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1.
Oncol Rep ; 49(3)2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-36799194

RESUMO

Subsequently to the publication of the above article, an interested reader drew to the authors' attention that, concerning the cell proliferation and migration assay data shown in Figs. 6D and 7B, there were a pair of panels showing overlapping data, such that the same data had apparently been selected to show the results from different experiments. Subsequently, the authors referred back to their original data, and identified further incorrectly assembled data panels in Figs. 3B and 7B. The corrected versions of Fig. 3B (showing the correct data for the 'AC245100.4 / PC3 / 0 h' scratch­wound assay data panel), Fig. 6D (showing the correct data for the 'PC3 / NC­mimic' and 'DU­145 / NC­inhibitor' data panels) and Fig. 7D (showing the correct data for the 'PC3 / 24 h / Inhibitor­miR­145­5p + siAC245100.4' data panel) are shown on the subsequent pages. The authors regret the errors that were made during the preparation of the published figures, and confirm that these errors did not grossly affect the conclusions reported in the study. The authors are grateful to the Editor of Oncology Reports for allowing them the opportunity to publish a Corrigendum, and all the authors agree to this Corrigendum. Furthermore, they apologize to the readership for any inconvenience caused. [Oncology Reports 45: 619­629, 2021; DOI: 10.3892/or.2020.7894].

2.
Int J Hyperthermia ; 40(1): 2154577, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36535924

RESUMO

OBJECTIVE: To compare the survival benefits of thermal ablation (TA) and radiotherapy in inoperable patients with stage III non-small cell lung cancer (NSCLC). METHOD: A retrospective analysis was conducted using the data from the Surveillance, Epidemiology, and End Results (SEER) program. Propensity score matching (PSM) was conducted to balance potential baseline confounding factors. Survival analyses were conducted using Kaplan-Meier and Cox regression methods. RESULTS: The present study included 33,393 inoperable patients with stage III NSCLC, including 106 patients treated with TA and 33,287 patients treated with radiotherapy. No statistical difference in overall survival (OS) (p = .065) or cancer-specific survival (CSS) (p = .996) was found between the patients treated with TA and those treated with radiotherapy. Using 1:3 matching, a matched cohort of 420 patients (105 patients treated with TA, 315 patients treated with radiotherapy) was identified. The differences in OS (p = .177) and CSS (p = .605) were still not significant between the radiotherapy and TA groups after PSM. According to subgroup analyses, TA showed comparable survival benefits in almost all subgroups compared to radiotherapy. CONCLUSION: For inoperable stage III NSCLC, the survival benefit of TA was comparable to radiotherapy. TA may be a potential therapeutic modality for inoperable stage III NSCLC.


Assuntos
Carcinoma Pulmonar de Células não Pequenas , Neoplasias Pulmonares , Humanos , Carcinoma Pulmonar de Células não Pequenas/cirurgia , Neoplasias Pulmonares/cirurgia , Estudos Retrospectivos , Pontuação de Propensão , Resultado do Tratamento
3.
Front Oncol ; 12: 984932, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36081544

RESUMO

Background: Thermal ablation (TA) is considered a safe alternative to surgical resection for the treatment of non-small cell lung cancer (NSCLC). While previous studies have shown that TA is beneficial for stage I NSCLC patients, however, few have reported on TA efficacy in patients with stage II-III NSCLC. The current study investigated the impact of TA on the overall survival (OS) and cancer-specific survival (CSS) of patients with stage II-III NSCLC. Methods: Data on patients with stage II-III NSCLC who did not undergo surgical resection between 2004 and 2015 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Propensity score matching (PSM), Kaplan-Meier survival curves, and Cox regression were used for statistical analyses. Results: A total of 57,959 stage II-III NSCLC patients who did not undergo surgical resection were included in this study, 261 of whom received TA. Overall, TA was associated with a longer OS (p = 0.035) and CSS (p = 0.005) than non-ablation. After 1:3 PSM, 252 patients receiving TA and 732 patients not receiving ablation were enrolled in the matched cohort. The OS (p = 0.047) and CSS (p = 0.029) remained higher in the TA group than in the non-ablation group after PSM. Cox regression analysis showed that age, sex, primary tumor site, pathological type, tumor size, radiotherapy, chemotherapy, and thermal ablation were independently associated with OS and CSS (p <0.05). Subgroup analysis found that the advantages of TA were more pronounced among individuals ≥70 years of age, with tumor size ≤3.0 cm, or who did not receive radiotherapy. Conclusion: TA could be an effective alternative treatment for stage II-III NSCLC patients unsuitable for surgical resection, particularly those ≥70 years of age, with tumor size ≤3.0 cm, or who have not received radiotherapy.

