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1.
EMBO J ; 38(14): e100978, 2019 07 15.
Artículo en Inglés | MEDLINE | ID: mdl-31304625

RESUMEN

Viral infection triggers the formation of mitochondrial antiviral signaling protein (MAVS) aggregates, which potently promote immune signaling. Autophagy plays an important role in controlling MAVS-mediated antiviral signaling; however, the exact molecular mechanism underlying the targeted autophagic degradation of MAVS remains unclear. Here, we investigated the mechanism by which RNF34 regulates immunity and mitophagy by targeting MAVS. RNF34 binds to MAVS in the mitochondrial compartment after viral infection and negatively regulates RIG-I-like receptor (RLR)-mediated antiviral immunity. Moreover, RNF34 catalyzes the K27-/K29-linked ubiquitination of MAVS at Lys 297, 311, 348, and 362 Arg, which serves as a recognition signal for NDP52-dependent autophagic degradation. Specifically, RNF34 initiates the K63- to K27-linked ubiquitination transition on MAVS primarily at Lys 311, which facilitates the autophagic degradation of MAVS upon RIG-I stimulation. Notably, RNF34 is required for the clearance of damaged mitochondria upon viral infection. Thus, we elucidated the mechanism by which RNF34-mediated autophagic degradation of MAVS regulates the innate immune response, mitochondrial homeostasis, and infection.


Asunto(s)
Proteínas Adaptadoras Transductoras de Señales/química , Proteínas Adaptadoras Transductoras de Señales/metabolismo , Proteínas Portadoras/metabolismo , Mitocondrias/metabolismo , Virosis/inmunología , Proteína 58 DEAD Box/metabolismo , Células HEK293 , Células HeLa , Humanos , Inmunidad Innata , Lisina/metabolismo , Mitofagia , Proteolisis , Receptores Inmunológicos , Transducción de Señal , Células THP-1 , Ubiquitinación , Virosis/metabolismo
2.
Sensors (Basel) ; 23(6)2023 Mar 08.
Artículo en Inglés | MEDLINE | ID: mdl-36991636

RESUMEN

In order to reduce the impact of the environment on the accuracy and sensitivity of detection, and to meet the requirements of concealment from detection and being lightweight, a technology for detecting flying metal objects based on photoelectric composite sensors is proposed. The method first analyzes the target's characteristics and detection environment, and then compares and analyzes the methods for detecting typical flying metal objects. On the basis of the traditional eddy current model, the photoelectric composite detection model that meets the requirements of detecting flying metal objects was studied and designed. For the problems of the short detection distance and the long response time of the traditional eddy current model, the performance of the eddy current sensor was improved to meet the requirements of detection through optimizing the detection circuit and coil parameter model. Meanwhile, to meet the goal of being lightweight, an infrared detection array model applicable to flying metal bodies was designed, and simulation experiments of composite detection based on the model were conducted. The results show that the flying metal body detection model based on photoelectric composite sensors met the requirements of distance and response time for detecting flying metal bodies and may provide an avenue for exploring the composite detection of flying metal bodies.

