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BACKGROUND: Whether patients with cT1 - 2N1M0 breast cancer can benefit from postoperative radiotherapy (RT) after receiving neoadjuvant chemotherapy (NAC) has been controversial. Therefore, the purpose of this study was to explore whether postoperative RT can benefit this group of patients in terms of survival. METHODS: We used Surveillance, Epidemiology, and End Results (SEER) data to conduct a retrospective review of women with cT1 - 2N1M0 breast cancer diagnosed between 20 and 80 years of age who received NAC between 2010 and 2015. Our study compared the impact of postoperative RT on overall survival (OS) and cancer-specific survival (CSS) in breast cancer patients using propensity score matching (PSM) and performed subgroup analysis. RESULTS: This study finally included 1092 cT1 - 2N1M0 breast cancer patients. Regardless of the patient's PSM status, postoperative RT was significantly associated with OS of cT1-2N1M0 breast cancer patients who received NAC. Specifically, the 10-year OS rate was 78.7% before PSM matching, compared with 71.1% in patients who did not receive postoperative RT, and the difference was more significant after PSM matching, which was 83.1% and 71.1% respectively. However, postoperative RT did not significantly benefit CSS in patients with cT1 - 2N1M0 breast cancer who received NAC. The 10-year CSS rate was 81.4% VS 76.2% (P = 0.085) before PSM matching and 85.8% VS 76.2%(P = 0.076) after matching. Due to the intersection of OS and CSS curves, this restricted mean survival time (RMST) method was chosen as a supplement. After 60 months, the OS difference in RMST between the postoperative RT group and the non-radiotherapy (noRT) group was 7.37 months (95%CI: 0.54-14.21; P = 0.034), and the CSS difference was 5.18 months (95%CI: -1.31-11.68; P = 0.118). Subgroup analysis found that in patients with right-sided breast cancer, postoperative RT improved the patient's OS (HR = 0.45, 95%CI: 0.21-0.95, P = 0.037) and CSS (HR = 0.42, 95%CI: 0.18-0.98, P = 0.045). CONCLUSIONS: Our results showed that additional postoperative RT improved the OS of cT1 - 2N1M0 breast cancer patients who received NAC, but failed to improve their CSS. It is worth noting that in the subgroup analysis of patients with right-sided breast cancer, we observed significant improvements in OS and CSS. And further prospective studies are still needed to verify the effect of postoperative RT in different subgroups.
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Neoplasias da Mama , Terapia Neoadjuvante , Programa de SEER , Humanos , Feminino , Neoplasias da Mama/terapia , Neoplasias da Mama/mortalidade , Neoplasias da Mama/radioterapia , Neoplasias da Mama/tratamento farmacológico , Terapia Neoadjuvante/métodos , Terapia Neoadjuvante/estatística & dados numéricos , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto , Idoso , Radioterapia Adjuvante , Estadiamento de Neoplasias , Quimioterapia Adjuvante/métodos , Período Pós-Operatório , Idoso de 80 Anos ou mais , Pontuação de Propensão , Taxa de Sobrevida , Adulto JovemRESUMO
BACKGROUND: The triglyceride-glucose (TyG) index is a new, simple, and inexpensive marker of insulin resistance that is becoming increasingly important as a promising predictor of diseases such as atherosclerosis. Atherosclerosis is the main cause of lower extremity arterial disease (LEAD). In this study, we investigated the relationship between TyG index values and LEAD risk in patients with diabetes. METHODS: Patients with diabetes hospitalized at the Endocrinology Department of our hospital from June 1, 2021, to May 31, 2022, were retrospectively included. Baseline data, biochemical indicators, and ankle-brachial index values were collected. Statistical methods were used to assess the relationship between TyG index values and the risk of LEAD. RESULTS: A total of 1,040 hospitalized patients with diabetes were included, they were divided into the LEAD group with 168 patients and the no LEAD group with 872 patients. TyG index values in the LEAD group were higher than those in the no LEAD group (9.94 ± 0.78 vs. 9.36 ± 0.70, P < 0.001). TyG index values were independently correlated with LEAD risk in patients with diabetes (odds ratio = 3.92, 95% confidence interval (CI): 2.92-5.26, P < 0.001) in multivariate logistic regression analysis after adjusting for different risk factors (all P < 0.05). The area under the receiver operating characteristic curve was 0.72 (95% CI: 0.68-0.76) when TyG index values were used to diagnose LEAD in patients with diabetes. When Youden's index reached the maximum value of 0.34, the optimal TyG index threshold for predicting the onset of diabetic LEAD was 9.56, sensitivity was 71.1%, and specificity was 63.0%. CONCLUSIONS: Increases in TyG index values were associated with the risk of LEAD in patients with diabetes and, thus, may be used as a predictor of LEAD in this patient population, especially in primary care institutions with relatively few resources.
