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1.
BMC Cancer ; 23(1): 797, 2023 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-37718392

RESUMO

BACKGROUND: We aimed to analyze the benefit of adjuvant chemotherapy in high-risk stage II colon cancer patients and the impact of high-risk factors on the prognostic effect of adjuvant chemotherapy. METHODS: This study is a multi-center, retrospective study, A total of 931 patients with stage II colon cancer who underwent curative surgery in 8 tertiary hospitals in China between 2016 and 2017 were enrolled in the study. Cox proportional hazard model was used to assess the risk factors of disease-free survival (DFS) and overall survival (OS) and to test the multiplicative interaction of pathological factors and adjuvant chemotherapy (ACT). The additive interaction was presented using the relative excess risk due to interaction (RERI). The Subpopulation Treatment Effect Pattern Plot (STEPP) was utilized to assess the interaction of continuous variables on the ACT effect. RESULTS: A total of 931 stage II colon cancer patients were enrolled in this study, the median age was 63 years old (interquartile range: 54-72 years) and 565 (60.7%) patients were male. Younger patients (median age, 58 years vs 65 years; P < 0.001) and patients with the following high-risk features, such as T4 tumors (30.8% vs 7.8%; P < 0.001), grade 3 lesions (36.0% vs 22.7%; P < 0.001), lymphovascular invasion (22.1% vs 6.8%; P < 0.001) and perineural invasion (19.4% vs 13.6%; P = 0.031) were more likely to receive ACT. Patients with perineural invasion showed a worse OS and marginally worse DFS (hazardous ratio [HR] 2.166, 95% confidence interval [CI] 1.282-3.660, P = 0.004; HR 1.583, 95% CI 0.985-2.545, P = 0.058, respectively). Computing the interaction on a multiplicative and additive scale revealed that there was a significant interaction between PNI and ACT in terms of DFS (HR for multiplicative interaction 0.196, p = 0.038; RERI, -1.996; 95%CI, -3.600 to -0.392) and OS (HR for multiplicative interaction 0.112, p = 0.042; RERI, -2.842; 95%CI, -4.959 to -0.725). CONCLUSIONS: Perineural invasion had prognostic value, and it could also influence the effect of ACT after curative surgery. However, other high-risk features showed no implication of efficacy for ACT in our study. TRIAL REGISTRATION: This study is registered on ClinicalTrials.gov, NCT03794193 (04/01/2019).


Assuntos
Neoplasias do Colo , Humanos , Masculino , Pessoa de Meia-Idade , Feminino , Estudos Retrospectivos , Neoplasias do Colo/tratamento farmacológico , Neoplasias do Colo/cirurgia , Fatores de Risco , Interpretação Estatística de Dados , Quimioterapia Adjuvante
2.
BMC Gastroenterol ; 23(1): 57, 2023 Mar 08.
Artigo em Inglês | MEDLINE | ID: mdl-36890451

RESUMO

BACKGROUND: Enteric fistula is one of the penetrating features in Crohn's disease (CD). This study aimed to clarify the prognostic factors for the efficacy of infliximab (IFX) treatment in luminal fistulizing CD patients. METHODS: We retrospectively included 26 cases diagnosed with luminal fistulizing CD hospitalized in our medical center from 2013 to 2021. The primary outcome of our research was defined as death from all causes and undergoing of any relevant abdominal surgery. Kaplan-Meier survival curves were used to describe overall survival. Univariate and multivariate analyses were used to identify prognostic factors. A predictive model was constructed using Cox proportional hazard model. RESULTS: The median follow-up time was 17.5 months (range 6-124 months). The 1- and 2-year surgery-free survival rates were 68.1% and 63.2%, respectively. In the univariate analysis, the efficacy of IFX treatment at 6 months after initiation (P < 0.001, HR 0.23, 95% CI 0.01-0.72) and the existence of complex fistula (P = 0.047, HR 4.11, 95% CI 1.01-16.71) was found significantly related to the overall surgery-free survival, while disease activity at baseline (P = 0.099) also showed predictive potential. The multivariate analysis showed that efficacy at 6 months (P = 0.010) was an independent prognostic factor. The C-index of the model for surgery-free survival was 0.923 (P < 0.001), indicating an acceptable predictive effect. CONCLUSION: Prognostic model including the existence of complex fistula, disease activity at baseline and efficacy of IFX at 6 months may be useful to predict long-term outcome of luminal fistulizing CD patients.


