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1.
J Org Chem ; 88(20): 14619-14633, 2023 Oct 20.
Article in English | MEDLINE | ID: mdl-37789599

ABSTRACT

Construction of pyrrolidinyl-spiroindoles with easily available starting materials has attracted considerable attention from the synthesis community and is in great demand. Here, we describe a base-promoted formal (3 + 2) cycloaddition of α-halohydroxamates with alkenyl-iminoindolines. The present methodology features mild reaction conditions and a broad substrate scope with up to 99% yield and excellent diastereoselectivity. The versatility of this approach is demonstrated through valuable synthetic transformations. Preliminary mechanistic studies shed light on the mechanism of this cycloaddition process.

2.
Perfusion ; : 2676591231210459, 2023 Oct 26.
Article in English | MEDLINE | ID: mdl-37885091

ABSTRACT

OVERVIEW: Acute type A aortic dissection (ATAAD) with persistent coma is a life-threatening condition associated with high mortality and poor neurological outcomes. The optimal timing for surgical intervention in these patients remains uncertain, and many patients are not eligible for surgery due to their poor prognosis. DESCRIPTION: In this case, a 53-year-old man with hypertension presented to the emergency department in a coma that had lasted for 9 hours. The patient was diagnosed with ATAAD and underwent the "Drum Tower Hospital" strategy, which involved preoperative assessments, including computed tomography angiography (CTA) and quantitative electroencephalogram (qEEG) monitoring. Surgical interventions, such as emergency stenting and aortic replacement, were performed to restore blood flow and repair the aorta. Postoperative monitoring, including qEEG, showed improvements in brain function. Despite the patient experiencing hemiplegia and a neurological deficit, the "Drum Tower Hospital" strategy, guided by comprehensive brain assessments, showed promise in managing ATAAD with coma. However, further research is needed to establish effective treatment strategies for these patients. Overall, ATAAD with persistent coma is a critical condition with limited treatment options. The "Drum Tower Hospital" strategy, supported by multimodal brain assessment, offers a potential approach to improve outcomes in these patients.

3.
Zhongguo Zhong Yao Za Zhi ; 48(17): 4634-4646, 2023 Sep.
Article in Zh | MEDLINE | ID: mdl-37802802

ABSTRACT

Dead heart is an important trait of pith-decayed Scutellariae Radix. The purpose of this study was to clarify the scientific connotation of the dead heart using multi-omics. Metabolomics and transcriptomics combined with multivariate statistical analysis such as principal component analysis(PCA) and partial least squares discriminant analysis(PLS-DA) were used to systematically compare the differences in chemical composition and gene expression among phloem, outer xylem and near-dead xylem of pith-decayed Scutella-riae Radix. The results revealed significant differences in the contents of flavonoid glycosides and aglycones among the three parts. Compared with phloem and outer xylem, near-dead xylem had markedly lowered content of flavonoid glycosides(including baicalin, norwogonin-7-O-ß-D-glucuronide, oroxylin A-7-O-ß-D-glucuronide, and wogonoside) while markedly increased content of aglycones(including 3,5,7,2',6'-pentahydroxy dihydroflavone, baicalin, wogonin, and oroxylin A). The differentially expressed genes were mainly concentrated in KEGG pathways such as phenylpropanoid metabolism, flavonoid biosynthesis, ABC transporter, and plant MAPK signal transduction pathway. This study systematically elucidated the material basis of the dead heart of pith-decayed Scutellariae Radix with multiple growing years. Specifically, the content of flavonoid aglycones was significantly increased in the near-dead xylem, and the gene expression of metabolic pathways such as flavonoid glycoside hydrolysis, interxylary cork development and programmed apoptosis was significantly up-regulated. This study provided a theoretical basis for guiding the high-quality production of pith-decayed Scutellariae Radix.


Subject(s)
Drugs, Chinese Herbal , Drugs, Chinese Herbal/chemistry , Scutellaria baicalensis/genetics , Scutellaria baicalensis/chemistry , Glucuronides , Multiomics , Flavonoids/chemistry
4.
Zhonghua Nan Ke Xue ; 23(12): 1075-1079, 2017 Dec.
Article in Zh | MEDLINE | ID: mdl-29738176

ABSTRACT

OBJECTIVE: To investigate the clinical application and outcomes of microdissection testicular sperm extraction (micro-TESE) in patients with nonmosaic Klinefelter syndrome (KS). METHODS: A total of 143 nonmosaic KS patients underwent micro-TESE in the Center of Reproductive Medicine of Peking University Third Hospital between July 2012 and August 2016. We analyzed their clinical and follow-up data and evaluated the outcomes. RESULTS: Spermatozoa were successfully retrieved from the testicular tissue in 44.76% (64/143) of the patients, 84.4% (54/64) by unilateral and 15.6% (10/64) by bilateral micro-TESE. Seventy-five of the KS patients were followed up in the years of 2014 and 2015. Of the 34 patients with successful sperm retrieval, 73.52% (25/34) achieved clinical pregnancy and 8 boys and 8 girls were already born in 14 of the 25 cases. CONCLUSIONS: The micro-TESE is a useful method for sperm retrieval in nonmosaic KS patients, with high rates of sperm retrieval, clinical pregnancy, and birth of biological offspring.


