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1.
Molecules ; 29(12)2024 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-38930848

RESUMO

The photoelectrochemical (PEC) conversion of organic small molecules offers a dual benefit of synthesizing value-added chemicals and concurrently producing hydrogen (H2). Ethylene glycol, with its dual hydroxyl groups, stands out as a versatile organic substrate capable of yielding various C1 and C2 chemicals. In this study, we demonstrate that pH modulation markedly enhances the photocurrent of BiVO4 photoanodes, thus facilitating the efficient oxidation of ethylene glycol while simultaneously generating H2. Our findings reveal that in a pH = 1 ethylene glycol solution, the photocurrent density at 1.23 V vs. RHE can attain an impressive 7.1 mA cm-2, significantly surpassing the outputs in neutral and highly alkaline environments. The increase in photocurrent is attributed to the augmented adsorption of ethylene glycol on BiVO4 under acidic conditions, which in turn elevates the activity of the oxidation reaction, culminating in the maximal production of formic acid. This investigation sheds light on the pivotal role of electrolyte pH in the PEC oxidation process and underscores the potential of the PEC strategy for biomass valorization into value-added products alongside H2 fuel generation.

2.
Gynecol Endocrinol ; 40(1): 2351525, 2024 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38726683

RESUMO

OBJECTIVE: Stable luteal cell function is an important prerequisite for reproductive ability and embryonic development. However, luteal insufficiency seriously harms couples who have the desire to have a pregnancy, and the most important thing is that there is no complete solution. In addition, Vaspin has been shown to have regulatory effects on luteal cells, but the complex mechanisms involved have not been fully elucidated. Therefore, this study aimed to explore the effect of Vaspin on rat luteal cells and its mechanism. METHODS: Granulosa lutein cells separated from the ovary of female rats were incubated for 24h with gradient concentrations of Vaspin, and granulosa lutein cells incubated with 0.5% bovine serum albumin were used as controls. The proliferation, apoptosis, angiogenesis, progesterone (P4) and estradiol (E2) were detected by CCK-8, Anneixn-FITC/PI staining, angiogenesis experiment and ELISA. Western blot was applied to observe the expression levels of proteins related to cell proliferation, apoptosis, angiogenesis and MEK/MAPK signaling pathway. RESULTS: Compared with the Control group, Vaspin could significantly up-regulate the proliferation of granulosa lutein cells and reduce the apoptosis. Moreover, Vaspin promoted the angiogenesis of granulosa lutein cells and the production of P4 and E2 in a concentration-dependent manner. Furthermore, Vaspin up-regulated the CyclinD1, CyclinB1, Bcl2, VEGFA and FGF-2 expression in granulosa lutein cells, and down-regulated the level of Bax. Also, Vaspin increased the p-MEK1 and p-p38 levels. CONCLUSION: Vaspin can up-regulate the proliferation and steroidogenesis of rat luteal cells and reduce apoptosis, which may be related to the influence of MEK/MAPK activity.


Assuntos
Apoptose , Proliferação de Células , Células Lúteas , Progesterona , Serpinas , Animais , Feminino , Proliferação de Células/efeitos dos fármacos , Serpinas/metabolismo , Serpinas/farmacologia , Ratos , Células Lúteas/efeitos dos fármacos , Células Lúteas/metabolismo , Apoptose/efeitos dos fármacos , Progesterona/farmacologia , Estradiol/farmacologia , Células Cultivadas , Ratos Sprague-Dawley , Sistema de Sinalização das MAP Quinases/efeitos dos fármacos , Neovascularização Fisiológica/efeitos dos fármacos
3.
Ear Nose Throat J ; : 1455613241237772, 2024 Mar 04.
Artigo em Inglês | MEDLINE | ID: mdl-38439628

RESUMO

Objective: Nasopharyngeal melanoma is a rare mucosal malignant melanoma with high recurrence rate, metastasis rate and vascular invasion rate. In this paper, we report a case of primary nasopharyngeal mucosal melanoma. Methods: A case of primary nasopharyngeal mucosal melanoma was reported, and its clinical symptoms, pathological characteristics, treatment and follow-up were described in detail. Results: This report describes a 59-year-old male patient with persistent nasal congestion and suspected malignant nasopharyngeal neoplasm. Patients receive surgical resection and adjuvant radiotherapy after complete resection. Imaging studies showed no tissue invasion or lymph node metastases. The results of immunohistochemistry were Melan-A(+), HMB45(+), and S100(+). The final diagnosis was malignant nasopharyngeal melanoma. After 2 years of follow-up, the prognosis was good, and there was no metastasis or recurrence. Discussion: Nasopharyngeal melanoma is a rare malignancy with a poor prognosis, and surgical resection is the mainstay of treatment. Postoperative adjuvant therapy can improve the rate of local control of lesions. Early diagnosis and thorough examination are extremely important for the patient's prognosis.

