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OBJECTIVE: To evaluate the safety and efficacy of rigid ureteroscopic lithotripsy with a pressure-controlling ureteral access sheath (PC-UAS) for complex steinstrasse. METHODS: Thirty-one consecutive patients (male: 18; female: 13) with steinstrasse were enrolled, six of whom had concurrent kidney stones. The mean cumulative stone size was 2.7 ± 1.3 cm. The patients were treated with rigid ureteroscopic lithotripsy using a PC-UAS. The cavity pressure parameters were set as follows: control value at -15 mmHg to -2 mmHg, warning value at 20 mmHg, and limit value at 30 mmHg. The infusion flow rate was set at 150-200 ml/min. A holmium laser (550 µm) was used to powderize the stone at 2.0-2.5 J/pulse with a frequency of 20-30 pulses/s. Analyses included cavity pressure, operative time, stone-free rates, and complications. RESULTS: Among the 31 patients, 29 were successfully treated with PC-UAS, with nine requiring adjunctive flexible ureteroscopy for stone migration to the kidney. Two procedures were converted to percutaneous nephrolithotomies due to failure of sheath placement. The cavity pressure of all 29 patients was well-maintained below 20 mmHg, with clear vision. The mean operative time was 48.2 ± 17.7 min. No complications, such as ureteral perforation, mucosal avulsion, or hemorrhage, occurred. Two cases of Clavien-Dindo grade I complications occurred. No major complications (Clavien-Dindo grade II-V) occurred. The mean postoperative hospitalization time was 1.7 days. The stone-free rates 1 day and 1 month after surgery were 93.1% and 96.6%, respectively. One patient with residual stones underwent extracorporeal shockwaves. CONCLUSIONS: Rigid ureteroscopic lithotripsy with PC-UAS can effectively control the cavity pressure, shorten the operation time, and improve the efficiency of broken stones, thus reducing the complication rate.
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Litotricia , Ureteroscopía , Humanos , Masculino , Femenino , Ureteroscopía/métodos , Litotricia/métodos , Persona de Mediana Edad , Adulto , Anciano , Presión , Resultado del Tratamiento , Cálculos Ureterales/terapia , Cálculos Ureterales/cirugía , Ureteroscopios , Diseño de Equipo , Uréter , Cálculos Renales/terapia , Cálculos Renales/cirugíaRESUMEN
Canagliflozin is an antidiabetic medicine that inhibits sodium-glucose cotransporter 2 (SGLT2) in proximal tubules. Recently, it was reported to have several noncanonical effects other than SGLT2 inhibiting. However, the effects of canagliflozin on skeletal muscle regeneration remain largely unexplored. Thus, in vivo muscle contractile properties recovery in mice ischemic lower limbs following gliflozins treatment was evaluated. The C2C12 myoblast differentiation after gliflozins treatment was also assessed in vitro. As a result, both in vivo and in vitro data indicate that canagliflozin impairs intrinsic myogenic regeneration, thus hindering ischemic limb muscle contractile properties, fatigue resistance recovery, and tissue regeneration. Mitochondrial structure and activity are both disrupted by canagliflozin in myoblasts. Single-cell RNA sequencing of ischemic tibialis anterior reveals a decrease in leucyl-tRNA synthetase 2 (LARS2) in muscle stem cells attributable to canagliflozin. Further investigation explicates the noncanonical function of LARS2, which plays pivotal roles in regulating myoblast differentiation and muscle regeneration by affecting mitochondrial structure and activity. Enhanced expression of LARS2 restores the differentiation of canagliflozin-treated myoblasts, and accelerates ischemic skeletal muscle regeneration in canagliflozin-treated mice. Our data suggest that canagliflozin directly impairs ischemic skeletal muscle recovery in mice by downregulating LARS2 expression in muscle stem cells, and that LARS2 may be a promising therapeutic target for injured skeletal muscle regeneration.