4.
Oncol Rep ; 45(2): 619-629, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33416179

RESUMO

Long non­coding RNAs (lncRNAs) are markedly involved in cancer progression. Thus, identification of these lncRNAs can aid in the treatment of cancer. The present study focused on investigating the overall biological function, mechanism of action and clinical importance of lncRNA AC245100.4 in prostate cancer (PCa). The present study identified that AC245100.4 expression was significantly upregulated in PCa tissues and cell lines. Knockdown of AC245100.4 impaired tumor growth in an animal model. Biological function analysis indicated that AC245100.4 overexpression notably promoted cell proliferation and migration, while knockdown of AC245100.4 suppressed cell proliferation and migration. Mechanism studies focused on the competing endogenous RNA (ceRNA) network of AC245100.4. Bioinformatics predictions indicated that both AC245100.4 and retinoblastoma binding protein 5 (RBBP5) had microRNA (miR) response elements for miR­145­5p. This was further verified using a dual luciferase and RNA immunoprecipitation assays. AC245100.4 could positively regulate RBBP5 expression, but negatively regulated miR­145­5p expression. In addition, AC245100.4 knockdown­mediated inhibitory effects on cell proliferation and migration could be reversed by miR­145­5p silencing. Overall, the present study proposed a novel model in which the AC245100.4/miR­145­5p/RBBP5 ceRNA network induced the development of PCa, providing novel insights for PCa treatment.


Assuntos
Proteínas de Ligação a DNA/genética , Regulação Neoplásica da Expressão Gênica , MicroRNAs/metabolismo , Neoplasias da Próstata/genética , RNA Longo não Codificante/metabolismo , Animais , Carcinogênese/genética , Linhagem Celular Tumoral , Movimento Celular/genética , Proliferação de Células/genética , Biologia Computacional , Técnicas de Silenciamento de Genes , Humanos , Masculino , Camundongos , Neoplasias da Próstata/patologia , RNA Longo não Codificante/genética , Regulação para Cima , Ensaios Antitumorais Modelo de Xenoenxerto
5.
Int J Biol Macromol ; 164: 2134-2140, 2020 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-32755704

RESUMO

The intestinal epithelium is known as an important barrier to protect the body from harmful pathogens or toxic substance that may induce intestinal barrier injury. The aim of this study was to investigate the effects of polysaccharide from the seeds of Plantago asiatica L. (PLP) on nonylphenol (NP) induced intestinal barrier injury in vitro. Caco-2 cells were pretreated with PLP, or co-cultured with PLP and NP simultaneously, and cytotoxicity, LDH leakage, transepithelial electrical resistance (TEER), FITC-dextran flux and tight junction (TJ) proteins were conducted to evaluate the intestinal barrier function. The results suggested that PLP pretreatment or co-culture with NP could significantly attenuated NP induced Caco-2 cytotoxicity, suppressed LDH release, restored the TEER value and paracellular permeability of Caco-2 monolayers, which were attributed to enhancing the TJ protein expressions. In addition, PLP co-cultured with NP possessed better protective effects against NP induced cytotoxicity. This study indicated that PLP assuaged NP induced intestinal barrier injury by increasing TJ, and threw light on the development of a dietary supplementation for preventing exogenous toxic substances induced intestinal barrier injury or improving intestinal TJ barrier function.


