RESUMO
BACKGROUND: This prospective cohort study, conducted at a high-volume esophageal cancer center from July 2019 to July 2022, aimed to investigate the link between the right gastroepiploic artery (RGEA) length and anastomotic leakage (AL) rates following minimally invasive esophagectomy (MIE). Real-world data on stomach blood supply in the Chinese population were examined. MATERIALS AND METHODS: A total of 516 cases were enrolled, categorized into two groups based on the Youden index-determined optimal cut-off value for the relative length of RGEA (length of RGEA/length of gastric conduit, 64.69%) through ROC analysis: Group SR (short RGEA) and Group LR (long RGEA). The primary observation parameter was the relationship between AL incidence and the ratio of direct blood supply from RGEA. Secondary parameters included the mean length of the right gastroepiploic artery, greater curvature, and the connection type between right and left gastroepiploic vessels. Patient data were prospectively recorded in electronic case report forms. RESULTS: The study revealed median lengths of 43.60 cm for greater curvature, 43.16 cm for the gastric conduit, and 26.75 cm for RGEA. AL, the most common postoperative complication, showed a significant difference between groups (16.88 vs. 8.84%, P =0.01). Multivariable binary logistic regression identified Group SR and LR (odds ratio: 2.651, 95% CI: 1.124-6.250, P =0.03) and Neoadjuvant therapy (odds ratio: 2.479, 95% CI: 1.374-4.473, P =0.00) as independent predictors of AL. CONCLUSIONS: The study emphasizes the crucial role of RGEA length in determining AL incidence in MIE for esophageal cancer. Preserving RGEA and fostering capillary arches between RGEA and LGEA are recommended strategies to mitigate AL risk.
Assuntos
Fístula Anastomótica , Neoplasias Esofágicas , Esofagectomia , Artéria Gastroepiploica , Humanos , Esofagectomia/efeitos adversos , Neoplasias Esofágicas/cirurgia , Fístula Anastomótica/etiologia , Fístula Anastomótica/epidemiologia , Masculino , Estudos Prospectivos , Feminino , Pessoa de Meia-Idade , Idoso , Procedimentos Cirúrgicos Minimamente Invasivos/efeitos adversos , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , China/epidemiologiaRESUMO
A triphenylphosphine-modified tetra-nuclear Cu(I) coordinated cluster was constructed for enhanced chemodynamic therapy (CDT) by increasing the number of metal centers. Once inside human bladder cancer (T24) cells, a larger amount of copper accumulated compared with the mono-nuclear Cu(I) complex; the additional copper could generate more â¢OH and then induce more obvious apoptosis via a Fenton-like reaction, thus further increasing the tumor inhibition effect and ultimately improving the CDT efficiency.
Assuntos
Cobre , Neoplasias , Linhagem Celular Tumoral , Humanos , Peróxido de Hidrogênio , Compostos OrganofosforadosRESUMO
Monoamine oxidase A (MAO-A) is a promising diagnostic marker for cancer, depression, Parkinson's disease, and liver disease. The fluorescence detection of MAO-A in living animals is of extreme importance for the early diagnosis of related diseases. However, the development of specific and mitochondrial-targeted and near-infrared (NIR) fluorescence MAO-A probes is still inadequate. Here, we designed and synthesized four NIR fluorescence probes containing a dihydroxanthene (DH) skeleton to detect MAO-A in complex biological systems. The specificity of our representative probe DHMP2 displays a 31-fold fluorescence turn-on in vitro, and it can effectively accumulate in the mitochondria and specifically detect the endogenous MAO-A concentrations in PC-3 and SH-SY5Y cell lines. Furthermore, the probe DHMP2 can be used to visualize the endogenous MAO-A activity in zebrafish and tumor-bearing mice. More importantly, it is the first time that the MAO-A activity of hepatic fibrosis tissues is detected through the probe DHMP2. The present study shows that the synthesized DHMP2 might serve as a potential tool for monitoring MAO-A activity in vivo and diagnosing related diseases.