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Aminoacil-ARNt Sintetasas , Inhibidores del Cotransportador de Sodio-Glucosa 2 , Aminoacil-ARNt Sintetasas/metabolismo , Aminoacil-ARNt Sintetasas/farmacología , Animales , Canagliflozina/metabolismo , Canagliflozina/farmacología , Canagliflozina/uso terapéutico , Diferenciación Celular , Glucosa/metabolismo , Hipoglucemiantes/metabolismo , Hipoglucemiantes/farmacología , Hipoglucemiantes/uso terapéutico , Isquemia/tratamiento farmacológico , Isquemia/metabolismo , Ratones , Músculo Esquelético/metabolismo , Sodio/metabolismo , Sodio/farmacología , Transportador 2 de Sodio-Glucosa/metabolismo , Transportador 2 de Sodio-Glucosa/farmacología , Inhibidores del Cotransportador de Sodio-Glucosa 2/metabolismo , Inhibidores del Cotransportador de Sodio-Glucosa 2/farmacologíaRESUMEN
BACKGROUND: Extensive cervicofacial reconstruction is challenging for plastic surgeons. Because of the location of the adjacent scalp flap nourished by the superficial temporal artery (STA), it can be a candidate for cervicofacial reconstruction. OBJECTIVES: This article aims to report a combined treatment of an expanded island STA flap and an 810-nm diode laser hair removal technique for extensive cervicofacial defects. METHODS: Between January 2015 and December 2018, 10 patients with lower face and neck scar contraction were reconstructed with a bilateral or unilateral expanded STA island flap and an 810-nm diode laser for hair removal in this retrospective study. Hair removal via the 810-nm laser was started when the injected volume reached the volume of the expander, with a fluence of 35 to 40 J/cm2 and a 1 to 2 Hz repetition rate. Before second-stage surgery, the hair reduction rate was assessed. Twelve months after surgery, the degree of epilation efficacy according to the satisfaction scale and Global Aesthetic Improvement Scale was evaluated. RESULTS: This study included 2 single-pedicle flaps and 8 double-pedicle flaps. The average size of the implanted expanders was 600 mL. The average injected volume was 1405 mL. Before second surgery, there was a 67.4% hair reduction rate. Twelve months after surgery, the results of Global Aesthetic Improvement Scale were very good (3), good (6), average (1), and poor (0). CONCLUSIONS: The expanded island STA flap and 810-nm diode laser technique may be a novel treatment option for severe face and neck aesthetic reconstruction.
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Remoción del Cabello , Humanos , Láseres de Semiconductores/uso terapéutico , Estudios Retrospectivos , Colgajos Quirúrgicos , Arterias TemporalesRESUMEN
OBJECTIVES: This paper introduces the surgical procedure of "terminal ileum suspension" in the radical resection for low rectal cancer patients and evaluates the possibility of its clinical application. METHODS: This paper retrospectively analyzed the data of patients with low rectal cancer who underwent "terminal ileum suspension" during radical resection of rectal cancer (Dixon) in our hospital, and introduces the specific surgical procedures and key points of "terminal ileum suspension". Observe the relevant conditions of patients during the operation, postoperative recovery and postoperative complications, and analyze the safety and feasibility of this operation ("terminal ileum suspension"). RESULTS: The operation of all 8 patients went smoothly, and no anastomotic leakage, intestinal obstruction, and open diversion of suspended terminal ileum were found. The application of "terminal ileum suspension" in the operation of low rectal cancer has achieved ideal clinical effect, without increasing the rate of anastomotic leakage and rehospitalization, reducing the proportion of the secondary return operation, and reducing the pain of the patients. CONCLUSION: "Terminal ileum suspension" is a safe, effective and feasible surgical method for laparoscopic radical resection of low rectal cancer, which can be applied in clinical practice.