Subject(s)
Klinefelter Syndrome , Microdissection , Sperm Retrieval , Female , Humans , Male , Pregnancy , Pregnancy Rate , Sperm Injections, Intracytoplasmic , Spermatozoa , Testis
5.
Med Sci Monit ; 22: 2513-9, 2016 Jul 18.
Article in English | MEDLINE | ID: mdl-27425418

ABSTRACT

BACKGROUND This study aimed to evaluate the efficacy of transforaminal endoscopic discectomy (TED) in the treatment of obese patients with lumbar disc herniation (LDH). MATERIAL AND METHODS A total of 69 obese patients with LDH (35 males and 34 females; age range, 24 to 43 years; median age, 34 years) were included in this study. These patients had undergone TED from March 2011 to December 2015 in the Third Hospital of Hebei Medical University. Their clinical and follow-up data were prospectively analyzed. The degree of pain and disability were measured on the basis of the Visual Analog Scale (VAS) at 1 day before surgery, immediately after surgery, and 3 months after surgery. Neurologic functions were measured on the basis of the Japanese Orthopaedic Association (JOA) system 1 day before surgery and 3 months after surgery. The MacNab score at last follow-up was recorded to evaluate the early clinical efficacy. Complications during and after the operation were recorded to evaluate the safety of surgery. RESULTS Two patients experienced abnormal sensations in the export nerve root zone postoperatively, which disappeared after 3 days of treatment with dehydration and administration of hormone (dexamethasone). Three cases of recurrence were observed at 6 months, 7 months, and 9 months postoperatively; they were scheduled to receive total laminectomy combined with bone grafting internal fixation. A total of 67 patients were followed up for 3-23 months and mean follow-up was 11.8 months. The VAS scores at postoperative 3 months and 1 year were significantly reduced compared to that before the operation, with significant differences between them (t=43.072, P<0.05; t=43.139, P<0.05). The JOA scores at last follow-up postoperatively was significantly higher than that before surgery (t=-60.312, P<0.05). At the last follow-up, 17 cases (25.3%) had excellent outcomes, 39 (58.2%) good, 7 (10.4%) fair, and 4 (5.9%) poor. Overall, 83.5% of patients had excellent or good rates. CONCLUSIONS The early efficacy of TED is relatively good and safe for the selected obese patients with LDH in this study. Larger-sample studies with longer duration and follow-up are required to detect the safety and effectiveness of TED.


Subject(s)
Diskectomy/methods , Intervertebral Disc Displacement/surgery , Obesity/physiopathology , Adult , Endoscopy/methods , Female , Humans , Intervertebral Disc Displacement/physiopathology , Lumbar Vertebrae/surgery , Male , Pain Measurement , Postoperative Period
6.
Med Sci Monit ; 22: 4604-4611, 2016 Nov 28.
Article in English | MEDLINE | ID: mdl-27890911

ABSTRACT

BACKGROUND To discuss the strategy of suprapedicular foraminal endoscopic approach to lumbar lateral recess decompression and evaluate the safety and effectiveness of this strategy. MATERIAL AND METHODS Complete clinical information of 52 cases of lumbar lateral recess decompression with therapy of suprapedicular foraminal endoscopic approach were analyzed during the period from February 2010 to April 2014 in the Third Hospital of Hebei. All patients were followed up for 24 months, and VAS, JOA, ODI, and LRD were compared between preoperative and postoperative therapy and changes of FA. Intraoperative and postoperative complications were recorded and the safety of the surgery was evaluated. The surgical "excellent" and "good" rates were evaluated using MacNab score. RESULTS VAS scores for lumbago and leg pain at 3, 6, 12, and 24 months after surgery were significantly lower than before surgery (p<0.05). JOA scores at 12 and 24 months after surgery were significantly higher than before surgery (p<0.05). ODI at 12 and 24 months after surgery were significantly lower than before surgery (p<0.05). LRD after surgery was higher (p<0.05), and FA was lower than before surgery. CONCLUSIONS Use of the suprapedicular foraminal endoscopic approach to lumbar lateral recess decompression is safe and effective, and this minimally invasive treatment can achieve satisfactory results, especially for elderly patients with complicated underlying diseases.


