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1.
Sci Total Environ ; 950: 175374, 2024 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-39122046

RESUMO

Microplastic (MP) pollution in global marine environments has been extensively reported and attracted significant concerns, but MP distribution in mudflat has rarely been studied. In this paper, the abundance, features and ecological risk of MP in South Yellow Sea Mudflat were investigated comprehensively. MP were both detected in waters (5.4 ± 0.38-11.3 ± 0.78 items/L) and sediments (5.1 ± 0.36-10.1 ± 0.69 items/g) from South Yellow Sea Mudflat. There existed different MP abundance tendencies from sampling Group I (coastal estuary or port) and II (purely coastal mudflat), while MP abundance in water from Group II was lower than that from Group I generally, but MP abundance in sediment from Group I was lower than that from Group II generally. This suggested that MP abundance in mudflat water could be associated with frequent human activities significantly, and disturbance might not be beneficial to MP accumulation in sediments. Fragments, transparent, polyethylene (PE), polypropylene (PP) and polystyrene (PS) were major MP features in mudflat water and sediment, and maximum proportion of size of MP was 0.001-0.25 mm in both water and sediment. Furthermore, the primary risk assessment indicated that MP pollution load for mudflat was low level. However, potential MP ecological risk for mudflat could reach dangerous level to very dangerous level by calculating and evaluating polymer risk index (PRI) and potential ecological risk index (PERI), which could be caused by high proportions of polyvinyl chloride (PVC) and polyacrylonitrile (PAN) with high hazard score. For the first time, reference data about MP pollution from South Yellow Sea Mudflat were supplied in this paper, which would be helpful for management and control of MP in mudflat.


Assuntos
Monitoramento Ambiental , Sedimentos Geológicos , Microplásticos , Poluentes Químicos da Água , Microplásticos/análise , Poluentes Químicos da Água/análise , Medição de Risco , Sedimentos Geológicos/química , China
2.
J Asthma ; : 1-11, 2024 Aug 23.
Artigo em Inglês | MEDLINE | ID: mdl-39120956

RESUMO

OBJECTIVE: This study aimed to evaluate trends in polypharmacy prevalence among adults with asthma in the United States. METHODS: Data from the 2001-2020 National Health and Nutrition Examination Survey were used to estimate the weighted prevalence of polypharmacy. Joinpoint regression analysis was conducted to evaluate trends in polypharmacy. Trends were first evaluated overall and then stratified by asthma severity and asthma control. A multivariable logistic regression model was used to identify factors associated with polypharmacy. RESULTS: From 2001 to 2020, a stable trend in polypharmacy among U.S. adults with asthma was observed (average annual percent change [AAPC]=1.02, p=0.71). Trends across different asthma severity were stable (mild asthma: AAPC=2.93, p=0.20; moderate asthma: AAPC=-2.22, p=0.35; severe asthma: AAPC=0.45, p=0.82). Trends in adults with good asthma control and those with poor control stayed constant (good control: AAPC=0.82, p=0.68; poor control: AAPC=-1.22, p=0.82). Several factors, including older age, females, Non-Hispanic Black, health insurance coverage, family income, number of healthcare visits, former smokers, multi-morbidities, asthma severity, and asthma control, were associated with polypharmacy. CONCLUSIONS: Polypharmacy prevalence has remained constant among U.S. adults with asthma over the past two decades. Despite a stable overall trend, disparities in polypharmacy prevalence persist across different asthma severity and control status, underscoring the need for tailored medication management to improve asthma care.

3.
ACS Omega ; 9(32): 34597-34607, 2024 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-39157079

RESUMO

As a promising nonvolatile memory device with two ends, the memristor has received extensive attention for its industrial manufacture. Density functional theory was used to analyze the adsorption properties of residual gas on hexagonal boron nitride (h-BN)-based memristor model surfaces with Stone-Wales-5577 grain boundary defects [h-BN(SW)]. First, by calculating the adsorption energy, geometric parameters, and charge transfer, we identified the most stable adsorption sites for hydrogen atoms (H-TB1) and H2 molecules (H2-TN2). We observed a tendency toward chemisorption for hydrogen atoms and physical adsorption for H2 molecules at these sites. Furthermore, two coadsorption configurations were formed by introducing H2 molecules and hydrogen atoms into single adsorption configurations: namely H-TB1_H2-TN1TN2 and H2-TN2_H-TB1TN1TN3. In the case of hydrogen-based configuration, there is weak dissociation of the H2 molecule, which does not facilitate hydrogen atom adsorption. However, adjacent hydrogen atoms tend to form stable dimers, while excess hydrogen atoms have a tendency to weakly chemisorb in the case of H2-based configuration. The pristine h-BN surface is more favorable for hydrogen atom migration compared to the h-BN(SW) surface due to its higher adsorption energy. On the h-BN(SW) surface, hydrogen atoms tend to migrate inward from the center of adjacent heptagonal boron nitride rings while coadsorption has a minimal impact on their vertical migration as well as that of H2 molecules. This work provides theoretical insights into the H/H2 trace gas interaction during h-BN wafer-level fabrication for memristor devices.

