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1.
Life Sci ; 347: 122662, 2024 Jun 15.
Artículo en Inglés | MEDLINE | ID: mdl-38670450

RESUMEN

AIMS: PI3Kδ is expressed predominately in leukocytes and is commonly found to be aberrantly activated in human B-cell lymphomas. Although PI3Kδ has been intensively targeted for discovering anti-lymphoma drugs, the application of currently approved PI3Kδ inhibitors has been limited due to unwanted systemic toxicities, thus warranting the development of novel PI3Kδ inhibitors with new scaffolds. MAIN METHODS: We designed TYM-3-98, an indazole derivative, and evaluated its selectivity for all four PI3K isoforms, as well as its efficacy against various B-cell lymphomas both in vitro and in vivo. KEY FINDINGS: We identified TYM-3-98 as a highly selective PI3Kδ inhibitor over other PI3K isoforms at both molecular and cellular levels. It showed superior antiproliferative activity in several B-lymphoma cell lines compared with the approved first-generation PI3Kδ inhibitor idelalisib. TYM-3-98 demonstrated a concentration-dependent PI3K/AKT/mTOR signaling blockage followed by apoptosis induction. In vivo, TYM-3-98 showed good pharmaceutical properties and remarkably reduced tumor growth in a human lymphoma xenograft model and a mouse lymphoma model. SIGNIFICANCE: Our findings establish TYM-3-98 as a promising PI3Kδ inhibitor for the treatment of B-cell lymphoma.


Asunto(s)
Antineoplásicos , Fosfatidilinositol 3-Quinasa Clase I , Linfoma de Células B , Inhibidores de las Quinasa Fosfoinosítidos-3 , Ensayos Antitumor por Modelo de Xenoinjerto , Humanos , Animales , Linfoma de Células B/tratamiento farmacológico , Linfoma de Células B/patología , Ratones , Antineoplásicos/farmacología , Fosfatidilinositol 3-Quinasa Clase I/antagonistas & inhibidores , Fosfatidilinositol 3-Quinasa Clase I/metabolismo , Línea Celular Tumoral , Inhibidores de las Quinasa Fosfoinosítidos-3/farmacología , Indazoles/farmacología , Indazoles/uso terapéutico , Apoptosis/efectos de los fármacos , Proliferación Celular/efectos de los fármacos , Femenino , Transducción de Señal/efectos de los fármacos , Ratones Desnudos
2.
ACS Omega ; 8(50): 47812-47820, 2023 Dec 19.
Artículo en Inglés | MEDLINE | ID: mdl-38144117

RESUMEN

Poly(methyl methacrylate) (PMMA) is widely used in the preservation and exhibition of cultural relics in museums. Accurately predicting its service life can help avoid many negative effects caused by PMMA aging. To study the change in the yellowing index of PMMA after aging in a UV light environment, an aging experiment was conducted. A prediction model for the service life of PMMA was established using nonlinear curve fitting and a back propagation (BP) neural network. By comparing the goodness of fit, simulation and modeling capabilities of the initial data, and the predictive ability for new data, it was found that the BP neural network prediction model outperformed the nonlinear curve fitting prediction model. In this study, the service life of newly produced PMMA samples was calculated as 7.83, 8.47, and 8.42 years, based on the yellowing index of retired PMMA as a benchmark and using the output data from the BP neural network prediction model. At this time, the performance and exhibition effect of the PMMA are poor, and the batch of PMMA needs to be updated.

3.
World J Gastrointest Surg ; 15(7): 1474-1484, 2023 Jul 27.
Artículo en Inglés | MEDLINE | ID: mdl-37555116

RESUMEN

BACKGROUND: Acupuncture promotes the recovery of gastrointestinal function and provides analgesia after major abdominal surgery. The effects of transcutaneous electrical acupoint stimulation (TEAS) remain unclear. AIM: To explore the potential effects of TEAS on the recovery of gastrointestinal function after gastrectomy and colorectal resection. METHODS: Patients scheduled for gastrectomy or colorectal resection were randomized at a 2:3:3:2 ratio to receive: (1) TEAS at maximum tolerable current for 30 min immediately prior to anesthesia induction and for the entire duration of surgery, plus two 30-min daily sessions for 3 consecutive days after surgery (perioperative TEAS group); (2) Preoperative and intraoperative TEAS only; (3) Preoperative and postoperative TEAS only; or (4) Sham stimulation. The primary outcome was the time from the end of surgery to the first bowel sound. RESULTS: In total, 441 patients were randomized; 405 patients (58.4 ± 10.2 years of age; 247 males) received the planned surgery. The time to the first bowel sounds did not differ among the four groups (P = 0.90; log-rank test). On postoperative day 1, the rest pain scores differed significantly among the four groups (P = 0.04; Kruskal-Wallis test). Post hoc comparison using the Bonferroni test showed lower pain scores in the perioperative TEAS group (1.4 ± 1.2) than in the sham stimulation group (1.7 ± 1.1; P = 0.04). Surgical complications did not differ among the four groups. CONCLUSION: TEAS provided analgesic effects in adult patients undergoing major abdominal surgery, and it can be added to clinical practice as a means of accelerating postoperative rehabilitation of these patients.

