RESUMO
BACKGROUND: Benign laryngotracheal stenosis is widely managed with minimally invasive endoscopic interventions, such as laser incision or excision scar, and dilation. However, various endoscopic treatments are significantly associated with a high recurrence rate. Local auxiliary measures, including inhalation of steroids, injection of steroids, and local topical application of mitomycin C, have been studied in order to increase the success rate. PURPOSE: To compare the efficacy of endoscopic treatments with and without local adjuncts in patients with benign laryngotracheal stenosis, and analyze their clinical outcomes, recurrence, and complications. METHODS: In the meta-analysis, databases including PubMed, EMBASE, OVID, and Web of Science were searched for papers comparing the outcomes of adjunct therapy with non-adjunct therapy in patients with laryngotracheal stenosis. The duplicate publications, reviews, comments or letters, conference abstracts, and case reports were excluded. The random effect model was used for assessing the pooled risk estimates. RESULTS: Eight studies (1204 cases) referring to two prospective randomized controlled studies, two prospective cohort studies, and four retrospective cohort studies were ultimately included in the meta-analysis. Three delivery modes of adjuncts were identified, including intralesion steroid injection (n = 2), inhaled steroid (n = 2), and topical application of mitomycin C (n = 4). The decreased risk estimates of recurrence rate were detected in patients receiving endoscopic treatments with steroid injection or inhaled steroid, compared with endoscopic interventions alone (P < 0.05). Additionally, patients undergoing adjunct therapies had lower risk estimates of recurrence, compared to those receiving endoscopic procedures alone (P < 0.05), based on the subgroup of prospective cohort studies, subglottis, Mayer-Cotton scale of I-II degree, and stenosis length of < 3 cm. The high heterogeneity of the pooling risk estimates perhaps was due to factors of auxiliary drug, clinical characteristics of patients, and methodology. No discernible difference in the incidence of complication was identified. CONCLUSIONS: Local application of steroids to minimally invasive interventions appear to reduce the recurrence rate of laryngotracheal stenosis. Various adjuncts available, including steroids and mitomycin C, appear to be safe and associated with a low risk estimate of adjuncts-specific complication rate. High quality multi-center randomized controlled studies are needed, with sufficient periods for follow-up and subjective and objective outcome indicators, to properly evaluate the efficacy, safety, and cost-effectiveness of adjuvant drugs.
RESUMO
Forest defoliators are one of the major biological disturbances to forest ecosystems. As one of the abnormal nutrient input paths into forest ecosystems, frass deposition from the pest outbreak plays a critical role in regulating soil organic carbon (SOC) in forest ecosystems. However, how frass deposition affects SOC and its fractions in forests remains unclear. Based on a severe outbreak of defoliator in an oak-sweetgum mixed forest in Jigong Mountain in 2014, we compared the difference in SOC between plots with and without frass deposition for 4 consecutive years. The results showed that frass deposition led to a significant increase of 25.1 % in soil microbial biomass C (MBC) and 32.0 % in dissolved organic C (DOC) in 2014, which further escalated to 50.4 % and 50.6 % in the subsequent year (2015), respectively. The response of SOC to frass deposition lagged behind MBC and DOC. Specifically, there was no change in SOC in 2014, but a significant increase (50.9 %) was observed in the subsequent 2-3 years. The positive dependences of MBC and DOC upon fine root biomass were negated under frass deposition, while the relationship between SOC and fine root biomass remained unaffected. Soil organic carbon and DOC showed non-linear responses to frass amount and the changed soil nitrogen content. Our finding that the response of SOC to frass deposition lagged behind soil labile C indicates that SOC exhibits a certain resilience towards forest disturbance. The findings also imply that investigating the long-term impacts of frass deposition on SOC in forests would contribute to the scientific assessment of forest C cycling under disturbance.
