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1.
Ann Med ; 55(2): 2295981, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-38128485

RESUMEN

INTRODUCTION: This study aimed to investigate the association between cardiorespiratory fitness (CRF) and perioperative morbidity and long-term mortality in operable patients with early-stage non-small cell lung cancer (NSCLC). PATIENTS AND METHODS: This prospective study included consecutive patients with early-stage NSCLC who underwent presurgical cardiopulmonary exercise testing between November 2014 and December 2019 (registration number: ChiCTR2100048120). Logistic and Cox proportional hazards regression were applied to evaluate the correlation between CRF and perioperative complications and long-term mortality, respectively. Propensity score overlap weighting was used to adjust for the covariates. We performed sensitivity analyses to determine the stability of our results. RESULTS: A total of 895 patients were followed for a median of 40 months [interquartile range 25]. The median age of the patients was 59 years [range 26-83], and 62.5% were male. During the study period, 156 perioperative complications and 146 deaths were observed. Low CRF was associated with a higher risk of death (62.9 versus 33.6 per 1000 person-years; weighted incidence rate difference, 29.34 [95% CI, 0.32 to 58.36] per 1000 person-years) and perioperative morbidity (241.6 versus 141.9 per 1000 surgeries; weighted incidence rate difference, 99.72 [95% CI, 34.75 to 164.70] per 1000 surgeries). A CRF of ≤ 20 ml/kg/min was significantly associated with a high risk of long-term mortality (weighted hazard ratio, 1.98 [95% CI, 1.31 to 2.98], p < 0.001) and perioperative morbidity (weighted odds ratio, 1.93 [1.28 to 2.90], p = 0.002) compared to higher CRF. CONCLUSION: The study found that low CRF is significantly associated with increased perioperative morbidity and long-term mortality in operable patients with early-stage NSCLC.


Low cardiorespiratory fitness is significantly associated with increased perioperative morbidity and long-term mortality in operable patients with early-stage non-small cell lung cancer.Future research is recommended to investigate the potential prognostic role of integrating cardiorespiratory fitness into the currently used prognosis algorithm for patients with non-small cell lung cancer.


Asunto(s)
Carcinoma de Pulmón de Células no Pequeñas , Capacidad Cardiovascular , Neoplasias Pulmonares , Humanos , Masculino , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Femenino , Estudios Prospectivos , Carcinoma de Pulmón de Células no Pequeñas/cirugía , Puntaje de Propensión , Neoplasias Pulmonares/cirugía , Prueba de Esfuerzo/métodos , Incidencia , Factores de Riesgo
2.
Lipids Health Dis ; 22(1): 154, 2023 Sep 19.
Artículo en Inglés | MEDLINE | ID: mdl-37726765

RESUMEN

BACKGROUND: Hepatitis C has been associated with the development of hepatic steatosis, which increases the risk of liver cancer. The microsomal triglyceride transporter protein (MTTP), is a lipid transport protein that mediates lipid metabolism and CD1d antigen presentation. The study aimed to explore the association between MTTP genotype (-493G/T) polymorphism and hepatic steatosis in hepatitis C. METHODS: The database "Pubmed, Cochrane library, CNKI, Web of science, Embase and CBM" were retrieved to identify the literature. The quality of the selected literature was evaluated using the "the Newcastle-Ottawa Scale" (NOS). Relevant data was extracted and analyzed using the Stata software. Heterogeneity was expressed by "Cochran's Q and I2", with I2 ≥ 50% or P < 0.05 indicating high heterogeneity. A random-effects model and subgroup analysis were conducted to identify the sources of heterogeneity. We also used "Funnel plots", "Egger's tests" and "Begg's tests" to evaluate biases in the literature. RESULTS: The study found a significant and positive association between liver steatosis and the HCV genotype 3 with a dominant model of the MTTP genotype (-493G/T) (OR = 11.57, 95%CI: 4.467-29.962, P < 0.001). In contrast, no correlation was found between hepatic steatosis and either the recessive, homozygous or heterozygous models (OR = 1.142, P = 0.5; OR = 1.581, P = 0.081; OR = 1.029, P = 0.86). There was no significant publication biases, as measured by the Funnel plot, and the Egger's and Begg's tests. Finally, sensitivity analysis showed the obtained results are stable. CONCLUSIONS: Dominant mutations in the T allele of the MTTP genotype (-493G/T) increase susceptibility to hepatic steatosis in patients presenting with the HCV genotype 3.