Assuntos
Mucosa Intestinal/efeitos dos fármacos , Fenóis/farmacologia , Plantago/química , Polissacarídeos/farmacologia , Sementes/química , Junções Íntimas/efeitos dos fármacos , Células CACO-2 , Linhagem Celular Tumoral , Permeabilidade da Membrana Celular/efeitos dos fármacos , Técnicas de Cocultura/métodos , Humanos
6.
Iran J Pharm Res ; 19(3): 520-532, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33680049

RESUMO

There is a strong need to develop MRI contrast agents (CAs) with lower in-vivo retention, stronger signal enhancement, and more specific imaging. Here, we report a novel dextran (DEX)-based nanomicelle system as an MRI CA with superior tumor imaging and relatively short intravascular persistence. Gadolinium (Gd)-chelate (DTPA-Gd) was conjugated directly to DEX hydroxyl via a degradable ester bond. DEX-DTPA-Gd was then modified with dodecylsuccinic anhydride to obtain the amphiphilic derivative, 2-dodecylsuccinic acid (DSA)-grafted DEX-DTPA-Gd. Nanomicelles were prepared by dissolving DSA-DEX-DTPA-Gd in water using ultrasonication. The physicochemical properties, cytotoxicity, and MRI efficiency of the synthesized CA were evaluated. The synthesized DSA-DEX-DTPA-Gd self-assembled into nanomicelles with an average diameter of 67.80 ± 5.21 nm. Within the given Gd concentration range, DSA-DEX-DTPA-Gd and Magnevist® exhibited similar cytotoxicity. DEX-based CAs resulted in a greater contrast enhancement of T1-weighted signal intensity in the tumor region than Magnevist®, and the tumors were clearly defined for at least 3 h. Simultaneously, the ester bond in DSA-DEX-DTPA-Gd facilitated the elimination of Gd chelates, compared with the relatively more stable amide linker. The DEX-based nanomicelle system with directly ester-bound DTPA-Gd may serve as an MRI CA with superior tumor imaging and relatively rapid elimination.

7.
Molecules ; 24(20)2019 Oct 17.
Artigo em Inglês | MEDLINE | ID: mdl-31627423

RESUMO

Myricetin (Myr) is a phytochemical with many functional properties. However, its hydrophobicity, low bioavailability, and stability limit its application. In this study, octadecanoate oat ß-glucan (OGE) was synthesized and gained recognition as a self-assembled micelle forming a polymer with a critical micelle concentration (CMC) of 59.4 µg/mL. The Myr-loaded OGE micelle was then prepared and characterized by dynamic light scattering (DLS), transmission electron microscope (TEM), X-ray diffractometer (XRD), and Fourier-transform infrared spectroscopy (FT-IR) spectra. The water solubility of Myr was greatly enhanced by forming the Myr/OGE inclusion complex. Consequently, compared to free Myr, the retention of Myr in Myr-loaded OGE micelle was effectively increased during the intestinal digestion phase, and its antioxidant activity was also improved. Overall, our findings demonstrated the potential applications of OGE polymer for the development of prospective micelle in health food, cosmetics, and pharmaceutical fields because they can aid in the delivery of hydrophobic functional compounds like Myr.


Assuntos
Antioxidantes/química , Portadores de Fármacos , Flavonoides/química , beta-Glucanas/química , Materiais Biomiméticos/química , Compostos de Bifenilo/antagonistas & inibidores , Compostos de Bifenilo/química , Composição de Medicamentos/métodos , Suco Gástrico/química , Humanos , Interações Hidrofóbicas e Hidrofílicas , Radical Hidroxila/antagonistas & inibidores , Radical Hidroxila/química , Micelas , Estrutura Molecular , Picratos/antagonistas & inibidores , Picratos/química , Solubilidade , Água/química
8.
Pharm Res ; 36(1): 10, 2018 Nov 08.
Artigo em Inglês | MEDLINE | ID: mdl-30411214