3.
Int Wound J ; 21(3): e14520, 2023 Nov 27.
Artículo en Inglés | MEDLINE | ID: mdl-38010066

RESUMEN

Post-joint arthroplasty infections, especially surgical site infections (SSI) and periprosthetic joint infections (PJI), significantly impact patient outcomes. The potential influence of malnutrition on these postoperative complications remains a crucial concern for clinicians. Adhering to PRISMA guidelines, we performed a systematic review and meta-analysis using four databases up to 19 July 2023. We sought studies on joint replacements, focusing on malnutrition as an SSI risk factor. The malnutrition criteria were defined by specific laboratory parameters. Two independent reviewers undertook data extraction and quality assessment, with discrepancies resolved through consensus or third-party review. Studies were evaluated for methodological quality using the Newcastle-Ottawa Scale (NOS). For statistical analyses, heterogeneity was assessed using the I2 statistic, and both fixed and random-effects models were employed based on heterogeneity levels, utilizing Stata software (version 17). Significant heterogeneity was present among studies examining the relationship between malnutrition and SSI (I2 = 59.5%, p = 0.03%). Employing the random-effects model, results indicated that malnourished individuals were approximately 2.63 times more likely to develop SSI post-operation. Further exploration into the association between malnutrition and PJI, from seven pertinent studies, also revealed an elevated risk (OR = 2.59, 95% CI: 1.79-3.39). Sensitivity analyses confirmed the robustness of these findings, and publication bias assessments supported the validity of the included studies. Malnutrition robustly correlates with an increased risk of both SSI and PJI following total joint arthroplasty. Emphasizing preoperative nutritional assessments and intervention strategies may offer a promising avenue to enhance patient outcomes and reduce postoperative complications.

4.
Genomics ; 112(6): 4435-4441, 2020 11.
Artículo en Inglés | MEDLINE | ID: mdl-32745503

RESUMEN

The mitochondrial genome (mitogenome) can help us understand the phylogenetic relationships within the genus Lethe and the subfamily Satyrinae. In this study, we sequenced the complete mitogenomes of 14 Lethe species, which range in size from 15,225 to 15,271 bp, with both 37 genes (13 PCGs, 22 tRNAs, 2 rRNAs) and a noncoding A + T-rich region. The gene arrangement and orientation is similar to typical mitogenomes of Lepidoptera. The Ka/Ks ratio shows that cox1 has the slowest evolutionary rate. The secondary structure of trnN lacks the Pseudouracil loop (TψC loop) in most Lethe species. The inferred phylogenetic analyses show that Lethe is a well-supported monophyletic group, and reveal 2 major clades within the genus Lethe, which is consistent with previous morphological classifications.


Asunto(s)
Mariposas Diurnas/genética , Genoma Mitocondrial , Animales , Mariposas Diurnas/clasificación , Uso de Codones , Genes de ARNr , Proteínas de Insectos/genética , Proteínas Mitocondriales/genética , Filogenia , ARN de Transferencia/química , ARN de Transferencia/genética
5.
Hepatology ; 70(3): 851-870, 2019 09.
Artículo en Inglés | MEDLINE | ID: mdl-30723919

RESUMEN

The unfolded protein response (UPR) signal in tumor cells activates UPR signaling in neighboring macrophages, which leads to tumor-promoting inflammation by up-regulating UPR target genes and proinflammatory cytokines. However, the molecular basis of this endoplasmic reticulum (ER) stress transmission remains largely unclear. Here, we identified the secreted form of Golgi protein 73 (GP73), a Golgi-associated protein functional critical for hepatocellular carcinoma (HCC) growth and metastasis, is indispensable for ER stress transmission. Notably, ER stressors increased the cellular secretion of GP73. Through GRP78, the secreted GP73 stimulated ER stress activation in neighboring macrophages, which then released cytokines and chemokines involved in the tumor-associated macrophage (TAM) phenotype. Analysis of HCC patients revealed a positive correlation of GP73 with glucose-regulated protein 78 (GRP78) expression and TAM density. High GP73 and CD206 expression was associated with poor prognosis. Blockade of GP73 decreased the density of TAMs, inhibited tumor growth, and prolonged survival in two mouse HCC models. Conclusion: Our findings provide insight into the molecular mechanisms of extracellular GP73 in the amplification and transmission of ER stress signals.