4.
Tissue Cell ; 89: 102479, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-39018713

RESUMO

Diabetic muscular atrophy is becoming a fast-growing problem worldwide, including sarcopenia, which is associated with substantial mortality and morbidity risk. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have been marketed and suggested to exert protective effects on not only glycemic control but also diabetic complications in diabetic patients. In this study, we investigated the therapeutic use of GLP-1RAs exendin-4, compared to antidiabetic drug metformin, for the intervention of muscular dysfunction during diabetic conditions using a streptozotocin (STZ)-induced diabetic mouse model. The results showed that both exendin-4 and metformin could effectively alleviate hyperglycemia in diabetic mice, and also counteract diabetes-induced muscle weight loss, weaker grip, and changes in muscle fiber cross-sectional area distribution. Unexpectedly, exendin-4, but not metformin, enhanced the increased kidney weight and histological change in diabetic mice. Taken together, these findings suggest that both exendin-4 and metformin could effectively improve the diabetic hyperglycemia and muscular dysfunction; but exendin-4 may aggravate the nephropathy in STZ-induced diabetic mice.


Assuntos
Diabetes Mellitus Experimental , Exenatida , Receptor do Peptídeo Semelhante ao Glucagon 1 , Metformina , Animais , Exenatida/farmacologia , Diabetes Mellitus Experimental/tratamento farmacológico , Diabetes Mellitus Experimental/complicações , Diabetes Mellitus Experimental/patologia , Metformina/farmacologia , Receptor do Peptídeo Semelhante ao Glucagon 1/agonistas , Receptor do Peptídeo Semelhante ao Glucagon 1/metabolismo , Camundongos , Masculino , Hipoglicemiantes/farmacologia , Estreptozocina , Modelos Animais de Doenças , Músculo Esquelético/efeitos dos fármacos , Músculo Esquelético/patologia , Músculo Esquelético/metabolismo , Peptídeos/farmacologia , Peçonhas/farmacologia , Atrofia Muscular/tratamento farmacológico , Atrofia Muscular/patologia , Atrofia Muscular/etiologia
5.
J Am Pharm Assoc (2003) ; : 102154, 2024 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-38964590

RESUMO

BACKGROUND: Asthma is a chronic disease that often requires medication for control. Polypharmacy remains a major issue to medication adherence; however, its evidence among patients with asthma is limited. OBJECTIVES: To evaluate the prevalence and determinants of polypharmacy and its associations with asthma control among adults with asthma in the United States. METHODS: Data from the 2005-2020 National Health and Nutrition Examination Survey (NHANES) were used to estimate the weighted prevalence of polypharmacy. Selected variables, including demographics, comorbidities, prescription medications, and asthma-related adverse events, were extracted from the NHANES. Multivariable logistic regression was conducted to identify factors associated with polypharmacy. Another two sets of multivariable logistic regression models were employed to further assess the association between polypharmacy and asthma-related adverse events: one for asthma attacks and the other for asthma-related emergency room visits. RESULTS: From 2005 to 2020, polypharmacy prevalence was 34.3% and 14.1% among adults with and without asthma, respectively. Characteristics, including older age (P<0.01), non-Hispanic blacks (P<0.01), health insurance coverage (P<0.01), number of healthcare visits (P<0.01), and multiple comorbidities (P<0.01) were associated with polypharmacy. Polypharmacy was associated with increased risks of having asthma attacks (OR, 1.38; 95% CI, 1.08-1.76) and asthma-related emergency room visits (OR, 1.46; 95% CI, 1.09-1.94) among adults with asthma. Among patients taking at least one asthma medication, risks of asthma attacks and asthma-related ER visits did not differ between those with and without polypharmacy. CONCLUSION: Approximately one in three adults with asthma experienced polypharmacy in the United States. Disparities existed in several characteristics, highlighting the necessity for appropriate care and policies among vulnerable populations. Further validation on the impact of polypharmacy on asthma control is required.

