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Necroptosis is a type of programmed cell death that is morphologically similar to necrosis. This type of cell death is involved in various pathophysiological disorders, including inflammatory, neurodegenerative, infectious, and malignant diseases. Receptor-interacting protein kinase 1 (RIPK1), RIPK3, and mixed lineage kinase domain-like protein (MLKL) pseudokinase constitute the core components of the necroptosis signaling pathway and are considered the most promising targets for therapeutic intervention. The discovery and characterization of necroptosis inhibitors not only accelerate our understanding of the necroptosis signaling pathway but also provide important drug candidates for the treatment of necroptosis-related diseases. Here, we will review recent research progress on necroptosis inhibitors, mechanisms of action and their potential applications for disease treatment.
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Apoptose , Proteínas Quinases , Humanos , Proteínas Quinases/genética , Proteínas Quinases/metabolismo , Necroptose/genética , Morte Celular , Necrose/genética , Proteína Serina-Treonina Quinases de Interação com Receptores/metabolismoRESUMO
The aim of the current study was to investigate the feasibility of three-dimensional ultrashort echo time quantitative susceptibility mapping (3D UTE-QSM) for the assessment of gadolinium (Gd) deposition in cortical bone. To this end, 40 tibial bovine cortical bone specimens were divided into five groups then soaked in phosphate-buffered saline (PBS) solutions with five different Gd concentrations of 0, 0.4, 0.8, 1.2, and 1.6 mmol/L for 48 h. Additionally, eight rabbits were randomly allocated into three groups, consisting of a normal-dose macrocyclic gadolinium-based contrast agent (GBCA) group (n = 3), a high-dose macrocyclic GBCA group (n = 3), and a control group (n = 2). All bovine and rabbit tibial bone samples underwent magnetic resonance imaging (MRI) on a 3-T clinical MR system. A 3D UTE-Cones sequence was utilized to acquire images with five different echo times (i.e., 0.032, 0.2, 0.4, 0.8, and 1.2 ms). The UTE images were subsequently processed with the morphology-enabled dipole inversion algorithm to yield a susceptibility map. The average susceptibility was calculated in three regions of interest in the middle of each specimen, and the Pearson's correlation between the estimated susceptibility and Gd concentration was calculated. The bone samples soaked in PBS with higher Gd concentrations exhibited elevated susceptibility values. A mean susceptibility value of -2.47 ± 0.23 ppm was observed for bovine bone soaked in regular PBS, while the mean QSM value increased to -1.75 ± 0.24 ppm for bone soaked in PBS with the highest Gd concentration of 1.6 mmol/L. A strong positive correlation was observed between Gd concentrations and QSM values. The mean susceptibility values of rabbit tibial specimens in the control group, normal-dose GBCA group, and high-dose GBCA group were -4.11 ± 1.52, -3.85 ± 1.33, and -3.39 ± 1.35 ppm, respectively. In conclusion, a significant linear correlation between Gd in cortical bone and QSM values was observed. The preliminary results suggest that 3D UTE-QSM may provide sensitive noninvasive assessment of Gd deposition in cortical bone.
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Gadolínio , Imageamento Tridimensional , Animais , Bovinos , Coelhos , Osso e Ossos/diagnóstico por imagem , Meios de Contraste , Osso Cortical/diagnóstico por imagem , Imageamento Tridimensional/métodos , Imageamento por Ressonância Magnética/métodosRESUMO
Chronic diabetic wounds represent a significant clinical challenge because of impaired healing processes, which require innovative therapeutic strategies. This study explores the therapeutic efficacy of insulin-induced gene 1-induced bone marrow mesenchymal stem cell exosomes (Insig1-exos) in promoting wound healing in diabetic mice. We demonstrated that Insig1 enhanced the secretion of bone marrow mesenchymal stem cell-derived exosomes, which are enriched with miR-132-3p. Through a series of in vitro and in vivo experiments, these exosomes significantly promoted the proliferation, migration, and angiogenesis of dermal fibroblasts under high-glucose conditions. They also regulated key wound-healing factors, including matrix metalloproteinase-9, platelet-derived growth factor, vascular endothelial growth factor, transforming growth factor-ß1, and platelet endothelial cell adhesion molecule-1, thereby accelerating wound closure in diabetic mice. Histological analysis showed that Insig1-exos were more effective in promoting epithelialization, enhancing collagen deposition, and reducing inflammation. Additionally, inhibition of miR-132-3p notably diminished these therapeutic effects, underscoring its pivotal role in the wound-healing mechanism facilitated by Insig1-exos. This study elucidates the molecular mechanisms through which Insig1-exos promotes diabetic wound healing, highlighting miR-132-3p as a key mediator. These findings provide new strategies and theoretical foundations for treating diabetes-related skin injuries.