Asunto(s)
Hígado Graso , Hepatitis C , Humanos , Proteínas Portadoras , Hígado Graso/genética , Genotipo , Hepacivirus/genética , Hepatitis C/complicaciones , Hepatitis C/genética
3.
Sci Rep ; 13(1): 13068, 2023 08 11.
Artículo en Inglés | MEDLINE | ID: mdl-37567977

RESUMEN

Switching to normal diet (ND) is the regular therapy for high-fat diet (HFD)-induced nonalcoholic fatty liver disease (NAFLD). Intermittent fasting (IF) is a unique treatment which may exhibits better therapeutic efficacy. Thus, we aim to investigate the therapeutic effects of these treatments and exploring the mechanisms. In the present study, NAFLD mouse model was induced by a 10-week HFD. Thereafter, mice adopted continued HFD, ND, or IF for the next 12 weeks. Finally, the liver was then harvested to assess lipid deposition, lipid metabolism, apoptosis, and autophagy, while blood was collected to determine blood glucose and insulin. The results showed that IF and ND treatment improved lipid deposition and metabolic disorder of NAFLD mice; the increasing body weight, liver weight, and HOMA-IR index of HFD mice were also alleviated by IF and ND. Furthermore, IF and ND treatment activated the macrophage migration inhibitory factor (MIF)/AMPK pathway and regulated its downstream autophagy and apoptosis. However, the efficacy of IF was better than ND. Both IF and ND activates MIF signaling and alleviate the lipotoxicity of NAFLD while IF therapy is more effective than ND. The different MIF up-regulation might be the underlying mechanism of why IF benefits more than ND.


Asunto(s)
Factores Inhibidores de la Migración de Macrófagos , Enfermedad del Hígado Graso no Alcohólico , Animales , Ratones , Dieta Alta en Grasa/efectos adversos , Ayuno Intermitente , Metabolismo de los Lípidos , Lípidos , Hígado/metabolismo , Factores Inhibidores de la Migración de Macrófagos/metabolismo , Ratones Endogámicos C57BL , Enfermedad del Hígado Graso no Alcohólico/etiología , Enfermedad del Hígado Graso no Alcohólico/terapia , Enfermedad del Hígado Graso no Alcohólico/metabolismo
4.
Sensors (Basel) ; 23(11)2023 May 26.
Artículo en Inglés | MEDLINE | ID: mdl-37299815

RESUMEN

As a powerful tool in scientific research and industrial technologies, the cold atom absolute gravity sensor (CAGS) based on cold atom interferometry has been proven to be the most promising new generation high-precision absolute gravity sensor. However, large size, heavy weight, and high-power consumption are still the main restriction factors of CAGS being applied for practical applications on mobile platforms. Combined with cold atom chips, it is possible to drastically reduce the complexity, weight, and size of CAGS. In this review, we started from the basic theory of atom chips to chart a clear development path to related technologies. Several related technologies including micro-magnetic traps, micro magneto-optical traps, material selection, fabrication, and packaging methods have been discussed. This review gives an overview of the current developments in a variety of cold atom chips, and some actual CAGS systems based on atom chips are also discussed. We summarize by listing some of the challenges and possible directions for further development in this area.