Subject(s)
Decompression, Surgical/methods , Endoscopy/methods , Spinal Stenosis/surgery , Aged , Aged, 80 and over , China , Female , Humans , Lumbar Vertebrae/surgery , Lumbosacral Region/surgery , Male , Middle Aged , Postoperative Complications , Retrospective Studies , Treatment Outcome
7.
Environ Toxicol ; 31(11): 1407-1414, 2016 Nov.
Article in English | MEDLINE | ID: mdl-25873302

ABSTRACT

Epithelial-mesenchymal transition (EMT) is believed to be involved in lung fibrosis process induced by paraquat (PQ); however, the molecular mechanism of this process has not been clearly established. The present study investigated the potential involvement of EMT after PQ poisoning. The expressions of EMT markers, such as E-cadherin and α-smooth muscle actin (α-SMA), at multiple time points after exposure to different concentrations of PQ were evaluated by western blot analysis. Following PQ treatment, EMT induction was observed under microscopy. Related fibrosis genes, including Matrix metalloproteinase 2 (MMP-2), Matrix metalloproteinase 9 (MMP-9), collagens type I (COL I), and type III (COL III), were also evaluated by measuring their mRNA levels using RT-PCR analysis. Signaling pathways were analyzed using selective pharmacological inhibitors for MAPK. Cell migration ability was evaluated by scratch wound and Transwell assays. The data showed that PQ-induced epithelial RLE-6NT cells to develop mesenchymal cell characteristics, as indicated by a significant decrease in the epithelial marker E-cadherin and a significant increase in the extracellular matrix (ECM) marker α-smooth muscle actin in a dose and time-dependent manner. Moreover, PQ-treated RLE-6NT cells had an EMT-like phenotype with elevated expression of MMP-2, MMP-9, and COL I and COL III and enhanced migration ability. Signal pathway analysis revealed that PQ-induced EMT led to ERK-1 and Smad2 phosphorylation through activation of the MAPK pathway. The results of the current study indicate that PQ-induced pulmonary fibrosis occurs via EMT, which is mediated by the MAPK pathway. This implies that the MAPK pathway is a promising therapeutic target in alveolar epithelial cells. © 2015 Wiley Periodicals, Inc. Environ Toxicol 31: 1407-1414, 2016.


Subject(s)
Alveolar Epithelial Cells/drug effects , Epithelial-Mesenchymal Transition/drug effects , MAP Kinase Signaling System/drug effects , Paraquat/toxicity , Pulmonary Fibrosis/chemically induced , Alveolar Epithelial Cells/metabolism , Alveolar Epithelial Cells/pathology , Animals , Cadherins/metabolism , Cell Movement/drug effects , Cells, Cultured , Matrix Metalloproteinase 2/metabolism , Matrix Metalloproteinase 9/metabolism , Phosphorylation/drug effects , Pulmonary Fibrosis/metabolism , Pulmonary Fibrosis/pathology , Rats , Smad2 Protein/metabolism , Transforming Growth Factor beta1/metabolism
8.
J Cell Sci ; 126(Pt 7): 1595-603, 2013 Apr 01.
Article in English | MEDLINE | ID: mdl-23444375

ABSTRACT

Chromosome segregation in mammalian oocyte meiosis is an error-prone process, and any mistake in this process may result in aneuploidy, which is the main cause of infertility, abortion and many genetic diseases. It is now well known that shugoshin and protein phosphatase 2A (PP2A) play important roles in the protection of centromeric cohesion during the first meiosis. PP2A can antagonize the phosphorylation of rec8, a member of the cohesin complex, at the centromeres and thus prevent cleavage of rec8 and so maintain the cohesion of chromatids. SETß is a protein that physically interacts with shugoshin and inhibits PP2A activity. We thus hypothesized that SETß might regulate cohesion protection and chromosome segregation during oocyte meiotic maturation. Here we report for the first time the expression, subcellular localization and functions of SETß during mouse oocyte meiosis. Immunoblotting analysis showed that the expression level of SETß was stable from the germinal vesicle stage to the MII stage of oocyte meiosis. Immunofluorescence analysis showed SETß accumulation in the nucleus at the germinal vesicle stage, whereas it was targeted mainly to the inner centromere area and faintly localized to the interchromatid axes from germinal vesicle breakdown to MI stages. At the MII stage, SETß still localized to the inner centromere area, but could relocalize to kinetochores in a process perhaps dependent on the tension on the centromeres. SETß partly colocalized with PP2A at the inner centromere area. Overexpression of SETß in mouse oocytes caused precocious separation of sister chromatids, but depletion of SETß by RNAi showed little effects on the meiotic maturation process. Taken together, our results suggest that SETß, even though it localizes to centromeres, might not be essential for chromosome separation during mouse oocyte meiotic maturation, although its forced overexpression causes premature chromatid separation.


