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OBJECTIVE: To analyze the efficacy of high-intensity focused ultrasound (HIFU) for adenomyosis and postoperative recurrence and its influencing factors. METHODS: Clinical and follow-up data of 308 patients with adenomyosis who were treated with HIFU in Haifu Center, Affiliated Hospital of Chengdu University of Traditional Chinese Medicine from September 2017 to January 2022 were retrospectively analyzed. The recurrence of adenomyosis and the efficacy of HIFU at 6 months after surgery were followed up. To explore factors influencing postoperative prognosis and recurrence, the following variables were analyzed: patients' age, course of disease, gravidity and parity, size of the uterus, duration of HIFU, duration of irradiation, treatment intensity, dysmenorrhea score, time of follow-up, combined treatment of traditional Chinese medicine (TCM), western medicine adjuvant treatment, lesion location and type, and menorrhagia. RESULTS: Among the 308 patients, 238 (77%) were followed up from 6 to 36 months, with an average follow-up time of 15.24 ± 9.97 months. The other 70 (23%) were lost to follow-up. At 6-month after surgery, efficacy rates of dysmenorrhea and menorrhagia management were 86.7% and 89.3%, respectively. Postoperative recurrence rates were 4.8% (1-12 months), 9.0% (12-24 months), and 17.0% (24-36 months) for dysmenorrhea; and 6.3% (1-12 months), 2.4% (12-24 months), and 12.2% (24-36 months) for menorrhagia. Multivariate logistic regression analyses showed that parity (P = 0.043, OR = 1.773, 95% CI 1.018-3.087), uterine size (P = 0.019, OR = 1.004, 95% CI 1.001-1.007), combined treatment of TCM (P = 0.047, OR = 1.846, 95% CI 1.008-3.381), diffuse lesion type (P = 0.013, OR = 0.464, 95% CI 0.254-0.848) and ablation rate (P = 0.015, OR = 0.481, 95%CI 0.267-0.868) were prognostic factors (P < 0.05). Age, course of disease, gravidity, duration of HIFU, duration of irradiation, treatment intensity, preoperative dysmenorrhea score, time of follow-up, western medicine adjuvant therapy, lesion location, and preoperative menstrual volume had no effect on prognosis (P > 0.05). CONCLUSION: HIFU can effectively relieve dysmenorrhea and reduce menstrual volume in patients with adenomyosis. Parity, uterine size, lesion type (diffuse), and ablation rate are risk factors for symptom recurrence after HIFU, while the combination of TCM therapy is a protective factor for relapse. We, therefore, recommend TCM in the adjuvant setting after HIFU according to patient condition.
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Adenomiosis , Ultrasonido Enfocado de Alta Intensidad de Ablación , Menorragia , Embarazo , Femenino , Humanos , Dismenorrea/terapia , Dismenorrea/cirugía , Menorragia/etiología , Resultado del Tratamiento , Estudios Retrospectivos , Adenomiosis/cirugía , Adenomiosis/patologíaRESUMEN
OBJECTIVES: We aimed to investigate the activity of regulatory T (Treg) cells in chronic Pseudomonas aeruginosa (PA) lung infection and its influence on effector T-cell responses. MATERIALS AND METHODS: C57BL/6 mice were randomly inoculated with PA-laden agarose beads (1 × 10(5) CFU/50 µL) or planktonic PA (1 × 10(5) CFU/50 µL), and euthanized at the time points of 4 hour, day 1, 3, 5, and 7. Bacterial load, bronchoalveolar lavage (BAL) fluid cell counts, and lung tissue histology were assessed. BAL fluid concentrations of TGF-ß1, IFN-γ, IL-1ß, IL-4, IL-6, IL-10, and IL-17A were measured. Messenger RNA (mRNA) levels of TGF-ß1, IL-10 and CD4(+) T-cell subtype-specific transcription factors were determined. The expression of CD4(+)CD25(+)forkhead box P3 (FoxP3)(+) cells in lungs and spleens were analyzed. RESULTS: Mice inoculated with PA-laden agarose beads developed chronic PA lung infection during 7-day study period, while mice inoculated with planktonic PA cleared bacteria in 3 days. Compared with mice recovered from acute PA lung infection, those with chronic infection had significantly increased effector T-cell responses, accompanied by a more severe neutrophilic inflammation. Mice with chronic PA lung infection had significantly lower concentration of TGF-ß1 and higher concentrations of IFN-γ, IL-1ß, IL-6, and IL-17A in BAL fluid. Meanwhile, they had significantly lower mRNA levels of TGF-ß1, IL-10 and FoxP3 in lung tissues, and lower expression of CD4(+)CD25(+)FoxP3(+) cells in lungs and spleens. CONCLUSIONS: These findings indicate that Treg cell activity is partly inhibited in mice with chronic PA lung infection, which contributes to the enhanced effector T-cell responses in airways.