5.
Sensors (Basel) ; 22(24)2022 Dec 16.
Artículo en Inglés | MEDLINE | ID: mdl-36560286

RESUMEN

Long-term sleep stage monitoring is very important for the diagnosis and treatment of insomnia. With the development of wearable electroencephalogram (EEG) devices, we developed a fast and accurate sleep stage classification method in this study with single-channel EEG signals for practical applications. The original sleep recordings were collected from the Sleep-EDF database. The wavelet threshold denoising (WTD) method and wavelet packet transformation (WPT) method were applied as signal preprocessing to extract six kinds of characteristic waves. With a comprehensive feature system including time, frequency, and nonlinear dynamics, we obtained the sleep stage classification results with different Support Vector Machine (SVM) models. We proposed a novel classification method based on cascaded SVM models with various features extracted from denoised EEG signals. To enhance the accuracy and generalization performance of this method, nonlinear dynamics features were taken into consideration. With nonlinear dynamics features included, the average classification accuracy was up to 88.11% using this method. In addition, with cascaded SVM models, the classification accuracy of the non-rapid eye movement sleep stage 1 (N1) was enhanced from 41.5% to 55.65% compared with the single SVM model, and the overall classification time for each epoch was less than 1.7 s. Moreover, we demonstrated that it was possible to apply this method for long-term sleep stage monitor applications.


Asunto(s)
Procesamiento de Señales Asistido por Computador , Máquina de Vectores de Soporte , Sueño , Fases del Sueño , Electroencefalografía/métodos
6.
Front Immunol ; 13: 1073094, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36578494

RESUMEN

Gastric cancer (GC) is the fourth most common cancer worldwide, with overall 5-year survival rate of approximate 20%. Although multimodal treatments that combine surgery with chemotherapy and immunotherapy have been shown to improve survival, pathological complete response (pCR) is rare in advanced GC patients with liver metastases. Pre-clinical studies and clinical trials have demonstrated the antitumor efficacy of invariant natural killer T (iNKT) cells in various malignancies, including GC. While multimodal therapy comprised of chemotherapy, anti-programmed cell death-1 (PD-1) therapy, and iNKT cell immunotherapy have not been reported in GC patients. This case report describes the treatment of an early 60s patient diagnosed with advanced stage IVB (T1N1M1) adenocarcinomas of gastric cardia with liver metastases who received multimodal therapy comprised of SOX chemotherapy, anti-programmed cell death-1 (PD-1) therapy, and iNKT cell immunotherapy followed by surgical resection. Dramatic decreases in tumor area were observed in both the primary tumor and metastatic lesions following six cycles of SOX chemotherapy and iNKT cell immunotherapy, and four cycles of anti-PD-1 therapy. This combined treatment resulted in the transformation of a remarkably large, unresectable liver metastases into a resectable tumor, and the patient received total gastrectomy with D2 lymph node dissection and liver metastasectomy. Subsequent pathological examination detected no cancer cells in either the primary site or liver metastatic lesions, supporting the likelihood that this treatment achieved pCR. To our knowledge, this report represents the first case of a metastatic gastric cancer patient displaying pCR after six months of multimodal therapy, thus supporting that a SOX chemotherapy, anti-PD-1 therapy, and iNKT cell immunotherapy combination strategy may be effective for treating, and potentially curing, patients with advanced gastric adenocarcinoma.


Asunto(s)
Adenocarcinoma , Neoplasias Hepáticas , Células T Asesinas Naturales , Neoplasias Gástricas , Humanos , Neoplasias Gástricas/patología , Células T Asesinas Naturales/patología , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Neoplasias Hepáticas/tratamiento farmacológico , Adenocarcinoma/patología , Inmunoterapia
7.
Transl Cancer Res ; 11(11): 4037-4050, 2022 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-36523315

