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Objective: To investigate the clinical features and prognostic factors of advanced myelodysplastic syndromes (MDS) in children. Methods: Clinical data of children diagnosed with advanced MDS in the Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences, between September 2009 and April 2022 were retrospectively collected. Follow-up assessments were performed through telephone interviews and the review of medical records until May 1, 2023. The clinical features of children with advanced MDS were summarized by analyzing chromosomal karyotype tests, second-generation gene sequencing results. Multivariate Cox regression analysis was used to investigate the prognostic factors of advanced MDS in children. Results: A total of 69 children, comprising 49 males and 20 females, aged [M (Q1, Q3)] 8 (5, 10) years, were enrolled in the study. Sixty-seven cases underwent chromosomal karyotype testing, of which 42 cases (62.7%) had abnormal karyotypes, with monosomy 7 the most common in 17 cases (25.4%). Forty-three cases underwent next-generation sequencing, with mutations in the SETBP1, NRAS, PTPN11 and RUNX1 genes more common, identified in 12 cases (27.9%), 9 cases (20.9%), 8 cases(18.6%), and 8 cases(18.6%), respectively. The follow-up time [M (Q1, Q3)] was 26 (13, 56) months and the 5-year overall survival rate was 56%(95%CI: 44.4%-70.5%). The 5-year overall survival rate for children who underwent hematopoietic stem cell transplantation (HSCT) was higher than that of children who did not undergo HSCT (73.9% vs 29.1%, P<0.001). HSCT (HR=0.118, 95%CI: 0.037-0.372, P<0.001) was a protective factor for the overall survival rate of children with advanced MDS. Serum ferritin level>356.3 µg/L (HR=6.497, 95%CI: 2.068-20.415, P=0.001) and moderate to severe splenomegaly (HR=4.075, 95%CI: 1.174-14.141, P=0.027) were risk factors for the overall survival rate of children with advanced MDS. Conclusions: Monosomy 7 was the most common abnormal karyotype and SETBP1 was the gene that had the highest mutation frequency in children with advanced MDS. HSCT, increased ferritin and moderate to severe splenomegaly are prognostic factors influencing the overall survival rate of children with advanced MDS.
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Cariotipificación , Mutación , Síndromes Mielodisplásicos , Humanos , Síndromes Mielodisplásicos/genética , Síndromes Mielodisplásicos/diagnóstico , Síndromes Mielodisplásicos/terapia , Masculino , Femenino , Niño , Pronóstico , Estudios Retrospectivos , Preescolar , Cromosomas Humanos Par 7/genética , Subunidad alfa 2 del Factor de Unión al Sitio Principal/genética , Secuenciación de Nucleótidos de Alto Rendimiento , Cariotipo Anormal , Deleción Cromosómica , Proteína Tirosina Fosfatasa no Receptora Tipo 11RESUMEN
Objective: To analyze the clinical application value of serum heme oxygenase (HO)-1expression level in non-alcoholic fatty liver disease (NAFLD) and, based on that, establish a diagnostic model combined with glucose regulatory protein 78 (GRP78) so as to clarify its diagnostic effectiveness and application value. Methods: A total of 210 NAFLD patients diagnosed by abdominal B-ultrasound and liver elastography were included, and at the same time, 170 healthy controls were enrolled. The general clinical data, peripheral blood cell counts, and biochemical indicators of the research subjects were collected. The expression levels of HO-1 and GRP78 were detected using an enzyme-linked immunosorbent assay. Multivariate analysis was used to screen independent risk factors for NAFLD. Visual output was performed through nomogram diagrams, and the diagnostic model was constructed. Receiver operating characteristic curve (ROC), calibration curve, and decision curve analysis (DCA) were used to evaluate the diagnostic effectiveness of NAFLD. Measurement data were analyzed using a t-test or Mann-Whitney U rank sum test to detect data differences between groups. Enumeration data were analyzed using the Fisher's exact probability test or the Pearson χ(2) test. Results: Compared with the healthy control group, the white blood cell count, aspartate aminotransferase (AST), alanine aminotransferase, gamma-glutamyl transferase (GTT), fasting blood glucose (Glu), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), serum HO-1, and GRP78 levels were significantly increased in the NAFLD group patients (Pâ <â 0.05). Binary logistic analysis results showed that AST, TG, LDL-C, serum HO-1, and GRP78 were independent risk factors for NAFLD (Pâ <â 0.05). A nomogram clinical predictive model HGATL was established using HO-1 (H), GRP78 (G) combined with AST (A), TG (T), and LDL-C (L), with the formula P=-21.469+3.621×HO-1+0.116 ×GRP78+0.674×AST+6.250×TG+4.122 ×LDL-C. The results confirmed that the area under the ROC curve of the HGATL model was 0.965â 8, with an optimal cutoff value of 81.69, a sensitivity of 87.06%, a specificity of 92.82%, a Pâ <â 0.05, and the diagnostic effectiveness significantly higher than that of a single indicator. The calibration curve and DCA both showed that the model had good diagnostic performance. Conclusion: The HGATL model can be used as a novel, non-invasive diagnosis model for NAFLD and has a positive application value in NAFLD diagnosis and therapeutic effect evaluation. Therefore, it should be explored and promoted in clinical applications.