Subject(s)
Centromere/metabolism , Chromatids/metabolism , Meiosis/physiology , Oncogene Proteins/metabolism , Oocytes/metabolism , Animals , Blotting, Western , DNA-Binding Proteins , Female , Fluorescent Antibody Technique , Histone Chaperones , Meiosis/genetics , Mice , Mice, Inbred ICR , Oncogene Proteins/genetics , Protein Phosphatase 2/metabolism , Real-Time Polymerase Chain Reaction
9.
Biol Reprod ; 92(1): 19, 2015 Jan.
Article in English | MEDLINE | ID: mdl-25472922

ABSTRACT

During meiotic cell-cycle progression, unequal divisions take place, resulting in a large oocyte and two diminutive polar bodies. The first polar body contains a subset of bivalent chromosomes, whereas the second polar body contains a haploid set of chromatids. One unique feature of the female gamete is that the polar bodies can provide beneficial information about the genetic background of the oocyte without potentially destroying it. Therefore, polar body biopsies have been applied in preimplantation genetic diagnosis to detect chromosomal or genetic abnormalities that might be inherited by the offspring. Besides the traditional use in preimplantation diagnosis, recent findings suggest additional important roles for polar bodies in assisted reproductive technology. In this paper, we review the new roles of polar bodies in assisted reproductive technology, mainly focusing on single-cell sequencing of the polar body genome to deduce the genomic information of its sibling oocyte and on polar body transfer to prevent the transmission of mtDNA-associated diseases. We also discuss additional potential roles for polar bodies and related key questions in human reproductive health. We believe that further exploration of new roles for polar bodies will contribute to a better understanding of reproductive health and that polar body manipulation and diagnosis will allow production of a greater number of healthy babies.


Subject(s)
Polar Bodies , Reproductive Techniques, Assisted/trends , Female , Genetic Testing/methods , Genome, Human , Humans , Male , Mitochondrial Diseases/diagnosis , Mitochondrial Diseases/genetics , Mitochondrial Diseases/prevention & control , Oocytes/metabolism , Pregnancy , Preimplantation Diagnosis/methods
10.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao ; 37(2): 215-20, 2015 Apr.
Article in English | MEDLINE | ID: mdl-25936711

ABSTRACT

OBJECTIVE: To evaluate the effects of melatonin (Mel) combined with cis-platinum (DDP) or methotrexate (MTX) on the proliferation of osteosarcoma cell line SaOS-2, and to explore whether Mel combined with DDP or MTX could play a synergistic antitumor effect. METHODS: SaOS-2 was treated with Mel alone or Mel combined with DDP or MTX. Cell counting kit-8 assay was used to measure the cell activities. Combination index(CI) value was used to evaluate the combined effects: CI<1 indicating synergetic effect, CI=1 additive, and CI>1 antagonistic.Flow cytometry was used to analyze cell cycle distribution and cell apoptosis. RESULTS: After treated with Mel (0.5,1,2,4,5 mmol/L), DDP (6.67, 16.67, 33.33, 66.66 µmol/L) or MTX(0.1, 0.5, 1, 2, 4 mmol/L)alone,SaOS-2 cell activities decreased in a dose-dependent manner (all P<0.05). The activities of SaOS-2 cell treated with both Mel (1 mmol/L) and DDP or MTX were significantly lower than that of DDP or MTX alone (all P<0.05).CI values of cells exposed to 1 mmol/L Mel plus 6.67, 16.67, 33.33, and 66.66 µmol/L DDP were 1.18, 1.21, 1.09, and 0.84, respectively,and CI values of cells exposed to 1 mmol/L Mel plus 0.1, 0.5, 1, 2, and 4 mmol/L MTX were 0.88, 0.88 ,0.83, 0.78, and 0.81, respectively. The G1-stage cells were increased and the S-stage cells were reduced when the cells were treated with Mel (1 mmol/L) alone or combined with MTX (0.5 mmol/L) (P<0.05). The S-stage cells were increased when the cells treated with MTX (0.5 mmol/L) (P<0.05). The apoptotic cells were increased when they treated with Mel (1 mmol/L) alone or combined with DDP (16.67 µmol/L) or MTX (0.5 mmol/L) (P<0.05). When the cells were treated with Mel combined with DDP or MTX, the apoptotic cells were more than that of DDP or Mel alone(P<0.05). CONCLUSIONS: Mel can inhibit SaOS-2 cells activity,block the cell cycle at G1-stage,and induce apoptosis. Mel has an antagonistic effect with lower concentration of DDP but a synergistic effect with MTX or higher concentration of DDP.


Subject(s)
Cell Proliferation , Apoptosis , Bone Neoplasms , Cell Cycle , Cell Line, Tumor , Cisplatin , Flow Cytometry , Humans , Melatonin , Methotrexate , Osteosarcoma
11.
Brain Behav ; 14(10): e70086, 2024 Oct.
Article in English | MEDLINE | ID: mdl-39378288

ABSTRACT

PURPOSE: This review explores advanced methods for assessing perioperative cerebral function in Type A aortic dissection (TAAD) patients, with a focus on quantitative electroencephalography (QEEG). It highlights the critical issue of cerebral malperfusion, which is associated with higher mortality and poor prognosis during the perioperative phase in TAAD patients. METHOD: The review centers on the utilization of QEEG as a pivotal tool for the extensive monitoring of brain function at various stages: preoperatively, intraoperatively, and postoperatively. It elaborates on the foundational principles of QEEG, including the mathematical and computational analysis of electroencephalographic signals, enriched with intuitive graphical representations of cerebral functional states. FINDING: QEEG is presented as an innovative approach for the real-time, noninvasive, and reliable assessment of cerebral function. The review details the application of QEEG in monitoring conditions such as preoperative cerebral malperfusion, intraoperative deep hypothermic circulatory arrest, and postoperative recovery of cerebral function in patients undergoing TAAD treatment. CONCLUSION: Although QEEG is still in an exploratory phase for TAAD patients, it has shown efficacy in other domains, suggesting its potential in multimodal brain function monitoring. However, its broader application requires further research and technological advancements.