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GPCR 37 (GPR37) is a GPCR expressed in the CNS; its physiological and pathophysiological functions are largely unknown. We tested the role of GPR37 in the ischemic brain of GPR37 knockout (KO) mice, exploring the idea that GPR37 might be protective against ischemic damage. In an ischemic stroke model, GPR37 KO mice exhibited increased infarction and cell death compared with wild-type (WT) mice, measured by 2,3,5-triphenyl-2H-tetrazolium chloride and TUNEL staining 24 h after stroke. Moreover, more severe functional deficits were detected in GPR37 KO mice in the adhesive-removal and corner tests. In the peri-infarct region of GPR37 KO mice, there was significantly more apoptotic and autophagic cell death accompanied by caspase-3 activation and attenuated mechanistic target of rapamycin signaling. GPR37 deletion attenuated astrocyte activation and astrogliosis compared with WT stroke controls 24-72 h after stroke. Immunohistochemical staining showed more ionized calcium-binding adapter molecule 1-positive cells in the ischemic cortex of GPR37 KO mice, and RT-PCR identified an enrichment of M1-type microglia or macrophage markers in the GPR37 KO ischemic cortex. Western blotting demonstrated higher levels of inflammatory factors IL-1ß, IL-6, monocyte chemoattractant protein, and macrophage inflammatory protein-1α in GPR37-KO mice after ischemia. Thus, GPR37 plays a multifaceted role after stroke, suggesting a novel target for stroke therapy.-McCrary, M. R., Jiang, M. Q., Giddens, M. M., Zhang, J. Y., Owino, S., Wei, Z. Z., Zhong, W., Gu, X., Xin, H., Hall, R. A., Wei, L., Yu, S. P. Protective effects of GPR37 via regulation of inflammation and multiple cell death pathways after ischemic stroke in mice.
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Isquemia Encefálica/fisiopatología , Muerte Celular/fisiología , Receptores Acoplados a Proteínas G/fisiología , Accidente Cerebrovascular/fisiopatología , Animales , Apoptosis , Autofagia , Encéfalo/metabolismo , Encéfalo/patología , Isquemia Encefálica/patología , Caspasa 3/metabolismo , Modelos Animales de Enfermedad , Inflamación/patología , Inflamación/fisiopatología , Masculino , Ratones , Ratones Endogámicos C57BL , Ratones Noqueados , Microglía/metabolismo , Receptores Acoplados a Proteínas G/deficiencia , Receptores Acoplados a Proteínas G/genética , Corteza Sensoriomotora/fisiopatología , Transducción de Señal , Accidente Cerebrovascular/patología , Serina-Treonina Quinasas TOR/metabolismoRESUMEN
The aim of this work was to study the expression of the cytokines IFN-γ, IL-4, IL-17 A, and TGF-ß1 in peripheral blood and follicular fluid (FF) of patients positive for antithyroid autoantibodies (ATA+) with normal thyroid gland function and the influence of these autoantibodies on in vitro fertilization and embryo transfer (IVF-ET) pregnancy outcomes. Nineteen patients were in the ATA+ group, and 27 patients tested negative for anti-thyroid autoantibody (ATA-). Blood samples were drawn from the two groups of patients on the oocyte retrieval day and the 5th and 14th days of transplantation; in addition, FF was extracted on the oocyte retrieval day from both groups of patients and tested through enzyme-linked immunosorbent assay (ELISA) for IFN-γ, IL-4, IL-17 A, and TGF-ß1. For the ATA+ group, the concentration of IFN-γ increased whereas the concentration of TGF-ß1 decreased in peripheral blood on the oocyte retrieval day (p < .05); the concentration of IL-4 decreased in peripheral blood on the 5th and 14th days of transplantation for the ATA+ group (p < .05); further, the concentration of IL-17 A increased whereas that of TGF-ß1 decreased in FF (p < .05). The ratio of IL-17 A/TGF-ß1 in the ATA+ group significantly increased in FF and peripheral blood on the oocyte retrieval day and the 14th day of transplantation (p < .05). The ratio of IL-17 A/TGF-ß1 in FF of the pregnant patients was significantly lower than in the non-pregnant patients (p < .05). The findings suggested that the ratio between pro-inflammatory and anti-inflammatory cytokines was adversely affected; therefore, adverse pregnancy outcomes of patients with ATA+ undergoing IVF-ET treatment may be attributed to immunological mechanisms.
