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1.
Intern Emerg Med ; 2024 Apr 12.
Artigo em Inglês | MEDLINE | ID: mdl-38607541
2.
Nat Chem ; 2024 Apr 09.
Artigo em Inglês | MEDLINE | ID: mdl-38594366

RESUMO

Conversion of plastic wastes to valuable carbon resources without using noble metal catalysts or external hydrogen remains a challenging task. Here we report a layered self-pillared zeolite that enables the conversion of polyethylene to gasoline with a remarkable selectivity of 99% and yields of >80% in 4 h at 240 °C. The liquid product is primarily composed of branched alkanes (selectivity of 72%), affording a high research octane number of 88.0 that is comparable to commercial gasoline (86.6). In situ inelastic neutron scattering, small-angle neutron scattering, solid-state nuclear magnetic resonance, X-ray absorption spectroscopy and isotope-labelling experiments reveal that the activation of polyethylene is promoted by the open framework tri-coordinated Al sites of the zeolite, followed by ß-scission and isomerization on Brönsted acids sites, accompanied by hydride transfer over open framework tri-coordinated Al sites through a self-supplied hydrogen pathway to yield selectivity to branched alkanes. This study shows the potential of layered zeolite materials in enabling the upcycling of plastic wastes.

3.
J Wound Care ; 33(Sup2a): x-xiii, 2024 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-38324424

RESUMO

Treatment of soft tissue wounds with bone or tendon exposure remains a tough clinical challenge for surgeons. The current clinical approaches include various types of flap reconstruction and artificial dermis grafting as well as negative pressure wound therapy (NPWT), which are time-consuming and often result in graft failure or significant scarring. Concentrated growth factor (CGF) is a novel blood extract that contains many growth factors, platelets and fibrin to promote an orderly healing process. However, few reports have focused on wounds with bone or tendon exposure. We present a limited series and two specific cases of skin wound with bone or tendon exposed that received surgical debridement followed by CGF treatment. CGF appeared to facilitate wound closure effectively and also reduced scar formation. Our findings provide a novel therapeutic option for refractory wounds with bone or tendon exposure.


Assuntos
Tratamento de Ferimentos com Pressão Negativa , Lesões dos Tecidos Moles , Humanos , Transplante de Pele , Cicatrização , Lesões dos Tecidos Moles/terapia , Cicatriz/cirurgia , Tendões/cirurgia , Peptídeos e Proteínas de Sinalização Intercelular/uso terapêutico , Resultado do Tratamento
4.
Ren Fail ; 46(1): 2312533, 2024 Jan 30.
Artigo em Inglês | MEDLINE | ID: mdl-38391179

RESUMO

OBJECTIVES: Currently, there is no consensus on the optimal timing for the initiation of peritoneal dialysis (PD) after catheter placement. DESIGN: Systematic review and meta-analysis. EXACT DATE OF DATA COLLECTION: From inception till July 31, 2023. MAIN OUTCOME MEASURES: To assess the outcomes and safety of unplanned PD initiation (<14/7 days after catheter insertion) in cohort studies. RESULTS: Fifteen studies involving 3054 participants were included. (1) The risk of unplanned initiation of leakage and Obstruction was no difference in both the break-in period (BI) <14 and BI < 7 groups. (2) Catheter displacement was more likely to occur in the emergency initiation group with BI < 7. (3) No significant differences were observed between the two groups regarding infectious complications. (4) There was no difference in transition to HD between patients with BI < 7 and BI < 14 d. CONCLUSION: Infectious complications of unplanned initiation of peritoneal dialysis did not differ from planned initiation. Emergency initiation in the BI < 7 group had higher catheter displacement, but heterogeneity was higher. There were no differences in leakage or obstruction in either group. Catheter survival was the same for emergency initiation of peritoneal dialysis compared with planned initiation of peritoneal dialysis and did not increase the risk of conversion to hemodialysis. REGISTRATION: This meta-analysis was registered on PROSPERO (https://www.crd.york.ac.uk/PROSPERO/, number: CRD42023431369).