4.
Chirality ; 35(12): 983-992, 2023 12.
Artículo en Inglés | MEDLINE | ID: mdl-37464916

RESUMEN

Fluoxetine (FLT) is a widely used antidepressant in clinical practice, which can be metabolized into active norfluoxetine (NFLT) in vivo. The stereoselectivity of FLT and NFLT enantiomers across the blood-brain barrier (BBB) is still to be clarified. In this study, accurate and reliable UPLC-MS/MS enantioselective analysis was established in rat plasma and brain. The characteristics of FLT and NFLT enantiomers across the BBB were studied by chemical knockout of rat transporters. We found that the dominant enantiomers of FLT and NFLT were S-FLT and R-NFLT, respectively, both in plasma and in brain. The FLT and NFLT enantiomers showed significant stereoselectivity across the BBB, and S-FLT and S-NFLT were the dominant configurations across the BBB. Chemical knockout of organic cation transporter 1 (OCT1) and OCT3 can affect the ratio of plasma FLT and NFLT enantiomers into the brain, suggesting that OCT1/3 is stereoselective for FLT and NFLT transport across the BBB.


Asunto(s)
Fluoxetina , Transportador 1 de Catión Orgánico , Ratas , Animales , Fluoxetina/análisis , Fluoxetina/metabolismo , Transportador 1 de Catión Orgánico/metabolismo , Barrera Hematoencefálica , Cromatografía Liquida/métodos , Estereoisomerismo , Espectrometría de Masas en Tándem/métodos
5.
Dalton Trans ; 52(19): 6254-6259, 2023 May 16.
Artículo en Inglés | MEDLINE | ID: mdl-37157970

RESUMEN

Nano bowl-like Co-Co6Mo6C2 coated by N,P co-doped carbon (Co-Co6Mo6C2@NPC) is reported as an electrocatalyst for Zn-air batteries. Co-Co6Mo6C2@NPC only needs an overpotential of 210 mV at 10 mA cm-2 for the OER, and the half-wave potential for the ORR is 0.81 V. In addition, the Co-Co6Mo6C2@NPC based battery shows a large open-circuit voltage of 1.335 V and a maximum power density of 160.5 mW cm-2, as well as good stability. The improved catalytic performance can be ascribed to the co-existence of Co6Mo6C2 and Co species to improve the intrinsic catalytic activity, and the bowl-like nanostructure to facilitate the mass transfer.

6.
Angew Chem Int Ed Engl ; 62(26): e202303791, 2023 Jun 26.
Artículo en Inglés | MEDLINE | ID: mdl-37102633

RESUMEN

Chemically recyclable, circular polymers continue to attract increasing attention, but rendering both catalysts for depolymerization and high-performance polymers recyclable is a more sustainable yet challenging goal. Here we introduce a dual catalyst/polymer recycling system in that recyclable inorganic phosphomolybdic acid catalyzes selective depolymerization of high-ceiling-temperature biodegradable poly(δ-valerolactone) in bulk phase, which, upon reaching suitable molecular weight, exhibits outstanding mechanical performance with a high tensile strength of ≈66.6 MPa, fracture strain of ≈904 %, and toughness of ≈308 MJ m-3 , and thus markedly outperforms commodity polyolefins, recovering its monomer in pure state and quantitative yield at only 100 °C. In sharp contrast, the uncatalyzed depolymerization not only requires a high temperature of >310 °C but is also low yielding and non-selective. Importantly, the recovered monomer can be repolymerized as is to reproduce the same polymer, thereby closing the circular loop, and the recycled catalyst can be reused repeatedly for depolymerization runs without loss of its catalytic activity and efficiency.