Assuntos
Doença de Crohn , Fístula , Humanos , Infliximab/uso terapêutico , Doença de Crohn/complicações , Doença de Crohn/tratamento farmacológico , Doença de Crohn/cirurgia , Anticorpos Monoclonais , Estudos Retrospectivos , Prognóstico , Fármacos Gastrointestinais/uso terapêutico , Resultado do Tratamento , Fístula/tratamento farmacológico , Fístula/etiologia
3.
J Minim Access Surg ; 16(2): 152-159, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-30416141

RESUMO

Context: Retrorectal tumours are rare with developmental cysts being the most common type. Conventionally, large retrorectal developmental cysts (RRDCs) require the combined transabdomino-sacrococcygeal approach. Aims: This study aims to investigate the surgical outcomes of the laparoscopic approach for large RRDCs. Settings and Design: A retrospective case series analysis. Subjects and Methods: Data of patients with RRDCs of 10 cm or larger in diameter who underwent the laparoscopic surgery between 2012 and 2017 at our tertiary centre were retrospectively analyzed. Statistical Analysis Used: Results are presented as median values or mean ± standard deviation for continuous variables and numbers (percentages) for categorical variables. Results: Twenty consecutive cases were identified (19 females; median age, 36 years). Average tumour size was 10.9 ± 1.1 cm. Cephalic ends of lesions ranged from S1/2 junction to S4 level. Caudally, 18 cysts extended to the sacrococcygeal hypodermis. Seventeen patients underwent the pure laparoscopy; three patients received a combined laparoscopic-posterior approach. The operating time was 167.1 ± 57.3 min for the pure laparoscopic group and 212.0 ± 24.5 min for the combined group. The intraoperative haemorrhage was 68.2 ± 49.7 and 66.7 ± 28.9 (mL), respectively. Post-operative complications included one trocar site hernia, one wound infection and one delayed rectal wall perforation. The median post-operative hospital stay was 7 days. With a median follow-up period of 36 months, 1 lesions recurred. Conclusions: The laparoscopic approach can provide a feasible and effective alternative for large RRDCs, with advantages of the minimally invasive surgery. For lesions with ultra-low caudal ends, especially those closely clinging to the rectum, a combined posterior approach is still necessary.

4.
BMC Gastroenterol ; 19(1): 61, 2019 Apr 25.
Artigo em Inglês | MEDLINE | ID: mdl-31023233

RESUMO

BACKGROUND: Ulcerative colitis (UC)-related post-colectomy enteritis is a very rare condition that is characterized by diffuse small-bowel mucosal inflammation following colectomy and could be very dangerous. In previously reported cases, corticosteroid therapy seemed to be the optimal choice for inducing remission; however, the patient studied herein presented with severe diarrhoea and hypovolemic shock and failed to achieve full remission with corticosteroid therapy. CASE PRESENTATION: We describe the case of a patient with severe pan-enteritis presenting with life-threatening diarrhoea complicated with hypovolemic shock and acute kidney injury after colectomy and ileal pouch anal anastomosis (IPAA) for UC; this patient was successfully treated by ileostomy closure after failing to achieve full remission with corticosteroid therapy. Next, we review other cases of post-colectomy enteritis reported in the literature and propose a flow-chart for its diagnosis and initial treatment. CONCLUSION: Post-colectomy enteritis can be dangerous, and the early awareness of this condition plays a vital role. Additionally, in patients who do not respond well to corticosteroid or immunosuppressant therapy, early closure of the ileostomy and re-establishment of the natural faecal stream could be important considerations.


Assuntos
Colite Ulcerativa/cirurgia , Enterite/etiologia , Proctocolectomia Restauradora/efeitos adversos , Injúria Renal Aguda/etiologia , Colite Ulcerativa/tratamento farmacológico , Diarreia/etiologia , Enterite/tratamento farmacológico , Enterite/cirurgia , Feminino , Glucocorticoides/uso terapêutico , Humanos , Ileostomia , Pessoa de Meia-Idade , Complicações Pós-Operatórias/tratamento farmacológico , Complicações Pós-Operatórias/cirurgia , Prednisona/uso terapêutico , Choque/etiologia
5.
Minim Invasive Ther Allied Technol ; 28(3): 135-142, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30688139

RESUMO

BACKGROUND: The purpose of this meta-analysis is to evaluate the evidence available on the safety as well as effectiveness of robotic resection as compared to conventional laparoscopic surgery for rectal cancer. MATERIAL AND METHODS: A comparison of laparoscopic and robotic surgical treatments for rectal cancer was collected. Eligible trials that analyzed probabilistic hazard ratios (HR) for endpoints of interest (including perioperative morbidity) and postoperative complications were included in our review. RESULTS: A total of six studies were included based on the present inclusion criteria. The pooled data showed that R-TME appeared to have association with remarkable reduction in the postoperative morbidity rate as compared to L-TME. Moreover, R-TME was also linked to lower conversion, decreased lymph node number, and longer operation time compared with L-TME. However, there was no difference in hospital stay, positive range of circumferential resection and blood loss between the two study groups. CONCLUSIONS: Robotic rectal cancer surgery provides favorable outcomes and is considered as a safe surgical technique in terms of postoperative oncological safety. Like laparoscopic TME surgery, robotic surgery may be a valid alternative and complementary approach with beneficial effects on minimally-invasive surgery.