Assuntos
Falência Renal Crônica , Diálise Peritoneal , Humanos , Estudos de Coortes , Falência Renal Crônica/terapia , Prognóstico , Diálise Renal
5.
Eye (Lond) ; 38(7): 1314-1319, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38168658

RESUMO

PURPOSE: Intraocular schwannoma is a rare tumour, which is often misdiagnosed. We presented the demographics and clinical characteristics of patients with intraocular schwannoma. METHODS: Retrospective case series were collected between May 2005 and July 2021 in Beijing Tongren Hospital. RESULTS: A total of 28 patients were diagnosed with intraocular schwannoma on histopathological examination of surgical specimen. The median age was 39 years (range: 12-64). Fourteen patients were female and 14 were male. Among the all subjects, 21/28 patients (75.0%) presented as visual loss, and 3/28 patients (10.7%) had visual field loss. Intraocular schwannoma presented as nonpigmented mass in the ciliary body in 12/28 cases (42.9%), in the choroid in 9/28 cases (32.1%), and in ciliochoroid in 7/28 cases (25.0%). Intraocular schwannoma was often clinically misdiagnosed as uveal melanoma, which occurred in 16/28 patients (57.1%). Tumour excision with pars plana vitrectomy was performed for all included patients. Endoresection with lens removal was performed for tumours in the choroid, while transscleral resection was performed for tumours located in ciliary body or ciliochoroid. Increased light transmission was detected in 12/28 cases (42.9%). In the consecutive follow-up (median: 73 months, range: 7-193 months), no cases of recurrence or metastatic disease were detected. CONCLUSIONS: Intraocular schwannoma is a rare benign tumour. It usually presents as nonpigmented mass, which can easily be misdiagnosed as nonpigmented uveal melanoma.


Assuntos
Neurilemoma , Humanos , Neurilemoma/diagnóstico , Neurilemoma/patologia , Neurilemoma/cirurgia , Pessoa de Meia-Idade , Adulto , Masculino , Feminino , Estudos Retrospectivos , Adolescente , Criança , Adulto Jovem , Acuidade Visual/fisiologia , Neoplasias Oculares/diagnóstico , Neoplasias Oculares/cirurgia , Neoplasias Oculares/patologia , Corpo Ciliar/patologia , Corpo Ciliar/cirurgia , Neoplasias Uveais/diagnóstico , Neoplasias Uveais/patologia , Neoplasias Uveais/cirurgia , Vitrectomia , Neoplasias da Coroide/diagnóstico , Neoplasias da Coroide/patologia , Neoplasias da Coroide/cirurgia
6.
Int J Clin Pract ; 2024: 1232211, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38229934

RESUMO

Background: Volume overload is a fatal complication for people undergoing hemodialysis. Therefore, regulating a patient's "dry weight" based on their fluid status is imperative. Clinical experiences are too subjective to accurately judge a patient's fluid status, but techniques have emerged for improved fluid control in the two decades. Specifically, lung ultrasonography (LUS) uses a unique aspect of ultrasound images, the B-lines, to evaluate extravascular lung water, which has increasingly attracted attention. However, the role of B-line quantification in predicting short-mid-term death and/or cardiovascular complications is unclear. Methods: Patients undergoing MHD at the hemodialysis center of Zhejiang Provincial People's Hospital from October 1, 2020, to February 28, 2021, were examined using LUS and a bioelectrical impedance analysis before and after dialysis, and related clinical data were collected. All patients were followed up for one year after the examination, and deaths and first cardiovascular events (e.g., stroke, myocardial infarction, and heart failure) during this period were recorded. Results: 98 patients were enrolled and divided into three groups in relation to their mild (<16 B-lines), moderate (16-30 B-lines), or severe (>30 B-lines) hypervolemia, defined by the number of B-lines. The long-term survival rate was significantly lower in the severe group than in the mild and moderate groups. LUS and bioelectrical impedance-related parameters (e.g., extracellular water-to-water ratio) were closely related to cardiac ultrasound parameters (left ventricular ejection fraction) (P < 0.001). The optimal B-line cutoff value on LUS for predicting fluid overload (defined clinically) in patients on hemodialysis was 11.5 lines (AUC = 0.840, 95% confidence interval 0.735-0.945, P < 0.001), and the diagnostic sensitivity and specificity were both 76.5%. During the one-year follow-up period, ten deaths and six cardiovascular events occurred. The survival rate was significantly lower in the severe group than in the mild group (log-rank test χ2 = 10.050, P=0.002) but did not differ between the severe and moderate groups (χ2 = 2.629, P=0.105). Conclusion: LUS is a cheap, noninvasive, simple, and repeatable volume-monitoring method that can assist with individualized fluid volume management in patients undergoing MHD. LUS results may also help to predict the short-mid-term survival rate of patients to a certain extent.