Asunto(s)
Carcinoma Hepatocelular/patología , Estrés del Retículo Endoplásmico/genética , Neoplasias Hepáticas/genética , Fosfoproteínas/genética , Microambiente Tumoral/genética , Análisis de Varianza , Animales , Carcinoma Hepatocelular/genética , Línea Celular Tumoral , Chaperón BiP del Retículo Endoplásmico , Xenoinjertos , Humanos , Neoplasias Hepáticas/patología , Ratones , Ratones Endogámicos , Transducción de Señal/genética , Estadísticas no Paramétricas , Análisis de Supervivencia , Regulación hacia Arriba/genética
6.
Med Sci Monit ; 26: e922703, 2020 Sep 18.
Artículo en Inglés | MEDLINE | ID: mdl-32946432

RESUMEN

BACKGROUND As we know, chemotherapy resistance is a critical factor leading to recurrence and metastasis of nonsmall-cell lung cancer (NSCLC). To clarify the key target and potential mechanism of resistance to gemcitabine (GEM) in NSCLC, we selected Gene Expression Omnibus Data Set and statistically analyzed a parent cell group and a GEM-resistant cell group. Results showed that the expression of troponin C1, slow skeletal and cardiac type (TNNC1) in GEM-resistant cells was higher than in parent cells, which implies that TNNC1 was associated with GEM resistance in lung cancer cells. MATERIAL AND METHODS TNNC1 expression level was detected by reverse transcription-quantitative polymerase chain reaction or western blot in GEM-resistant patient serum and cell lines. It could reduce or increase autophagy response and GEM resistance accordingly by inhibition of the short interfering ribonucleic acid or by forced overexpression of TNNC1 viruses in A549 cell line and GEM-resistant cell line (A549/GemR) respectively. Blocking autophagy with 3-methyladenine increased the sensitivity of chemotherapy confirmed by flow cytometry and microtubule-associated protein 1A/1B - light chain 3 punctate assay. What's more, in a loss-of-function model, silencing of forkhead box 03 (FOXO3) in A549/GemR cells could rescue the autophagy weakened by TNNC1. RESULTS TNNC1 promoted GEM chemoresistance of NSCLC by activating cytoprotective autophagy, regulated negatively by FOXO3. This research may provide a completely new strategy for NSCLC treatment. CONCLUSIONS Targeting the TNNC1/FOXO3 signaling pathway in NSCLC may be a novel strategy to combat GEM resistance.


Asunto(s)
Carcinoma de Pulmón de Células no Pequeñas/metabolismo , Desoxicitidina/análogos & derivados , Resistencia a Antineoplásicos , Regulación Neoplásica de la Expresión Génica , Neoplasias Pulmonares/metabolismo , Proteínas de Neoplasias/biosíntesis , Troponina C/biosíntesis , Células A549 , Carcinoma de Pulmón de Células no Pequeñas/tratamiento farmacológico , Carcinoma de Pulmón de Células no Pequeñas/genética , Carcinoma de Pulmón de Células no Pequeñas/patología , Desoxicitidina/farmacología , Humanos , Neoplasias Pulmonares/tratamiento farmacológico , Neoplasias Pulmonares/genética , Neoplasias Pulmonares/patología , Proteínas de Neoplasias/genética , Troponina C/genética , Gemcitabina
7.
J Anim Breed Genet ; 136(1): 3-14, 2019 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-30417949

RESUMEN

Bamaxiang pig is from Guangxi province in China, characterized by its small body size and two-end black coat colour. It is an important indigenous breed for local pork market and excellent animal model for biomedical research. In this study, we performed genomewide association studies (GWAS) on 43 growth and carcass traits in 315 purebred Bamaxiang pigs based on a 1.4 million SNP array. We observed considerable phenotypic variability in the growth and carcass traits in the Bamaxiang pigs. The corresponding SNP based heritability varied greatly across the 43 traits and ranged from 9.0% to 88%. Through a conditional GWAS, we identified 53 significant associations for 35 traits at p value threshold of 10-6 . Among which, 26 associations on chromosome 3, 7, 14 and X passed a genomewide significance threshold of 5 × 10-8 . The most remarkable loci were at around 30.6 Mb on chromosome 7, which had growth stage-dependent effects on body lengths and cannon circumferences and showed large effects on multiple carcass traits. We discussed HMGA1 NUDT3, EIF2AK1, TMEM132C and AFF2 that near the lead SNP of significant loci as plausible candidate genes for corresponding traits. We also showed that including phenotypic covariate in GWAS can help to reveal additional significant loci for the target traits. The results provide insight into the genetic architecture of growth and carcass traits in Bamaxiang pigs.