4.
Small ; 19(48): e2302970, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37594726

RESUMO

Regulating the electronic structure of active sites and monitoring the evolution of the active component is essential to improve the intrinsic activity of catalysts for electrochemical reactions. Herein, a highly efficient pre-electrocatalyst of iron diselenide with rich Se vacancies achieved by phosphorus doping (denoted as P-FeSe2 ) for oxygen evolution reaction (OER) is reported. Systematically experimental and theoretical results show that the formed Se vacancies with phosphorus doping can synergistically modulate the electronic structure of FeSe2 and facilitate OER kinetics with the resulting enhanced electrical conductivity and electrochemical surface area. Importantly, the in situ formed FeOOH species on the surface of the P-FeSe2 nanorods (denoted as P-FeOOH(Se)) during the OER process acts as an active component to efficiently catalyze OER and exhibits a low overpotential of 217 mV to reach 10 mA cm-2 with good durability. Promisingly, an alkaline electrolyzer assembled with P-FeOOH(Se) and Pt/C electrodes requires an ultra-low cell voltage of 1.50 V at 10 mA cm-2 for overall water splitting, which is superior to the RuO2 || Pt/C counterpart and most of the state-of-the-art electrolyzers, demonstrating the high potential of the fabricated electrocatalyst by P doping strategy to explore more highly efficient selenide-based catalysts for various reactions.

5.
Omega ; 119: 102875, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37009427

RESUMO

With the rapid development of telemedicine and the impact of the COVID-19 pandemic, more and more patients are now resorting to using telemedicine channels for healthcare services. However, for hospitals, there exists a lack of managerial guidance in place to help them adopt telemedicine in a practical and standardized way. This study considers a hospital operating with both telemedicine (virtual) and face-to-face (physical) medical channels, and which allocates its capacity by also taking into account the possibility of both referrals and misdiagnosis. Methodologically, we construct a game model based on a queuing framework. We first analyze equilibrium strategies for patient arrivals. Then we propose the necessary conditions for a hospital to develop a telemedicine channel and to operate both channels simultaneously. Finally, we find the optimal decisions for the service level of telemedicine, which can also be regarded as the optimal proportion of diseases treated by telemedicine, and the optimal hospital capacity allocation ratio between the two channels. We also find that hospitals in a full coverage market (e.g., for certain small-scale hospitals and community hospitals or cancer hospitals) are more difficult to adopt telemedicine than hospitals in a partial coverage market (e.g., for comprehensive large-scale hospitals with many potential patients). Small-scale hospitals are more suited to operating telemedicine as a gatekeeper to help triage patients, while large hospitals are more prone to regard telemedicine as a medical channel for providing professional medical services to patients. We also analyze the effects of the telemedicine cure rate and the cost ratio of telemedicine to the physical hospital on the overall healthcare system performance, including the physical hospital arrival rate, patients' waiting time, total profit, and social welfare. Then we compare the performance, ex ante versus ex post, the implementation of telemedicine. It is shown that when the market is partially covered, the total social welfare is always higher than it was before the implementation. However, as far as the profit goes, if the telemedicine cure rate is low and the cost ratio is high, the total hospital profit may be lower than it was prior to using telemedicine. However, the profit and social welfare of hospitals in the full coverage market are always lower than it was before the implementation. In addition, the waiting time in the hospital is always higher than that before the implementation, which means that the implementation of telemedicine will make patients who must receive treatment in the physical hospital face even worse congestion than before. More insights and results are gleaned from a series of numerical studies.

6.
Pharmacol Res ; 191: 106773, 2023 05.
Artigo em Inglês | MEDLINE | ID: mdl-37068531

RESUMO

Specific medications to combat cerebellar ataxias, a group of debilitating movement disorders characterized by difficulty with walking, balance and coordination, are still lacking. Notably, cerebellar microglial activation appears to be a common feature in different types of ataxic patients and rodent models. However, direct evidence that cerebellar microglial activation in vivo is sufficient to induce ataxia is still lacking. Here, by employing chemogenetic approaches to manipulate cerebellar microglia selectively and directly, we found that specific chemogenetic activation of microglia in the cerebellar vermis directly leads to ataxia symptoms in wild-type mice and aggravated ataxic motor deficits in 3-acetylpyridine (3-AP) mice, a classic mouse model of cerebellar ataxia. Mechanistically, cerebellar microglial proinflammatory activation induced by either chemogenetic M3D(Gq) stimulation or 3-AP modeling hyperexcites Purkinje cells (PCs), which consequently triggers ataxia. Blockade of microglia-derived TNF-α, one of the most important proinflammatory cytokines, attenuates the hyperactivity of PCs driven by microglia. Moreover, chemogenetic inhibition of cerebellar microglial activation or suppression of cerebellar microglial activation by PLX3397 and minocycline reduces the production of proinflammatory cytokines, including TNF-α, to effectively restore the overactivation of PCs and alleviate motor deficits in 3-AP mice. These results suggest that cerebellar microglial activation may aggravate the neuroinflammatory response and subsequently induce dysfunction of PCs, which in turn triggers ataxic motor deficits. Our findings thus reveal a causal relationship between proinflammatory activation of cerebellar microglia and ataxic motor symptoms, which may offer novel evidence for therapeutic intervention for cerebellar ataxias by targeting microglia and microglia-derived inflammatory mediators.