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Neumonía Bacteriana/inmunología , Infecciones por Pseudomonas/inmunología , Linfocitos T Reguladores/fisiología , Animales , Enfermedad Crónica , Citocinas/metabolismo , Modelos Animales de Enfermedad , Femenino , Factores de Transcripción Forkhead/metabolismo , Interleucina-10/metabolismo , Ratones Endogámicos C57BL , Neumonía Bacteriana/metabolismo , Neumonía Bacteriana/microbiología , Infecciones por Pseudomonas/metabolismo , Infecciones por Pseudomonas/microbiología , Pseudomonas aeruginosa , Distribución Aleatoria , Linfocitos T Colaboradores-Inductores/metabolismo , Factor de Crecimiento Transformador beta1/metabolismoRESUMEN
Chronic pelvic pain caused by the sequelae of inflammatory pelvic disease is a common clinical condition of pelvic pain in women. At present, the main challenges in its treatment are the limited effectiveness of pain relief and the frequent recurrence of symptoms, which significantly impact patients' quality of life and impose a considerable psychological burden on them. It is a clinically challenging disease. After summarizing years of treatment experience, the author's team discovered that acupoint catgut embedding demonstrated notable clinical efficacy in managing chronic pelvic pain stemming from pelvic inflammatory disease sequelae. Compared to existing Western medicine treatment methods, acupoint catgut embedding offers advantages such as a good analgesic effect, lower recurrence rate, economic benefits, and a relatively straightforward procedure. This article provides a comprehensive guide on embedding absorbable catgut into patients' acupoints for the treatment of chronic pelvic pain in females resulting from the sequelae of pelvic inflammatory disease.
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Puntos de Acupuntura , Catgut , Dolor Crónico , Enfermedad Inflamatoria Pélvica , Dolor Pélvico , Humanos , Dolor Pélvico/terapia , Dolor Pélvico/etiología , Femenino , Dolor Crónico/terapia , Dolor Crónico/etiología , Enfermedad Inflamatoria Pélvica/complicaciones , Enfermedad Inflamatoria Pélvica/terapia , Terapia por Acupuntura/métodosRESUMEN
Background and Objective: During embryonic development, the dysregulation of the proliferation and differentiation of neuronal progenitors triggers congenital brain malformations. These malformations are common causes of morbidity and mortality in patients younger than 2 years old. Animal models have provided considerable insights into the etiology of diseases that cause congenital brain malformations. However, the interspecies differences in brain structure limit the ability to transfer these insights directly to studies of humans. In recent years, brain organoids generated from human embryonic stem cells (hESCs) or human induced pluripotent stem cells (hiPSCs) using a 3-dimensional (3D) culture system have been used to resemble the structure and function of a developing human brain. Therefore, we aimed to summarize the different congenital brain malformations that have been modeled by organoids and discuss the ability of this model to reveal the cellular and molecular mechanisms of congenital brain malformations. Methods: A comprehensive search was performed using PubMed and Web of Science's Core Collection for literature published from July 1, 2000 to July 1, 2022. Keywords included terms related to brain organoids and congenital brain malformations, as well as names of individual malformations. Key Content and Findings: The self-assembled 3D aggregates have been used to recapitulate structural malformations of human brains, such as microcephaly, macrocephaly, lissencephaly (LIS), and periventricular nodular heterotopia (PH). The use of disease-specific brain organoids has revealed unprecedented details of mechanisms that cause congenital brain malformations. Conclusions: This review summarizes the establishment and development of brain organoid technologies and provides an overview of their applications in modeling congenital brain malformations. Although several hurdles still need to be overcome, using brain organoids has greatly expanded our ability to reveal the pathogenesis of congenital brain malformations. Compared with existing methods, the combination with cutting-edge technologies enables a more accurate diagnosis and development of increasingly personalized targeted therapy for patients with congenital brain diseases.
