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Background: Gallbladder neuroendocrine neoplasms (GB-NENs) are a rare malignant disease, with most cases diagnosed at advanced stages, often resulting in poor prognosis. However, studies regarding the prognosis of this condition and its comparison with gallbladder adenocarcinomas (GB-ADCs) have yet to yield convincing conclusions. Methods: We extracted cases of GB-NENs and GB-ADCs from the Surveillance, Epidemiology, and End Results (SEER) database in the United States. Firstly, we corrected differences in clinical characteristics between the two groups using propensity score matching (PSM). Subsequently, we visualized and compared the survival outcomes of the two groups using the Kaplan-Meier method. Next, we employed the least absolute shrinkage and selection operator (LASSO) regression and Cox regression to identify prognostic factors for GB-NENs and constructed two nomograms for predicting prognosis. These nomograms were validated with an internal validation dataset from the SEER database and an external validation dataset from a hospital. Finally, we categorized patients into high-risk and low-risk groups based on their overall survival (OS) scores. Results: A total of 7,105 patients were enrolled in the study, comprising 287 GB-NENs patients and, 6,818 GB-ADCs patients. There were substantial differences in clinical characteristics between patients, and GB-NENs exhibited a significantly better prognosis. Even after balancing these differences using PSM, the superior prognosis of GB-NENs remained evident. Independent prognostic factors selected through LASSO and Cox regression were age, histology type, first primary malignancy, tumor size, and surgery. Two nomograms for prognosis were developed based on these factors, and their performance was verified from three perspectives: discrimination, calibration, and clinical applicability using training, internal validation, and external validation datasets, all of which exhibited excellent validation results. Using a cutoff value of 166.5 for the OS nomogram score, patient mortality risk can be identified effectively. Conclusion: Patients with GB-NENs have a better overall prognosis compared to those with GB-ADCs. Nomograms for GB-NENs prognosis have been effectively established and validated, making them a valuable tool for assessing the risk of mortality in clinical practice.
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Adenocarcinoma , Neoplasias da Vesícula Biliar , Neoplasias Gastrointestinais , Tumores Neuroendócrinos , Humanos , Estados Unidos , Prognóstico , Tumores Neuroendócrinos/diagnóstico , Medição de Risco , Adenocarcinoma/diagnóstico , Neoplasias da Vesícula Biliar/diagnósticoRESUMO
The flavor and taste of Lonicerae japonicae flos (LJF) products are heavily influenced by geographical origin. Tracing the geographical origin is an important aspect of LJF quality assessment. Here, DNA methylation analysis coupled with chemometrics revealed that, in 10 CpG islands upstream of genes in the chlorogenic acid and iridoid biosynthetic pathways, DNA methylation differences appear close association with LJF geographical origin. DNA methylation status in these CpG islands was determined using the cationic conjugated polymer fluorescence resonance energy transfer method. As a result, LJFs from 39 geographical origins were classified into four groups corresponding to Northern China, Central Plain of China, Southeast China, and Western China, according to cluster analysis and principal component analysis. Our findings contribute to an understanding of the modulation of LJF taste and can assist in understanding how DNA methylation in LJF varies with geographical origin.
