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BACKGROUND: We sought to investigate the midterm results of kissing self-expanding covered stents (SECSs) for the reconstruction of aortic bifurcation in complex aortoiliac occlusive disease. METHODS: Data of consecutive patients who had undergone endovascular treatment for aortoiliac occlusive disease were screened. Only patients with TransAtlantic Inter-Society Consensus (TASC) class C and D lesions treated by bilateral iliac kissing stents (KSs) were included. Midterm primary patency, risk factors, and limb salvage rates were analyzed. Follow-up results were analyzed using the Kaplan-Meier curves. Cox proportional hazards models were used to identify the predictors of primary patency. RESULTS: A total of 48 patients (95.8% men; mean age, 65.3 ± 10.2 years) were treated with kissing SECSs. Of them, 17 patients had TASC-II class C lesions and 31 had class D lesions. There were 38 total occlusive lesions, with a mean occlusive lesion length of 108.2 ± 57.3 mm. The overall mean lesion length was 140.3 ± 60.5 mm, and the mean length of implanted stents in the aortoiliac arteries was 141.9 ± 59.9 mm. The mean diameter of the deployed SECSs was 7.8 ± 0.5 mm. The mean follow-up time was 36.5 ± 15.8 months, and the follow-up rate was 95.8%. At 36 months, the overall primary patency, assisted primary patency, secondary patency, and limb salvage rates were 92.2%, 95.7%, 97.8%, and 100%, respectively. Univariate Cox regression analysis revealed that stent diameter ≤7 mm (hazard ratio [HR]: 9.53; 95% confidence interval [CI] 1.56-57.94, P = 0.014) and severe calcification (HR: 12.66; 95% CI 2.04-78.45, P = 0.006) were significantly associated with restenosis. Multivariate analysis showed severe calcification to be the only significant determinant of restenosis (HR: 12.66; 95% CI 2.04-78.45, P = 0.006). CONCLUSIONS: Kissing SECSs provide good midterm results for the treatment of aortoiliac occlusive disease. A stent diameter >7 mm is a potent protective factor against restenosis. Because severe calcification appears to be the only significant determinant of restenosis, patients with severe calcification require close follow-up.
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Doenças da Aorta , Arteriopatias Oclusivas , Aterosclerose , Calcinose , Síndrome de Leriche , Masculino , Humanos , Pessoa de Meia-Idade , Idoso , Feminino , Arteriopatias Oclusivas/diagnóstico por imagem , Arteriopatias Oclusivas/cirurgia , Resultado do Tratamento , Doenças da Aorta/diagnóstico por imagem , Doenças da Aorta/cirurgia , Artéria Ilíaca/diagnóstico por imagem , Artéria Ilíaca/cirurgia , Fatores de Tempo , Fatores de Risco , Stents , Grau de Desobstrução Vascular , Aorta Abdominal , Estudos RetrospectivosRESUMO
BACKGROUND: Kaixinsan (KXS) decoction is a traditional Chinese herbal formulation commonly used to treat depression. This study aimed to evaluate the efficacy and safety of KXS, which is widely used, alone and in combination with other therapies, for the treatment of depression. The main objective was to assess the efficacy and safety of KXS in the treatment of depression as a single agent or in combination with other methods. METHODS: Randomized controlled trials of KXS in the treatment of depression were systematically searched from several Chinese and English databases with no language restriction. Patients in these studies met the relevant diagnostic criteria for depression. Data on HAMD, SDS, practical situations, and occurrence of side effects in the studies were extracted. Finally, the methodological quality and risk of bias of the included studies were assessed using the Jadad scale and Cochrane bias evaluation tool. RESULTS: Twelve studies with 1034 patients were included after screening. The Jadad scale and Cochrane bias evaluation tool indicated that the quality of the studies ranged from fair to good, with 41.7% categorized as good and 58.3% as poor. Egger test and funnel plots showed that the publication bias remain low. CONCLUSION: The results showed that the frequency of side effects in the control group was higher than that in the treatment group, and there was a statistically significant difference. KXS was comparable or superior to antidepressants in treating depression and has fewer side effects. The data analysis showed that effectiveness and other indicators differed significantly by geographic area and dosage form, which has implications for future clinical work.