Assuntos
Insuficiência Cardíaca , Função Ventricular Esquerda , Humanos , Volume Sistólico , Impedância Elétrica , Pulmão/diagnóstico por imagem , Ultrassonografia , Diálise Renal/efeitos adversos
7.
Exp Eye Res ; 238: 109715, 2024 01.
Artigo em Inglês | MEDLINE | ID: mdl-37951338

RESUMO

This study aimed to examine the intraocular tolerability of the epidermal growth factor receptor antibody cetuximab, when applied intravitreally, and its effect on axial elongation. Guinea pigs aged 2-3 weeks were subjected to bilateral plano glasses and bilateral lens-induced myopization (LIM) as a single procedure for group I (n = 8) and group II (n = 8), respectively. In the animals of group III (n = 8), group IV (n = 8), and group V (n = 8), the right eyes of the animals, in addition to LIM, received four weekly intravitreal injections of cetuximab (Erbitux®) in doses of 6.25 µg, 12.5 µg, and 25 µg, respectively. As controls, the left eyes, in addition to LIM, received corresponding intraocular injections of phosphate-buffered saline. The animals underwent regular ophthalmoscopic examinations and biometry for axial length measurements. With increasing doses of cetuximab, the inter-eye difference in axial elongation (at study end, left eyes minus right eyes) were significantly the smallest in group I (0.00 ± 0.02 mm) and group II (-0.01 ± 0.02 mm), they were larger in group III (0.04 ± 0.04 mm) and group IV (0.10 ± 0.03 mm), and they were the largest in group V (0.11 ± 0.01 mm). The inter-eye difference in axial elongation enlarged (P < 0.001) with the number of injections applied. Retinal thickness at the posterior pole (right eyes) was significantly thicker in group V than in group II (P < 0.01). The density of apoptotic cells (visualized by TUNEL-staining) did not vary significantly between any of the groups (all P > 0.05). The results suggest that intravitreal injections of cetuximab in young guinea pigs with LIM resulted in a reduction in axial elongation in a dose-dependent and number of treatment-dependent manner. Intraocular toxic effects, such as intraocular inflammation, retinal thinning, or an increased density of apoptotic cells in the retina, were not observed in association with the intravitreally applied cetuximab.


Assuntos
Cristalino , Miopia , Cobaias , Animais , Miopia/metabolismo , Cetuximab/toxicidade , Cetuximab/metabolismo , Retina/metabolismo , Cristalino/metabolismo , Injeções Intraoculares , Modelos Animais de Doenças
8.
Am J Nephrol ; 55(1): 1-17, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-37793348

RESUMO

BACKGROUND: Mineralocorticoid receptor blockade could be a potential approach for the inhibition of chronic kidney disease (CKD) progression. The benefits and harms of different mineralocorticoid receptor antagonists (MRAs) in CKD are inconsistent. OBJECTIVES: The aim of the study was to summarize the benefits and harms of MRAs for CKD patients. METHODS: We searched MEDLINE, EMBASE, and the Cochrane databases for trials assessing the effects of MRAs on non-dialysis-dependent CKD populations. Treatment and adverse effects were summarized using meta-analysis. RESULTS: Fifty-three trials with 6 different MRAs involving 22,792 participants were included. Compared with the control group, MRAs reduced urinary albumin-to-creatinine ratio (weighted mean difference [WMD], -90.90 mg/g, 95% CI, -140.17 to -41.64 mg/g), 24-h urinary protein excretion (WMD, -0.20 g, 95% CI, -0.28 to -0.12 g), estimated glomerular filtration rate (eGFR) (WMD, -1.99 mL/min/1.73 m2, 95% CI, -3.28 to -0.70 mL/min/1.73 m2), chronic renal failure events (RR, 0.86, 95% CI, 0.79-0.93), and cardiovascular events (RR, 0.84, 95% CI, 0.77-0.92). MRAs increased the incidence of hyperkalemia (RR, 2.04, 95% CI, 1.73-2.40) and hypotension (RR, 1.80, 95% CI, 1.41-2.31). MRAs reduced the incidence of peripheral edema (RR, 0.65, 95% CI, 0.56-0.75) but not the risk of acute kidney injury (RR, 0.94, 95% CI, 0.79-1.13). Nonsteroidal MRAs (RR, 0.66, 95% CI, 0.57-0.75) but not steroidal MRAs (RR, 0.20, 95% CI, 0.02-1.68) significantly reduced the risk of peripheral edema. Steroidal MRAs (RR, 5.68, 95% CI, 1.26-25.67) but not nonsteroidal MRAs (RR, 0.52, 95% CI, 0.22-1.22) increased the risk of breast disorders. CONCLUSIONS: In the CKD patients, MRAs, particularly in combination with angiotensin-converting enzyme inhibitor/angiotensin receptor blocker, reduced albuminuria/proteinuria, eGFR, and the incidence of chronic renal failure, cardiovascular and peripheral edema events, whereas increasing the incidence of hyperkalemia and hypotension, without the augment of acute kidney injury events. Nonsteroidal MRAs were superior in the reduction of more albuminuria with fewer peripheral edema events and without the augment of breast disorder events.