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Autoinmunidad , Citocinas/sangre , Líquido Folicular/metabolismo , Técnicas Reproductivas Asistidas/estadística & datos numéricos , Glándula Tiroides/inmunología , Estudios de Casos y Controles , Femenino , Humanos , Embarazo , Resultado del Embarazo , Estudios ProspectivosRESUMEN
The present study was conducted to investigate the preventive effects of squid ink polysaccharides (SIP) on the damage of sperm and reproduction induced by cyclophosphamide that is most commonly used for treating clinically cancers. Male Kunming mice exposed to cyclophosphamide were administered with SIP and were sacrificed to determine sperm parameters, testicular antioxidant ability and reproductive capacity. Data indicated that cyclophosphamide caused obvious changes in mice such as significant reduction (P<0.01) of glutathione reductase activity (GR), vitamin C (Vc) content and total antioxidant capacity (T-AOC) in the testes, as well as elevation (P<0.01) of abnormal rates of sperm and fetus, and a decrease in the total fetal count and average fetal count (P<0.01), were totally alleviated by SIP. From these findings it can be concluded that SIP decreases chemotherapeutic damage to sperm and reproduction in mice induced by cyclophosphamide.
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Antineoplásicos Alquilantes/efectos adversos , Antioxidantes/farmacología , Ciclofosfamida/efectos adversos , Decapodiformes/química , Polisacáridos/farmacología , Testículo/efectos de los fármacos , Animales , Antioxidantes/aislamiento & purificación , Líquidos Corporales/química , Tamaño de la Camada/efectos de los fármacos , Masculino , Ratones Endogámicos , Estrés Oxidativo/efectos de los fármacos , Exposición Paterna , Polisacáridos/aislamiento & purificación , Reproducción/efectos de los fármacos , Testículo/metabolismo , Testículo/patologíaRESUMEN
BACKGROUND: Posttraumatic hydrocephalus (PTH) is a frequent complication secondary to traumatic brain injury, especially among patients keeping chronic unconscious. And effects of shunt implantation on improving outcomes among these patients are still controversial. This study was aimed to assess the long-term outcomes following shunt implantation among patients who had PTH and kept chronic unconscious. METHODS: A prospective study was performed to include patients who had PTH and remained in severe conscious disturbance from March 2010 to December 2010. All of included patients would have shunt implantation and be closely followed up at least for 2 years to assess final outcomes. RESULTS: Fifteen patients having PTH were identified. Before shunt implantation, 2 patients kept vegetative state (Glasgow Outcome Scale [GOS] score 2), and 13 patients kept minimally consciousness with severe disability (GOS score 3). After shunt implantation, the shunt device was removed because of intracranial infection in 1 patient, and the other patient died because of allergic shock. Among the remaining 13 patients, finally 7 patients had improvement on GOS or Modified Barthel Index (MBI) score during the 2-year follow-up, but only 1 patient achieved a good outcome (GOS score 4, independent life). Among them, 5 patients' outcomes improved as assessed by GOS or MBI score during the first 3 months following shunt implantation. During the fourth to sixth month following shunt implantation, there were 2 patients who showed first rise on GOS or MBI score. Beyond 6 months, no patient showed initial improvement. And among patients who showed improvement, most of them kept improving during a certain time. CONCLUSIONS: A proportion of patients who had PTH and remained in severe conscious disturbance would benefit from shunt implantation, and the improvement may turn up late after this procedure.
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Derivaciones del Líquido Cefalorraquídeo , Coma Postraumatismo Craneoencefálico/cirugía , Sedación Consciente , Hidrocefalia/cirugía , Complicaciones Posoperatorias/cirugía , Adulto , Anciano , Coma Postraumatismo Craneoencefálico/diagnóstico , Femenino , Estudios de Seguimiento , Escala de Consecuencias de Glasgow , Humanos , Hidrocefalia/diagnóstico , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/diagnósticoRESUMEN
In-situ API crystallization in carrier matrices has attracted extensive attention in recent years for its advantages over traditional preparation processes. However, due to the lack of systemic research on molecular self-assembly behaviors, the products obtained by in-situ crystallization suffer from the problems of polymorphic transformation and drug expulsion during storage, limiting its industrial application. This paper investigates the in-situ sequential crystallization behavior of tristearin (SSS) and fenofibrate (FEN), utilizing SSS as the carrier and FEN as the API. It was found that the behavior of mixed crystallization significantly differs from single-component crystallization, including direct formation of stable form of SSS and the rapid crystallization of FEN. During the crystallization process, the melting FEN promotes the movement of SSS molecules, while the sliding of SSS lamellae, in turn, provides a mechanical stimulus to enhance the nucleation of FEN. Based on the observed synergistic crystallization behavior, the distribution and stability of the API within FEN solid lipid microparticles (SLMs) during storage were evaluated, while also examining the stability variations in SLMs formulated at different cooling rates and drug loading concentrations. The findings indicate that the initial nucleated FEN results in a decrease in the surrounding molten FEN and the irregularity of the SSS lamellas, thereby preventing the remaining molten FEN from achieving complete crystallization within a brief period. Due to the compatibility between FEN and SSS, some SSS may blend with the molten FEN, potentially resulting in further crystallization during storage and consequently increasing the risk of drug expulsion.