RESUMO

PURPOSE: Theranostic nanoplatforms are promising approaches for diagnosis and treatment. Here, we report a drug-loaded nanomicelle system with biocleavable gadolinium (Gd) chelates as a multifunctional biodegradable agent for simultaneous magnetic resonance imaging (MRI) and drug delivery. METHODS: Self-assembled nanomicelles based on stearic acid-grafted chitooligosaccharide were utilized as vehicles. Gd chelates, DTPA-Gds, were linked to the nanomicelles via redox-responsive disulfide bonds, and hydrophobic drugs were encapsulated in the micelle cores. MRI and cargo delivery were investigated in orthotopic pancreatic tumor-bearing mice. RESULTS: In vivo MRI demonstrated that the biodegradable agent was cleaved by endogenous thiols after intravenous injection, and the released DTPA-Gds were eliminated rapidly. At the same time, the agent resulted in a greater contrast enhancement of T1-weighted MR signal intensity at the tumor region than Magnevist®, and the tumor boundaries were clearly defined for at least 2 h. In addition, the agent possessed high drug-loading and tumor-targeting capacities. Loading content and encapsulation efficiency of docetaxel were 3.2% and 99.4%, respectively. Compared with Taxotere®, the commercially available docetaxel injection, the docetaxel-loaded agent significantly increased the drug concentration in tumor tissue in vivo. CONCLUSION: The fabricated multifunctional agent may serve as a biodegradable nanoscale MRI contrast agent and as a drug delivery system for tumor diagnosis and treatment.


Assuntos
Quitina/análogos & derivados , Portadores de Fármacos , Nanopartículas , Neoplasias/diagnóstico por imagem , Neoplasias/tratamento farmacológico , Ácidos Esteáricos/química , Animais , Quelantes , Quitina/química , Quitosana , Sistemas de Liberação de Medicamentos , Feminino , Gadolínio , Humanos , Imageamento por Ressonância Magnética , Camundongos Endogâmicos ICR , Micelas , Oligossacarídeos
9.
Tex Heart Inst J ; 43(2): 158-60, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-27127434

RESUMO

Sinus of Valsalva aneurysm is a rare cardiac abnormality. Ruptured sinus of Valsalva aneurysms in pregnancy are of course rarer still. We present a case in which an aneurysm ruptured into the right ventricular outflow tract during pregnancy. In 2012, a 26-year-old Chinese woman, in the 18th week of pregnancy and with no apparent evidence of cardiac problems, was diagnosed with atrioventricular septal defects and a sinus of Valsalva aneurysm that had ruptured into her right ventricular outflow tract. After an uncomplicated full-term pregnancy, she gave birth to a healthy baby boy by cesarean section. Fifty days postpartum, the patient underwent surgical repair of the ruptured aneurysm and other cardiac defects. Her surgical outcome was good. As of May 2013, the patient and her baby were healthy. Ruptured sinus of Valsalva aneurysm in pregnancy can be asymptomatic, and women with such a rupture can have a normal full-term pregnancy and give birth to healthy babies. Cesarean section is preferable for pregnant women with ruptured sinus of Valsalva aneurysm because the hemodynamic changes associated with labor can aggravate the aneurysm. Surgical repair should be performed as soon as the patient's condition allows.


Assuntos
Ruptura Aórtica/diagnóstico , Procedimentos Cirúrgicos Cardíacos/métodos , Complicações Cardiovasculares na Gravidez , Seio Aórtico , Ultrassonografia Pré-Natal , Adulto , Ruptura Aórtica/cirurgia , Cesárea , Ecocardiografia Transesofagiana , Feminino , Humanos , Recém-Nascido , Masculino , Gravidez , Resultado da Gravidez
10.
J Med Case Rep ; 8: 91, 2014 Mar 10.
Artigo em Inglês | MEDLINE | ID: mdl-24607268

RESUMO

INTRODUCTION: Complete endocardial cushion defect is a congenital heart disease characterized by a variable deficiency of the atrioventricular area in the developing heart. The mortality rate for an unrepaired endocardial cushion defect in pregnancy and the postpartum period is high. CASE PRESENTATION: We present a rare case of a pregnant woman with complete endocardial cushion defect. A 20-year-old Chinese woman with unrepaired complete endocardial cushion defect delivered a premature male baby at 33 weeks and six days of pregnancy in our hospital. The baby had a normal human karyotype and a birth defect of hypospadias deformity. Our patient died from heart failure 10 minutes after delivery. She had severe pulmonary hypertension and suspected trisomy 21. CONCLUSION: Our experience further emphasizes the necessity of prenatal screening for congenital heart defects and of prompt surgical correction for endocardial cushion defects during infancy. Mortality for endocardial cushion defect during pregnancy and the postpartum period is high and women with complete endocardial cushion defect should avoid pregnancy, especially those women who cannot intellectually judge their risks.

