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1.
Sci Adv ; 10(7): eadk1721, 2024 Feb 16.
Artigo em Inglês | MEDLINE | ID: mdl-38363834

RESUMO

Characterizing the tumor microenvironment at the molecular level is essential for understanding the mechanisms of tumorigenesis and evolution. However, the specificity of the blood proteome in localized region of the tumor and its linkages with other systems is difficult to investigate. Here, we propose a spatially multidimensional comparative proteomics strategy using glioma as an example. The blood proteome signature of tumor microenvironment was specifically identified by in situ collection of arterial and venous blood from the glioma region of the brain for comparison with peripheral blood. Also, by integrating with different dimensions of tissue and peripheral blood proteomics, the information on the genesis, migration, and exchange of glioma-associated proteins was revealed, which provided a powerful method for tumor mechanism research and biomarker discovery. The study recruited multidimensional clinical cohorts, allowing the proteomic results to corroborate each other, reliably revealing biological processes specific to gliomas, and identifying highly accurate biomarkers.


Assuntos
Neoplasias Encefálicas , Glioma , Humanos , Proteômica/métodos , Neoplasias Encefálicas/patologia , Proteoma/metabolismo , Glioma/patologia , Biomarcadores , Microambiente Tumoral
2.
Neuroepidemiology ; 2024 Jan 30.
Artigo em Inglês | MEDLINE | ID: mdl-38290491

RESUMO

OBJECTIVE: Parkinson's Disease (PD) is a profoundly incapacitating neurodegenerative disorder, which presents a substantial challenge to the economic sustainability of the global healthcare system. The present study seeks to clarify the factors that contribute to the costs associated with PD hospitalization and analyze the economic burden it imposes. METHODS: We examined data of 19,719 patients with a primary diagnosis of PD who were admitted to hospitals in Hubei Province, China, during the study period. Healthcare data were obtained from the database of electronic medical records. The study presents a comprehensive analysis of the demographic characteristics and investigates the factors that affect their healthcare expenditure. RESULTS: The cohort consisted of 10,442 (53.0%) males and 9,277 (47.0%) females. The age group of 66-70 years experienced the highest incidence of hospitalization among PD patients, with a mortality rate of 0.76‰. The average length of stay for patients was 9.9 ± 8.6 days and the average cost per patient was $1759.9 ± 4787.7. Surgical interventions were conducted on a mere 2.0% of the total inpatient population. The primary cost component for these interventions was material expenses, accounting for 70.1% of the total. Non-surgical patients primarily incurred expenses related to diagnosis and medication. Notably, surgical patients faced a substantial out-of-pocket rate, reaching up to 90.6%. Surgery was identified as the most influential factor that negatively affected both length of stay and hospitalization costs. Inpatients exhibited significant associations with prolonged length of stay and increased medical expenditure as age increased. Male patients had significantly longer hospital stays and higher medical costs than did females. Additionally, patient's occupation and type of medical insurance exerted significant effects on both length of stay and medical expense. CONCLUSION: Age significantly affects PD hospitalization costs. Given the prevailing demographic shift towards an aging population, the government's medical insurance burden related to PD will continue to escalate. Meanwhile, high treatment expenses and out-of-pocket rates impose substantial financial burdens on patients, limiting surgical intervention access to a small fraction of patients. Addressing these issues is of utmost importance in order to ensure comprehensive disease management for the majority of individuals affected by PD.

3.
Small ; 19(43): e2302768, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37381638

RESUMO

The Li-CO2 battery has great potential for both CO2 utilization and energy storage, but its practical application is limited by low energy efficiency and short cycle life. Efficient cathode catalysts are needed to address this issue. Herein, this work reports on molecularly dispersed electrocatalysts (MDEs) of nickel phthalocyanine (NiPc) anchored on carbon nanotubes (CNTs) as the cathode catalyst for Li-CO2 batteries. The dispersed NiPc molecules efficiently catalyze CO2 reduction, while the conductive and porous CNTs networks facilitate CO2 evolution reaction, leading to enhanced discharging and charging performance compared to the NiPc and CNTs mixture. Octa-cyano substitution on NiPc (NiPc-CN) further enhances the interaction between the molecule and CNTs, resulting in better cycling stability. The Li-CO2 battery with the NiPc-CN MDE cathode shows a high discharge voltage of 2.72 V and a small discharging-charging potential gap of 1.4 V, and can work stably for over 120 cycles. The reversibility of the cathode is confirmed by experimental characterizations. This work lays a foundation for the development of molecular catalysts for Li-CO2 battery cathodes.