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Enfermedad del Hígado Graso no Alcohólico , Humanos , Glucosa , LDL-Colesterol , Hemo-Oxigenasa 1 , Chaperón BiP del Retículo Endoplásmico , TriglicéridosRESUMEN
Drug resistance is a serious problem in cancer therapy. Growing evidence has shown that docosahexaenoic acid has anti-inflammatory and chemopreventive abilities. Studies have shown that autophagy inhibition and ferroptosis are promising therapeutic strategies for overcoming multidrug resistance. This study was aimed to examine whether docosahexaenoic acid (DHA) could reverse docetaxel resistance in prostate cancer cells. Cell survival was examined by MTT and colony formation. Protein expression was determined by Western blot. Reactive oxygen species (ROS) production was measured by flow cytometry. DHA displayed anti-cancer effects on proliferation, colony formation, migration, apoptosis, autophagy and epithelial mesenchymal transition. Glutathione-S-transferase π is an enzyme that plays an important role in drug resistance. DHA inhibited GSTπ protein expression and induced cytoprotective autophagy by regulating the PI3K/AKT signalling pathway in PC3R cells. DHA combined with PI3K inhibitor (LY294002) enhanced apoptosis by alleviating the expression of LC3B, (pro-) caspase- 3 and (uncleaved) PARP. DHA induced ferroptosis by attenuating the expression of glutathione peroxidase 4 (GPX4) and nuclear erythroid 2-related factor 2 (Nrf2). DHA-treated PC3R cells produced ROS. The ROS and cytotoxicity were reversed by treatment with ferrostatin-1. DHA combined with docetaxel inhibited EMT by regulating the expression of E-cadhein and N-cadherin. In summary, DHA reversed drug resistance and induced cytoprotective autophagy and ferroptosis by regulating the PI3K/AKT/Nrf2/GPX4 signalling pathway in PC3R cells. We propose that DHA could be developed as a chemosensitizer and that the PI3K/AKT /Nrf2/GPX4 signalling pathway might be a promising therapeutic target for overcoming cancer drug resistance.
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Factor 2 Relacionado con NF-E2 , Neoplasias de la Próstata , Masculino , Humanos , Factor 2 Relacionado con NF-E2/metabolismo , Factor 2 Relacionado con NF-E2/farmacología , Docetaxel/farmacología , Transición Epitelial-Mesenquimal , Ácidos Docosahexaenoicos/farmacología , Fosfatidilinositol 3-Quinasas/metabolismo , Fosfatidilinositol 3-Quinasas/farmacología , Proteínas Proto-Oncogénicas c-akt/metabolismo , Especies Reactivas de Oxígeno/metabolismo , Neoplasias de la Próstata/tratamiento farmacológico , Resistencia a AntineoplásicosRESUMEN
OBJECTIVE: Ciprofol is a newly developed intravenous sedative-hypnotic drug. The objective of the study was to prove whether ciprofol was non-inferior to propofol for the successful induction of general anesthesia. The ideal post-induction sedation level was assessed by comparing patients' clinical symptoms and their hemodynamic effects in responding to noxious stimuli, mostly tracheal intubation and bispectral index (BIS) alterations following ciprofol/propofol administration. PATIENTS AND METHODS: In this multi-center, randomized, double-blind phase 3 trial, selective surgery patients were randomly assigned in a 1:1 ratio to either ciprofol 0.4 mg/kg (n = 88) or propofol 2.0 mg/kg (n = 88) groups. The primary endpoint was the percentage of patients with successful anesthesia inductions. Secondary endpoints included the times to successful induction of general anesthesia and loss of the eyelash reflex, changes in BIS, as well as safety indicators. RESULTS: The anesthesia induction success rates for both ciprofol 0.4 mg/kg and propofol 2 mg/kg groups were 100.0%, with a 95% CI lower success limit of -4.18% difference between the two groups, indicating that ciprofol was non-inferior to propofol. For secondary outcomes, the average time to successful anesthesia and loss of the eyelash reflex were 0.91 min and 0.80 min for ciprofol and 0.80 min and 0.71 min for propofol, respectively. The pattern of BIS changes with ciprofol was similar to propofol and stable during the anesthesia maintenance period. Safety was comparable with 88.6% TEAEs in the ciprofol group compared to 95.5% in the propofol group. The incidence of injection pain was significantly lower in the ciprofol group compared to the propofol group (6.8% vs. 20.5%, p < 0.05). In addition, the patients treated with ciprofol had a lesser increase in blood pressure and heart rate, and fewer cases with BIS > 60 within 15 min of intravenous administration, which indicated that ciprofol may provide a better ideal sedation level during the post-induction period under an equivalent dosing regimen to propofol. CONCLUSIONS: Ciprofol for patients undergoing selective surgery is a new option for the induction of general anesthesia.