Assuntos
Laparoscopia/métodos , Neoplasias Retais/cirurgia , Procedimentos Cirúrgicos Robóticos/métodos , Humanos , Tempo de Internação , Linfonodos/patologia , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Duração da Cirurgia , Complicações Pós-Operatórias/etiologia , Resultado do Tratamento
6.
Curr Microbiol ; 74(12): 1389-1393, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28840359

RESUMO

The Gram-stain-negative, rod-shaped and non-motile bacterial strain, designated ZGLJ7-1T, was isolated from a pit mud. Phylogenetic analysis based on 16S rRNA gene sequence showed that strain ZGLJ7-1T was related to the genus Lysobacter and had the highest 16S rRNA gene sequence similarity with the type strain of Lysobacter arseniciresistens ZS79T (97.4%). The predominant cellular fatty acids were iso-C15:0, iso-C17:1ω9c, iso-C11:0 and iso-C11:03-OH. Strain ZGLJ7-1T had Q-8 as the predominant ubiquinone. The polar lipid profile contained diphosphatidylglycerol, phosphatidylglycerol, phosphatidylethanolamine, one unidentified phospholipid, two unidentified aminolipids and two unidentified lipids. The genomic DNA G+C content of strain ZGLJ7-1T was 69.5 mol%. Strain ZGLJ7-1T shared DNA relatedness with 35% Lysobacter arseniciresistens CGMCC 1.10752T. Combined data from phenotypic, phylogenetic and DNA-DNA relatedness studies demonstrated that the strain ZGLJ7-1T is a representative of a novel species of the genus Lysobacter, for which we propose the name Lysobacter zhanggongensis sp. nov. (type strain ZGLJ7-1T = KACC 18547T = CGMCC 1.15404T).


Assuntos
Lysobacter/classificação , Lysobacter/isolamento & purificação , Microbiologia do Solo , Composição de Bases , Análise por Conglomerados , Citosol/química , DNA Bacteriano/química , DNA Bacteriano/genética , DNA Ribossômico/química , DNA Ribossômico/genética , Ácidos Graxos/análise , Locomoção , Lysobacter/genética , Lysobacter/fisiologia , Microscopia Eletrônica de Varredura , Hibridização de Ácido Nucleico , Fosfolipídeos/análise , Filogenia , Quinonas/análise , RNA Ribossômico 16S/genética , Análise de Sequência de DNA
7.
Int J Colorectal Dis ; 31(6): 1163-8, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-27044403

RESUMO

OBJECTIVES: According to practice guidelines, adjuvant chemotherapy (ACT) is required for all patients with locally advanced rectal cancer who have received neoadjuvant chemoradiotherapy (NCRT) and total mesorectal excision (TME). The objective of this study was to determine whether ACT is necessary for patients achieving pathological complete response (pCR) after NCRT followed by surgery. METHODS: By retrospectively reviewing a prospectively collected database in our single tertiary care center, 210 patients with locally advanced rectal cancer who underwent NCRT followed by TME were identified between February 2005 and August 2013. All patients achieving ypCR were enrolled in this study, in which who underwent ACT (chemo group) and who did not (non-chemo group) were compared in terms of local recurrence (LR) rate, 5-year disease-free survival (DFS) rate and overall survival (OS) rate. RESULTS: Forty consecutive patients with ypCR were enrolled, 19 (47.5 %) in chemo group and 21 (52.5 %) in non-chemo group. After a median follow-up of 57 months, five patients developed systemic recurrences, with the 5y-DFS rate of 83.5 %. No LR occurred in the two groups. The 5y-DFS rates for patients in chemo group and non-chemo group was 90.9 and 76.0 %, respectively, showing no statistically significant difference (p = 0.142). Multivariate analysis showed that tumor grade was the only independent prognostic factor for 5y-DFS and 5y-OS. CONCLUSIONS: Results of this study suggested that it may not be necessary for all rectal cancer patients with ypCR after NCRT and radical surgery to receive ACT. Prospective randomized trials are warranted to further determine the value of ACT for ypCR patients.


Assuntos
Quimiorradioterapia , Terapia Neoadjuvante , Neoplasias Retais/patologia , Neoplasias Retais/terapia , Adolescente , Adulto , Idoso , Quimioterapia Adjuvante , Intervalo Livre de Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Neoplasias Retais/cirurgia , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
8.
Eye Contact Lens ; 42(3): 196-201, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-27078614