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Aterosclerose , Diabetes Mellitus , Humanos , Estudos Retrospectivos , Resultado do Tratamento , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/epidemiologia , Extremidade Inferior , Fatores de Risco , Glucose , Glicemia , Biomarcadores , TriglicerídeosRESUMO
General methods for the preparation of geminal bis(boronates) are of great interest due to their widespread applications in organic synthesis. While the terminal gem-diboron compounds are readily accessible, the construction of the sterically encumbered, internal analogues has remained a prominent challenge. Herein, we report a formal umpolung strategy to access these valuable building blocks. The readily available 1,1-diborylalkanes were first converted into the corresponding α-halogenated derivatives, which then serve as electrophilic components, undergoing a formal substitution with a diverse array of nucleophiles to form a series of C-C, C-O, C-S, and C-N bonds. This protocol features good tolerance to steric hindrance and a wide variety of functional groups and heterocycles. Notably, this strategy can also be extended to the synthesis of diaryl and terminal gem-diboron compounds, therefore providing a general approach to various types of geminal bis(boronates).
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BACKGROUND: Sulfonamide residues in foods of animal origin are potential risks to consumer health, so it is very important to inspect them. Among the previously reported instrumental methods, the best method can only be used to determine at most 22 sulfonamides. Thus, an instrumental method capable of determining more sulfonamide species is desirable. RESULTS: In this study, sulfadoxine was used as a template to synthesize a type of magnetic molecularly imprinted polymer that could recognize 35 sulfonamides. After characterization, this composite was used to develop a dispersive solid-phase extraction method for extraction and purification of the 35 sulfonamides in pork, followed by determination using an ultra-performance liquid chromatography photodiode array method. This composite exhibited high adsorption capacity (11.01-19.21 µg mg-1 ) and high recovery (>89.01%), and could be reused at least ten times. Due to the enrichment effect during sample preparation (enrichment factor 22-66), the limits of detection for determination of the 35 drugs in pork were in the range of 0.08-0.53 ng g-1 . The detection results for some real pork samples were consistent with a liquid chromatographic-tandem mass spectrometric method. After comparison, the present method showed generally better performances than the previously reported sample preparation methods and instrumental methods for detection of sulfonamides. CONCLUSION: The method developed in the present study could be used as a practical tool for routine detection of sulfonamide residues in pork samples. © 2022 Society of Chemical Industry.
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Impressão Molecular , Carne de Porco , Carne Vermelha , Animais , Suínos , Polímeros Molecularmente Impressos/análise , Cromatografia Líquida de Alta Pressão/métodos , Carne Vermelha/análise , Carne de Porco/análise , Sulfonamidas/química , Cromatografia Líquida , Extração em Fase Sólida/métodos , Sulfanilamida , Fenômenos Magnéticos , Impressão Molecular/métodosRESUMO
Permanent pacemaker implantation is one of the most effective treatments for chronic arrhythmia. However, there is a certain risk associated with radiation therapy in cancer patients with implantable cardiac pacemakers. To prevent radiotherapy-induced pacemaker failure, there are established medical guidelines for the use of pacemakers in patients undergoing radiotherapy. With advancements in science and technology, the variety of available pacemakers has considerably increased, and radiotherapy equipment has also been updated. Given the variations in irradiation methods and the types of radiation used in clinical practice, there is a pressing need for international consensus on the regulations governing the use of cardiac pacemakers in cancer patients. Currently, many countries lack clinical guidelines for radiotherapy in cancer patients with cardiac pacemakers. This review summarizes recent reports and studies from PubMed (National Center for Biotechnology Information) regarding the safety of radiotherapy in cancer patients with implanted cardiac pacemakers, and provides valuable insights for clinical practice.