Asunto(s)
Poliésteres , Polímeros , Poliésteres/química , Polímeros/química , Polienos , Catálisis
7.
J Orthop Surg Res ; 17(1): 557, 2022 Dec 21.
Artículo en Inglés | MEDLINE | ID: mdl-36544170

RESUMEN

BACKGROUND: Osteosarcoma is highly malignant. The migration, invasion, and chemoresistance contribute to poor prognosis of osteosarcoma. Research reported that endogenous bornavirus-like nucleoprotein 3 pseudogene (EBLN3P) promotes the progression of osteosarcoma. METHODS: In this study, the expression of EBLN3P in osteosarcoma tissue with different methotrexate (MTX) treatment responses was measured. Osteosarcoma cell lines with MTX resistance were constructed, and bioinformatic analysis was performed to explore the potential involved targets and pathways. RESULTS: Higher EBLN3P was associated with MTX resistance. Downregulation of LncEBLN3P decreased the MTX resistance of osteosarcoma cells by sponging miR-200a-3p, an important microRNA that affects epithelial-mesenchymal transition (EMT). The decreased miR-200a-3p resulted in the upregulation of its target gene O-GlcNAc transferase (OGT), which in turn promoted the EMT process of osteosarcoma cells. Further analysis confirmed that the loss of OGT and over-expression of miR-200a-3p could partly abolish the MTX resistance induced by LncEBLN3P. CONCLUSION: LncEBLN3P is upregulated in osteosarcoma and increases the MTX resistance in osteosarcoma cells through downregulating miR-200a-3p, which in turn promoted the EMT process of osteosarcoma cells by increasing the OGT.


Asunto(s)
Neoplasias Óseas , Resistencia a Antineoplásicos , Metotrexato , MicroARNs , Osteosarcoma , ARN Largo no Codificante , Humanos , Neoplasias Óseas/tratamiento farmacológico , Neoplasias Óseas/genética , Neoplasias Óseas/patología , Línea Celular Tumoral , Movimiento Celular/genética , Proliferación Celular/genética , Regulación Neoplásica de la Expresión Génica/genética , Metotrexato/farmacología , MicroARNs/genética , MicroARNs/metabolismo , Osteosarcoma/tratamiento farmacológico , Osteosarcoma/genética , Osteosarcoma/patología , Seudogenes , ARN Largo no Codificante/genética , Resistencia a Antineoplásicos/genética
8.
Zool Res ; 43(5): 886-896, 2022 Sep 18.
Artículo en Inglés | MEDLINE | ID: mdl-36052553

RESUMEN

Various peptide toxins in animal venom inhibit voltage-gated sodium ion channel Nav1.7, including Nav-targeting spider toxin (NaSpTx) Family I. Toxins in NaSpTx Family I share a similar structure, i.e., N-terminal, loops 1-4, and C-terminal. Here, we used Mu-theraphotoxin-Ca2a (Ca2a), a peptide isolated from Cyriopagopus albostriatus, as a template to investigate the general properties of toxins in NaSpTx Family I. The toxins interacted with the cell membrane prior to binding to Nav1.7 via similar hydrophobic residues. Residues in loop 1, loop 4, and the C-terminal primarily interacted with the S3-S4 linker of domain II, especially basic amino acids binding to E818. We also identified the critical role of loop 2 in Ca2a regarding its affinity to Nav1.7. Our results provide further evidence that NaSpTx Family I toxins share similar structures and mechanisms of binding to Nav1.7.


Asunto(s)
Venenos de Araña , Animales , Péptidos/química , Canales de Sodio , Venenos de Araña/química , Venenos de Araña/genética , Venenos de Araña/farmacología , Bloqueadores del Canal de Sodio Activado por Voltaje/química , Bloqueadores del Canal de Sodio Activado por Voltaje/farmacología , Bloqueadores del Canal de Sodio Activado por Voltaje/uso terapéutico
9.
Heliyon ; 8(9): e10677, 2022 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-36164531

RESUMEN

Background and objectives: Psoriasis is an independent risk factor for coronary heart disease. It is important for predicting the complications of coronary heart disease in patients with psoriasis. Methods: In this study, related cases were collected from the case system of Qingdao University, and commonly used laboratory indicators were extracted. Artificial neural network (ANN) and logistics regression analysis were used to learn to distinguish psoriasis patients, coronary heart disease patients, and psoriasis patients with coronary heart disease. We identified independent risk factors for coronary heart disease in psoriasis patients that exacerbate coronary heart disease symptoms in patients with psoriasis. Findings: Analysis shows that the accuracy of the ANN model was higher than 79%. It was determined that age, chlorinated, phosphorus, magnesium, low-density lipoprotein, triglycerides, high density lipoprotein and total cholesterol are independent risk factors for coronary heart disease in patients with psoriasis. Similarly, gender, age, chlorinated, magnesium, triglycerides, and high density lipoprotein are risk factors that exacerbate coronary heart disease symptoms in patients with psoriasis. Interpretation: The presented approach is a valuable tool for identifying psoriasis patients, coronary heart disease patients, and psoriasis patients with coronary heart disease. It can also serve as a support tool clinicians in the diagnostic process, by providing an outstanding support in the diagnostics prevention of coronary heart disease in psoriasis.

