for prostate cancer, 16.19% for lung cancer , 12.14% for liver cancer, and 11.78% for esophageal cancer, respectively. The survival rates of all cancers in Zhongshan City showed an increasing trends in 1970-2014 (AAPC=1.5%, P=0.025), and it was higher in female cancers than that of male in all periods. Conclusion: The standardized 5-year net survival rates of all and major cancers in Zhongshan City of Guangdong Province show an increasing trend from 1970 to 2014, but they are still at a medium-low levels compared with the countries and regions participating in CONCORD-3 project, suggesting that Zhongshan should continue to strengthen cancer prevention and control.
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Neoplasias Hepáticas , Neoplasias Pulmonares , Neoplasias Nasofaríngeas , Neoplasias do Colo do Útero , Neoplasias Uterinas , Humanos , Masculino , Feminino , Carcinoma Nasofaríngeo , Neoplasias Pulmonares/epidemiologiaRESUMO
The establishment of a high-quality gastric cancer database significantly improves the efficiency and standardization of diagnosis and treatment of this disease. Our center has developed a specialized, single-center gastric cancer database and initiated the China Gastrointestinal Cancer Surgery Union, catalyzing the exploration of multi-center databases. This article encapsulates multi-level experience and provides a detailed overview of the quality control methods we implement in both constructing and managing the gastric cancer database. Utilizing an electronic medical record system and a multi-disciplinary treatment (MDT) approach, we have designed the database in a modular and multi-nodal manner. A synthesis of automatic retrieval of structured data and manual entry, coupled with a rigorous MDT system and real-time supervision at various nodes, bolster our real-time quality control efforts. Ensuring data security and digitized management plans alongside real-time review protocol and a multi-level review system, we maintain the highest standards in the initiation and management of the database. Through the establishment of the China Gastrointestinal Cancer Surgery Union platform, we endorse the concept that multi-center database construction should be driven by research objectives, consider data accessibility, while placing an emphasis on building inter-center consensus on data quality control. Moving forward, it is crucial that the development of multi-center databases promotes uniformity in medical standards across centers, cultivates stable public data sharing platforms, ensures robust data security protocols, routinely conducts data quality assessments, and bolsters multi-center cooperation and exchanges to promote the homogeneity of medical standards.
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Procedimentos Cirúrgicos do Sistema Digestório , Neoplasias Gastrointestinais , Neoplasias Gástricas , Humanos , Neoplasias Gástricas/cirurgia , Neoplasias Gástricas/diagnóstico , Bases de Dados Factuais , Controle de QualidadeRESUMO
OBJECTIVE: The aim of this study was to investigate the clinical effectiveness of semaglutide on weight loss, body composition and muscle strength in the Chinese population with obesity. PATIENTS AND METHODS: Data were retrospectively analyzed for participants prescribed semaglutide in 2021 and 2022 from a Chinese weight management clinic. Changes in weight, body composition, biochemical indicators, calf circumference and handgrip strength were collected. Body fat and skeletal muscle were also measured using the bioelectrical impedance analysis. Paired t-test was used to compare the values after 6 months of treatment with the baseline values. RESULTS: A total of 53 obese patients received 24 weeks of lifestyle intervention plus semaglutide treatment. 10 patients who failed to adhere to the follow-up were excluded, and 43 patients were studied. The average baseline body mass index (BMI) was 33.0 kg/m2, and the average body weight was 90.0 kg. After 6 months of treatment, the patient's weight was significantly reduced by 9.9 ± 3.9 kg (p < 0.001), and the weight loss percentage was 11.2 ± 4.5% (p< 0.001). The proportion of patients with weight loss ≥ 5% and ≥ 10% was 93% and 54%, respectively. Fasting blood glucose, fasting insulin, Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) index, blood uric acid and blood lipid levels also decreased after treatment. Body composition analysis showed that the loss of skeletal muscle mass was 1.4 ± 1.3 kg (p < 0.001), which was significantly less than the loss of fat mass of 5.6 ± 3.7 kg (p < 0.001). By percentage, the fat mass loss was 15.6 ± 10.1%, and the muscle mass loss was 4.8 ± 4.4% (p < 0.001). The visceral fat area was significantly reduced by 24.4 ± 17.7 cm (p < 0.001). There was no significant change in skeletal muscle index (8.1 ± 1.0 kg/m2 at baseline and 7.9 ± 1.0 kg/m2 at 24 weeks). The calf circumference (42.6 ± 3.6 cm at baseline, 41.2 ± 3.8 cm at 24 weeks) and grip strength (33.3 ± 9.5 kg at baseline, 32.3 ± 9.0 kg at 24 weeks) did not decrease significantly. The main adverse reactions were mild gastrointestinal dysfunction (nausea, diarrhea and vomiting), without ketoacidosis. CONCLUSIONS: In a real-world setting, semaglutide can reduce the weight and fat of obese patients while effectively maintaining muscle mass and muscle strength.