4.
Front Oncol ; 13: 1161496, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37035181

RESUMO

Background: Reoperation may be beneficial for patients with recurrent gliomas. Minimizing the residual tumor volume (RTV) while ensuring the functionality of relevant structures is the goal of the reoperation of recurrent gliomas. Intraoperative ultrasound (IoUS) may be helpful for intraoperative tumor localization, intraoperative real-time imaging to guide surgical resection, and postoperative evaluation of the RTV in the reoperation for recurrent gliomas. Objective: To assess the effect of real-time ioUS on minimizing RTV in recurrent glioma surgery compared to Non-ioUS. Methods: We retrospectively analyzed the data from 92 patients who had recurrent glioma surgical resection: 45 were resected with ioUS guidance and 47 were resected without ioUS guidance. RTV, Karnofsky Performance Status (KPS) at 6 months after the operation, the number of recurrent patients, and the time to recurrence were evaluated. Results: The average RTV in the ioUS group was significantly less than the Non-ioUS group (0.27 cm3 vs. 1.33 cm3, p = 0.0004). Patients in the ioUS group tended to have higher KPS scores at 6 months of follow-up after the operation than those in the Non-ioUS group (70.00 vs. 60.00, p = 0.0185). More patients in the Non-ioUS group experienced a recurrence than in the ioUS group (43 (91.49%) vs. 32 (71.11%), p = 0.0118). The ioUS group had a longer mean time to recurrence than the Non-ioUS group (7.9 vs. 6.3 months, p = 0.0013). Conclusion: The use of ioUS-based real-time for resection of recurrent gliomas has been beneficial in terms of both RTV and postoperative outcomes, compared to the Non-ioUS group.

5.
Front Neurol ; 14: 1344672, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38375353

RESUMO

Objective: To evaluate the effectiveness of combined resection and radiotherapy (CRAR) for the treatment of primary pineal malignant melanoma (PPMM). Methods: Relevant studies were identified through a literature search in PubMed, Embase, and Web of Science from 1899 to September 1, 2023. Then we further screened the literature according to the updated PRISMA 2020 guidelines. The article information, patient information, treatment, and survival rate were analyzed. The primary outcome measures the survival rate of CRAR compared with the overall patients and the patients without treatment. Secondary outcome measures operation methods, radiotherapy methods, and dose. Results: In total, 28 published articles were recorded. Among them, 35.71% (10/28) articles were on CRAR. The median overall survival, CRAR, and no treatment survival were 65, 88, and 12 weeks, respectively. The median overall survival of CRAR was demonstrably better than that of no treatment (p < 0.0001) and overall survival, even with p = 0.1177. Most of the operations adopted a supracerebellar infratentorial approach, and stereotactic radiation to tumor bed usually ranged between 50 and 60 Gy. Small dose and multiple fractions was the most popular radiotherapy method. Conclusion: Currently, CRAR, compared with other treatments, is more beneficial to prolonging the survival of PPMM patients. However, many more clinical cases are needed to verify it as the best treatment approach.

6.
Front Neurol ; 13: 979494, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36204001

RESUMO

Background: An essential surgical tool in neurosurgery is the suction tube. The skillful and accurate use of a suction tube facilitates the neurosurgical operation. Objective: This study is to verify the practicality of an adjustable pressure suction tube (APS tube) and to explore the ideal APS tube diameter and tip negative pressure for different intracranial structures. Methods: APS tubes were used to aspirate brain tissues and carotid arteries of rats. Laser speckle contrast imaging (LSCI) was used to record the blood flow velocity (BFV). We measured APS tube diameter, air inlet size, tip negative pressure and central negative pressure and calculated the correlation between them. In our department, intraoperative real-time parameters including APS tube diameter, length, air inlet size, and central negative pressure were recorded, and the tube tip negative pressure suitable for different intracranial structures and parts was calculated. Results: All experiments were carried out using APS tubes. Experiments on rats objectively reflected a severe structural damage to the brain and blood vessels by the suction tube, which might even result in an irreversible reduction in blood flow., Rat carotid arteries and brain tissue suffered severe damage when the tip negative pressure exceeded 33.4 ± 1.8 and 29.2 ± 2.0 kPa, respectively. BFV failed to return to the preoperative level 3 min after the operation (p < 0.05), and this decrease was more pronounced when the suction tube diameter was large (p < 0.05). The tip negative pressure was positively and negatively correlated with central negative pressure and the air inlet size, and was independent of APS tube diameter. A total of 50 operations including 39 tumor resection operations and 11 moyamoya disease bypass operations were recorded. Large-diameter APS tubes (3.5 mm) with an closed air inlet were frequently used to maintain a greater tip negative pressure before the incision of dura mater. When important structures such as motor cortex and brainstem were involved, 1.5- or 2.0-mm-diameter APS tubes were mostly used, and an air inlet was opened up to 0.7-2.1 mm to maintain a safe tip negative pressure (7.4-27.9 kPa). Conclusion: APS tubes with a mechanical knob provide stable and precise adjustment of the tip negative pressure, avoiding excessive negative pressure that causes serious damage to the intracranial structure. And, this allows the surgeon to hold the suction tube more freely and operate at any angle with an appropriate fulcrum near the incision to achieve efficient atraumatic suction and enhance surgical safety.