6.
Bioresour Technol ; 406: 130992, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38885726

RESUMO

Methane recovery and organics removal in sulfate (SO42-)-rich wastewater anaerobic digestion are hindered by electron competition between methanogenesis and sulfidogenesis. Here, intermittently electrostimulated bioelectrodes were developed to facilitate direct interspecies electron transfer (DIET)-driven syntrophic methanogenesis, increasing substrate competition among methanogenic archaea (MA). By optimising the electrochemical environment, MA was able to employ electron transfer more efficiently than sulfate-reducing bacteria (SRB), resulting in significant methane accumulation (58.1 ± 1.0 mL-CH4/m3reactor) and COD removal (90.5 ± 0.5 %) at lower COD/SO42- ratio. Intermittent electrostimulation improved the metabolic pathway for electroactive bacteria to utilize acetate and direct electrons to electrotrophic MA, decreasing SRB abundance and affecting the sulfate reduction pathway. Intermittently electrostimulated biofilms significantly increased gene levels of key enzymes in electron transport for cytochrome and e-pili biosynthesis, crucial for DIET, demonstrating enhanced DIET-driven syntrophic methanogenesis. This study provides a strategic approach to optimize methanogenesis in sulfate-rich wastewater anaerobic digestion.


Assuntos
Metano , Sulfatos , Águas Residuárias , Sulfatos/metabolismo , Anaerobiose , Transporte de Elétrons , Metano/metabolismo , Reatores Biológicos , Biofilmes , Archaea/metabolismo , Bactérias/metabolismo , Elétrons , Eletrodos
7.
Cell Rep Med ; 5(7): 101615, 2024 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-38897205

RESUMO

The clinical efficacy of neoadjuvant immunotherapy plus chemotherapy remains elusive in localized epidermal growth factor receptor (EGFR)-mutant non-small cell lung cancer (NSCLC). Here, we report interim results of a Simon's two-stage design, phase 2 trial using neoadjuvant sintilimab with carboplatin and nab-paclitaxel in resectable EGFR-mutant NSCLC. All 18 patients undergo radical surgery, with one patient experiencing surgery delay. Fourteen patients exhibit confirmed radiological response, with 44% achieving major pathological response (MPR) and no pathological complete response (pCR). Similar genomic alterations are observed before and after treatment without influencing the efficacy of subsequent EGFR-tyrosine kinase inhibitors (TKIs) in vitro. Infiltration and T cell receptor (TCR) clonal expansion of CCR8+ regulatory T (Treg)hi/CXCL13+ exhausted T (Tex)lo cells define a subtype of EGFR-mutant NSCLC highly resistant to immunotherapy, with the phenotype potentially serving as a promising signature to predict immunotherapy efficacy. Informed circulating tumor DNA (ctDNA) detection in EGFR-mutant NSCLC could help identify patients nonresponsive to neoadjuvant immunochemotherapy. These findings provide supportive data for the utilization of neoadjuvant immunochemotherapy and insight into immune resistance in EGFR-mutant NSCLC.


Assuntos
Anticorpos Monoclonais Humanizados , Protocolos de Quimioterapia Combinada Antineoplásica , Carcinoma Pulmonar de Células não Pequenas , Receptores ErbB , Neoplasias Pulmonares , Mutação , Terapia Neoadjuvante , Humanos , Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Carcinoma Pulmonar de Células não Pequenas/genética , Carcinoma Pulmonar de Células não Pequenas/patologia , Receptores ErbB/genética , Terapia Neoadjuvante/métodos , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pulmonares/genética , Neoplasias Pulmonares/patologia , Feminino , Masculino , Pessoa de Meia-Idade , Idoso , Mutação/genética , Anticorpos Monoclonais Humanizados/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Paclitaxel/uso terapêutico , Carboplatina/uso terapêutico , Adulto , Resultado do Tratamento , DNA Tumoral Circulante/genética , Albuminas
8.
Open Access Rheumatol ; 16: 75-85, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38756916

RESUMO

Background: Rheumatoid arthritis fibroblast-like synovial cells (RA-FLS) have become the core effector cells for the progression of rheumatoid arthritis due to their "tumor-like cell" characteristics, such as being able to break free from growth restrictions caused by contact inhibition, promoting angiogenesis, invading surrounding tissues, and leading to uncontrolled synovial growth. In recent years, cold air plasma (CAP) has been widely recognized for its clear anticancer effect. Inspired by this, this study investigated the inhibitory effect of CAP on the tumor-like biological behavior of RA-FLS through in vitro experiments. Methods: Treatment of RA-FLS with CAP at different time doses (0s, 30s, 60s, 120s). 5-ethynyl-2'-deoxyuridine (EdU) proliferation assay was used to determine the cell viability. Analysis of cell migration and invasion was performed by wound-healing assay, transwell assay and immunofluorescent staining for f-actin, respectively. Flow cytometry technique was used for analysis of cell cycle and determination of reactive oxygen species (ROS). Hoechst staining was used for analysis of cell apoptosis. Protein expression was analyzed by Western blot analysis. Results: Molecular and cellular level mechanisms have revealed that CAP blocks RA-FLS in the G2/M phase by increasing intracellular reactive oxygen species (ROS), leading to increased apoptosis and significantly reduced migration and invasion ability of RA-FLS. Conclusion: Overall, CAP has significant anti proliferative, migratory, and invasive effects on RA-FLS. This study reveals a new targeted treatment strategy for RA.

