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Hepatocyte nuclear factor 4 alpha (HNF4α) and the pregnane X receptor (PXR) are involved in hepatocyte regeneration. It is not clear whether HNF4α is involved in hepatocyte regeneration through the regulation of PXR. This study aims to explore the regulatory relationship between HNF4a and PXR, and whether it affects hepatocyte regeneration. A mouse PXR gene reporter and an HNF4α overexpression plasmid were constructed and transfected into mouse hepatoma cells (Hepa1-6). Overexpression of HNF4α, detection of the PXR gene reporter fluorescence value, PXR gene, and protein expression analysis were conducted to explore the regulatory relationship between HNF4α and PXR. Apoptosis and cell cycle data were measured to verify whether HNF4α is involved in hepatocyte regeneration through PXR. The luciferase gene reporter assay results indicated when HNF4α was overexpressed, the fluorescence value of the PXR gene reporter was higher than that in the control at 24 h. With increasing HNF4α expression, the PXR gene and protein expression increased, indicating that HNF4α binds to the PXR promoter and upregulates PXR expression. Apoptosis and cell cycle analysis results demonstrated that when the expression of HNF4α increased, the expression of PXR increased, the apoptosis rate decreased, and the proliferation rate increased. Meanwhile, when the upward trend of PXR gene expression was inhibited by ketoconazole, the proliferation rate decreased. By inhibiting HNF4α and creating a partial hepatectomy (PHx), we demonstrated that HNF4α can upregulate PXR to promote liver regeneration in vivo. Therefore, HNF4α is shown to improve hepatocyte regeneration by upregulating PXR, which provides a reference for future research on the combined application of drugs for the treatment of liver injury.
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Apoptose , Fator 4 Nuclear de Hepatócito , Hepatócitos , Receptor de Pregnano X , Regulação para Cima , Fator 4 Nuclear de Hepatócito/metabolismo , Fator 4 Nuclear de Hepatócito/genética , Animais , Hepatócitos/metabolismo , Receptor de Pregnano X/metabolismo , Receptor de Pregnano X/genética , Camundongos , Regeneração Hepática/genética , Linhagem Celular Tumoral , Receptores de Esteroides/metabolismo , Receptores de Esteroides/genética , Regiões Promotoras GenéticasRESUMO
Reconstructive spectrometers/spectral cameras have immense potential for portable applications in various fields, including environmental monitoring, biomedical research and diagnostics, and agriculture and food safety. However, the performance of these spectrometers/spectral cameras is severely limited by the operational bandwidth, spectral diversity, and angle sensitivity of the spectral modulation devices. In this work, we propose a compact spectrometer based on plasmonic metasurfaces that operate across the entire visible wavelength range, covering wavelengths from 400 to 750â nm. We experimentally demonstrate the effective spectral reconstruction achieved by the designed metasurface spectrometer, exhibiting angle tolerance to the incident light within the range of ± 12°. Our results highlight the potential for constructing broadband, large field-of-view hyperspectral cameras.
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GABBR1 receptors have been implicated in the progression of rheumatoid arthritis (RA), and p38 MAP kinase (MAPK) was shown to be downregulated by GABA and result in unchecked production of pro-inflammatory cytokine. GABBR1 is a member of GABA receptors, and it is known to be upregulated and plays a vital role in RA. Glucocorticoids are efficient therapeutics in rheumatoid arthritis (RA) and are known to regulate GABA actions; therefore, we intended to investigate the potential of glucocorticoids in RA concerning the potential pathway GABBR1/MAPK. Joint specimens were obtained from collagen-induced arthritis mouse model. A double-blind semi-quantitative analysis of vascularity, cell infiltration, as well as lining thickness by help of a 4-point scale setting was used to assess joint inflammation. Expression of GABBR1 and p38 was evaluated immunohistochemically. In vitro peripheral blood (PB), synovial fluid (SF), and mononuclear cells (MCs) were acquired from RA mice. Western blotting was used for detecting expression of GABBR1 and p38 proteins. The presence of high levels of GABBR1 and p38 was prevalent in RA joints relative to healthy joints and related to the inflammation level. Glucocorticoid treatment alters GABBR1 along with p38 protein expression in joints while reducing joint inflammation. Ex vivo and in vitro assays revealed glucocorticoids have a direct impact on p38, such as the decreased GABBR1 expression level after dexamethasone incubation with SFMC. GABBR1 together with p38 expression in RA joints depends on local inflammation and can be targeted by glucocorticoids.