RESUMO

PURPOSE: We investigated the relationship between tear menisci and corneal subbasal nerve density (SND) in long-term soft contact lens (CL) wearers. METHODS: Three groups were enrolled for this study: asymptomatic non-CL controls (N-CL group), asymptomatic soft CL wearers (A-CL group), and symptomatic soft CL wearers with self-reported moderate to severe dryness (S-CL group). Upper and lower tear menisci height (UTMH, LTMH) and area (UTMA, LTMA) were measured by optical coherence tomography. This was followed by measurements of fluorescein tear breakup time, fluorescein staining, and the Schirmer I test. In vivo confocal microscopy measured the SND in the nasal, central, and temporal regions of the cornea. RESULTS: The UTMH, UTMA, LTMH, and LTMA were significantly lower in the S-CL group compared with the N-CL group (P<0.05). The combined corneal SND of the temporal and nasal regions of the S-CL group was lower than for the N-CL group (P<0.05). The LTMH was correlated with the SND of the temporal (r=0.410), nasal (r=0.423), combined temporal and nasal (r=0.516), and combined temporal, nasal, and central regions (r=0.430, all P<0.01). The LTMA was also correlated with the SND of the temporal (r=0.379), nasal (r=0.292), combined temporal and nasal (r=0.422), and combined temporal, nasal, and central regions (r=0.367, all P<0.05). The temporal and nasal corneal SNDs were more strongly correlated with the LTMH and LTMA than with the UTMH and UTMA. CONCLUSIONS: Soft CL wearers with dry eye symptoms have reduced tear menisci. The alteration of midperipheral corneal SND may contribute to dry eye symptoms.


Assuntos
Lentes de Contato Hidrofílicas , Córnea/inervação , Síndromes do Olho Seco/fisiopatologia , Erros de Refração/terapia , Lágrimas/fisiologia , Nervo Trigêmeo/patologia , Adulto , Feminino , Fluoresceína/administração & dosagem , Corantes Fluorescentes/administração & dosagem , Fluorofotometria , Humanos , Masculino , Microscopia Confocal , Erros de Refração/fisiopatologia , Coloração e Rotulagem , Lágrimas/química , Tomografia de Coerência Óptica , Adulto Jovem
9.
Zhonghua Yan Ke Za Zhi ; 52(1): 30-5, 2016 Jan.
Artigo em Zh | MEDLINE | ID: mdl-26899218

RESUMO

OBJECTIVE: To investigate the correlations between corneal sensation, tear meniscus volume, and tear film osmolarity after femtosecond laser-assisted LASIK (FS-LASIK) surgery. METHODS: In this prospective clinical study, 31 patients undergoing FS-LASIK for myopia were recruited. The upper and lower tear meniscus volumes (UTMV and LTMV) were measured by customized anterior segment optical coherence tomography, tear film osmolarity was measured by a TearLab Osmolarity test device, central corneal sensation was measured by a Cochet-Bonner esthesiometer preoperatively, at 1 week, 1 and 3 months postoperatively. Repeated measures analysis of variance was used to evaluate whether the tear film osmolarity, tear meniscus volume, and corneal sensation were changed after surgery. The correlations between these variables were analyzed by the Pearson correlation analysis. RESULTS: The tear film osmolarity was (310.03 ± 16.48) mOsms/L preoperatively, (323.51 ± 15.92) mOsms/L at 1 week, (319.93 ± 14.27) mOsms/L at 1 month, and (314.97±12.91) mOsms/L at 3 months. The UTMV was (0.42±0.15), (0.25± 0.09), (0.30±0.11), and (0.35±0.09) µL, respectively; the LTMV was (0.60±0.21),(0.37±0.08), (0.44± 0.14), and (0.52±0.17) µL, respectively. The tear film osmolarity was significantly higher at 1 week and 1 month postoperatively compared with the baseline (P=0.001, 0.004), and reduced to the preoperative level at 3 months (P=0.573). The UTMV, LTMV, and corneal sensation values presented significant decreases at all postoperative time points (all P<0.05). The Pearson correlation analysis showed the postoperative UTMV had a weak relationship with corneal sensation at 1 week after surgery (r=0.356,P=0.005). There were significant correlations between the preoperative LTMV and corneal sensation at 1 week, 1 and 3 months (respectively, r=0.422, 0.366, 0.352;P=0.001, 0.004, 0.006). No significant correlations were found between the tear film osmolarity, tear meniscus volume, and corneal sensation after surgery (all P>0.05). CONCLUSION: The tear film osmolarity, tear meniscus volume, and corneal sensation became aggravated due to the FS-LASIK surgery procedures. There were significant correlations between the preoperative tear meniscus volume and recovery of corneal sensation early after surgery. A higher tear meniscus volume before surgery may contribute to a faster corneal sensation recovery.


Assuntos
Córnea/fisiologia , Ceratomileuse Assistida por Excimer Laser In Situ , Miopia/cirurgia , Sensação , Lágrimas , Análise de Variância , Córnea/química , Humanos , Miopia/fisiopatologia , Concentração Osmolar , Período Pós-Operatório , Estudos Prospectivos , Lágrimas/química , Tomografia de Coerência Óptica
10.
Zhonghua Wai Ke Za Zhi ; 52(11): 826-30, 2014 Nov.
Artigo em Zh | MEDLINE | ID: mdl-25604020