Assuntos
Carbono , Florestas , Solo , Solo/química , Carbono/análise , Microbiologia do Solo , Monitoramento Ambiental , China , Árvores , BiomassaRESUMO
AIM: To evaluate the effect of low-degree astigmatism on objective visual quality through the Optical Quality Analysis System (OQAS). METHODS: This study enrolled 46 participants (aged 23 to 30y, 90 eyes) with normal or corrected-to-normal vision. The cylindrical lenses (0, 0.5, 0.75, 1.0, and 1.25 D) were placed at the axial direction (180°, 45°, 90°, and 135°) in front of the eyes with the best correction to form 16 types of regular low-degree astigmatism. OQAS was used to detect the objective visual quality, recorded as the objective scattering index (OSI), OQAS values at contrasts of 100%, 20%, and 9% predictive visual acuity (OV100%, OV20%, and OV9%), modulation transfer function cut-off (MTFcut-off) and Strehl ratio (SR). The mixed effect linear model was used to compare objective visual quality differences between groups and examine associations between astigmatic magnitude and objective visual quality parameters. RESULTS: Apparent negative relationships between the magnitude of low astigmatism and objective visual quality were observed. The increase of OSI per degree of astigmatism at 180°, 45°, 90°, and 135° axis were 0.38 (95%CI: 0.35, 0.42), 0.50 (95%CI: 0.46, 0.53), 0.49 (95%CI: 0.45, 0.54) and 0.37 (95%CI: 0.34, 0.41), respectively. The decrease of MTFcut-off per degree of astigmatism at 180°, 45°, 90°, and 135° axis were -10.30 (95%CI: -11.43, -9.16), -12.73 (95%CI: -13.62, -11.86), -12.75 (95%CI: -13.79, -11.70), and -9.97 (95%CI: -10.92, -9.03), respectively. At the same astigmatism degree, OSI at 45° and 90° axis were higher than that at 0° and 135° axis, while MTFcut-off were lower. CONCLUSION: Low astigmatism of only 0.50 D can significantly reduce the objective visual quality.
RESUMO
BACKGROUND: Dry eyes can cause discomfort. To treat dry eye disease, cyclosporine A (CsA) and Lifitegrast are two eye drugs approved by the U.S. Food and Drug Administration (FDA). However, frequent use of eye drops can be challenging and lead to poor compliance, especially in elderly patients. Therefore, this study aimed to develop a drug sustained-release vector and explore its therapeutic effect in animal models of dry eye. METHODS: Firstly, drug membranes loaded with both CsA and Lifitegrast using a carrier called poly(lactate-co-ε-caprolactone) (P(LLA-CL)) were prepared and evaluated for their physicochemical properties, release behavior in vitro, and safety in vivo. Next, a rabbit dry eye model using a 0.1% benzalkonium chloride (BAC) solution was developed and treated by drug-loaded micro membranes. We observed and recorded conjunctival hyperemia, corneal staining, corneal edema, corneal neovascularization, conjunctival goblet cells and hematoxylin and eosin (H&E) staining. Finally, we detected the MUC5AC and MMP-9 by immunofluorescence staining and enzyme-linked immunosorbent assay (ELISA). RESULTS: The composite film released both CsA and Lifitegrast for at least one month. Compared to the blank membrane group, conjunctival hyperemia, corneal fluorescein staining, corneal edema, corneal neovascularization and conjunctival goblet cells recovered faster in the drug membrane group, and the difference was statistically significant. At the molecular level, the drug membrane group showed an increase in mucin density and a significant anti-inflammatory effect. CONCLUSIONS: The implantation of CsA/Lifitegrast loaded P(LLA-CL) membrane under the subconjunctival of the rabbit eye is safe. The study suggests that this subconjunctival administration could be developed into a minimally invasive delivery system to help patients with dry eye disease who require multiple daily eyedrops but have poor compliance.
RESUMO
Background: Cataract surgery and laser peripheral iridotomy (LPI) are effective approaches for preventing primary angle closure diseases (PACDs), as well as acute primary angle closure (APAC). Due to the development of population screening and increases in cataract surgery rates, this study aimed to examine trends in the admission rates of PACD among the urban population in China. Methods: This cross-sectional study examined patients who were admitted to a hospital for PACD, and who underwent cataract surgery or LPI operations. The data were obtained from the Yinzhou Regional Health Information Platform (YRHIP) from 2011 to 2021. The annual rates of PACD and APAC admissions, cataract surgery and LPI were analyzed, with the number of cases used as numerators and the annual resident population in Yinzhou district used as denominators. Results: A total of 2,979 patients with PACD admissions, 1,023 patients with APAC admissions, 53,635 patients who underwent cataract surgery and 16,450 patients who underwent LPI were included. The number of annual admissions for PACD gradually increased from 22 cases (1.6/100000) in 2011 to 387 cases (30.8/100000) in 2016, after which it decreased to 232 cases (16.2/100000) in 2019 and then increased to 505 cases (30.6/100000) in 2021. The number of cataract surgeries gradually increased from 1728 (127.7/100000) in 2011 to 7002 (424.9/100000) in 2021. Similarly, the number of LPI gradually increased from 109 (8.0/100000) in 2011 to 3704 (224.8/100000) in 2021. Conclusion: The admission rates of PACD for the urban population in China have declined in recent years after a long increasing trend in the rates of cataract surgery and LPI. However, it increased rapidly during the COVID-19 epidemic. The national health database should be further utilized to investigate temporal trends in the prevalence of PACD.