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Ischemic brain injury is a common cause of long-term neurological deficits in children as well as adults, and no efficient treatments could reverse the sequelae in clinic till now. Stem cells have the capacity of self-renewal and multilineage differentiation. The therapeutic efficacy of stem cell transplantation for ischemic brain injury have been tested for many years. The grafts could survive and mature in the ischemic brain environment. Stem cell transplantation could improve functional recovery of ischemic brain injury models in pre-clinical trials. The potential mechanisms included cell replacement, release of neurotrophic and anti-inflammatory factors, immunoregulation as well as activation of endogenous neurogenesis. Besides, many clinical trials were conducted and some of trials already had preliminary results. From the current published data, cell transplantation for clinical application is safe and feasible. No severe adverse events and tumorigenesis were reported. While the therapeutic efficacy of stem cell therapy in clinic still needs more evidences. In this review, we overviewed the studies about stem cell therapy for ischemic brain injury. Different types of stem cells used for transplantation as well as the therapeutic mechanisms were discussed in detail. The related pre-clinical and clinical trials were summarized into two separate tables. In addition, we also discussed the unsolved problems and concerns about stem cell therapy for ischemic brain injury that need to be overcome before clinic transformation.
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The Ag-Ga/poly(methyl methacrylate) nanoparticles were prepared in-situ by emulsion polymerization method under ultrasonic irradiation without any initiators or metal reductant. HRTEM, EDS and XRD experiments were performed to characterize the nanoparticles. The results indicated that the nanocomposite particles possessed core-shell structure with diameters of 80-200 nm, as well as excellent monodispersity. The phenomenon that the polymer forms the shell via layer-by-layer self-assembly was found. XRD proved the existence of Ag0.72Ga0.28 and the probability of new Ag-Ga alloy because of two unknown diffraction peaks.
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INTRODUCTION: Gestational diabetes mellitus (GDM) is a gestational complication that affects maternal and child health. The placenta provides the fetus with the necessary nutrition and oxygen and takes away the metabolic waste. Patients with GDM are diagnosed and treated merely on the basis of the blood glucose level; this approach does nothing to help evaluate the status of the placenta, which is worth noting in GDM. The purpose of this research was to clarify the relation between thioredoxin-interacting protein (TXNIP) and reactive oxygen species (ROS) in the placenta of patients with GDM, which has thus far remained unclear. METHODS: The expression of TXNIP in the placentas of 10 patients with GDM and 10 healthy puerperae (control group) was investigated via immunofluorescence. The relation among TXNIP, ROS, and the function of mitochondria was explored in HTR-8/SVneo cells stimulated by high glucose (HG). RESULTS: The results showed the expression of TXNIP in the placentas of patients with GDM was higher than that in the control group, and the expression of TXNIP in HTR-8/SVneo cells treated with HG was higher than that in the control group, causing the accumulation of ROS and changes of mitochondria, promoting apoptosis and inhibition of migration. CONCLUSIONS: High expression of TXNIP caused by HG mediates the increasing ROS and the mitochondria dysfunction in GDM; this impairs the function of the placenta and is the basis for the prediction of perinatal outcome.
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BACKGROUND: Chronic kidney disease (CKD) is an independent risk factor for cardiovascular disease (CVD). However, the association between CKD and CVD risk in patients with type 2 diabetes mellitus (T2DM) in China has not yet been well investigated. This study aimed to determine the association of CKD with the risks of coronary heart disease (CHD) and stroke in a Chinese population with T2DM. METHODS: A total of 1401 inpatients with T2DM at the Second Affiliated Hospital of Zhejiang University School of Medicine between April 2008 and November 2013 were included in this study. The CKD-Epidemiology Collaboration equation for Asians was used to classify CKD. The UK Prospective Diabetes Study risk engine was used to estimate the risks of CHD and stroke. RESULTS: CHD risk was significantly increased with CKD stage (20.1%, 24.8%, and 34.3% in T2DM patients with no CKD, CKD Stage 1-2, and Stage 3-5, respectively; P < 0.001 for all). The stroke risk was also increased with CKD stage (8.6%, 12.7%, and 25.4% in T2DM patients with no CKD, CKD Stage 1-2, and Stage 3-5, respectively; P < 0.001 for all). Compared with no-CKD group, the odds ratios (OR s) for high CHD risk were 1.7 (P < 0.001) in the CKD Stage 1-2 group and 3.5 (P < 0.001) in the CKD Stage 3-5 group. The corresponding OR s for high stroke risk were 1.9 (P < 0.001) and 8.2 (P < 0.001), respectively. CONCLUSION: In patients with T2DM, advanced CKD stage was associated with the increased risks of CHD and stroke.