RESUMO

OBJECTIVE: To evaluate the short-term outcomes of laparoscopic extralevator abdominoperineal excision (ELAPE) without changing position during operation. METHODS: Totally 51 patients with distal advanced rectal cancer received surgical operation in Peking Union Midical College Hospital from September 2011 to April 2014. There were 29 male and 22 female patients with a mean age of (61 ± 10) years. Twenty-six percent of the patients received preoperative concomitant chemotherapy and radiation. Twenty-seven patients underwent laparoscopic abdominoperineal excision (APE) procedure, while 24 patients underwent ELAPE procedure. In both groups, patients were kept Lithotomy-Trendelenburg position during operation. The fat tissue in ischialrectal fossa was not routinely removed, except the tumor invasion. All the patients' pelvic peritoneum was closed by continuous suturing, and subcutaneous tissue and skin by interrupted suturing. Retrospectively compare the pathoclinical features, operation time, bleeding, node retrieval, lateral margin and complications by t-text and χ(2) test respectively between ELAPE and APE procedures both by laparoscopic approach. RESULTS: No significant differences were found in term of age, gender, BMI, distance from anal verge, percentage of neoadjuvant chemoradiation, and TNM staging between these two groups (all P > 0.05). The operation time was significantly shorter in ELAPE group ((181 ± 41) minutes vs. (228 ± 58) minutes, t = -3.265, P = 0.002). The bleeding volume was less in ELAPEE group (50 (80) ml vs 80 (100) ml (M(QR)), Z = -2.259, P = 0.024). The lateral margin, urinal retention and perineal wound healing were comparable for these two groups. No pelvic hernia was found during the postoperative follow-up (2 to 34 months) in both groups (all P > 0.05). CONCLUSIONS: Laparoscopic extralevator abdominoperineal excision without changing position is feasible for distal rectal cancer. Some essential steps can be simultaneously accomplished during operation without changing position. Closing the pelvic peritoneum is important for preventing the intestine dropping from abdominal cavity to presacral cavity.


Assuntos
Abdome/cirurgia , Procedimentos Cirúrgicos do Sistema Digestório/métodos , Laparoscopia , Períneo/cirurgia , Neoplasias Retais/cirurgia , Idoso , Canal Anal , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Duração da Cirurgia , Pelve/cirurgia , Neoplasias Retais/patologia , Estudos Retrospectivos , Resultado do Tratamento
11.
Zhonghua Wai Ke Za Zhi ; 52(4): 249-53, 2014 Apr.
Artigo em Zh | MEDLINE | ID: mdl-24924567

RESUMO

OBJECTIVE: To investigate the feasibility of laparoscopic approach for totally mesocolic resection and D3 lymphadenectomy in right colectomy. METHODS: A retrospective study was conducted to analyze the operating time, blood loss, lymph node retrieval, postoperative complications and converting rate. The relationships of 3-year disease-free survival (DFS), 3-year overall survival (OS) to gender, age, American Society of Anesthesiologists (ASA) score, body mass index (BMI), T-staging, N-staging and TNM classification were also analyzed by Kaplan-Meier surviving curve and Log-rank test. RESULTS: A total of 111 patients were enrolled in present study. There were 50 male and 61 female patients. The average operating time was (168 ± 42) minutes, blood loss was (81 ± 63) ml, lymph node retrieval was (30 ± 12). The converting rate to open surgery was 1.8%. There was no death within 30 days after operation. The 3-year DFS and 3-year OS was 86.5% and 93.7% respectively. The short-term complications occurred in 17.1% of the patients, including diarrhea (7 cases), ileus (3 cases), urinary infection (3 cases), wound dehiscence (2 cases) and so on. With the T staging progress, DFS and OS in patients showed a gradual decline, but the difference did not reach statistical significance (P > 0.05). TNM classification had relation to DFS (χ(2) = 6.985, P = 0.030), while N-staging showed significant relations both to DFS and OS (χ(2) = 14.397, P = 0.001; χ(2) = 16.699, P = 0.000). CONCLUSION: Laparascopic approach to right hemicolectomy with complete mesocolic resection and D3 lymphadenectomy is safe and has satisfied oncological outcome.


Assuntos
Colectomia/métodos , Neoplasias do Colo/cirurgia , Excisão de Linfonodo , Idoso , Intervalo Livre de Doença , Feminino , Humanos , Laparoscopia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento
12.
Eur J Ophthalmol ; 34(2): 574-582, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38099818