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Cristalización , Estabilidad de Medicamentos , Fenofibrato , Fenofibrato/química , Lípidos/química , Triglicéridos/química , Tamaño de la Partícula , Portadores de Fármacos/química , Hipolipemiantes/química , Química Farmacéutica/métodos , Composición de Medicamentos/métodos , Almacenaje de MedicamentosRESUMEN
Background: Picroside II (PII), an iridoid glycoside extracted from the rhizomes and stems of the genus Picroside, exhibits pronounced hepatoprotective properties. Pre-administration of PII protects against acute liver injury caused by D-galactosamine (D-Gal), carbon tetrachloride (CCl4), and acetaminophen (APAP). This study aimed to elucidate the ramifications of PII administration subsequent to the initiation of acute hepatic injury. Methods: Exploring the role of PII treatment in APAP-treated cell and rat models and in D-Gal and CCl4-treated rat models. Results: In rats, APAP treatment increased serum aspartate transaminase, alanine transaminase, and alkaline phosphatase levels and decreased glutathione activity and the fluidity of the liver mitochondrial membrane. In L-02 cells, APAP exposure resulted in a decrement in membrane potential, an augmentation in the liberation of reactive oxygen species, and an acceleration of apoptotic processes. Moreover, PII pre-administration protected against D-Gal-induced acute hepatic injury and CCl4-induced chronic hepatic injury in rodent models, whereas PII administration post-injury aggravated CCl4-induced chronic hepatic injury. Conclusions: Our results suggest that the effects of PII depend on the hepatic physiological or pathological state at the time of intervention. While PII possesses the potential to avert drug-induced acute hepatic injury through the mitigation of oxidative stress, its administration post-injury may exacerbate the hepatic damage, underscoring the critical importance of timing in therapeutic interventions.
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Duck adenovirus type-3 (DAdV-3) is a poorly characterized duck virus. A comprehensive analysis of the DAdV-3 pathogenicity and host immune response could be a valuable addition. Herein, DAdV-3 was isolated from Muscovy duck and virus-specific genes were confirmed by polymerase chain reaction (PCR). The obtained gene fragments were sequenced and compared with the reference sequence. Results confirmed that the clinically isolated virus was DAdV-3, named as HF-AN-2020. To evaluate DAdV-3 host immune response, the expression levels of MDA5, STING, IRF7, MAVS, and NF-κB, and inflammatory cytokines (IFN-ß, IFN-γ, and IL-1ß) were determined by quantitative reverse transcriptase PCR (qRT-PCR). The expression levels of IFN-ß and IFN-γ were 32.6- and 28.6-fold, respectively, higher (P < 0.01) than the control group. It was found that the upregulation of STING and NF-κB pathways was directly involved in the regulation of inflammatory cytokines (IFN-ß, IFN-γ, and IL-1ß). Furthermore, the gene regulation pathways consecutively upregulated the expression levels of MDA5, STING, IRF7, MAVS, and NF-κB up to 31.6, 10.5, 31.4, 2.2, and 2.6-fold, respectively, higher (P < 0.01) than the control group. The TCID50 of DAdV-3 for Muscovy duck and chicken was 10-3.24/0.1 mL with 0% mortality, indicating low pathogenicity in both Muscovy ducks and chickens, but DAdV-3 can induce higher expression of interferons. Genome analysis showed mutations in 4 amino acids located in ORF19B (Ser to Thr), ORF66 (Leu to Phe, Ile to Leu), and ORF67 (Gly to stop codon). This study provides essential and basic information for further research on the mechanism of the cellular immune responses against adenoviruses.