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Depressão , Medicamentos de Ervas Chinesas , Medicina Tradicional Chinesa , Humanos , Depressão/tratamento farmacológico , Medicamentos de Ervas Chinesas/efeitos adversosRESUMO
In the present study, it was aimed to evaluate whether there is an objective tongue image indicator that could be used to evaluate malignant risk of thyroid nodules through a cross sectional study. From December 2018 to December 2020, the TFDA-1 digital tongue-face diagnostic instrument was used to collect the tongue images. TDAS 2.0 software was used for tongue image analysis. A standardized database was constructed by combining patient physical examination results and tongue image analysis results. The relationship between tongue image index and TI-RADS classification of thyroid nodules was tested. A total of 5,900 cases were collected and 4,615 cases were included in the present study after excluding 154 cases due to incomplete information, 1,221 cases with thyroid nodules were separated into 417 cases TI-RADS 2 group, 693 cases in TI-RADS 3 group and 111 cases in TI-RADS 4 group. Without considering confounding factors, tongue image indexes zhiCon, zhiASM, zhiENT, zhiMEAN, zhiClrB, zhiClrR, zhiClrG, zhiClrI, zhiClrL and zhiClrY were significantly different among the three groups (P<0.05). Excluding the influence of age, sex, body mass index, smoking and drinking, the results of one-way variance linear trend analysis showed that the values of zhiCon, zhiENT and zhiMEAN increased with the increasing TI-RADS category, while the values of zhiASM decreased with the increase of TI-RADS category. Tongue texture index may be helpful for differentiating the benign and malignant of thyroid nodules.
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Conifers make up about one third of global forests but are threatened by seed parasitoid wasp species. Many of these wasps belong to the genus Megastigmus, yet little is known about their genomic background. In this study, we provide chromosome-level genome assemblies for two oligophagous conifer parasitoid species of Megastigmus, which represent the first two chromosome-level genomes of the genus. The assembled genomes of Megastigmus duclouxiana and M. sabinae are 878.48 Mb (scaffold N50 of 215.60 Mb) and 812.98 Mb (scaffold N50 of 139.16 Mb), respectively, which are larger than the genome size of most hymenopterans due to the expansion of transposable elements. Expanded gene families highlight the difference in sensory-related genes between the two species, reflecting the difference in their hosts. We further found that these two species have fewer family members but more single-gene duplications than polyphagous congeners in the gene families of ATP-binding cassette transporter (ABC), cytochrome P450 (P450) and olfactory receptors (OR). These findings shed light on the pattern of adaptation to a narrow spectrum of hosts in oligophagous parasitoids. Our findings suggest potential drivers underlying genome evolution and parasitism adaptation, and provide valuable resources for understanding the ecology, genetics and evolution of Megastigmus, as well as for the research and biological control of global conifer forest pests.
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Traqueófitas , Vespas , Animais , Vespas/genética , Traqueófitas/genética , Genômica , Adaptação Fisiológica , CromossomosRESUMO
Elevation plays a crucial factor in the distribution of plants, as environmental conditions become increasingly harsh at higher elevations. Previous studies have mainly focused on the effects of large-scale elevational gradients on plants, with little attention on the impact of smaller-scale gradients. In this study we used 14 microsatellite loci to survey the genetic structure of 332 Juniperus squamata plants along elevation gradient from two sites in the Hengduan Mountains. We found that the genetic structure (single, clonal, mosaic) of J. squamata shrubs is affected by differences in elevational gradients of only 150 m. Shrubs in the mid-elevation plots rarely have a clonal or mosaic structure compared to shrubs in lower- or higher-elevation plots. Human activity can significantly affect genetic structure, as well as reproductive strategy and genetic diversity. Sub-populations at mid-elevations had the highest yield of seed cones, lower levels of asexual reproduction and higher levels of genetic diversity. This may be due to the trade-off between elevational stress and anthropogenic disturbance at mid-elevation since there is greater elevational stress at higher-elevations and greater intensity of anthropogenic disturbance at lower-elevations. Our findings provide new insights into the finer scale genetic structure of alpine shrubs, which may improve the conservation and management of shrublands, a major vegetation type on the Hengduan Mountains and the Qinghai-Tibet Plateau.