Assuntos
Ataxia Cerebelar , Camundongos , Animais , Ataxia Cerebelar/induzido quimicamente , Células de Purkinje/fisiologia , Microglia , Fator de Necrose Tumoral alfa/farmacologia , Cerebelo , Citocinas
7.
Front Pharmacol ; 14: 1071709, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36874016

RESUMO

Background: Drug-induced liver injury (DILI) is a potentially serious adverse drug reaction. Due to the lack of definite etiology, specific clinical manifestations, and diagnostic methods, its prediction and diagnosis are challenging. Elderly individuals are deemed to be at high risk for DILI due to abnormal pharmacokinetics, aging tissue repair function, comorbidities, and taking multiple drugs. This study aimed to identify the clinical characteristics and explore the risk factors associated with the severity of illness in elderly patients with DILI. Methods: In the present study, the clinical characteristics at the time of liver biopsy of consecutive patients with biopsy-proven DILI who presented at our hospital from June 2005 to September 2022 were evaluated. Hepatic inflammation and fibrosis were assessed according to the Scheuer scoring system. The presence of autoimmunity was considered if IgG level >1.1 × ULN (1826 mg/dL), or high titer (>1:80) of ANA, or SMA. Results: In total, 441 patients were enrolled, and the median age was 63.3 years (IQR, 61.0-66.0); 122 (27.7%), 195 (44.2%), or 124 (28.1%) were classified as having minor, moderate, or severe hepatic inflammation, respectively; and 188 (42.6%), 210 (47.6%) or 43 (9.8%) patients presented minor, significant fibrosis or cirrhosis, respectively. Female sex (73.5%) and the cholestatic pattern (47.6%) were dominant in elderly DILI patients. Autoimmunity existed in 201 patients (45.6%). Comorbidities were not directly associated with the severity of DILI. PLT (OR: 0.994, 95% CI: 0.991-0.997; p < 0.001), AST (OR: 1.001, 95% CI: 1.000-1.003, p = 0.012), TBIL (OR: 1.006, 95% CI: 1.003-1.010, p < 0.001), and autoimmunity (OR: 1.831, 95% CI: 1.258-2.672, p = 0.002) were associated with the degree of hepatic inflammation. Meanwhile, PLT (OR: 0.990, 95% CI: 0.986-0.993, p < 0.001), TBIL (OR: 1.004, 95% CI: 1.000-1.007, p = 0.028), age (OR: 1.123, 95% CI: 1.067-1.183, p < 0.001), and autoimmunity (OR: 1.760, 95% CI: 1.191-2.608, p = 0.005) were associated with the stage of hepatic fibrosis. Conclusion: This study revealed that the presence of autoimmunity represents a more serious illness state of DILI, deserving more intensive monitoring and progressive treatment.

8.
Comput Ind Eng ; 176: 108893, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36532864

RESUMO

Amid the epidemic outbreaks such as COVID-19, a large number of patients occupy inpatient and intensive care unit (ICU) beds, thereby making the availability of beds uncertain and scarce. Thus, elective surgery scheduling not only needs to deal with the uncertainty of the surgery duration and length of stay in the ward, but also the uncertainty in demand for ICU and inpatient beds. We model this surgery scheduling problem with uncertainty and propose an effective algorithm that minimizes the operating room overtime cost, bed shortage cost, and patient waiting cost. Our model is developed using fuzzy sets whereas the proposed algorithm is based on the differential evolution algorithm and heuristic rules. We set up experiments based on data and expert experience respectively. A comparison between the fuzzy model and the crisp (non-fuzzy) model proves the usefulness of the fuzzy model when the data is not sufficient or available. We further compare the proposed model and algorithm with several extant models and algorithms, and demonstrate the computational efficacy, robustness, and adaptability of the proposed framework.