10.
J Int Med Res ; 50(8): 3000605221117138, 2022 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-35949173

RESUMEN

OBJECTIVE: The cell cycle-related proteins cyclin B1 (CCNB1) and cyclin B2 (CCNB2) are potentially involved in the underlying mechanisms of psoriasis. The present study aimed to explore this possibility using bioinformatics approaches. METHODS: CCNB1 and CCNB2 protein levels were evaluated in 14 psoriasis patients and five healthy controls by enzyme-linked immunosorbent assays, and their mRNA levels were evaluated using data from four publicly available datasets (GSE53552, GSE41664, GSE14905, and GSE13355). Comparison of high- and low-expressing groups were performed to reveal CCNB1- and CCNB2-related differentially expressed genes, which were then assessed based on gene ontology and Kyoto Encyclopedia of Genes and Genomes pathway analyses. Correlation analyses between CCNB1 and CCNB2 levels and immune infiltration, as well as typical targets of psoriasis, were also performed. RESULTS: Overall, 12 CCNB1 and CCNB2 common immune-related targets potentially involved in psoriasis were identified. These could regulate the cell cycle of through multiple pathways. In addition, CCNB1 and CCNB2 were found to potentially support the release of key molecular targets of psoriasis through the regulation of mast cell activation and macrophage polarization. CONCLUSIONS: These findings suggest that CCNB1 and CCNB2 may represent valuable molecular biomarkers of psoriasis, contributing to its onset and progression.


Asunto(s)
Ciclina B2 , Psoriasis , Biología Computacional , Ciclina B1/genética , Ciclina B1/metabolismo , Ciclina B2/genética , Ciclina B2/metabolismo , Ontología de Genes , Humanos , Psoriasis/genética
11.
Clin Cosmet Investig Dermatol ; 15: 1447-1458, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35924255

RESUMEN

Background: Psoriasis is a recurrent, chronic, inflammation- and immune-mediated skin disease with multiple causative factors. However, the genetic markers associated with recurrence have not yet been fully elucidated. Accordingly, in this study, we aimed to identify markers associated with the recurrence of psoriasis. Methods: We analyzed differentially expressed genes to determine which targets were associated with the recurrence of psoriasis and used these data to construct a protein-protein interaction network using Cytoscape software. The results were then validated by analysis of core targets using Gene Expression Omnibus (GEO) datasets and clinical samples. Functional enrichment analysis was used to explore the potential mechanisms mediating the recurrence of psoriasis. Results: We screened out six core targets that played important roles in recurrence of psoriasis, and validation of GEO datasets and clinical samples showed that the expression levels of five core targets were higher in patients with psoriasis than in healthy individuals. Functional enrichment analysis revealed that the cell cycle and oocyte meiosis signaling pathways were involved in the recurrence of psoriasis. Conclusion: Our findings provided insights into the mechanisms mediating the onset and recurrence of psoriasis.

12.
Ren Fail ; 44(1): 1160-1168, 2022 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-35880645

RESUMEN

BACKGROUND: Parathyroidectomy (PTX) is a treatment for hyperparathyroidism (HPT) and has uncertain risks and benefits. The aim of this study was to evaluate the effect of PTX versus nonoperative treatment among nondiabetic hemodialysis patients. METHODS: A retrospective matched cohort study was performed. Each PTX patient was matched with one patient who had severe HPT but rejected PTX. The patients were matched by sex, birth date, date of first dialysis, nondiabetic status, and left ventricular ejection fraction. The serum markers, survival, main adverse cardiovascular and cerebrovascular event (MACCE) rates, and hospitalization were compared between the PTX patients and matched non-PTX patients. RESULTS: There were 1143 patients at our center in the Chinese National Renal Data System (CNRDS) between 2010 and 2020. Of these, 75 PTX patients were matched with 75 non-PTX patients. Rapid decreases in the mean intact parathyroid hormone, calcium and phosphorus concentrations, and a gradual increase in hemoglobin concentration were observed in the PTX group. The mortality was 2.9 per 100 patient-years in the PTX group and 10.9 per 100 patient-years in the non-PTX group (p < 0.001). Compared with non-PTX patients, PTX patients had an adjusted HR for death of 0.236 (95% CI 0.108-0.518). The cumulative MACCE rates were 6.7 per 100 patient-years in the PTX group and 15.2 per 100 patient-years in the non-PTX group (p < 0.001). The adjusted HR of the occurrence of first MACCE for PTX patients compared with non-PTX patients was 0.524 (95% CI 0.279-0.982). The cumulative hospitalization rates were 50.3 per 100 patient-years in the PTX group and 66.5 per 100 patient-years in the matched non-PTX group (p < 0.001). CONCLUSIONS: Compared with non-PTX patients, PTX was associated with an improvement in the biochemical measures and patient-level outcomes in nondiabetic hemodialysis patients with severe HPT.