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População do Leste Asiático , Força da Mão , Humanos , Adulto , Estudos Retrospectivos , Obesidade , Redução de Peso , Composição Corporal , Índice de Massa Corporal , Força Muscular , Resultado do Tratamento , Peso CorporalRESUMO
OBJECTIVE: To explore the concentration range and penetration depth of methylene blue near-infrared fluorescence imaging, and to clarify the role of methylene blue in oral lymphatic drainage and sentinel lymph node localization, so as to lay a foundation for the potential research and application of sentinel lymph node in oral cancer. METHODS: 10% (mass fraction) methylene blue injection was diluted into 29 different concentrations with 0.9% (mass fraction) normal saline, and the concentration range of methylene blue near-infrared fluorescence imaging was determined by near-infrared fluorescence imager. The maximum penetration depth of methylene blue near-infrared fluorescence was determined by covering pigskin with different thicknesses (1, 2, 3, 4 and 5 mm) in methylene blue solution. 0.2 mL methylene blue solution was injected into the submucosal 0.5 cm at the lateral margin of tongue on one side of the rats. The near-infrared fluorescence imager was used for continuously monitoring for 3 hours. The first near-infrared fluorescence hotspot was identified as sentinel lymph node and labeled by percutaneous observation. The rats were then sacrificed and dissected in the head and neck. Near-infrared fluorescence imaging was performed again to observe whether the fluorescent tissue was consistent with the labeled fluorescent hotspot in vitro, and the presence of lymphoid tissue was confirmed by pathological examination after resection. RESULTS: Except that no fluorescence signals were detected in the blank control groups, the fluorescence intensity of methylene blue increased first and then decreased with its solution concentration decreased. When the concentration of methylene blue was diluted to the picomole level, the fluorescence signal could still be detected. The maximum penetration depth of methylene blue fluorescence was 4 mm. Methylene blue near-infrared fluorescence could be localized in oral lymphatic drainage and sentinel lymph node. The fluorescence was sustained for more than 3 hours after methylene blue injection. Methylene blue solution concentrations of 3.34 mmol/L, 6.68 mmol/L, 13.37 mmol/L and 26.74 mmol/L were selected in the rats to map sentinel lymph node by near-infrared fluorescence. CONCLUSION: Methylene blue near-infrared fluorescence has a certain penetrating ability and can transcuta-neously map the sentinel lymph node and their associated lymphatic vessels in rats, which is expected to be further applied in the study of sentinel lymph node in oral cancer.
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Neoplasias Bucais , Linfonodo Sentinela , Ratos , Animais , Biópsia de Linfonodo Sentinela/métodos , Linfonodo Sentinela/diagnóstico por imagem , Azul de Metileno , Neoplasias Bucais/patologia , Imagem Óptica , Linfonodos/diagnóstico por imagem , Linfonodos/patologiaRESUMO
The ^{18}O(α,γ)^{22}Ne reaction is critical for AGB star nucleosynthesis due to its connection to the abundances of several key isotopes, such as ^{21}Ne and ^{22}Ne. However, the ambiguous resonance energy and spin-parity of the dominant 470 keV resonance leads to substantial uncertainty in the ^{18}O(α,γ)^{22}Ne reaction rate for the temperature of interest. We have measured the resonance energies and strengths of the low-energy resonances in ^{18}O(α,γ)^{22}Ne at the Jinping Underground Nuclear Astrophysics experimental facility (JUNA) with improved precision. The key 470 keV resonance energy has been measured to be E_{α}=474.0±1.1 keV, with such high precision achieved for the first time. The spin-parity of this resonance state is determined to be 1^{-}, removing discrepancies in the resonance strengths in earlier studies. The results significantly improve the precision of the ^{18}O(α,γ)^{22}Ne reaction rates by up to about 10 times compared with the previous data at typical AGB temperatures of 0.1-0.3 GK. We demonstrate that such improvement leads to precise ^{21}Ne abundance predictions, with an impact on probing the origin of meteoritic stardust SiC grains from AGB stars.