7.
J Cancer Res Ther ; 16(5): 1069-1076, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33004749

RESUMO

BACKGROUND: Previous studies have shown that vinorelbine/capecitabine (NX) and docetaxel/capecitabine (TX) chemotherapy has a certain effect in advanced breast cancer. However, there are few clinical studies directly comparing TX and NX regimen chemotherapy, especially in patients with advanced breast cancer previously treated with anthracycline and taxane. The purpose of this Phase II study was to compare survival and side effects between patients with anthracycline- and taxane-resistant advanced breast cancer treated with NX and those treated with TX chemotherapy. PATIENTS AND METHODS: From February 2012 to March 2014, a total number of 97 patients were randomly assigned to NX (n = 55) or TX (n = 42). Baseline characteristics were relatively well-balanced in the two treatment arms. The clinical trial registration number (clincaltrials.gov) is NCT01635465. RESULTS: After a median follow-up of 46.0 months, there was no significant difference between the NX and TX arms in objective response rate (17.9% vs. 21.1%; P = 0.686) and progression-free survival (6 months vs. 7 months; P = 0.560). The overall survival period of the TX arm was longer than that of the NX arm (32 months vs. 27 months) but without statistical significance. Both regimens were well-tolerated. The main toxicities were neutropenia, leukopenia, and anemia. In the TX arm, hand-foot syndrome occurred more frequently than in the NX arm (P < 0.01), but frequencies of other minor adverse effects were similar between the two arms. CONCLUSION: NX and TX regimens are both alternative treatments for patients with anthracycline- and taxane-resistant advanced breast cancer, but the safety profile was more favorable and manageable with the NX regimen. TRIAL REGISTRATIONS: ClinicalTrials.gov NCT01635465. Registered 09 July 2012.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias da Mama/tratamento farmacológico , Resistencia a Medicamentos Antineoplásicos/efeitos dos fármacos , Antraciclinas/administração & dosagem , Neoplasias da Mama/patologia , Capecitabina/administração & dosagem , Docetaxel/administração & dosagem , Feminino , Humanos , Pessoa de Meia-Idade , Metástase Neoplásica , Taxa de Sobrevida , Resultado do Tratamento , Vinorelbina/administração & dosagem
8.
J Cancer Res Clin Oncol ; 146(10): 2589-2594, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32700108

RESUMO

BACKGROUND: Primary pineal malignant melanoma (PPMM) is a rare entity of primary central nervous system melanomas, with only 26 cases reported in the literature to date. CASE PRESENTATION: We report the case of a 65-year-old male with a PPMM who has prolonged survival of more than 104 weeks after combined microsurgical and endoscopic total resection. This is the first report: combined microscope and endoscopy total resection; PPMM in China; PPMM with total resection alone. CONCLUSION: Combined microscope and endoscopy total resection is beneficial to prolong the survival of patients. But the best approach to treatment needs verification from more clinical cases in future.