RESUMEN

Background: Platelet-to-lymphocyte ratio (PLR) has been used to predict the prognosis of patients with hepatocellular carcinoma (HCC) with inconsistent results. This meta-analysis aimed to clarify the prognostic value of PLR in patients with HCC. Methods: We systematically retrieved relevant literature published in the PubMed, Embase, Web of Science, and Cochrane databases up to November 20, 2021. The primary outcomes were the hazard ratios (HRs) and their 95% confidence intervals (CIs) for overall survival (OS), and secondary study outcomes were recurrence-free survival (RFS), disease-free survival (DFS), progression-free survival (PFS). All statistical analyses were conducted by Review Manager 5.4.1 and STATA 16.0 software. Results: A total of 21 studies comprising 8,779 patients were included in this meta-analysis. Pooled results suggested that a high PLR was significantly associated with poor OS (HR: 1.34, 95% CI: 1.18-1.52, P<0.00001; I2=59%, P=0.0005), RFS or DFS (HR: 1.35, 95% CI: 1.13-1.63, P=0.001; I2=69%, P=0.002), and PFS (HR: 1.55, 95% CI: 1.09-2.22, P=0.02; I2=73%, P=0.02). The subgroup analysis for OS showed, when the PLR cutoff value was greater than 150, the heterogeneity decreased to 0 (HR: 1.48, 95% CI: 1.33-1.68, P<0.00001; I2=0%, P=0.56); when the HBsAg positive population was increased to 100%, the heterogeneity decreased to 0 (HR: 1.46, 95% CI: 1.22-1.73, P<0.0001; I2=0%, P=0.45); compared with other regions in the world, it was more significant in China (HR: 1.43, 95% CI: 1.26-1.62, P<0.00001; I2=52%, P=0.01). In addition, scatter plot showed that the HR was negatively correlated with the proportion of patients with liver cirrhosis. Conclusions: This meta-analysis suggests that PLR is a negative correlation prognostic biomarker for HCC, high PLR values indicate poor OS, RFS, DFS and PFS, especially in hepatitis B virus (HBV) related patients.

8.
Sci Rep ; 12(1): 20277, 2022 11 23.
Artículo en Inglés | MEDLINE | ID: mdl-36434120

RESUMEN

Myocardial injury reduction and recovery under acute cardiac stress are adversely impacted by insulin resistance (IR). We previously demonstrated that Rhodiola improved cardiac anti-stress capacity in mice. Thus, this study focuses on the preventive efficacy of Rhodiola on exhaustive exercise (EE)-induced myocardial injury of IR mice. An 8-week high-fat diet (HFD) model of IR mice was established. Rhodiola was administrated by garaging. After the 8-week intervention, half of the mice performed EE to simulate acute cardiac stress, and determine myocardial injury; The remaining mice were sacrificed following fasting to assess metabolic disorder. We found myocardial injury induced by EE in IR mice was worse and was alleviated by Rhodiola pre-conditioning. Further, the nuclear factor erythroid 2-related factor 2 (Nrf2)-related antioxidant system was impaired by HFD, while mitochondrial dynamic fusion and fission were activated by HFD as a physiological protective compensation. The Rhodiola administration rescued Nrf2 impairment and further facilitated mitochondrial fusion and fission. All these results indicate that Rhodiola is a potential treatment for the prevention of cardiac events in type 2 diabetes mellitus and metabolic syndrome patients, and the Nrf2-related antioxidant activity and mitochondrial dynamics are the proposed mechanisms.


Asunto(s)
Diabetes Mellitus Tipo 2 , Lesiones Cardíacas , Resistencia a la Insulina , Rhodiola , Ratones , Animales , Insulina , Factor 2 Relacionado con NF-E2 , Diabetes Mellitus Tipo 2/metabolismo , Resistencia a la Insulina/fisiología , Lesiones Cardíacas/tratamiento farmacológico , Lesiones Cardíacas/prevención & control , Antioxidantes/farmacología
9.
Life Sci ; 308: 120949, 2022 Nov 01.
Artículo en Inglés | MEDLINE | ID: mdl-36096243

