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BACKGROUND: The comparative effectiveness of volatile anaesthesia and total intravenous anaesthesia (TIVA) in terms of patient outcomes after cardiac surgery remains a topic of debate. METHODS: Multicentre randomised trial in 16 tertiary hospitals in China. Adult patients undergoing elective cardiac surgery were randomised in a 1:1 ratio to receive volatile anaesthesia (sevoflurane or desflurane) or propofol-based TIVA. The primary outcome was a composite of predefined major complications during hospitalisation and mortality 30 days after surgery. RESULTS: Of the 3123 randomised patients, 3083 (98.7%; mean age 55 yr; 1419 [46.0%] women) were included in the modified intention-to-treat analysis. The composite primary outcome was met by a similar number of patients in both groups (volatile group: 517 of 1531 (33.8%) patients vs TIVA group: 515 of 1552 (33.2%) patients; relative risk 1.02 [0.92-1.12]; P=0.76; adjusted odds ratio 1.05 [0.90-1.22]; P=0.57). Secondary outcomes including 6-month and 1-yr mortality, duration of mechanical ventilation, length of ICU and hospital stay, and healthcare costs, were also similar for the two groups. CONCLUSIONS: Among adults undergoing cardiac surgery, we found no difference in the clinical effectiveness of volatile anaesthesia and propofol-based TIVA. CLINICAL TRIAL REGISTRATION: Chinese Clinical Trial Registry (ChiCTR-IOR-17013578).
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Anestésicos por Inhalación , Anestésicos Intravenosos , Procedimientos Quirúrgicos Cardíacos , Desflurano , Complicaciones Posoperatorias , Propofol , Humanos , Propofol/efectos adversos , Femenino , Masculino , Persona de Mediana Edad , Procedimientos Quirúrgicos Cardíacos/efectos adversos , Procedimientos Quirúrgicos Cardíacos/mortalidad , Anestésicos Intravenosos/efectos adversos , Anestésicos por Inhalación/efectos adversos , Anciano , Complicaciones Posoperatorias/mortalidad , Complicaciones Posoperatorias/prevención & control , Adulto , Sevoflurano/efectos adversos , Anestesia Intravenosa/métodos , China/epidemiología , Tiempo de Internación/estadística & datos numéricos , Anestesia por Inhalación/métodos , Anestesia por Inhalación/efectos adversos , Resultado del TratamientoRESUMEN
Single-atom heterogeneous catalysts (SAHCs) provide an enticing platform for understanding catalyst structure-property-performance relationships. The 100% atom utilization and adjustable local coordination configurations make it easy to probe reaction mechanisms at the atomic level. However, the progressive deactivation of metal-single-atom (MSA) with high surface energy leads to frequent limitations on their commercial viability. This review focuses on the atomistic-sensitive reactivity and atomistic-progressive deactivation of MSA to provide a unifying framework for specific functionality and potential deactivation drivers of MSA, thereby bridging function, purpose-modification structure-performance insights with the atomistic-progressive deactivation for sustainable structure-property-performance accessibility. The dominant functionalization of atomically precise MSA acting on properties and reactivity encompassing precise photocatalytic reactions is first systematically explored. Afterward, a detailed analysis of various deactivation modes of MSA and strategies to enhance their durability is presented, providing valuable insights into the design of SAHCs with deactivation-resistant stability. Finally, the remaining challenges and future perspectives of SAHCs toward industrialization, anticipating shedding some light on the next stage of atom-economic chemical/energy transformations are presented.
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Covalent organic frameworks (COFs) have attracted growing interests as new material platform for a range of applications. In this study, a triazine-carbazole-based covalent organic framework (COF-TCZ) was designed as highly porous material with conjugated donor-acceptor networks, and feasibly synthesized by the Schiff condensation of 4,4',4''-(1,3,5-triazine-2,4,6-triyl)tr ianiline (TAPB) and 9-(4-formylphenyl)-9H-carbazole-3,6-dicarbaldehyde (CZTA) under the solvothermal condition. Considering the effect of linkage, the imine-linked COF-TCZ was further oxidized to obtain an amide-linked covalent organic framework (COF-TCZ-O). The as-synthesized COFs show high crystallinity, good thermal and chemical stability, and excellent photoactive properties. Two π-conjugated triazine-carbazole-based COFs with tunable linkages are beneficial for light-harvesting capacity and charge separation efficiency, which are empolyed as photocatalysts for the oxidation reaction of N-aryltetrahydroisoquinoline. The COFs catalyst systems exhibit the outstanding photocatalytic performance with high conversion, photostability and recyclability. Photoelectrochemical tests were employed to examine the behavior of photogenerated charge carriers in photo-illumination system. The control experiments provide further insights into the nature of photocatalysis. In addition, the current research also provided a valuable approach for developing photofunctional COFs to meet challenge in achieving the great potential of COFs materials in organic conversion.