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Diabetes Mellitus Experimental , Exossomos , Células-Tronco Mesenquimais , MicroRNAs , Cicatrização , Animais , Masculino , Camundongos , Movimento Celular , Proliferação de Células , Diabetes Mellitus Experimental/metabolismo , Diabetes Mellitus Experimental/terapia , Exossomos/metabolismo , Fibroblastos/metabolismo , Células-Tronco Mesenquimais/metabolismo , Camundongos Endogâmicos C57BL , MicroRNAs/genética , MicroRNAs/metabolismoRESUMO
Cholestane-3ß,5α,6ß-triol (CT) and its analogues are abundant in natural sources and are reported to demonstrate cytotoxicity toward different kinds of tumor cells without a deep probe into their mechanism of action. CT is also one of the major metabolic oxysterols of cholesterol in mammals and is found to accumulate in various diseases. An extensive exploration of the biological roles of CT over the past few decades has established its identity as an apoptosis inducer. In this study, the effects of CT on A549 cell death were investigated through cell viability assays. RNA-sequencing analysis and western blot of CT-treated A549 cells revealed the role of CT in inducing endoplasmic reticulum (ER) stress response and enhancing autophagy flux, suggesting a putative mechanism of CT-induced cell-death activation involving reactive oxygen species (ROS)-mediated ER stress and autophagy. It is reported for the first time that the upregulation of autophagy induced by CT can serve as a cellular cytotoxicity response in accelerating CT-induced cell death in A549 cells. This research provides evidence for the effect of CT as an oxysterol in cell response to oxidative damage and allows for a deep understanding of cholesterol in its response in an oxidative stress environment that commonly occurs in the progression of various diseases.
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Autofagia , Sobrevivência Celular , Colestanóis , Estresse do Retículo Endoplasmático , Espécies Reativas de Oxigênio , Humanos , Estresse do Retículo Endoplasmático/efeitos dos fármacos , Autofagia/efeitos dos fármacos , Células A549 , Espécies Reativas de Oxigênio/metabolismo , Sobrevivência Celular/efeitos dos fármacos , Apoptose/efeitos dos fármacos , Colesterol/metabolismo , Colestanos/farmacologia , Morte Celular/efeitos dos fármacos , Estresse Oxidativo/efeitos dos fármacosRESUMO
Straw management is an important issue for many developing countries. In China, straw return is an effective way of straw management, involving substantial financial subsidies and impacts on public welfare through environmental improvements. The public plays a significant role as a financial source and beneficiary, and sustainable straw return policies need to respond to the public's interests and concerns. Assessments of the public's heterogeneous preferences and willingness to pay can provide useful social insights into straw return policies. However, public opinion has not received sufficient attention. To fill this gap, this study utilized random parameter logit and latent class models based on a choice experiment survey data to assess willingness to pay and preference heterogeneity for environmental benefits of straw return. The results show that urban residents were willing to pay 20.71 CNY, 17.37 CNY, and 11.79 CNY, respectively, for increasing 1% soil organic matter content, clean air days, and chemical fertilizer reduction through straw return. Respondents' preferences were significantly influenced by their socioeconomic and cognitive characteristics. Specifically, respondents with higher income and more understanding of straw return policy have a significant preference for more attributes; older, lower-income, and less understanding groups have a significant preference for fewer attributes. The findings will not only enhance the accuracy and effectiveness of straw return policies, helping to form sustainable straw return policies, but also highlighting the necessity of broadening the scope of analysis for sustainable agricultural practices to provide a more comprehensive assessment, especially for developing countries facing straw management problems.