9.
Hepatobiliary Pancreat Dis Int ; 22(3): 263-269, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-36435702

RESUMO

BACKGROUND: The effective treatment for hepatocellular carcinoma (HCC) depends on early diagnosis. Previously, the abnormal expression of Wnt3a as the key signaling molecule in the Wnt/ß-catenin pathway was found in HCC cells and could be released into the circulation. In this study, we used rat model of hepatocarcinogenesis to dynamically investigate the alteration of oncogenic Wnt3a and to explore its early monitor value for HCC. METHODS: Sprague-Dawley rats (SD) were fed with diet 2-fluorenylacetamide (2-FAA, 0.05%) for inducing hepatocarcinogenesis, and grouped based on liver morphological alteration by Hematoxylin & Eosin (H&E) staining; rats fed with normal chow were used as normal control (NC). Total RNA and protein were purified from rat livers. Differently expressed genes (DEGs) or Wnt3a mRNA, cellular distribution, and Wnt3a protein levels were analyzed by whole genome microarray with signal logarithm ratio (SLR log2cy5/cy3), immunohistochemistry, and enzyme-linked immunosorbent assay, respectively. RESULTS: Models of rat hepatocarcinogenesis were successfully established based on liver histopathological H&E staining. Rats were divided into the cell degeneration (rDeg), precancerosis (rPre-C) and HCC (rHCC) groups. Total numbers of the up- and down-regulated DEGs with SLR ≥ 8 were 55 and 48 in the rDeg group, 268 and 57 in the rPre-C group, and 312 and 201 in the rHCC group, respectively. Significantly altered genes were involved in cell proliferation, signal transduction, tumor metastasis, and apoptosis. Compared with the NC group, Wnt3a mRNA was increased by 4.6 folds (P < 0.001) in the rDeg group, 7.4 folds (P < 0.001) in the rPre-C group, and 10.4 folds (P < 0.001) in the rHCC group; the positive rates of liver Wnt3a were 66.7% (P = 0.001) in the rDeg group, 100% (P < 0.001) in the rPre-C group, and 100% (P < 0.001) in the rHCC group, respectively. Also, there were significant differences of liver Wnt3a (P < 0.001) or serum Wnt3a (P < 0.001) among different groups. CONCLUSIONS: Overexpression of Wnt3a was associated with rat hepatocarcinogenesis and it should be expected to be a promising monitoring biomarker for HCC occurrence at early stage.


Assuntos
Carcinogênese , Carcinoma Hepatocelular , Neoplasias Hepáticas , Proteína Wnt3A , Animais , Ratos , Biomarcadores Tumorais/metabolismo , Carcinogênese/genética , Carcinoma Hepatocelular/patologia , Neoplasias Hepáticas/patologia , Ratos Sprague-Dawley , RNA Mensageiro/metabolismo , Via de Sinalização Wnt , Proteína Wnt3A/análise
10.
World J Gastrointest Oncol ; 14(9): 1739-1757, 2022 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-36187400

RESUMO

BACKGROUND: Primary malignant melanoma of the esophagus (PMME) is a rare malignant disease and has not been well characterized in terms of clinicopathology and survival. AIM: To investigate the clinical features and survival factors in Chinese patients with PMME. METHODS: The clinicopathological findings of ten cases with PMME treated at Henan Provincial People's Hospital were summarized. Moreover, the English- and Chinese-language literature that focused on Chinese patients with PMME from 1980 to September 2021 was reviewed and analyzed. Univariate and multivariate analyses were employed to investigate the clinicopathologic factors that might be associated with survival. RESULTS: A total of 290 Chinese patients with PMME, including ten from our hospital and 280 from the literature were enrolled in the present study. Only about half of the patients (55.8%) were accurately diagnosed before surgery. Additionally, 91.1% of the patients received esophagectomy, and 88 patients (36.5%) received adjuvant therapy after surgery. The frequency of lymph node metastasis (LNM) was 51.2% (107/209), and LNM had a positive rate of 45.3% even when the tumor was confined to the submucosal layer. The risk of LNM increased significantly with the pT stage [P < 0.001, odds ratio (OR): 2.47, 95% confidence interval (CI): 1.72-3.56] and larger tumor size (P = 0.006, OR: 1.21, 95%CI: 1.05-1.38). The median overall survival (OS) was 11.0 mo (range: 1-204 mo). The multivariate Cox analysis showed both the pT stage [P = 0.005, hazard ratio (HR): 1.70, 95%CI: 1.17-2.47] and LNM (P = 0.009, HR: 1.78, 95%CI: 1.15-2.74) were independent prognostic factors for OS. The median disease-free survival (DFS) was 5.3 mo (range: 0.8-114.1 mo). The multivariate analysis indicated that only the advanced pT stage (P = 0.02, HR: 1.93, 95%CI: 1.09-3.42) was a significant independent indicator of poor RFS in patients with PMME. CONCLUSION: The correct diagnosis of PMME before surgery is low, and physicians should pay more attention to avoid a misdiagnosis or missed diagnosis. Extended lymph node dissection should be emphasized in surgery for PMME even though the tumor is confined to the submucosal layer. Both the LNM and pT stage are independent prognosis factors for OS, and the pT stage is the prognosis factor for DFS in patients with PMME.