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INTRODUCTION: Previous studies have confirmed that low shear stress (LSS) induces glycocalyx disruption, leading to endothelial dysfunction. However, the role of autophagy in LSS-induced glycocalyx disruption and relevant mechanism are not clear. In this study, we hypothesized that LSS may promote autophagy, disrupting the endothelium glycocalyx. METHODS: Human umbilical vein endothelial cells were subjected to physiological shear stress and LSS treatments, followed by the application of autophagy inducers and inhibitors. Additionally, cells were treated with specific matrix metalloproteinase-2 (MMP-2) and matrix metalloproteinase-9 (MMP-9) inhibitor. The expression of autophagic markers, glycocalyx, MMP-2, and MMP-9 was measured. RESULTS: LSS impacted the expression of endothelium autophagy markers, increasing the expression of LC3II.LC3I-1 and Beclin-1, and decreasing the levels of p62, accompanied by glycocalyx disturbance. Moreover, LSS upregulated the expression of MMP-2 and MMP-9 and downregulated the levels of syndecan-1 and heparan sulfate (HS). Additionally, expression of MMP-2 and MMP-9 was increased by an autophagy promoter but was decreased by autophagy inhibitor treatment under LSS. Autophagy and MMP-2 and MMP-9 further caused glycocalyx disruption. CONCLUSION: LSS promotes autophagy, leading to glycocalyx disruption. Autophagy increases the expression of MMP-2 and MMP-9, which are correlated with the glycocalyx destruction induced by LSS.
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Glicocálix , Metaloproteinasa 2 de la Matriz , Humanos , Glicocálix/metabolismo , Metaloproteinasa 2 de la Matriz/metabolismo , Metaloproteinasa 9 de la Matriz/metabolismo , Células Endoteliales de la Vena Umbilical Humana/metabolismo , Autofagia , Estrés MecánicoRESUMEN
Background: Shedding of glycocalyx is relevant to worse prognosis in surgical patients, and elevated levels of serum matrix metalloproteinase-9 (MMP-9) are associated with this phenomenon. This study aimed to investigate the dynamic alterations of serum glycocalyx components and MMP-9 during cardiopulmonary bypass (CPB), and evaluate their predictive capacities for prolonged intensive care unit (ICU) stay, as well as their correlation with coagulation dysfunction. Methods: This retrospective study analyzed serum levels of syndecan-1, heparan sulfate (HS), and MMP-9 at different time points during CPB, and assessed their association with prolonged ICU stay and coagulation dysfunction. Results: Syndecan-1, HS, and MMP-9 exhibited divergent changes during CPB. Serum levels of syndecan-1 (AUC = 78.0 %) and MMP-9 (AUC = 78.4 %) were validated as reliable predictors for prolonged ICU stay, surpassing the predictive value of creatinine (AUC = 70.0 %). Syndecan-1 (rho = 0.566, P < 0.01 at T1 and rho = 0.526, P < 0.01 at T2) and HS (rho = 0.403, P < 0.05 at T4) exhibited correlations with activated partial thromboplastin time (APTT) ratio beyond the normal range. Conclusions: Our findings advocate the potential efficacy of serum glycocalyx components and MMP-9 as early predictive indicators for extended ICU stay following cardiac surgery with CPB. Additionally, we observed a correlation between glycocalyx disruption during CPB and coagulation dysfunction. Further studies with expansive cohorts are warranted to consolidate our findings and explore the predictive potential of other glycocalyx components.