Assuntos
Neoplasias Encefálicas/patologia , Neoplasias Encefálicas/cirurgia , Melanoma/patologia , Melanoma/cirurgia , Glândula Pineal/patologia , Glândula Pineal/cirurgia , Idoso , Neoplasias Encefálicas/diagnóstico por imagem , Endoscopia/métodos , Humanos , Imageamento por Ressonância Magnética , Masculino , Melanoma/diagnóstico por imagem , Glândula Pineal/diagnóstico por imagem
10.
Int J Lab Hematol ; 42(5): 526-532, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32564505

RESUMO

INTRODUCTION: Thalassemia traits and iron deficiency anemia are the most common types of hypochromic microcytic anemia with similar clinical and laboratory features. It is vital to establish a new screening model based on HbA2 levels and red cell indices for the differentiation of TT from IDA in hypochromic microcytic anemia cases. METHOD: The data comprised of the red blood cell indices and HbA2 prenatal diagnostic test results of 810 individuals who were identified to conform to the following criteria: MCV < 80 fl or MCH < 26 pg. We launched a new model consisting mainly of significative red cell indices and HbA2 levels, as well as proposing cutoff values by using decision trees and logistic regression analyses. Next, we evaluated our new method by comparing the sensitivity, specificity, positive, and negative predictive values with those of the previous formulas. RESULTS: We put forward a new model and compared it with 5 efficient formulas. The new model exhibited the highest accuracy (0.918), with its sensitivity and specificity calculated as 0.917 and 0.921, respectively. Our new model's Youden index was 0.838, which is higher than the other formulas' Youden indices. CONCLUSIONS: The new screening model, based on HbA2 levels and red cell indices, is suitable for the screening of thalassemia patients in the hypochromic microcytic anemia group and has the best efficiency in distinguishing TT and IDA.


Assuntos
Anemia Hipocrômica/sangue , Anemia Hipocrômica/diagnóstico , Anemia Ferropriva/sangue , Anemia Ferropriva/diagnóstico , Hemoglobina A2 , Talassemia/sangue , Talassemia/diagnóstico , Adolescente , Adulto , Alelos , Anemia Hipocrômica/etiologia , Diagnóstico Diferencial , Índices de Eritrócitos , Feminino , Frequência do Gene , Genótipo , Hemoglobina A2/genética , Humanos , Masculino , Mutação , Curva ROC , Sensibilidade e Especificidade , Adulto Jovem
12.
J Cell Biochem ; 121(4): 2909-2926, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-31692077

RESUMO

The thyroid hormone receptors (TRs) mediate thyroid hormone (T3 )-dependent gene expression. The nuclear import and export signals that direct TR shuttling are well characterized, but little is known about factors modulating nuclear retention. We used fluorescence-based nucleocytoplasmic scoring and fluorescence recovery after photobleaching in transfected cells to investigate whether Mediator subunits MED1 and MED13 play a role in nuclear retention of TR. When MED1 was overexpressed, there was a striking shift towards a greater nuclear localization of TRß1 and the oncoprotein v-ErbA, subtypes with cytosolic populations at steady-state, and TRß1 intranuclear mobility was reduced. For TRα1, there was no observable change in its predominantly nuclear distribution pattern or mobility. Consistent with a role for MED1 in nuclear retention, the cytosolic TRα1 and TRß1 population were significantly greater in MED1-/- cells, compared with MED1+/+ cells. Exposure to T3 and epidermal growth factor, which induces MED1 phosphorylation, also altered TR intranuclear dynamics. Overexpression of miR-208a, which downregulates MED13, led to a more cytosolic distribution of nuclear-localized TRα1; however, overexpression of MED13 had no effect on TRß1 localization. The known binding site of MED1 overlaps with a transactivation domain and nuclear export signal in helix 12 of TR's ligand-binding domain (LBD). Coimmunoprecipitation assays demonstrated that TR's LBD interacts directly with exportins 5 and 7, suggesting that binding of exportins and MED1 to TR may be mutually exclusive. Collectively, our data provide evidence that MED1 promotes nuclear retention of TR, and highlight the dual functionality of helix 12 in TR transactivation and nuclear export.


Assuntos
Subunidade 1 do Complexo Mediador/metabolismo , Proteínas Oncogênicas v-erbA/metabolismo , Receptores dos Hormônios Tireóideos/metabolismo , Transporte Ativo do Núcleo Celular , Animais , Sítios de Ligação , Núcleo Celular/metabolismo , Citoplasma/metabolismo , Citosol/metabolismo , Fibroblastos/metabolismo , Expressão Gênica , Genes erbA , Células HeLa , Humanos , Carioferinas/metabolismo , Complexo Mediador/metabolismo , Camundongos , Fosforilação , Transporte Proteico , Receptores beta dos Hormônios Tireóideos/metabolismo , Hormônios Tireóideos/metabolismo , Transfecção
13.
World Neurosurg ; 135: 357-366.e4, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31759149