11.
PLoS One ; 8(12): e83071, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-24376634

RESUMO

BACKGROUND: The aim of this study was to observe the rotation patterns at the papillary muscle plane in the Left Ventricle(LV) with normal subjects using two-dimensional speckle tracking imaging(2D-STI). METHODS: We acquired standard of the basal, the papillary muscle and the apical short-axis images of the LV in 64 subjects to estimate the LV rotation motion by 2D-STI. The rotational degrees at the papillary muscle short-axis plane were measured at 15 different time points in the analysis of two heart cycles. RESULTS: There were counterclockwise rotation, clockwise rotation, and counterclockwise to clockwise rotation at the papillary muscle plane in the LV with normal subjects, respectively. The ROC analysis of the rotational degrees was performed at the papillary muscle short-axis plane at the peak LV torsion for predicting whether the turnaround point of twist to untwist motion pattern was located at the papillary muscle level. Sensitivity and specificity were 97% and 67%, respectively, with a cut-off value of 0.34°, and an area under the ROC curve of 0.8. At the peak LV torsion, there was no correlation between the rotational degrees at the papillary muscle short-axis plane and the LVEF in the normal subjects(r = 0.000, p = 0.998). CONCLUSIONS: In the study, we conclude that there were three rotation patterns at the papillary muscle short-axis levels, and the transition from basal clockwise rotation to apical counterclockwise rotation is located at the papillary muscle level.


Assuntos
Músculos Papilares/fisiologia , Rotação , Função Ventricular Esquerda , Adulto , Ecocardiografia/métodos , Feminino , Ventrículos do Coração/diagnóstico por imagem , Humanos , Interpretação de Imagem Assistida por Computador , Masculino , Pessoa de Meia-Idade , Contração Miocárdica/fisiologia , Músculos Papilares/diagnóstico por imagem , Curva ROC , Volume Sistólico/fisiologia
12.
Zhonghua Xin Xue Guan Bing Za Zhi ; 39(10): 920-4, 2011 Oct.
Artigo em Chinês | MEDLINE | ID: mdl-22321276

RESUMO

OBJECTIVE: To assess the left ventricular longitudinal rotation (LR) in patients with dilated cardiomyopathy (DCM). METHODS: Conventional echocardiography (GE-Vivid7) was performed in 35 healthy subjects and 42 DCM patients. Left atrial diameter was measured by M-mode echocardiography, left ventricular end-systolic, end-diastolic volume and left ventricular ejection fraction (LVEF) were calculated by bi-plane simpson's method. The peak velocity during early diastole (Ve) and late diastole (Va) of anterior mitral valve were measured by pulse-waved doppler, and the ratio Ve/Va was calculated. The peak radial systolic strain, strain rate in systolic, early and late diastolic periods were measured. Segmental LR and global LR were assessed using two-dimensional speckle tracking imaging (2D-STI). RESULTS: The peak radial systolic strain, strain rate in systolic, early and late diastolic periods in DCM group were significantly lower than in healthy subjects, the rotation degrees of the middle and base lateral, the apex and the base septum walls were significantly lower than those of the healthy subjects. A prominent counterclockwise LR (0.76° ± 2.63°) was shown in healthy subjects while prominent clockwise LR (-1.58° ± 3.42°) was present in DCM patients. The time delay between the left ventricular lateral wall and the base septum wall in DCM patients significantly correlated with the peak LR of the left ventricular (r = 0.409, P < 0.01; r = 0.396, P < 0.01). CONCLUSIONS: 2D-STI can be used to assess the LR in DCM patients and a clockwise LR is present in DCM patients which might be caused by the time delay between the left ventricular lateral wall and the base-septum wall.