9.
Am J Transl Res ; 16(4): 1353-1365, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38715836

RESUMO

BACKGROUND: There is no reliable means to evaluate the immune status of liver transplant recipients. We proposed a novel score model, namely Mingdao immune cell analysis and Mingdao immune score system, to quantify the immunity. METHODS: Data from those who underwent a single liver transplant between January 2017 and June 2020 at Beijing Chaoyang Hospital, were collected. In addition, healthy volunteers were also enrolled. The score model was based on the immune cell populations determined by flow cytometry. RESULTS: There were a total of 376 healthy controls with 376 tests and 148 liver transplant recipients with 284 tests in this study. Evaluated by Mingdao immune cell analysis and Mingdao immune score system, the mean scores of healthy controls were near zero suggesting a balanced immune system. In contrast, the mean scores of liver transplant recipients were negative both before and after surgery indicating a compromised immune system. When liver transplant recipients were given a reduced or routine first dose according to their preoperative score, they had similar recovery of liver function. Moreover, liver transplant recipients with increased scores ≥ 5 were associated with elevated aspartate transaminase and alanine amiotransferase. Finally, on multivariate analysis the score model was the only significant independent risk factor for clinical acute rejection (P = 0.021; Odds ratio, 0.913; 95% confidence interval, 0.845-0.987). CONCLUSION: The novel score model could be used as an indicator to reflect immunity and to regulate immunosuppressants in liver transplant recipients after surgery.

10.
J Am Acad Orthop Surg ; 32(20): e1067-e1078, 2024 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-38759231

RESUMO

INTRODUCTION: With the legalization of marijuana in the United States, the number of patients with cannabis use disorder (CUD) in the joint arthroplasty population has increased markedly. The primary purpose of this meta-analysis was to determine whether there were differences in clinical and economic outcomes after total joint arthroplasty (TJA) between patients with and without perioperative CUD. METHODS: We searched PubMed, Embase, Scopus, and Web of Science databases up to July 2018 to identify all eligible studies investigating the association of CUD with postoperative outcomes in patients undergoing TJA. Postoperative outcomes assessed consisted of complications, readmission, length of stay (LOS), implant revision, and cost of care. For dichotomous outcomes, pooled odds ratios (OR) with 95% confidence intervals (CI) were calculated using a random effects model. RESULTS: We identified 10 retrospective cohort studies with a total of 17,981,628 study participants. Patients with CUD had significantly higher odds of medical complications (OR 1.33 [95% CI 1.07 to 1.66], P = 0.01) and implant-related complications (OR 1.75 [95% CI: 1.64 to 1.88], P < 0.00001) than noncannabis users. Specifically, CUD was associated with significantly increased odds of cardiac complications (OR 1.95 [95% CI 1.50 to 2.54], P < 0.00001), cerebrovascular accidents (OR 2.06 [95% CI 1.66 to 2.57], P < 0.00001), postoperative infections (OR 1.68 [95% CI 1.34 to 2.10], P < 0.00001), periprosthetic fracture (OR 1.42 [95% CI 1.19 to 1.70], P < 0.0001), mechanical loosening (OR 1.54 [95% CI 1.42 to 1.66], P < 0.00001), and dislocation/instability (OR 1.88 [95% CI 1.32 to 2.68], P = 0.0005). Longer LOS and higher cost of care were also found in patients with CUD. CONCLUSION: This study strengthens the body of evidence that patients with CUD face higher risk of postoperative complications and greater financial burden after knee and hip arthroplasties. Physicians should inform patients about adverse outcomes and undertake appropriate risk adjustments before elective orthopaedic surgery. LEVEL OF EVIDENCE: Level III.


Assuntos
Artroplastia de Quadril , Artroplastia do Joelho , Abuso de Maconha , Estudos Observacionais como Assunto , Complicações Pós-Operatórias , Humanos , Artroplastia do Joelho/efeitos adversos , Artroplastia de Quadril/efeitos adversos , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/epidemiologia , Abuso de Maconha/complicações , Tempo de Internação/estatística & dados numéricos , Reoperação/estatística & dados numéricos , Readmissão do Paciente/estatística & dados numéricos
11.
Neural Netw ; 176: 106339, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38703420

RESUMO

Malaria is a significant health concern worldwide, particularly in Africa where its prevalence is still alarmingly high. Using artificial intelligence algorithms to diagnose cells with malaria provides great convenience for clinicians. In this paper, a densely connected convolutional dynamic learning network (DCDLN) is proposed for the diagnosis of malaria disease. Specifically, after data processing and partitioning of the dataset, the densely connected block is trained as a feature extractor. To classify the features extracted by the feature extractor, a classifier based on a dynamic learning network is proposed in this paper. Based on experimental results, the proposed DCDLN method demonstrates a diagnostic accuracy rate of 97.23%, surpassing the diagnostic performance than existing advanced methods on an open malaria cell dataset. This accurate diagnostic effect provides convincing evidence for clinicians to make a correct diagnosis. In addition, to validate the superiority and generalization capability of the DCDLN algorithm, we also applied the algorithm to the skin cancer and garbage classification datasets. DCDLN achieved good results on these datasets as well, demonstrating that the DCDLN algorithm possesses superiority and strong generalization performance.