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Fibro-osseous lesions is a class of diseases with obvious similarities in clinical manifestations and pathological features, which has been attracting the attention of clinicians and pathologists. The latest WHO 2022 Classification (5th edition) included six of these diseases (cemento-osseous dysplasia, segmental odontomaxillary dysplasia, fibrous dysplasia, juvenile trabecular ossifying fibroma, psammomatoid ossifying fibroma and familial gigantiform cementoma) in the " fibro-osseous tumours and dysplasias ", and put forward new ideas on the diagnosis and treatment of these diseases. According to the latest WHO 2022 Classification (5th edition), the clinical and pathological features, diagnosis and differential diagnosis of these six diseases were described.
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Cementoma , Fibroma Ossificante , Neoplasias Maxilomandibulares , Humanos , Fibroma Ossificante/diagnóstico , Fibroma Ossificante/patologia , Diagnóstico Diferencial , Cementoma/diagnóstico , Cementoma/patologia , Ossos FaciaisRESUMO
This century has seen significant advances in the treatment and research of gastric cancer in China. Chinese scholars have made a series of key technological breakthroughs in minimally invasive surgery, perioperative treatment and artificial intelligence diagnosis. These world-leading clinical researches have improved treatment outcomes and reduced surgical trauma. Global surveillance of trends in cancer survival 2000-14 reported that survival of gastric cancer in China has significantly improved during the last 20 years. This paper reviews the research history of surgical oncology for gastric cancer in China, summarises the experience and attempts to explore the future direction.
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Neoplasias Gástricas , Oncologia Cirúrgica , Humanos , Neoplasias Gástricas/cirurgia , Inteligência Artificial , Gastrectomia , China/epidemiologia , Procedimentos Cirúrgicos Minimamente InvasivosRESUMO
Cartilage and giant cell-related neoplastic lesions originating in the temporomandibular joint region have similar clinical, imaging and pathological manifestations, making the diagnosis of these disorders challenging to varying degrees. Diagnostic findings can influence treatment procedures and a definitive pathological diagnosis is important for the prognosis of these conditions. In this article, we discuss the pathological diagnosis and differentiation of four benign cartilage and giant cell related tumors and tumor-like lesions that occur in the temporomandibular joint, namely synovial chondromatosis, tumoral calcium pyrophosphate deposition disease, pigmented villonodular synovitis and chondroblastoma, taking into account their clinical features and histological manifestations, with a view to providing a basis for clinical management.
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Condromatose Sinovial , Sinovite Pigmentada Vilonodular , Humanos , Articulação Temporomandibular/patologia , Condromatose Sinovial/diagnóstico , Condromatose Sinovial/patologia , Sinovite Pigmentada Vilonodular/diagnóstico , Sinovite Pigmentada Vilonodular/patologia , Células Gigantes/patologia , CartilagemRESUMO
Objective: To compare the prognostic influence and postoperative pathology of different comprehensive treatment models for adenocarcinoma of esophagogastric junction. Methods: Between January 2012 and December 2017, a total of 219 patients with adenocarcinoma of esophagogastric junction underwent surgery in Gastrointestinal Cancer Center, Peking University Cancer Hospital & Institute and were enrolled in this study. The clinicopathological data of these patients were collected. The patients were categorized into 3 groups according to different treatment models: surgery-first group, neoadjuvant chemotherapy (NAC) group and neoadjuvant chemoradiotherapy (nCRT) group. A trimatch propensity score analysis was applied to control potential confounders among the three groups by using R language software. A total of 7 covariates including gender, age, comorbidity, body mass index, clinical T stage, clinical N stage and Siewert type were included, and the caliper value was taken as 0.2. After matching, a total of 87 patients were included for analysis with 27 patients for each group. There were 82 males and 5 females, with a median age of 63 years (range: 38 to 76 years). The effect of preoperative treatment on postoperative tumor pathology among the three different comprehensive treatment models was explored by χ2 