RESUMEN

AIMS: Rhodiola was found to be a potential treatment for nonalcoholic fatty liver disease (NAFLD). The macrophage migration inhibitory factor (MIF)-regulated lipophagy and lipid metabolism might be the therapeutic targets of Rhodiola. MAIN METHODS: A 16-week high-fat diet (HFD) was used to simulate a NAFLD mouse model. Rhodiola extract or normal saline were administrated to mice. Blood was collected to assess blood glucose and insulin, and livers were harvested to assess lipid accumulation and metabolism. In cell experiments, the active ingredient of Rhodiola, salidroside, and recombinant MIF protein (rMIF) were used to treat palmitate (PA)-incubated HepG2 cells, with MIF-siRNA or NC-siRNA transfection. Then, the level of lipophagy and lipid metabolism was examined. KEY FINDINGS: Rhodiola improved lipid accumulation and metabolism disorder of HFD mice. The oil red O staining of the liver showed that increased lipid droplets in the NAFLD liver could be relieved by Rhodiola; Rhodiola also alleviated the increasing body weight, liver weight, and HOMA-IR index of HFD mice. Results in cell experiments were consistent: salidroside relieved the lipid droplet accumulation and triglyceride release in PA cells, as well as reduced lipophagosome and lipid metabolism disorder in PA cells. However, all these effects of salidroside were partially blocked by MIF-siRNA transfection. SIGNIFICANCE: Rhodiola reduces lipid accumulation in the liver of NAFLD by facilitating the MIF pathway and the downstream lipophagy and lipid metabolism. MIF may be an endogenous regulator of liver lipophagy and lipid metabolism and a potential therapeutic target for NAFLD.


Asunto(s)
Factores Inhibidores de la Migración de Macrófagos , Enfermedad del Hígado Graso no Alcohólico , Rhodiola , Animales , Glucemia/metabolismo , Dieta Alta en Grasa , Glucósidos , Insulina/metabolismo , Metabolismo de los Lípidos , Hígado/metabolismo , Ratones , Ratones Endogámicos C57BL , Enfermedad del Hígado Graso no Alcohólico/metabolismo , Palmitatos/farmacología , Fenoles , Extractos Vegetales/uso terapéutico , ARN Interferente Pequeño/farmacología , Rhodiola/genética , Rhodiola/metabolismo , Solución Salina/metabolismo , Solución Salina/farmacología , Solución Salina/uso terapéutico , Triglicéridos/metabolismo
10.
Front Endocrinol (Lausanne) ; 13: 961231, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36147562

RESUMEN

The macrophage migration inhibitory factor (MIF) expressed in hepatocytes can limit steatosis during obesity. Lipotoxicity in nonalcoholic fatty liver disease is mediated in part by the activation of the stress kinase JNK, but whether MIF modulates JNK in lipotoxicity is unknown. In this study, we investigated the role of MIF in regulating JNK activation and high-fat fostered liver lipotoxicity during simultaneous exercise treatment. Fifteen mice were equally divided into three groups: normal diet, high-fat diet, and high-fat and exercise groups. High-fat feeding for extended periods elicited evident hyperlipemia, liver steatosis, and cell apoptosis in mice, with inhibited MIF and activated downstream MAPK kinase 4 phosphorylation and JNK. These effects were then reversed following prescribed swimming exercise, indicating that the advent of exercise could prevent liver lipotoxicity induced by lipid overload and might correlate to the action of modulating MIF and its downstream JNK pathway. Similar detrimental effects of lipotoxicity were observed in in vitro HepG2 cells palmitic acid treatment. Suppressed JNK reduced the hepatocyte lipotoxicity by regulating the BCL family, and the excess JNK activation could also be attenuated through MIF supplementation or exacerbated by MIF siRNA administration. The results found suggest that exercise reduces lipotoxicity and inhibits JNK activation by modulating endogenous hepatic MIF in NAFLD. These findings have clinical implications for the prevention and intervention of patients with immoderate diet evoked NAFLD.


Asunto(s)
Factores Inhibidores de la Migración de Macrófagos , Enfermedad del Hígado Graso no Alcohólico , Animales , Sistema de Señalización de MAP Quinasas , Factores Inhibidores de la Migración de Macrófagos/genética , Ratones , Quinasas de Proteína Quinasa Activadas por Mitógenos/metabolismo , Enfermedad del Hígado Graso no Alcohólico/metabolismo , Ácido Palmítico , ARN Interferente Pequeño
11.
Micromachines (Basel) ; 13(7)2022 Jun 29.
Artículo en Inglés | MEDLINE | ID: mdl-35888852