Assuntos
Algoritmos , Malária , Redes Neurais de Computação , Humanos , Malária/diagnóstico , Aprendizado Profundo , Inteligência Artificial , Neoplasias Cutâneas/diagnóstico , Diagnóstico por Computador/métodos , Aprendizado de Máquina
12.
Cytojournal ; 21: 12, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38628288

RESUMO

Objective: This study aimed to identify differential metabolites and key metabolic pathways between lung adenocarcinoma (LUAD) tissues and normal lung (NL) tissues using metabolomics techniques, to discover potential biomarkers for the early diagnosis of lung cancer. Material and Methods: Forty-five patients with primary ground-glass nodules (GGN) identified on computed tomography imaging and who were willing to undergo surgery at Shanghai General Hospital from December 2021 to December 2022 were recruited to the study. All participants underwent video thoracoscopy surgery with segmental or wedge resection of the lung. Tissue samples for pathological examination were collected from the site of ground-glass nodules (GGN) lesion and 3 cm away from the lesion (NL). The pathology results were 35 lung adenocarcinoma (LUAD) cases (13 invasive adenocarcinoma, 14 minimally invasive adenocarcinoma, and eight adenocarcinoma in situ), 10 benign samples, and 45 NL tissues. For the untargeted metabolomics technique, 25 LUAD samples were assigned as the case group and 30 NL tissues as the control group. For the targeted metabolomics technique, ten LUAD samples were assigned as the case group and 15 NL tissues as the control group. Samples were analyzed by untargeted and targeted metabolomics, with liquid chromatography-tandem mass spectrometry detection used as part of the experimental procedure. Results: Untargeted metabolomics revealed 164 differential metabolites between the case and control groups, comprising 110 up regulations and 54 down regulations. The main metabolic differences found by the untargeted method were organic acids and their derivatives. Targeted metabolomics revealed 77 differential metabolites between the case and control groups, comprising 69 up regulations and eight down regulations. The main metabolic changes found by the targeted method were fatty acids, amino acids, and organic acids. The levels of organic acids such as lactic acid, fumaric acid, and malic acid were significantly increased in LUAD tissue compared to NL. Specifically, an increased level of L-lactic acid was found by both untargeted (variable importance in projection [VIP] = 1.332, fold-change [FC] = 1.678, q = 0.000) and targeted metabolomics (VIP = 1.240, FC = 1.451, q = 0.043). Targeted metabolomics also revealed increased levels of fumaric acid (VIP = 1.481, FC = 1.764, q = 0.106) and L-malic acid (VIP = 1.376, FC = 1.562, q = 0.012). Most of the 20 differential fatty acids identified were downregulated, including dodecanoic acid (VIP = 1.416, FC = 0.378, q = 0.043) and tridecane acid (VIP = 0.880, FC = 0.780, q = 0.106). Furthermore, increased levels of differential amino acids were found in LUAD samples. Conclusion: Lung cancer is a complex and heterogeneous disease with diverse genetic alterations. The study of metabolic profiles is a promising research field in this cancer type. Targeted and untargeted metabolomics revealed significant differences in metabolites between LUAD and NL tissues, including elevated levels of organic acids, decreased levels of fatty acids, and increased levels of amino acids. These metabolic features provide valuable insights into LUAD pathogenesis and can potentially serve as biomarkers for prognosis and therapy response.

13.
Arch Osteoporos ; 19(1): 24, 2024 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-38565791

RESUMO

A survey of awareness and attitudes to the management of fragility fractures among the membership of the Asia Pacific Orthopaedic Association conducted in 2022 found considerable variation in care across the region. A Call to Action is proposed to improve acute care, rehabilitation and secondary fracture prevention across Asia Pacific. PURPOSE: Fragility fractures impose a substantial burden on older people and their families, healthcare systems and national economies. The current incidence of hip and other fragility fractures across the Asia Pacific region is enormous and set to escalate rapidly in the coming decades. This publication describes findings of a survey of awareness and attitudes to the management of fragility fractures among the membership of the Asia Pacific Orthopaedic Association (APOA) conducted in 2022. METHODS: The survey was developed as a collaboration between the Asia Pacific Osteoporosis and Fragility Fracture Society and the Asia Pacific Fragility Fracture Alliance, and included questions relating to aspects of care upon presentation, during surgery and mobilisation, secondary fracture prevention, and access to specific services. RESULTS: In total, 521 APOA members completed the survey and marked variation in delivery of care was evident. Notable findings included: Fifty-nine percent of respondents indicated that analgesia was routinely initiated in transit (by paramedics) or within 30 minutes of arrival in the Emergency Department. One-quarter of respondents stated that more than 80% of their patients underwent surgery within 48 hours of admission. One-third of respondents considered non-hip, non-vertebral fractures to merit assessment of future fracture risk. One-third of respondents reported the presence of an Orthogeriatric Service in their hospital, and less than a quarter reported the presence of a Fracture Liaison Service. CONCLUSION: A Call to Action for all National Orthopaedic Associations affiliated with APOA is proposed to improve the care of fragility fracture patients across the region.