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Infecciones por Adenoviridae , Patos , Animales , Adenoviridae/genética , FN-kappa B/metabolismo , Virulencia , Pollos/genética , Pollos/metabolismo , Infecciones por Adenoviridae/veterinaria , Interferones , Inmunidad Innata/genética , InmunomodulaciónRESUMEN
BACKGROUND: Older patients with cancer have a higher risk for malnutrition and impaired quality of life (QoL). The present study aimed to investigate the relationship between malnutrition diagnosed according to the Global Leadership Initiative Malnutrition (GLIM) criteria and QoL across various tumor types, and to evaluate the combined prognostic value of malnutrition and QoL in predicting survival among older patients with cancer. METHODS: This multicenter, observational cohort study included 5310 older patients with cancer and 2184 with malnutrition (moderate stage, n = 1023; severe stage, n = 1161). An empirical cumulative distribution curve was performed to illustrate the correlation between malnutrition and QoL. The primary objective was to investigate the association between malnutrition and QoL using logistic regression analysis. Survival analyses were performed to assess the combined prognostic value of malnutrition and QoL. RESULTS: The median age of the patients (66.9% male, 33.1% female) was 70 years (interquartile range [IQR] 67-74 years) years. The median QoL score was highest in patients without malnutrition (91.88 [IQR 84.44-97.44]), followed by those with moderate (86.15 [IQR 76.18-93.85) and severe (82.31 [IQR 69.87-91.11]) malnutrition. Logistics regression revealed that the risk for developing impaired QoL increased 1.98 (95% confidence interval [CI] 1.64-2.38; P < 0.001) and 2.33 (95% CI 1.93-2.81; P < 0.001) times in patients with moderate and severe malnutrition, respectively. Kaplan-Meier curves showed that QoL in combination with GLIM criteria demonstrated a significant discriminative performance for survival and served as an independent prognostic factor among older patients with cancer, especially for lung and gastric cancers. CONCLUSIONS: Malnutrition diagnosed according to the GLIM criteria was a predictor of impaired QoL. Additionally, the combination of QoL and malnutrition demonstrated utility for predicting survival outcomes in older patients with cancer.
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Desnutrición , Neoplasias , Calidad de Vida , Humanos , Desnutrición/diagnóstico , Femenino , Masculino , Anciano , Neoplasias/complicaciones , Evaluación Nutricional , Pronóstico , Estado Nutricional , Evaluación Geriátrica/métodos , Estudios de Cohortes , Análisis de SupervivenciaRESUMEN
BACKGROUND: Acute normovolemic hemodilution (ANH) was first introduced in glioblastoma surgery, and its role in reducing allogeneic blood transfusion was investigated in this study. METHODS: This study enrolled supratentorial glioblastoma patients who received total resection. In the ANH group, the patients were required to draw blood before the operation, and the blood will be transfused back to the patient during the operation. The association between ANH and clinical features was investigated. RESULTS: Sixty supratentorial glioblastoma patients were enrolled in this study, 25 patients were allocated in the ANH group, and another 35 patients were included in the control group. ANH dramatically reduced the need for allogeneic blood transfusion (3 [12%] vs 12 [34.3%], P = 0.049), and the blood transfusion per total of patients was dramatically decreased by the application of ANH (0.40 ± 1.15 units vs 1.06 ± 1.59 units, P = 0.069). Furthermore, ANH also markedly reduced the requirement of fresh frozen plasma (FFP) transfusion (2 [8%] vs 11 [31.4%], P = 0.030) and the volume of FFP transfusion per total of patients (32.00 ± 114.46 mL vs 115.71 ± 181.00 mL, P = 0.033). The complication rate was similar between the two groups. CONCLUSIONS: ANH was a safe and effective blood conservation technique in glioblastoma surgery.
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Based on the scarcity theory, this study focuses on exploring the relationship between the severity of public health emergencies (i.e., COVID-19) and individual irrational consumer behaviors through the serial mediating variables of perceived scarcity (PS) and negative mentality (NM). An online questionnaire was used to collect data from participants in China and we obtained 466 effective (115 male and 351 female) questionnaires in total. The findings showed that the relationship between each pair of factors - perceived pandemic severity, PS, NM, and irrational consumption behaviors - was significantly positive. Although the perception of the severity of this public health emergency did not directly predict irrational consumer behavior, the effect was mediated by PS and NM independently and serially. These findings reveal that people who strongly perceive scarcity and are prone to negative attitudes are more likely to demonstrate irrational consumer behaviors (such as rushing to buy and hoard living supplies) once the public perceives a public health emergency as severe. This effect occurs because the PS that results from the epidemic affects people's cognition, emotion, and behavior.