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Herein we reported a transition metal-free deborylative cyclization strategy, based on which two routes have been developed, generating racemic and enantioenriched cyclopropylboronates. The cyclization of geminal-bis(boronates) bearing a leaving group was highly diastereoselective, tolerating a few functional groups and applicable to heterocycles. When optically active epoxides were used as the starting materials, enantioenriched cyclopropylboronates could be efficiently prepared with >99 % stereospecificity. Mechanistic studies showed that the leaving group at the γ-position played a crucial role and significantly promoted the activation of the gem-diboron moiety.
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Alleviating vascular injury improves the prognosis of atherosclerosis. Semaphorin-3a (Sema3A) is a special membrane-associated secreted protein with various biological properties, like pro-inflammation, anti-tumor and et al. This study aims to investigate the effects of inhibition of Sema3A on lipopolysaccharide (LPS)-induced vascular injury in mice. The mice were randomized into three groups: control, LPS, and LPS + siRNA. Mice in the combined group were given siRNA through fast tail vein injection, then LPS was injected intraperitoneally 7 days later, finally the mice were euthanized 24 h later. Vascular function and structure were assessed by vascular injury biomarkers and relevant stainings. LPS-induced vascular dysfunction and pathological injury were substantially improved by inhibition of Sema3A. Western blot and quantitative real-time polymerase chain reaction assays were used for investigating molecular pathways. The relevant proteins of vascular endothelial cells activation, intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1), increased after LPS stimulation, while these effects were reversed by inhibition of Sema3A. The levels of inflammatory cytokines (IL-1ß, IL-6 and NLRP3) were upregulated after LPS stimulation, however, inhibition of Sema3A reversed it through NF-κB and MAPKs signaling pathways involvement. Moreover, inhibition of Sema3A alleviated LPS-induced oxidative stress, evidenced by a decrease in total reactive oxygen species and an increase in antioxidant protein of SOD-1. The results showed that inhibition of Sema3A protects against LPS-induced vascular injury by suppressing vascular endothelial cells activation, vascular inflammation, and vascular oxidative stress, implying that inhibition of Sema3A might be used as a therapeutic strategy for septic vascular injury or atherosclerosis.
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Aterosclerose , Lesões do Sistema Vascular , Animais , Células Endoteliais/metabolismo , Inflamação/induzido quimicamente , Inflamação/genética , Inflamação/prevenção & controle , Lipopolissacarídeos/toxicidade , Camundongos , NF-kappa B , RNA Interferente Pequeno , Semaforina-3A/genética , Semaforina-3A/metabolismoRESUMO
Zinc (Zn) is an essential micro-nutrient for humans, and Zn deficiency is of global concern. In addition to inherited and pathological Zn deficiencies, insufficient dietary intake is leading cause, especially in those consuming cereal grains as a stable food, in which Zn concentration and bioavailability are relatively low. To improve Zn levels in the human body, it is important to understand the accumulation and bioavailability of Zn in cereal grains. In recent years, knowledge on the molecular mechanisms underlying Zn uptake, transport, homeostasis, and deposition within cereal crops has been accumulating, paving the way for a more targeted approach to improving the nutrient status of crop plants. In this paper, we briefly review existing studies on the distribution and transport pathways of Zn in major small-grained cereals, using wheat as a case study. The findings confirm that Zn transport in plants is a complex physiological process mainly governed by Zn transporters and metal chelators. This work reviews studies on Zn uptake, transport, and deposition in wheat plants, summarizes the possible barriers impairing Zn deposition in wheat grains, and describes strategies for increasing Zn concentration in wheat grains.
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Triticum , Zinco , Disponibilidade Biológica , Quelantes/metabolismo , Grão Comestível/metabolismo , HumanosRESUMO
Stem node has been found to be a hub for controlling mineral nutrient distribution in gramineous plants. However, the characteristics of stem nodes associated with whole-plant carbon partitioning in maize (Zea mays L.) and their responses to nitrogen (N) availability remains elusive. Maize plants were grown in greenhouse under low to high N supply. Plant growth, sugar accumulation, and sugar transporters in nodes and leaves, as well as the anatomical structure of nodes, were investigated at vegetative phase. When compared to N-sufficient plants, low-N availability stunted growth and resulted in 49-64% less sugars in leaves, which was attributed to low photosynthesis or the accelerated carbon export, as evidenced by more 13C detected further below leaf tips. Invariably higher sugar concentrations were found in the stem nodes, rather than in the leaves across N treatments, indicating a crucial role of nodes in facilitating whole-plant carbon partitioning. More and smaller vascular bundles and phloem were observed in stem nodes of N-deficient plants, while higher sugar levels were found in the bottom nodes than in the upper ones. Low-N availability upregulated the gene expressions of sugar transporters, which putatively function in nodes such as ZmSWEETs and ZmSUTs at the bottom stem, but suppressed them in the upper ones, showing a developmental impact on node function. Further, greater activity of sugar transporters in the bottom nodes was associated with less sugars in leaves. Overall, these results highlighted that stem nodes may play an important role in facilitating long-distance sugar transport in maize.