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Amino acid metabolism has been implicated in tumorigenesis and tumor progression. Alterations in intracellular and extracellular metabolites associated with metabolic reprogramming in cancer have profound effects on gene expression, cell differentiation, and tumor immune microenvironment. However, the prognostic significance of amino acid metabolism in head and neck cancer remains to be further investigated. In this study, we identified 98 differentially expressed genes related to amino acid metabolism in head and neck cancer in The Cancer Genome Atlas. Using batch univariate Cox regression and Lasso regression, we extracted nine amino acid metabolism-related genes. Based on that, we developed the amino acid metabolism index. The prognostic value of this index was validated in two Gene Expression Omnibus cohorts. The results show that this model can help predict tumor recurrence and prognosis. The infiltration of immune cells in the tumor microenvironment was analyzed, and it was discovered that the high index is associated with an immunosuppressive microenvironment. In addition, this study demonstrated the impact of the amino acid metabolism index on clinical indicators, survival of patients with head and neck cancer, and the prediction of treatment response to immune checkpoint inhibitors. We conducted several cell experiments and demonstrated that epigenetic drugs could affect the index and enhance tumor immunity. In conclusion, our study demonstrates that the index not only has important prognostic value in head and neck cancer patients but also facilitates patient stratification for immunotherapy.
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Neoplasias de Cabeça e Pescoço , Recidiva Local de Neoplasia , Humanos , Prognóstico , Neoplasias de Cabeça e Pescoço/genética , Carcinogênese , Imunossupressores , Aminoácidos , Microambiente Tumoral/genéticaRESUMO
With the increasing attention and awareness of the ecological environment, ecotourism is becoming ever more popular, but it still brings problems and challenges to the sustainable development of the environment. To solve such challenges, it is necessary to review literature in the field of ecotourism and determine the key research issues and future research directions. This paper uses scientometrics implemented by CiteSpace to conduct an in-depth systematic review of research and development in the field of ecotourism. Two bibliographic datasets were obtained from the Web of Science, including a core dataset and an expanded dataset, containing articles published between 2003 and 2021. Our research shows that ecotourism has been developing rapidly in recent years. The research field of ecotourism spans many disciplines and is a comprehensive interdisciplinary subject. According to the research results, the evolution of ecotourism can be roughly divided into three phases: human disturbance, ecosystem services and sustainable development. It could be concluded that it has entered the third stage of Shneider's four-stage theory of scientific discipline. The research not only identifies the main clusters and their advance in ecotourism research based on high impact citations and research frontier formed by citations, but also presents readers with new insights through intuitive visual images. Supplementary Information: The online version contains supplementary material available at 10.1007/s10668-022-02190-0.
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Intelligent Tutoring Systems (ITSs) have a great potential to effectively transform teaching and learning. As more efforts have been put on designing and developing ITSs and integrating them within learning and instruction, mixed types of results about the effectiveness of ITS have been reported. Therefore, it is necessary to investigate how ITSs work in real and natural educational contexts and the associated challenges of ITS application and evaluation. Through a systematic literature review method, this study analyzed 40 qualified studies that applied social experiment methods to examine the effectiveness of ITS during 2011-2022. The obtained results highlighted a complicated landscape regarding the effectiveness of ITS in real educational contexts. Specifically, there was an "intelligent" regional gap regarding the distribution of countries where ITS studies using social experiment methods were conducted. Compared to learning performance, relatively less attention was paid to investigating the impact of ITS on non-cognitive factors, process-oriented factors, and social outcomes, calling for more research in this regard. Considering the complexities and challenges existing in real educational fields, there was a lack of scientific rigor in terms of experimental design and data analysis in some of the studies. Based on these findings, suggestions for future study and implications were proposed.