Assuntos
Ortopedia , Fraturas por Osteoporose , Humanos , Idoso , Fraturas por Osteoporose/epidemiologia , Fraturas por Osteoporose/prevenção & controle , Ásia/epidemiologia , Inquéritos e Questionários , Apolipoproteínas A
14.
J Cardiothorac Surg ; 19(1): 182, 2024 Apr 05.
Artigo em Inglês | MEDLINE | ID: mdl-38581004

RESUMO

PURPOSE: In VATS surgery, precise preoperative localization is particularly crucial when dealing with small-diameter pulmonary nodules located deep within the lung parenchyma. The purpose of this study was to compare the efficacy and safety of laser guidance and freehand hook-wire for CT-guided preoperative localization of pulmonary nodules. METHODS: This retrospective study was conducted on 164 patients who received either laser guidance or freehand hook-wire localization prior to Uni-port VATS from September 1st, 2022 to September 30th, 2023 at The First Affiliated Hospital of Soochow University. Patients were divided into laser guidance group and freehand group based on which technology was used. Preoperative localization data from all patients were compiled. The localization success and complication rates associated with the two groups were compared. The risk factors for common complications were analyzed. RESULTS: The average time of the localization duration in the laser guidance group was shorter than the freehand group (p<0.001), and the average CT scan times in the laser guidance group was less than that in the freehand group (p<0.001). The hook-wire was closer to the nodule in the laser guidance group (p<0.001). After the localization of pulmonary nodules, a CT scan showed 14 cases of minor pneumothorax (22.58%) in the laser guidance group and 21 cases (20.59%) in the freehand group, indicating no statistical difference between the two groups (p=0.763). CT scans in the laser guidance group showed pulmonary minor hemorrhage in 8 cases (12.90%) and 6 cases (5.88%) in the freehand group, indicating no statistically significant difference between the two groups (p=0.119). Three patients (4.84%) in the laser guidance group and six patients (5.88%) in the freehand group had hook-wire dislodgement, showing no statistical difference between the two groups (p=0.776). CONCLUSION: The laser guidance localization method possessed a greater precision and less localization duration and CT scan times compared to the freehand method. However, laser guidance group and freehand group do not differ in the appearance of complications such as pulmonary hemorrhage, pneumothorax and hook-wire dislodgement.


Assuntos
Neoplasias Pulmonares , Nódulos Pulmonares Múltiplos , Pneumotórax , Nódulo Pulmonar Solitário , Humanos , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/cirurgia , Pneumotórax/cirurgia , Estudos Retrospectivos , Nódulo Pulmonar Solitário/cirurgia , Cirurgia Torácica Vídeoassistida/métodos , Nódulos Pulmonares Múltiplos/diagnóstico por imagem , Nódulos Pulmonares Múltiplos/cirurgia , Tomografia Computadorizada por Raios X/métodos , Hemorragia
15.
Front Surg ; 11: 1360125, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38444900

RESUMO

Minimally invasive thoracic surgery, including video-assisted thoracoscopic surgery and robot-assisted thoracoscopic surgery, has been proven to have an advantage over open thoracotomy with less pain, fewer postoperative complications, faster discharge, and better tolerance among elderly patients. We introduce a uniportal robot-assisted thoracoscopic double-sleeve lobectomy performed on a patient following neoadjuvant immunotherapy. Specialized instruments like customized trocars with a reduced diameter, bulldog clamps, and double-needle sutures were utilized to facilitate the maneuverability through the single incision. This technique integrates the merits of multiport robot-assisted thoracic surgery with uniportal video-assisted thoracoscopic surgery.