Asunto(s)
Sitios Genéticos/genética , Análisis de Secuencia por Matrices de Oligonucleótidos , Polimorfismo de Nucleótido Simple , Porcinos/crecimiento & desarrollo , Porcinos/genética , Animales , Cromosomas/genética , Estudio de Asociación del Genoma Completo , Fenotipo
8.
Analyst ; 139(19): 4994-5000, 2014 Oct 07.
Artículo en Inglés | MEDLINE | ID: mdl-25101356

RESUMEN

Carbon porous materials (CPMs) with high surface areas up to 2660 m(2) g(-1), directly fabricated by a facile microwave-assisted route, were applied to the electrochemical detection of dopamine (DA). The CPM-modified electrodes exhibited excellent selectivity, a desirable detection limit (2.9 nM), and extraordinary sensitivity (2.56 mA µM(-1) cm(-2)) for detection of DA, even in the presence of large amounts of foreign species, such as ascorbic acid (AA) and uric acid (UA), making feasible the practical applications of these electrodes as DA sensors.


Asunto(s)
Carbono/química , Dopamina/análisis , Técnicas Electroquímicas , Ácido Ascórbico/química , Electrodos , Microondas , Oxidación-Reducción , Porosidad , Ácido Úrico/química
9.
Sci Rep ; 14(1): 13672, 2024 06 13.
Artículo en Inglés | MEDLINE | ID: mdl-38871779

RESUMEN

Invasive pests reduce biodiversity and ecosystem service functions, thereby leading to economic and also agricultural losses. Banana skipper (Erionota torus Evans), red palm weevil (Rhynchophorus ferrugineus), and coconut caterpillar (Opisina arenosella Walker) are invasive insect pests in the palm-growing regions and they have had serious consequences for the planting of bananas (Musa nana), palms (Trachycarpus fortune) and coconut (Cocos nucifera). Based on screened occurrence data, the present research utilized Maximum Entropy model (Maxent) to simulate the distribution dynamics of these three invasive insects in China, under current and future climate (2050s, 2070s, 2090s) in two shared socio-economic pathways (SSPs: 126 and 585) of the newly released coupled model intercomparison project phase6 (CMIP6). The results show that: (1) Under current and future climate conditions, all model groups exhibited an AUC value exceeding 0.92, which shows that the model prediction results are very good;(2) The suitable habitat area of E. torus Evans remains relatively stable with some expansion in the SSP126 of 2090s and some contraction in the SSP585 of 2090s. The suitable habitat area of R. ferrugineus showed an overall contraction, with substantial contraction in the SSP585 of 2090s.The suitable habitat area of O. arenosella has an overall expansion, with the most pronounced expansion in the SSP585 of 2070s; (3) The current centroid of suitable habitats for R. ferrugineus and E. torus Evans is located in Guangxi Province and wholely shift toward the south direction under future climate. The centroid of suitable habitats for O. arenosella is currently located in the northeastern maritime area of Hainan Province and will shift toward the north direction under future climate; (4) Temperature, precipitation and Human disturbance factors (Population density and Human influence index) were crucial variables for describing the distribution of the three species. For E. torus Evans in particular, percentage contributions of Population density was up to 31.4, which is only 0.1 different from ranked first Bio19 (Precipitation of the coldest quarter). The dynamics of habitats of these three species and the correlating driver factors proposed in this work provide essential insights into future spatial management of the three invasive insects in China. Our work is necessary and timely in identifying newly areas at high risk of expansion of the three invasive insects in the future, then suggesting strategic control measures to prevent their spread, and finally providing scientific evidence for the early prevention and rapid response to the three invasive insects.