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Necroptosis is a programmed necrosis that is mediated by receptor-interacting protein kinases RIPK1, RIPK3 and the mixed lineage kinase domain-like protein, MLKL. Necroptosis must be strictly regulated to maintain normal tissue homeostasis, and dysregulation of necroptosis leads to the development of various inflammatory, infectious, and degenerative diseases. Ubiquitylation is a widespread post-translational modification that is essential for balancing numerous physiological processes. Over the past decade, considerable progress has been made in the understanding of the role of ubiquitylation in regulating necroptosis. Here, we will discuss the regulatory functions of ubiquitylation in necroptosis signaling pathway. An enhanced understanding of the ubiquitylation enzymes and regulatory proteins in necroptotic signaling pathway will be exploited for the development of new therapeutic strategies for necroptosis-related diseases.
Assuntos
Apoptose , Necroptose , Apoptose/genética , Humanos , Necroptose/genética , Necrose/genética , Proteínas Quinases/genética , Proteínas Quinases/metabolismo , UbiquitinaçãoRESUMO
Synaptic plasticity damages play a crucial role in the onset and development of depression, especially in the hippocampus, which is more susceptible to stress and the most frequently studied brain region in depression. And, mitochondria have a major function in executing the complex processes of neurotransmission and plasticity. We have previously demonstrated that Iptakalim (Ipt), a new ATP-sensitive potassium (K-ATP) channel opener, could improve the depressive-like behavior in mice. But the underlying mechanisms are not well understood. The present study demonstrated that Ipt reversed depressive-like phenotype in vivo (chronic mild stress-induced mice model of depression) and in vitro (corticosterone-induced cellular model). Further study showed that Ipt could upregulate the synaptic-related proteins postsynaptic density 95 (PSD 95) and synaptophysin (SYN), and alleviated the synaptic structure damage. Moreover, Ipt could reverse the abnormal mitochondrial fission and fusion, as well as the reduced mitochondrial ATP production and collapse of mitochondrial membrane potential in depressive models. Knocking down the mitochondrial ATP-sensitive potassium (Mito-KATP) channel subunit MitoK partly blocked the above effects of Ipt. Therefore, our results reveal that Ipt can alleviate the abnormal mitochondrial dynamics and function depending on MitoK, contributing to improve synaptic plasticity and exert antidepressive effects. These findings provide a candidate compound and a novel target for antidepressive therapy.
Assuntos
Depressão/tratamento farmacológico , Canais KATP/antagonistas & inibidores , Mitocôndrias/efeitos dos fármacos , Propilaminas/farmacologia , Estresse Psicológico/complicações , Sinapses/efeitos dos fármacos , Animais , Depressão/etiologia , Depressão/patologia , Hipocampo/efeitos dos fármacos , Hipocampo/metabolismo , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Mitocôndrias/metabolismo , Plasticidade Neuronal , Sinapses/metabolismoRESUMO
Pericytes are present tight around the intervals of capillaries, play an essential role in stabilizing the blood-brain barrier, regulating blood flow and immunomodulation, and persistent contraction of pericytes eventually leads to impaired blood flow and poor clinical outcomes in ischemic stroke. We previously show that iptakalim, an ATP-sensitive potassium (K-ATP) channel opener, exerts protective effects in neurons, and glia against ischemia-induced injury. In this study we investigated the impacts of iptakalim on pericytes contraction in stroke. Mice were subjected to cerebral artery occlusion (MCAO), then administered iptakalim (10 mg/kg, ip). We showed that iptakalim administration significantly promoted recovery of cerebral blood flow after cerebral ischemia and reperfusion. Furthermore, we found that iptakalim significantly inhibited pericytes contraction, decreased the number of obstructed capillaries, and improved cerebral microcirculation. Using a collagen gel contraction assay, we demonstrated that cultured pericytes subjected to oxygen-glucose deprivation (OGD) consistently contracted from 3 h till 24 h during reoxygenation, whereas iptakalim treatment (10 µM) notably restrained pericyte contraction from 6 h during reoxygenation. We further showed that iptakalim treatment promoted K-ATP channel opening via suppressing SUR2/EPAC1 complex formation. Consequently, it reduced calcium influx and ET-1 release. Taken together, our results demonstrate that iptakalim, targeted K-ATP channels, can improve microvascular disturbance by inhibiting pericyte contraction after ischemic stroke. Our work reveals that iptakalim might be developed as a promising pericyte regulator for treatment of stroke.