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BACKGROUND: The occurrence of coronavirus disease 2019 (COVID-19) has overwhelmed the blood supply chain worldwide and severely influenced clinical procedures with potential massive blood loss, such as clipping surgery for aneurysmal subarachnoid hemorrhage (aSAH). Whether acute normovolemic hemodilution (ANH) is safe and effective in aneurysm clipping remains largely unknown. METHODS: Patients with aSAH who underwent clipping surgery within 72 hours from bleeding were included. The patients in the ANH group received 400 mL autologous blood collection, and the blood was returned as needed during surgery. The relationships between ANH and perioperative allogeneic blood transfusion, postoperative outcome, and complications were analyzed. RESULTS: Sixty-two patients with aSAH were included between December 2019 and June 2020 (20 in the ANH group and 42 in the non-ANH group). ANH did not reduce the need of perioperative blood transfusion (3 [15%] vs. 5 [11.9%]; P = 0.734). However, ANH significantly increased serum hemoglobin levels on postoperative day 1 (11.5 ± 2.5 g/dL vs. 10.3 ± 2.0 g/dL; P = 0.045) and day 3 (12.1 ± 2.0 g/dL vs. 10.7 ± 1.3 g/dL; P = 0.002). Multivariable analysis indicated that serum hemoglobin level on postoperative day 1 (odds ratio, 0.895; 95% confidence interval, 0.822-0.973; P = 0.010) was an independent risk factor for unfavorable outcome, and receiver operating characteristic curve analysis showed that it had a comparable predictive power to World Federation of Neurosurgical Societies grade (Z = 0.275; P > 0.05). CONCLUSIONS: ANH significantly increased postoperative hemoglobin levels, and it may hold the potential to improve patients' outcomes. Routine use of ANH should be considered in aneurysm clipping surgery.
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Aneurisma Roto/cirugía , Transfusión de Sangre Autóloga/métodos , Procedimientos Médicos y Quirúrgicos sin Sangre/métodos , Hemodilución/métodos , Aneurisma Intracraneal/cirugía , Procedimientos Neuroquirúrgicos/métodos , Hemorragia Subaracnoidea/cirugía , Adulto , Anciano , Transfusión Sanguínea/estadística & datos numéricos , COVID-19 , Femenino , Hemoglobinas/metabolismo , Humanos , Masculino , Persona de Mediana Edad , Atención Perioperativa , SARS-CoV-2 , Instrumentos QuirúrgicosRESUMEN
Nylon 6,6 composite fiber containing grafted graphene (nylon 6,6-g-graphene) was prepared by nylon and graphene grafted with acyl chloride (graphene-COCl) through extrusion reaction. Graphene-COCl was prepared through acid-treated reacting, graphene with thionyl chloride functional group. The chemical structure of nylon 6,6-g-graphene obtained using reactive extrusion technique was characterized using Fourier transform infrared spectrometer. It was found that this kind of composite fiber has the characteristics of less amount of graphene and excellent mechanical properties and has certain application prospects. Nylon 6,6-g-graphene dispersed evenly in the Nylon composite. But pristine graphene exhibited aggregate structure when composite was produced by pristine graphene through reactive extrusion. The composite reinforcement was increased obviously with the increase content of grafted graphene. After examined, the nylon/nylon 6,6-g-graphene with a certain content grafted graphene composite exhibited high level of reinforcement, and mechanical properties were improved.