Asunto(s)
Cambio Climático , Especies Introducidas , Gorgojos , Animales , China , Gorgojos/fisiología , Ecosistema , Agricultura , Biodiversidad
10.
Plants (Basel) ; 12(12)2023 Jun 16.
Artículo en Inglés | MEDLINE | ID: mdl-37375966

RESUMEN

In recent years, invasive alien plants (IAPs) have caused serious ecological disasters and economic losses in China. This study combined three IAP species richness-related indices (species richness of IAPs, first records of IAPs, and the relative species richness of IAPs), as well as indices reflecting distribution and dispersal patterns (average similarity coefficient of IAPs) and invasiveness (average risk score of IAPs), to conduct an integrated regional-invasion risk assessment based on the principal component analysis (PCA) method. Partial least-squares (PLS) regression was conducted to explore the explanatory power of 12 environmental and anthropogenic factors on different invasion indices. The results indicated that coastal provinces and Yunnan had high IAP introduction risk, as well as high synthetic-risk scores. The dispersal of IAPs in mid-latitude provinces should be particularly prevented. For species richness of IAPs, more environmental factors with variable importance for the project (VIP) values higher than 1 were retained in the optimal model, reflecting the importance of environmental filtering on IAPs. Visitors were the most important predictor for first records of IAPs. Compared to species richness (R2 = 79.5%), first records were difficult to predict (R2 = 60.4%) and were influenced by anthropogenic factors. There was spatial distribution congruence of various families of IAPs. Generally, the correlations of the residuals of species richness were still significant, with 0.421 (p < 0.05) as the lowest Pearson correlation coefficient, which indicated that external factors could not fully explain the spatial distribution congruence. These findings could enrich the relevant research on IAP invasion mechanisms and provide suggestions for regional IAP detection and response.

11.
Zootaxa ; 5351(5): 590-594, 2023 Sep 29.
Artículo en Inglés | MEDLINE | ID: mdl-38221463

RESUMEN

A new species of the genus Synochoneura Obraztsov, 1955, S. wuyishana sp. nov. is described and illustrated from Wuyishan National Park in Fujian Province of China. The new species resembles S. sapana, but differs in wing pattern and female genitalia characters. Illustrations of adults and genitalia are provided. Additionally, a key to the Chinese Synochoneura species based on morphology is presented. The type specimens are deposited in the Department of Entomology, College of Plant Protection, South China Agricultural University, Guangzhou.


Asunto(s)
Lepidópteros , Mariposas Nocturnas , Humanos , Femenino , Animales , Parques Recreativos , Genitales , Genitales Femeninos , China , Distribución Animal
12.
Artículo en Inglés | MEDLINE | ID: mdl-36360768

RESUMEN

Indicators can monitor ecological environment changes and help maintain ecological balance. Bioindicators are divided into animal, plant, and microbial indicators, of which animal and plant indicators have previously been the most researched, but microbial indicators have drawn attention recently owing to their high sensitivity to the environment and their potential for use in monitoring environmental changes. To date, reviews of studies of animals and plants as indicator species have frequently been conducted, but reviews of research on microorganisms as indicator species have been rare. In this review, we summarize and analyze studies using microorganisms as indicator species in a variety of ecosystems, such as forests, deserts, aquatic and plateau ecosystems, and artificial ecosystems, which are contained in wetlands, farmlands, and mining ecosystems. This review provides useful information for the further use of microorganisms as indicators to reflect the changes in different environmental ecosystems.