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In the title compound, C(16)H(12)BrN(3)O(4), the furan-2(5H)-one ring forms a dihedral angle of 33.19â (9)° with the 4-bromo-benzene unit and is nearly perpendicular to the 4-nitro-benzene segment, making a dihedral angle of 89.93â (10)°. In the crystal, N-Hâ¯O hydrogen bonds link the mol-ecules, generating an infinite chain along [010]. The chains are linked into a three-dimensional network by C-Hâ¯O, C-Hâ¯π and π-π contacts [centroid-centroid separation = 3.805â (2)â Å].
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In the title mol-ecule, C(10)H(7)ClO(3), the butyrolactone core, a furan-2(5H)-one, forms a dihedral angle of 59.21â (5)° with the benzene ring. In the crystal, two types of hydrogen bonds (O-Hâ¯O and C-Hâ¯Cl) link mol-ecules into infinite chains along the b axis. π-π contacts [centroid-centroid distances = 3.6359â (10) and 3.8776â (11)â Å] link the chains into a three-dimensional network.
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BACKGROUND: Osteoporotic vertebral compression fractures (OVCFs) are common health issues in the elderly that cause chronic pain in over one-third of patients. This study was sought to evaluate the efficacy and safety of acupuncture for alleviating pain caused by OVCFs. METHODS: We performed a search of 8 electronic databases for publications from the inception to 30th March 2021. Eligible studies were randomized clinical trials (RCTs) that evaluated the effect of acupuncture for the treatment of OVCFs. Two investigators evaluated literature quality and extracted data independently. RevMan V.5.4.1 was used for data analyses, with pooled risk estimates presented as mean difference (MD) or relative risk (RR) along with corresponding 95% confidence intervals (CIs), as appropriate. RESULTS: Fourteen RCTs involving 1,130 patients were included in this meta-analysis. Compared with the control group, acupuncture showed a greater benefit on pain reduction caused by OVCFs (1 week: MD = -1.26, 95% CI: (-1.82,-0.70); 1 month: MD = -1.63, 95% CI: (-1.82,-1.43); 6 months: MD = -1.13, 95% CI: (-1.55, -0.70)). Acupuncture treatment was also associated with fewer adverse events, lower ODI index, and higher bone density than the control group (safety: (RR: 0.30, 95% CI: 0.12-0.75); ODI: MD = -3.19, 95% CI: (-5.20, -1.19); bone density: MD = 0.15, 95% CI: (0.05, 0.26)). The GRADE quality of these results was assessed as low or very low. CONCLUSIONS: Compared with the control treatment, acupuncture was more effective and safer in relieving the pain caused by OVCF and made a greater improvement on patient's ODI score and bone density. Given the low level of our study evidence, future high-quality studies are needed to verify our study findings.
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BACKGROUND: Diffuse reduction of spleen density (DROSD) is related to cancer prognosis; however, its role in intrahepatic cholangiocarcinoma (ICC) remains unclear. AIM: To assess the predictive value of DROSD in the prognosis of ICC after curative resection. METHODS: In this multicenter retrospective cohort study, we enrolled patients with ICC who underwent curative hepatectomy between 2012 and 2019. Preoperative spleen density was measured using computed tomography. Overall survival (OS) and recurrence-free survival (RFS) rates were calculated and compared utilizing the Kaplan-Meier method. Univariable and multivariable Cox regression analyses were applied to identify independent factors for OS and RFS. A nomogram was created with independent risk factors to predict prognosis of patients with ICC. RESULTS: One hundred and sixty-seven ICC patients were enrolled. Based on the diagnostic cut-off values (spleen density ≤ 45.5 Hounsfield units), 55 (32.9%) patients had DROSD. Kaplan-Meier analysis indicated that patients with DROSD had worse OS and RFS than those without DROSD (P < 0.05). Cox regression analysis revealed that DROSD, carcinoembryonic antigen level, carbohydrate antigen 19-9 level, length of hospital stay, lymph node metastasis, and postoperative complications were independent predictors for OS (P < 0.05). The nomogram created with these factors was able to predict the prognosis of patients with ICC with good reliability (OS C-index = 0.733). The area under the curve for OS was 0.79. CONCLUSION: ICC patients with DROSD have worse OS and RFS. The nomogram is a simple and practical method to identify high-risk ICC patients with poor prognosis.