RESUMO

PURPOSE: To describe a stromal lenticule rotation surgical technique to correct mixed astigmatism and evaluate the initial clinical outcomes of this innovative approach. METHODS: This retrospective case series included five eyes from five patients with mixed astigmatism that underwent intrastromal lenticule rotation surgery. The eyes were evaluated for uncorrected visual acuity, corrected distance visual acuity, manifest refraction, central corneal thickness, corneal volume, anterior and posterior K readings, and corneal higher order aberrations (HOAs) (including total HOAs, spherical aberrations, coma, and trefoil) using the Scheimpflug-Placido topographer before and 3 months after surgery. The corneal epithelium and stroma were imaged using anterior segment optical coherence tomography (AS-OCT) postoperatively. A paired-sample t-test was used to analyse the data. RESULTS: Clinical improvement was found in the uncorrected distance visual acuity (0.64 ± 0.11 logMAR vs. 0.20 ± 0.17 logMAR) and spherical and cylindrical diopters (D) (+2.65 ± 1.32 D vs. -0.05 ± 0.51 D and -4.95 ± 0.94 D vs. -1.10 ± 0.78 D, respectively). Anterior flat keratometry readings showed a steep trend (40.65 ± 1.24 D vs. 42.73 ± 0.63 D). Anterior corneal astigmatism decreased from 4.50 ± 0.55 D to 2.05 ± 0.73 D. According to the AS-OCT images, no significant epithelial remodelling was observed postoperatively. Although no significant differences were found among the increased corneal HOAs, the coma and trefoil changed much more than spherical aberrations 3 months postoperatively. CONCLUSIONS: The results for these five eyes suggest that the autologous stromal lenticule rotation technique is safe and effective; it may be an economical and feasible surgical option for correcting mixed astigmatism.


Assuntos
Astigmatismo , Humanos , Astigmatismo/cirurgia , Refração Ocular , Estudos Retrospectivos , Coma , Topografia da Córnea , Substância Própria/cirurgia
13.
Int J Nanomedicine ; 19: 4045-4060, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38736656

RESUMO

Purpose: Dry eye disease (DED) is a multifactorial ocular surface disease with a rising incidence. Therefore, it is urgent to construct a reliable and efficient drug delivery system for DED treatment. Methods: In this work, we loaded C-dots nanozyme into a thermosensitive in situ gel to create C-dots@Gel, presenting a promising composite ocular drug delivery system to manage DED. Results: This composite ocular drug delivery system (C-dots@Gel) demonstrated the ability to enhance adherence to the corneal surface and extend the ocular surface retention time, thereby enhancing bioavailability. Furthermore, no discernible ocular surface irritation or systemic toxicity was observed. In the DED mouse model induced by benzalkonium chloride (BAC), it was verified that C-dots@Gel effectively mitigated DED by stabilizing the tear film, prolonging tear secretion, repairing corneal surface damage, and augmenting the population of conjunctival goblet cells. Conclusion: Compared to conventional dosage forms (C-dots), the C-dots@Gel could prolong exhibited enhanced retention time on the ocular surface and increased bioavailability, resulting in a satisfactory therapeutic outcome for DED.


Assuntos
Antioxidantes , Carbono , Córnea , Síndromes do Olho Seco , Hidrogéis , Animais , Síndromes do Olho Seco/tratamento farmacológico , Camundongos , Carbono/química , Antioxidantes/química , Antioxidantes/farmacocinética , Antioxidantes/farmacologia , Antioxidantes/administração & dosagem , Hidrogéis/química , Hidrogéis/administração & dosagem , Hidrogéis/farmacocinética , Córnea/efeitos dos fármacos , Sistemas de Liberação de Medicamentos/métodos , Modelos Animais de Doenças , Disponibilidade Biológica , Lágrimas/efeitos dos fármacos , Lágrimas/química , Compostos de Benzalcônio/química , Compostos de Benzalcônio/administração & dosagem , Compostos de Benzalcônio/farmacocinética , Feminino , Masculino , Temperatura , Pontos Quânticos/química
14.
J Hazard Mater ; 465: 133373, 2024 Mar 05.
Artigo em Inglês | MEDLINE | ID: mdl-38159520

RESUMO

The adhesion of high-viscosity oil contamination poses limitations on three-dimensional (3D) materials' practical use in treating oilfield-produced water (OPW). In this study, we developed a hybrid pDA/TiO2/SiO2 coating (PTS) on the surface of hydrophilic activated carbon (ACF1) through a combination of dopamine (DA) polymerization, ethyl orthosilicate (TEOS) hydrolysis, and the condensation of TiO2 nanoparticles (NPs) with SiO2 NPs. This coating was designed for gravity-based oil-water separation. The inherent porosity and generous pore size of ACF1-PTS conferred it an ultra-high permeation flux (pure water flux of 3.72 × 105 L∙m-2∙h-1), allowing it to effectively separate simulated oil-water mixtures and oil-water emulsions while maintaining exceptional permeation flux and oil rejection efficiency. When compared to cleaning methods involving ethanol aqueous solutions and NaClO, ultraviolet (UV) illumination cleaning proved superior, enabling oil-contaminated ACF1-PTS to exhibit remarkable flux recovery efficiency and oil-removal capabilities during cyclic separation of actual OPW. Furthermore, the ACF1-PTS material demonstrated impressive stability and durability when exposed to acidic environments (acid, alkali, and salt), robust hydraulic washout conditions, and 25-cycle tests. This study offers valuable insights and research avenues for the development of highly efficient and environmentally friendly 3D oil-water separation materials for the actual treatment of OPW.