11.
World J Clin Cases ; 10(23): 8262-8270, 2022 Aug 16.
Artigo em Inglês | MEDLINE | ID: mdl-36159527

RESUMO

BACKGROUND: Lymph node skip metastases are common in lung, breast, and thyroid cancer patients, but are rare in colon cancer patients. Specifically, lymph node skip metastases occur in 1%-3% of colon cancer patients. Previous reports have demonstrated colon cancer skip metastases involving the retropancreatic and portocaval lymph nodes and Virchow's node; however, reports involving skip metastases into the left neck lymph nodes and left shoulder skin are extremely rare, as are related reports of clinical treatment and prognosis. CASE SUMMARY: A 44-year-old Chinese man was admitted to the hospital for evaluation of persistent shoulder pain for 3 d and a cutaneous mass (3.0 cm × 2.0 cm) on the left shoulder. The left shoulder cutaneous mass was excised and bisected, revealing tissues with a fish-like appearance. The pathologic diagnosis of the cutaneous mass suggested a signature [CDX-2 (++), CK20 (++), Ki-67 (+) > 50%] of infiltrating or metastatic colorectal adenocarcinoma. An enhanced computed tomography scan of the abdomen revealed chronic appendicitis with fecal stone formation, cecal edema, and a pelvic effusion. A colonoscopy revealed a cauliflower-like mass within the ascending colon area that involved the lumen. The surface of the ascending colon mass was eroded and bleeding; a biopsy was performed. The pathologic diagnosis of the colonoscopy biopsy was an ascending colon mucinous adenocarcinoma. The patient underwent a laparoscopic radical resection of the right colon based on the pathological diagnosis. The tumor was 5.0 cm × 4.5 cm × 1.8 cm in size and infiltrated the entire thickness of the intestinal wall with vascular tumor thrombi. No nerve tissue involvement was noted. The ileum and colon resection margins were negative. The postoperative pathologic analysis revealed non-metastatic involvement of ileocecal, pericolic, or peri-ileal lymph nodes. The postoperative medical examination revealed palpably enlarged lymph nodes in the left neck, and the following color Doppler ultrasound examination of the neck confirmed enlarged lymph nodes in the left neck. After surgical resection and pathologic diagnosis, a common pathologic signature consistent with resected cutaneous mass and right colon was identified, suggesting skip metastasis of left cervical lymph nodes. The patient was then treated with eight courses of chemotherapy and under follow-up evaluations for 4 years; currently, no tumor recurrences or metastases have been noted. CONCLUSION: We report an abnormal skip metastasis involving the left shoulder skin and left neck lymph node in a patient with ascending colon adenocarcinoma. Specifically, we observed non-metastatic involvement of the lymph nodes around the tumor site but with metastases to the cervical lymph nodes. The standard surgical operations were performed to resect the cutaneous mass, tumor tissue, and cervical lymph nodes, followed by chemotherapy for eight courses. The patient is healthy with no tumor recurrences or metastases for 4 years. This clinical case will contribute to future research about the abnormal skip metastasis in colon cancers and a better clinical treatment design.

12.
Comput Ind Eng ; 169: 108210, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35529173

RESUMO

During the COVID-19 period, randomly arrived patients flooded into the hospital, which caused staffing beds to be occupied. Then, elective surgeries could not be carried out timely. It not only affects the health of patients but also affects hospital income. The key to the above problem is how to deal with uncertainty, which is one of the most difficult problems faced in the field of optimization. Specifically, surgery duration, length of stay, the arrival time of emergency patients, and whether they are infected with the SARS-CoV-2 virus are uncertain. Therefore, we propose a bed configuration to ensure that elective patients are not affected by non-elective patients such as COVID-19 patients. More importantly, we propose a planning model based on robust optimization and fuzzy set theory, which for the first time consider different categories of uncertainty in the same healthcare system. Given that the problem is more complex than the classical surgical scheduling problem, which is NP-hard in most cases, we propose a hybrid algorithm (GA-VNS-H) based on genetic algorithm, variable neighborhood search, and heuristics for problem traits. Specifically, the heuristic for operating room allocation is used to improve the efficiency, the genetic algorithm and variable neighborhood can improve the global and local search capabilities, respectively, and the adaptive mechanism can reduce the algorithm solution time. Experiments show that the algorithm has better calculation efficiency and solution accuracy. In addition, the elective surgery planning model under the new bed configuration model can effectively cope with the uncertain environment of COVID-19.