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PURPOSE: Diagnosis of cervical neoplasia hinges upon microscopic inspection of cervical samples. This has inherent operator-dependent variability. Testing for high-risk human papilloma virus (HPV) may help to triage patients with pre-invasive disease in determining clinical intervention and follow-up. However, HPV presence/absence does not reflect the cervical epithelial cell's molecular status. Epigenetic modifications, e.g. DNA methylation, have been observed in the early stages of neoplastic change, preceding gene mutations. Here, we assess the correlation between cytologic/histologic results and combined DNA methylation data of 5 genes in different grades of cervical dysplasia. EXPERIMENTAL DESIGN: Cervical specimens collected via the liquid-based cytology system were each microscopically examined. Residual cells were subjected to DNA methylation analysis (Methylight) of gene loci CCNA1, PAX1, HS3ST2, DAPK1 and TFPI2. Methylation data were compared with cytologic/histologic reports. Statistical methods were applied to assess the ability of DNA methylation status to subtype the cervical neoplastic lesions according to their corresponding cytologic/histologic reports. RESULTS: A total of 165 subjects provided cytologically proven 63 HSIL, 49 LSIL and 53 normal samples. All patients with HSIL and LSIL underwent colposcopic examination. Patients with LSIL were all found to be CIN1; patients with HSIL were subsequently subdivided into 10 squamous cell carcinoma (SCC), 31 CIN3, 10 CIN2 and 12 CIN1. For each gene, there was increasing frequency of methylation from normal and LSIL (CIN1), through HSIL (CIN2 and CIN3), to SCC. Methylation of ≥1 of genes investigated was observed in 88% of combined HSIL (CIN2 and CIN3) and SCC cases. All genes showed significant increase in methylation level (PMR value) with increasing disease grade (p<0.005). CCNA1 was the only gene that was able to distinguish CIN2 from CIN3 specimens (p=0.016). Based on receiver operating characteristic (ROC) analysis, HS3ST2 was the most significant candidate in segregating HSIL/SCC from normal/LSIL cases (p<0.0001); at an optimal cutoff value, sensitivity and specificity between 70% and 80% were obtained. CONCLUSIONS: Development of DNA methylation status of a gene panel to improve diagnostic accuracy in cervical neoplasia is warranted.
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Metilação de DNA , Displasia do Colo do Útero/genética , Proteínas Reguladoras de Apoptose/genética , Proteínas Quinases Dependentes de Cálcio-Calmodulina/genética , Carcinoma de Células Escamosas/genética , Carcinoma de Células Escamosas/patologia , Ciclina A1/genética , Proteínas Quinases Associadas com Morte Celular , Feminino , Glicoproteínas/genética , Humanos , Modelos Logísticos , Fatores de Transcrição Box Pareados/genética , Fatores de Risco , Sulfotransferases/genética , Displasia do Colo do Útero/patologia , Neoplasias do Colo do Útero/genética , Neoplasias do Colo do Útero/patologiaRESUMO
Alterations in the blood brain barrier and brain vasculature may be involved in neurodegeneration and neuroinflammation. We sought to determine if vascular remodeling characterized by angiogenic vessels or increased vascular density, occurred in pathologically confirmed Alzheimer's disease (AD) postmortem human brain tissues. We examined brains of deceased, older catholic clergy from the Religious Order Study, a longitudinal clinical-pathological study of aging and AD. The hippocampus, midfrontal cortex, substantia nigra, globus pallidus and locus ceruleus were examined for integrin alphavbeta3 immunoreactivity, a marker of angiogenesis, and vascular densities. Activated microglia cell counts were also performed. All areas except the globus pallidus exhibited elevated alphavbeta3 immunoreactivity in AD cases compared with controls. Only in the hippocampus did the ongoing angiogenesis result in increased vascular density compared with controls. Vascular density was correlated with Abeta load in the hippocampus and alphavbeta3 reactivity was correlated with neurofibrillary tangles in the midfrontal cortex and in the substantia nigra. These data indicate that ongoing angiogenesis is present in brain regions affected by AD pathology and may be related to tissue injury.