Subject(s)
Aortic Dissection , Electroencephalography , Humans , Electroencephalography/methods , Aortic Dissection/surgery , Aortic Dissection/physiopathology , Male , Brain/physiopathology , Brain/surgery , Aortic Aneurysm/surgery , Aortic Aneurysm/physiopathology
12.
J Contin Educ Nurs ; 55(7): 359-364, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38567920

ABSTRACT

BACKGROUND: This study investigated the impact of applying the anchored teaching mode with nursing interns on the cardiac surgery intensive care unit (CSICU). METHOD: A total of 110 interns were divided into a control group (taught through traditional methods) and an experimental group (taught using the anchored teaching mode). The anchored mode, emphasizing student-centered learning, included creating scenarios, identifying problems, using self-directed and collaborative learning, and evaluating outcomes. RESULTS: Our study found that the experimental group showed significantly higher scores in emergency response ability, nursing skills, and teaching effectiveness compared with the control group at graduation. CONCLUSION: The findings suggest that implementing the anchored teaching mode can effectively enhance the education of nursing interns on the CSICU, emphasizing the need for further research across different departments and types of hospitals. [J Contin Educ Nurs. 2024;55(7):359-364.].


Subject(s)
Critical Care Nursing , Humans , Male , Female , Adult , Critical Care Nursing/education , Cardiac Surgical Procedures/education , Intensive Care Units , Curriculum , Education, Nursing, Continuing/organization & administration , Clinical Competence , Nursing Staff, Hospital/education
13.
Front Cardiovasc Med ; 11: 1364332, 2024.
Article in English | MEDLINE | ID: mdl-38707890

ABSTRACT

Background: Postoperative acute kidney injury (PO-AKI) is a prevalent complication among patients with acute type A aortic dissection (aTAAD) for which unrecognized trajectories of renal function recovery, and their heterogeneity, may underpin poor success in identifying effective therapies. Methods: This was a retrospective, single-center cohort study in a regional Great Vessel Center including patients undergoing aortic dissection surgery. Estimated glomerular filtration rate (eGFR) recovery trajectories of PO-AKI were defined through the unsupervised latent class mixture modeling (LCMM), with an assessment of patient and procedural characteristics, complications, and early-term survival. Internal validation was performed by resampling. Results: A total of 1,295 aTAAD patients underwent surgery and 645 (49.8%) developed PO-AKI. Among the PO-AKI cohort, the LCMM identified two distinct eGFR trajectories: early recovery (ER-AKI, 51.8% of patients) and late or no recovery (LNR-AKI, 48.2% of patients). Binary logistic regression identified five critical determinants regarding poor renal recovery, including chronic kidney disease (CKD) history, renal hypoperfusion, circulation arrest time, intraoperative urine, and myoglobin. LNR-AKI was associated with increased mortality, continuous renal replacement therapies, mechanical ventilation, ICU stay, and hospital stay. The assessment of the predictive model was good, with an area under the curve (AUC) of 0.73 (95% CI: 0.69-0.76), sensitivity of 61.74%, and specificity of 75.15%. The internal validation derived a consistent average AUC of 0.73. The nomogram was constructed for clinicians' convenience. Conclusion: Our study explored the PO-AKI recovery patterns among surgical aTAAD patients and identified critical determinants that help to predict individuals at risk of poor recovery of renal function.