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Artrite Experimental , Artrite Reumatoide , Glucocorticoides , Proteínas Quinases p38 Ativadas por Mitógeno , Artrite Reumatoide/tratamento farmacológico , Artrite Reumatoide/metabolismo , Artrite Reumatoide/patologia , Animais , Glucocorticoides/farmacologia , Proteínas Quinases p38 Ativadas por Mitógeno/metabolismo , Artrite Experimental/tratamento farmacológico , Artrite Experimental/metabolismo , Artrite Experimental/patologia , Camundongos , Masculino , Articulações/patologia , Articulações/efeitos dos fármacos , Articulações/metabolismo , Camundongos Endogâmicos DBA , Líquido Sinovial/metabolismo , Líquido Sinovial/efeitos dos fármacos , Microambiente Celular/efeitos dos fármacos , Leucócitos Mononucleares/metabolismo , Leucócitos Mononucleares/efeitos dos fármacos , Modelos Animais de DoençasRESUMO
Fusing multiple sensor perceptions, specifically LiDAR and camera, is a prevalent method for target recognition in autonomous driving systems. Traditional object detection algorithms are limited by the sparse nature of LiDAR point clouds, resulting in poor fusion performance, especially for detecting small and distant targets. In this paper, a multi-task parallel neural network based on the Transformer is constructed to simultaneously perform depth completion and object detection. The loss functions are redesigned to reduce environmental noise in depth completion, and a new fusion module is designed to enhance the network's perception of the foreground and background. The network leverages the correlation between RGB pixels for depth completion, completing the LiDAR point cloud and addressing the mismatch between sparse LiDAR features and dense pixel features. Subsequently, we extract depth map features and effectively fuse them with RGB features, fully utilizing the depth feature differences between foreground and background to enhance object detection performance, especially for challenging targets. Compared to the baseline network, improvements of 4.78%, 8.93%, and 15.54% are achieved in the difficult indicators for cars, pedestrians, and cyclists, respectively. Experimental results also demonstrate that the network achieves a speed of 38 fps, validating the efficiency and feasibility of the proposed method.
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Macroporous resin column chromatography, MCI medium pressure column chromatography, and semi-preparative high performance liquid chromatography were employed to isolate the chemical components from the aqueous extract of the whole herb of Scindapsus officinalis. The structures of the compounds were identified based on the physical and chemical properties and the spectroscopic data. Ten compounds were isolated from the aqueous extract and identified as 3,4-dihydroxyphenylethyl-8-O-[ß-D-apiofuranosyl-(1â4)]-ß-D-glucopyranoside(1), alternamide B(2), 3,4-dihydroxyphenylethyl-O-ß-D-glucopyranoside(3), 1-(4-hydroxy)-phenylethyl-ß-D-galactopyranoside(4), 3,4-dihydroxyphenylethyl-8-O-[ß-D-apiofuranosyl-(1â2)]-ß-D-glucopyranoside(5), hydroxytyrosol-4-O-ß-D-glucopyranoside(6), 3,5-dihydroxyphenylethyl-3-O-ß-D-glucopyranoside(7), salidroside(8), dihydroisoquinolone(9), and 4-methoxybenzenepropanol-3-O-ß-D-glucopyranoside(10). Among them, compound 1 was a new one, and compounds 2-10 were obtained from S. officinalis for the first time. The RAW264.7 cells were exposed to lipopolysaccharide for the mode-ling of inflammation, and the cells were then used to examine anti-inflammatory activities of the compounds. The results showed that compounds 6 and 7 had strong anti-inflammatory activities, while compounds 1, 2, and 5 had moderate anti-inflammatory activities.