test, ANOVA or Wilcoxon rank sum test. Mann-Whitney U test or χ2 test were used to undergo pairwise comparisons. Kaplan-Meier method and Log-rank test were used to analyze the overall survival and progression-free survival. Results: The proportion of vascular embolism in the surgery-first group was 72.4% (21/29), which was significantly higher than NAC group (37.9% (11/29), χ2=6.971, P=0.008) and nCRT group (6.9% (2/29), χ2=26.696, P<0.01). The proportions of pathological T3-4 stage in nCRT group and NAC group were 55.2% (16/29) and 62.1% (18/29), respectively, which were significantly lower than the surgery-first group (93.1% (27/29), χ2=10.881, P=0.001; χ2=8.031, P=0.005). Compared with the NAC group (55.2% (16/29), χ2=6.740, P=0.009) and nCRT group (31.0% (9/29), χ2=18.196, P<0.01), the proportion of lymph node positivity 86.2% (25/29) were significantly higher in the surgery-first group. The 5-year overall survival rates were 62.1%, 68.6% and 41.4% for the surgery-first group, NAC group and nCRT group, respectively (χ2=4.976, P=0.083). The 5-year progression-free survival rates were 61.7%, 65.1% and 41.1% for the surgery-first group, NAC group and nCRT group, respectively. The differences in overall survival (χ2=4.976, P=0.083) and progression-free survival (χ2=4.332, P=0.115) among the three groups were nonsignificant. Conclusions: Postoperative pathology is significantly different among the three groups. Neoadjuvant chemotherapy and neoadjuvant chemoradiotherapy could decrease the proportions of vascular embolism, pathological T3-4 stage and lymph node positivity to achieve local tumor control. The prognosis of overall survival and progression-free survival are not significantly different among the three groups.
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Adenocarcinoma , Junção Esofagogástrica , Adenocarcinoma/patologia , Adulto , Idoso , Estudos de Coortes , Junção Esofagogástrica/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Terapia Neoadjuvante , Pontuação de PropensãoRESUMO
Objective: To explore the clinical features and survival of newly diagnosed follicular lymphoma (FL) patients with diffuse large B-cell lymphoma (DLBCL) component. Methods: 1845 newly diagnosed FL patients aged ≥ 18 years with grades 1-3a in 11 medical centers in China from 2000 to 2020 were included, and patients with DLBCL component were screened. The clinical data and survival data of the patients were retrospectively analyzed, and the prognostic factors were screened by univariate and multivariate analysis. Results: 146 patients (7.9% ) with newly diagnosed FL had DLBCL component. The median age was 56 (25-83) years, 79 males (54.1% ) . The pathology of 127 patients showed the proportion of DLBCL component. Patients were divided into two groups according to whether the proportion of DLBCL component was ≥ 50% . The study found that patients with DLBCL component ≥ 50% had higher grade 3 ratio (94.3% vs 91.9% , P=0.010) , Ki-67 index ≥ 70% ratio (58.5% vs 32.9% , P=0.013) and PET-CT SUVmax ≥ 13 ratio (72.4% vs 46.3% , P=0.030) than patients with DLBCL component<50% . All patients received CHOP or CHOP like ± rituximab chemotherapy. The overall response rate (ORR) was 88.2% , and the complete response (CR) rate was 76.4% . In the groups with different proportions of DLBCL component, there was no significant difference in the remission rate after induction treatment and the incidence of disease progression within 2 years after initiation of treatment (POD24) (P<0.05) . The overall estimated 5-year progression free survival (PFS) rate was 58.9% , and the 5-year overall survival (OS) rate was 90.4% . The 5-year OS rate of POD24 patients was lower than that of non POD24 patients (70.3% vs 98.5% , P<0.001) . Compared with non maintenance treatment of rituximab, maintenance treatment of rituximab could not benefit the 5-year PFS rate (57.7% vs 58.8% , P=0.543) , and the 5-year OS rate had a benefit trend, but the difference was not statistically significant (100% vs 87.8% , P=0.082) . Multivariate analysis showed that failure to reach CR after induction treatment was an independent risk factor for PFS (P=0.006) , while LDH higher than normal was an independent risk factor for OS (P=0.031) . Conclusion: FL patients with DLBCL component ≥50% have more invasive clinical and pathological features. CHOP/CHOP like ± rituximab regimen can improve the clinical efficacy of patients. Rituximab maintenance therapy can not benefit the PFS and OS of patients. Failure to reach CR after induction therapy was the independent unfavorable factor for PFS.