Assuntos
Injúria Renal Aguda , Hiperpotassemia , Hipotensão , Falência Renal Crônica , Insuficiência Renal Crônica , Humanos , Antagonistas de Receptores de Mineralocorticoides/efeitos adversos , Hiperpotassemia/induzido quimicamente , Hiperpotassemia/epidemiologia , Albuminúria/induzido quimicamente , Insuficiência Renal Crônica/complicações , Insuficiência Renal Crônica/tratamento farmacológico , Insuficiência Renal Crônica/induzido quimicamente , Injúria Renal Aguda/induzido quimicamente , Injúria Renal Aguda/epidemiologia , Edema
9.
Clin Case Rep ; 11(12): e8272, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38046807

RESUMO

Management of large jaw cyst is challenging since high risks including pathologic fracture, limited opening, and insufficient bone healing occur after enucleation. The current case of concentrated growth factor (CGF) gel to fill defect after enucleation of large jaw cyst is rare. A 12-year-old boy with pain and swelling for 4 months in the left mandible region made a medical consultation at our hospital. Computerized tomography scan indicated that cystic lesion was found in the left mandible region. In this case, we present a patient with large jaw cyst (31 mm × 44 mm × 53 mm) who received enucleation followed by CGF gel filling the defect. The patient was discharged after 13 days without discomfort symptoms. The lesion size was reduced significantly at 1-month re-examination. No abnormality was detected in maxillofacial region at 1-year re-examination. Application of CGF gel is one of the possible options for filling defect after jaw cyst enucleation.

10.
Front Pharmacol ; 14: 1292745, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38034989

RESUMO

Background: Aspirin, with its pleiotropic effects such as anti-inflammatory and anti-platelet aggregation, has been widely used for anti-inflammatory, analgesic, and cardiovascular diseases. However, the association between the use of aspirin before the intensive care unit (ICU) and clinical outcomes in critically ill patients with acute kidney injury (AKI) is unknown. Methods: Patients with AKI in this retrospective observational study were selected from the Marketplace for Medical Information in Intensive Care IV (MIMIC-IV). The association between aspirin intervention and 30-day mortality was assessed using Cox proportional hazards model. Logistic regression models were used to assess the association of aspirin intervention with the risks of intracranial hemorrhage, gastrointestinal bleeding and blood transfusion. The propensity score matching (PSM) method was adopted to balance the baseline variables. Sensitivity analysis was performed to validate the results by multiple interpolations for the missing data. Results: The study included 4237 pre-ICU aspirin users and 9745 non-users. In multivariate models, we found a decreased risk of mortality in those who received aspirin before ICU compared to those who did not (30-day:hazard ratio [HR], 0.70; 95% CI, 0.62-0.79; p < 0.001; 90-day:HR, 0.70; 95% CI, 0.63-0.77, p < 0.001; 180-day:HR, 0.72; 95%CI,0.65-0.79, p < 0.001). This benefit was consistent in the post-PSM analyses, sensitivity analyses, and subgroup analyses. Moreover, aspirin intervention was associated with a reduced risk of intracranial hemorrhage and gastrointestinal bleeding (HR, 0.16; 95% CI, 0.10-0.25; p < 0.001; HR, 0.59; 95% CI, 0.38-0.88, p = 0.012) after being adjusted by relating covariates, whereas with a increased risk of blood transfusion (HR, 1.28; 95% CI, 1.16-1.46; p < 0.001). Conclusion: Patients with AKI treated with aspirin before ICU admission might have reduced 30-day, 90-day and 180-day mortality without increasing the risk of intracranial hemorrhage (ICH) or gastrointestinal bleeding, but may increase the risk of transfusion.