13.
Ann Oper Res ; 315(1): 463-505, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35340826

RESUMO

Operating Room (OR) management has been among the mainstream of hospital management research, as ORs are commonly considered as one of the most critical and expensive resources. The complicated connection and interplay between ORs and their upstream and downstream units has recently attracted research attention to focus more on allocating medical resources efficiently for the sake of a balanced coordination. As a critical step, surgical scheduling in the presence of uncertain surgery durations is pivotal but rather challenging since a patient cannot be hospitalized if a recovery bed will not be available to accommodate the admission. To tackle the challenge, we propose an overflow strategy that allows patients to be assigned to an undesignated department if the designated one is full. It has been proved that overflow strategy can successfully alleviate the imbalance of capacity utilization. However, some studies indicate that implementation of the overflow strategy exacerbates the readmission rate as well as the length of stay (LOS). To rigorously examine the overflow strategy and explore its optimal solution, we propose a Fuzzy model for surgical scheduling by explicitly considering downstream shortage, as well as the uncertainty of surgery duration and patient LOS. To solve the Fuzzy model, a hybrid algorithm (so-called GA-P) is developed, stemming from Genetic Algorithm (GA). Extensive numerical results demonstrate the plausible efficiency of the GA-P algorithm, especially for large-scale scheduling problems (e.g., comprehensive hospitals). Additionally, it is shown that the overflow cost plays a critical role in determining the efficiency of the overflow strategy; viz., benefits from the overflow strategy can be reduced as the overflow cost increases, and eventually almost vanishes when the cost becomes sufficiently large. Finally, the Fuzzy model is tested to be effective in terms of simplicity and reliability, yet without cannibalizing the patient admission rate.

14.
Trials ; 22(1): 905, 2021 Dec 11.
Artigo em Inglês | MEDLINE | ID: mdl-34895306

RESUMO

BACKGROUND: Chronic subdural haematoma (CSDH) is a common condition in the elderly that often requires neurosurgical management. For small CSDH, evidence has emerged that statins may reduce haematoma volume and improve outcomes, presumably by reducing local inflammation and promoting vascular repair. We wish to extend this evidence in a study that aims to determine the efficacy and safety of atorvastatin combined with low-dose dexamethasone in patients with CSDH. METHODS: The second ATorvastatin On Chronic subdural Hematoma (ATOCH-II) study is a multi-centre, randomized, placebo-controlled, double-blind trial which aims to enrol 240 adult patients with a conservative therapeutic indication for CSDH, randomly allocated to standard treatment with atorvastatin 20 mg combined with low-dose dexamethasone (or matching placebos) daily for 28 days, and with 152 days of follow-up. The primary outcome is a composite good outcome defined by any reduction from baseline in haematoma volume and survival free of surgery at 28 days. Secondary outcomes include functional outcome on the modified Rankin scale (mRS) and modified Barthel Index at 28 days, surgical transition and reduction in haematoma volumes at 14, 28 and 90 days. DISCUSSION: This multi-centre clinical trial aims to provide high-quality evidence on the efficacy and safety of the combined treatment of atorvastatin and low-dose dexamethasone to reduce inflammation and enhance angiogenesis in CSDH. TRIAL REGISTRATION: ChiCTR, ChiCTR1900021659 . Registered on 3 March 2019, http://www.chictr.org.cn/showproj.aspx?proj=36157 .


Assuntos
Hematoma Subdural Crônico , Adulto , Idoso , Atorvastatina/efeitos adversos , Dexametasona/efeitos adversos , Método Duplo-Cego , Hematoma Subdural Crônico/diagnóstico por imagem , Hematoma Subdural Crônico/tratamento farmacológico , Humanos , Estudos Multicêntricos como Assunto , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento
15.
Zhonghua Nan Ke Xue ; 27(2): 145-149, 2021 Feb.
Artigo em Chinês | MEDLINE | ID: mdl-34914331

RESUMO

OBJECTIVE: To investigate the clinicopathological characteristics and prognosis of incidental prostate cancer (PCa). METHODS: We retrospectively analyzed the clinical data and pathological characteristics of 96 cases of incidental PCa in 580 patients undergoing radical cystectomy and followed them up for prognosis. RESULTS: The incidence rate of incidental PCa was 16.6% (96/580). The patients were 42-90 years old, with a median age of 73 years, 6 (6.2%) ≤60 and 90 (93.8%) over 60 years old. The average maximum diameter of the tumor was about 3.5 cm (range 1.0-9.0 cm). Histologically, 86 (89.6%) of the bladder cancer cases were high-grade invasive urothelial carcinoma (7 with squamous differentiation, 2 with sarcomatoid differentiation, 4 with glandular differentiation, and 1 with plasmacytoid/diffuse variant) and 7 were low-grade urothelial carcinoma, of which 1 case was poorly differentiated neuroendocrine carcinoma and 2 cases were bladder adenocarcinoma, including 1 case of signet ring cell carcinoma. All the PCa cases were classified as the histopathological type of classic acinar adenocarcinoma of the prostate, 67 (69.8%) with a Gleason score ≤ 6, and 29 (30.2%) with a Gleason score ≥ 7. Of the total number of incidental PCa cases, 32 (33.3%) were of clinical significance, and 59 (61.5%) of the patients were followed up for 1-95 (mean 28.7) months, during which 42 (71.2%) survived and 17 (28.8%) died, including 2 deaths due to non-cancer factors. No statistically significant difference was found in the median survival time between the 5 clinically significant and 10 non-clinically significant cases (P = 0.322). CONCLUSIONS: There is a high probability of incidental PCa among bladder cancer patients aged >60 years. Standardized sampling plays an important role in detection of the malignancy. There is only a small proportion of incidental PCa cases with clinical significance, and therefore it affects less the prognosis than bladder cancer.