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Enfermedad Coronaria/epidemiología , Diabetes Mellitus Tipo 2/epidemiología , Insuficiencia Renal Crónica/epidemiología , Accidente Cerebrovascular/epidemiología , Adulto , Anciano , Anciano de 80 o más Años , Albuminuria/orina , China , Enfermedad Coronaria/etiología , Enfermedad Coronaria/orina , Creatinina/orina , Estudios Transversales , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/orina , Femenino , Humanos , Masculino , Persona de Mediana Edad , Insuficiencia Renal Crónica/complicaciones , Insuficiencia Renal Crónica/orina , Factores de Riesgo , Accidente Cerebrovascular/etiología , Accidente Cerebrovascular/orina , Adulto JovenRESUMEN
Carotid atherosclerosis (CA) and carotid plaque (CP) are highly correlated with cardiovascular disease. We aimed to determine the prevalence of CA and CP and their relationship with 10-year risks of stroke and coronary heart disease (CHD) in type 2 diabetes mellitus (T2DM).We studied 1584 T2DM patients aged 20 years and older. CA and CP were detected using ultrasonography. Ten-year stroke and CHD risk were determined using the United Kingdom Prospective Diabetes Study (UKPDS) risk engine.The prevalence of CA and CP increased gradually with age. Men had a higher prevalence of CA than women (CA: 58.18% vs 51.54%, Pâ<â.01). The 10-year CHD risk (27.9% vs 15.4%, Pâ<â.001) and stroke risk (15.2% vs 5.70%, Pâ<â.001) were higher in patients with CA than that of those without CA. Compared with patients without CA, the odds ratios (ORs) of CHD in CA and CP group were 4.47 and 10.78 for men, and 4.19 and 5.20 for women, respectively; in the case of stroke, the OR in CA and CP group were 8.83 and 12.07 for men, and 4.35 and 4.90 for women, respectively (Pâ<â.001 for all). Multivariate binary logistic regression analysis showed that CA was an independent risk factor for CHD [ORâ=â2.66, 95% confidence interval (95% CI), 2.05-3.46, Pâ<â.001] and stroke (ORâ=â3.11, 95% CI, 2.38-4.07, Pâ<â.001).CA and CP were prevalent in patients with T2DM and positively correlated with 10-year CHD and stroke risk. CA was an independent risk factor for 10-year CHD risk.
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Arterias Carótidas/diagnóstico por imagen , Enfermedades de las Arterias Carótidas , Enfermedad Coronaria/epidemiología , Diabetes Mellitus Tipo 2/epidemiología , Accidente Cerebrovascular , Adulto , Anciano , Enfermedades de las Arterias Carótidas/diagnóstico , Enfermedades de las Arterias Carótidas/epidemiología , China/epidemiología , Comorbilidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Pronóstico , Estudios Prospectivos , Medición de Riesgo/métodos , Factores de Riesgo , Estadística como Asunto , Accidente Cerebrovascular/diagnóstico , Accidente Cerebrovascular/epidemiología , Ultrasonografía/métodos , Ultrasonografía/estadística & datos numéricosRESUMEN
OBJECTIVE: To investigate the effects of exogenous recombinant human brain natriuretic peptide (rhBNP) after primary percutaneous coronary intervention (PCI) on non-invasive hemodynamic in acute myocardial infarction patients with left ventricular failure. METHODS: A number of 96 acute myocardial infarction patients accompanied with heart failure after PCI hospitalized in the People's Hospital of Sanya during February 2012 to October 2015 were selected. They were randomly divided into the therapy group (n = 50) and control group (n = 46). On the basis of routine treatment, patients in the therapy group were treated with intravenous rhBNP (1.5 µg/kg was intravenous injection with uniform speed of 3 min, followed by continuous infusion 0.0075 µg/kg·min for 72 h), while the control group received conventional treatment. BioZ-2011 non-invasive hemodynamic real-time monitoring system was used to monitor the hemodynamic parameters changes and the leaves of plasma pro-BNP, serum creatinine, serum potassium, serum sodium and urine volume of each group before and after treating for 30 min, 1 h, 3 h, 6 h, 12 h, 24 h, 48 h, 72 h. RESULTS: Patients in the therapy group showed no effect on heart rate, while after 30 min of intravenous injection of rhBNP, CO, CI, SV, and SI increased significantly and LVET and TFC reduced at the same time, which had certain effect on blood pressure (SBP/DBP). Compared with the control group, the therapy group showed a faster and more effective improvement on hemodynamics. CONCLUSIONS: Acute myocardial infarction patients complicated with left heart failure after primary PCI can significantly improve hemodynamics by treating with rhBNP.