16.
Adv Sci (Weinh) ; 11(17): e2400862, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38408138

RESUMO

Hematoma, a risk factor of implant-associated infections (IAIs), creates a Fe-rich environment following implantation, which proliferates the growth of pathogenic bacteria. Fe metabolism is a major vulnerability for pathogens and is crucial for several fundamental physiological processes. Herein, a deferiprone (DFP)-loaded layered double hydroxide (LDH)-based nanomedicine (DFP@Ga-LDH) that targets the Fe-rich environments of IAIs is reported. In response to acidic changes at the infection site, DFP@Ga-LDH systematically interferes with bacterial Fe metabolism via the substitution of Ga3+ and Fe scavenging by DFP. DFP@Ga-LDH effectively reverses the Fe/Ga ratio in Pseudomonas aeruginosa, causing comprehensive interference in various Fe-associated targets, including transcription and substance metabolism. In addition to its favorable antibacterial properties, DFP@Ga-LDH functions as a nano-adjuvant capable of delaying the emergence of antibiotic resistance. Accordingly, DFP@Ga-LDH is loaded with a siderophore antibiotic (cefiderocol, Cefi) to achieve the antibacterial nanodrug DFP@Ga-LDH-Cefi. Antimicrobial and biosafety efficacies of DFP@Ga-LDH-Cefi are validated using ex vivo human skin and mouse IAI models. The pivotal role of the hematoma-created Fe-rich environment of IAIs is highlighted, and a nanoplatform that efficiently interferes with bacterial Fe metabolism is developed. The findings of the study provide promising guidance for future research on the exploration of nano-adjuvants as antibacterial agents.


Assuntos
Antibacterianos , Biofilmes , Ferro , Infecções Relacionadas à Prótese , Pseudomonas aeruginosa , Biofilmes/efeitos dos fármacos , Camundongos , Ferro/metabolismo , Animais , Antibacterianos/farmacologia , Pseudomonas aeruginosa/efeitos dos fármacos , Infecções Relacionadas à Prótese/tratamento farmacológico , Infecções Relacionadas à Prótese/microbiologia , Deferiprona/farmacologia , Modelos Animais de Doenças , Cefiderocol , Infecções por Pseudomonas/tratamento farmacológico , Humanos , Nanomedicina/métodos
17.
Stem Cells Transl Med ; 13(4): 399-413, 2024 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-38366885

RESUMO

Intravenous administration of conditioned medium from stem cells of human exfoliated deciduous teeth (SHED-CM) regenerates mechanically injured osteochondral tissues in mouse temporomandibular joint osteoarthritis (TMJOA). However, the underlying therapeutic mechanisms remain unclear. Here, we showed that SHED-CM alleviated injured TMJ by inducing anti-inflammatory M2 macrophages in the synovium. Depletion of M2 by Mannosylated Clodrosome abolished the osteochondral repair activities of SHED-CM. Administration of CM from M2-induced by SHED-CM (M2-CM) effectively ameliorated mouse TMJOA by inhibiting chondrocyte inflammation and matrix degradation while enhancing chondrocyte proliferation and matrix formation. Notably, in vitro, M2-CM directly suppressed the catabolic activities while enhancing the anabolic activities of interleukin-1ß-stimulated mouse primary chondrocytes. M2-CM also inhibited receptor activator of nuclear factor NF-κB ligand-induced osteoclastogenesis in RAW264.7 cells. Secretome analysis of M2-CM and M0-CM revealed that 5 proteins related to anti-inflammation and/or osteochondrogenesis were enriched in M2-CM. Of these proteins, the Wnt signal antagonist, secreted frizzled-related protein 1 (sFRP1), was the most abundant and played an essential role in the shift to anabolic chondrocytes, suggesting that M2 ameliorated TMJOA partly through sFRP1. This study suggests that secretome from SHED exerted remarkable osteochondral regeneration activities in TMJOA through the induction of sFRP1-expressing tissue-repair M2 macrophages.


Assuntos
Osteoartrite , Células-Tronco , Humanos , Camundongos , Animais , Meios de Cultivo Condicionados/farmacologia , Meios de Cultivo Condicionados/metabolismo , Células-Tronco/metabolismo , Macrófagos/metabolismo , Osteoartrite/terapia , Osteoartrite/metabolismo , Anti-Inflamatórios/metabolismo , Dente Decíduo
18.
J Biomed Mater Res A ; 112(7): 1025-1040, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38363033

RESUMO

The current evidence provides support for the involvement of bone marrow mesenchymal stem cells (BMSCs) in the regulation of airway epithelial cells. However, a comprehensive understanding of the underlying biological mechanisms remains elusive. This study aimed to isolate and characterize BMSC-derived exosomes (BMSC-Exos) and epithelial cells (ECs) through primary culture. Subsequently, the impact of BMSC-Exos on ECs was assessed in vitro, and sequencing analysis was conducted to identify potential molecular mechanisms involved in these interactions. Finally, the efficacy of BMSC-Exos was evaluated in animal models in vivo. In this study, primary BMSCs and ECs were efficiently isolated and cultured, and high-purity Exos were obtained. Upon uptake of BMSC-Exos, ECs exhibited enhanced proliferation (p < .05), while migration showed no difference (p > .05). Notably, invasion demonstrated significant difference (p < .05). Sequencing analysis suggested that miR-21-5p may be the key molecule responsible for the effects of BMSC-Exos, potentially mediated through the MAPK or PI3k-Akt signaling pathway. The in vivo experiments showed that the presence of methacrylated gelatin (GelMA) loaded with BMSC-Exos in composite scaffold significantly enhanced epithelial crawling in the patches in comparison to the pure decellularized group. In conclusion, this scheme provides a solid theoretical foundation and novel insights for the research and clinical application of tracheal replacement in the field of tissue engineering.