11.
Curr Protoc ; 3(11): e917, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37929691

RESUMO

Three-dimensional cell encapsulation has rendered itself a staple in the tissue engineering field. Using recombinantly engineered, biopolymer-based hydrogels to encapsulate cells is especially promising due to the enhanced control and tunability it affords. Here, we describe in detail the synthesis of our hyaluronan (i.e., hyaluronic acid) and elastin-like protein (HELP) hydrogel system. In addition to validating the efficacy of our synthetic process, we also demonstrate the modularity of the HELP system. Finally, we show that cells can be encapsulated within HELP gels over a range of stiffnesses, exhibit strong viability, and respond to stiffness cues. © 2023 Wiley Periodicals LLC. Basic Protocol 1: Elastin-like protein modification with hydrazine Basic Protocol 2: Nuclear magnetic resonance quantification of elastin-like protein modification with hydrazine Basic Protocol 3: Hyaluronic acid-benzaldehyde synthesis Basic Protocol 4: Nuclear magnetic resonance quantification of hyaluronic acid-benzaldehyde Basic Protocol 5: 3D cell encapsulation in hyaluronan elastin-like protein gels.


Assuntos
Ácido Hialurônico , Hidrogéis , Elastina , Encapsulamento de Células , Benzaldeídos , Hidrazinas
12.
Medicine (Baltimore) ; 102(42): e35772, 2023 Oct 20.
Artigo em Inglês | MEDLINE | ID: mdl-37861479

RESUMO

To investigate the distribution characteristics of pathogens in different stages of pressure ulcers and observe the application of linear polarized polychromatic light (LPPL) combined with silver sulfadiazine cream in treating varying stages of pressure ulcers. This study comprised 88 patients with pressure ulcers who were enrolled in the department of burn and plastic surgery of our hospital from April 2019 to April 2022. The wound exudates from patients were collected, followed by analyzing the distribution of pathogens in different stages of pressure ulcers. Patients were randomly divided into 2 groups. The first group (n = 44) received LPPL combined with silver sulfadiazine. The other group was intervened with LPPL group only for 2 weeks. The clinical efficacy, condition, and pain in the 2 groups, as well as the healing timeframes for patients were measured at different stages. The findings showed that among 88 patients with pressure ulcers, 62 were infected, and the infection rate was 70.45%. The pathogens that were observed in stage II and III to IV pressure ulcers were mainly Gram-negative bacteria. The total effective rate in the combined group was 90.91%, which was much higher than that of LPPL group (70.45%). Compared with LPPL group, the pressure ulcer scale for healing and visual analogue scale scores in the combined group were markedly lower (P < .05). It is important to note that in LPPL group, the healing time of patients in stage II and stage III to IV in the combined arm were 9.76 ±â€…2.38 days and 13.19 ±â€…2.54 days, respectively. The corresponding time in the LPPL group was prolonged to 13.20 ±â€…3.76 and 18.82 ±â€…4.17 days, respectively. The main pathogens associated with wound infection in patients with pressure ulcers are Gram-negative bacteria. The curative effects of LPPL combined with sulfadiazine silver cream on patients with pressure ulcer is obviously improved, and the recovery and pain relief are faster while the healing time of pressure ulcer is shorter.


Assuntos
Queimaduras , Úlcera por Pressão , Humanos , Sulfadiazina de Prata/uso terapêutico , Sulfadiazina de Prata/farmacologia , Úlcera por Pressão/tratamento farmacológico , Cicatrização , Queimaduras/tratamento farmacológico , Dor/tratamento farmacológico
13.
Neuromolecular Med ; 25(4): 616-631, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37796401

RESUMO

Anxiety manifestations and cognitive dysfunction are common sequelae in patients with sepsis-associated encephalopathy (SAE). Microglia-mediated inflammatory signaling is involved in anxiety, depression, and cognitive dysfunction during acute infection with bacterial lipopolysaccharide (LPS). However, the molecular mechanisms underlying microglia activation and behavioral and cognitive deficits in sepsis have not been in fully elucidated. Based on previous research, we speculated that the CD137 receptor/ligand system modulates microglia function during sepsis to mediate classical neurological SAE symptoms. A murine model of SAE was established by injecting male C57BL/6 mice with LPS, and cultured mouse BV2 microglia were used for in vitro assays. RT-qPCR, immunofluorescence staining, flow cytometry, and ELISA were used to assess microglial activation and the expression of CD137L and inflammation-related cytokines in the mouse hippocampus and in cultured BV2 cells. In addition, behavioral tests were conducted in assess cognitive performance and behavioral distress. Immunofluorescence and RT-qPCR analyses showed that hippocampal expression of CD137L was upregulated in activated microglia following LPS treatment. Pre-treatment with the CD137L neutralizing antibody TKS-1 significantly reduced CD137L levels, attenuated the expression of M1 polarization markers in microglia, and inhibited the production of TNF-α, IL-1ß, and IL-6 in both LPS-treated mice and BV2 cells. Conversely, stimulation of CD137L signaling by recombinant CD137-Fc fusion protein activated the synthesis and release of pro-inflammatory cytokines in cultures BV2 microglia. Importantly, open field, elevated plus maze, and Y-maze spontaneous alternation test results indicated that TKS-1 administration alleviated anxiety-like behavior and spatial memory decline in mice with LPS-induced SAE. These findings suggest that CD137L upregulation in activated microglia critically contributes to neuroinflammation, anxiety-like behavior, and cognitive dysfunction in the mouse model of LPS-induced sepsis. Therefore, therapeutic modulation of the CD137L/CD137 signaling pathway may represent an effective way to minimize brain damage and prevent cognitive and emotional deficits associated with SAE.