14.
Sci Rep ; 14(1): 7845, 2024 04 03.
Article in English | MEDLINE | ID: mdl-38570622

ABSTRACT

Temporary neurological dysfunction (TND), a common complication following surgical repair of Type A Aortic Dissection (TAAD), is closely associated with increased mortality and long-term cognitive impairment. Currently, effective treatment options for TND remain elusive. Therefore, we sought to investigate the potential of postoperative relative band power (RBP) in predicting the occurrence of postoperative TND, with the aim of identifying high-risk patients prior to the onset of TND. We conducted a prospective observational study between February and December 2022, involving 165 patients who underwent surgical repair for TAAD at our institution. Bedside Quantitative electroencephalography (QEEG) was utilized to monitor the post-operative brain electrical activity of each participant, recording changes in RBP (RBP Delta, RBP Theta, RBP Beta and RBP Alpha), and analyzing their correlation with TND. Univariate and multivariate analyses were employed to identify independent risk factors for TND. Subsequently, line graphs were generated to estimate the incidence of TND. The primary outcome of interest was the development of TND, while secondary outcomes included intensive care unit (ICU) admission and length of hospital stay. A total of 165 patients were included in the study, among whom 68 (41.2%) experienced TND. To further investigate the independent risk factors for postoperative TND, we conducted both univariate and multivariate logistic regression analyses on all variables. In the univariate regression analysis, we identified age (Odds Ratio [OR], 1.025; 95% CI, 1.002-1.049), age ≥ 60 years (OR, 2.588; 95% CI, 1.250-5.475), hemopericardium (OR, 2.767; 95% CI, 1.150-7.009), cardiopulmonary bypass (CPB) (OR, 1.007; 95% CI, 1.001-1.014), RBP Delta (OR, 1.047; 95% CI, 1.020-1.077), RBP Alpha (OR, 0.853; 95% CI, 0.794-0.907), and Beta (OR, 0.755; 95% CI, 0.649-0.855) as independent risk factors for postoperative TND. Further multivariate regression analyses, we discovered that CPB time ≥ 180 min (OR, 1.021; 95% CI, 1.011-1.032), RBP Delta (OR, 1.168; 95% CI, 1.105-1.245), and RBP Theta (OR, 1.227; 95% CI, 1.135-1.342) emerged as independent risk factors. TND patients had significantly longer ICU stays (p < 0.001), and hospital stays (p = 0.002). We obtained the simplest predictive model for TND, consisting of three variables (CPB time ≥ 180 min, RBP Delta, RBP Theta, upon which we constructed column charts. The areas under the receiver operating characteristic (AUROC) were 0.821 (0.755, 0.887). Our study demonstrates that postoperative RBP monitoring can detect changes in brain function in patients with TAAD during the perioperative period, providing clinicians with an effective predictive method that can help improve postoperative TND in TAAD patients. These findings have important implications for improving clinical care in this population.Trial registration ChiCTR2200055980. Registered 30th Jan. 2022. This trial was registered before the first participant was enrolled.


Subject(s)
Aortic Dissection , Azides , Deoxyglucose/analogs & derivatives , Humans , Middle Aged , Prospective Studies , Aortic Dissection/surgery , Treatment Outcome , Risk Factors , Retrospective Studies , Postoperative Complications/etiology
15.
J Am Heart Assoc ; 13(19): e034351, 2024 Oct.
Article in English | MEDLINE | ID: mdl-39291506

ABSTRACT

BACKGROUND: Type A aortic dissection presents challenges with postoperative cerebral complications, and this study evaluates the predictive value of quantitative electroencephalography for perioperative brain function prognosis. METHODS AND RESULTS: Amplitude-integrated electroencephalography (aEEG) processes raw signals through filtering, amplitude integration, and time compression, displaying the data in a semilogarithmic format. Using this method, postoperative relative band power (post-RBP) α% and dynamic aEEG (ΔaEEG) grade were significantly associated with neurological dysfunction in univariate and multivariable analyses, with area under the receiver operating characteristic curve of 0.876 (95% CI, 0.825-0.926) for the combined model. Postoperative relative band power α% and ΔaEEG were significantly associated with adverse outcomes, with area under the receiver operating characteristic curve of 0.903 (95% CI, 0.835-0.971) for the combined model. Postoperative relative band power α% and ΔaEEG were significantly associated with transient neurological dysfunction and stroke, with areas under the receiver operating characteristic curve of 0.818 (95% CI, 0.760-0.876) and 0.868 (95% CI, 0.810-0.926) for transient neurological dysfunction, and 0.815 (95% CI, 0.743-0.886) and 0.831 (95% CI, 0.746-0.916) for stroke. Among 56 patients, the Alberta Stroke Program Early Computed Tomography score was superior to ΔaEEG in predicting neurological outcomes (area under the receiver operating characteristic curve of 0.872 versus 0.708 [95% CI, 0.633-0.783]; P<0.05). CONCLUSIONS: Perioperative quantitative electroencephalography monitoring offers valuable insights into brain function changes in patients with type A aortic dissection. ∆aEEG grades can aid in early detection of adverse outcomes, while postoperative relative band power and ∆aEEG grades predict transient neurological dysfunction. Quantitative electroencephalography can assist cardiac surgeons in assessing brain function and improving outcomes in patients with type A aortic dissection. REGISTRATION: URL: https://www.chictr.org.cn; Unique identifier: ChiCTR2200055980.