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Anti-Inflamatórios , Anti-Inflamatórios/farmacologia , Cromatografia Líquida de Alta PressãoRESUMO
"Nine Steaming Nine Sun-Drying" Polygonti rhizome has been used as valuable tonic health-care products for thousands of years. This research aimed to determine the correlations between the structure and anti-diabetic activities of three novel polysaccharides isolated from the raw and "Nine Steaming Nine Sun-Drying" Polygonti rhizome, with PRP-R from the raw ones and PRP-9Z and PRP-9A from the steamed ones. Structures of the isolated polysaccharides were determined by IR and NMR spectra, as well as monosaccharide composition and methylation analysis. In vitro assays indicated that PRP-9Z could improve the glucose consumptions more effectively than PRP-R and PRP-9A via Akt/GSK3ß insulin signal pathway by western blotting analysis. In vivo assays indicated PRP-9Z could improve the glucose tolerance in the BKS-db mice. Histopathological assay demonstrated that PRP-9Z effectively reduced the damage of the kidney and liver. The above results indicated that PRP-9Z from "Nine Steaming Nine Sun-Drying" Polygonti rhizome showed significant anti-diabetic properties, which indicated that PRP-9Z with higher content of â1)-ß-Frup-(2â was more active than PRP-R with higher â1,6)-ß-Fruf-(2â and PRP-9A with higher â4)-ß-Galp(1â.
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Polissacarídeos , Rizoma , Animais , Camundongos , Rizoma/química , Polissacarídeos/química , Vapor , Extratos Vegetais/química , Glucose/análiseRESUMO
Peroxynitrite (ONOO-) is a critical ROS in living systems, and could induce lipid peroxidation which is the driver of ferroptotic cell death. Therefore, precise and rapid detection of cellular ONOO- is critical for the deep study of the biological functions of ONOO- during ferroptosis. Herein, we developed fluorescent probes (Rh-1, Rh-2 and Rh-3) for the rapid detection of intracellular ONOO- during ferroptosis. These probes used bishydrazide groups as the reactive sites for ONOO-. The response of these probes to ONOO- resulted in the production of the emissive xanthene fluorophore, providing a marked enhancement in the fluorescence intensity at 561 nm. The probe Rh-3 exhibited prominent selectivity and sensitivity towards ONOO-. Bioimaging experiments suggested that Rh-3 could be applied to image exogenous and endogenous ONOO- in living cells. By fluorescence imaging, it was demonstrated that erastin-induced ferroptosis caused increased levels of the endogenous ONOO-, and ferrostatin-1 (Fer-1) and vitamin E (VE) could markedly inhibit the excessive production of ONOO- during ferroptosis in living cells.
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Ferroptose , Corantes Fluorescentes , Corantes Fluorescentes/química , Ácido Peroxinitroso/química , Ácido Peroxinitroso/metabolismo , Imagem Óptica , XantenosRESUMO
One new phenolic cyclobutantetraol ester united chromone glycoside (1), one new amide (2), and three new phenyl ethanol glycosides (3-5) were obtained from the water extract of Scindapsus officinalis (Roxb.) Schott, in which compound 1 was the first reported structure incorporating the phenolic cyclobutantetraol ester and chromone via the glucose phenolic metabolites in nature. Structures of the isolated compounds, including absolute configurations, were elucidated according to the analysis of HRESIMS, NMR, ECD and BLYP/6-31G* geometry optimization calculations of 13C NMR data. All isolates (1-5) were evaluated for the antidiabetic activity by the insulin resistance (IR) model and anti-inflammatory activity against NO production in vitro. Compounds 1-3 showed strong antidiabetic activities, greatly promoting the glucose consumption in the insulin resistance HepG2 cells compared with the model group, however, 1-5 showed weak anti-inflammatory activities.
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Hipoglicemiantes , Resistência à Insulina , Humanos , Hipoglicemiantes/farmacologia , Estrutura Molecular , Glicosídeos/química , Cromonas , Anti-Inflamatórios/farmacologia , Anti-Inflamatórios/química , Fenóis , Ésteres , GlucoseRESUMO
Ferroptosis is an emerging iron-dependent oxidative cell death type, and recently has been demonstrated to show close relation with Golgi apparatus (GA). Exploring the fluctuation of superoxide anion (O2â¢-) level in GA during ferroptosis is of great significance to profoundly study the biological functions of GA in ferroptosis. Here, we present a GA-targeting probe (N-GA) to monitor cellular O2â¢- during ferroptosis. N-GA employed a triflate group and a tetradecanoic amide unit as the recognition site for O2â¢- and GA-targeting unit, respectively. After the response of N-GA to O2â¢-, the triflate unit of N-GA converted into hydroxyl group with strong electron-donating ability, generating bright green fluorescence under UV light. N-GA exhibited excellent sensitivity and selectivity towards O2â¢-. Fluorescence imaging results showed that N-GA could be applied as a GA-targeting probe to monitor cellular O2â¢-. The stimulation of cells with PMA and rotenone could result in the massive generation of endogenous O2â¢- in GA. Erastin-induced ferroptosis can markedly induce the increase of O2â¢- level in GA. Similar to Fer-1 and DFO, dihydrolipoic acid (DHLA) and rutin were demonstrated to inhibit the enormous production of O2â¢- in GA of the living cells during ferroptosis.