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Metilação de DNA , Transferência Ressonante de Energia de Fluorescência , Cátions/química , Cromatografia Líquida de Alta Pressão , Espectrometria de Massas em Tandem , Metabolômica , Epigênese Genética , ChinaRESUMO
OBJECTIVE: Although total joint replacement (TJR) procedures are efficacious, perioperative high-dose factors replacement therapy (FRT) to avoid catastrophic bleeding represents a significant hurdle, particularly for patients with multiple joint affection. Double simultaneous bilateral TJRs were reported as safe and cost-effective. However, little is known about multiple TJRs. The feasibility and effects remain debatable. Surgeons need to weigh the high cost of FRT against safety. Accordingly, we aimed to evaluate the clinical outcomes and cost-effectiveness of single-anesthetic multiple-joint procedures of lower limbs in end-stage hemophilic arthropathy. METHODS: Our retrospective cohort study retrieved data from an inpatient database of patients with hemophilia who underwent total knee arthroplasty (TKA), total hip arthroplasty (THA), and/or ankle arthrodesis from January 2000 to April 2016. Complications, hospital stays, transfusion, doses of clotting factor, medical costs, range of motion (ROM), Harris hip scores (HHSs) and Hospital for special surgery knee scores (HSSs) were recorded. A P value < 0.05 was considered significant. RESULTS: A total number of 81 patients were included in this study, among which 89 TKAs and 52 THAs were performed. Compared to the single TJR group, the simultaneous multiple TJR group showed a significantly higher rate of blood transfusions (P < 0.05). But no significant differences were found in the length of hospital stays, factor consumption, hospitalization costs excluding prosthesis expenses, and total complication rates. Finally, similar postoperative ROM, HHS, and HSS were witnessed in two groups (P value > 0.05). CONCLUSION: Our data indicated that simultaneous multiple TJRs are a safe and cost-effective choice for treating hemophilic patients with multiple HA-affected lower limb joints.
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Anestésicos , Artrite , Artroplastia de Quadril , Humanos , Estudos Retrospectivos , Análise Custo-Benefício , Seguimentos , Resultado do TratamentoRESUMO
Fel Ursi(bear bile) has been used as medicine for a long history, with wide clinical applications and definite curative efficacy. Fel Ursi has good pharmacodynamic activities in the treatment of liver and gallbladder diseases, and cardiovascular and cerebrovascular diseases. According to the places of origin, traditional Fel Ursi is divided into "Dongdan" and "Nandan". According to the gallbladder properties, it is divided into "Jindan" "Tiedan" "Caihuadan", and "Youdan". With the development of bear bile drainage technology, Pulvis Fellis Ursi has entered the market and been used clinically instead of Fel Ursi. At present, obtaining artificial Pulvis Fellis Ursi by chemical compounding and biotransformation is the hotspot in medical research, which can solve the shortage problem of bear bile resources, and also protect endangered animals. The quality problem of Fel Ursi in the market is prominent, with counterfeit products prepared from sheep bile, cow bile, pig bile, and chicken bile. Due to the scarcity of bear bile resources, the related research contents are scattered, and there is a lack of systematic analysis and summary. This paper focused on the development of Fel Ursi to clarify the source and classification of traditional Fel Ursi, and summarized the harvesting, processing, identification, and use of Fel Ursi. Additionally, the paper also compared the quality standards of Fel Ursi, summarized the technological development process of Pulvis Fellis Ursi, and prospected the modern research and clinical application of Pulvis Fellis Ursi, which is expected to provided references for the collation of bear bile resources, the clinical application of Fel Ursi, the development of Fel Ursi drugs, and related research on artificial Pulvis Fellis Ursi.
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Bile , Ursidae , Animais , Medicina Tradicional ChinesaRESUMO
The surgical methods for treating spasmodic torticollis include the denervation and myotomy (DAM) of the affected muscles and deep brain stimulation (DBS). This study reports on the long-term efficacy, prognostic factors, safety, and hospitalization costs following these two procedures. We collected data from 94 patients with spasmodic torticollis, of whom 41 and 53 were treated with DAM and DBS, respectively, from June 2008 to December 2020 at the Chinese People's Liberation Army General Hospital. We used the Tsui scale and the global outcome score of the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) to evaluate the preoperative and postoperative clinical conditions in all patients. We also determined the costs of hospitalization, prognostic factors, and serious adverse events following the two surgical procedures. The mean follow-up time was 68.83 months (range = 13-116). Both resection surgery and DBS showed good results in terms of Tsui (Z = -5.103, p = 0.000; Z = -6.210, p = 0.000) and TWSTRS scores (t = 8.762, p = 0.000; Z = -6.308, p = 0.000). Compared with the DAM group, the preoperative (47.71, range 24-67.25) and postoperative (18.57, range 0-53) TWSTRS scores in the DBS group were significantly higher (Z = -3.161, p = 0.002). We found no correlation between prognostic factors and patient age, gender, or disease duration for either surgical procedure. However, prognostic factors were related to the length of the postoperative follow-up period in the DBS surgery group (Z = -2.068, p = 0.039; Z = -3.287, p = 0.001). The mean hospitalization cost in the DBS group was 6.85 times that found in the resection group (Z = -8.284, p = 0.000). The total complication rate was 4.26%. We found both resection surgery and DBS showed good results in the patients with spasmodic torticollis. Compared with DAM, DBS had a greater improvement in TWSTRS score; however, it was more expensive. Prognostic factors were related to the length of the postoperative follow-up period in patients who underwent DBS surgery.