Asunto(s)
Ecosistema , Monitoreo del Ambiente , Animales , Humedales , Plantas , Ambiente
13.
Front Chem ; 10: 1079214, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36601553

RESUMEN

Oxidative steam reforming of ethanol (OSRE) to produce hydrogen has been investigated over a series of supported PtRu catalysts, with different supports. Bimetallic PtRu-based catalysts were prepared by the impregnation method using H2PtCl6 and RuCl3 as precursors. Six supports (reducible oxides of ZrO2, CeO2, and Co3O4, and irreducible oxides of ZnO, Al2O3, and NiO) were chosen to fabricate bimetallic catalysts. The catalytic performance of the OSRE reaction in the series of PtRu-based samples was evaluated using a fixed-bed flow reactor under atmospheric pressure. In front reaction, the catalyst was pre-activated by reduction under 200°C for 3 h. The gas hourly space velocity was adjusted at 66,000 h-1, and the optimal molar ratios of the H2O/EtOH and O2/EtOH feeds were 4.9 and 0.44, respectively. The results indicated that the PtRu supported on the ZrO2 and CeO2 exhibited superior catalytic performance in the OSRE reaction under a low temperature (a TR of approximately 320°C) for producing the main products of H2 and CO2 with lower CO and CH4 by-products. Also, it was quite stable during a long time evaluation; the maximum YH2 maintained at 4.5-4.2, and the CO distribution approached 3.3-3.5 mol% around 84 h test at 340°C over the PtRu/ZrO2 catalyst.

15.
J Nanosci Nanotechnol ; 21(12): 6082-6087, 2021 12 01.
Artículo en Inglés | MEDLINE | ID: mdl-34229807

RESUMEN

The increase of harmful carbon monoxide (CO) caused by incomplete combustion can affect human health even lead to suffocation. Therefore reducing the CO discharged by vehicles or factories is urgent to improve the air quality. The spinel cobalt (II, III) oxide (Co3O4) is an active catalyst for CO abatement. In this study, we tried to fabricate dispersing Co3O4 via the dispersion-precipitation method with acetic acid, formic acid, and oxalic acid as the chelating dispersants. Then, the asprepared samples were calcined at 300 ºC for 4 h to obtain active catalysts, and assigned as Co(A), Co(F) and Co(O) respectively, the amount of the dispersants used are labeled as I (0.12 mole), II (0.03 mole) and III (0.01 mole). For comparison, another CoAP sample was prepared via alkaliinduced precipitation and calcined at 300 ºC. All samples were characterized by X-ray diffraction (XRD), temperature-programmed reduction (TPR), scanning electron microscope (SEM), and nitrogen adsorption/desorption system, and the catalytic activity focused on the CO oxidation. The influence of chelating dispersant on the performance of abatement of CO was pursued in this study. Apparently, the results showed that the chelating dispersant can influence the catalytic activity of CO abatement. An optimized ratio of dispersant can improve the performance, while excess dispersant lessens the surface area and catalytic performance. The series of Co(O) samples can easily donate the active oxygen since the labile Co-O bonding and indicated the preferential performance than both Co(A) and Co(F) samples. The nanorod Co(O)-II showed preferential for CO oxidation, T50 and T90 approached 96 and 127 ºC, respectively. Also, the favorable durability of Co(O)-II sample maintains 95% conversion still for 50 h at 130 ºC and does not emerge deactivation.


Asunto(s)
Monóxido de Carbono , Óxidos , Catálisis , Cobalto , Humanos
16.
J Hazard Mater ; 157(2-3): 496-502, 2008 Sep 15.
Artículo en Inglés | MEDLINE | ID: mdl-18313217