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AVC Isquêmico , Acidente Vascular Cerebral , Trifosfato de Adenosina , Animais , Camundongos , Microcirculação , Pericitos , Propilaminas , Acidente Vascular Cerebral/tratamento farmacológicoRESUMO
PURPOSE: Pulmonary metastasis was a negative factor of osteosarcoma prognosis. However, there is no universal criteria to confirm pulmonary metastasis at pulmonary micro nodule (PMN, Dmax ≤ 5 mm) stage other than pathology. We aimed to identify prevalence of PMNs, determine prognosis of osteosarcoma with PMNs, and analyze risk factors related to PMN progression. METHODS: We retrospectively reviewed 425 consecutive osteosarcoma patients. According to dynamic change in size and number of PMNs, patients were divided into PMN progression and non-progression group. Demographic data, initial laboratory data, radiological features, and oncological evaluations were analyzed. Cox regression was used to identify risk factors for PMN progression. Overall survival rate was measured and analyzed with Kaplan-Meier method. Differences with p < 0.05 were considered significant. RESULTS: PMNs were found in 74% (315/425) osteosarcoma patients, half of whom (157/315) suffering PMN progression. Overall survival rate was 70.2%, while survival rates for PMN progression group and non-progression group were 53.40% and 87.40%, respectively. Clinical risk factors for PMN progression in certain patients included blood vessel invasion, extrapulmonary metastases, low tumour cell necrosis rate, and large tumour size. Radiologic risk factors included greatest diameter, distance to pleura, CT value, solid components, and smooth border. CONCLUSION: PMN is quite common in osteosarcoma patients. PMN progression is related to both certain clinical and radiological factors, which could assist surgeons to determine its possibility to progress at an early stage.
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Neoplasias Ósseas , Neoplasias Pulmonares , Osteossarcoma , Neoplasias Ósseas/patologia , Humanos , Neoplasias Pulmonares/epidemiologia , Neoplasias Pulmonares/secundário , Prevalência , Estudos RetrospectivosRESUMO
As energy metabolism regulation factor, peroxisome proliferator-activated receptor (PPAR) is thought to be a potential target for the treatment of depression. The present study was performed to evaluate the effects of activating PPARß/δ, the most highly expressed subtype in the brain, in depressive in vivo and in vitro models. We observed that PPARß/δ agonist GW0742 significantly alleviated depressive behaviors in mice and promoted the formation of autophagosomes around the damaged mitochondria in hippocampal astrocytes. Our in vitro experiments showed that GW0742 could reduce mitochondrial oxidative stress, and thereby attenuate endoplasmic reticulum (ER) stress-mediated apoptosis pathway via inhibiting IRE1α phosphorylation, subsequently protect against astrocytic apoptosis and loss. Furthermore, we found that PPARß/δ agonist induces astrocytic mitophagy companied with the upregulated UCP2 expressions. Knocking down UCP2 in astrocytes could block the anti-apoptosis and pro-mitophagy effects of GW0742. In conclusion, our findings reveal PPARß/δ activation protects against ER stress-induced astrocytic apoptosis via enhancing UCP2-mediated mitophagy, which contribute to the anti-depressive action. The present study provides a new insight for depression therapy.
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PPAR delta , PPAR beta , Animais , Astrócitos/metabolismo , Estresse do Retículo Endoplasmático , Endorribonucleases/metabolismo , Camundongos , Mitofagia , PPAR delta/metabolismo , PPAR beta/metabolismo , Fenóis , Proteínas Serina-Treonina Quinases , Compostos de Sulfidrila , Tiazóis , Proteína Desacopladora 2/genética , Proteína Desacopladora 2/metabolismoRESUMO
Breast pseudoaneurysm is a very rare complication. In this study, we report a patient with huge breast pseudoaneurysm after ultrasound-guided vacuum-assisted biopsy (UGVAB) of breast nodules. In treatment, we used microwave ablation to treat the pseudoaneurysm, and then used UGVAB again to eliminate the complicated hematoma. The patients obtained good therapeutic effect. From this case, we experience that, before the interventional operations for breast nodules, the systematic ultrasound examination should be performed. In the needle entering channel, the obvious blood vessels should be avoided to reduce the unnecessary vascular injury. When the pseudoaneurysm occurs, the patient's condition, pseudoaneurysm situation and hematoma size should be comprehensively considered, combined with the multidisciplinary consultation, for selecting the best treatment strategy.