Asunto(s)
Hiperparatiroidismo Secundario , Hiperparatiroidismo , Fallo Renal Crónico , Estudios de Cohortes , Humanos , Hiperparatiroidismo Secundario/complicaciones , Hiperparatiroidismo Secundario/cirugía , Fallo Renal Crónico/cirugía , Fallo Renal Crónico/terapia , Hormona Paratiroidea , Paratiroidectomía , Diálisis Renal , Estudios Retrospectivos , Volumen Sistólico , Función Ventricular Izquierda
13.
Curr Drug Deliv ; 19(4): 508-517, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-34238184

RESUMEN

BACKGROUND: The research and development of drugs for the treatment of central nervous system diseases faces many challenges at present. One of the most important questions to be answered is, how does the drug cross the blood-brain barrier to get to the target site for pharmacological action. Fluoxetine is widely used in clinical antidepressant therapy. However, the mechanism by which fluoxetine passes through the BBB also remains unclear. Under physiological pH conditions, fluoxetine is an organic cation with a relatively small molecular weight (<500), which is in line with the substrate characteristics of organic cation transporters (OCTs). Therefore, this study aimed to investigate the interaction of fluoxetine with OCTs at the BBB and BBB-associated efflux transporters. This is of great significance for fluoxetine to better treat depression. Moreover, it can provide a theoretical basis for clinical drug combination. METHODS: In vitro BBB model was developed using human brain microvascular endothelial cells (hCMEC/D3), and the cellular accumulation was tested in the presence or absence of transporter inhibitors. In addition, an in vivo trial was performed in rats to investigate the effect of OCTs on the distribution of fluoxetine in the brain tissue. Fluoxetine concentration was determined by a validated UPLC-MS/MS method. RESULTS: The results showed that amantadine (an OCT1/2 inhibitor) and prazosin (an OCT1/3 inhibitor) significantly decreased the cellular accumulation of fluoxetine (P <.001). Moreover, we found that N-methylnicotinamide (an OCT2 inhibitor) significantly inhibited the cellular uptake of 100 and 500 ng/mL fluoxetine (P <.01 and P <.05 respectively). In contrast, corticosterone (an OCT3 inhibitor) only significantly inhibited the cellular uptake of 1000 ng/mL fluoxetine (P <.05). The P-glycoprotein (P-gp) inhibitor, verapamil, and the multidrug resistance associated proteins (MRPs) inhibitor, MK571, significantly decreased the cellular uptake of fluoxetine. However, intracellular accumulation of fluoxetine was not significantly changed when fluoxetine was incubated with the breast cancer resistance protein (BCRP) inhibitor Ko143. Furthermore, in vivo experiments proved that corticosterone and prazosin significantly inhibited the brain-plasma ratio of fluoxetine at 5.5 h and 12 h, respectively. CONCLUSION: OCTs might play a significant role in the transport of fluoxetine across the BBB. In addition, P-gp, BCRP, and MRPs seemed not to mediate the efflux transport of fluoxetine.


Asunto(s)
Barrera Hematoencefálica , Fluoxetina , Transportador de Casetes de Unión a ATP, Subfamilia G, Miembro 2/metabolismo , Animales , Transporte Biológico , Barrera Hematoencefálica/metabolismo , Cromatografía Liquida , Corticosterona/metabolismo , Corticosterona/farmacología , Células Endoteliales/metabolismo , Fluoxetina/metabolismo , Fluoxetina/farmacología , Humanos , Proteínas de Neoplasias/metabolismo , Proteínas de Neoplasias/farmacología , Prazosina/metabolismo , Prazosina/farmacología , Ratas , Espectrometría de Masas en Tándem
14.
Anesthesiology ; 135(2): 218-232, 2021 08 01.
Artículo en Inglés | MEDLINE | ID: mdl-34195765