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In order to better understand the current situation of Chinese public sports, this paper studies Chinese public sports. According to SATI3.2 statistics, 71 newsletters have published a total of 903 articles, of which 40 newsletters have one article, 19.7% of the newsletters have 2-9 books, and 17 magazines have more than 10 issues. The results show that by measuring data, we can better understand the current state of China's public services. This paper uses the method of bibliometric analysis to sort out and summarize the policies, characteristics, hotspots, and trends of China's public service field under the social network environment. The survey shows that the education sector has paid less for public entertainment in recent years. The research direction is system, equity, government procurement, interest, capital allocation, strategy, and supply chain. This paper highlights that the shortcomings of public sports research in our country: "public sports services" and "public sports services" are not integrated; there are many macrostudies on public service sports but few microstudies; there is no track and field research for special public groups. This paper puts forward research guidance for China's public sports services and, at the same time, strengthens the research on public services of different products of rural sports development, strengthens the research on the intelligence of sports public services, and strengthens the research on the role of public sports. Governments at all levels support and strengthen research on public sports service standards, strengthen research on public sports performance measurement measures, and strengthen public sports balance research.
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Civilização , Serviços de Saúde , Bibliometria , China , Rede SocialRESUMO
Conventional environmental health studies have primarily focused on limited environmental stressors at the population level, which lacks the power to dissect the complexity and heterogeneity of individualized environmental exposures. Here, as a pilot case study, we integrated deep-profiled longitudinal personal exposome and internal multi-omics to systematically investigate how the exposome shapes a single individual's phenome. We annotated thousands of chemical and biological components in the personal exposome cloud and found they were significantly correlated with thousands of internal biomolecules, which was further cross-validated using corresponding clinical data. Our results showed that agrochemicals and fungi predominated in the highly diverse and dynamic personal exposome, and the biomolecules and pathways related to the individual's immune system, kidney, and liver were highly associated with the personal external exposome. Overall, this data-driven longitudinal monitoring study shows the potential dynamic interactions between the personal exposome and internal multi-omics, as well as the impact of the exposome on precision health by producing abundant testable hypotheses.
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Expossoma , Exposição Ambiental/efeitos adversos , Saúde Ambiental , Monitoramento Ambiental/métodos , HumanosRESUMO
BACKGROUND: The high signal of paravertebral muscle (PVM) on T2-weighted image (T2WI) is usually considered to be fatty degeneration. However, it is difficult to distinguish inflammatory edema from fatty degeneration on T2WI. The purpose of this study was to identify different types of PVM high signal in patients with low back pain (LBP) through magnetic resonance imaging (MRI) and histology. METHODS: Seventy patients with LBP underwent MRI. The signal change of multifidus both on T2WI and fat suppression image (FSI) was quantified by Image J. Furthermore, 25 of the 70 patients underwent surgery for degenerative lumbar disease and their multifidus were obtained during the operation. Histological analysis of the samples was performed by HE staining. RESULT: Three types of PVM signal changes were identified from the MRI. Type 1 (n = 36) indicated fatty degeneration characterized by a high signal on T2WI and low signal on FSI. High signal on both T2WI and FSI, signifying type 2 meant inflammatory edema (n = 9). Type 3 (n = 25) showed high signal on T2WI and partial signal suppression on FSI, which meant a combination of fatty degeneration and inflammatory edema. Histological results were consistent with MRI. Among the 25 patients who underwent surgery, type 1 (n = 14) showed adipocytes infiltration, type 2 (n = 3) showed inflammatory cells infiltration and type 3 (n = 8) showed adipocytes and inflammatory cells infiltration. CONCLUSION: From our results, there are three types of pathological changes in patients with PVM degeneration, which may help to decide on targeted treatments for LBP.