Assuntos
Extração de Catarata , Glaucoma de Ângulo Fechado , População Urbana , Humanos , Glaucoma de Ângulo Fechado/epidemiologia , Glaucoma de Ângulo Fechado/cirurgia , China/epidemiologia , Estudos Transversais , Masculino , Feminino , Idoso , Extração de Catarata/estatística & dados numéricos , Extração de Catarata/tendências , Pessoa de Meia-Idade , População Urbana/estatística & dados numéricos , Hospitalização/estatística & dados numéricos , Hospitalização/tendências , Idoso de 80 Anos ou mais , Adulto , Admissão do Paciente/estatística & dados numéricos , Admissão do Paciente/tendênciasRESUMO
Chitosan, as a natural biomass material, is green, recyclable, sustainable and well biocompatible. The molecular chain is rich in active groups such as amino and hydroxyl groups, and its preparation of fluorescent probes has the advantages of biocompatibility and efficient detection performance. In this study, a bis(benzaldehyde) (BHD) fluorescent functional molecule was designed. Then a series of fluorescent chitosan-based hydrogel films (CSBHD) were prepared using chitosan as raw material and BHD as cross-linking agent. As a fluorescent probe for metal ions, CSBHD was able to efficiently detect Fe2+ with a linear correlation of fluorescence intensity in the range of 0-160 µM, and the limit of detection (LOD) was 0.55 µM. Moreover, it has excellent adsorption performance for Fe2+ ions, with a maximum adsorption capacity of 223.5 g/mg at 500 mg/L Fe2+ concentration. Finally, we characterised the structure and microscopic morphology of CSBHD films and found that CSBHD as a hydrogel film has a high cross-linking density, good water resistance, excellent thermal stability, strong resistance to swelling, and excellent stability in cycling tests. Hence, it has great potential for application in adsorption and detection of Fe2+ ions. It also provides a good strategy for the application of chitosan based fluorescent probe materials in environmental monitoring and heavy metal ion adsorption.
Assuntos
Benzaldeídos , Quitosana , Corantes Fluorescentes , Hidrogéis , Ferro , Quitosana/química , Adsorção , Hidrogéis/química , Ferro/química , Benzaldeídos/química , Corantes Fluorescentes/química , Reagentes de Ligações Cruzadas/química , Limite de Detecção , Membranas Artificiais , Poluentes Químicos da Água/análise , Poluentes Químicos da Água/químicaRESUMO
OBJECTIVE: To make surgeons aware of the differing types of preauricular sinuses (PAS), we summarize our experience with diagnosis and treatment of varying types of PAS. METHODS: We retrospectively reviewed clinical data from patients who had undergone preauricular fistulectomy between March 2015 and March 2020. These patients were categorized into two groups according to locations of congenital fistula pit. RESULTS: Twelve patients with variant PAS accounted for 6.8% (12/177) of all patients. The variant types of PAS could be classified into three types (from type 1 to type 3), based on the location of the fistula pit. Type 1 (seven patients; eight ears) patients had pits located on the ascending helix crus, whereas type 2 (four patients, four ears) and type 3 (one patient, one ear) patients had pits located on the external auditory canal (EAC) and lobule, respectively. Fistular tracts penetrated the cartilage of the helix crus in seven of the type 1 variant ears. Swelling and discharge were located at the ascending helix crus (in four ears), cavum concha (in two ears), and posterior to the auricle (in one ear). In four of the type 2 ears, the fistular tracts were located at the anterior margin of the ascending limb of the helix. CONCLUSION: Fistula tracts where fistula pit occurred on the ascending helix crus were more likely to penetrates through the cartilage, and fistula tracts with fistula pits that occurred on the EAC were adjacent to the cartilage of the ascending helix and tragus. Meticulous dissection and complete removal of fistula tissue are critical to avoid postoperative recurrence. LEVEL OF EVIDENCE: 4 Laryngoscope, 134:3839-3845, 2024.