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OBJECTIVES: The prognosis of invasive micropapillary carcinoma (IMPC) of the breast is determined by many clinicopathological factors. This study aims to identify prognostic factors and develop reliable nomogram to predict the overall survival (OS) in patients with IMPC. DESIGN: Log-rank test and Cox proportional hazards analysis were used to identify variables and construct a nomogram based on the training cohort. C-index and calibration curves were performed to evaluate the performance of the model in the training cohort and validation cohorts. SETTING: We collected the patient data from the Surveillance, Epidemiology and End Results (SEER) database. This database holds data related to the cancer incidence from 18 population-based cancer registries in the USA. PARTICIPANTS: The SEER database was used to screen 754 eligible patients as the study cohort. The whole cohort was randomly divided into a training cohort (n=377) and a validation cohort (n=377). RESULTS: Age at diagnosis, hormone receptors, number of positive regional lymph nodes and clinical stage were independent prognostic factors for patients with IMPC. The calibration curves presented excellent consistency between the actual and nomogram-predict survival probabilities in the training and validation cohorts. The C-index values of the nomogram were 0.794 and 0.774 for OS in the training and validation cohorts, respectively. CONCLUSIONS: The novel nomogram provides new insights of the risk of each prognostic factor and can assist doctors in predicting the 1-year, 3-year and 5-year OS in patients with IMPC.
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Carcinoma , Nomogramas , Humanos , Pronóstico , Factores de RiesgoRESUMEN
BACKGROUND: Pain-depression comorbidity has become a great burden to individuals and society. Nevertheless, the mechanisms underlying comorbid diseases have still not been fully revealed. Ultrasound-guided pulsed radiofrequency (PRF) on peripheral nerves, which produces remarkable analgesia via high-frequency electromagnetic energy, has become a main, minimally invasive treatment for chronic neuropathic pain. OBJECTIVES: The aim of this study was to explore the effect of ultrasound-guided PRF on the sciatic nerve of spared nerve injury (SNI) rats to relieve pain-induced depression. STUDY DESIGN: Experimental trial in rats. SETTING: The research took place in the Laboratory of The First Affiliated Hospital of Wenzhou Medical University. METHODS: Sixty male Wistar rats were randomly divided into a sham group, an SNI group, an SNI + free-PRF group, and an SNI + PRF group. Ultrasound-guided PRF was applied to the sciatic nerve on day 7 after SNI. The basal paw mechanical withdrawal threshold (PMWT) was evaluated as a measure for pain-related behavior, and a sucrose preference test was performed as a measure for depression-related behavior. The expression levels of spinal interferon regulatory factor 8 (IRF8) and of brain-derived neurotrophic factor (BDNF) in the prefrontal cortex (PFC) were also studied on days 21 and 42. RESULTS: The results showed that the PMWT was significantly decreased in rats following SNI operation; the decreased levels of PMWT were reversed in the SNI + PRF group after the application of PRF on the sciatic nerve on day 7. There were no statistically significant differences among the groups in the sucrose preference rate on day 21 after SNI operation. The sucrose preference rate on day 42 was higher in the SNI + PRF group than in the SNI + free-PRF group. Western blot and reverse transcription polymerase chain reaction also demonstrated that ultrasound-guided PRF on the sciatic nerve downregulated overexpression of spinal IRF8 and increased the levels of BDNF in the PFC. LIMITATIONS: This study was performed using only an SNI rat model which cannot represent all rodent neuropathic pain models. Only the short-term effectiveness of ultrasound-guided PRF on the sciatic nerve of SNI rats was investigated. The BDNF changes of other important brain areas were not taken into consideration in this study. CONCLUSIONS: These findings suggest that ultrasound-guided PRF on sciatic nerve could alleviate pain-induced depression. The mechanisms of this treatment may be involved in the downregulated spinal IRF8 and the increased BDNF in PFC.