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Dor Lombar , Atrofia Muscular , Estudos Transversais , Humanos , Dor Lombar/diagnóstico por imagem , Dor Lombar/patologia , Imageamento por Ressonância Magnética , Atrofia Muscular/patologia , Músculos Paraespinais/patologiaRESUMO
BACKGROUND: This study aimed to investigate the usefulness of superb microvascular imaging (SMI), a novel non-contrast-enhanced ultrasound technique, in characterizing neovessels within carotid atherosclerotic plaques through comparison with contrast-enhanced ultrasound (CEUS) and histology. METHODS: Patients with carotid plaque were recruited and underwent SMI and CEUS ultrasound imaging of the carotid arteries. The maximum plaque thickness, length, and stenosis of each plaque were measured. Grade of the neovessels was determined by SMI and CEUS, respectively. Grade 0 was defined as no blood flow signal/microbubbles within plaques; grade 1 was defined as moderate blood flow signals/microbubbles confined to the shoulder and/or adventitial side of the plaque; and grade 2 was defined as extensive intraplaque signals/microbubbles. Patients with symptomatic carotid stenosis (stenosis ≥50%) or asymptomatic carotid stenosis (stenosis ≥70%) underwent endarterectomy, and plaque specimens were subjected to immunohistochemical analysis of CD31 expression. The neovessels were quantified by histology. The agreement of SMI with CEUS and histology in characterizing neovessels was analyzed using weighted Kappa statistic and Spearman's correlation analyses. RESULTS: Seventy-eight patients (mean age: 67.3±8.9 years old, 63 males) were recruited. Of these patients, 52 (66.7%) had a unilateral plaque and 26 (33.3%) had bilateral plaques in the carotid arteries. For the 104 carotid plaques detected, the mean plaque thickness and length were 4.3±1.1 and 18.8±6.6 mm, respectively. The prevalence of <50%, 50-69%, and ≥70% stenosis was 43.3%, 24.0%, and 32.7%, respectively. Excellent agreement was found between SMI and CEUS (κ=0.825 at the plaque level; κ=0.820 at the patient level) in evaluating the neovessel grade within the carotid plaques. Of the 25 patients who underwent carotid endarterectomy, a strong correlation (r=0.660, P<0.001) was found between SMI and histology in the evaluation of intraplaque neovessels. SMI had excellent scan-rescan (κ=0.857), intra-reader (κ=0.810), and inter-reader (κ=0.754) agreement in the assessment of intraplaque neovessels. CONCLUSIONS: The SMI technique is capable of reliably characterizing neovessels within carotid atherosclerotic plaques and demonstrates good to excellent agreement with histology and CEUS.
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Computing vibrational properties of crystals in the presence of complex defects often necessitates the use of (semi-)empirical potentials, which are typically not well characterized for perfect crystals. Here we explore the efficacy of a commonly used embedded-atomempirical interatomic potential for the UxTh1-xO2system, to compute phonon dispersion, lifetime, and branch specific thermal conductivity. Our approach for ThO2involves using lattice dynamics and the linearized Boltzmann transport equation to calculate phonon transport properties based on second and third order force constants derived from the empirical potential and from first-principles calculations. For UO2, to circumvent the accuracy issues associated with first-principles treatments of strong electronic correlations, we compare results derived from the empirical interatomic potential to previous experimental results. It is found that the empirical potential can reasonably capture the dispersion of acoustic branches, but exhibits significant discrepancies for the optical branches, leading to overestimation of phonon lifetime and thermal conductivity. The branch specific conductivity also differs significantly with either first-principles based results (ThO2) or experimental measurements (UO2). These findings suggest that the empirical potential needs to be further optimized for robust prediction of thermal conductivity both in perfect crystals and in the presence of complex defects.