Assuntos
Fibrose/diagnóstico por imagem , Corantes Fluorescentes/uso terapêutico , Cirrose Hepática/diagnóstico por imagem , Monoaminoxidase/metabolismo , Animais , Humanos , Peixe-ZebraRESUMO
BACKGROUND: International normalized ratio (INR) self-testing can improve the management of anticoagulation therapy with warfarin for the patients following mechanical heart valve replacement. Several reviews and studies have demonstrated self-management as an option to improve patient's outcome considerably after mechanical heart valve replacement. We sought to analyze the security, economy and discuss the prospect of self-testing of anticoagulation therapy in patients following mechanical heart valve replacement in China, and evaluate the accuracy and stability of CoaguChek XS portable INR-testing device. METHODS: This was a prospective self-controlled clinical study conducted with 526 patients receiving oral warfarin anticoagulation therapy after mechanical heart valve replacement in the period of Mar.1, 2012 - Nov.1, 2012 in Cardiovascular Surgery Department of West China Hospital of Sichuan University. The same patient performed INR testing with CoaguChek XS portable coagulometer (group1) and central lab (group 2) in parallel. The follow-up time was 6 months. Meanwhile, a questionnaire was handed out to survey the expenses required for the re-examination visits to the hospital, time, and anticoagulation complications. RESULTS: No severe anticoagulation complications occurred in all the patients. No significant difference of the INR results were observed between group 1 and group 2, they showed significant relevance, r = 0.953(p < 0.05). Compared with the conventional method of INR testing in hospital, the portable coagulometer is convenient, quick and less traumatic. Self-testing of anticoagulation therapy reduced the cost and the time required for re-examination. CONCLUSIONS: Results of CoaguChek XS monitor are precise and have a good consistency and stability as compared with traditional laboratory testing. For the patients receiving anticoagulation therapy after mechanical heart valve replacement, the self-testing of anticoagulation therapy with portable coagulometer is a safe choice, and it has a promising future application in China.
Assuntos
Anticoagulantes/efeitos adversos , Implante de Prótese de Valva Cardíaca , Coeficiente Internacional Normatizado/instrumentação , Sistemas Automatizados de Assistência Junto ao Leito , Autocuidado , Varfarina/administração & dosagem , Adulto , Idoso , China , Custos e Análise de Custo , Feminino , Humanos , Coeficiente Internacional Normatizado/economia , Masculino , Pessoa de Meia-Idade , Avaliação de Programas e Projetos de Saúde , Estudos Prospectivos , Varfarina/efeitos adversos , Adulto JovemRESUMO
OBJECTIVE: The study objective was to evaluate the safety and efficacy of concomitant bipolar radiofrequency ablation and heart valve replacement in patients with rheumatic heart disease and atrial fibrillation. METHODS: A total of 191 patients with rheumatic heart disease and chronic atrial fibrillation underwent valve replacement with concomitant bipolar radiofrequency ablation. There were 78 male and 113 female patients with a mean age of 46.0 ± 9.1 years and an atrial fibrillation duration of 43.7 ± 15.4 months. Valve replacement surgery included mitral valve replacement in 121 patients, mitral and aortic valve replacement in 59 patients, mitral and tricuspid valve replacement in 8 patients, and triple valve replacement in 3 patients. All patients received oral antiarrhythmic drugs for 3 to 6 months postoperatively. Follow-up electrocardiography and color Doppler echocardiography were performed postoperatively. RESULTS: The mean aortic crossclamping time was 84.0 ± 25.5 minutes, and cardiopulmonary bypass time was 139.4 ± 39.1 minutes. There was no abnormal bleeding due to bipolar radiofrequency ablation. Three patients (1.57%) died of low cardiac output syndrome in hospital at 2, 3, and 5 days after surgery. Major perioperative complications include reoperation for bleeding (n = 1), reoperation for wound infection (n = 1), intra-aortic balloon pump placement (n = 2), and renal failure (n = 2). All other patients were discharged without complications. The mean follow-up time was 17.4 ± 11.8 months with a follow-up rate of 95.3%. There were no cases of late death, complete atrioventricular block, or anticoagulation-induced complications. Of 158 patients who were followed up for 1 year, sinus rhythm was maintained in 125 (79.11%). CONCLUSIONS: Concomitant bipolar radiofrequency ablation is an effective and safe technique for treating atrial fibrillation in patients with rheumatic heart disease undergoing valve replacement, with promising follow-up results.