15.
J Inflamm Res ; 17: 387-398, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38264424

RESUMO

Aim: The diagnosis of inflammatory bowel disease (IBD) worldwide is complicated and results in diagnostic delay. However, the diagnostic interval of IBD and the factors associated with diagnostic delay in patients in China have not been determined. Methods: We retrospectively analyzed clinical data of hospitalized IBD patients in Peking Union Medical College Hospital from January 1998 to January 2018. Patients were divided into non-delayed and delayed groups according to their diagnostic interval. Results: A total of 516 and 848 patients were confirmed to have Crohn's disease (CD) and ulcerative colitis (UC), respectively. The median diagnostic intervals were 6 and 20 months in patients with UC and CD, respectively (P<0.05). A decreasing trend in the diagnostic interval for IBD was observed over time, from 9 months to 1 month in UC patients and from 30 months to 3 months in CD patients. The longest diagnostic interval was 29.5 months in CD patients with first symptoms at the age of 51-60 years and 12.5 months in UC patients at the age of 41-50 years. In patients with CD, intestinal obstruction (OR=2.71), comorbid diabetes (OR=4.42), and appendectomy history (OR=2.18) were risk factors for diagnostic delay, whereas having fever as the first symptom may reduce its risk (OR=0.39). In patients with UC, the misdiagnosis of chronic enteritis (OR=2.10) was a risk factor for diagnostic delay. Conclusion: The diagnostic interval for IBD has decreased over the years. Some clinical manifestations, such as initial symptoms and age at symptom onset, may help to shorten this interval. Diseases such as tuberculosis and infectious enteritis should be considered during differentiation.

16.
Viruses ; 15(2)2023 01 31.
Artigo em Inglês | MEDLINE | ID: mdl-36851618

RESUMO

This study focuses on clarifying the regulation of chicken 14-3-3σ protein on the fibrous histiocyte proliferation caused by ALV-J-SD1005 strain infection. DF-1 cells were inoculated with 102 TCID50 of ALV-J-SD1005 strain; the cell proliferation viability was dramatically increased and 14-3-3σ expressions were dramatically decreased within 48 h after inoculation. Chicken 14-3-3σ over-expression could significantly decrease the cell proliferation and the ratio of S-phase cells, but increase the ratio of G2/M-phase cells in ALV-J-infected DF-1 cells; by contrast, chicken 14-3-3σ knockdown expression could cause the opposite effects. Additionally, chicken 14-3-3σ over-expression could also dramatically down-regulate the expressions of CDK2/CDC2, but up-regulate p53 expressions in the DF-1 cells; in contrast, the knockdown expression could significantly increase the expressions of CDK2/CDC2 and decrease p53 expressions. It can be concluded that chicken 14-3-3σ can inhibit cell proliferation and cell cycle by regulating CDK2/CDC2/p53 expressions in ALV-J-infected DF1 cells. ALV-J-SD1005 strain can promote cell proliferation by reducing 14-3-3σ expressions. This study helps to clarify the forming mechanism of acute fibrosarcoma induced by ALV-J infection.


Assuntos
Vírus da Leucose Aviária , Animais , Vírus da Leucose Aviária/genética , Galinhas , Proteína Supressora de Tumor p53/genética , Proliferação de Células , Fibroblastos
17.
Sci Total Environ ; 873: 162376, 2023 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-36828060

RESUMO

The development of the shale oil and gas extraction industry has heightened concerns about shale oil and gas wastewater (SOGW). This review comprehensively summarizes, analyzes, and evaluates multiple issues in SOGW desalination. The detailed analysis of SOGW water quality and various disposal strategies with different water quality standards reveals the water quality characteristics and disposal status of SOGW, clarifying the necessity of desalination for the rational management of SOGW. Subsequently, potential and implemented technologies for SOGW desalination are reviewed, mainly including membrane-based, thermal-based, and adsorption-based desalination technologies, as well as bioelectrochemical desalination systems, and the research progress of these technologies in desalinating SOGW are highlighted. In addition, various pretreatment methods for SOGW desalination are comprehensively reviewed, and the synergistic effects on SOGW desalination that can be achieved by combining different desalination technologies are summarized. Renewable energy sources and waste heat are also discussed, which can be used to replace traditional fossil energy to drive SOGW desalination and reduce the negative impact of shale oil and gas exploitation on the environment. Moreover, real project cases for SOGW desalination are presented, and the full-scale or pilot-scale on-site treatment devices for SOGW desalination are summarized. In order to compare different desalination processes clearly, operational parameters and performance data of varying desalination processes, including feed salinity, water flux, salt removal rate, water recovery, energy consumption, and cost, are collected and analyzed, and the applicability of different desalination technologies in desalinating SOGW is qualitatively evaluated. Finally, the recovery of valuable inorganic resources in SOGW is discussed, which is a meaningful research direction for SOGW desalination. At present, the development of SOGW desalination has not reached a satisfactory level, and investing enough energy in SOGW desalination in the future is still necessary to achieve the optimal management of SOGW.