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Nitrogênio , Zea mays , Carboidratos , Carbono/metabolismo , Nitrogênio/metabolismo , Floema/metabolismo , Folhas de Planta/metabolismo , Plantas/metabolismo , Açúcares/metabolismo , Zea mays/metabolismoRESUMO
In this study, nitrobenzene was used as dummy template to synthesize a type of specific molecularly imprinted microspheres for chloramphenicol, and 4-nitroaniline was coupled with three fluorophores to synthesize three fluorescent tracers. Then a competitive fluorescence method was developed on a conventional microplate for detection of chloramphenicol in chicken and pork samples. This method contained only one sample-loading step, so one assay was finished within 30 min. The IC50 was 1.8 ng/ml, and the limit of detection was 0.06 ng/g. The recoveries from chloramphenicol-fortified blank meat samples were in the range 67.5-96.2%. Furthermore, this method could be recycled three times. The detection results for some real meat samples were identical to that of a LC-MS/MS method. Therefore, this method could be used as a practical tool for routine screening for the residue of chloramphenicol in large number of meat samples.
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Cloranfenicol , Impressão Molecular , Cloranfenicol/análise , Cromatografia Líquida , Carne/análise , Microesferas , Espectrometria de Massas em TandemRESUMO
In cells, mechanical forces play a key role in impacting cell behaviors, including adhesion, differentiation, migration, and death. Herein, a 20 nm mitochondria-targeted zinc-doped iron oxide nanocube is designed as a nanospinner to exert mechanical forces under a rotating magnetic field (RMF) at 15 Hz and 40 mT to fight against cancer. The nanospinners can efficiently target the mitochondria of cancer cells. By means of the RMF, the nanocubes assemble in alignment with the external field and produce a localized mechanical force to impair the cancer cells. Both in vitro and in vivo studies show that the nanospinners can damage the cancer cells and reduce the brain tumor growth rate after the application of the RMF. This nanoplatform provides an effective magnetomechanical approach to treat deep-seated tumors in a spatiotemporal fashion.
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Magnetismo , Mitocôndrias/metabolismo , Nanotecnologia , Neoplasias/terapia , Linhagem Celular Tumoral , Linhagem da Célula , Humanos , Fenômenos Mecânicos , Neoplasias/patologiaRESUMO
Targeting mitochondria has always been a challenging goal for therapeutic nanoparticle agents due to their heterotypic features and size, which usually lead to a lysosome/endosome endocytosis pathway. To overcome this limitation, in this work, a portfolio targeting strategy combining a small targeting molecule with a biomembrane was developed. Modification of small targeting molecule H2N-TPP on gold nanoparticles (GNPs) could not only facilitate the mitochondrial targeting but could also induce gold nanoparticle assembly. Therefore, the GNPs were endowed with good absorption and photothermal conversion abilities in the near-infrared (NIR) region. Meanwhile, a biomimetic strategy was adopted by wrapping the gold nanoparticle assembly (GNA) with cancer cell membranes (CCMs), which helped the GNA enter the prostatic cancer cell via a homotypic membrane-fusion process to avoid being trapped in endosomes/lysosomes. Thereafter, the GNA remaining in the cytoplasm could reach mitochondria more efficiently via guidance from H2N-TPP molecules. This "biomembrane-small molecule" combination targeting process was evidenced by fluorescence microscopy, and the highly efficient photothermal ablation of prostatic tumors in vivo was demonstrated. This portfolio targeting strategy could be extended to various nanodrugs/agents to realize an accurate subcellular targeting efficiency for cancer treatments or cell detections.