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Ensuring spontaneously adjusting behaviors of the public in their daily life in response to heat waves is an important aspect of successful public health intervention under climate change. However, the current response behavior guidance released by the government is insufficient because of the limited understanding of public perceptions of heat-related risk and the motivating factors for the public's diverse adaptive behaviors. Here, we conducted a survey on the behavioral adaptations of 3065 urban residents in response to heat waves in Jinan, which is a typical city suffering from a hot climate. We provided evidence on the current state of residents' perception of heat waves and the mechanism of how risk perception mediates individual behavioral intentions upon exposure to high ambient temperatures. We found that the mediating effects of risk perception varied significantly with respect to different types of adaptive behaviors. Concern behaviors appeared be motivated completely by the mediating effects of perceived concern (b = 0.45, pâ¯<â¯0.01 for concerns about health guidelines; b = 0.36, pâ¯<â¯0.01 for concerns about the weather forecast) and severity (b = 0.11, pâ¯<â¯0.01 for concerns about health guidelines), while outdoor activity could be consciously adjusted according to temperature changes without those mediating effects (pâ¯>â¯0.05). Indoor cooling behaviors and transportation behaviors are partially mediated by risk perception (b = -0.04, pâ¯<â¯0.01; b = 0.08, pâ¯<â¯0.01; b = 0.08, pâ¯<â¯0.01 for indoor fan usage, use of air-conditioned buses, and use of private cars, respectively). The conclusions could help determine more targeted and detailed interventions to enhance public behavioral adjustments, including participation in adaption to and emergency preparedness for extreme temperature under the ongoing climate changes.
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Terapia Comportamental , Raios Infravermelhos , Percepção , Adulto , China , Cidades , Mudança Climática , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medição de Risco , Fatores Socioeconômicos , Inquéritos e QuestionáriosRESUMO
Nano-structured superlattices may have novel physical properties and irradiation is a powerful mean to drive their self-organization. However, the formation mechanism of superlattice under irradiation is still open for debate. Here we use atomic kinetic Monte Carlo simulations in conjunction with a theoretical analysis to understand and predict the self-organization of nano-void superlattices under irradiation, which have been observed in various types of materials for more than 40 years but yet to be well understood. The superlattice is found to be a result of spontaneous precipitation of voids from the matrix, a process similar to phase separation in regular solid solution, with the symmetry dictated by anisotropic materials properties such as one-dimensional interstitial atom diffusion. This discovery challenges the widely accepted empirical rule of the coherency between the superlattice and host matrix crystal lattice. The atomic scale perspective has enabled a new theoretical analysis to successfully predict the superlattice parameters, which are in good agreement with independent experiments. The theory developed in this work can provide guidelines for designing target experiments to tailor desired microstructure under irradiation. It may also be generalized for situations beyond irradiation, such as spontaneous phase separation with reaction.
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To investigate the safety, cost-effectiveness, and clinical outcomes of simultaneous bilateral total knee arthroplasty (TKA) in hemophilic arthropathy (HA), the requirements for transfusions, complications, costs, hospital stays, Hospital for Special Surgery (HSS) knee scores, knee range of motion (ROM) and revision rates were compared between simultaneous bilateral and unilateral TKA in HA patients. A total of 36 patients and 54 knees were included. Compared to the unilateral group, the bilateral group did not require more transfusions (2.39 ± 3.13 vs 0.83 ± 1.38 units of RBCs, p > 0.05) or consumption of coagulation factors (50091.67 ± 25168.5 vs 46477.78 ± 11348.32 IU, p > 0.05), complications rate (13/36 vs 6/18, p > 0.05), hospital stay (32.39 ± 19.77 vs 29.11 ± 12.67 days, p > 0.05), or costs excluding prostheses (14945.41 ± 6634.35 vs 14742.12 ± 5746.78 US dollars, p > 0.05). Additionally, the two groups exhibited similar medium-term knee HSS scores (83.67 ± 7.11 vs 81.00 ± 10.35, p > 0.05) and ROM (89.39° ± 13.66° vs 88.91° ± 12.90°, p > 0.05). Our data indicate that bilateral TKA is a safe and cost-effective treatment for HA with similar medium-term results compared to unilateral TKA.