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Propofol , Anestesia General , Anestésicos Intravenosos , Método Doble Ciego , Procedimientos Quirúrgicos Electivos , Humanos , Hipnóticos y Sedantes , Propofol/farmacologíaRESUMEN
ABSTRACT: Objective To study the qualitative analysis strategy for unknown synthetic cannabinoid in the suspicious herbal product when no reference substance is available. Methods The synthetic cannabinoid in herbal blend was extracted with methanol. The extract was concentrated by rotary evaporator and separated and purified by preparative liquid chromatography, to obtain high purity synthetic cannabinoid sample. Gas chromatography-mass spectrometry ï¼GC-MSï¼, ultra-high performance liquid chromatography-quadrupole time-of-flight mass spectrometry ï¼UPLC-QTOF-MSï¼ and nuclear magnetic resonance ï¼NMRï¼ were used to determine the structure of the prepared compound. Results High purity unknown sample ï¼10 mgï¼ was obtained by preparative liquid chromatography. The sample was analyzed by GC-MS, UPLC-TOF-MS and NMR, and through spectrum analysis, the unknown synthetic cannabinoid was determined as 5F-EDMB-PICA. Conclusion The method to extract unknown synthetic cannabinoid from low content herbal products by preparative liquid chromatography was established, and the structure of the unknown sample was identified by comprehensive use of GC-MS, UPLC-QTOF-MS and NMR. The information will assist forensic laboratories in identifying this substance or other compounds with similar structures in their casework.
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Cannabinoides , Cromatografía Líquida de Alta Presión , Cromatografía Liquida , Cromatografía de Gases y Espectrometría de Masas , Espectrometría de MasasRESUMEN
ABSTRACT: Objective To establish an ion chromatography method for the salt form determination of new psychoactive substances ï¼NPSï¼. Methods The method of conducting qualitative and quantitative analysis of six types of organic acid ions ï¼acetate ion, tartrate ion, maleate ion, oxalate ion, fumarate ion, citrate ionï¼ and five types of inorganic anions ï¼fluoride ion, chloride ion, nitrate ion, sulfate ion, phosphate ionï¼ in NPS sample by ion chromatography was developed. The salt forms of 222 seized NPS samples ï¼103 samples with synthetic cannabinoids, 81 samples with cathinones, 44 samples with phenylethylamines, 12 samples with tryptamines, 7 samples with phencyclidines, 6 samples with piperazines, 2 samples with aminoindenes, 26 samples with fentanyls and 43 samples with other types of NPSï¼ were analyzed by this method. Results Each anion had good linearity in the corresponding linear range, the correlation coefficients ï¼rï¼ were greater than 0.999, the limits of detection were 0.01-0.05 mg/L, and the limits of quantitative were 0.1-0.5 mg/L. Except that 5F-BEPIRAPIM was hydrochloride, the salt forms of the other 102 synthetic cannabinoids were all base. The salt form of 81 cathinone samples, 44 phenylethylamine samples, 7 phencyclidine samples and 2 aminoindene samples were all hydrochloride. The salt forms of tryptamine samples included base, hydrochloride, fumarate and oxalate. The salt forms of piperazine samples included base and hydrochloride. The salt forms of fentanyl samples and samples of other types included base, hydrochloride and citrate. Conclusion Ion chromatography is a simple, accurate and efficient method for determining the salt form of NPS samples, which makes the qualitative and quantitative conclusions of NPS more scientific and rigorous.
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Psicotrópicos/química , Cromatografía Liquida , Cromatografía de Gases y Espectrometría de Masas , IonesRESUMEN
ABSTRACT: Objective To establish an infrared spectroscopic method for the rapid qualitative and quantitative analysis of caffeine and sodium benzoate in Annaka samples. Methods Qualitative and quantitative modeling samples were prepared by mixing high-purity caffeine and sodium benzoate. The characteristic absorption peaks of caffeine and sodium benzoate in Annaka samples were determined by analyzing the infrared spectra of the mixed samples. The quantitative model of infrared spectra was established by partial least squares ï¼PLSï¼. Results By analyzing the infrared spectra of 17 mixed samples of caffeine and sodium benzoate ï¼the purity of caffeine ranges from 10% to 80%ï¼, the characteristic absorption peaks for caffeine were determined to be 1 698, 1 650, 1 237, 972, 743, and 609 cm-1. The characteristic absorption peaks for sodium benzoate were 1 596, 1 548, 1 406, 845, 708 and 679 cm-1. When the detection of all characteristic absorption peaks was the positive identification criteria, the positive detection rate of caffeine and sodium benzoate in 48 seized Annaka samples was 100%. The linear range of PLS quantitative model for caffeine was 10%-80%, the coefficient of determination ï¼ R2ï¼ was 99.9%, the root mean square error of cross validation ï¼RMSECVï¼ was 0.68%, and the root mean square error of prediction ï¼RMSEPï¼ was 0.91%; the linear range of PLS quantitative model for sodium benzoate was 20%-90%, the R2 was 99.9%, the RMSECV was 0.91% and the RMSEP was 1.11%. The results of paired sample t test showed that the differences between the results of high performance liquid chromatography method and infrared spectroscopy method had no statistical significance. The established infrared quantitative method was used to analyze 48 seized Annaka samples, the purity of caffeine was 27.6%-63.1%, and that of sodium benzoate was 36.9%-72.3%. Conclusion The rapid qualitative and quantitative analysis of caffeine and sodium benzoate in Annaka samples by infrared spectroscopy method could improve identification efficiency and reduce determination cost.