Assuntos
Pavilhão Auricular , Humanos , Estudos Retrospectivos , Masculino , Feminino , Adulto , Criança , Adolescente , Pavilhão Auricular/anormalidades , Pavilhão Auricular/cirurgia , Meato Acústico Externo/anormalidades , Meato Acústico Externo/cirurgia , Fístula/cirurgia , Fístula/classificação , Fístula/congênito , Adulto Jovem , Pré-Escolar , Pessoa de Meia-Idade , Otopatias/cirurgia , Otopatias/congênito , Otopatias/classificação , Otopatias/diagnósticoRESUMO
Purpose: To characterize the natural history of normal-tension glaucoma (NTG) in Chinese patients. Methods: The prospective observational cohort study included patients with untreated NTG with a minimum follow-up of 2 years. Functional progression was defined by visual field (VF) deterioration, while structural progression was characterized by thinning of the retinal nerve fiber layer (RNFL) or ganglion cell inner plexiform layer (GCIPL). Results: Among 84 participants (mean age, 60.5 years; mean deviation, -5.01 decibels [dB]) with newly diagnosed NTG followed for an average of 69.7 months, 63.1% progressed during the observation period. Specifically, 29.8% progressed by VF, and 48.8% progressed by either RNFL or GCIPL. In Cox proportional hazards analysis, disc hemorrhage (hazard ratio [HR], 2.82; 95% confidence interval [CI], 1.48-5.35), female gender (HR, 1.98; 95% CI, 1.08-3.62), and mean IOP during the follow-up period (HR, 1.14 per mm Hg; 95% CI, 1.00-1.31) were significant predictors of glaucomatous progression. Additionally, longer axial length (AL; HR, 0.57 per millimeter; 95% CI, 0.35-0.94) was protective against VF progression faster than -0.50 dB/y, and higher minimum diastolic blood pressure (DBP; HR, 0.96 per mm Hg; 95% CI, 0.92-1.00) was protective against structural progression. Conclusions: Nearly two-thirds of untreated Chinese patients with NTG progressed over an average follow-up of 70 months by VF, RNFL, or GCIPL. Disc hemorrhage, female gender, higher mean IOP, shorter AL, and lower minimum DBP were significant predictors for disease progression.
Assuntos
Glaucoma , Glaucoma de Baixa Tensão , Feminino , Humanos , Pessoa de Meia-Idade , China/epidemiologia , Hemorragia , Glaucoma de Baixa Tensão/diagnóstico , Estudos Prospectivos , Fatores de Risco , Masculino , IdosoRESUMO
PURPOSE: To explore the association between progressive peripapillary capillary vessel density (pcVD) reduction and the progression of visual field (VF) impairment in individuals with normal tension glaucoma (NTG). DESIGN: Prospective cohort study. METHODS: The study enrolled 110 participants with one eye each, totalling 110 NTG eyes. VF defects were evaluated using standard automated perimetry mean deviation (MD), while pcVD measurements were obtained using optical coherence tomography angiography throughout the follow-up period. Estimates of VF progression were determined by event-based and trend-based analyses. Fast VF progression was defined as an MD slope steeper than -0.5 dB/year, while the slow progression or stable VF was defined as an MD slope better or equal to -0.25 dB/year. Linear mixed-effects models were employed to analyse the rates of change in pcVD reduction and VF MD decline over time. Additionally, univariable and multivariable linear models were used to examine the relationship between pcVD changes and VF loss rates in NTG. RESULTS: Slow VF progression or stable VF was observed in 45% of subjects, while 25% had moderate progression and 30% showed fast progression. Patients with VF progression exhibited faster rate of pcVD reduction in peripapillary global region (-0.73 ± 0.40%/year vs. -0.56 ± 0.35%/year, p = 0.022). Moreover, this rate positively correlated with VF MD decline in NTG (estimate 0.278, 95% CI 0.122-0.433, p = 0.001). CONCLUSION: In individuals with NTG, faster VF progression was linked to a quicker reduction in pcVD, suggesting a positive correlation between pcVD decline and VF deterioration.