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Neuralgia , Tratamiento de Radiofrecuencia Pulsada , Ratas , Masculino , Animales , Ratas Sprague-Dawley , Ratas Wistar , Manejo del Dolor , Factor Neurotrófico Derivado del Encéfalo/metabolismo , Depresión/terapia , Tratamiento de Radiofrecuencia Pulsada/métodos , Neuralgia/terapia , Neuralgia/metabolismo , Factores Reguladores del Interferón , Nervio Ciático/lesiones , Corteza Prefrontal/metabolismo , Ultrasonografía Intervencional , Modelos Animales de EnfermedadRESUMEN
BACKGROUND: Cardiopulmonary bypass (CPB) leads to shedding of the glycocalyx of endothelial cells, resulting in a series of complications such as tissue edema and coagulatory and microcirculatory dysfunctions. Matrix metalloproteinases (MMPs) can cause glycocalyx shedding in a variety of pathological processes, but their role in the process of CPB is still unclear. We hypothesized that the MMPs inhibitor doxycycline would reduce glycocalyx shedding by inhibiting MMPs during CPB. METHODS: Thirty-six patients were randomized to receive either 100 mg oral doxycycline (an MMPs inhibitor) or a matching placebo pill twice a day for three days before CPB. The primary outcome was the concentration of plasma syndecan-1. Secondary outcomes included heparan sulphate, MMP-2, MMP-9, ratio of urinary albumin to creatinine, and short-term clinical outcomes. In order to further prove that MMPs in plasma caused the glycocalyx shedding, human umbilical vein endothelial cells were cultured with plasma obtained from cardiac surgery patients before or after CPB (with or without MMPs inhibitor GM6001). The change in glycocalyx content was detected by immunofluorescence. RESULTS: CPB resulted in an increase of MMPs and shedding of the glycocalyx. Plasma syndecan-1 was higher in the control group than in the doxycycline group (median difference:15.04 µg/L; 95% CI: 9.14-20.94 µg/L; P < 0.001). Similar to syndecan-1, plasma heparan sulphate, MMP-2, and MMP-9 concentrations in the doxycycline group were significantly lower than those in the control group during CPB. Doxycycline was also correlated with a reduction in the ratio of urinary albumin to creatinine and improved the short-term clinical outcomes of patients. Endothelial cells cultured with plasma from patients after CPB showed significant shedding of syndecan-1 and heparan sulphate (post-CPB group vs pre-CPB group, P < 0.001). GM6001 was shown to reduce shedding of syndecan-1 and heparan sulphate by inhibiting MMPs (post-CPB + GM6001 group vs post-CPB group, P < 0.001). CONCLUSION: Doxycycline can reduce glycocalyx shedding by inhibiting MMPs during CPB.
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Puente Cardiopulmonar , Doxiciclina , Glicocálix , Sindecano-1 , Albúminas , Creatinina , Doxiciclina/uso terapéutico , Células Endoteliales , Heparitina Sulfato , Humanos , Metaloproteinasa 2 de la Matriz/sangre , Metaloproteinasa 9 de la Matriz/sangre , Microcirculación , Sindecano-1/sangreRESUMEN
BACKGROUND: Systemic immune-inflammation index (SII) has been identified as a prognostic biomarker in various diseases. However, its significance in acute pancreatitis (AP) has not been reported. Therefore, the main aim of this study was to determine the association of SII with clinical outcomes of AP patients, after adjusting for several confounders. METHODS: This retrospective cohort study was conducted using data retrieved from the Medical Information Mart for Intensive Care III database (MIMIC-III). The study only included patients diagnosed with AP. SII was calculated as the platelet counts x neutrophil counts/lymphocyte counts. Cox regression models were employed to assess the impact of SII on the 30- and 90-day mortality of AP patients. Subgroup analysis was carried out to explore the stability of the relationship between SII and AP mortality. RESULTS: A total of 513 patients were found to be eligible based on the inclusion and exclusion criteria. For 30-day all-cause mortality, in the model adjusted for multiple confounders, the HR (95% CI) for mid-SII group (SII: 75.6-104.2) and high-SII groups (SII: >104.2) were 1.29 (0.65, 2.56) and 2.57 (1.35, 4.88), respectively, compared to the low-SII group (SII: <75.5). A similar trend was observed for 90-day mortality. Subgroup analyses presented a stable relationship between SII and 30-day all-cause mortality of AP patients. CONCLUSION: SII is a potentially useful prognostic biomarker for AP. However, prospective studies are needed to confirm this finding.