Assuntos
Células Epiteliais , Exossomos , Gelatina , Células-Tronco Mesenquimais , Alicerces Teciduais , Células-Tronco Mesenquimais/citologia , Células-Tronco Mesenquimais/metabolismo , Exossomos/metabolismo , Gelatina/química , Gelatina/farmacologia , Animais , Alicerces Teciduais/química , Células Epiteliais/citologia , Células Epiteliais/metabolismo , Humanos , Metacrilatos/química , MicroRNAs/genética , MicroRNAs/metabolismo , Proliferação de Células/efeitos dos fármacos , Células da Medula Óssea/citologia , Células da Medula Óssea/metabolismo , Células Cultivadas , Masculino , Movimento Celular/efeitos dos fármacos
19.
J Thorac Dis ; 16(1): 401-413, 2024 Jan 30.
Artigo em Inglês | MEDLINE | ID: mdl-38410569

RESUMO

Background: The utilization of computed tomography (CT)-guided localization and electromagnetic navigation bronchoscopy (ENB)-guided localization has gained significant traction in the localization of pulmonary nodules before video-assisted thoracoscopic surgery (VATS). This study aimed to ascertain the precision and safety of the two groups in the preoperative resection of isolated nodules in small peripheral lungs. Furthermore, we examined the subsequent outcomes pertaining to the decline in lung function and alterations in anxiety and depression following resection utilizing both localization techniques. Methods: A total of 177 patients with small-sized pulmonary nodules, scheduled to undergo video-assisted thoracoscopic limited resection, were enrolled in this study. The study involved the examination and comparison of pertinent findings obtained through the utilization of CT-guided hook-wire or ENB injection techniques. Results: The nodules were localized by ENB in 57 patients and by CT guidance in 120 patients. There were no significant complications in ENB-guided localization group (0/57). CT-guided hook-wire localization group had more complications (61/120, P<0.001). There was no disparity observed in pulmonary function decline 3 months post-operation between the two cohorts. The analysis of postoperative Hospital Anxiety and Depression Scale (HADS) scores indicated that the CT-guided localization group exhibited higher anxiety and depression scores on the initial day and 2 weeks following surgery. Conclusions: ENB-guided and CT-guided localization can effectively identify solitary pulmonary nodules. ENB-guided localization has fewer complications, lower incidence of adverse events, and less impact on postoperative anxiety or depression, suggesting that this is a promising, safe, and feasible method for localization of solitary pulmonary nodules.

20.
Cancer Immunol Immunother ; 73(3): 58, 2024 Feb 22.
Artigo em Inglês | MEDLINE | ID: mdl-38386050

RESUMO

B cells possess anti-tumor functions mediated by granzyme B, in addition to their role in antigen presentation and antibody production. However, the variations in granzyme B+ B cells between tumor and non-tumor tissues have been largely unexplored. Therefore, we integrated 25 samples from the Gene Expression Omnibus database and analyzed the tumor immune microenvironment. The findings uncovered significant inter- and intra-tumoral heterogeneity. Notably, single-cell data showed higher proportions of granzyme B+ B cells in tumor samples compared to control samples, and these levels were positively associated with disease-free survival. The elevated levels of granzyme B+ B cells in tumor samples resulted from tumor cell chemotaxis through the MIF- (CD74 + CXCR4) signaling pathway. Furthermore, the anti-tumor function of granzyme B+ B cells in tumor samples was adversely affected, potentially providing an explanation for tumor progression. These findings regarding granzyme B+ B cells were further validated in an independent clinic cohort of 40 liver transplant recipients with intrahepatic cholangiocarcinoma. Our study unveils an interaction between granzyme B+ B cells and intrahepatic cholangiocarcinoma, opening up potential avenues for the development of novel therapeutic strategies against this disease.


Assuntos
Neoplasias dos Ductos Biliares , Colangiocarcinoma , Transplante de Fígado , Humanos , Granzimas/genética , Colangiocarcinoma/genética , Colangiocarcinoma/cirurgia , Prognóstico , Neoplasias dos Ductos Biliares/genética , Neoplasias dos Ductos Biliares/cirurgia , Ductos Biliares Intra-Hepáticos , Microambiente Tumoral
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