Assuntos
Carcinoma de Células de Transição , Neoplasias da Próstata , Neoplasias da Bexiga Urinária , Adulto , Idoso , Idoso de 80 Anos ou mais , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias da Próstata/epidemiologia , Estudos Retrospectivos , Neoplasias da Bexiga Urinária/epidemiologia
16.
Adv Sci (Weinh) ; 8(18): e2101775, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34302445

RESUMO

The electronic structure of active sites is critically important for electrochemical reactions. Here, the authors report a facile approach to independently regulate the electronic structure of Fe in Ni0.75 Fe0.25 Se2 by P doping. The resulting electrode exhibits superior catalytic performance for the oxygen evolution reaction (OER) showing a low overpotential (238 mV at 100 mA cm-2 , 185 mV at 10 mA cm-2 ) and an impressive durability in an alkaline medium. Additionally, the mass activity of 328.19 A g-1 and turnover frequency (TOF) of 0.18 s-1 at an overpotential of 500 mV are obtained for P─Ni0.75 Fe0.25 Se2 which is much higher than that of Ni0.75 Fe0.25 Se2 and RuO2 . This work presents a new strategy for the rational design of efficient electrocatalysts for OER.

17.
Front Oncol ; 10: 578948, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33335853

RESUMO

BACKGROUND: Previous studies have shown that miR-100-5p expression is abnormal in prostate cancer. However, the role and regulatory mechanism of miR-100-5p requires further investigation. Thus, the aim of this study was to observe the effects of miR-100-5p on the proliferation, migration and invasion of prostate cancer (PCa) cells and to explore the potential related regulatory mechanism. MATERIALS AND METHODS: Differential miRNA expression analysis was performed using next-generation sequencing (NGS) in the patients with PCa and benign prostatic hyperplasia (BPH). The expression levels of miR-100-5p were detected using real-time fluorescence quantitative PCR (qRT-PCR). PCa cells were transfected with NC-mimics or miR-100-5p mimics, inhibitor by using liposome transfection. Moreover, the CCK-8 proliferation assay, colony formation assay, cell scratch assay and Transwell assay were used to detect the effects of miR-100-5p on cell proliferation, migration, and invasion. In addition, the target gene of miR-100-5p was verified by luciferase reporter gene assay, and the influence of miR-100-5p on the expression of mTOR mRNA by qRT-PCR and the expression of mammalian target of rapamycin (mTOR) protein was detected by western blot and immunohistochemical staining. RESULTS: Differential expression analysis of high-throughput sequencing data showed low expression of miR-100-5p in the patients of PCa. It was further confirmed by qRT-PCR that the expression of miR-100-5p in PCa cells was significantly lower than that in RWPE-1 cells (P<0.01). miR-100-5p expression in lymph node carcinoma of prostate(LNCaP) cells was markedly upregulated after transfection with miR-100-5p mimics (P<0.01), while cell proliferation, migration and invasion capacities were clearly reduced (P<0.01). mTOR mRNA and protein expression was also substantially lowered (P<0.01) and mTOR adjusted the expression of NOX4. Finally, we further confirmed by immunohistochemical staining that miR-100-5p regulated the expression of mTOR and NOX4. CONCLUSION: miR-100-5p is expressed at low levels in PCa cells, and it can suppress PCa cell proliferation, migration and invasion, the mechanism of which is related to downregulating the expression of mTOR.