Assuntos
Capilares , Progressão da Doença , Angiofluoresceinografia , Pressão Intraocular , Glaucoma de Baixa Tensão , Disco Óptico , Vasos Retinianos , Tomografia de Coerência Óptica , Testes de Campo Visual , Campos Visuais , Humanos , Campos Visuais/fisiologia , Glaucoma de Baixa Tensão/fisiopatologia , Glaucoma de Baixa Tensão/diagnóstico , Masculino , Estudos Prospectivos , Feminino , Tomografia de Coerência Óptica/métodos , Pessoa de Meia-Idade , Vasos Retinianos/diagnóstico por imagem , Vasos Retinianos/fisiopatologia , Capilares/patologia , Capilares/fisiopatologia , Disco Óptico/irrigação sanguínea , Pressão Intraocular/fisiologia , Seguimentos , Angiofluoresceinografia/métodos , Idoso , Fundo de Olho , Células Ganglionares da Retina/patologia , Fatores de Tempo , Densidade Microvascular , Fibras Nervosas/patologiaRESUMO
INTRODUCTION: Proximal femur simple bone cysts (SBCs) are rare in children, but with a risk of pathological fractures and the associated poor outcomes. This study aimed to evaluate the functional and radiographic outcomes of children with proximal femur SBCs. PATIENTS AND METHODS: 38 children with proximal femur SBCs treated surgically at our department, West China hospital, were enrolled in the study. Patients were divided into two groups according to whether pathological fractures presented before treatment. The non-fracture group received treatment of open curettage, cavity electrocauterization, bone grafting, and fixation (proximal femoral plate, intramedullary nail or Kirschner wire). The pathological fracture group received the same procedures of curettage, electrocauterization, grafting, and fixation. Autogenous iliac bone grafting was done in all cases, and the artificial bone was used as a supplementary based on the size of the cavity. Postoperatively, all patients underwent hip spica or similar orthosis immobilization for six weeks and received the same rehabilitation program after the removal of hip spica. Patients were evaluated by two independent observers, including the functional results based on the Ratliff's criteria, avascular necrosis, healing rate based on the Neer scoring system, coxa vara, and premature physeal arrest. We described the good outcome in Ratliff's criteria as "Satisfactory results", and fair and poor outcomes as "Unsatisfactory results." Grade 1 and grade 2 Neer results were termed as failures in treatment, and grades 3 and 4 were considered successes and healing. RESULTS: 38 patients with 38 hips (18 on the left side and 20 on the right side) were evaluated, including 9 females and 29 males, with a mean age of 9.0±2.6 years old (range, 5 to 14 years). There was no significant difference between these two groups in the baseline data of gender, age, side, grafting, staging, and fixation methods. The rate of unsatisfactory functional results in the pathological fractures group was 56.3% (9/16), significantly higher than that in patients without fracture (22.7%, 5/22. p= 0.047). There was also a significant difference in avascular necrosis of the femoral head between the pathological fractures group (7/16) and the group without fracture (2/22, p=0.021). Thirty cases presented with healing, including 13 in the fractures group and 17 in the non-fracture group (p=1.000), and eight cases were graded as failures (2 cases of grade 1 and 6 cases of grade 2). There were also no significant differences between these two groups in premature physeal arrest (2 in fracture group and 1 in non-fracture group, P=0.562), and Coxa vara (3 in the fracture group and 0 in non-fracture group, P=0.066). CONCLUSIONS: Pathological fracture significantly increases the risk of unsatisfactory functional results and avascular necrosis of the femoral head in patients with femoral neck SBCs. Prophylactic treatment and fixation of SBCs in weight bearing proximal femur region is better to manage without complications than managing with pathological fractures.
Assuntos
Cistos Ósseos , Coxa Vara , Fraturas do Colo Femoral , Necrose da Cabeça do Fêmur , Fraturas Ósseas , Fraturas Espontâneas , Masculino , Criança , Feminino , Humanos , Fraturas Espontâneas/etiologia , Necrose da Cabeça do Fêmur/diagnóstico por imagem , Necrose da Cabeça do Fêmur/etiologia , Necrose da Cabeça do Fêmur/cirurgia , Fraturas Ósseas/complicações , Fêmur/diagnóstico por imagem , Fêmur/cirurgia , Fios Ortopédicos/efeitos adversos , Cistos Ósseos/complicações , Cistos Ósseos/diagnóstico por imagem , Cistos Ósseos/cirurgia , Resultado do Tratamento , Fixação Interna de Fraturas/efeitos adversos , Estudos Retrospectivos , Fraturas do Colo Femoral/cirurgiaRESUMO
Fe3+ is essential for humans, and its deficiency or excess can be harmful to human health; thus, it is crucial to detect Fe3+. Herein, a novel 1,8-naphthylimide rhodamine-based fluorescent probe (NA-RhBEA) was prepared from rhodamine B, anhydrous ethylenediamine, and 1,8-naphthoic anhydride. This fluorescent probe complexes Fe3+ with N and O on the carboxyl groups of its spironolactam structure and part of the 1,8-naphthalenedicarboxylic anhydride structure, which results in spironolactam ring-opening and fluorescence. NA-RhBEA has high selectivity for Fe3+ in ethanol/buffer solution (4 : 1, v/v), and fluorescence is detected at an excitation wavelength λEX = 500 nm, an absorption peak appears at 585 nm, and a significant color change appears. The effect of the fluorescence intensity of Fe3+ under a series of different concentration conditions was investigated, and it was concluded that the fluorescence intensity increased with increasing Fe3+ concentration in the range of 0-500 µmol, and its detection limit was 0.84 µmol L-1. In addition, we explored the detection ability of NA-RhBEA in solutions with different pH values, mixed metal ions, and different solvents, and the results showed that the fluorescent sensor also has good anti-interference properties and some practical applicability.