RESUMEN

With the development of flexible electronics, flexible microheaters have been applied in many areas. Low power consumption and fast response microheaters have attracted much attention. In this work, systematic thermal and mechanical analyses were conducted for a kind of flexible microheater with two different wire structures. The microheater consisted of polyethylene terephthalate (PET) substrate and copper electric wire with graphene thin film as the middle layer. The steady-state average temperature and heating efficiency for the two structures were compared and it was shown that the S-shaped wire structure was better for voltage-controlled microheater other than circular-shaped structure. In addition, the maximum thermal stress for both structures was from the boundary of microheaters, which indicated that not only the wire structure but also the shape of micro heaters should be considered to reduce the damage caused by thermal stress. The influence resulting from the thickness of graphene thin film also has been discussed. In all, the heating efficiency for flexible microheaters can be up to 135 °C/W. With the proposed PID voltage control system, the response time for the designed microheater was less than 10 s. Moreover, a feasible fabrication process flow for these proposed structures combing thermal analysis results in this work can provide some clues for flexible microheaters design and fabrication in other application areas.

12.
Medicine (Baltimore) ; 100(6): e24723, 2021 Feb 12.
Artículo en Inglés | MEDLINE | ID: mdl-33578617

RESUMEN

ABSTRACT: This study objected to evaluate the accuracy of the gamma-glutamyl transpeptidase-to-platelet ratio (GPR), aspartate aminotransferase-to-platelet ratio index (APRI), red cell distribution width (RDW), and fibrosis-4 index (FIB4) index, compared with liver biopsy (LB), in predicting the severity of inflammation in drug-induced liver injury (DILI) patients.We evaluated patients with DILI who were followed at the First Hospital of Jilin University and underwent LB. Accuracy of each method was analyzed using ROC analysis. Classifications of liver inflammation included G0-4.One hundred fifty six DILI patients were included with LB and complete medical records. 62.8% (98), 39.1% (61), and 16.7% (26) were classified as ≥G2, ≥G3, or G4, respectively. The AUROCs, by degree of inflammation, were: ≥G2: GPR: 0.654, RDW: 0.635, APRI: 0.728, and FIB4: 0.739; ≥G3: GPR: 0.623, RDW: 0.703, APRI: 0.777, and FIB4: 0.781; and G4: GPR: 0.556, RDW: 0.647, APRI: 0.729, and FIB4: 0.714. To predict ≥G2 inflammation, there were no differences between the AUROCs for GPR, RDW, APRI, and FIB4. To predict ≥G3 inflammation, the AUROCs for FIB4 and APRI were higher than that for GPR (0.781 vs 0.623, P < .01; 0.777 vs 0.623, P < .05). As for G4 inflammation, the AUROCs for FIB4 and APRI were also higher than GPR (0.714 vs 0.556, P < .05, 0.729 vs 0.556, P < .05).When the level of inflammation was higher than G2 in patients with DILI, it could be predicted using APRI and FIB4 as non-invasive markers for this condition.


Asunto(s)
Aspartato Aminotransferasas/sangre , Enfermedad Hepática Inducida por Sustancias y Drogas/sangre , Índices de Eritrocitos , Índice de Severidad de la Enfermedad , gamma-Glutamiltransferasa/sangre , Adulto , Biomarcadores/sangre , Biopsia , Enfermedad Hepática Inducida por Sustancias y Drogas/complicaciones , Enfermedad Hepática Inducida por Sustancias y Drogas/enzimología , Enfermedad Hepática Inducida por Sustancias y Drogas/patología , Femenino , Hepatitis/etiología , Humanos , Hígado/patología , Masculino , Persona de Mediana Edad , Recuento de Plaquetas
13.
J Int Med Res ; 48(10): 300060520964352, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-33115313

RESUMEN

Hepatic vein thrombosis is a rare occurrence in the clinical course of eosinophilic granulomatosis with polyangiitis (EGPA). The major mechanism of thrombosis has been postulated to involve the release of toxic proteins from eosinophils. A 36-year-old man with EGPA was admitted to our hospital in July 2018 with hematemesis and melena. Findings on physical examination included ascites and pigmentation of the lower extremities. Ultrasonography of the hepatic vein and inferior vena cava showed an obstruction of the hepatic vein. Magnetic resonance imaging showed low enhancement in the right hepatic vein region. At 34 years of age, the patient's EGPA had initially presented as asthma with eosinophilia (white blood cell count of 11.46 × 1012/L with 14.6% eosinophils). His skin biopsy showed infiltration of inflammatory cells and eosinophils, especially around medium-sized vessels, which was consistent with EGPA. The patient was thus diagnosed with Budd-Chiari syndrome associated with EGPA.