RESUMO

BACKGROUND: Cerebral hyperperfusion syndrome (CHS) after bypass surgery is known as a complication of moyamoya disease (MMD). However, the incidence of CHS has not been accurately reported, and there is no consensus on related risk factors. OBJECTIVE: To evaluate the incidence and characteristics of CHS in patients with MMD after revascularization surgery via meta-analysis. METHODS: Relevant cohort studies were retrieved through a literature search of PubMed, Embase, and Ovid until December 1, 2018. Eligible studies were identified per search criteria. A systematic review and meta-analysis were used to assess the CHS total incidence, incidence in pediatric patients with MMD and adult patients with MMD, incidence for direct and combined bypass surgery, progress rate, and proportion of each symptom (including transient neurologic deficits [TNDs], hemorrhage, and seizure). RESULTS: A total of 27 cohort studies with 2225 patients were included in this meta-analysis. The weighted proportions per random-effects model were 16.5% (range, 11.3%-22.3%) for CHS total incidence, 3.8% (range, 0.3%-9.6%) for pediatric patients with MMD, 19.9% (range, 11.7%-29.4%) for adult patients with MMD, 15.4% (range, 5.4%-28.8%) for direct bypass surgery, and 15.2% (range, 8.4%-23.2%) for combined bypass surgery. Progress rate was 39.5% (range, 28.7%-50.8%). The most common CHS-related symptom was TNDs (70.2%; range, 56.3%-82.7%), followed by hemorrhage (15.0%; range, 5.5%-26.9%) and seizure (5.3%; range, 0.6%-12.9%). CONCLUSIONS: CHS is a common complication after revascularization surgery in MMD. It is more frequently seen in adult patients. The most common CHS-related symptom was TNDs, followed by hemorrhage and seizure.


Assuntos
Revascularização Cerebral , Circulação Cerebrovascular , Doença de Moyamoya/cirurgia , Complicações Pós-Operatórias/epidemiologia , Distribuição por Idade , Transtornos Cerebrovasculares/diagnóstico por imagem , Transtornos Cerebrovasculares/epidemiologia , Transtornos Cerebrovasculares/fisiopatologia , Humanos , Hemorragias Intracranianas/epidemiologia , Angiografia por Ressonância Magnética , Imageamento por Ressonância Magnética , Imagem de Perfusão , Complicações Pós-Operatórias/diagnóstico por imagem , Complicações Pós-Operatórias/fisiopatologia , Hemorragia Pós-Operatória/epidemiologia , Convulsões/epidemiologia , Síndrome , Tomografia Computadorizada de Emissão de Fóton Único
14.
Brain Res Bull ; 153: 143-149, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31425730

RESUMO

Cranioplasty is a challenge to neurosurgeons, especially considering protection of intracranial contents. In recent years, material choice for cranioplasty is still controversial, which brings complexity to this seemingly straightforward procedure. PEEK, a tough, rigid, biocompatible material, has been used more recently in cranioplasty to provide better protection. The aim of this review is to summarize the outcome of research conducted on the material for cranioplasty applications. We also reviewed the comparison of PEEK with several common materials in previous articles. This is also the most complete data review article at present. In addition, the combination of nano-materials and PEEK is also a hotspot of research, so we have made a careful review of this aspect. We also summarized our own experience, telling about the future prospects of PEEK in the field of clinical cranioplasty should be highlighted. Improving the bioactivity, porosity, thinning, biocompatibility, antibacterial ability, integration and cost reduction of PEEK implants without affecting their mechanical properties is a major challenge.


Assuntos
Cetonas/uso terapêutico , Procedimentos de Cirurgia Plástica/métodos , Polietilenoglicóis/uso terapêutico , Crânio/cirurgia , Animais , Benzofenonas , Materiais Biocompatíveis/uso terapêutico , Cimentos Ósseos , Osso e Ossos/cirurgia , Humanos , Polímeros , Próteses e Implantes/tendências
15.
Nat Commun ; 9(1): 4574, 2018 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-30385749

RESUMO

The YEATS domain has been identified as a reader of histone acylation and more recently emerged as a promising anti-cancer therapeutic target. Here, we detail the structural mechanisms for π-π-π stacking involving the YEATS domains of yeast Taf14 and human AF9 and acylated histone H3 peptides and explore DNA-binding activities of these domains. Taf14-YEATS selects for crotonyllysine, forming π stacking with both the crotonyl amide and the alkene moiety, whereas AF9-YEATS exhibits comparable affinities to saturated and unsaturated acyllysines, engaging them through π stacking with the acyl amide. Importantly, AF9-YEATS is capable of binding to DNA, whereas Taf14-YEATS is not. Using a structure-guided approach, we engineered a mutant of Taf14-YEATS that engages crotonyllysine through the aromatic-aliphatic-aromatic π stacking and shows high selectivity for the crotonyl H3K9 modification. Our findings shed light on the molecular principles underlying recognition of acyllysine marks and reveal a previously unidentified DNA-binding activity of AF9-YEATS.