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BACKGROUND: The glycocalyx plays an important physiological role and may be damaged during cardiopulmonary bypass. Sevoflurane can protect the glycocalyx; however, its relevance in a clinical setting is unknown. OBJECTIVE: Glycocalyx degradation during cardiopulmonary bypass in patients was investigated. On the basis of the available experimental data, we hypothesised that sevoflurane-based anaesthesia would confer additional protection against cardiopulmonary bypass-induced glycocalyx damage. DESIGN: Randomised controlled study. SETTING: Clinical study at The First Affiliated Hospital of Wenzhou Medical University between June 2018 and March 2019. PATIENTS: Fifty-one patients. INTERVENTIONS: After intubation and mechanical ventilation, patients undergoing elective heart valve surgery were maintained under general anaesthesia with either propofol or sevoflurane during surgery. MAIN OUTCOME MEASURES: Glycocalyx markers (such as syndecan-1, heparan sulphate and hyaluronan), sheddases responsible for the degradation of the endothelial glycocalyx (such as matrix metalloproteinase-9 and cathepsin-B), urine albumin-to-creatinine ratio and levels of lactic acid and myocardial enzymes were all measured. Postoperative mechanical ventilation time and length of stay in the cardiac care unit and hospital were also measured. Morbidity and mortality after 30 days and 1 year were evaluated. RESULTS: The vascular endothelial glycocalyx was damaged during cardiopulmonary bypass. The glycocalyx damage in the sevoflurane group was less extensive than that in the propofol group. The urine albumin-to-creatinine ratio increased in both groups but was lower in the sevoflurane group. Enzymes including matrix metalloproteinase-9 and cathepsin-B were positively correlated with glycocalyx marker concentrations. After operation, the sevoflurane group showed lower levels of lactic acid and myocardial enzyme, as well as shorter duration of postoperative mechanical ventilation than the propofol group. CONCLUSION: Sevoflurane can decrease glycocalyx degradation in patients undergoing heart valve surgery under cardiopulmonary bypass. TRIAL REGISTRATION: Chinese Clinical Trial Registry, chictr.org.cn, identifier: ChiCTR1800016367.
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Anestésicos por Inhalación , Procedimientos Quirúrgicos Cardíacos , Éteres Metílicos , Propofol , Anestésicos por Inhalación/efectos adversos , Procedimientos Quirúrgicos Cardíacos/efectos adversos , Glicocálix , Válvulas Cardíacas , Humanos , Éteres Metílicos/efectos adversos , SevofluranoRESUMEN
A catalytically active conjugated microporous polymer (SP-CMP-Cu) was facilely constructed with condensation polymerization of salen-Cu (salen = N,N'-bis(3-tertbutyl-5-formylsalicylidene) ethylenediamine) and pyrrole. The as-synthesized SP-CMP-Cu was completely characterized by powder X-ray diffraction (PXRD), Fourier transform infrared (FT-IR) spectroscopy, thermogravimetric analysis (TGA), X-ray photoelectron spectroscopy (XPS), and energy-dispersive X-ray (EDX) analysis. The morphological features of SP-CMP-Cu were revealed by scanning electron microscopy (SEM) and transmission electron microscopy (TEM). According to the N2 adsorption/desorption isotherm, the Brunauer-Emmett-Teller (BET) surface area of SP-CMP-Cu was calculated to be 252 m2 g-1 with a total pore volume of 0.178 cm3 g-1. SP-CMP-Cu exhibited an outstanding catalytic performance for the Henry reaction in aqueous solutions with excellent conversion and good selectivity. Moreover, SP-CMP-Cu can be reused for up to five consecutive runs without any significant loss in its catalytic efficiency.
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Wall shear stress (WSS) plays a key role in maintaining glycocalyx function, gene expression, and structure. Experimental studies have discussed the relationship between the shedding of the endothelial glycocalyx (EG) and WSS. However, rare literature about how WSS affects the EG during cardiopulmonary bypass (CPB) was mentioned. This study aimed to investigate the correlation between the WSS of carotid arteries and shedding of the EG during CPB in humans. The WSS level was calculated in accordance with an equation. The plasma concentrations of heparan sulfate, syndecan-1, and nitric oxide were measured to reflect shedding of the EG at six time points. A negative correlation was observed between the peak wall shear stress (PWSS) and syndecan-1 (R = - 0.5, p < 0.01) and heparan sulfate (R = - 0.461, p < 0.01) during CPB. The WSS is closely associated with the components of glycocalyx shedding during CPB. The WSS produced by non-pulsatile flow during CPB may contribute to the degradation of EG.