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Ouro/química , Ouro/metabolismo , Raios Infravermelhos , Fusão de Membrana , Nanopartículas Metálicas/química , Mitocôndrias/metabolismo , Fototerapia/métodos , Biomimética , Linhagem Celular Tumoral , Endossomos/metabolismo , Humanos , Lisossomos/metabolismoRESUMO
OBJECTIVE: Granulocyte colony-stimulating factor (G-CSF) is the critical regulator of the proliferation, differentiation, and survival of granulocytes. Recently, it has been shown that G-CSF can adversely affect bone health in both animal models and patients. Here, the authors aimed to investigate whether G-CSF could inhibit the growth of osteoblasts and osteocytes by regulating nitric oxide. METHODS: The C57BL/6 mice were divided into the control group, G-CSF treatment group and recovery group (G-CSF+L-NAME). The morphology of femurs was assessed by histology and immunohistochemistry. The expression of apoptosis-related molecules in femurs was detected by immunohistochemistry and quantitative RT-PCR, respectively. To examine if neutrophil-secreted factors can induce apoptosis in osteoblasts, Gr1-positive (Gr1+) neutrophils from the bone marrow of wild-type mice were sorted and co-cultured with MC3T3 pre-osteoblasts for 2 days. RESULTS: The number of osteoblasts and newly embedding osteocytes significantly decreased and markers related to osteoblasts and osteocytes were downregulated in the G-CSF treatment compared to the control group. Moreover, G-CSF treatment did not change proliferation markers but induced apoptosis in osteoblast-lineage cells. The combined treatment of mice with G-CSF and a nitric oxide inhibitor partially restored the number of osteoblasts and osteocyte parameters. CONCLUSIONS: The G-CSF can inhibit osteoblasts and osteocytes by upregulating nitric oxide.
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Fator Estimulador de Colônias de Granulócitos/farmacologia , Neutrófilos/efeitos dos fármacos , Óxido Nítrico/biossíntese , Osteoblastos/efeitos dos fármacos , Osteócitos/efeitos dos fármacos , Animais , Apoptose/efeitos dos fármacos , Proliferação de Células/efeitos dos fármacos , Feminino , Camundongos , Camundongos Endogâmicos C57BL , Neutrófilos/citologia , Neutrófilos/metabolismo , Osteoblastos/citologia , Osteócitos/citologia , Osteócitos/metabolismo , Regulação para Cima/efeitos dos fármacosRESUMO
We reported the first lysosome targeted two-photon fluorescent probe (Lyso-NP) as a viscosity probe for monitoring autophagy. The fluorescence lifetime of Lyso-NP exhibited an excellent linear relationship with viscosity value ( R2 = 0.99, x = 0.39). Lyso-NP also showed the specific capability for imaging lysosomal viscosity under two-photon excitation at 860 nm along with good biocompatibility. More importantly, Lyso-NP could be used to monitor the autophagy process in living cells by quantitatively detecting lysosomal viscosity changes during the membrane fusion process via two-photon fluorescence lifetime imaging.
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Autofagia , Corantes Fluorescentes/química , Imagem Óptica , Fótons , Humanos , Células MCF-7 , Microscopia de Fluorescência , Estrutura Molecular , ViscosidadeRESUMO
Maize (Zea mays) plants exhibit altered carbon partitioning under nitrogen (N) deficiency, but the mechanisms by which N availability affects sugar export out of leaves and transport into developing ears remain unclear. Maize was grown under field conditions with different N supply. Plant growth, sugar movement, and starch turnover in source or sink tissues were investigated at silking and 20 or 21 days after silking. Nitrogen deficiency stunted plant growth and grain yield compared with N-sufficient plants, and resulted in greater starch concentrations in leaves due to more as well as larger starch granules in bundle sheath cells. Transmission electron microscopy revealed an open symplastic pathway for sucrose movement in N-deficient leaves, while the expression levels of transporters responsible for sucrose efflux and phloem loading were lower than in N-sufficient leaves. Nonetheless, greater starch concentrations in the apical cob portion of N-deficient plants implied sufficient carbon supply relative to the diminished sink strength (decreased kernel number and weight). Together with the high sugar concentrations in the developing kernels, the results indicated that reduced sink capacity and sugar utilization during grain filling may limit the yield in N-deficient plants, which in turn imposes a feedback inhibition on sugar export from leaves.