RESUMEN

BACKGROUND: Delirium is a common and serious postoperative complication, especially in the elderly. Epidural anesthesia may reduce delirium by improving analgesia, reducing opioid consumption, and blunting stress response to surgery. This trial therefore tested the hypothesis that combined epidural-general anesthesia reduces the incidence of postoperative delirium in elderly patients recovering from major noncardiac surgery. METHODS: Patients aged 60 to 90 yr scheduled for major noncardiac thoracic or abdominal surgeries expected to last 2 h or more were enrolled. Participants were randomized 1:1 to either combined epidural-general anesthesia with postoperative epidural analgesia or general anesthesia with postoperative intravenous analgesia. The primary outcome was the incidence of delirium, which was assessed with the Confusion Assessment Method for the Intensive Care Unit twice daily during the initial 7 postoperative days. RESULTS: Between November 2011 and May 2015, 1,802 patients were randomized to combined epidural-general anesthesia (n = 901) or general anesthesia alone (n = 901). Among these, 1,720 patients (mean age, 70 yr; 35% women) completed the study and were included in the intention-to-treat analysis. Delirium was significantly less common in the combined epidural-general anesthesia group (15 [1.8%] of 857 patients) than in the general anesthesia group (43 [5.0%] of 863 patients; relative risk, 0.351; 95% CI, 0.197 to 0.627; P < 0.001; number needed to treat 31). Intraoperative hypotension (systolic blood pressure less than 80 mmHg) was more common in patients assigned to epidural anesthesia (421 [49%] vs. 288 [33%]; relative risk, 1.47, 95% CI, 1.31 to 1.65; P < 0.001), and more epidural patients were given vasopressors (495 [58%] vs. 387 [45%]; relative risk, 1.29; 95% CI, 1.17 to 1.41; P < 0.001). CONCLUSIONS: Older patients randomized to combined epidural-general anesthesia for major thoracic and abdominal surgeries had one third as much delirium but 50% more hypotension. Clinicians should consider combining epidural and general anesthesia in patients at risk of postoperative delirium, and avoiding the combination in patients at risk of hypotension.


Asunto(s)
Analgesia Epidural/métodos , Anestesia General/métodos , Delirio del Despertar/epidemiología , Evaluación Geriátrica/métodos , Procedimientos Quirúrgicos Operativos , Anciano , Anciano de 80 o más Años , China/epidemiología , Quimioterapia Combinada , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad
15.
Anesthesiology ; 135(2): 233-245, 2021 08 01.
Artículo en Inglés | MEDLINE | ID: mdl-34195784

RESUMEN

BACKGROUND: Experimental and observational research suggests that combined epidural-general anesthesia may improve long-term survival after cancer surgery by reducing anesthetic and opioid consumption and by blunting surgery-related inflammation. This study therefore tested the primary hypothesis that combined epidural-general anesthesia improves long-term survival in elderly patients. METHODS: This article presents a long-term follow-up of patients enrolled in a previous trial conducted at five hospitals. Patients aged 60 to 90 yr and scheduled for major noncardiac thoracic and abdominal surgeries were randomly assigned to either combined epidural-general anesthesia with postoperative epidural analgesia or general anesthesia alone with postoperative intravenous analgesia. The primary outcome was overall postoperative survival. Secondary outcomes included cancer-specific, recurrence-free, and event-free survival. RESULTS: Among 1,802 patients who were enrolled and randomized in the underlying trial, 1,712 were included in the long-term analysis; 92% had surgery for cancer. The median follow-up duration was 66 months (interquartile range, 61 to 80). Among patients assigned to combined epidural-general anesthesia, 355 of 853 (42%) died compared with 326 of 859 (38%) deaths in patients assigned to general anesthesia alone: adjusted hazard ratio, 1.07; 95% CI, 0.92 to 1.24; P = 0.408. Cancer-specific survival was similar with combined epidural-general anesthesia (327 of 853 [38%]) and general anesthesia alone (292 of 859 [34%]): adjusted hazard ratio, 1.09; 95% CI, 0.93 to 1.28; P = 0.290. Recurrence-free survival was 401 of 853 [47%] for patients who had combined epidural-general anesthesia versus 389 of 859 [45%] with general anesthesia alone: adjusted hazard ratio, 0.97; 95% CI, 0.84 to 1.12; P = 0.692. Event-free survival was 466 of 853 [55%] in patients who had combined epidural-general anesthesia versus 450 of 859 [52%] for general anesthesia alone: adjusted hazard ratio, 0.99; 95% CI, 0.86 to 1.12; P = 0.815. CONCLUSIONS: In elderly patients having major thoracic and abdominal surgery, combined epidural-general anesthesia with epidural analgesia did not improve overall or cancer-specific long-term mortality. Nor did epidural analgesia improve recurrence-free survival. Either approach can therefore reasonably be selected based on patient and clinician preference.


Asunto(s)
Analgesia Epidural/mortalidad , Anestesia General/mortalidad , Evaluación Geriátrica/métodos , Procedimientos Quirúrgicos Operativos/mortalidad , Anciano , Anciano de 80 o más Años , Analgesia Epidural/métodos , Anestesia General/métodos , China/epidemiología , Quimioterapia Combinada , Femenino , Estudios de Seguimiento , Evaluación Geriátrica/estadística & datos numéricos , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Sobrevida
16.
J Pharm Biomed Anal ; 202: 114140, 2021 Aug 05.
Artículo en Inglés | MEDLINE | ID: mdl-34015592