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Linfoma Folicular , Linfoma Difuso de Grandes Células B , Anticorpos Monoclonais Murinos/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Humanos , Linfoma Folicular/diagnóstico , Linfoma Folicular/tratamento farmacológico , Linfoma Difuso de Grandes Células B/diagnóstico , Linfoma Difuso de Grandes Células B/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Estudos Retrospectivos , Rituximab/uso terapêuticoRESUMO
In this paper, an initial pressure adjustable explosion vessel was developed, and the effect of negative pressure, positive pressure (0.2-1.8 atm) different initial ambient pressure on the explosive shock wave generated by the explosion of explosives was studied. The relationships between the specific impulse, shock wave velocity, the amount of explosive gas products and the ambient pressure were analyzed for different initial pressure environments. It was found that: the overpressure of the blast shock wave decreases with the initial ambient pressure of the explosion, and there exists a negative pressure environment with a dramatic pressure decrease near 0.6 atm, defined as the super-sensitive negative pressure Pcr. The propagation velocity of an explosive wave increases with a decrease in the ambient pressure, and the propagation velocity at a pressure of 1.8 atm is four times less than the velocity at a pressure of 0.2 atm. The production of explosive gas products did not change. The greater the initial pressure of the environment where the explosive is located, the smaller the ratio of the gas generated by the explosion to the initial force gas in the explosion vessel is, and the greater the impact on the propagation of shock waves is. The maximum attenuation of the first specific impulse i1 is 72.97% and the maximum attenuation of the second specific impulse i2 is 72.39%. The experiments provide reference data for high-altitude military confrontation, high-altitude weapons and ammunition development, and deep-earth protection engineering.
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Objective: To investigate the long-term efficacy and safety of left cardiac sympathetic denervation(LCSD) for long QT syndrome(LQTS) patients with either recurrence on drug therapy intolerance/refusal. Methods: This study was a retrospective cohort study. The cases selected from 193 patients with LQTS who were enrolled in the Chinese Channelopathy Registry Study from November 1999 to November 2012. This study selected 28 LQTS patients with either recurrence on drug therapy intolerance/refusal and underwent LCSD surgery in the Peking University People's Hospital or Beijing Tongren Hospital. The patients were allocated into 3 groups: high-risk group(n=13, baseline QTc ≥550 ms or symptomatic in the first year of life or highly malignant genetics); intermediate-risk group(n=10, 500 ms≤baseline QTc<550 ms, symptomatic after the first year and without highly malignant genetics); low-risk group(n=5, baseline QTc<500 ms, symptomatic after the first year and without highly malignant genetics). LCSD was performed with the traditional supraclavicular approach or video assisted thoracoscopic surgery (VATS). Patients were regularly followed up until 20 years after the surgery. Data were collected before and 1 year after surgery and at the last follow-up. Patients' electrocardiograph(ECG), cardiac events and surgery-related complications were recorded. Kaplan-Meier survival analysis was used to determine the cardiac event-free survival based on different risk stratification and genotypes. Results: A total of 28 LQTS patients, aged 20.5 (15.0, 37.5) and underwent LCSD surgery, were enrolled in this study, including 23(82.1%) women. There were 11(39.3%) patients treated with traditional approach while 17(60.7%) with VATS-LCSD. There were 19(67.9%) patients had positive genetic test results, including 4 LQT1, 12 LQT2, 1 LQT1/LQT2 mixed type, and 2 Jervell-Lange-Nielsen (JLN) syndrome. The median follow-up period was 