Assuntos
DNA/metabolismo , Código das Histonas , Proteínas Nucleares/metabolismo , Domínios Proteicos , Proteínas de Saccharomyces cerevisiae/metabolismo , Fator de Transcrição TFIID/metabolismo , Acetilação , Acilação , Cristalografia por Raios X , DNA/ultraestrutura , Humanos , Lisina/metabolismo , Mutação , Proteínas Nucleares/química , Proteínas Nucleares/ultraestrutura , Ligação Proteica , Proteínas de Saccharomyces cerevisiae/química , Proteínas de Saccharomyces cerevisiae/genética , Proteínas de Saccharomyces cerevisiae/ultraestrutura , Fator de Transcrição TFIID/química , Fator de Transcrição TFIID/genética , Fator de Transcrição TFIID/ultraestrutura
16.
World Neurosurg ; 120: e1024-e1030, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30201582

RESUMO

OBJECTIVE: To investigate the clinical benefits of emergent single burr hole evacuation technology in traumatic acute subdural hematoma (ASDH) with cerebral herniation cases. METHODS: We conducted a review comparing patients with ASDH with cerebral herniation who underwent single burr hole evacuation followed by decompressive craniectomy and intracranial hematoma removal surgery (n = 45, group A) and those who underwent decompressive craniectomy and intracranial hematoma removal surgery after rapid infusion of mannitol 250 mL (n = 53, group B) in our institution. Pre- and postoperative assessments included Glasgow Coma Scale (GCS), Glasgow Outcome Scale (GOS), activities of daily living (ADLs), and common complication incidences. RESULTS: At 1 and 6 months after operation, the median GCS score of group A was significantly higher than group B (P = 0.04 and P = 0.03, respectively). After 6 months, the GOS score and ADLs between the 2 groups had significant differences (P < 0.05). There were no differences between the 2 groups in the common complication incidences. CONCLUSIONS: Emergent single burr hole evacuation in combination with decompressive craniectomy surgery is a useful treatment for ASDH with cerebral herniation, which can achieve reduction of intracranial pressure as soon as possible and improve the prognosis.


Assuntos
Lesões Encefálicas Traumáticas/cirurgia , Craniectomia Descompressiva , Drenagem , Encefalocele/cirurgia , Hematoma Subdural Agudo/cirurgia , Adulto , Idoso , Lesões Encefálicas Traumáticas/complicações , Craniectomia Descompressiva/instrumentação , Diuréticos Osmóticos/uso terapêutico , Encefalocele/complicações , Feminino , Seguimentos , Hematoma Subdural Agudo/complicações , Humanos , Masculino , Manitol/uso terapêutico , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Estudos Retrospectivos , Resultado do Tratamento , Adulto Jovem
17.
Vitam Horm ; 106: 45-66, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29407444

RESUMO

The thyroid hormone receptors, TRα1 and TRß1, are members of the nuclear receptor superfamily that forms one of the most abundant classes of transcription factors in multicellular organisms. Although primarily localized to the nucleus, TRα1 and TRß1 shuttle rapidly between the nucleus and cytoplasm. The fine balance between nuclear import and export of TRs has emerged as a critical control point for modulating thyroid hormone-responsive gene expression. Mutagenesis studies have defined two nuclear localization signal (NLS) motifs that direct nuclear import of TRα1: NLS-1 in the hinge domain and NLS-2 in the N-terminal A/B domain. Three nuclear export signal (NES) motifs reside in the ligand-binding domain. A combined approach of shRNA-mediated knockdown and coimmunoprecipitation assays revealed that nuclear entry of TRα1 is facilitated by importin 7, likely through interactions with NLS-2, and importin ß1 and the adapter importin α1 interacting with both NLS-1 and NLS-2. Interestingly, TRß1 lacks NLS-2 and nuclear import depends solely on the importin α1/ß1 heterodimer. Heterokaryon and fluorescence recovery after photobleaching shuttling assays identified multiple exportins that play a role in nuclear export of TRα1, including CRM1 (exportin 1), and exportins 4, 5, and 7. Even single amino acid changes in TRs dramatically alter their intracellular distribution patterns. We conclude that mutations within NLS and NES motifs affect nuclear shuttling activity, and propose that TR mislocalization contributes to the development of some types of cancer and Resistance to Thyroid Hormone syndrome.