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Coronary heart disease (CHD) and stroke are common complications of type 2 diabetes mellitus (T2DM). We aimed to explore the differences in the risks of CHD and stroke between Chinese women and men with T2DM and their association with metabolic syndrome (MS). This study included 1514 patients with T2DM. The Asian Guidelines of ATPIII (2005) were used for MS diagnosis, and the UKPDS risk engine was used to evaluate the 10-year CHD and stroke risks. Women had lower CHD risk (15.3% versus 26.3%), fatal CHD risk (11.8% versus 19.0%), stroke risk (8.4% versus 10.3%), and fatal stroke risk (1.4% versus 1.6%) compared with men with T2DM (p < 0.05-0.001). The CHD risk (28.4% versus 22.6%, p < 0.001) was significantly higher in men with MS than in those without MS. The CHD (16.2% versus 11.0%, p < 0.001) and stroke risks (8.9% versus 5.8%, p < 0.001) were higher in women with MS than in those without MS. In conclusion, our findings indicated that Chinese women with T2DM are less susceptible to CHD and stroke than men. Further, MS increases the risk of both these events, highlighting the need for comprehensive metabolic control in T2DM.
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Hyperparasitism is a normal behavior of parasitoids, which often happens among species. Conspecific hyperparasitism, such as some kinds of heteronomous hyperparasitic behaviors, has been only reported in some species belonging to Aphelinidae. In this article, the conspecific hyperparasitism of Pachycrepoideus vindemmiae (Pteromalidae) is reported, with Drosophila puparia as hosts. Hosts were exposed to P. vindemmiae females twice to parasitism with nine, twelve, and fifteen day intervals between the two exposures. None of the infested hosts emerged more than one offspring, and emergence of parasitoid offspring occurred in two obvious events, synchronously with the exposure time intervals, which suggested that offspring emerging during the first and second events would come from the primary and secondary parasitoids, respectively, and the inference with the developmental duration of offspring also indicated this. With two P. vindemmiae strains that could be identified by a simple sequence repeat marker, the above speculation of the origin of those offspring emerging during the two events was confirmed. Dissection of hosts exposed twice revealed a cannibalism behavior of larvae from the secondary foundresses on the primary conspecific pupae. Our results suggested a conspecific hyperparasitism behavior of the secondary parasitoids on the primary conspecifics. Measures showed a reduced body size for the adults from the conspecific hyperparasitism. Foundresses from the conspecific hyperparasitism had less fitness variables than those from primary parasitism, with shorter longevity, less life time fecundity, lower values of infestation degree, and lower success rate of parasitism. However, when the parasitoids from the conspecific hyperparasitism met healthy Drosophila puparia, their offspring would recover to normal size. Frequency of the conspecific hyperparasitism behavior enhanced with the decreasing of proportion of healthy hosts in the oviposition patch. The conspecific hyperparasitism of P. vindemmiae on the primary conspecifics would be helpful to last the population when healthy hosts are absent in the oviposition patch.
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Canibalismo , Pupa , Avispas/fisiología , Animales , Tamaño Corporal , Femenino , Interacciones Huésped-Parásitos , MasculinoRESUMEN
AIM: To explore the effect of the abstracts of lumbricus on the secretion of NO and TNF-alpha by mouse Mphi s and splenocytes. METHODS: Murine Mphi s and spleen cell were co-cultured with various doses of lumbricus abstracts for 24 hours and then the supernate was collected. The levels of NO and TNF-alpha were detected by diazotization reaction and MTT colorimetry, respectively. RESULTS: Compared with control group, 0.1 g/L of lumbricus abstracts could increase the NO level and antagonize the inhibition of dexamethasone(Dex). 1 x 10(-4), 1 x 10(-3) g/L of lumbricus abstracts could increase TNF-alpha level and also antagonize the inhibition of Dex on the secretion of TNF-alpha by Mphi s and splenic cells. CONCLUSION: The abstracts of lumbricus can activate Mphi s and splenic cells to secrete NO and TNF-alpha and antagonize the inhibition effect of Dex on these cells.