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Oridonin, a natural diterpenoid compound extracted from a Chinese herb, has been proved to exert anti-oxidative stress effects in various disease models. The aim of the present study was to investigate the protective effects of oridonin on oxidative stress-induced endothelial injury in ischaemic stroke. We found oridonin repaired blood-brain barrier (BBB) integrity presented with upregulation of tight junction proteins (TJ proteins) expression, inhibited the infiltration of periphery inflammatory cells and neuroinflammation and thereby reduced infarct volume in ischaemic stroke mice. Furthermore, our results showed that oridonin could protect against oxidative stress-induced endothelial injury via promoting nuclear translocation of nuclear factor-erythroid 2 related factor 2 (Nrf-2). The specific mechanism could be the activation of AKT(Ser473)/GSK3ß(Ser9)/Fyn signalling pathway. Our findings revealed the therapeutic effect and mechanism of oridonin in ischaemic stroke, which provided fundamental evidence for developing the extracted compound of Chinese herbal medicine into an innovative drug for ischaemic stroke treatment.
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Diterpenos do Tipo Caurano/farmacologia , Endotélio/metabolismo , AVC Isquêmico/metabolismo , Fator 2 Relacionado a NF-E2/metabolismo , Estresse Oxidativo/efeitos dos fármacos , Transdução de Sinais/efeitos dos fármacos , Animais , Anti-Inflamatórios/farmacologia , Biomarcadores , Barreira Hematoencefálica/metabolismo , Permeabilidade Capilar , Sobrevivência Celular/efeitos dos fármacos , Modelos Animais de Doenças , Suscetibilidade a Doenças , Endotélio/efeitos dos fármacos , Endotélio/patologia , Glucose/metabolismo , Glicogênio Sintase Quinase 3 beta/metabolismo , Imuno-Histoquímica , AVC Isquêmico/etiologia , Masculino , Camundongos , Neurônios/efeitos dos fármacos , Neurônios/metabolismo , Oxigênio/metabolismo , Proteínas Proto-Oncogênicas c-akt/metabolismo , Espécies Reativas de Oxigênio/metabolismoRESUMO
PURPOSE: To evaluate 3D UTE bicomponent imaging of cortical bone ex vivo and in vivo using a newly designed soft-hard composite pulse for excitation. METHODS: Chemical shift artifacts, presenting as fat-water oscillation or combination-induced signal oscillation, significantly reduce the accuracy of quantitative UTE bicomponent analysis of cortical bone. To achieve fat suppression for more reliable bicomponent analysis, a newly developed soft-hard excitation pulse was used with UTE imaging and compared with a single rectangular pulse excitation without and with a conventional fat saturation (FatSat) module. These 3 sequences were applied to 8 bovine bone samples without marrow fat, 3 bovine bone samples with marrow fat, and tibial midshafts of 5 healthy human volunteers. Bicomponent analyses were performed in both ex vivo and in vivo studies. RESULTS: The soft-hard pulse provided comparable fat suppression, but much reduced bone signal attenuation compared with the FatSat module. Better bicomponent T2∗ fitting was also achieved with the soft-hard excitation pulse because it greatly reduced chemical shift artifacts and outperformed the single rectangular pulse without or with FatSat. Although the FatSat module reduced fat signals and related fat-water oscillation, the water signals were significantly attenuated with more than 40% reduction due to direction saturation. For the inner layer of tibial midshaft in healthy volunteers, fitting errors increased from 3.78% for the soft-hard pulse to 11.43% and 5.16%, respectively, for the single rectangular pulse without and with the FatSat module. CONCLUSION: The 3D UTE sequence with a new soft-hard excitation pulse allows more reliable bicomponent imaging of cortical bone.