RESUMO
INTRODUCTION: Open reduction is a therapeutic option for displaced radial neck fracture in children, which once was considered the last resort because of its potential risk for functional outcomes. This study aimed to identify risk factors for open reduction in operatively treated radial neck fractures in children. PATIENTS AND METHODS: One hundred and thirty-seven patients with displaced radial neck fractures, treated surgically at our department from January 2010 to December 2021 were retrospectively enrolled. Patients' data of age, sex, injury side, obesity, type of fractures, combined fractures, nerve injury, reduction methods, and delay from injury to surgery were reviewed. Univariate analysis and multivariate logistic regression were used to identify independent risk factors and odds ratios of open reduction. RESULTS: Overall, 137 patients (62 females and 75 males) with an average of 8.0 ± 2.2 years were analyzed. There were 62 cases of type III fractures and 75 cases of type IV based on the Judet classification. Thirty-two cases had combined fractures and 19 cases presented with nerve injury. The open reduction rate was 24.1 % (33/137). Univariate analysis indicated obesity, fracture type, and combined fractures were significantly associated with open reduction. (P = 0.039, P = 0.000 and P = 0.000, respectively). While multivariate logistic regression analysis showed that only fracture type (OR, 5.18; CI, 1.63-16.46, p = 0.005) and combined fractures (OR, 7.79; CI, 2.97-20.41, p = 0.000) were independent risk factors for open reduction. CONCLUSIONS: Judet type IV fracture and combined fractures are two significant risk factors for open reduction in operatively treated radial neck fractures in children. These findings will facilitate preoperative decision making, remind surgeons of the risk of failure in closed reduction and the use of new surgical techniques to decrease the open reduction poor outcome rate.
Assuntos
Fraturas da Cabeça e do Colo do Rádio , Fraturas do Rádio , Masculino , Feminino , Humanos , Criança , Estudos Retrospectivos , Resultado do Tratamento , Rádio (Anatomia)/cirurgia , Fixação Interna de Fraturas/métodos , ObesidadeRESUMO
The design and development of a rapid and quantitative method for the detection of heavy metal ions is of great importance for environmental protection. We have prepared a 1,8-Naphthalimide modified cellulose composite fluorescent hydrogel (CENAEA/PAA) with a stereo double network structure. Characterized by excellent hydrogel functional structure and fluorescence detection performance, it can efficiently and selectively identify and detect Cr(VI) with linear quenching in the range of 0-400 µmol/L and detection limit of 0.58 µmol/L for Cr(VI). The results show that the CENAEA/PAA can effectively adsorb Cr(VI) with a maximum adsorption capacity of 189.04 mg/g. Finally, the morphological characteristics, chemical structure, fluorescence properties and adsorption behavior of CENAEA/PAA were analyzed and fitted well with the pseudo-second-order model and Freundlich model. Thus, the present work provides a green and sustainable approach for the synthesis of a functional material that can be used for the detection and adsorption of heavy metal ions.
Assuntos
Metais Pesados , Poluentes Químicos da Água , Naftalimidas , Corantes Fluorescentes , Hidrogéis , Cromo/química , Íons , Celulose/química , Adsorção , Poluentes Químicos da Água/química , Cinética , Concentração de Íons de HidrogênioRESUMO
Cigarette smoke exposure is an important factor in chronic inflammation in patients with allergic rhinitis (AR); however, the relationship between cigarette smoke and AR-related glucocorticoid resistance requires further study. In mice, calpeptin significantly reduces inflammation of the lower respiratory tract caused by cigarette smoke, but whether it can treat glucocorticoid-resistant AR caused by cigarette smoke requires further research. In this study, we confirmed that cigarette smoke exposure can aggravate the Th2 inflammatory response in AR leading to glucocorticoid resistance. The underlying mechanism may be related to decreased expression of DNA methyltransferase 3a (Dnmt3a), and increased expression of interferon regulatory factor 1 (IRF1). In addition, we found that calpeptin can inhibit the expression of IRF1 and thus treat AR-associated glucocorticoid resistance in rats exposed to cigarette smoke. These data suggest that calpeptin may downregulate IRF1 and therefore treat glucocorticoid resistance in AR-associated with cigarette smoke exposure.