RESUMEN

A rapid ultra-high performance liquid chromatography coupled with triple quadrupole tandem mass spectrometry (UHPLC-QqQ MS/MS) approach with high sensitivity and selectivity was developed for the quantification of twenty compounds, including 9 saponins, 8 flavonoids, 2 oligosaccharide esters and 1 phenolic acid, in rat plasma and brain, which was administrated intragastrically with Jia-Wei-Qi-Fu-Yin (JWQFY), Mass spectrometric detection was operated under multiple reaction monitoring (MRM) mode. All calibration curves possessed good linearity with correlation coefficients ( r2) higher than 0.9916 in their respective linear ranges. For intra- and inter-day precision, all the relative standard deviations (RSDs) at different levels were less than 14.68 %. Based on the UHPLC-QqQ MS/MS quantitative results, pharmacokinetic study and brain distribution of multiple components in JWQFY was then successfully performed. As a result, constituents with discrepancy structures showed diverse pharmacokinetic and distribution characteristics. For instance, ferulic acid (phenolic acid), 3, 6'-disinapoyl sucrose and tenuifoliside A (oligosaccharide esters) showed short Tmax (< 10 min), whereas the Tmax of ginsenosides Rb1, Rb2 and Rc (ppd-type terpenoid saponins) were much longer (> 4 h). Besides, ferulic acid, epimedin C, icariin, glycyrrhizin, ginsenoside Rb1 and ginsenoside Rg1 were considered as the potential effective ingredients of JWQFY because of their relatively high exposure to blood and brain. Our study would provide relevant information for discovery of pharmacodynamic ingredients, as well as further action mechanisms investigations of JWQFY.


Asunto(s)
Medicamentos Herbarios Chinos , Espectrometría de Masas en Tándem , Administración Oral , Animales , Encéfalo , Cromatografía Líquida de Alta Presión , Ratas , Reproducibilidad de los Resultados
17.
Ann Transl Med ; 9(4): 349, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33708976

RESUMEN

BACKGROUND: Neurodevelopmental and neurodegenerative theories of depression suggest that patients with major depressive disorder (MDD) may follow abnormal developmental, maturational, and aging processes. However, a lack of lifespan studies has precluded verification of these theories. Herein, we analyzed functional magnetic resonance imaging (fMRI) data to comprehensively characterize age-related functional trajectories, as measured by the fractional amplitude of low frequency fluctuations (fALFF), over the course of MDD. METHODS: In total, 235 MDD patients with age-differentiated onsets and 235 age- and sex-matched healthy controls (HC) were included in this study. We determined the pattern of age-related fALFF changes by cross-sectionally establishing the general linear model (GLM) between fALFF and age over a lifespan. Furthermore, the subjects were divided into four age groups to assess age-related neural changes in detail. Inter-group fALFF comparison (MDD vs. HC) was conducted in each age group and Granger causal analysis (GCA) was applied to investigate effective connectivity between regions. RESULTS: Compared with the HC, no significant quadratic or linear age effects were found in MDD over the entire lifespan, suggesting that depression affects the normal developmental, maturational, and degenerative process. Inter-group differences in fALFF values varied significantly at different ages of onset. This implies that MDD may impact brain functions in a highly dynamic way, with different patterns of alterations at different stages of life. Moreover, the GCA analysis results indicated that MDD followed a distinct pattern of effective connectivity relative to HC, and this may be the neural basis of MDD with age-differentiated onsets. CONCLUSIONS: Our findings provide evidence that normal developmental, maturational, and ageing processes were affected by MDD. Most strikingly, functional plasticity changes in MDD with different ages of onset involved dynamic interactions between neuropathological processes in a tract-specific manner.

18.
Ann Transl Med ; 8(18): 1165, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-33241014

RESUMEN

BACKGROUND: A transthoracic impedance (TTI) signal is an important indicator of the quality of chest compressions (CCs) during cardiopulmonary resuscitation (CPR). We proposed an automatic detection algorithm including the wavelet decomposition, fuzzy c-means (FCM) clustering, and deep belief network (DBN) to identify the compression and ventilation waveforms for evaluating the quality of CPR. METHODS: TTI signals were collected from a cardiac arrest model that electrically induced cardiac arrest in pigs. All signals were denoised using the wavelet and morphology method. The potential compression and ventilation waveforms were marked using an algorithm with a multi-resolution window. The compressions and ventilations in these waveforms were identified and classified using the FCM clustering and DBN methods. RESULTS: Using the FCM clustering method, the positive predictive values (PPVs) for compressions and ventilations were 99.7% and 95.7%, respectively. The sensitivities of recognition were 99.8% for compressions and 95.1% for ventilations. The DBN approach exhibited similar PPV and sensitivity results to the FCM clustering method. The time cost was satisfactory using either of these techniques. CONCLUSIONS: Our findings suggest that FCM clustering and DBN can be utilized to effectively and accurately evaluate CPR quality, and provide information for improving the success rate of CPR. Our real-time algorithms using FCM clustering and DBN eliminated most distortions and noises effectively, and correctly identified the compression and ventilation waveforms with a low time cost.