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Doença de Alzheimer/patologia , Encéfalo/patologia , Artérias Cerebrais/patologia , Neovascularização Patológica/patologia , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/metabolismo , Doença de Alzheimer/fisiopatologia , Peptídeos beta-Amiloides/análise , Peptídeos beta-Amiloides/metabolismo , Arteríolas/metabolismo , Arteríolas/patologia , Arteríolas/fisiopatologia , Biomarcadores/análise , Biomarcadores/metabolismo , Barreira Hematoencefálica/metabolismo , Barreira Hematoencefálica/patologia , Barreira Hematoencefálica/fisiopatologia , Encéfalo/irrigação sanguínea , Encéfalo/fisiopatologia , Mapeamento Encefálico , Contagem de Células , Artérias Cerebrais/metabolismo , Artérias Cerebrais/fisiopatologia , Progressão da Doença , Encefalite/metabolismo , Encefalite/patologia , Encefalite/fisiopatologia , Feminino , Gliose/metabolismo , Gliose/patologia , Gliose/fisiopatologia , Humanos , Imuno-Histoquímica , Integrina alfaVbeta3/análise , Integrina alfaVbeta3/metabolismo , Masculino , Microcirculação/fisiologia , Microglia/patologia , Neovascularização Patológica/metabolismo , Neovascularização Patológica/fisiopatologiaRESUMO
At present, artificial vertebral implants have proven to be effective in the treatment of spinal tumors, infections, fractures and other diseases. However, the fusion artificial vertebral body can cause adjacent intervertebral joint degeneration and loss of original physiological curvature and activity. The movable artificial vertebral body can, to some extent, restore the normal physiological movement and reduce biomechanical changes of the spine, reducing the occurrence of complication. The design of movable artificial vertebral body is to equip movable device when the basis of reliable stability is obtained. According to its principle it can be divided into ball socket joint or elastic deformation. However the overall design of movable artificial vertebral body needs further improvement. Traditional mechanical processing methods are difficult to process complex prostheses and the agreement rate between traditional produced prostheses and lesions was low. While the emerging 3D printing technology can achieve individualized improvement of prosthesis, its slow rate and high cost need to be improved. The materials of movable artificial vertebral body includes metal, ceramics, biomaterials, high polymer materials and so on. Titanium alloy is the main material in metal materials, which is widely used, but its modulus of elasticity is still far from that of human bone and it lacks ideal bone fusion. Ceramic materials are rich in variety but fragile and poor in wear resistance. Biomaterials include autogenous bone, allogeneic bone, etc., with limited source and complicated operation. There are many kinds of polymer and biodegradable materials which obtain excellent and ideal properties. But their properties and applications need to be further studied. The movable artificial vertebral body still needs to be promoted and developed. The clinical experimental data is still insufficient, and long-term curative effect needs to be further observed and studied. This paper reviews the development, advantages, design, processing and materials of movable artificial vertebral bodies and provides useful reference for optimization design, processing and clinical application of movable artificial vertebral bodies.