Assuntos
Transporte Proteico/fisiologia , Receptores alfa dos Hormônios Tireóideos/metabolismo , Receptores beta dos Hormônios Tireóideos/metabolismo , Animais , Regulação da Expressão Gênica , Humanos , Receptores alfa dos Hormônios Tireóideos/genética , Receptores beta dos Hormônios Tireóideos/genética
18.
Brain Res ; 1678: 245-253, 2018 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-29074342

RESUMO

OBJECTIVE: To complete a retrospective comparison of endoscope-assisted burr-hole craniostomy (EBHC) and ordinary burr-hole craniostomy (OBHC) in the treatment of septated chronic subdural hematoma (SCSH). METHODS: A retrospective case note review comparing EBHC and OBHC of SCSH was therefore performed. Data of patients with a SCSH for EBHC or OBHC during the period from January 2011 to December 2016 were retrospectively collected and analysed. Of 73 patients, 42 underwent EBHC and 31 patients were treated by OBHC. The primary outcome measure was recurrence rate and secondary outcome measures were clinical outcome at first postoperative day, discharge and 6 months, the length of hospital stay for neurosurgery, the operative time, and the placement time of drainage tube. RESULT: The rate of recurrence was significantly lower in the EBHC (0/42 0%) than in the OBHC (8/31, 25.8%) group (p = .0030). The rate of morbidity was significantly lower in the EBHC (2/42, 4.8%) than in the OBHC (11/31, 35.5%) group (p = .0121). At 30 days, mortality did not differ between groups. Significantly more patients treated with EBHC were alive at 6 months than were those with OBHC. No patient died as a consequence of the operative procedure in the both groups. A discharge GCS of 15 was recorded in more participants with EBHC than in those with OBHC. Gross neurological deficit was significantly less frequent in those with EBHC than in those with OBHC at first postoperative day and discharge, but did not differ at 6 month follow-up. The mean placement time of drainage tube was significantly less in those with EBHC (27.2 h) than in those with OBHC (52.0 h, p = .0055). The mean length of hospital stay for neurosurgery was 4 days in the EBHC group, while it was 5 days in the OBHC group (p = .0015). The mean hematoma reduction rate was significantly higher in those with EBHC than in those with OBHC at first postoperative day (85.3% vs 72.5%, p = .0037) and discharge (90.3% vs 85.1%, p = .0127). CONCLUSION: Comparing two minimally invasive procedure protocols for treatment of SCSH, EBHC is a safe and effective surgical technique. It significantly surpasses the results obtained in OBHC in lowering recurrence rate, morbidity rate, placement time of drainage tube, and length of hospital stay for neurosurgery. We recommend EBHC technique to be widely used in the treatment of SCSH, even common chronic subdural hematoma (CSH), subacute and acute subdural hematomas, acute epidural hematomas and empyemas to avoid large craniotomies, particularly in elderly patients, so that patients can receive the best treatment on the basis of minimal trauma.


Assuntos
Craniotomia/métodos , Endoscopia/métodos , Hematoma Subdural Crônico/cirurgia , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Drenagem , Feminino , Transtornos Neurológicos da Marcha/etiologia , Transtornos Neurológicos da Marcha/cirurgia , Escala de Coma de Glasgow , Hematoma Subdural Crônico/complicações , Hematoma Subdural Crônico/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Tomógrafos Computadorizados , Resultado do Tratamento
19.
ACS Nano ; 12(1): 289-297, 2018 01 23.
Artigo em Inglês | MEDLINE | ID: mdl-29241007