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Carbono/metabolismo , Grão Comestível/crescimento & desenvolvimento , Nitrogênio/deficiência , Açúcares/metabolismo , Zea mays/metabolismo , Transporte Biológico , Sequestro de Carbono , Grão Comestível/metabolismo , Folhas de Planta/metabolismo , Zea mays/crescimento & desenvolvimentoRESUMO
Fluorescent probes, as noninvasive tools for visualizing the metabolism of biomolecules, hold great potential to explore their physiological and pathological processes. For cysteine (Cys), however, none of the reported fluorescent probes could image the metabolic processes in living cells. To achieve this goal, we developed a coumarin derivative based on rational design of the dual recognition sites for Cys and its metabolite, SO2. The probe displayed distinct two channels with turn-on fluorescent emission toward Cys and SO2, which were successfully applied for imaging both A549 cells and zebrafish. Further, with reversible fluorescent responses toward Cys, the probe could image the enzymatic conversion of Cys to SO2 in living A549 cells in a ratiometric manner. The present work reports the first probe to image the endogenous generated SO2 without incubation of the SO2 donors.
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Cisteína/metabolismo , Corantes Fluorescentes/química , Dióxido de Enxofre/metabolismo , Animais , Linhagem Celular Tumoral , Cisteína/química , Fluorescência , Corantes Fluorescentes/metabolismo , Humanos , Estrutura Molecular , Espectrofotometria Ultravioleta , Dióxido de Enxofre/química , Peixe-ZebraRESUMO
Herein, a novel near-infrared fluorescent probe for ratiometric detection of bisulfate was designed and developed based on a conjugation of naphthopyran-benzothiazolium system. The sensor showed excellent selectivity, high sensitivity and a rapid response toward bisulfite in aqueous solution. Upon the addition of HSO3-, the sensor displayed 37-fold (I520/I630) fluorescence intensity enhancement, accompanied by an apparent color change from violet to colorless, suggesting that the sensor can be used to detect HSO3- with "naked-eye". Notably, the addition product can be applied to the design of regenerative chemodosimeters based on the H2O2 promoted elimination of bisulfite and recovery of probe 1. Further cell and zebrafish imaging experiment demonstrated that the sensor could image the bisulfite/H2O2 redox cycle in biological system with ratiometric manners.
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Corantes Fluorescentes/química , Peróxido de Hidrogênio/análise , Sulfitos/análise , Peixe-Zebra/metabolismo , Animais , Corantes Fluorescentes/síntese química , Humanos , Células MCF-7 , Microscopia Confocal , Espectrometria de FluorescênciaRESUMO
BACKGROUND: As a newly approved immune checkpoint inhibitor in China, serplulimab has been widely used in the immunotherapy of tumors. However, the immune-related adverse events of immune checkpoint inhibitors should not be ignored. Although immune checkpoint inhibitor-induced type 1 diabetes mellitus is a rare complication, it may cause diabetic ketoacidosis and endanger the lives of patients. CASE PRESENTATION: This case report describes a 55-year-old male of Han nationality from China diagnosed with small-cell lung cancer with multiple metastases who experienced an adverse event of type 1 diabetes mellitus 68 weeks after receiving serplulimab therapy. The patient presented with typical symptoms of diabetic ketoacidosis, including severe thirst, nausea, vomiting, deep respirations, and stupor. Despite the absence of diabetes-related autoantibodies, the patient had extremely low levels of insulin and C-peptide release. Other potential causes of diabetes were ruled out, confirming the condition as serplulimab-induced immune checkpoint inhibitor-induced type 1 diabetes mellitus. After aggressive treatment to correct diabetic ketoacidosis, the patient's blood glucose levels stabilized and symptoms of diabetes improved significantly, although long-term insulin maintenance therapy was necessary. CONCLUSION: This case highlights a rare, late-onset adverse event of immune checkpoint inhibitor-induced type 1 diabetes mellitus that may be overlooked during treatment with serplulimab. The monitoring of blood glucose levels and early signs and symptoms of diabetes cannot be relaxed at the late stage of treatment, even if patients do not have elevated blood glucose levels before and during the middle stage of treatment.