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Coluna Vertebral , Materiais Biocompatíveis , Fenômenos Biomecânicos , Humanos , Próteses e Implantes , Neoplasias da Coluna Vertebral , TitânioRESUMO
Cervical cancer is a major cause of mortality in females worldwide, with the majority of cases reported in developing countries. The molecular mechanisms of this disease are unclear. However, increasing evidence indicates that the expression or overexpression of Girdin is associated with a poor prognosis in a variety of cancer types. Therefore, the aim of the current study was to evaluate the potential association between Girdin expression, and malignant properties of cervical cancer lesions and HeLa cells. Girdin protein expression was examined in 87 samples of cervical squamous cell lesions, including intraepithelial neoplasia (grades I and III) and invasive carcinoma, using immunohistochemical (IHC) staining. A short-hairpin RNA (shRNA) approach was employed to specifically suppress the expression of Girdin mRNA in HeLa cells in vitro, allowing the role of Girdin in a number of malignant properties to be evaluated. Girdin protein was observed in the cytoplasm of 79/87 (90.8%) cervical cancer lesion specimens. However, no positive Girdin signals were identified in healthy cervical squamous epithelium samples. Furthermore, a significant correlation between Girdin expression and lesion grade was identified (Spearman's correlation coefficient, 0.566; P<0.001). When Girdin was suppressed by Girdin shRNA, the rate of HeLa cell growth was significantly reduced in vitro (P<0.05). Additional analysis determined that Girdin was associated with serum-deprived induced HeLa apoptosis. Thus, patients with high-grade cervical cancer tumors exhibited a strong expression for Girdin, and Girdin appears to key in HeLa cell proliferation and serum-deprived induced apoptosis, supporting the hypothesis that Girdin may be important in the process of cervical carcinogenesis.
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BACKGROUND: Somatosensory evoked potential (SSEP) monitoring is performed to examine postoperative clinical findings when a monitoring event was noted intraoperatively and to ascertain the alarm threshold for intraoperative neural damage. METHODS: The tibial SSEP of both lower limbs was recorded intraoperatively in patients with idiopathic scoliosis. Change of SSEP amplitude as opposed to the baseline was categorized into 4 levels: decrease <40%, decrease of 40%-50%, decrease of 50%-60%, and decrease >60%. Postoperative neurologic function of patients was examined and compared with SSEP data. RESULTS: The baseline amplitude before incision was significantly different from the amplitude after spine exposure. An amplitude reduction of >60% during scoliosis correction procedures was observed in 6 legs, and 4 of them had postoperative deterioration in motor status. As the measure of threshold for alarm, an amplitude reduction of >50% compared with baseline resulted in more false-positive outcomes compared with amplitude attenuation of >60%. CONCLUSIONS: Compared with the traditional SSEP baseline before skin incision, the baseline acquired after spine exposure results in more accurate monitoring. A >60% decrease in SSEP amplitude could be a more suitable alarm threshold.
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Potenciais Somatossensoriais Evocados/fisiologia , Monitorização Intraoperatória/métodos , Escoliose/fisiopatologia , Escoliose/cirurgia , Fusão Vertebral/métodos , Adolescente , Adulto , Criança , Feminino , Humanos , Estudos Longitudinais , Masculino , Estudos Retrospectivos , Sensibilidade e Especificidade , Medula Espinal/cirurgia , Adulto JovemRESUMO
OBJECTIVE: To investigate the clinical features, diagnosis and treatment in patients with subclinical pituitary adenoma apoplexy (SPAA). METHODS: A retrospective analysis of all operated patients with SPAA was performed. There were 50 male and 80 female patients, ranging from 16 to 65 years (average 39 years). Endocrinological hormones were measured in all patients pre- and post-operatively, and pituitary imaging was obtained by CT scan, MRI or both. RESULTS: Transsphenoidal surgery was achieved in 89 patients, and transcranial surgery was achieved in 41 patients. There was no operative mortality. PRL adenomas were the most common tumor type (56.2%). SPAA usually occurred in patients with big or giant adenomas (97%). Hypertension and diabetes mellitus were the possible predisposing factors. Postoperative follow-up ranged from 0.5 to 6 years (mean 3.2 years). Tumor recurrence happened in 8 patients. Only 12 patients required radiotherapy with tumor residual (4 cases) and recurrence (8 cases) after surgery. Long-term thyroid or steroid hormone replacement was necessary in 25% and 20% of patients, respectively, and long-term desmopressin therapy was necessary in 1% of patients. CONCLUSIONS: The incidence of SPAA was higher than acute pituitary apoplexy. PRL adenomas are the most common tumor type. MRI is the best investigative modality of choice. Transsphenoidal surgery is a safe and effective method. The rate of long-term endocrinological hormones replacement therapy of SPAA is lower than acute pituitary apoplexy, and the prognosis of SPAA is better than acute pituitary apoplexy. Radiotherapy is indicated if the tumor residual or recurrence are confirmed by CT or MRI after surgery.