Assuntos
Cardiomiopatia Dilatada/fisiopatologia , Função Ventricular Esquerda , Estudos de Casos e Controles , Diagnóstico por Imagem , Diástole , Ecocardiografia , Ecocardiografia Doppler , Átrios do Coração , Ventrículos do Coração , Humanos , Rotação , Sístole
13.
Zhonghua Liu Xing Bing Xue Za Zhi ; 29(5): 486-92, 2008 May.
Artigo em Chinês | MEDLINE | ID: mdl-18956684

RESUMO

OBJECTIVE: To study whether CETP TaqIB,KCNE1 S38G and eNOS T-786C genetic polymorphisms are associated with non-valvular atrial fibrillation in the Han population from Zhejiang province. METHODS: Polymerase chain reaction restriction fragment length polymorphism assay was used to detect the distribution of alleles and genotypes of CETP TaqIB, KCNE1 S38G and eNOS T-786C in 147 patients with non-valvular atrial fibrillation and in 147 subjects as controls in Han population of Zhejiang province. RESULTS: (1) The frequency of CETP B1 allele in NVAF patients was higher than that of the control group and showing a statistically significant difference (OR = 1.763, 95% CI: 1.247-2.492, P = 0.002). (2) Results from logistic regression analysis revealed that: after adjustment of confounding variables such as sex, age, smoking, hypertension and body mass index, data from the binary logistic analysis showed a statistically significant difference in CETP TaqIB genetic polymorphism between patients and controls. (3) From multifactor dimensionality reduction analysis, results showed an interaction of CETP TaqIB, KCNE1 S38G and eNOS T-786C genetic polymorphisms. Odds ratio of the three simultaneously existing genetic polymorphisms was 1.849 times more than CETP TaqIB alone. CONCLUSION: CETP BI allele was an independent risk factor for predisposition to non-valvular atrial fibrillation. These findings suggested that the simultaneous existence of CETP B1, KCNE1 S38G and eNOS T-786C allele might be elevated with the predisposition to non-valvular atrial fibrillation in the Han population of Zhejiang province.


Assuntos
Fibrilação Atrial/genética , Proteínas de Transferência de Ésteres de Colesterol/genética , Óxido Nítrico Sintase Tipo III/genética , Canais de Potássio de Abertura Dependente da Tensão da Membrana/genética , Idoso , Estudos de Casos e Controles , Feminino , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Polimorfismo de Nucleotídeo Único
14.
Zhonghua Yi Xue Yi Chuan Xue Za Zhi ; 25(2): 225-9, 2008 Apr.
Artigo em Chinês | MEDLINE | ID: mdl-18393253

RESUMO

OBJECTIVE: To study whether the polymorphisms of TaqIB of cholesteryl transfer protein (CETP) gene and 1444C/T of C reactive protein (CRP) gene are associated with non-valvular atrial fibrillation in the Chinese Han population. METHODS: Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) assay was used to detect the distribution of genotypes of CETP TaqIB and CRP 1444C/T in 147 patients with non-valvular atrial fibrillation and 147 control subjects in Chinese Han population. RESULTS: (1) The distribution of CETP TaqIB and CRP 1444C/T genotypes was in Hardy-Weinberg equilibrium. (2) A statistically significant difference between patients and controls for CETP TaqIB (P= 0.005, OR= 0.614, beta = -0.488) and CRP 1444C/T (P= 0.003, OR= 2.428, beta = 0.887) was observed. (3) In female group, significant difference was observed in smoking, CETP TaqIB and CRP 1444C/T polymorphisms. And in male group, significant difference was observed in body mass index and CETP TaqIB polymorphisms. CONCLUSION: (1) These results suggest that CETP TaqIB (B2 allele as protective factor) and CRP1444C/T (T allele as risk factor) genetic polymorphisms may be associated with the non-valvular atrial fibrillation in the Chinese Han population. (2) Smoking and CRP1444T single nucleotide polymorphism may induce hereditary susceptibility to non-valvular atrial fibrillation in female. Obesity may induce hereditary susceptibility to non-valvular atrial fibrillation in male.