189.3(138.7, 204.9) months. The dropout rate was 10.7%(3/28) while 3 patients in the intermediate-risk group were lost to follow-up. Horner syndrome occurred in 1 patient (in the high-risk group). Sudden cardiac deaths were observed in 3 (12.0%) patients (all in the high-risk group), and 12 patients (48.0%) had syncope recurrences (2 in low-risk group, 3 in intermediate-risk group and 7 in high-risk group). A significant reduction in the mean yearly episodes of cardiac events was observed, from (3.5±3.3) before LCSD to(0.2±0.1) at one year after LCSD and (0.5±0.8) at last follow up(P<0.001). The mean QTc was shortened from (545.7±51.2)ms before the surgery to (489.0±40.1)ms at the last follow-up (P<0.001). Among the 20 patients with basic QTc ≥500 ms and completing the follow-up, the QTc intervals of 11(55.0%) patients were shortened to below 500 ms. The event free survival rates for any cardiac events after LCSD decreased sequentially in the low-, intermediate- and high-risk groups, and the difference was statistically significant (χ²=7.24, log-rank P=0.026). No difference was found in the event free survival rates among LQT1, LQT2 and undefined gene patients (χ²=5.20, log-rank P>0.05). Conclusions: LCSD surgery can reduce the incidence of cardiac events and shorten the QTc interval in patients with LQTS after the long-term follow-up. LCSD surgery is effective and safe for patients with LQTS ineffective or intolerant to drug therapy. However, high-risk patients are still at a high risk of sudden death after surgery and should be actively monitored and protected by combined therapies.
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Síndrome do QT Longo , Eletrocardiografia , Feminino , Coração , Humanos , Masculino , Estudos Retrospectivos , Simpatectomia/efeitos adversos , Simpatectomia/métodosRESUMO
Testicular ischemia-reperfusion injury (TIR) is a urological emergency common among male newborns, children, and adolescents. Testicular injury and its consequences, such as altered hormone production, subfertility, and infertility, are determined by the duration and degree of testicular torsion. Early diagnosis and treatment are crucial to preserving the testes and fertility. Previous studies suggest that reactive oxygen species contribute to the pathogenesis of TIR injury, but the underlying mechanism remains unclear. Several drugs/plants reportedly exhibit antioxidative activities to protect against TIR. This review summarizes current studies on the role of antioxidants in preventing experimental TIR injury and discusses the underlying pathophysiological mechanisms.
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Infertilidade , Traumatismo por Reperfusão , Torção do Cordão Espermático , Masculino , Criança , Adolescente , Recém-Nascido , Humanos , Antioxidantes/farmacologia , Antioxidantes/uso terapêutico , Testículo , Torção do Cordão Espermático/complicações , Espécies Reativas de Oxigênio , Traumatismo por Reperfusão/etiologiaRESUMO
Fluorine is one of the most interesting elements in nuclear astrophysics, where the ^{19}F(p,α)^{16}O reaction is of crucial importance for Galactic ^{19}F abundances and CNO cycle loss in first generation Population III stars. As a day-one campaign at the Jinping Underground Nuclear Astrophysics experimental facility, we report direct measurements of the essential ^{19}F(p,αγ)^{16}O reaction channel. The γ-ray yields were measured over E_{c.m.}=72.4-344 keV, covering the Gamow window; our energy of 72.4 keV is unprecedentedly low, reported here for the first time. The experiment was performed under the extremely low cosmic-ray-induced background environment of the China JinPing Underground Laboratory, one of the deepest underground laboratories in the world. The present low-energy S factors deviate significantly from previous theoretical predictions, and the uncertainties are significantly reduced. The thermonuclear ^{19}F(p,αγ)^{16}O reaction rate has been determined directly at the relevant astrophysical energies.