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Adenoma/diagnóstico , Adenoma/terapia , Apoplexia Hipofisária/diagnóstico , Apoplexia Hipofisária/terapia , Neoplasias Hipofisárias/diagnóstico , Neoplasias Hipofisárias/terapia , Adenoma/complicações , Adolescente , Adulto , Idoso , Terapia Combinada , Feminino , Terapia de Reposição Hormonal , Humanos , Hipofisectomia/métodos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Apoplexia Hipofisária/etiologia , Neoplasias Hipofisárias/complicações , Estudos Retrospectivos , Resultado do TratamentoRESUMO
Platelets are key players in fundamental processes of vascular biology, such as angiogenesis, tissue regeneration, and tumor metastasis. However, the underlying mechanisms remain unclear. In this study, some tumor vascular endothelial cells were positively stained by antiplatelet antibodies. Further investigation revealed that platelets were taken up by endothelial cells in vitro and in vivo. Human umbilical vascular endothelial cells were rendered apoptotic under conditions of serum deprivation. However, endothelial apoptosis was suppressed and cell viability was enhanced when platelets were added to the cultures. Endothelial survival was paralleled by an upregulation of phosphorylated Akt and p70 S6K. In conclusion, this study demonstrated that platelets can be phagocytosed by endothelial cells, and the phagocytosed platelets could suppress endothelial apoptosis and promote cell viability level. The mechanism underlying this process involves the activation of Akt signaling.
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Plaquetas , Células Endoteliais/metabolismo , Neovascularização Patológica/fisiopatologia , Fagocitose/fisiologia , Transdução de Sinais/fisiologia , Animais , Apoptose/fisiologia , Western Blotting , Carcinoma Ductal Pancreático/patologia , Comunicação Celular , Sobrevivência Celular/fisiologia , Técnicas de Cocultura , Imunofluorescência , Humanos , Imuno-Histoquímica , Camundongos , Microscopia Eletrônica de Transmissão , Neoplasias Pancreáticas/patologia , Proteínas Proto-Oncogênicas c-akt/metabolismo , Veias UmbilicaisRESUMO
Based on the primary tumor site, liver cancer can be divided into two categories: (1) primary liver cancer and (2) metastatic cancer to the liver from a distant primary site. Guided cryoablation via many imaging methods induces iceball formation and tumor necrosisand is an attractive option for treating unresectable hepatocellular carcinoma (HCC) and metastatic liver cancer. There are several advantages to using cryoablation for the treatment of liver cancer: it can be performed percutaneously, intraoperatively, and laparoscopically; iceball formation can be monitored; it has little impact on nearby large blood vessels; and it induces a cryo-immunological response in situ. Clinically, primary research has shown that percutaneous cryoablation of liver cancer is relatively safe and efficient, and it can be combined with other methods, such as radiation therapy, chemotherapy, and immunology, to control disease. Although research is preliminary, cryosurgery is fast becoming an alternative treatment method for HCC or liver tumors. Here, we review the mechanisms of liver tumor cryoablation, cryoablation program selection, clinical efficiency, and complications following treatment.