Subject(s)
Aortic Dissection , Electroencephalography , Predictive Value of Tests , Humans , Electroencephalography/methods , Male , Female , Aortic Dissection/physiopathology , Aortic Dissection/surgery , Aortic Dissection/complications , Aortic Dissection/diagnosis , Middle Aged , Prospective Studies , Aged , Aortic Aneurysm/surgery , Aortic Aneurysm/physiopathology , Aortic Aneurysm/complications , Prognosis , ROC Curve , Postoperative Complications/diagnosis , Postoperative Complications/physiopathology , Postoperative Complications/etiology , Brain/physiopathology , Brain/diagnostic imaging , Brain Waves
16.
Biol Reprod ; 88(5): 117, 2013 May.
Article in English | MEDLINE | ID: mdl-23515675

ABSTRACT

Maternal diabetes has adverse effects not only on oocyte quality but also on embryo development. However, it is still unknown whether the DNA imprinting in oocytes is altered by diabetes. By using streptozotocin (STZ)-induced and nonobese diabetic (NOD) mouse models we investigated the effect of maternal diabetes on DNA methylation of imprinted genes in oocytes. Mice which were judged as being diabetic 4 days after STZ injection were used for experiments. In superovulated oocytes of diabetic mice, the methylation pattern of Peg3 differential methylation regions (DMR) was affected in a time-dependent manner, and evident demethylation was observed on Day 35 after STZ injection. The expression level of DNA methyltransferases (DNMTs) was also decreased in a time-dependent manner in diabetic oocytes. However, the methylation patterns of H19 and Snrpn DMRs were not significantly altered by maternal diabetes, although there were some changes in Snrpn. In NOD mice, the methylation pattern of Peg3 was similar to that of STZ-induced mice. Embryo development was adversely affected by maternal diabetes; however, no evident imprinting abnormality was observed in oocytes from female offspring derived from a diabetic mother. These results indicate that maternal diabetes has adverse effects on DNA methylation of maternally imprinted gene Peg3 in oocytes of a diabetic female in a time-dependent manner, but methylation in offspring's oocytes is normal.


Subject(s)
DNA Methylation , Diabetes Mellitus, Experimental/metabolism , Diabetes Mellitus, Type 1/metabolism , Gene Expression , Oocytes/metabolism , Animals , Diabetes Mellitus, Experimental/genetics , Diabetes Mellitus, Type 1/genetics , Embryonic Development/genetics , Female , Genomic Imprinting , Kruppel-Like Transcription Factors/genetics , Kruppel-Like Transcription Factors/metabolism , Mice , Mice, Inbred NOD , RNA, Long Noncoding/genetics , RNA, Long Noncoding/metabolism , snRNP Core Proteins
17.
Reprod Fertil Dev ; 25(3): 495-502, 2013.
Article in English | MEDLINE | ID: mdl-23182369

ABSTRACT

UCHL5IP is one of the subunits of the haus complex, which is important for microtubule generation, spindle bipolarity and accurate chromosome segregation in Drosophila and human mitotic cells. In this study, the expression and localisation of UCHL5IP were explored, as well as its functions in mouse oocyte meiotic maturation. The results showed that the UCHL5IP protein level was consistent during oocyte maturation and it was localised to the meiotic spindle in MI and MII stages. Knockdown of UCHL5IP led to spindle defects, chromosome misalignment and disruption of γ-tubulin localisation in the spindle poles. These results suggest that UCHL5IP plays critical roles in spindle formation during mouse oocyte meiotic maturation.


Subject(s)
Cell Cycle Proteins/metabolism , Metaphase , Microtubule-Associated Proteins/metabolism , Oocytes/metabolism , Oogenesis , Spindle Apparatus/metabolism , Tubulin/metabolism , Animals , Blotting, Western , Cell Cycle Proteins/antagonists & inhibitors , Cell Cycle Proteins/genetics , Female , Fluorescent Antibody Technique, Indirect , In Vitro Oocyte Maturation Techniques , Meiosis , Mice , Mice, Inbred ICR , Microinjections , Microscopy, Confocal , Microtubule-Associated Proteins/antagonists & inhibitors , Microtubule-Associated Proteins/genetics , Morpholinos , Oligoribonucleotides, Antisense , Oocytes/cytology , Protein Serine-Threonine Kinases/metabolism , Protein Transport , Proto-Oncogene Proteins/metabolism , RNA Interference , Polo-Like Kinase 1
18.
IEEE Trans Cybern ; 53(4): 2211-2224, 2023 Apr.
Article in English | MEDLINE | ID: mdl-34606469

ABSTRACT

Task allocation is a crucial issue of mobile crowdsensing. The existing crowdsensing systems normally select the optimal participants giving no consideration to the sudden departure of mobile users, which significantly affects the sensing quality of tasks with a long sensing period. Furthermore, the ability of a mobile user to collect high-precision data is commonly treated as the same for different types of tasks, causing the unqualified data for some tasks provided by a competitive user. To address the issue, a dynamic task allocation model of crowdsensing is constructed by considering mobile user availability and tasks changing over time. Moreover, a novel indicator for comprehensively evaluating the sensing ability of mobile users collecting high-quality data for different types of tasks at the target area is proposed. A new Q -learning-based hyperheuristic evolutionary algorithm is suggested to deal with the problem in a self-learning way. Specifically, a memory-based initialization strategy is developed to seed a promising population by reusing participants who are capable of completing a particular task with high quality in the historical optima. In addition, taking both sensing ability and cost of a mobile user into account, a novel comprehensive strength-based neighborhood search is introduced as a low-level heuristic (LLH) to select a substitute for a costly participant. Finally, based on a new definition of the state, a Q -learning-based high-level strategy is designed to find a suitable LLH for each state. Empirical results of 30 static and 20 dynamic experiments expose that this hyperheuristic achieves superior performance compared to other state-of-the-art algorithms.