Assuntos
Ligante 4-1BB , Encefalopatia Associada a Sepse , Sepse , Animais , Humanos , Masculino , Camundongos , Citocinas/metabolismo , Modelos Animais de Doenças , Hipocampo , Lipopolissacarídeos/toxicidade , Camundongos Endogâmicos C57BL , Microglia , Doenças Neuroinflamatórias , Sepse/complicações , Sepse/tratamento farmacológico , Sepse/metabolismo , Encefalopatia Associada a Sepse/tratamento farmacológico , Encefalopatia Associada a Sepse/metabolismo , Ligante 4-1BB/efeitos dos fármacos , Ligante 4-1BB/metabolismo , Anticorpos Monoclonais/farmacologia , Anticorpos Monoclonais/uso terapêutico
14.
Sci Rep ; 13(1): 15838, 2023 09 22.
Artigo em Inglês | MEDLINE | ID: mdl-37739989

RESUMO

Chronic kidney disease (CKD) is a prevalent pathological condition worldwide. Parathyroid hormone (PTH) is an important index related to bone metabolism in CKD patients and has not received enough attention. This study was performed to investigate the incidence and diagnostic rate of CKDin hospital as well as PTH testing and treatment for secondary hyperparathyroidism (SHPT) in patients with stage 3 to 5 CKD. The data of patients who visited Zhejiang Provincial People's Hospital from February 2006 to April 2022 were retrieved from the hospital database. All data were divided into three subgroups using PTH testing and SHPT treatment as major comparative indicators for analysis. The data were then analyzed for overall PTH testing, CKD incidence, and diagnostic rate. Among 5,301,391 patients, the incidence of CKD was 13.14%. The missed diagnosis rate for CKD was 65.76%. The total PTH testing rate was 1.22%, of which 15.37% of PTH testing was performed in patients with stage 3 to 5 CKD. The overall diagnosis rate of SHPT in patients with stage 3 to 5 CKD was 31.0%. The prophylactic medication rate was 7.4%, and the rate of post-diagnostic drug therapy was 22.2% in patients who underwent SHPT treatment. The high misdiagnosis rate and low PTH testing rate of CKD requires prompt attention from clinicians. SHPT treatment should be considered especially in patients with stage 3 to 5 CKD.


Assuntos
Hiperparatireoidismo Secundário , Hipoparatireoidismo , Insuficiência Renal Crônica , Humanos , Hormônio Paratireóideo , Diagnóstico Ausente , Bases de Dados Factuais , Hiperparatireoidismo Secundário/diagnóstico , Hiperparatireoidismo Secundário/epidemiologia , Insuficiência Renal Crônica/diagnóstico , Insuficiência Renal Crônica/epidemiologia
15.
Nat Commun ; 14(1): 4346, 2023 07 19.
Artigo em Inglês | MEDLINE | ID: mdl-37468483

RESUMO

The biofabrication of three-dimensional (3D) tissues that recapitulate organ-specific architecture and function would benefit from temporal and spatial control of cell-cell interactions. Bioprinting, while potentially capable of achieving such control, is poorly suited to organoids with conserved cytoarchitectures that are susceptible to plastic deformation. Here, we develop a platform, termed Spatially Patterned Organoid Transfer (SPOT), consisting of an iron-oxide nanoparticle laden hydrogel and magnetized 3D printer to enable the controlled lifting, transport, and deposition of organoids. We identify cellulose nanofibers as both an ideal biomaterial for encasing organoids with magnetic nanoparticles and a shear-thinning, self-healing support hydrogel for maintaining the spatial positioning of organoids to facilitate the generation of assembloids. We leverage SPOT to create precisely arranged assembloids composed of human pluripotent stem cell-derived neural organoids and patient-derived glioma organoids. In doing so, we demonstrate the potential for the SPOT platform to construct assembloids which recapitulate key developmental processes and disease etiologies.