18.
Medicine (Baltimore) ; 99(22): e19993, 2020 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-32481368

RESUMO

BACKGROUND: miR-141 has gradually demonstrated its value in the diagnosis of prostate cancer. However, the diagnostic parameters in previous studies differ. A systematic review was conducted to explore the diagnostic value of miR-141 in prostate cancer. METHODS: A comprehensive search of the literature in the PubMed, Medline, Cochrane Library, and Embase databases was performed. The included 7 studies assessed the diagnostic value of miR-141 in patients with prostate cancer up to October 31, 2019. We used meta-disc version 1.4 and STATA software version 12.0 to analyze the data. RESULTS: The pooled sensitivity and specificity were 0.70 (95% confidence interval [CI] 0.64-0.75) and 0.73 (95% CI 0.64-0.80), respectively. The positive likelihood ratio was 2.88 (95% CI 1.40-5.93), and the negative likelihood ratio was 0.38 (95% CI 0.20-0.71). Further, we note that the pooled diagnostic odds ratio of miR-141 for prostate cancer was 9.94 (95% CI: 2.55-38.80). The summary area under the receiver operating characteristic curve was 0.83 (95% CI: 0.79-0.86). The results of meta-regression suggested that heterogeneity was mainly derived from patient age. The results of the Fagan nomogram showed that it was increased significantly by testing miR-141 for diagnosing prostate cancer. CONCLUSION: This meta-analysis suggests that miR-141 has a high diagnostic value for prostate cancer. In the future, large-scale prospective studies are needed to verify and evaluate this result.


Assuntos
MicroRNAs/metabolismo , Neoplasias da Próstata/metabolismo , Humanos , Masculino , Neoplasias da Próstata/diagnóstico
19.
Hepatobiliary Pancreat Dis Int ; 19(3): 218-228, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32414577

RESUMO

BACKGROUND: Hepatectomy and liver transplantation (LT) are the two most commonly performed surgical procedures for various hepatic lesions. microRNA (miRNA) and long non-coding RNA (lncRNA) have been gradually unveiled their roles as either biomarkers for early diagnosis or potentially therapeutic tools to manipulate gene expression in many disease entities. This review aimed to discuss the effects of miRNA or lncRNA in the hepatectomy and LT fields. DATA SOURCES: We did a literature search from 1990 through January 2018 to summarize the currently available evidence with respect to the effects of miRNA and lncRNA in liver regeneration after partial hepatectomy, as well as their involvement in several key issues related to LT, including ischemia-reperfusion injury, allograft rejection, tolerance, recurrence of original hepatic malignancies, etc. RESULTS: Certain miRNAs and lncRNAs are actively involved in the regulation of various aspects of liver resection and transplantation. During the process of liver regeneration after hepatectomy, the expression of miRNAs and lncRNAs shows dynamic changes. CONCLUSIONS: It is now clear that miRNAs and lncRNAs orchestrate in various aspects of the pathophysiological process of LT and hepatectomy. Better understanding of the underlying mechanism and future clinical trials may strengthen their positions as either biomarkers or potential therapeutic targets in the management of complications after liver surgery.


Assuntos
Rejeição de Enxerto/genética , Tolerância Imunológica/genética , Regeneração Hepática/genética , MicroRNAs/genética , RNA Longo não Codificante/genética , Traumatismo por Reperfusão/genética , Doença Aguda , Animais , Biomarcadores/sangue , Carcinoma Hepatocelular/genética , Regulação da Expressão Gênica , Rejeição de Enxerto/sangue , Rejeição de Enxerto/diagnóstico , Hepatectomia , Humanos , Neoplasias Hepáticas/genética , Neoplasias Hepáticas/cirurgia , Transplante de Fígado , MicroRNAs/fisiologia , Recidiva Local de Neoplasia/genética , RNA Longo não Codificante/fisiologia , Traumatismo por Reperfusão/sangue , Traumatismo por Reperfusão/diagnóstico , Transdução de Sinais
20.
Clin Lab ; 65(5)2019 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-31115237

RESUMO

BACKGROUND: Hepatocellular carcinoma (HCC) is the most common primary liver cancer and accounts for over 90% of all primary liver cancers. Increasing evidence suggests that microRNAs (miRNAs) mediate signaling pathways by gene expression regulation. METHODS: In this study, we evaluated the role of miR-29a-3p in HCC progression. MiR-29a-3p was found significantly down-regulated in HCC tissues compared to adjacent non-tumor tissues. Meantime, PTEN expression was up-regulated in HCC tissues. Moreover, NF-κB activity was decreased following PTEN up-regulation. RESULTS: In vitro assays in the HCC cell line BEL7402 demonstrated that miR-29a-3p suppresses cell proliferation. CONCLUSIONS: miR-29a-3p participates in the HCC progression by regulation of NF-κB pathway via targeting PTEN.


Assuntos
Carcinoma Hepatocelular/genética , Regulação Neoplásica da Expressão Gênica , Neoplasias Hepáticas/genética , MicroRNAs/genética , NF-kappa B/metabolismo , Alcoolismo/complicações , Carcinoma Hepatocelular/complicações , Carcinoma Hepatocelular/metabolismo , Linhagem Celular Tumoral , Progressão da Doença , Humanos , Neoplasias Hepáticas/complicações , Neoplasias Hepáticas/metabolismo , PTEN Fosfo-Hidrolase/genética , PTEN Fosfo-Hidrolase/metabolismo , Transdução de Sinais
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