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Ferroptose , Superóxidos , Corantes Fluorescentes/toxicidade , Ferro , Complexo de Golgi/metabolismoRESUMO
Coal-fired industrial boilers (CFIBs) that provide heat for industrial production operate to produce large quantities of wastes containing hazardous trace elements (HTEs), threatening the quality of the environment. Based on the established facility-level material flow inventory of five typical HTEs (Hg, As, Cd, Cr, and Pb) of Chinese CFIBs in 2020, we explored the enrichment characteristics and environmental risks of HTEs in wastes at the regional scale from the perspective of substance flow and enrichment levels. Results showed that the shares of HTEs entering the waste stream were 2.2-16.8 % higher in the focus regions of continuous improvement of air quality compared to the non-focus regions, explained by the higher synergistic control efficiencies of their air pollution control facilities (ACPFs), at 86.6-90.4 % (Hg), 98.6-99.1 % (As), 95.1-95.9 % (Cd), 93.2-94.8 % (Cr), and 97.1-98.0 % (Pb), respectively. In addition, the national averages of HTEs in slag, fly ash, and flue gas desulphurisation (FGD) were simulated to be 0.15-0.87 g/t, 3.25-18.44 g/t, 0.30-0.96 g/t, 19.76-70.11 g/t, and 15.85-73.74 for Hg, As, Cd, Cr, and Pb, respectively. Nationally, the integrated environmental risks of the five HTEs in slag, fly ash, and FGD residue exhibited Considerable, Very High, and Very High level of environmental risk, with the cumulative environmental risk indexes of 171, 317, and 281, respectively. Hg and Cd were the major contributors to the environmental risks of slag, fly ash, and FGD residue, with environmental risk contributions ranging from 23.8 to 82.3 % and 16.0 to 66.1 %, respectively. Results can provide data support for modelling the environmental release of HTEs from wastes and formulating control strategies for environmental management agencies.
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Coal-fired industrial boilers (CFIBs) are critical anthropogenic contributors of heavy metals (HMs) because of their high coal consumption and complicated air pollution control facilities (APCDs). This study explored the flows of Hg, As, Cd, Cr, and Pb in CFIBs at regional scale by establishing a boiler-level HMs inflow-outflow inventory. The results indicate that large-capacity CFIBs (≥ 65 t/h) are the leading contributors to HMs inflows. The inflow intensities of HMs in the provinces exhibited three classes of clustering characteristics. Significant regional heterogeneity was characterized by the distribution of HMs inflows and outflows, with higher HMs inflows and outflows in the northern and east-central coastal areas. However, the relatively low synergistic control efficiency of Cd in Northwest China resulted in a higher contribution of waste than inflow. The wastes generated during the operation of CFIBs are the major outflows of HMs. Hg was observed to have the highest outflow of atmospheric emissions owing to its high volatility. In addition, significant differences in the magnitude of HM outflow were identified among the provinces. The application of efficient APCDs contributes significantly to the partitioning of HMs into waste flows, thereby decreasing regional atmospheric emissions.