18.
World Neurosurg X ; 17: 100150, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36419927

RESUMO

Background: Pelvic schwannoma (PS), a type of slow-growing and noninvasive neoplasm that occurs in the pelvis, is relatively rare in adults. However, due to the anatomical structures, surgical excision of the tumors is often difficult using the traditional approach. Methods: Data of patients who underwent laparoscopic excision of PS at our hospital between September 2012 and September 2021 were reviewed. All surgeries were performed in the general surgery department. Clinical data were collected from the inpatient and outpatient medical records. Results: In total, 12 patients (median age, 52 years) underwent laparoscopy for PS without conversion to laparotomy. Eight cases of tumors were located in the presacral space, and the others were found in the lateral wall of the pelvis (N = 4). The median operative time was 145 (range, 70-215) minutes, with a median blood loss of 35 (range, 5-200) mL. Among all cases, 3 patients experienced minor postoperative complications. The median postoperative hospital stay was 4 (range, 2-7) days. Moreover, postoperative pathological examinations showed that all PSs were benign. No patient experienced local recurrence during a median follow-up period of 32 (range, 2-106) months. Conclusions: Our findings indicate that laparoscopic resection of PS is feasible, which has a significant advantage in enhancing the accessibility of pelvic structures and preserving nerve and vascular integrities.

19.
Asia Pac J Clin Oncol ; 19(2): e5-e11, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32199033

RESUMO

INTRODUCTION: This study was to compare the prevalence of stoma-related complications and stoma reversal perioperative complications of patients with low-lying rectal cancer who received preventative loop ileostomy and those who underwent loop transverse colostomy. METHODS: This retrospective single-center study analyzed the clinicopathologic and surgical data of 288 patients with pathologically proven primary rectal cancer who underwent anterior resection with either preventative loop ileostomy (n = 82) or loop transverse colostomy. To achieve comparability of a propensity score matching method was used to match patients from each group in a 1:2 ratio. Determinants of stoma-related complications were analyzed by multivariate logistic regression analysis. RESULTS: Forty-nine (74.3%) patients in the loop ileostomy group experienced stoma-related complications versus 48.7% in the loop transverse colostomy group (P < 0.01). Irritant dermatitis was the most frequent complication in both groups. The loop ileostomy group had a significantly higher rate (24.24%) of stoma reversal perioperative complications than the loop transverse colostomy group. Multivariate logistic regression analysis showed that ileostomy versus loop transverse colostomy was a significant independent risk for stoma-related complications and stoma reversal perioperative complications. Furthermore, by Clavien-Dindo classification, patients receiving loop ileostomy had an overall higher rate of complications and stoma reversal perioperative complications versus those undergoing loop transverse colostomy (P < 0.01). The rate of grade II complications was significantly higher in the loop ileostomy group (43.9%) than that of loop transverse colostomy group (13.5%, P < 0.01), whereas the rate of grade I, and grade IIIa and IIIb complications and stoma reversal perioperative complications was comparable between the two groups. CONCLUSION: The study has demonstrated that loop transverse colostomy is associated with significantly lower rates of stoma-related complications and stoma reversal perioperative complications compared to loop transverse colostomy.


Assuntos
Ileostomia , Neoplasias Retais , Humanos , Ileostomia/efeitos adversos , Ileostomia/métodos , Colostomia/efeitos adversos , Colostomia/métodos , Estudos Retrospectivos , Pontuação de Propensão , Neoplasias Retais/cirurgia , Neoplasias Retais/patologia , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia
20.
ACS Nano ; 17(4): 3901-3912, 2023 Feb 28.
Artigo em Inglês | MEDLINE | ID: mdl-36753692

RESUMO

The physicochemical properties of a semiconductor surface, especially in low-dimensional nanostructures, determine the electrical and optical behavior of the devices. Thereby, the precise control of surface properties is a prerequisite for not only preserving the intrinsic material quality but also manipulating carrier transport behavior for promoting device characteristics. Here, we report a facile approach to suppress the photocorrosion effect while boosting the photoresponse performance of n-GaN nanowires in a constructed photoelectrochemical-type photodetector by employing Co3O4 nanoclusters as a hole charging layer. Essentially, the Co3O4 nanoclusters not only alleviate nanowires from corrosion by optimizing the oxygen evolution reaction kinetics at the nanowire/electrolyte interface but also facilitate an efficient photogenerated carrier separation, migration, and collection process, leading to a significant ease of photocurrent attenuation (improved by nearly 867% after Co3O4 decoration). Strikingly, a record-high responsivity of 217.2 mA W-1 with an ultrafast response/recovery time of 0.03/0.02 ms can also be achieved, demonstrating one of the best performances among the reported photoelectrochemical-type photodetectors, that ultimately allowed us to build an underwater optical communication system based on the proposed nanowire array for practical applications. This work provides a perspective for the rational design of stable nanostructures for various applications in photo- and biosensing or energy-harvesting nanosystems.

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