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BACKGROUND: Clinical practice guidelines recommend objective nutritional assessments in managing chronic kidney disease (CKD) patients but were developed while referencing to a North-American population. Specific recommendations for assessing muscle mass were suggested (mid-arm circumference, MAC; corrected mid-arm muscle area, cAMA; mid-arm muscle circumference, MAMC). This study aimed to assess correlation and association of these assessments with dietary protein intake in a multi-ethnic Asian population of healthy and CKD patients. METHODS: We analyzed 24-hour urine collections of selected participants to estimate total protein intake (TPI; g/day). Ideal body weight (IDW; kg) was calculated and muscle assessments conducted. Analyses involved correlation and linear regression, taking significance at p<0.05. RESULTS: There were 232 stable CKD patients and 103 healthy participants comprising of 51.0% male, 38.5% Chinese, 29.6% Malay, 23.6% Indian, and 8.4% others. The mean TPI was 58.9 ± 18.4 g/day in healthy participants and 53.6 ± 19.4 g/day in CKD patients. When normalized to ideal body weight, TPI-IDW (g/kg/day) was similar in healthy and CKD participants. Overall, TPI was associated with MAC (r=0.372, p<0.001), cAMA (r=0.337, p<0.001), and MAMC (r=0.351, p<0.001). TPI-IDW was also associated with MAC (r=0.304, p<0.001), cAMA (r=0.202, p<0.001), and MAMC (r=0.200, p<0.001) but not for TPI normalized to actual body weight. When examined separately, TPI was associated with MAC, cAMA, and MAMC in both CKD and healthy participants, but was associated with TPI-IDW only in CKD patients. CONCLUSION: Total protein intake was associated with muscle assessments in all participants. TPI normalized to IDW should only be used in CKD patients.
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Proteínas Alimentares/administração & dosagem , Etnicidade , Músculos/patologia , Adulto , Idoso , Antropometria , Braço , Índice de Massa Corporal , Peso Corporal , China/etnologia , Feminino , Humanos , Índia/etnologia , Malásia/etnologia , Masculino , Pessoa de Meia-Idade , Avaliação Nutricional , Insuficiência Renal CrônicaRESUMO
AIM: To retrospectively assess the effect of comprehensive cryosurgery (ablation of intra- and extra-hepatic tumors) plus dendritic cell-cytokine-induced killer cell immunotherapy in metastatic hepatocellular cancer. METHODS: We divided 45 patients into cryo-immunotherapy (21 patients), cryotherapy (n = 12), immunotherapy (n = 5) and untreated (n = 7) groups. Overall survival (OS) after diagnosis of metastatic hepatocellular cancer was assessed after an 8-year follow-up. RESULTS: Median OS was higher following cryo-immunotherapy (32 mo) or cryotherapy (17.5 mo; P < 0.05) than in the untreated group (3 mo) and was higher in the cryo-immunotherapy group than in the cryotherapy group (P < 0.05). In the cryo-immunotherapy group, median OS was higher after multiple treatments (36.5 mo) than after a single treatment (21 mo; P < 0.05). CONCLUSION: Cryotherapy and, especially, cryo-immunotherapy significantly increased OS in metastatic hepatocellular cancer patients. Multiple cryo-immunotherapy was associated with a better prognosis than single cryo-immunotherapy.
Assuntos
Carcinoma Hepatocelular/terapia , Criocirurgia , Células Dendríticas/transplante , Imunoterapia Adotiva , Neoplasias Hepáticas/terapia , Adulto , Idoso , Carcinoma Hepatocelular/imunologia , Carcinoma Hepatocelular/mortalidade , Carcinoma Hepatocelular/secundário , Células Cultivadas , Técnicas de Cocultura , Terapia Combinada , Criocirurgia/efeitos adversos , Criocirurgia/mortalidade , Citocinas/imunologia , Células Dendríticas/imunologia , Feminino , Humanos , Imunoterapia Adotiva/efeitos adversos , Imunoterapia Adotiva/mortalidade , Estimativa de Kaplan-Meier , Células Matadoras Naturais/imunologia , Neoplasias Hepáticas/imunologia , Neoplasias Hepáticas/mortalidade , Neoplasias Hepáticas/patologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Tempo , Resultado do TratamentoRESUMO
We review a few popular statistical models for correlated binary outcomes, present maximum likelihood estimates for the model parameters, and discuss model selection issues using a variety of goodness-of-fit test statistics. We apply bootstrap strategies that are computationally efficient to evaluate the performance of goodness-of-fit statistics and observe that generally the power and the type I error rate of the goodness-of-fit statistics depend on the model under investigation. Our simulation results show that careful choice of goodness-of-fit statistics is an important issue especially when we have a small sample and the outcomes are highly correlated. Two biomedical applications are included.