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Cafeína , Benzoato de Sodio , Cromatografía Líquida de Alta Presión , Análisis de los Mínimos Cuadrados , Espectroscopía Infrarroja CortaRESUMEN
OBJECTIVE: Non-small cell lung cancer (NSCLC) is the leading cause of cancer-related death worldwide. microRNAs (miRNAs) have been confirmed as vital regulators of multiple tumors, including NSCLC. The aim of the current study was to explore the biological mechanisms of miR-99b in NSCLC progression. PATIENTS AND METHODS: NSCLC tissues and adjacent matched human non-neoplastic lung tissues used in this study were collected from 50 cases of NSCLC patients. The expression of miR-99b and NIPBL in NSCLC tissues and cell lines (A549, NCI-H460, NCI-H1299 and SPC-A1) were determined by real-time-polymerase chain reaction (qRT-PCR). The NIPBL protein level was measured by Western blot. Dual-Luciferase reporter, Western blotting and qRT-PCR were carried out to verify the potential target of miR-99b. Transwell assay was used for investigating miR-99b effect on cell migration and invasion in NSCLC cells. RESULTS: The results of qRT-PCR indicated that the expression of miR-99b was downregulated in the NSCLC tissues and cell lines. Overexpression of miR-99b could significantly inhibit the invasion and migration capacities in NSCLC cells. Furthermore, we also determined that NIPBL was a direct target of miR-99b. Additionally, we found NIPBL was implicated in the suppressive effects on NSCLC cell invasion and migration mediated by miR-99b. CONCLUSIONS: In summary, miR-99b exerted anti-tumor functions in NSCLC via regulation of NIPBL, suggesting that miR-99b/NIPBL axis may be novel biomarkers for NSCLC treatments.
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Carcinoma de Pulmón de Células no Pequeñas/metabolismo , Proteínas de Ciclo Celular/metabolismo , Neoplasias Pulmonares/metabolismo , MicroARNs/metabolismo , Carcinoma de Pulmón de Células no Pequeñas/patología , Proteínas de Ciclo Celular/genética , Movimiento Celular , Femenino , Humanos , Neoplasias Pulmonares/patología , Masculino , MicroARNs/genética , Persona de Mediana Edad , Células Tumorales CultivadasRESUMEN
OBJECTIVE: Abnormal lipid metabolism plays a role that cannot be ignored in articular cartilage bone marrow lesions, synovial inflammation, and the destruction of chondrocytes (CHs). Ceramide is one of the key constructions of membrane lipid bilayers, which is an intracellular lipid mediator regulating varieties of cellular behaviors. The purpose of this study was to explore the role of ceramide and its inhibitor in the development of the CHs degeneration. PATIENTS AND METHODS: CHs were isolated from the cartilage collecting from the osteoarthritis (OA) patients, and oleic acid/palmitic (O/P) acid was used to induce CHs lipid disordered. Then, myriocin was used to inhibit the accumulation of ceramide. After that, the apoptosis, cell viability, glucose uptake, oxidative stress, and the chondrogenic gene expression were tested to evaluate the degenerated degree of CHs. RESULTS: Results revealed that O/P induced CH apoptosis, ceramide accumulation, a higher level of oxidative stress, IL-1ß and MMP-13, but it also decreased the collagen-â ¡ and SOX-9 expressions and affected the glucose uptake of CHs. After the stimulation of myriocin, the side effects induced by O/P was partly reversed. CONCLUSIONS: O/P induces the accumulation of ceramide and the degeneration of CHs, and myriocin can reject the harmful effect caused by O/P via the suppression of ceramide.