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Diabetes Mellitus Tipo 1 , Cetoacidose Diabética , Neoplasias Pulmonares , Carcinoma de Pequenas Células do Pulmão , Masculino , Humanos , Pessoa de Meia-Idade , Diabetes Mellitus Tipo 1/induzido quimicamente , Diabetes Mellitus Tipo 1/tratamento farmacológico , Inibidores de Checkpoint Imunológico/efeitos adversos , Cetoacidose Diabética/induzido quimicamente , Glicemia , Neoplasias Pulmonares/tratamento farmacológico , Carcinoma de Pequenas Células do Pulmão/tratamento farmacológico , Insulina , Anticorpos MonoclonaisRESUMO
The triglyceride-glucose (TyG) index is a simple and inexpensive new marker of insulin resistance that is being increasingly used for the clinical prediction of metabolic syndrome (MetS). Nevertheless, there are only a few comparative studies on its predictive capacity for MetS versus those using the traditional homeostasis model assessment (HOMA). We conducted a cross-sectional study using a database from the National Health and Nutrition Examination Survey (1999 March to 2020 pre-pandemic period). Using statistical methods, we compared the predictive abilities of the TyG index and HOMA (including HOMA of insulin resistance [HOMA-IR] and HOMA of beta-cell function [HOMA-ß]) for MetS. A total of 34,195 participants were enrolled and divided into the MetS group (23.1%) or no MetS group (76.9%) according to the International Diabetes Federation (IDF) diagnostic criteria. After applying weighted data, the baseline characteristics of the population were described. Following the exclusion of medication influences, the final count was 31,304 participants. Receiver operating characteristic curve analysis revealed that while distinguishing between MetS and no MetS, the TyG index had an area under the curve (AUC) of 0.827 (sensitivity = 71.9%, specificity = 80.5%), and the cutoff was 8.75, slightly outperforming HOMA-IR (AUC = 0.784) and HOMA-ß (AUC = 0.614) with a significance of P < 0.01. The prevalence of MetS in the total population calculated using the TyG index cutoff value was 30.9%, which was higher than that reported in the IDF diagnostic criteria. Weighted data analysis using univariate and multivariate logistic regression displayed an independent association between elevated TyG and HOMA-IR with the risk of MetS. Subgroup analysis further revealed differences in the predictive ability of the TyG index among adult populations across various genders and ethnicities, whereas such differences were not observed for children and adolescents. The TyG index is slightly better than HOMA in predicting MetS and may identify more patients with MetS; thus, its applications in a clinical setting can be appropriately increased.
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Glicemia , Homeostase , Resistência à Insulina , Síndrome Metabólica , Inquéritos Nutricionais , Triglicerídeos , Humanos , Síndrome Metabólica/sangue , Síndrome Metabólica/diagnóstico , Síndrome Metabólica/epidemiologia , Masculino , Feminino , Triglicerídeos/sangue , Pessoa de Meia-Idade , Glicemia/análise , Glicemia/metabolismo , Estudos Transversais , Adulto , Curva ROC , Biomarcadores/sangue , IdosoRESUMO
BACKGROUND: Lung cancer is prone to metastasize to the brain, which is difficult for surgery and leads to poor prognosis due to poor chemotherapy efficacy. OBJECTIVE: Our aim is to evaluate the efficacy and safety of stereotactic body radiotherapy (SBRT) for brain multi-metastases. METHODS: In the retrospective study, a total of 51 non-small cell lung cancer (NSCLC) patients with brain multi-metastases (3-5 metastases) receiving SBRT in the local hospital between 2016 and 2019 were enrolled for analyzing the efficacy and safety of SBRT. The primary endpoints included 1-year local control rate, radiotherapy toxicity, overall survival and progression-free survival. RESULTS: The median follow-up for the enrolled patients was 21 months, and the 1-year and 2-year OS rates were 82.4% and 45.1%, respectively. Demographic analysis showed no significant differences between SBRT alone and combination with whole brain radiotherapy in clinical characteristics including age, gender and Eastern Cooperative Oncology Group performance status. The 1-year local control rate was 77.3% (17/22) for SBRT alone, which was comparable to 79.3% (23/29) of combined radiotherapy. Cox proportional hazard regression demonstrated that the prognostic benefit of combining WBRT was not significantly superior to SBRT alone (HR = 0.851, P= 0.263). Their radiotherapy toxicity rate was lower in SBRT alone group (13.6%, vs. 44.8% for combination; P= 0.017). CONCLUSION: The current research suggested that SBRT alone could effectively relieve tumor burden and improve the prognosis and quality of life for NSCLC patients with brain multi-metastases, which should be validated in further prospective clinical trials.