19.
Huan Jing Ke Xue ; 41(9): 4011-4020, 2020 Sep 08.
Artículo en Chino | MEDLINE | ID: mdl-33124281

RESUMEN

Groundwater resources are important sources of water in the arid region of northwestern China, but their overexploitation and utilization has led to a series of ecological and environmental problems. Exploring the characteristics and mechanism of groundwater chemical evolution is important for the rational use of groundwater resources. The characteristics of groundwater chemical evolution were studied in the Yongji Irrigation Area of Hetao Irrigation District and the formation mechanism of the chemical compounds in groundwater were investigated using cluster analysis, factor analysis, and other statistical methods. The influence degree of different factors was calculated. The results showed that the major cations in groundwater in the study area were Na+ and K+, and the major anions were Cl- and HCO3-. Moreover, Na+, K+, and Cl- showed high spatial variability and were the main factors contributing to groundwater salinization. The major chemical compounds in the groundwater in the study area were Cl-Na, HCO3 ·Cl ·SO4-Na, and HCO3-Na. Based on the cluster analysis results, the groundwater was divided into four categories (A1, A2, B1, and B2), of which A1 was highly mineralized by Cl-Na type water, while A2, B1, and B2 were mainly HCO3 ·Cl ·SO4-Na and HCO3-Na type water. Principal component analysis results suggest that groundwater chemistry was mainly affected by salinization, carbonate karstification, and human activities with the influence degrees of 45.976%, 23.853% and 16.678%, respectively. Evaporation, salt rock dissolution, and cation exchange were important sources of Na+ and Cl- accumulation in the irrigation area. Agricultural irrigation (leaching of soil salts) and drought (intense transpiration) were the key drivers of groundwater salinization in the irrigation area.


Asunto(s)
Agua Subterránea , Contaminantes Químicos del Agua , Riego Agrícola , China , Monitoreo del Ambiente , Evolución Química , Humanos , Contaminantes Químicos del Agua/análisis
20.
J Clin Invest ; 130(12): 6510-6522, 2020 12 01.
Artículo en Inglés | MEDLINE | ID: mdl-32853180

RESUMEN

The sodium-phosphate cotransporter NPT2a plays a key role in the reabsorption of filtered phosphate in proximal renal tubules, thereby critically contributing to phosphate homeostasis. Inadequate urinary phosphate excretion can lead to severe hyperphosphatemia as in tumoral calcinosis and chronic kidney disease (CKD). Pharmacological inhibition of NPT2a may therefore represent an attractive approach for treating hyperphosphatemic conditions. The NPT2a-selective small-molecule inhibitor PF-06869206 was previously shown to reduce phosphate uptake in human proximal tubular cells in vitro. Here, we investigated the acute and chronic effects of the inhibitor in rodents and report that administration of PF-06869206 was well tolerated and elicited a dose-dependent increase in fractional phosphate excretion. This phosphaturic effect lowered plasma phosphate levels in WT mice and in rats with CKD due to subtotal nephrectomy. PF-06869206 had no effect on Npt2a-null mice, but promoted phosphate excretion and reduced phosphate levels in normophophatemic mice lacking Npt2c and in hyperphosphatemic mice lacking Fgf23 or Galnt3. In CKD rats, once-daily administration of PF-06869206 for 8 weeks induced an unabated acute phosphaturic and hypophosphatemic effect, but had no statistically significant effect on FGF23 or PTH levels. Selective pharmacological inhibition of NPT2a thus holds promise as a therapeutic option for genetic and acquired hyperphosphatemic disorders.


Asunto(s)
Hiperfosfatemia/metabolismo , Fosfatos/metabolismo , Insuficiencia Renal Crónica/metabolismo , Proteínas Cotransportadoras de Sodio-Fosfato de Tipo IIa , Animales , Factor-23 de Crecimiento de Fibroblastos , Factores de Crecimiento de Fibroblastos/genética , Factores de Crecimiento de Fibroblastos/metabolismo , Hiperfosfatemia/genética , Hiperfosfatemia/patología , Masculino , Ratones , Ratones Noqueados , N-Acetilgalactosaminiltransferasas/genética , N-Acetilgalactosaminiltransferasas/metabolismo , Ratas , Ratas Sprague-Dawley , Insuficiencia Renal Crónica/genética , Insuficiencia Renal Crónica/patología , Proteínas Cotransportadoras de Sodio-Fosfato de Tipo IIa/antagonistas & inhibidores , Proteínas Cotransportadoras de Sodio-Fosfato de Tipo IIa/genética , Proteínas Cotransportadoras de Sodio-Fosfato de Tipo IIa/metabolismo , Polipéptido N-Acetilgalactosaminiltransferasa
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