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Ceramidas/antagonistas & inhibidores , Condrocitos/efectos de los fármacos , Ácidos Grasos Monoinsaturados/farmacología , Ácido Oléico/antagonistas & inhibidores , Palmitatos/antagonistas & inhibidores , Adulto , Anciano , Cartílago Articular/metabolismo , Cartílago Articular/patología , Ceramidas/metabolismo , Condrocitos/metabolismo , Femenino , Humanos , Masculino , Persona de Mediana Edad , Ácido Oléico/farmacología , Osteoartritis/metabolismo , Osteoartritis/patología , Palmitatos/farmacologíaRESUMEN
OBJECTIVE: CircRNAs are vital factors involved in the pathological processes. This study aims to elucidate the biological functions of hsa_circ_0000337 in affecting the malignant progress of glioma. PATIENTS AND METHODS: Relative levels of hsa_circ_0000337 in 45 cases of glioma and 24 cases of normal tissues were tested. The correlation between hsa_circ_0000337 and clinical features of glioma was assessed. Proliferative and metastatic abilities of U87 and U251 cells regulated by hsa_circ_0000337 were examined by 5-Ethynyl-2'-deoxyuridine (EdU) and transwell assay, respectively. Potential molecular mechanism of hsa_circ_0000337 on regulating glioma cell functions was clarified by bioinformatic analysis, which was further verified through rescue experiments. RESULTS: Hsa_circ_0000337 was highly expressed in glioma cases. Its level was correlated to poor prognosis of glioma. In vitro experiments obtained the conclusion that hsa_circ_0000337 accelerated proliferative and metastatic abilities of glioma cells. Serving as a ceRNA, hsa_circ_0000337 sponged miRNA-942-5p to upregulate MAT2A, thus inducing the malignant phenotypes of glioma. CONCLUSIONS: Hsa_circ_0000337/miRNA-942-5p / MAT2A axis is responsible for the deterioration of glioma. Hsa_circ_0000337 may be a potential therapeutic target for glioma.
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Neoplasias del Sistema Nervioso Central/metabolismo , Glioma/metabolismo , Metionina Adenosiltransferasa/metabolismo , MicroARNs/metabolismo , ARN Circular/metabolismo , Regulación hacia Arriba , Sitios de Unión , Movimiento Celular , Proliferación Celular , Células Cultivadas , Neoplasias del Sistema Nervioso Central/patología , Glioma/patología , Humanos , Metionina Adenosiltransferasa/genética , MicroARNs/genética , ARN Circular/genéticaRESUMEN
ABSTRACT: Objective To study the identification method for 4'-F-4-methylaminorex ï¼4'-F-4-MARï¼ in samples without reference substance. Methods Gas chromatography-mass spectrometry ï¼GC-MSï¼, ultra-high-performance liquid chromatography-quadrupole time-of-flight-mass spectrometry ï¼UPLC-QTOF-MSï¼, nuclear magnetic resonance ï¼NMRï¼ and Fourier transform infrared ï¼FTIRï¼ were comprehensively used for the structure identification of 4'-F-4-MAR in samples. Results Under the positive electrospray ionization ï¼ESI+ï¼ mode, quasi-molecular ion in the first order mass spectrometry of the unknown compound was 195.092 6 and its molecular formula was inferred to be C10H11FN2O. The fragment ions in the mass spectrometry of the unknown compound were compared with the related fragment ions of 4,4'-dimethylaminorex ï¼4,4'-DMARï¼ in literature. It was found that the main fragment ions of the unknown compound were all 4 bigger than the corresponding fragment ions of 4,4'-DMAR. Therefore, the unknown compound was inferred to be a 4,4'-DMAR analogue with a methyl substituted by a fluorine in the benzene ring. The equivalent protons at δ=7.30 and δ=7.06 in 1H-nuclear magnetic resonance ï¼1H-NMRï¼ spectra and the characteristic spin-spin coupling constants ï¼1JC-F=245.2 Hz, 2JC-F=21.3 Hz, 3JC-F=8.1 Hzï¼ for 13C-19F interactions in carbon spectra, further proved that the fluorine substituted methyl at the para-position of the benzene ring. Finally, the unknown compound was determined as 4'-F-4-MAR. Conclusion A method that comprehensively used the identification materials 4'-F-4-MAR in GC-MS, UPLC-QTOF-MS, NMR and FTIR is established and the fragmentation mechanism of fragmentation ions of 4'-F-4-MAR created under the two modes -- electron impact ï¼EIï¼ and electrospray ionization under collision induced dissociation ï¼ESI-CIDï¼ is deduced. The information will assist forensic science laboratories in identifying this compound or other substances with similar structure in their case work.
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Aminorex , Espectrometría de Masa por Ionización de Electrospray , Cromatografía Líquida de Alta Presión , Cromatografía de Gases y Espectrometría de Masas , Espectrometría de Masas , NitroimidazolesRESUMEN
Electrostatic solitary wave (ESW)-a Debye-scale structure in space plasmas-was believed to accelerate electrons. However, such a belief is still unverified in spacecraft observations, because the ESW usually moves fast in spacecraft frame and its interior has never been directly explored. Here, we report the first measurements of an ESW's interior, by the Magnetospheric Multiscale mission located in a magnetotail reconnection jet. We find that this ESW has a parallel scale of 5λ_{De} (Debye length), a superslow speed (99 km/s) in spacecraft frame, a longtime duration (250 ms), and a potential drop eφ_{0}/kT_{e}â¼5%. Inside the ESW, surprisingly, there is no electron acceleration, no clear change of electron distribution functions, but there exist strong electrostatic electron cyclotron waves. Our observations challenge the conventional belief that ESWs are efficient at particle acceleration.