RESUMEN

Microwave-enhance catalytic degradation (MECD) of 4-chlorophenol (4-CP) using nickel oxide was studied. A mix-valenced nickel oxide was obtained from nickel nitrate aqueous solution through a precipitation with sodium hydroxide and an oxidation by sodium hypochlorite (assigned as PO). Then, the as-prepared PO was irradiated under microwave irradiation to fabricate a high active mix-valenced nickel oxide (assigned as POM). Further, pure nanosized nickel oxide was obtained from the POM by calcination at 300, 400 and 500 degrees C (labeled as C300, C400 and C500, respectively). They were characterized by X-ray (XRD), infrared spectroscopy (IR) and temperature-programmed reduction (TPR). Their catalytic activities towards the degradation of 4-CP on the efficiency of the degradation were further investigated under continuous bubbling of air through the liquid-phase and quantitative evaluation by high pressure liquid chromatography (HPLC). Also, the effects of temperature, pH and kinds of catalysts on the efficiency of the degradation have been investigated. The results showed that the 4-CP was degraded completely by MECD method within 20 min under pH 7, T=40 degrees C and C=200 g dm(-3) over POM catalyst. The relative activity was affected significantly with the oxidation state of nickel.


Asunto(s)
Clorofenoles/química , Microondas , Níquel/química , Contaminantes Químicos del Agua/química , Catálisis , Concentración de Iones de Hidrógeno , Tamaño de la Partícula , Temperatura , Purificación del Agua/métodos
18.
J Hazard Mater ; 92(3): 241-51, 2002 Jun 10.
Artículo en Inglés | MEDLINE | ID: mdl-12031609

RESUMEN

The adsorption properties of nitric oxide (NO) on alumina supported palladium were studied by a simultaneous thermogravimetric-analysis and differential-scanning-calorimetry (TGA-DSC) in a temperature ranges between 220 and 470 K. Upon adsorption, NO molecules on both Pd/Al2O3 and Pd/NaOH-Al2O3 samples were molecularly adsorbed between 220 and 300 K. Some NO molecules were strongly adsorbed on Pd/NaOH-Al2O3 and possessed a higher enthalpy of adsorption [approximately 140 kJ (mol NO)(-1)] than Pd/Al2O3 [approximately 114 kJ (mol NO)(-1)]. Upon heating above 320 K, the adsorbed NO molecule on these palladium surface was dissociated. In addition, a temperature programmed desorption and mass spectrometer (TPD-MS) study in a temperature range between 300 and 1100 K further indicated that some strongly adsorbed NO molecules may stay on basic sites (*b) and Pd-NaOH interface sites (*i) to enhance the decomposition of NO.


Asunto(s)
Contaminantes Atmosféricos/química , Óxido Nítrico/química , Paladio/química , Adsorción , Óxido de Aluminio/química , Calor
19.
Fertil Steril ; 102(4): 1085-1090.e2, 2014 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-25123637

RESUMEN

OBJECTIVE: To assess the efficacy and safety of primary surgical evacuation therapy for cesarean scar pregnancy (CSP) of the first trimester, and to evaluate its possible prognostic factors. DESIGN: Retrospective consecutive cohort study. SETTING: Tertiary care university hospital. SUBJECT(S): A cohort of patients with CSP and clear ultrasound images who underwent primary surgical evacuation from January 2000 to December 2012. INTERVENTION(S): Patients fulfilling the ultrasound criteria of CSP were further classified into superficial and deep groups according to their implantation locations and extents. The final decision on the method of treatment, including methotrexate chemotherapy, surgical evacuation, and others, was made by the patients after consultation with the physician. Pretreatment patient characteristics were compared in the patients with superficial and deep implantation, as were the results after primary surgical evacuation. MAIN OUTCOME MEASURE(S): Rates of successful treatment by primary surgical evacuation of CSP and the need for salvage intervention in the patients with deep and superficial implantation. RESULT(S): Forty-eight CSP patients who had sufficient data and imaging for analysis were enrolled. Of these 48 cases, 26 in the superficial group and 14 in the deep group were willing to undergo primary surgical evacuation. Blood loss and need for salvage intervention were significantly lower in the patients with superficial implantation. Surgical evacuation was successful in 23 of 26 patients (88.5%) with superficial implantation and in 8 of 14 patients (57.1%) with deep implantation. Patients who failed primary surgical evacuation showed complete recovery, with uterus preservation, after salvage interventions, including laparoscopic surgery, angioembolization, and laparotomy. CONCLUSION(S): Preoperative determination of CSP implantation depth and extent is important in selecting candidates for surgical treatment. Primary single-step surgical evacuation was successful in most patients with superficial implantation, but patients should be informed of the possibility of salvage interventions before undergoing surgical evacuation.