RESUMO

Graphene based materials have profoundly impacted research in nanotechnology, and this has significantly advanced biomedical, electronics, energy, and environmental applications. Laser-induced graphene (LIG) is made photothermally and has enabled a rapid route for graphene layers on polyimide surfaces. However, polysulfone (PSU), poly(ether sulfone) (PES), and polyphenylsulfone (PPSU) are highly used in numerous applications including medical, energy, and water treatment and they are critical components of polymer membranes. Here we show LIG fabrication on PSU, PES, and PPSU resulting in conformal sulfur-doped porous graphene embedded in polymer dense films or porous substrates using reagent- and solvent-free methods in a single step. We demonstrate the applicability as flexible electrodes with enhanced electrocatalytic hydrogen peroxide generation, as antifouling surfaces and as antimicrobial hybrid membrane-LIG porous filters. The properties and surface morphology of the conductive PSU-, PES-, and PPSU-LIG could be modulated using variable laser duty cycles. The LIG electrodes showed enhanced hydrogen peroxide generation compared to LIG made on polyimide, and showed exceptional biofilm resistance and potent antimicrobial killing effects when treated with Pseudomonas aeruginosa and mixed bacterial culture. The hybrid PES-LIG membrane-electrode ensured complete elimination of bacterial viability in the permeate (6 log reduction), in a flow-through filtration mode at a water flux of ∼500 L m-2 h-1 (2.5 V) and at ∼22 000 L m-2 h-1 (20 V). Due to the widespread use of PSU, PES, and PPSU in modern society, these functional PSU-, PES-, and PPSU-LIG surfaces have great potential to be incorporated into biomedical, electronic, energy and environmental devices and technologies.


Assuntos
Grafite/química , Membranas Artificiais , Polímeros/química , Sulfonas/química , Enxofre/química , Antibacterianos/química , Antibacterianos/farmacologia , Eletrodos , Filtração/instrumentação , Grafite/farmacologia , Peróxido de Hidrogênio/química , Lasers , Polímeros/farmacologia , Porosidade , Pseudomonas aeruginosa/efeitos dos fármacos , Sulfonas/farmacologia , Enxofre/farmacologia
20.
World Neurosurg ; 107: 900-905, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-28842228

RESUMO

BACKGROUND: Microelectrode recording (MER) and intraoperative magnetic resonance imaging (iMRI) have been used in deep brain stimulation surgery for Parkinson disease (PD), but comparative methodology is lacking. Therefore, we compared the 1-year follow-up outcomes of MER-guided and iMRI-guided subthalamic nucleus (STN) deep brain stimulation (DBS) surgery in PD patients. METHODS: We conducted a review comparing PD patients who underwent MER-guided (n = 76, group A) and iMRI-guided STN DBS surgery (n = 61, group B) in our institution. Pre- and postoperative assessments included Unified Parkinson's Disease Rating Scale-III (UPDRS-III) score, Parkinson's Disease Questionnaire (PDQ-39), Mini-Mental State Examination (MMSE), levodopa equivalent daily doses (LEDDs), and magnetic resonance images. RESULTS: The mean magnitudes of electrode discrepancy were x = 1.1 ± 0.2 mm, y = 1.3 ± 0.3 mm, and z = 2.1 ± 0.5 mm in group A and x = 1.3 ± 0.4 mm, y = 1.2 ± 0.2 mm, and z = 2.5 ± 0.7 mm in group B. Significant differences were not found between 2 groups for x, y, or z (P = 0.34, P = 0.26, and P = 0.41, respectively). At 1 year, when levodopa was withdrawn for 12 hours, the UPDRS-III score improved by 66.3% ± 13.5% in group A and 64.8% ± 12.7% in group B (P = 0.24); the PDQ-39 summary index score improved by 49.7% ± 14.3% in group A and 44.1% ± 12.7% in group B (P = 0.16); the MMSE score improved by 4.2% ± 2.1% in group A and 11.1% ± 3.2% in group B (P = 0.43); and LEDDs decreased by 48.7% ± 10.1% in group A and 56.9% ± 12.0% in group B (P = 0.32). CONCLUSIONS: MER and iMRI both are effective ways to ensure adequate electrode placement in DBS surgery, but there is no superiority between both techniques, at least in terms of 1-year follow-up outcomes.


Assuntos
Estimulação Encefálica Profunda/métodos , Imageamento por Ressonância Magnética/métodos , Doença de Parkinson/cirurgia , Núcleo Subtalâmico/cirurgia , Cirurgia Assistida por Computador/métodos , Adulto , Idoso , Estudos de Coortes , Feminino , Seguimentos , Humanos , Masculino , Microeletrodos , Pessoa de Meia-Idade , Doença de Parkinson/diagnóstico por imagem , Estudos Retrospectivos , Núcleo Subtalâmico/diagnóstico por imagem , Fatores de Tempo , Resultado do Tratamento
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