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OBJECTIVE: To review the first 8-month outcome of the Common Mental Disorder Clinic model in Hong Kong in terms of patient exit status and improvement in depressive and anxiety symptoms. METHODS: During the first appointment, patients were interviewed by a multidisciplinary team comprising a psychiatrist, a psychiatric nurse, and an occupational therapist. A multidisciplinary case conference was conducted to discuss clinical observations, diagnosis, issues of concern, and the optimal individualised treatment plan. Low-intensity interventions by nurses and/or occupational therapists were provided, as were optional, time-limited, protocol-based interventions by clinical psychologists for those with mild to moderate depressive and anxiety symptoms. Pharmacological intervention may be used when indicated. Upon completion of the treatment plan, patients were reassessed by the treating psychiatrist. Discharge options included discharge without psychiatric follow-up, step-up to psychiatric outpatient clinics, and step-down services. The self-administered Patient Health Questionnaire-9 (PHQ-9) and Generalised Anxiety Disorder 7-item scale (GAD-7) were used to assess the past 2 weeks' depressive and anxiety symptoms, respectively, at baseline and at each session. RESULTS: From July 2015 to February 2016, 1325 Chinese patients received the new service. Of them, 170 men and 363 women (mean age, 52.6 years) completed the treatment plan. After treatment, their mean PHQ-9 score decreased from 11.06 to 7.55 (p < 0.001), and the mean GAD-7 score decreased from 9.94 to 6.54 (p < 0.001). After treatment, 42.4% and 48.2% of the patients were within the normal range of PHQ-9 and GAD-7 scores, respectively, compared with 16.9% and 20.8% before treatment. The mean time to implementation of the individualised treatment plan was 82.33 days. Of the patients, 54.4% were discharged without any need for medical or psychiatric follow-up; 28% were stepped up to psychiatric outpatient clinics; and 17.3% were stepped down. The predictors of exit status were whether psychiatric medication was prescribed during initial intake (p = 0.011), whether psychiatric medication was prescribed at last follow-up (p < 0.001), the service period (p = 0.010), and the GAD-7 final score (p = 0.005). CONCLUSIONS: The first 8-month outcome of the new service model was encouraging, with shortened waiting time, reduced severity of symptoms, and better exit status (high recovery and step-down rates).
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Evaluación de Resultado en la Atención de Salud , Grupo de Atención al Paciente , Ansiedad/terapia , Pueblo Asiatico , Depresión/terapia , Femenino , Hong Kong , Humanos , Masculino , Persona de Mediana Edad , Psicoterapia , Estudios Retrospectivos , Factores de TiempoRESUMEN
OBJECTIVE: To study the expression and significance of micro ribonucleic acid (miR)-126 and vascular endothelial growth factor (VEGF) in the vitreous body and proliferative membrane tissues of affected eyes and plasma in proliferative diabetic retinopathy (PDR). PATIENTS AND METHODS: A total of 50 PDR patients admitted to our hospital from January 2017 to January 2018 were collected, including 17 cases in stage IV, 20 cases in stage V, and 13 cases in stage VI according to the DR staging criteria. Another 30 patients with an idiopathic macular hole were selected as control group. After admission, the examinations were performed, venous blood was drawn, and vitrectomy was performed, during which the vitreous body and proliferative membrane tissues were taken. The plasma VEGF content was detected via enzyme-linked immunosorbent assay (ELISA). The VEGF protein expression level was detected via Western blotting in vitreous body and proliferative membrane tissues. Moreover, the miR-126 expression was detected via quantitative polymerase chain reaction (qPCR). RESULTS: In the vitreous body tissues, proliferative membrane tissues and plasma, the expression level of miR-126 was significantly lower in control group than that in stage IV, V, and VI groups (p<0.05). The miR-126 expression was significantly lower in stage IV group than that in stage V and VI groups (p<0.05), meanwhile, miR-126 expression was significantly lower in stage V group than that in stage VI group (p<0.05). In the vitreous body tissues, proliferative membrane tissues and plasma, the VEGF mRNA and protein expression levels were significantly higher in control group than those in stage IV, V, and VI groups (p<0.05). The VEGF expressions were significantly higher in stage IV group than those in stage V and VI groups (p<0.05). In addition, VEGF expressions were significantly higher in stage V group than those in stage VI group (p<0.05). Furthermore, the VEGF expression level was negatively correlated with the miR-126 expression level. CONCLUSIONS: We found that the abnormally high expression of miR-126 negatively regulates VEGF, which may be one of the important mechanisms of occurrence of PDR. The miR-126 and VEGF content can serve as important predictors for the condition of PDR.