Asunto(s)
Cesárea/efectos adversos , Cicatriz/etiología , Embarazo Ectópico/cirugía , Legrado por Aspiración , Adulto , Cicatriz/diagnóstico por imagen , Femenino , Hospitales Universitarios , Humanos , Persona de Mediana Edad , Embarazo , Primer Trimestre del Embarazo , Embarazo Ectópico/diagnóstico por imagen , Estudios Retrospectivos , Centros de Atención Terciaria , Resultado del Tratamiento , Ultrasonografía Doppler en Color , Ultrasonografía Prenatal , Legrado por Aspiración/efectos adversos
20.
Taiwan J Obstet Gynecol ; 52(4): 505-11, 2013 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-24411034

RESUMEN

OBJECTIVE: To describe the treatment outcomes of aberrant ectopic implantations in the lower segment of the uterus in a cohort population and to evaluate whether or not low-lying-implantation ectopic pregnancy (LLIEP), a new term, is appropriate to include in the traditional diagnoses of cervical pregnancy (CP), cesarean scar pregnancy (CSP), and other unusual aberrant implantations in the lower segment of the uterus in the first trimester, in terms of clinical characteristics, treatment, and prognosis. MATERIALS AND METHODS: Forty-two women with ectopic pregnancies of <12 weeks' gestational age from July 2003 to December 2008 were prospectively studied. Each patient underwent an ultrasound evaluation by an experienced consultation team and was grouped into the CP, CSP, or cervico-isthmic pregnancy (CIP) group. Patients underwent either suction dilatation and curettage (D and C) alone, or laparoscopic uterine artery blockage followed by suction D and C, to remove the aberrant trophoblasts without other adjuvant treatments. Clinical characteristics and biochemical factors, including obstetric history, patient age, body mass index (BMI), gestational age, serum hematocrit and ß-hCG level, operation method, operation time, and intraoperative blood loss were evaluated. RESULTS: There were no significant differences in patient age (mean = 34.1 ± 6.4 years), previous number of cesarean deliveries (mean = 1.5 ± 0.8), gestational age (mean = 6.9 ± 1.2 weeks), serum ß-hCG (mean = 35,384.3 ± 41,726.9 mIU/mL), operation time (mean = 60.3 ± 46.6 minutes), and surgical blood loss (mean = 124.7 ± 191.5 mL) among the three patient groups. The uterus was successfully preserved in all patients after treatment. CONCLUSION: The prognosis of surgical management for ectopic implantations in the lower segment of the uterus is good. The new term LLIEP seems appropriate to cover all forms of aberrant ectopic implantations in the lower segment of the uterus in the first trimester, in terms of treatment efficacy. The use of LLIEP for preoperative ultrasound diagnosis would enable the clinician to diagnose unusual cases more easily, without the need to change the current treatment policy.


Asunto(s)
Cuello del Útero , Cicatriz , Embarazo Ectópico/diagnóstico por imagen , Embarazo Ectópico/cirugía , Adulto , Pérdida de Sangre Quirúrgica , Cesárea/efectos adversos , Gonadotropina Coriónica Humana de Subunidad beta/sangre , Cicatriz/etiología , Femenino , Humanos , Tempo Operativo , Embarazo , Primer Trimestre del Embarazo , Embarazo Ectópico/sangre , Estudios Prospectivos , Resultado del Tratamiento , Ultrasonografía , Embolización de la Arteria Uterina , Legrado por Aspiración
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