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Coal-fired power plants (CFPPs) are one of the most significant sources of mercury (Hg) emissions certified by the Minamata Convention, which has attracted much attention in recent years. In this study, we used the Web of Science and CiteSpace to analyze the knowledge structure of this field from 2000 to 2022 and then reviewed it systematically. The field of Hg emissions from coal-fired power plants has developed steadily. The research hotspots can be divided into three categories: (1) emission characterization research focused on speciation changes and emission calculations; (2) emission control research focused on control technologies; (3) environmental impact research focused on environmental pollution and health risk. In conclusion, using an oxygen-rich atmosphere for combustion and installing high-efficiency air pollution control devices (APCDs) helped to reduce the formation of Hg0. The average Hg removal rates of APCDs and modified adsorbents after ultra-low emission retrofit were distributed in the range of 82-93% and 41-100%, respectively. The risk level of Hg in combustion by-products was highest in desulfurization sludge (RAC > 10%) followed by fly ash (10% < RAC < 30%) and desulfurization gypsum (1% < RAC < 10%). Additionally, we found that the implementation of pollution and carbon reduction policies in China had reduced Hg emissions from CFPPs by 45% from 2007 to 2015, increased the efficiency of Hg removal from APCDs to a maximum of 96%, and reduced global transport and health risk of atmospheric Hg. The results conjunctively achieved by CiteSpace, and the literature review will enhance understanding of CFPP Hg emission research and provide new perspectives for future research.
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Poluentes Atmosféricos , Carvão Mineral , Mercúrio , Centrais Elétricas , Mercúrio/análise , Poluentes Atmosféricos/análise , Bibliometria , Poluição do Ar , Poluição Ambiental , Monitoramento Ambiental , ChinaRESUMO
Ferroptosis is a burgeoning iron-dependent cell death form, and has close relation with hypochlorous acid (HClO). Exploring the fluctuation of the HClO level in living cells during ferroptosis could contribute to the profound study of the biological functions of HClO during ferroptosis. Here, we present a turn-on probe (RH-C) for the imaging of intracellular HClO during ferroptosis. The probe RH-C utilized the N,N-dimethylthiocarbamate group as a selective recognition site for HClO, and displayed desirable sensitivity and selectivity to HClO. The probe RH-C could detect the exogenous and endogenous HClO in living cells. Furthermore, RH-C was competent in monitoring the changes of endogenous HClO level during the process of ferroptosis. Biological imaging results suggested that erastin-induced ferroptosis can result in the excessive production of the endogenous HClO, and ferrostatin-1 (Fer-1) and vitamin E (VE) could block the massive accumulation of HClO in living cells.
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Ferroptose , Corantes Fluorescentes , Ácido Hipocloroso/metabolismo , Imagem Óptica/métodos , Morte CelularRESUMO
The substantial amount of mercury emissions from coal-fired flue gas causes severe environmental contamination. With the Minamata Convention now officially in force, it is critical to strengthen mercury pollution control. Existing activated carbon injection technologies suffer from poor desulfurization performance and risk secondary-release risks. Therefore, considering the potential industrial application of adsorbents, we selected cost-effective and readily available activated coke (AC) as the carrier in this study. Four metal selenides-copper, iron, manganese, and tin-were loaded onto the AC to overcome the application problems of existing technologies. After 120 min of adsorption, the CuSe/AC exhibited the highest efficiency in removing Hg0, surpassing 80% according to the experimental findings. In addition, the optimal adsorption temperature window was 30-120 °C, the maximum adsorption rate was 2.9 × 10-2 mg·g-1·h-1, and the effectiveness of CuSe/AC in capturing Hg0 only dropped by 5.2% in the sulfur-containing atmosphere. The physicochemical characterization results indicated that the AC surface had a uniform loading of CuSe with a nanosheet structure resembling polygon and that the Cu-to-Se atomic ratio was close to 1:1. Finally, two possible Hg0 reaction pathways on CuSe/AC were proposed. Moreover, it was elucidated that the highly selective binding of Hg0 with ligand-unsaturated Se- was the key factor in achieving high adsorption efficiency and sulfur resistance in the selenium-functionalized AC adsorbent. This finding offers substantial theoretical support for the industrial application of this adsorbent.
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Carvão Mineral , Coque , Mercúrio , Selênio , Adsorção , Selênio/química , Mercúrio/química , Poluentes Atmosféricos/químicaRESUMO
Viscoelasticity is a crucial property of cells, which plays an important role in label-free cell characterization. This paper reports a model-fitting-free viscoelasticity calculation method, correcting the effects of frequency, surface adhesion and liquid resistance on AFM force-distance (FD) curves. As demonstrated by quantifying the viscosity and elastic modulus of PC-3 cells, this method shows high self-consistency and little dependence on experimental parameters such as loading frequency, and loading mode (Force-volume vs. PeakForce Tapping). The rapid calculating speed of less than 1ms per curve without the need for a model fitting process is another advantage. Furthermore, this method was utilized to characterize the viscoelastic properties of primary clinical prostate cells from 38 patients. The results demonstrate that the reported characterization method a comparable performance with the Gleason Score system in grading prostate cancer cells, This method achieves a high average accuracy of 97.6% in distinguishing low-risk prostate tumors (BPH and GS6) from higher-risk (GS7-GS10) prostate tumors and a high average accuracy of 93.3% in distinguishing BPH from prostate cancer.