Assuntos
Fibrilação Atrial/genética , Proteína C-Reativa/genética , Proteínas de Transferência de Ésteres de Colesterol/genética , Polimorfismo de Nucleotídeo Único/genética , Idoso , Povo Asiático/genética , Feminino , Predisposição Genética para Doença/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Fumar
15.
Spine J ; 7(6): 671-81, 2007.
Artigo em Inglês | MEDLINE | ID: mdl-17998127

RESUMO

BACKGROUND CONTEXT: The ultrashort-course chemotherapeutical scheme of less than 6 months has been used for part of patients with pulmonary tuberculosis and satisfactory curative effects have already been achieved. However, few systematic and clinical reports so far about medical treatment of spinal tuberculosis by using ultrashort-course chemotherapeutical schemes have been published in the spine-care literature. PURPOSE: To assess the results of ultrashort-course chemotherapy (UCC) in conjunction with partial excision of pathological vertebrae for spinal tuberculosis. STUDY DESIGN/SETTING: This is a retrospective comparative study of case series from a single center. PATIENT SAMPLE: Seventy-six cases of spinal tuberculosis, treated during 1998 and 2003 by senior author, were reviewed. All the cases underwent chemotherapies in conjunction with the uniform partial excision of pathological vertebra and had a minimum follow-up of 2 years. OUTCOME MEASURES: Clinical manifestations, laboratory tests, imaging examination, examination by ultrasonic wave B, drug complications, and clinical effects based on the previously described evaluative measures. METHODS: Of the 76 cases, 28 had UCC with the scheme of 2SHRZ/2.5H(2)R(2)Z(2), 23 had short-course chemotherapy (SCC) with the scheme of 3SHRZ/5H(2)R(2)Z(2), and 25 had standard chemotherapy (SC) with the scheme of 3SHRZ/9H(2)R(2)Z(2). All the patients had anterior partial excisions of pathological vertebrae, large iliac strut graft, and anterior or posterior fixation. The mean time of follow-up surveys for the ultrashort-course, short-course, and standard chemotherapy cases was 42.3 m, 46.5 m, and 55.4 m, respectively. RESULTS: The observance indices included 1) clinical manifestations: disappearance of tuberculosis symptoms, no CC pains, recovery of normal life or work, no percussion pains on pathologic sites, and recovery of neural functions; 2) laboratory tests: normal or close to normal test results of both erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) or one of them; 3) imaging examinations: X-ray films, computed tomography scan, and magnetic resonance imaging examinations show disappearance of abscesses, no new destructive foci, bone union on the bone grafting interface, satisfactory correction of deformities, and less than 5 degrees of the angle loss of deformity corrections; 4) examination by ultrasonic wave B: no opaque dark area of fluid sonolucent areas identified in possible sites of paravertebral abscesses or gravitation abscesses; and 5) drug complications: hepatic and renal functions, nervus vestibularis lesion, and gastrointestinal tract reactions. All the cases met the protetrakis indices and obtained complete clinical cure of spinal tuberculosis in the last follow-up. The significant differences of major drug complications were found among the 3 groups, with 5 cases of UCC (18%), 15 cases of SCC (65%), and 19 cases of SC (76%). The lasting chemotherapeutic lesion of liver, kidney, or the permanent nervus vestibularis lesion were found 3 cases in SCC, 5 cases in SC, and no case in UCC group. CONCLUSIONS: No significant differences in clinical cure rate were found among 3 groups. UCC in conjunction with anterior partial excisions of pathological vertebrae, large iliac strut graft, and anterior or posterior internal instrumental fixation achieved excellent clinical results and the lowest complication rate of antituberculosis chemotherapy.


Assuntos
Antituberculosos/administração & dosagem , Transplante Ósseo , Fusão Vertebral , Tuberculose da Coluna Vertebral/tratamento farmacológico , Tuberculose da Coluna Vertebral/cirurgia , Adulto , Terapia Combinada , Feminino , Seguimentos , Humanos , Masculino , Estudos Retrospectivos , Vértebras Torácicas/diagnóstico por imagem , Vértebras Torácicas/cirurgia , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Tuberculose da Coluna Vertebral/diagnóstico por imagem , Cicatrização
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