19.
J Cardiovasc Surg (Torino) ; 64(3): 331-337, 2023 Jun.
Article in English | MEDLINE | ID: mdl-37078983

ABSTRACT

BACKGROUND: A modified aortic arch "island anastomosis" with a stent graft technique was used in 33 patients with acute type A aortic dissection. We retrospectively reviewed our experience of this procedure and the short-term follow-up results. METHODS: This retrospective analysis included 33 patients with acute type A aortic dissection undergoing the modified aortic arch island anastomosis with stent graft procedure. Postoperatively, computed tomography angiography images were obtained before discharge and at 12 months. RESULTS: All patients underwent successful surgery without intraoperative death. Three patients received dialysis because of postoperative renal insufficiency, 1 patient received tracheotomy because of postoperative respiratory insufficiency, and 5 patients had postoperative delirium. Surgery caused stroke in 1 patient. No paraplegia was found, and no re-exploration for bleeding was performed. One patient died in the hospital due to multiple organ failure, and the other patients were discharged as expected. Only 1 patient had a proximal endoleak, and the patient was stable under close follow-up. The diameter of the descending thoracic aorta was smaller at 12 months postoperatively than preoperatively (34.5±2.5 mm versus 36.7±2.9 mm, P<0.05). The average diameter of the true lumen of the descending thoracic aorta was larger at 12 months postoperatively than preoperatively (24.1±3.1 mm versus 14.9±2.3 mm, P<0.05). CONCLUSIONS: The modified aortic arch island anastomosis with stent graft technique is a feasible and safety surgical strategy for acute type A aortic dissection. Short-term outcomes are satisfactory.


Subject(s)
Aortic Aneurysm, Thoracic , Aortic Dissection , Blood Vessel Prosthesis Implantation , Humans , Aorta, Thoracic/diagnostic imaging , Aorta, Thoracic/surgery , Retrospective Studies , Aortic Aneurysm, Thoracic/diagnostic imaging , Aortic Aneurysm, Thoracic/surgery , Blood Vessel Prosthesis Implantation/adverse effects , Blood Vessel Prosthesis Implantation/methods , Treatment Outcome , Aortic Dissection/diagnostic imaging , Aortic Dissection/surgery , Stents , Anastomosis, Surgical
20.
Brain Behav ; 13(7): e3091, 2023 07.
Article in English | MEDLINE | ID: mdl-37211914

ABSTRACT

OBJECTIVE: The diagnostic and prognostic value of quantitative electroencephalogram (qEEG) parameters, specifically the symmetry of amplitude-integrated electroencephalography (aEEG) and relative band power (RBP), in the postoperative stroke of the cerebral hemisphere following type A aortic dissection, remains an area of inquiry. METHODS: We analyzed and processed 56 patients with type A aortic dissection who underwent bedside qEEG monitoring and analyzed the qEEG indices, brain CT, and clinical data of these patients. qEEG (symmetry of aEEG and RBP, and affected/unaffected hemisphere) indices were analyzed at discharge and 60 days after discharge. RESULTS: A total of 56 patients were studied. The 60-day mortality rate was 12.5%. The affected hemisphere's diagnosis and mortality after 1-year follow-up were evaluated, and RBP beta demonstrated the highest area under the curve values with 95% confidence intervals (CI) of .849 (95% CI: .771-.928) and .91 (95% CI: .834-.986), respectively. According to the results of the logistic regression analysis, we have identified the strongest predictors for cerebral hemisphere stroke and 1-year mortality in stroke patients. Specifically, aEEGmin exhibited the highest predictive power with an odds ratio (OR) of .735 for cerebral hemisphere stroke, whereas DTABR was confirmed as one of the strongest predictors with an OR of 1.619 for 1-year mortality in stroke patients, indicating a high level of reliability. Spearman correlation coefficients showed that aEEGmax and aEEGmin were positively correlated with Alberta Stroke Program Early CT Score (aEEGmax: rho = .50, p < .001; aEEGmin: rho = .44, p < .001). CONCLUSIONS: QEEG has been proven to be a sensitive indicator for monitoring brain function and can be monitored continuously. It can help clinicians detect and treat these patients early and improve long-term prognosis.


Subject(s)
Stroke , Humans , Prognosis , Reproducibility of Results , Stroke/diagnosis , Electroencephalography/methods
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