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Hiperplasia Prostática , Neoplasias da Próstata , Masculino , Humanos , Próstata/patologia , Viscosidade , Hiperplasia Prostática/patologia , Módulo de ElasticidadeRESUMO
Human hands are amazingly skilled at recognizing and handling objects of different sizes and shapes. To date, soft robots rarely demonstrate autonomy equivalent to that of humans for fine perception and dexterous operation. Here, an intelligent soft robotic system with autonomous operation and multimodal perception ability is developed by integrating capacitive sensors with triboelectric sensor. With distributed multiple sensors, our robot system can not only sense and memorize multimodal information but also enable an adaptive grasping method for robotic positioning and grasp control, during which the multimodal sensory information can be captured sensitively and fused at feature level for crossmodally recognizing objects, leading to a highly enhanced recognition capability. The proposed system, combining the performance and physical intelligence of biological systems (i.e., self-adaptive behavior and multimodal perception), will greatly advance the integration of soft actuators and robotics in many fields.
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Background: Thyroglossal duct cyst (TGDC) is a common congenital neck mass that is the most frequent cause of neck swelling in children. The traditional open Sistrunk procedure for TGDC often leaves a visible scar on the neck. Therefore, it is essential to consider the impact of neck scarring on the quality of life for children and adolescents. Our study aimed to assess the safety and efficacy of robotic TGDC resection using the bilateral axillo-breast approach (BABA) in adolescents. Case Description: A 16-year-old female patient presented with a neck mass (no pain or redness) that had been present for 3 years. The palpable neck mass moved with swallowing and there was no history of other significant medical conditions. An ultrasound scan of the neck indicated a weak hypoechoic area in the thyrohyoid region measuring 29 mm × 20 mm. Additionally, the ultrasonography of the thyroid gland showed no obvious abnormalities. A computer tomography (CT) scan confirmed a low-density lesion on the right hyoid bone, measuring 27 mm × 18 mm × 26 mm, consistent with a TGDC. We successfully performed a BABA robotic TGDC resection on the 16-year-old female adolescent who had a strong desire for scar-free surgery. Conclusions: BABA robotic TGDC resection could achieve the same surgical effect as conventional open surgery while providing better cosmetic outcomes, which are essential for the physical and mental well-being of teenagers. Therefore, BABA robotic TGDC resection may be a safe and feasible treatment option with excellent cosmetic results in adolescents.
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During cardiac development, mechanotransduction from the in vivo microenvironment modulates cardiomyocyte growth in terms of the number, area, and arrangement heterogeneity. However, the response of cells to different degrees of mechanical stimuli is unclear. Organ-on-a-chip, as a platform for investigating mechanical stress stimuli in cellular mimicry of the in vivo microenvironment, is limited by the lack of ability to accurately quantify externally induced stimuli. However, previous technology lacks the integration of external stimuli and feedback sensors in microfluidic platforms to obtain and apply precise amounts of external stimuli. Here, we designed a cell stretching platform with an in-situ sensor. The in-situ liquid metal sensors can accurately measure the mechanical stimulation caused by the deformation of the vacuum cavity exerted on cells. The platform was applied to human cardiomyocytes (AC16) under cyclic strain (5%, 10%, 15%, 20 and 25%), and we found that cyclic strain promoted cell growth induced the arrangement of cells on the membrane to gradually unify, and stabilized the cells at 15% amplitude, which was even more effective after 3 days of culture. The platform's precise control and measurement of mechanical forces can be used to establish more accurate in vitro microenvironmental models for disease modeling and therapeutic research.