Asunto(s)
Síndrome de Budd-Chiari , Síndrome de Churg-Strauss , Granulomatosis con Poliangitis , Adulto , Síndrome de Budd-Chiari/diagnóstico por imagen , Síndrome de Budd-Chiari/etiología , China , Venas Hepáticas , Humanos , Masculino
14.
J Int Med Res ; 48(8): 300060520947918, 2020 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-32833541

RESUMEN

Mixed adenoneuroendocrine carcinoma (MANEC) is a rare tumour of the gastrointestinal tract with both epithelial and neuroendocrine components. We describe a case of a 57-year-old man who presented with yellow sclera and dark urine. Contrast-enhanced computed tomography (CT) showed enlargement of the intra and extrahepatic bile ducts and a neoplastic lesion at the end of the common bile duct which was indistinguishable from the adjacent head of the pancreas and duodenum. A pancreaticoduodenectomy was performed and histopathological examination of resected samples showed that tumour was a complex lesion with adenocarcinoma and neuroendocrine components positive for neuroendocrine markers (chromogranin A and synaptophysin) with a Ki-67 labelling index of 40%. The patient was diagnosed with MANEC in the ampulla of Vater with a neuroendocrine carcinoma component of approximately 70%. Ampullary MANECs are highly aggressive tumours with a high risk for distant metastases and a poor prognosis. Therefore, establishing a standard therapeutic strategy is crucial.


Asunto(s)
Adenocarcinoma , Ampolla Hepatopancreática , Carcinoma Neuroendocrino , Neoplasias Gastrointestinales , Adenocarcinoma/diagnóstico por imagen , Adenocarcinoma/cirugía , Ampolla Hepatopancreática/diagnóstico por imagen , Ampolla Hepatopancreática/cirugía , Carcinoma Neuroendocrino/diagnóstico por imagen , Carcinoma Neuroendocrino/cirugía , China , Humanos , Masculino , Persona de Mediana Edad
15.
Medicine (Baltimore) ; 98(35): e16909, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-31464924

RESUMEN

RATIONALE: Congenital hepatic fibrosis (CHF) is an autosomal recessive disease characterized by periportal fibrosis, portal hypertension, and renal cystic disease. Essentially, CHF is a variant of fibrocystic disorder in which liver and kidney are commonly affected. Other frequently associated conditions include Caroli syndrome and polycystic kidney disease. CHF is also a known accompaniment in an array of inherited disorders with multiorgan involvement. PATIENT CONCERNS: The 20-year-old male patient with declining vision (14 years duration), intermittent gingival bleeding (7 years duration), and abdominal distension (5 years duration), presented with exacerbation of these symptoms during the prior 2 months. The patient had been previously diagnosed with retinal macular degeneration, idiopathic thrombocytopenic purpura, and hepatosplenomegaly. DIAGNOSES: Liver biopsy showed disordered hepatic acini and fibrous parenchymal banding, indicative of CHF. INTERVENTIONS: After the treatment of diuresis and liver protectants, the clinical symptoms of the patients were improved. We subsequently recommend chromosomal analysis, although the family refused. OUTCOMES: Three months after discharge, the patient was followed up by telephone. The patient had obvious abdominal distension and we advised that he should be admitted again. But the family refused. LESSONS: CHF is an AR disease resulting in portal hypertension and often associated with renal malformations. CHF is also linked to a number of other disorders, many of which are ciliopathies. Because the clinical manifestations of CHF are nonspecific or lacking, its diagnosis is problematic, relying largely on liver biopsy. Once CHF is identified, physicians are obligated to investigate other organ systems, particularly a search for neuromuscular, retina or renal involvement. This case underscores the value of radiologic imaging, pathologic examination, and genetic testing in successfully diagnosing a rare disease.