Assuntos
Bioimpressão , Células-Tronco Pluripotentes , Humanos , Organoides , Bioimpressão/métodos , Hidrogéis , Materiais Biocompatíveis
16.
Ren Fail ; 45(1): 2230322, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37466047

RESUMO

OBJECTIVE: Antibiotic treatments are known to disturb gut microbiota, but their effects on the mucosal barrier and extraintestinal diseases are rarely discussed. The aim of this study was to evaluate and visualize the impact of antibiotics on colonic mucus and the microbial community, and to assess whether intestinal dysbacteriosis is involved in the pathogenesis and progression of extraintestinal diseases in vivo. MATERIALS AND METHODS: Twenty-one SD rats were randomly assigned into three groups followed by different experimental treatments. The albumin-creatinine ratio, urinary protein and occult blood semi-quantified test were tested. Fecal samples were collected at different time points (0,4, and 12 weeks) for 16S rRNA gene sequencing. Colon and kidney specimens were examined using light microscopy and transmission electron microscopy (TEM) to identify morphological changes. RESULTS: Ceftriaxone intervention for one week did not cause any symptoms of diarrhea or weight loss, but the alpha and beta diversities of gut microbiota decreased quickly and significantly, a lower Firmicutes/Bacteroidetes (F/B) ratio was observed. At week 12, although the alpha and beta diversities increased to a level similar to that of the control (CON) group, LEfSe analysis indicated that the microbial community composition still differed significantly in each group. In addition, KEGG metabolic prediction revealed different metabolic functions in each group. TEM examination of colon revealed that dramatic morphological changes were observed in the ceftriaxone (Cef) group, wherein microvilli were misaligned and shortened significantly and morphologically intact bacteria were seen on the epithelial cell surface. TEM examination of kidneys from the Cef group showed characteristic glomerular changes in the form of widely irregularly thickened glomerular basement membrane (GBM) and foot process fusion or effacement; mild thickening of the GBM and foot process fusion was detected when ceftriaxone and Resatorvid (TAK242, an inhibitor of TLR4 signaling) are used together in the ceftriaxone + TAK242 (TAK) group. CONCLUSIONS: Short-term use of ceftriaxone induced dynamic changes of gut microbiota and lead to intestinal barrier disruption and ultrastructural changes of kidneys in the SD rats. Moreover, interference with the TLR4-dependent signaling pathway can alleviate the damage to the intestinal barrier and kidney.


Assuntos
Ceftriaxona , Nefropatias , Ratos , Animais , Ceftriaxona/farmacologia , Ceftriaxona/metabolismo , Mucosa Intestinal/metabolismo , Mucosa Intestinal/patologia , RNA Ribossômico 16S/genética , Receptor 4 Toll-Like/metabolismo , Ratos Sprague-Dawley , Antibacterianos/efeitos adversos , Nefropatias/patologia , Rim
17.
Invest Ophthalmol Vis Sci ; 64(10): 24, 2023 07 03.
Artigo em Inglês | MEDLINE | ID: mdl-37466949

RESUMO

Purpose: The mechanism underlying axial elongation during myopia progression remains unknown. Epidermal growth factor receptor (EGFR) signaling is associated with axial elongation. We explored whether mammalian target of rapamycin complex 1 (mTORC1) signaling acts as the downstream pathway of EGFR and participates in negative lens-induced axial elongation (NLIAE). Methods: Three-week-old male pigmented guinea pigs underwent binocular NLIAE. (1) To investigate whether EGFR is the upstream regulator of mTORC1, an EGFR inhibitor (20 µg erlotinib) was intravitreally injected once a week for three weeks. (2) To assess the effect of mTORC1 inhibition on NLIAE, an mTORC1 inhibitor (2 µg, 10 µg, and 20 µg everolimus) was intravitreally injected once a week for three weeks. (3) To explore the long-term effect of mTORC1 overactivation on axial elongation, an mTORC1 agonist (4 µg MHY1485) was intravitreally injected once a week for three months. Biometric measurements included axial length and choroidal thickness were performed. Results: Compared with the guinea pigs without NLIAE, NLIAE was associated with activation of mTORC1 signaling, which was suppressed by intravitreal erlotinib injection. Intravitreally injected everolimus suppressed NLIAE-induced axial elongation, mTORC1 activation, choroidal thinning, and hypoxia-inducible factor-1α expression in the sclera. Immunofluorescence revealed that the retinal pigment epithelium was the primary location of mTORC1 activation during NLIAE. Combining NLIAE and MHY1485 intravitreal injections significantly promoted axial elongation, choroidal thinning, and peripapillary choroidal atrophy. Conclusions: The mTORC1 signaling is associated with increased axial elongation, as in NLIAE, raising the possibility of inhibiting mTORC1 as a novel treatment for slowing myopia progression.