RESUMO
Chitosan is a kind of natural polysaccharide biomass with the second highest content in nature after cellulose, which has good biological properties such as biocompatibility, biodegradability, hemostasis, mucosal adsorption, non-toxicity, and antibacterial properties. Therefore, hydrogels prepared from chitosan have the advantages of good hydrophilicity, unique three-dimensional network structure, and good biocompatibility, so they have received extensive attention and research in environmental testing, adsorption, medical materials, and catalytic supports. Compared with traditional polymer hydrogels, biomass chitosan-based hydrogels have advantages such as low toxicity, excellent biocompatibility, outstanding processability, and low cost. This paper reviews the preparation of various chitosan-based hydrogels using chitosan as raw material and their applications in the fields of medical materials, environmental detection, catalytic carriers, and adsorption. Some views and prospects are put forward for the future research and development of chitosan-based hydrogels, and it is believed that chitosan-based hydrogels will be able to obtain more valuable applications.
Assuntos
Quitosana , Quitosana/química , Materiais Biocompatíveis/química , Hidrogéis/química , Polissacarídeos/química , CeluloseRESUMO
BACKGROUND: The optimal treatments for adult benign laryngotracheal stenosis presently remains controversial. The majority of the disadvantages of endoscopic interventions with high recurrence rate and open surgical therapy accompanied by sophisticated techniques, complication and mortality, highlights the dilemma of option for treatments. PURPOSE: To compare endoscopic treatments with open surgical interventions in adult patients with benign laryngotracheal stenosis, analyze their clinical outcomes, recurrence, complication and mortality. METHODS: In the meta-analysis, the databases including PubMed, Embase, Ovid and Web of Science were searched for studies reporting adult benign laryngotracheal stenosis, and clinical outcomes were compared. The duplicate publications, reviews, comments or letters, conference abstracts, case reports were excluded. The random effect model was used for calculating the pooled effect estimates. RESULTS: Eight studies (1627 cases) referring to six retrospective and two prospective researches were ultimately included in the meta-analysis. The decreased risk estimates of recurrence rate in patients receiving open surgical interventions were detected, comparing with endoscopic interventions (P < 0.05). Subgroup analysis revealed that decreased risk estimates of restenosis rate were also observed in patients receiving open surgical interventions compared with endoscopic interventions (P < 0.05), based on prospective studies, Europe and America, < 2-year follow-up, laryngeal stenosis, stenotic length without inter-group difference or stenotic grade II alone. However, there were no statistically significant difference of recurrence rate between the two interventions (P > 0.05) based on retrospective studies, South Asia and Africa, ≥ 2-year follow-up, involving tracheal lesion, stenotic length with inter-group difference, or stenotic grades of I-IV. No notable difference in the incidence of complication or mortality were identified. CONCLUSIONS: Open surgical interventions were more suitable for most laryngotracheal stenosis without contraindications. Endoscopic interventions are increasingly being used to treat simple laryngotracheal stenosis, as well as complex airway stenosis in carefully selected cases. Multi-center prospective randomized controlled trials should be conducted to search for the standard treatments for laryngotracheal stenosis.
Assuntos
Laringoestenose , Estenose Traqueal , Humanos , Adulto , Laringoestenose/cirurgia , Laringoestenose/etiologia , Estudos Prospectivos , Constrição Patológica , Estudos Retrospectivos , Endoscopia/efeitos adversos , Estenose Traqueal/cirurgia , Estenose Traqueal/complicações , Resultado do TratamentoRESUMO
OBJECTIVES: The study aimed to construct prognostic models for OS and CSS in patients with T1N0M0 glottic SCC. In addition, we used PSM to re-assess the effect of surgery alone and radiation alone. METHODS: The Surveillance, Epidemiology, and End Results database was searched for patients with confirmed T1N0M0 glottic SCC. Patients with complete data were randomly divided into the training and the validation cohort (7:3), Cox-regression analysis was performed to identified significant predictors of OS and CSS. PSM was used to mimic randomized controlled the trials. Kaplan-Meier survival method and log-rank tests were utilized for survival analysis. RESULTS: A total 1827 patients met the inclusion criteria. Survival analysis indicated that the patients who underwent the primary site surgery had a better OS (P = 0.002) and CSS (P = 0.008), compared with non-surgery patients. Cox-regression analysis proved that age, marital status, T1 stages, surgery, radiation, sequential treatments, and chemotherapy had significant effects on OS. While age, marital status, histologic grade, surgery, radiation, sequential treatments, and chemotherapy were substantially associated with CSS. Patients who received primary site surgery had a better OS and CSS, compared with non-surgical patients. Patients receiving radiation had a better CSS than non-radiation patients. However, patients who received sequential treatments or chemotherapy had a worse OS and CSS, compared with controlled groups. Predictive nomogram models were established to predict patients' prognosis with good consistency between the actual observation and the nomogram prediction. Before PSM, patients who underwent surgery alone had a better OS and CSS than those who received radiation alone. After PSM, patients receiving surgery still had a better OS than those receiving radiation. However, there were no statistically significant differences in CSS. CONCLUSIONS: Nomogram models were developed to predict OS and CSS in patients with T1N0M0 glottic SCC. Primary site surgery could definitely increase OS and CSS, while radiation could significantly increase CSS. Using PSM, surgery alone could significantly enhance OS, as compared to radiation alone. Chemotherapy should not be recommended for early glottic carcinoma.