Asunto(s)
Enfermedades Genéticas Congénitas/diagnóstico , Cirrosis Hepática/diagnóstico , Hígado/patología , Biopsia , Enfermedades Genéticas Congénitas/complicaciones , Enfermedades Genéticas Congénitas/patología , Hemorragia Gingival/etiología , Humanos , Cirrosis Hepática/complicaciones , Cirrosis Hepática/patología , Degeneración Macular , Masculino , Negativa del Paciente al Tratamiento , Adulto Joven
16.
Med Sci Monit ; 25: 3344-3353, 2019 May 06.
Artículo en Inglés | MEDLINE | ID: mdl-31059494

RESUMEN

BACKGROUND A Chinese population-based study aimed to investigate the risk factors for the incidence and severity of drug-induced liver injury (DILI) from Chinese herbal medicines and conventional Western medicines. MATERIAL AND METHODS Liver biopsy and routine laboratory testing, including serum lipid measurements, was performed on 465 patients, including 168 patients with DILI and 297 patients without DILI. Histological grading of DILI used the METAVIR scoring system and the severity of DILI was graded as levels 0-5. Multivariate and univariate regression analysis were used to compare the two study groups, using a risk-adjusted odds ratio (AOR). RESULTS There was no significant association between age, alcohol status, cardiovascular disease (CVD), hypertension, or type 2 diabetes mellitus and development of DILI. However, when compared with controls, patients with dyslipidemia (AOR, 2.173; 95% CI, 1.388-3.401; P=0.001) had an increased incidence of DILI, and men had a reduced incidence of DILI when compared with women (AOR, 0.276; 95% CI, 0.169-0.450; P<0.001). Risk factors for severe DILI (≥level 3) included drinking alcohol (AOR, 6.506; 95% CI, 2.184-19.384; P=0.001), and dyslipidemia (AOR, 3.095; 95% CI, 1.345-7.123; P=0.008). Patients with an increased duration of drug treatment of >1 year had a reduced risk of developing severe DILI compared with patients with a medication duration of ≤1 month (AOR, 0.259; 95% CI, 0.084-0.802). CONCLUSIONS Increased risk of the incidence of DILI was significantly associated with female gender and dyslipidemia, and the risk of developing severe DILI was associated with drinking alcohol and dyslipidemia.


Asunto(s)
Enfermedad Hepática Inducida por Sustancias y Drogas/etiología , Enfermedad Hepática Inducida por Sustancias y Drogas/metabolismo , Dislipidemias/fisiopatología , Adulto , Pueblo Asiatico/genética , China , Dislipidemias/genética , Femenino , Humanos , Incidencia , Lípidos/análisis , Lípidos/sangre , Hígado/efectos de los fármacos , Hígado/lesiones , Hígado/metabolismo , Masculino , Persona de Mediana Edad , Oportunidad Relativa , Estudios Retrospectivos , Factores de Riesgo , Índice de Severidad de la Enfermedad
17.
Opt Express ; 23(20): 26342-55, 2015 Oct 05.
Artículo en Inglés | MEDLINE | ID: mdl-26480148

RESUMEN

We report an electro-optic photonic integrated circuit which can perform the exclusive (XOR) logic operation based on two silicon parallel-cascaded microring resonators (MRRs) fabricated on the silicon-on-insulator (SOI) platform. PIN diodes embedded around MRRs are employed to achieve the carrier injection modulation. Two electrical pulse sequences regarded as two operands of operations are applied to PIN diodes to modulate two MRRs through the free carrier dispersion effect. The final operation result of two operands is output at the Output port in the form of light. The scattering matrix method is employed to establish numerical model of the device, and numerical simulator SG-framework is used to simulate the electrical characteristics of the PIN diodes. XOR operation with the speed of 100Mbps is demonstrated successfully.

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