Assuntos
Everolimo , Miopia , Masculino , Animais , Cobaias , Cloridrato de Erlotinib/uso terapêutico , Everolimo/farmacologia , Everolimo/uso terapêutico , Miopia/tratamento farmacológico , Injeções Intravítreas , Receptores ErbB , Mamíferos
19.
Ren Fail ; 45(1): 2203247, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37133857

RESUMO

Managing patient 'dry weight' according to clinical standards has deficiencies. Research has focused on the effectiveness of using bioelectrical impedance technology for fluid management in dialysis patients. Whether bioelectrical impedance monitoring can improve dialysis patients prognoses remain controversial. We performed a meta-analysis of randomized controlled trials to determine whether bioelectrical impedance was effective in improving dialysis patients prognoses. The primary outcome was all-cause mortality (13.6 ± 9.1 months). Secondary outcomes were left ventricular mass index (LVMI), arterial stiffness assessed using Pulse Wave Velocity (PWV), and N-terminal brain natriuretic peptide precursor (NT-proBNP). Of 4,641 citations retrieved, we identified 15 eligible trials involving 2763 patients divided into experimental (n = 1386) and control (n = 1377) groups. In 14 studies with mortality data, the meta-analysis showed that bioelectrical impedance intervention reduced the risk of all-cause mortality (rate ratios [RR]: 0.71; 95% confidence interval [CI]: 0.51, 0.99; p = .05; I2 = 1%). Subgroup analysis of patients on hemodialysis (RR: 0.72; 95% CI: 0.42, 1.22; p = .22) and peritoneal dialysis (RR: 0.62; 95% CI: 0.35, 1.07; p = .08) showed no significant mortality difference between intervention and control groups. It reduced the risk of all-cause mortality in the Asian population (RR: 0.52; p = .02), and reduced NT-proBNP (mean difference [MD]: -1495.73; p = 0.002; I2=0%) and PWV (MD: -1.55; p = .01; I2=89%). Bioelectrical impedance intervention reduced the LVMI in hemodialysis patients (MD: -12.69; p < .0001; I2=0%). Our analysis shows that in dialysis patients, bioelectrical impedance technology intervention could reduce, but not eliminate, the risk of all-cause mortality. Overall, this technology can improve the prognosis of dialysis patients.


Assuntos
Análise de Onda de Pulso , Diálise Renal , Humanos , Impedância Elétrica , Ensaios Clínicos Controlados Aleatórios como Assunto , Prognóstico
20.
Phys Chem Chem Phys ; 25(17): 12220-12230, 2023 May 03.
Artigo em Inglês | MEDLINE | ID: mdl-37073883

RESUMO

The catalytic performance of titanosilicates involving hydrogen peroxide (H2O2) as the oxidant is strongly influenced by the solvents. Until now, there is still a lack of a universal principle that can guide the choice of a solvent. Herein, the kinetics of H2O2 activation catalyzed by various titanosilicates in different solvents is investigated, and an isokinetic compensation effect is concluded. This indicates that the solvent participates in the H2O2 activation process for the formation of a Ti-OOH species. Additionally, the results of isotopically labeled infrared spectra preliminarily confirm that the solvent acts as the mediator to promote the proton transfer during the H2O2 activation process. The catalytic activities of a series of TS-1 catalysts toward 1-hexene epoxidation are compared, which include Ti(OSi)3OH species with a range of densities but a constant total Ti content. This reveals that the solvent effect is closely related to the Ti active sites of these TS-1 catalysts. Based on these results, a principle for the rational choice of solvent for this catalytic process is proposed. ROH is found to be the mediator for Ti(OSi)4 sites, and methanol, which has a strong proton-donating ability, is the best solvent for these sites. However, for the Ti(OSi)3OH sites, water (H2O) is the mediator, and a weaker hydrogen bonding between H2O molecules promotes proton transfer more effectively. The solvent influences the catalytic performance by perturbing the hydrogen bonds between the H2O molecules, and aprotic acetonitrile, which has a strong ability to break the hydrogen bonding network between H2O molecules, is the best solvent for Ti(OSi)3OH sites. This study provides experimental evidence that the solvent promotes the catalytic performance of titanosilicates by assisting the proton transfer during the catalytic H2O2 activation process, which will pave the way toward the rational choice of solvent for the titanosilicate-catalyzed oxidation systems.

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