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Proliferación Celular/fisiología , Retinopatía Diabética/diagnóstico , Retinopatía Diabética/metabolismo , MicroARNs/biosíntesis , Factor A de Crecimiento Endotelial Vascular/biosíntesis , Retinopatía Diabética/genética , Femenino , Expresión Génica , Humanos , Masculino , MicroARNs/genética , Persona de Mediana Edad , Factor A de Crecimiento Endotelial Vascular/genéticaRESUMEN
ABSTRACT: Objective To provide the reference for the identification of unknown fentanyl analogues by studying the characteristic ions and main fragmentation pathways of fentanyl analogues in the modes of collision induced dissociation ï¼CIDï¼ and electron ionization ï¼EIï¼. Methods Nine fentanyl analogues ï¼2, 2'-difluorofentanyl, acetyl fentanyl, fentanyl, butyl fentanyl, valeryl fentanyl, acryloyl fentanyl, furan fentanyl, 4-fluorine isobutyl fentanyl, carfentanylï¼ were selected and analyzed with ultra-high performance liquid chromatography-quadrupole time-of-flight-mass spectrometry ï¼UHPLC-QTOF-MSï¼ and gas chromatography-mass spectrometry ï¼GC-MSï¼. The mass spectrum obtained was analyzed. The CID and EI fragmentation routes of fentanyl analogues were speculated. Results The CID and EI fragmentation pathways were highly similar. In the CID mode, characteristic ions were formed by the carbon-nitrogen bond cleavage between the piperidine ring and the N-phenyl-amide moiety, within the piperidine ring, and between the phenethyl and piperidine ring. While in the EI mode, dissociation of the piperidine ring, as well as cleavage between the piperidine ring and the phenethyl were the main fragmentation pathways. Conclusion This study summarizes the main fragmentation pathways and characteristic ions of fentanyl analogues in the CID and EI modes, which is useful for forensic laboratories to identify and structural analyze fentanyl type new psychoactive substance in practical work.
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Técnicas de Química Analítica/métodos , Cromatografía Líquida de Alta Presión , Fentanilo/análisis , Cromatografía de Gases y Espectrometría de Masas , Espectrometría de Masas , Fentanilo/análogos & derivados , HumanosRESUMEN
BACKGROUND: Neuropathic pain, a type of chronic pain as a result of direct central or peripheral nerve damage, is associated with significant quality of life and functional impairment. Its underlying mechanisms remain unclear. We investigated whether ROR2, a member of the receptor tyrosine kinase-like orphan receptor (ROR) family, participates in modulation of neuropathic pain. METHODS: Thermal hyperalgesia and mechanical allodynia were measured using radiant heat and von Frey filament testing. Immunofluorescence staining was used to detect expression of ROR2 in neuronal nuclei. Fos expression was determined by immunocytochemistry. Phosphorylation status was detected by western blot and immunoprecipitation. Small interfering RNA was used to knock down ROR2 expression. RESULTS: ROR2 was upregulated and activated in spinal neurones after chronic constriction injury (CCI) in mice [1.3 (0.1) to 2.1 (0.1)-fold of sham, P<0.01] from Day 1-21. CCI induced significant demethylation of the CpG island in the ROR2 gene promoter [0.37 (0.06) vs 0.12 (0.03)% CpG methylation, P<0.001]. Knockdown of ROR2 in the spinal cord prevented and reversed CCI-induced pain behaviours and spinal neuronal sensitisation [Fos expression: 130 (12) vs 81 (8) cells, P<0.05; 120 (11) vs 70 (7) cells, P<0.05]. In contrast, activation of spinal ROR2 by intrathecal injection of Wnt5a induced pain behaviours and spinal neuronal sensitisation [Fos expression: 11 (1) vs 100 (12) cells, P<0.001] in wild-type mice. Furthermore, ROR2-mediated pain modulation required phosphorylation of N-methyl-D-aspartate receptor 2B subunit (GluN2B) at Ser 1303 and Tyr1472 by pathways involving protein kinase C (PKC) and Src family kinases. Intrathecal injection of GluN2B, PKC, or Src family kinase-specific inhibitors significantly attenuated Wnt5a-induced pain behaviours. CONCLUSIONS: ROR2 in the spinal cord regulates neuropathic pain via phosphorylation of GluN2B, suggesting a potential target for prevention and relief of neuropathic pain.