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Puente Cardiopulmonar/efectos adversos , Arterias Carótidas/metabolismo , Endotelio Vascular/metabolismo , Glicocálix/metabolismo , Adulto , Biomarcadores/sangre , Velocidad del Flujo Sanguíneo , Arterias Carótidas/diagnóstico por imagen , Arterias Carótidas/fisiopatología , Endotelio Vascular/fisiopatología , Femenino , Heparitina Sulfato/sangre , Humanos , Masculino , Persona de Mediana Edad , Óxido Nítrico/sangre , Estudios Prospectivos , Flujo Sanguíneo Regional , Estrés Mecánico , Sindecano-1/sangreRESUMEN
The highly hydrophilic COF material (TFPT-BMTH) was constructed by pore surface functionalizing strategy, and exhibited excellent porosity, high crystallinity, and good thermal and chemical stability. The resulting COF exhibits significant catalytic activity and recyclability together with environmental benignity in photocatalytic oxidation of benzylamine in water under ambient conditions.
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OBJECTIVE: The association between the shedding of the endothelial glycocalyx (EG) and the pathogenesis of microcirculatory perfusion disturbances has been discussed in experimental studies. This discussion, however, has limited relevance in a clinical setting. We investigated EG shedding in patients undergoing cardiopulmonary bypass (CPB) and its association with alterations in microvascular perfusion. METHODS: The plasma levels of syndecan-1, heparan sulfate, and hyaluronan were used as markers of glycocalyx degradation. Microcirculatory parameters included perfused vessel density (PVD) and De Backer Scores. Sidestream dark field imaging (SDF) was applied to visualize sublingual microcirculation during the preoperative resting state (T0), after sternum splitting, after aortic clamping, 5â¯min before aortal declamping, 1â¯h after CPB (T4), 4â¯h after CPB, 24â¯h after CPB (T6), and 48â¯h after CPB. RESULTS: Thirty patients undergoing cardiac surgery were recruited. The plasma levels of glycocalyx degradation markers increased after CPB. This increase indicated severe glycocalyx shedding at T4 relative to that at T0. By T6, the plasma levels of glycocalyx degradation markers had decreased to baseline levels in a stepwise manner. PVD and the De Backer Scores decreased at T4 and recovered at T6. Glycocalyx marker concentrations were correlated with microvascular alterations during cardiac surgery. CONCLUSIONS: Glycocalyx components are closely related to microcirculation perfusion disorders. Damage to the glycocalyx during surgery with CPB may play a key role in microcirculation perfusion dysfunction.
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Procedimientos Quirúrgicos Cardíacos/efectos adversos , Puente Cardiopulmonar/efectos adversos , Células Endoteliales/metabolismo , Glicocálix/metabolismo , Microcirculación , Mucosa Bucal/irrigación sanguínea , Anciano , Biomarcadores/sangre , Velocidad del Flujo Sanguíneo , Células Endoteliales/patología , Femenino , Glicocálix/patología , Heparitina Sulfato/sangre , Humanos , Ácido Hialurónico/sangre , Masculino , Persona de Mediana Edad , Periodo Perioperatorio , Estudios Prospectivos , Flujo Sanguíneo Regional , Sindecano-1/sangre , Factores de TiempoRESUMEN
OBJECTIVE: Thyroid cancer has the highest prevalence among the cancer types that affect the endocrine system; however, its molecular mechanisms are not yet determined. Cadherin-16 (CDH16) plays an important role in the tumorigenesis of human cancers, but its influence on papillary thyroid cancer (PTC) is poorly investigated. This study aimed to explore the role of CDH16 in PTC. METHODS: We performed quantitative real-time polymerase chain reaction to investigate CDH16 expression in PTC. The clinical significance of CDH16 expression in PTC was then evaluated using The Cancer Genome Atlas (TCGA) database. Bioinformatics analysis was also conducted to determine the potential molecular mechanisms of CDH16. RESULTS: CDH16 was remarkably downregulated in PTC tumors compared with that in corresponding normal thyroid tissues in the local and TCGA cohorts. This downregulation was associated with unfavorable clinicopathological features, including histological type, high tumor stage, aggressive lymph node metastasis (LNM), and advanced clinical stage. In addition, logistic analyses revealed that the reduced expression of CDH16 can aggravate the risk of LNM in PTC. Bioinformatics analysis indicated that the co-expressed CDH16 genes mainly participated in signaling the cancer-related pathways. CONCLUSION: CDH16 is involved in PTC progression and acts as an LNM-related gene in PTC.