Assuntos
Carcinoma de Células Escamosas , Neoplasias de Cabeça e Pescoço , Humanos , Prognóstico , Nomogramas , Estadiamento de Neoplasias , Carcinoma de Células Escamosas de Cabeça e Pescoço/terapia , Carcinoma de Células Escamosas de Cabeça e Pescoço/patologia , Carcinoma de Células Escamosas/cirurgia , Programa de SEER , Neoplasias de Cabeça e Pescoço/patologiaRESUMO
Purpose: To investigate the development of refraction in anisometropic amblyopia who had been with patching therapy. Methods: We retrospectively reviewed 37,528 medical records of the amblyopes who had been treated with patching therapy between July 2003 and January 2020 at the School of Optometry and Ophthalmology and Eye Hospital of Wenzhou Medical University. We included unilateral anisometropic amblyopia with a follow-up length of not < 2 years. In total, 371 cases were enrolled and followed up for a mean of 4.76 ± 2.11 years. The subjects were then divided into different groups and periods according to their initial spherical equivalent (SE) refractive error and best-corrected visual acuity (BCVA) of the amblyopic eye. Linear mixed-effects models were fitted to calculate the annual change of SE. Results: The annual changes in SE were -0.32 (-0.35 to -0.30) and -0.16 (-0.19 to -0.14) D/yr for the amblyopic eye and the fellow eye, respectively. The annual changes in SE of amblyopic eyes during the treatment period and the successfully treated period were -0.36 (-0.43 to -0.29; 95% CI) and -0.27 (-0.32 to -0.23; 95% CI) D/yr, respectively; the annual SE changes of the fellow eye during the treatment period and the successfully-treated period were -0.07 (-0.14 to -0.01; 95% CI) and -0.18 (-0.22 to -0.14; 95% CI) D/yr, respectively. Conclusion: The amblyopic eye experienced a significantly greater degree of refractive error changes than the fellow eye and underwent a continuous refractive error reduction before and after 7 years old. After the patching therapy was terminated, emmetropization in the amblyopic eye remained synchronized, whereas the refractive error change was increased in the fellow eye.
RESUMO
Background and purpose: Acylcarnitines (ACars) are important for insulin resistance and type 2 diabetes (T2D). However, their roles in diabetic retinopathy (DR) remain controversial. In this study, we aimed to investigate the association of ACars with DR and their values in DR detection. Methods: This was a two-center case-control study based on the propensity score matching approach between August 2017 to June 2018 in Eastern China. Multivariable logistic regression models were applied to estimate the association of plasma ACars with DR. Differential ACars were screened by models of least absolute shrinkage and selection operator, elastic net, and weighted quantile sum regression, and their roles in DR identification were further evaluated by the area under the receiver operating curve (AUC). Results: Eight of twenty plasma ACars (8:0, 12:0, 12:1, 14:1, 16:2, 18:0, 18:2 and 18:3) were associated with DR, while only ACar 8:0 was selected by three variable selection methods. As compared to those with the 1st tertile of ACar 8:0, the adjusted odds ratio (OR) and 95% confidence interval (CI) of DR were 0.22 (0.08, 0.59) and 0.12 (0.04, 0.36) for subjects in the 2nd and 3rd tertiles, respectively (P for trend < 0.001). Consistent associations were also observed in both restricted cubic spline regression models and subgroup analyses. AUC (95% CI) were 0.74 (0.66, 0.82) for ACar 8:0 alone and 0.77 (0.70, 0.85) for ACar 8:0 combined with covariates. Conclusions: Our findings suggest higher ACar 8:0 is significantly associated with a decreased risk of DR, which provides a unique window for early identification of DR.