RESUMO
BACKGROUND: There is scant evidence regarding the effects of exercise type and duration on quality of life (QoL) in digestive system cancer (DSC) survivors. We aim to investigate the optimal type and duration of exercise to improve QoL for DSC survivors through a systematic review and network meta-analysis. METHODS: A systematic literature search of PubMed, Embase, and Web of Science was performed. Eligibility for study inclusion was limited to studies that were randomized controlled trials involving all kinds of exercise in adult patients with DSCs, and the comparator was in standard care or other types of exercise. The primary outcome was QoL, including general health, physical health, mental health, and role function. Secondary outcomes included cancer-related symptoms such as fatigue, insomnia, depression, anxiety, and duration of hospital stay. The network meta-analyses were performed using a random-effect model. RESULTS: The analysis included 32 eligible articles and a total of 2558 participants. Our primary outcome indicated that short-term aerobic exercise significantly enhanced general health (standardized mean difference (SMD)â¯=â¯0.66, 95% credible intervals (CrIs): 0.05 to 1.30), and also contributed to a better mental health (SMDâ¯=â¯0.38, 95%CrI: -0.05 to 0.81) and role function (SMDâ¯=â¯0.48, 95%CrI: -0.27 to 1.20). Although without significant changes, short-term resistance exercise tended to increase the physical health of patients with DSCs (SMDâ¯=â¯0.69, 95%CrI: -0.07 to 1.50) and effective in alleviating fatigue (SMDâ¯=â¯-0.77, 95%CrI: -1.50 to 0.01). Short-term aerobic exercise was related to a lower score of insomnia (SMDâ¯=â¯-1.20, 95%CrI: -2.40 to 0.06), depression (SMDâ¯=â¯-0.51, 95%CrI: -1.50 to 0.45), and anxiety (SMDâ¯=â¯-0.45, 95%CrI: -1.30 to 0.34). All types of exercise related to a trend of declined hospital stays (-0.87 to -5.00 day). Long-term resistance exercise, however, was negatively associated with general health (SMDâ¯=â¯-0.33, 95%CrI: -1.70 to 1.00), physical health (SMDâ¯=â¯-0.18, 95%CrI: -1.30 to 0.90), and role function (SMDâ¯=â¯-1.20, 95%CrI: -2.50 to 0.11). CONCLUSION: This study suggests that short-term aerobic exercise, with or without resistance exercise programs, enhances QoL (especially for general health) as well as relieves cancer-related symptoms for DSC survivors, while long-term resistance exercise may have negative effects, and thus should be adopted cautiously. These results provide important evidence for the management of DSCs.
Assuntos
Neoplasias do Sistema Digestório , Distúrbios do Início e da Manutenção do Sono , Adulto , Humanos , Qualidade de Vida , Metanálise em Rede , Exercício Físico , Fadiga , Ensaios Clínicos Controlados Aleatórios como AssuntoRESUMO
Sepsisinduced myocardial dysfunction is one of the features of multiple organ dysfunction in sepsis, which is associated with extremely high mortality and is characterized by impaired myocardial compliance. To date, there are few effective treatment options available to cure sepsis. Tannic acid (TA) is reportedly protective during sepsis; however, the underlying mechanisms by which TA protects against septic heart injury remain elusive. The present study investigated the potential effects and underlying mechanisms of TA in alleviating lipopolysaccharide (LPS)induced H9C2 cardiomyocyte cell apoptosis. H9C2 cells were treated with LPS (15 µg/ml), TA (10 µM) and TA + LPS; control cells were treated with medium only. Apoptosis was measured using flow cytometry, reverse transcriptionquantitative PCR (RTqPCR) and western blot analysis. Additionally, the levels of cellular reactive oxygen species (ROS), malondialdehyde and nicotinamide adenine dinucleotide phosphate were evaluated. Western blotting and RTqPCR were also employed to detect the expression levels of endoplasmic reticulum (ER) stressassociated functional proteins. The present findings demonstrated that TA reduced the degree of LPSinduced H9C2 cell injury, including inhibition of ROS production and ER stress (ERS)associated apoptosis. ERSassociated functional proteins, including activating transcription factor 6, protein kinaselike ER kinase, inositolrequiring enzyme 1, spliced X boxbinding protein 1 and C/EBPhomologous protein were suppressed in response to TA treatment. Furthermore, the expression levels of ERSassociated apoptotic proteins, including cJun Nterminal kinase, Bax, cytochrome c, caspase3, caspase12 and caspase9 were reduced following treatment with TA. Additionally, the protective effects of TA on LPSinduced H9C2 cells were partially inhibited following treatment with the ROS inhibitor Nacetylcysteine, which demonstrated that ROS mediated ERSassociated apoptosis and TA was able to decrease ROSmediated ERSassociated apoptosis. Collectively, the present findings demonstrated that the protective effects of TA against LPSinduced H9C2 cell apoptosis may be associated with the amelioration of ROSmediated ERS. These findings may assist the development of potential novel therapeutic methods to inhibit the progression of myocardial cell injury.
Assuntos
Apoptose/efeitos dos fármacos , Estresse do Retículo Endoplasmático/efeitos dos fármacos , Lipopolissacarídeos/efeitos adversos , Espécies Reativas de Oxigênio/metabolismo , Taninos/farmacologia , Acetilcisteína/farmacologia , Animais , Linhagem Celular , Proteínas Quinases JNK Ativadas por Mitógeno/metabolismo , Miocárdio/metabolismo , Miócitos Cardíacos/metabolismo , RatosRESUMO
OBJECTIVE: To prospectively compare microwave (MW) ablation using a modified internal cooled-shaft antenna with radiofrequency (RF) ablation in in vivo porcine liver and in patients with small hepatocellular carcinoma (sHCC). METHODS: In an animal study, MW and RF ablations using a cooled-shaft antenna or internally cooled electrode were performed in in vivo porcine liver. Coagulation diameters of both ablations were compared. For clinical study, 42 patients with sHCC were treated with MW or RF ablation. Complete ablation (CA) and local tumour progression (LTP) were compared. RESULTS: MW ablation produced significantly larger ablation zones than RF ablation in both porcine liver and sHCC with an ablated volume of 33.3 ± 15.6 cm(3) vs. 18.9 ± 9.1 cm(3) and 109.3 ± 58.3 cm(3) vs. 48.7 ± 30.5 cm(3), respectively. The CA rate was 95.5 % (21/22) for MW ablation and 95.0 % (19/20) for RF ablation. In a 5.1-month follow-up, the LTP rate was 18.2 % (4/22) in the MW ablation group and 15.0 % (3/20) in the RF ablation group. CONCLUSION: MW ablation using a modified cooled-shaft antenna produces a larger ablation zone than RF ablation, with an efficacy similar to RF ablation in local tumour control. MW ablation is a safe and promising treatment of sHCC.