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Osso Cortical , Imageamento por Ressonância Magnética , Animais , Osso e Ossos/diagnóstico por imagem , Bovinos , Osso Cortical/diagnóstico por imagem , Humanos , Imageamento Tridimensional , Tíbia/diagnóstico por imagemRESUMO
BACKGROUND: Opioid titration is necessary to achieve rapid, safe pain relief. Medication can be administered via patient-controlled analgesia (PCA) or by a healthcare provider (non-PCA). We evaluated the efficacy of intravenous PCA versus non-PCA hydromorphone titration for severe cancer pain (≥7 at rest on the 11-point numeric rating scale [NRS]). PATIENTS AND METHODS: Patients with severe cancer pain were randomized 1:1 to PCA or non-PCA titration, stratified by opioid-tolerant or opioid-naïve status. The PCA pump was set to no continuous dose, with a hydromorphone bolus dose 10% to 20% of the total previous 24-hour equianalgesic (for opioid-tolerant patients) or 0.5 mg (for opioid-naïve patients). For the non-PCA group, the initial hydromorphone bolus dose was identical to that in the PCA group, with the subsequent dose increased by 50% to 100% (for NRS unchanged or increased) or repeated at the current dose (for NRS 4-6). Hydromorphone delivery was initiated every 15 minutes (for NRS ≥4) or as needed (for NRS ≤3). The primary endpoint was time to successful titration (TST; time from first hydromorphone dose to first occurrence of NRS ≤3 in 2 consecutive 15-minute intervals). RESULTS: Among 214 patients (PCA, n=106; non-PCA, n=108), median TSTs (95% CI) were 0.50 hours (0.25-0.50) and 0.79 hours (0.50-1.42) for the PCA and non-PCA groups, respectively (hazard ratio [HR], 1.64; 95% CI, 1.23-2.17; P=.001). TSTs in opioid-tolerant patients were 0.50 hours (0.25-0.75) and 1.00 hours (0.50-2.00) for the PCA and non-PCA groups, respectively (HR, 1.92; 95% CI, 1.32-2.78; P=.003); in opioid-naive patients, TST was not significantly different for the PCA versus non-PCA groups (HR, 1.35; 95% CI, 0.88-2.04; P=.162). Pain score (median NRS; interquartile range) over 24 hours was significantly lower in the PCA group (2.80; 2.15-3.22) than in the non-PCA group (3.00; 2.47-3.53; P=.020). PCA administration produces significantly higher patient satisfaction with pain control than non-PCA administration (P<.001). CONCLUSIONS: Intravenous hydromorphone titration for severe cancer pain was achieved more effectively with PCA than with non-PCA administration.
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Dor do Câncer , Neoplasias , Humanos , Hidromorfona/efeitos adversos , Analgésicos Opioides/efeitos adversos , Analgesia Controlada pelo Paciente , Dor do Câncer/tratamento farmacológico , Dor do Câncer/etiologia , Dor , Neoplasias/complicações , Neoplasias/tratamento farmacológicoRESUMO
OBJECTIVE: To develop a fully automated full-thickness cartilage segmentation and mapping of T1, T1ρ, and T2*, as well as macromolecular fraction (MMF) by combining a series of quantitative 3D ultrashort echo time (UTE) cones MR imaging with a transfer learning-based U-Net convolutional neural networks (CNN) model. METHODS: Sixty-five participants (20 normal, 29 doubtful-minimal osteoarthritis (OA), and 16 moderate-severe OA) were scanned using 3D UTE cones T1 (Cones-T1), adiabatic T1ρ (Cones-AdiabT1ρ), T2* (Cones-T2*), and magnetization transfer (Cones-MT) sequences at 3 T. Manual segmentation was performed by two experienced radiologists, and automatic segmentation was completed using the proposed U-Net CNN model. The accuracy of cartilage segmentation was evaluated using the Dice score and volumetric overlap error (VOE). Pearson correlation coefficient and intraclass correlation coefficient (ICC) were calculated to evaluate the consistency of quantitative MR parameters extracted from automatic and manual segmentations. UTE biomarkers were compared among different subject groups using one-way ANOVA. RESULTS: The U-Net CNN model provided reliable