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CD4+ T cells play critical roles in mediating adaptive immunity to a variety of pathogens. Recently, new subset of CD4+T named as T helper 9 cells that express the prototypical interleukin-9 (IL-9) cytokine have been recognized in human and mice models during different parasitic infections. Haemonchus contortus is a gastrointestinal nematode of small ruminants which cause high mortality in young animals. During infection, Excretory and Secretary Products (ESPs) are released in the host body. No other study has reported yet on immunomodulatory dynamics of H. contortus ESPs on Th9 immune response in vitro or in vivo. In this study, immunomodulatory effects of ESPs (5, 10, 20, 40, 80; µg/mL) incubated with goat PBMCs on Th9 cells, IL-9 immune response and TGF-ß/Smad signaling regulator were evaluated in vitro. Moreover, for in vivo study, goats were infected with different doses (P-800, P-2400, and P-8000) of H. contortus infective larva (L3) and immunomodulatory effects on Th9 cells, IL-9 immune response and TGF-ß/Smad signaling regulator were evaluated at 7, 10, 14, 18, 21, 28 Days Post Infection (DPI). Flow cytometry was performed to evaluate the effects on Th9 cells and quantitative real time polymerase chain reaction was performed to evaluate the IL-9 cytokine transcription level. Additionally, fecal egg counting was also performed in parallel to confirm the infection. All goats were dewormed at 29 DPI and all experiments were also performed at 35 DPI, one week post deworming. The finding indicated that 10, 20, 40, 80 µg/mL concentration of ESPs incubated with goat PBMCs showed significant increase in the production of Th9 cells, signature cytokine IL-9 and expression of TGF-ß/Smad signaling regulator as compared to control group in vitro.All infected groups showed significant increase in production of Th9 cells and IL-9 cytokine and expression of TGF-ß/Smad key genes at 18, 21, and 28 DPI as compared to control group. Likewise, at 14 DPI, P-2400 and P-8000 groups showed significant increase in production of Th9 cells, IL-9 cytokine and expression of TGF-ß/Smad key genes. While at 10 DPI, production of Th9 cells and IL-9 was significantly increased in P-2400 & P-8000 groups, and at 7 DPI only P-8000 showed significantly increase in IL-9 production. No immunomodulatory effects were observed at 0 and 3 DPI. Additionally, significant gradually up-regulated key genes expression of TGF-ß/Smad signaling regulator in all infected groups confirmed the above results. After deworming, production of Th9 cells, associated immune response and expression of signaling regulator in each group were significantly decreased. Based on this study, it is concluded that Th9 immune response was induced during H. contortus infection in goat by up-regulation of TGF-ß/Smad signaling key genes.
Asunto(s)
Linfocitos T CD4-Positivos/inmunología , Hemoncosis/inmunología , Interleucina-9/inmunología , Factor de Crecimiento Transformador beta/inmunología , Inmunidad Adaptativa , Animales , Femenino , Cabras , Haemonchus , Masculino , Recuento de Huevos de Parásitos , Transducción de Señal , Subgrupos de Linfocitos T/inmunologíaRESUMEN
The control of water conservancy ecosystem for Oncomelaniahupensissnails and water conservancy combined with schistosomiasis prevention and control are an important part of the comprehensive control of schistosomiasis in China. It has played an important role in the prevention and control of schistosomiasis in a long-term. The technique regulation for water con-servancy combined with schistosomiasis prevention has nearly 30 years'development gradually and formed a series of technical specification. Its theoretical basis is associated with the water ecology and hydraulics of snails. This paper mainly reviews the soil, grass, water, light and others related to ecological elements of the snails, and the water conservancy ecological control technique of snails and the current water conservancy measurements combined with schistosomiasis prevention and control in the field of schistosomiasis prevention and control, and puts forward the proposals for the water conservancy combined with schistosomiasis prevention and control technology development in the future. The water conservancy combined with schistosomiasis prevention and control should have further development in the new situation in order to play a more important role for schistosomiasis elimination in China.
Asunto(s)
Conservación de los Recursos Naturales , Ecosistema , Esquistosomiasis , Agua , Animales , China/epidemiología , Erradicación de la Enfermedad , Ecología , Humanos , Esquistosomiasis/epidemiología , Esquistosomiasis/prevención & controlRESUMEN
Oncomelania hupensis is the only intermediate host of Schistosoma japonicum, and control of Oncomelania snails is an important measure to control and interrupt the transmission of schistosomiasis. Therefore, snail control plays a very critical role in the national schistosomiasis control programmes of China. Pyriclobenzuron, which was recently developed by National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, is the latest great advance in the research on molluscicides and is expected to solve the problem of toxicity to fish, which is worthy of expanding experiments.