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Artroplastia do Joelho , Hemofilia A/complicações , Artropatias/cirurgia , Adolescente , Adulto , Custos e Análise de Custo , Seguimentos , Humanos , Tempo de Internação , Pessoa de Meia-Idade , Complicações Pós-Operatórias/epidemiologia , Resultado do Tratamento , Adulto JovemRESUMO
BACKGROUND: The accurate identification of botanical origin in commercial products is important to ensure food authenticity and safety for consumers. The Dendrobium species have long been commercialised as functional food supplements and herbal medicines in Asia. Three valuable Dendrobium species, namely Dendrobium officinale, D. huoshanense and D. moniliforme, are often mutually adulterated in trade products in pursuit of higher profit. RESULTS: In this paper, a rapid and reliable semi-quantitative method for identifying the botanical origin of Dendrobium products in terminal markets was developed using high-resolution melting (HRM) analysis with specific primer pairs to target the trnL-F region. The HRM analysis method detected amounts of D. moniliforme adulterants as low as 1% in D. huoshanense or D. officinale products. CONCLUSION: The results have demonstrated that HRM analysis is a fast and effective tool for the differentiation of these Dendrobium species both for their authenticity as well as for the semi-quantitative determination of the purity of their processed products. © 2017 Society of Chemical Industry.
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Dendrobium/genética , Plantas Medicinais/genética , Ásia , Primers do DNA/química , Primers do DNA/genética , DNA de Plantas/química , DNA de Plantas/genética , Dendrobium/química , Análise Discriminante , Medicina Herbária/economia , Plantas Medicinais/química , Controle de Qualidade , Temperatura de TransiçãoRESUMO
This report presents an accelerated kinetic Monte Carlo (KMC) method to compute the diffusivity of hydrogen in hcp metals and alloys, considering both thermally activated hopping and quantum tunneling. The acceleration is achieved by replacing regular KMC jumps in trapping energy basins formed by neighboring tetrahedral interstitial sites, with analytical solutions for basin exiting time and probability. Parameterized by density functional theory (DFT) calculations, the accelerated KMC method is shown to be capable of efficiently calculating hydrogen diffusivity in α-Zr and Zircaloy, without altering the kinetics of long-range diffusion. Above room temperature, hydrogen diffusion in α-Zr and Zircaloy is dominated by thermal hopping, with negligible contribution from quantum tunneling. The diffusivity predicted by this DFT + KMC approach agrees well with that from previous independent experiments and theories, without using any data fitting. The diffusivity along
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OBJECTIVE: To examine the changes in body mass index (BMI) and waist circumference (WC) in Guangzhou, South China, which is probably experiencing the most rapid economic transition in history. METHODS: In this study, 17,786 Chinese aged 50+ years were recruited from 2003 to 2008 and followed up until 2012. BMI and WC were measured at two time points. RESULTS: During the mean follow-up of 3.6 years (median = 3, interquartile = 1), age-adjusted mean BMI increased only slightly. By contrast, mean WC increased sharply by 0.94 cm (95% confidence interval 0.93-0.94) annually in men and 1.29 cm (1.28-1.29) annually in women. In 77% of women and 69% of men, WC increased, and among them, the mean annual increase was 2.01 cm and 1.70 cm, respectively. Among healthy, never-smoking participants, the incidence of central obesity was 29.0% (36.4% in women and 14.2% in men). The incidence of general obesity was 1.9% and was similarly low in both men and women (2.1% vs. 1.8%). Conversely, 20.3% of individuals with general obesity became nonobese, and 12.8% of individuals with central obesity returned to normal. CONCLUSIONS: Central obesity has risen sharply in this cohort. Such increases may have been greatly underestimated previously and should form the basis of an even stronger warning for regions undergoing economic transitions in China and elsewhere.