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OBJECTIVE: To explore the personality portraits of patients with type 2 diabetes mellitus (T2DM), its relationship with medication adherence and the influencing factors of medication adherence. METHODS: T2DM patients from 22 community health service stations of 4 community health service centers in Tongzhou district and Shunyi district in Beijing were selected as the research objects. A self-designed questionnaire was used to collect demographic information. The short version of Big Five personality scale was used to collect personality information, and latent profile analysis was used to explore their personality portraits. The medication adherence was evaluated by medication adherence scale, and the difference of medication adherence among the different personality portraits was explored by analysis of variance. The influencing factors of medication adherence were explored by the ordinal Logistic regression model. RESULTS: In the study, 751 T2DM patients were included. Latent profile analysis showed that the T2DM patients in this study could be divided into four types of personality portraits, including introverted and stable type (42.7%), negative type (12.7%), anxiety type (15.3%) and active and responsible type (29.3%). Among them, 75 patients said that they did not use medicine or insulin, 5 patients were lack of data, and finally 671 patients with T2DM were included in the analysis about medication adherence. The analysis of variance showed that there was no significant difference in medication adherence between anxiety type (5.55±1.65) and negative type (5.94±1.53, P=0.089), but the medication adherence score of anxiety type was significantly lower than that of introverted and stable type (6.17±1.46, P=0.001) and active and responsible type (6.09±1.65, P=0.004). Anxiety type and negative type were seen as a whole in the ordinal Logistic regression model named anxiety and negative type. The results showed that compared with anxiety and negative type, the active and responsible type or introverted and stable type was the protective factor for good medication adherence (OR=1.567, 95%CI: 1.096-2.237; OR=1.774, 95%CI: 1.214-2.591), and the education level also affected the medication adherence. CONCLUSION: T2DM can be classified into four types of personality portraits based on Big Five personality theory. The anxiety and negative type after the combination of anxiety type and negative type is the independent risk factor for poor medication adherence. In addition, education level is also the influencing factor of medication compliance.
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Diabetes Mellitus Tipo 2 , Ansiedade/epidemiologia , Pequim , Diabetes Mellitus Tipo 2/tratamento farmacológico , Humanos , Adesão à Medicação , PersonalidadeRESUMO
BACKGROUND: Irritable bowel syndrome (IBS) is one of the most common functional gastrointestinal (GI) disorders affecting up to 11.5% of the general global population. The brain-gut axis has been shown to play an important role in the pathogenesis of IBS. Several studies confirmed that intrinsic brain abnormalities existed in patients with IBS. But, studies of abnormal regional homogeneity (ReHo) in IBS have reported inconsistent results. The objective of this protocol is to conduct a meta-analysis using the Seed-based d mapping software package to identify the most consistent and replicable findings of ReHo in IBS patients. METHOD: We will search the following three electronic databases: MEDLINE, EMBASE and Web of Science. The primary outcome will include the peak coordinates and effect sizes of differences in ReHo between patients with IBS and healthy controls from each dataset. The secondary outcomes will be the effects of age, illness severity, illness duration, and scanner field strength. The SDM approach was used to conduct voxel-wise meta-analysis. Whole-brain voxel-based jackknife sensitivity analysis was performed to conduct jackknife sensitivity analysis. A random effects model with Q statistics is used to conduct heterogeneity and publication bias between studies and meta-regression analyses were carried out to examine the effects of age, illness severity, illness duration, and scanner field strength. RESULTS: The results of this paper will be submitted to a peer-reviewed journal for publication. CONCLUSION: This research will determine the consistent pattern of alterations in ReHo in IBS patients.
Assuntos
Encéfalo/fisiopatologia , Motilidade Gastrointestinal/fisiologia , Mucosa Intestinal/fisiopatologia , Síndrome do Intestino Irritável/fisiopatologia , Imageamento por Ressonância Magnética/métodos , Encéfalo/diagnóstico por imagem , Mapeamento Encefálico/métodos , Humanos , Metanálise como Assunto , Descanso/fisiologia , Índice de Gravidade de Doença , Revisões Sistemáticas como AssuntoRESUMO
Correction to: European Review for Medical and Pharmacological Sciences 2020; 24 (19): 10086-10095-DOI: 10.26355/eurrev_202010_23228-PMID: 33090416, published online 15 October, 2020. After publication, the authors received a comment on PubPeer "The characterization of exosomes in this study is very limited. There is no characterization of ultrastructure (EM) and size. The anti-CD63 immunoblot does not have the typical smeared appearance and is therefore questionable. In addition, the text is full of errors and unscientific expressions". The authors thank the reader for pointing out these criticisms and specify that they re-performed some of the assays and then added the exosomes' ultrastructure with TEM. In addition, they replaced a more typical CD63 band. Spelling errors have also been corrected (in the method's section, 'lysate' was changed to 'lysis'). There are amendements to this paper. The Publisher apologizes for any inconvenience this may cause. https://www.europeanreview.org/article/23228.