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Golimumab and etanercept both exhibit good efficacy in treating rheumatic diseases, while the patient self-reported measurement of treatment improvement and injection experience lacks sufficient evidence. Hence, this study aimed to compare the satisfaction with disease improvement and injection experience and the level of injection site reactions (ISRs) between golimumab-treated and etanercept-treated patients with rheumatic diseases. A total of 312 patients with rheumatic diseases were serially enrolled. Among them, 158 patients received golimumab (golimumab group); the other 154 patients were treated with etanercept (etanercept group) according to the actual disease status, physician advice, and patient willingness. Satisfaction with disease improvement was assessed using the 7-point Likert scale; satisfaction with injection experience and level of ISRs were both determined by the 5-point Likert scale. Satisfaction degrees with global injection experience (Pâ =â .025), injection device (Pâ =â .008), injection frequency (Pâ =â .010), and injection convenience (Pâ =â .003) were superior in the golimumab group to the etanercept group, while satisfaction degrees with global disease improvement, symptom relief, and speed of action did not vary (all Pâ >â .050) between the 2 groups. Discomfort (Pâ =â .005), swelling (Pâ <â .001), pain (Pâ =â .028), and burning (Pâ =â .035) levels were lower in the golimumab group than in the etanercept group. In addition, among 56 patients with a history of tumor necrosis factor inhibitor treatment before golimumab, 40 (71.4%) patients preferred golimumab to other tumor necrosis factor inhibitor. After switching to golimumab treatment, the level of ISRs in most patients was reduced or comparable. Golimumab achieves a satisfying injection experience and relieves the level of ISRs over etanercept in patients with rheumatic diseases.
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Anticorpos Monoclonais , Antirreumáticos , Artrite Reumatoide , Doenças Reumáticas , Humanos , Etanercepte/uso terapêutico , Adalimumab/uso terapêutico , Estudos de Coortes , Inibidores do Fator de Necrose Tumoral/uso terapêutico , Autorrelato , Artrite Reumatoide/tratamento farmacológico , Satisfação do Paciente , Doenças Reumáticas/tratamento farmacológico , Fator de Necrose Tumoral alfa/uso terapêutico , Resultado do TratamentoRESUMO
Transoral vestibular robotic thyroidectomy can really make the patient's body surface free of scar. This study aimed to compare the surgical and patient-related outcomes between the transoral vestibular robotic thyroidectomy and traditional low-collar incision thyroidectomy. The clinical data of 120 patients underwent transoral vestibular robotic thyroidectomy (TOVRT) or traditional low-collar incision thyroidectomy (TLCIT) were collected from May 2020 to October 2021. Propensity score matching analysis was used to minimize selection bias. All these patients were diagnosed with papillary thyroid carcinoma (PTC) through ultrasound-guided fine-needle aspiration prior to surgical intervention and surgical plan was tailored for each patient. An intraoperative recurrent laryngeal nerve (RLN) detection system was used in all patients, whose RLNs were identified and protected. We performed transoral vestibular robotic thyroidectomy with three intraoral incisions. Additional right axillary fold incisions were adopted occasionally to enhance fine reverse traction of tissue for radical tumor dissection. Clinical data including gender, age, tumor size, BMI, operation time, postoperative drainage volume and time, pain score, postoperative length of stay (LOS),number of lymph nodes removed, complications, and medical expense were observed and analyzed. Propensity score matching was used for 1:1 matching between the TOVRT group and the TLCIT group. All these patients accepted total thyroidectomy(or lobectomy) plus central lymph node dissection and all suffered from PTC confirmed by postoperative pathology. No conversion to open surgery happened in TOVRT group. The operative time of TOVRT group was longer than that of TLCIT group (P < 0.05). The postoperative drainage volume of TOVRT group was more than that of TLCIT group (P < 0.05). The drainage tube placement time of TOVRT group were longer than that of TLCIT group (P < 0.05). Significant differences were also found in intraoperative bleeding volume, pain score and medical expense between the two groups (P < 0.05). The incidence of perioperative common complications such as hypoparathyroidism and vocal cord paralysis in the two groups was almost identical (P > 0.05). However, there were some specific complications such as surgical area infection (one case), skin burn (one case), oral tear (two cases), and paresthesia of the lower lip and the chin (two cases) were found in TOVRT group. Obviously, the postoperative cosmetic effect of the TOVRT group was better than TLCIT group (P < 0.05). TOVRT is safe and feasible for low to moderate-risk PTC patients and is a potential alternative for patients who require no scar on their neck. Patients accepted TOVRT can get more satisfaction and have less psychologic injury caused by surgery.