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Adiposidade/fisiologia , Índice de Massa Corporal , Obesidade/epidemiologia , Circunferência da Cintura/fisiologia , Idoso , China/epidemiologia , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Obesidade/fisiopatologiaRESUMO
INTRODUCTION: Because allogeneic blood transfusion carries a risk of serious complications, erythropoietin (EPO) has been used in patients scheduled for total hip or knee arthroplasty in an effort to reduce the need for allogeneic blood transfusion; however, its efficacy, cost-effectiveness, and safety are still controversial. The purpose of this review was to determine the hematopoiesis-promoting effect and potential complications, as well as the cost-effectiveness, of preoperative use of EPO in patients scheduled for total hip or knee arthroplasty. METHODS: We searched MEDLINE, EMBASE, Cochrane, and ClinicalTrials.gov databases for relevant literature from 2000 to 2015. Risk of bias was assessed for all included studies and data were extracted and analyzed. RESULTS: Preoperative use of EPO was associated with lower exposure to allogeneic blood transfusion (odds ratio = 0.41) and higher hemoglobin concentration after surgery (standardized mean difference = 0.86, Pâ<â0.001). Complications were not generally reported, but there was no significant difference between the group with and without EPO based on given data. Cost-effectiveness was also summarized but was not conclusive. CONCLUSION: Preoperative administration of EPO reduces the requirement for allogeneic blood transfusion and increases hemoglobin level after surgery. The studies of cost-effectiveness were not conclusive. Further studies and guidelines specific to blood management in the perioperative stage of total knee and hip arthroplasty are expected.
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Artroplastia de Quadril , Artroplastia do Joelho , Eritropoetina/uso terapêutico , Cuidados Pré-Operatórios , Transfusão de Sangue/estatística & dados numéricos , Análise Custo-Benefício , Eritropoetina/efeitos adversos , Eritropoetina/economia , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do TratamentoRESUMO
BACKGROUND: Observational studies and small intervention studies suggest alcohol raises gamma-glutamyltransferase (GGT). We used Mendelian randomization to assess the causal effect of alcohol use on GGT in older Chinese people. METHODS: An instrumental variable (IV) analysis in 2,321 men and 2,757 women aged 50+ years from phase 3 of the Guangzhou Biobank Cohort Study with ALDH2 (rs671) genotyped, alcohol use and GGT available was used to assess the causal effect of alcohol use on GGT. Rs671 was used as an IV and F-statistics was used to test for weak instrument hypothesis. An F-statistic of ≥10 indicates the IV is not weak. RESULTS: In men, the F-statistic for rs671 on alcohol use was 70. Using IV analysis alcohol use increased GGT by 10.60 U/L per alcohol unit (10 gram ethanol) per day (95% confidence interval (CI) 6.58 to 14.62). The estimate was lower in observational multivariate regression: 3.48 U/L GGT per alcohol unit per day (95% CI 2.84 to 4.11) adjusted for age, education, physical activity and smoking. In women, rs671 was not associated with alcohol or GGT and the F-statistic was 7 precluding IV analysis. CONCLUSION: In Mendelian randomization, we found confirmative evidence that alcohol use increases GGT among Southern Chinese men. Moreover, we found that the ALDH2 variant rs671 was not associated with GGT among Southern Chinese women who generally consume very low levels of alcohol. Taken together our findings strongly suggest that alcohol increases GGT, although we cannot rule out the possibility that other unknown factors may cause a different relation between alcohol and GGT in other populations.