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Neuralgia/genética , Neuralgia/fisiopatología , Receptores Huérfanos Similares al Receptor Tirosina Quinasa/genética , Receptores Huérfanos Similares al Receptor Tirosina Quinasa/farmacología , Receptores de N-Metil-D-Aspartato/metabolismo , Animales , Western Blotting , Modelos Animales de Enfermedad , Técnica del Anticuerpo Fluorescente , Masculino , Ratones , Ratones Endogámicos ICR , Fosforilación , Reacción en Cadena de la Polimerasa , Ratas , Receptores de N-Metil-D-Aspartato/genéticaRESUMEN
INTRODUCTION: There is currently a lack of a well-formed consensus regarding the effects of depression on the survival of glioma patients. A more thorough understanding of such effects may better highlight the importance of recognizing depressive symptoms in this patient population and guide treatment plans in the future. OBJECTIVE: The aim of this meta-analysis was to study the effect of depression on glioma patients' survival. METHODS: A meta-analysis was conducted according to the PRISMA guidelines. PubMed, Embase, and Cochrane databases were searched for studies that reported depression and survival among glioma patients through 11/06/2016. Both random-effects (RE) and fixed-effect (FE) models were used to compare survival outcomes in glioma patients with and without depression. RESULTS: Out of 619 identified articles, six were selected for the meta-analysis. Using RE model, the various measures for survival outcomes displayed worsened outcomes for both high and low-grade glioma patients with depression compared to those without depression. For binary survival outcomes, the overall pooled risk ratio for survival was 0.70 (95% CI: 0.47, 1.04; 6 studies; I2â¯=â¯54.9%, P-heterogeneityâ¯=â¯0.05) for high grade gliomas (HGG) and 0.28 (95% CI: 0.04, 1.78; I2â¯=â¯0%, P-heterogeneityâ¯=â¯1.00; one study) for low grade gliomas (LGG) was. A sub-group analysis in the HGG group by depression timing (pre- versus post-operative) revealed no differences between depression and survival outcomes (P-interactionâ¯=â¯0.47). For continuous survival outcomes, no statistically significant difference was found among the high and low-grade glioma groups (P-interactionâ¯=â¯0.31). The standardized mean difference (SMD) in survival outcomes was -0.56 months (95%CI: -1.13, 0.02; 4 studies, I2â¯=â¯89.4%, P-heterogeneity < 0.01) for HGG and -1.69 months (95%CI: -3.26, -0.13; one study; I2â¯=â¯0%, P-heterogeneityâ¯=â¯1.00) for LGG. In patients with HGG, the pooled HR of death also showed a borderline significant increased risk of death among depressive patients (HR 1.42, 95% CI: 1.00, 2.01). Results using the FE model were not materially different. CONCLUSIONS: Depression was associated with significantly worsened survival regardless of time of diagnosis, especially among patients with high-grade glioma.
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Neoplasias Encefálicas/mortalidad , Depresión/mortalidad , Glioma/mortalidad , Humanos , Clasificación del Tumor , Selección de Paciente , Factores de RiesgoRESUMEN
The hippocampus and the medial prefrontal cortex (mPFC) are traditionally associated with regulating memory and executive function, respectively. The contribution of these brain regions to food intake control, however, is poorly understood. The present study identifies a novel neural pathway through which monosynaptic glutamatergic ventral hippocampal field CA1 (vCA1) to mPFC connectivity inhibits food-motivated behaviors through vCA1 glucagon-like peptide-1 receptor (GLP-1R). Results demonstrate that vCA1-targeted RNA interference-mediated GLP-1R knockdown increases motivated operant responding for palatable food. Chemogenetic disconnection of monosynaptic glutamatergic vCA1 to mPFC projections using designer receptors exclusively activated by designer drugs (DREADDs)-mediated synaptic silencing ablates the food intake and body weight reduction following vCA1 GLP-1R activation. Neuropharmacological experiments further reveal that vCA1 GLP-1R activation reduces food intake and inhibits impulsive operant responding for palatable food via downstream communication to mPFC NMDA receptors. Overall these findings identify a novel neural pathway regulating higher-order cognitive aspects of feeding behavior.
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Ingestión de Alimentos/fisiología , Conducta Alimentaria/fisiología , Péptido 1 Similar al Glucagón/fisiología , Animales , Región CA1 Hipocampal/fisiología , Conducta Alimentaria/efectos de los fármacos , Alimentos , Péptido 1 Similar al Glucagón/metabolismo , Receptor del Péptido 1 Similar al Glucagón/genética , Receptor del Péptido 1 Similar al Glucagón/fisiología , Hipocampo/fisiología , Masculino , Motivación/fisiología , Vías Nerviosas/fisiología , Corteza Prefrontal/fisiopatología , Ratas , Ratas Sprague-Dawley , Transducción de Señal/fisiologíaRESUMEN
Both neurocognitive deficits and schizophrenia are highly heritable. Genetic overlap between neurocognitive deficits and schizophrenia has been observed in both the general population and in the clinical samples. This study aimed to examine if the polygenic architecture of susceptibility to schizophrenia modified neurocognitive performance in schizophrenia patients. Schizophrenia polygenic risk scores (PRSs) were first derived from the Psychiatric Genomics Consortium (PGC) on schizophrenia, and then the scores were calculated in our independent sample of 1130 schizophrenia trios, who had PsychChip data and were part of the Schizophrenia Families from Taiwan project. Pseudocontrols generated from the nontransmitted parental alleles of the parents in these trios were compared with alleles in schizophrenia patients in assessing the replicability of PGC-derived susceptibility variants. Schizophrenia PRS at the P-value threshold (PT) of 0.1 explained 0.2% in the variance of disease status in this Han-Taiwanese samples, and the score itself had a P-value 0.05 for the association test with the disorder. Each patient underwent neurocognitive evaluation on sustained attention using the continuous performance test and executive function using the Wisconsin Card Sorting Test. We applied a structural equation model to construct the neurocognitive latent variable estimated from multiple measured indices in these 2 tests, and then tested the association between the PRS and the neurocognitive latent variable. Higher schizophrenia PRS generated at the PT of 0.1 was significantly associated with poorer neurocognitive performance with explained variance 0.5%. Our findings indicated that schizophrenia susceptibility variants modify the neurocognitive performance in schizophrenia patients.