cartilage segmentation with a mean Dice score of 0.82 and a mean VOE of 29.86%. The consistency of Cones-T1, Cones-AdiabT1ρ, Cones-T2*, and MMF calculated using automatic and manual segmentations ranged from 0.91 to 0.99 for Pearson correlation coefficients, and from 0.91 to 0.96 for ICCs, respectively. Significant increases in Cones-T1, Cones-AdiabT1ρ, and Cones-T2* (p < 0.05) and a decrease in MMF (p < 0.001) were observed in doubtful-minimal OA and/or moderate-severe OA over normal controls. CONCLUSION: Quantitative 3D UTE cones MR imaging combined with the proposed U-Net CNN model allows a fully automated comprehensive assessment of articular cartilage. KEY POINTS: ⢠3D UTE cones imaging combined with U-Net CNN model was able to provide fully automated cartilage segmentation. ⢠UTE parameters obtained from automatic segmentation were able to reliably provide a quantitative assessment of cartilage.
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Cartilagem Articular , Imageamento Tridimensional , Cartilagem Articular/diagnóstico por imagem , Humanos , Imageamento por Ressonância Magnética , Redes Neurais de ComputaçãoRESUMO
BACKGROUND: En bloc resection of malignant tumors involving upper thoracic spine is technically difficult. We surgically treated a patient with grade 2 chondrosarcoma involving T1-5, left upper thoracic cavity, and chest wall. CASE PRESENTATION: A 37 years old, male patient was referred to our hospital for a huge lump involved left shoulder and chest wall. In order to achieve satisfied surgical margins, anterior approach, posterior approach, and lateral approach were carried out sequentially. After en bloc tumor resection, the upper thoracic spine was reconstructed with a 3D-printed modular vertebral prosthesis, and the huge chest wall defect was repaired by a methyl methacrylate layer between 2 pieces of polypropylene mesh. Postoperatively, the patient suffered from pneumonia and neurological deterioration which fully recovered eventfully. At 24 months after operation, the vertebral prosthesis and internal fixation were intact; there was no tumor local recurrence, and the patient was alive with stable pulmonary metastases. CONCLUSION: This case report describes resection of a huge chondrosarcoma involving not only multilevel upper thoracic spine, but also entire left upper thoracic cavity and chest wall. Although with complications, en bloc tumor resection with combined surgical approach and effective reconstructions could improve oncologic and functional prognosis in carefully selected spinal tumor patients.
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Condrossarcoma , Neoplasias da Coluna Vertebral , Parede Torácica , Adulto , Condrossarcoma/diagnóstico por imagem , Condrossarcoma/cirurgia , Humanos , Masculino , Recidiva Local de Neoplasia , Neoplasias da Coluna Vertebral/diagnóstico por imagem , Neoplasias da Coluna Vertebral/cirurgia , Vértebras Torácicas/diagnóstico por imagem , Vértebras Torácicas/cirurgia , Parede Torácica/diagnóstico por imagem , Parede Torácica/cirurgiaRESUMO
Streptomycin (STR) plays an essential role in bacterial infection treatments. Selectivity and sensitivity of photoelectrochemical (PEC) sensors are the two most important parameters, which can be measured using the photosensitivity of its active material. We prepared a novel PEC sensor to detect STR using Bi/BiVO4/LDH (layered double hydroxides) heterostructures as an active material, which is photoactive in the visible light wavelength range. The simultaneous presence of LDH and Bi/BiVO4 enhanced the material photocurrent response, which was linear to the STR concentrations in the 0.01-500 nmol/L range. The STR detection limit by this sensor was 0.0042 nmol/L. Our novel PEC-based sensing strategy includes using an ultra-sensitive and highly selective sensor for STR detection. Additionally, the two-pot synthesis of Bi/BiVO4/LDH developed in this work is environmentally friendly.