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OBJECTIVES: Few studies on prognostic indicators for primary thyroid lymphoma (PTL) have been presented due to the uncommon nature of the tumor. This is the first study to explore the independent prognostic factors in the 2 PTL subtypes. METHODS: We retrospectively reviewed 1,653 cases of PTL. The cases comprised 28 Chinese patients from a local cohort and 1,625 patients from the Surveillance, Epidemiology, and End Results database from 1973 to 2013. Statistical analysis was performed to determine the demographics and prognostic factors of PTL patients. RESULTS: The disease-specific survival (DSS) and prognostic indicators were significantly different between patients with extranodal marginal zone B-cell lymphoma of the mucosa-associated lymphoid tissue (MALT) and patients with diffuse large B-cell lymphoma (DLBCL). Patients with MALT lymphoma were younger (P=0.011) and had lower clinical stage (P=0.014) compared to patients with DLBCL. Cox regression analysis revealed that age, treatment modalities employed, clinical stage, and number of other types of cancer were independent prognostic factors for DLBCL patients. CONCLUSION: PTL demonstrates specific clinical features and is associated with a relatively good prognosis. Older age is associated with poor DSS in both MALT patients and DLBCL patients. Additionally, combination of different treatment modalities is associated with improved DSS in DLBCL patients.
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OBJECTIVES: The purpose of this study was to investigate the correlation between flow-mediated dilatation of the brachial artery and serum endothelial biomarkers and to discuss the feasibility of sonographic evaluation of acute endothelial injury during cardiopulmonary bypass (CPB) surgery. METHODS: Sonography was applied to determine the percentage of change in the brachial artery size during flow-mediated dilatation. Meanwhile, the plasma concentrations of endothelial-derived biomarkers, such as endothelin 1, nitric oxide, and von Willebrand factor, were measured to monitor the changes in endothelial function. We analyzed the correlation between flow-mediated dilatation and biomarkers during the perioperative period of CPB in 27 patients. RESULTS: All of the biomarkers changed dramatically, especially during the CPB period. There was a negative correlation between flow-mediated dilatation and von Willebrand factor (P = .001; R = -0.31). CONCLUSIONS: A CPB event has a substantial impact on endothelial function, and sonographic assessment of the percentage of change in the brachial artery size during flow-mediated dilatation allows early detection of acute endothelial function injury in cardiac surgery.
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Arteria Braquial/diagnóstico por imagen , Arteria Braquial/fisiopatología , Puente Cardiopulmonar/efectos adversos , Endotelio Vascular/lesiones , Endotelio Vascular/fisiopatología , Ultrasonografía , Enfermedad Aguda , Biomarcadores/sangre , Velocidad del Flujo Sanguíneo/fisiología , Endotelina-1/sangre , Endotelio Vascular/diagnóstico por imagen , Estudios de Factibilidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Óxido Nítrico/sangre , Factor de von WillebrandRESUMEN
A hydrazone-based covalent organic framework (COF) was synthesized by condensation of 2,5-dimethoxyterephthalohydrazide with 1,3,5-triformylbenzene under solvothermal conditions. The COF material exhibits excellent porosity with a BET surface area of up to 1501â m2 g-1 , high crystallinity, and good thermal and chemical stability. Moreover, it showed efficient photocatalytic activity towards cross-dehydrogenative coupling (CDC) reactions between tetrahydroisoquinolines and nucleophiles such as nitromethane, acetone, and phenylethyl ketone. The metal-free catalytic system also offers attractive advantages including simplicity of operation, wide substrate adaptability, ambient reaction conditions, and robust recycling capability of the catalyst, thus providing a promising platform for highly efficient and reusable photocatalysts.