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Consumo de Bebidas Alcoólicas , Análise da Randomização Mendeliana , gama-Glutamiltransferase/genética , gama-Glutamiltransferase/metabolismo , Idoso , Aldeído Desidrogenase/genética , Aldeído Desidrogenase/metabolismo , Aldeído-Desidrogenase Mitocondrial , China , Estudos de Coortes , Feminino , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Polimorfismo de Nucleotídeo Único , Fatores Socioeconômicos , gama-Glutamiltransferase/sangueRESUMO
Ichthyophthirius multifiliis, an external fish parasite, often causes significant economic damage to the aquaculture industry. Since the use of malachite green was banned, the search of alternative substance to control I. multifiliis infections becomes stringent. In present study, in vitro and in vivo anti-ich efficacies of isopsoralen and psoralidin, two active compounds isolated from methanol extract of Psoralea corylifolia by bioassay-guided fractionation based on the efficacy of anti-ich encysted tomonts, were evaluated. In vitro antiprotozoal efficacy of psoralidin is much better than that of isopsoralen. Psoralidin can kill all theronts at concentrations of 0.8 mg/L or more during 4 h exposure; and terminate reproduction of I. multifiliis post 6 h exposure of protomonts to 0.9 mg/L and encysted tomonts to 1.2 mg/L. In vivo trials showed that 5 h exposure of infected fish to 2.5 mg/L of psoralidin significantly reduced the number of theronts released from tomonts. Furthermore, we observed that a part of protomonts, collected from infected fish post treatment, presented characteristic morphological changes of apoptosis after staining with Annexin V-EGFP/propidium iodide, indicating the possible mechanism of psoralidin against I. multifiliis trophont in situ. On the basis of these results, psoralidin can be used as a potential lead compound for the development of commercial drug against I. multifiliis.
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Benzofuranos/farmacologia , Infecções por Cilióforos/veterinária , Cumarínicos/farmacologia , Doenças dos Peixes/parasitologia , Furocumarinas/farmacologia , Hymenostomatida/efeitos dos fármacos , Psoralea/química , Animais , Antiprotozoários/administração & dosagem , Antiprotozoários/química , Antiprotozoários/farmacologia , Benzofuranos/administração & dosagem , Benzofuranos/química , Infecções por Cilióforos/tratamento farmacológico , Infecções por Cilióforos/parasitologia , Cumarínicos/administração & dosagem , Cumarínicos/química , Relação Dose-Resposta a Droga , Furocumarinas/administração & dosagem , Furocumarinas/química , Carpa Dourada , Estrutura MolecularRESUMO
OBJECTIVE: Few studies have systematically investigated the impact of past occupational dust exposure on mental health. We examined whether retired factory workers exposed to any of the 4 dusts of silica, cement, coal and asbestos had more depressive symptoms and anxiety in southern China, which has experienced rapid economic development. METHODS: We used data from the Guangzhou Biobank Cohort Study phase 3. Exposures, lifestyle, symptoms and medical history of the participants were assessed with a structured interview. Self-reported intensity and duration of past occupational dust exposure were used to derive cumulative exposure. Outcome measures were assessed by the 15-item Chinese version of the Geriatric Depression Scale (score ≥5) and the single-item on anxiety. RESULTS: The results revealed that 359 workers were exposed to at least one of the 4 dusts and that 1,253 were unexposed (controls). After adjustment of multiple confounders, greater risks of depressive symptoms were associated with high exposure to silica (odds ratio (OR) of 3.12, 95% CI of 1.17-8.31) and asbestos (OR of 6.90; CI of 1.29-36.75). Risks of anxiety were higher in those with low or high exposures to dust (OR of 2.01 and CI of 1.04-3.87 and OR of 2.29 and CI of 1.30-4.03, respectively) and cement (OR of 3.20 and CI of 1.27-8.07 and OR of 2.30 and CI of 1.09-4.87, respectively), and those with high exposure to silica (OR of 5.29, CI of 1.76-15.92). CONCLUSIONS: Past occupational exposures to silica, cement, coal and asbestos dusts were associated with adverse mental health outcomes in retired factory workers. The mechanism underlying the relationship between occupational exposures and psychological symptoms in later life needs to be further studied.