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1.
Nat Commun ; 15(1): 6556, 2024 Aug 02.
Artículo en Inglés | MEDLINE | ID: mdl-39095386

RESUMEN

The migratory insertion of metal-hydride into alkene has allowed regioselective access to organometallics, readily participating in subsequent functionalization as one conventional pathway of hydroalkylation, whereas analogous process with feedstock alkyne is drastically less explored. Among few examples, the regioselectivity of metal-hydride insertion is mostly governed by electronic bias of alkynes. To alter the regioselectivity and drastically expand the intermediate pools that we can access, one aspirational design is through alternative nickel-alkyl insertion, providing opposite regioselectivity induced by steric demand. Leveraging in situ formed nickel-alkyl species, we herein report the regio- and enantioselective hydroalkylation of alkynes with broad functional group tolerance, excellent regio- and enantioselectivity, enabling efficient route to diverse valuable chiral allylic amines motifs. Preliminary mechanistic studies indicate the aminoalkyl radical species can participate in metal-capture and lead to formation of nickel-alkyl, of which the migratory insertion is key to reverse regioselectivity observed in metal-hydride insertion.

2.
Int J Surg ; 2024 Aug 22.
Artículo en Inglés | MEDLINE | ID: mdl-39172717

RESUMEN

BACKGROUND: Multimodal analgesic strategy is pivotal for enhanced recovery after surgery. The objective of this trial was to assess the effect of subanesthetic esketamine vs. placebo combined with erector spinae plane block (ESPB) vs. intercostal nerve block (ICNB) on postoperative recovery following thoracoscopic lung resection. MATERIALS AND METHODS: This randomized, controlled, 2×2 factorial trial was conducted at a university hospital in Suzhou, China. One hundred adult patients undergoing thoracoscopic lung surgery were randomized to one of four groups (esketamine-ESPB, esketamine-ICNB, placebo-ESPB, and placebo-ICNB) to receive i.v. esketamine 0.3 mg/kg or normal saline placebo combined with ESPB or ICNB using 0.375% ropivacaine 20 mL. All patients received flurbiprofen axetil and patient-controlled fentanyl. The primary outcome was quality of recovery (QoR) at 24 h postoperatively, assessed using the QoR-15 scale, with a minimal clinically important difference of 6.0. RESULTS: The median age was 57 years and 52% were female. No significant interaction effect was found between esketamine and regional blocks on QoR (P=0.215). The QoR-15 score at 24 h was 111.5±5.8 in the esketamine group vs. 105.4±4.5 in the placebo group (difference=6.1, 95% CI, 4.0-8.1; P<0.001); 109.7±6.2 in the ESPB group vs. 107.2±5.6 in the ICNB group (difference=2.5, 95% CI, 0.2-4.9; P=0.033; not statistically significant after Bonferroni correction). Additionally, esketamine resulted in higher QoR-15 scores at 48 h (difference=4.6) and hospital discharge (difference=1.6), while ESPB led to a higher QoR-15 score at 48 h (difference=3.0). CONCLUSIONS: For patients undergoing thoracoscopic lung resection, subanesthetic esketamine improved QoR after surgery, while ICNB can be used interchangeably with ESPB as a component of multimodal analgesia.

3.
Huan Jing Ke Xue ; 45(8): 4837-4846, 2024 Aug 08.
Artículo en Chino | MEDLINE | ID: mdl-39168700

RESUMEN

To understand the pollution status, distribution characteristics, and pollution sources of soil heavy metals in tourist cities in northwest China, the soil content of heavy metals As, Cd, Cr, Cu, Hg, Ni, Pb, and Zn in the main areas of Dunhuang City was collected and analyzed. The soil heavy metal pollution level was quantitatively evaluated by the methods of the geo-accumulation index and improved Nemerow pollution index, and the sources of heavy metal pollution were quantitatively analyzed using cluster analysis and the positive matrix factorization (PMF) model. The contribution rate of each pollution source to ecological risk was determined by combining the PMF model and comprehensive ecological risk index. The results showed that except for the mean contents of As and Ni, the mean contents of Cd, Cr, Cu, Hg, Pb, and Zn were all higher than the background values in Gansu Province. However, the average content of the eight elements was lower than the screening value of construction land in the Standard for Soil Pollution Risk Control of Soil Environmental Quality Construction Land (trial) (GB 36600-2018). Among them, the enrichment of Cd, Pb, and Hg was more serious, and the exceedance rate was higher than 90%. The results of the geo-accumulation index indicated that urban soils were mainly polluted by Hg in the study area, and Cd, Cr, Cu, Pb, and Zn pollution also existed in different degrees. The improved Nemerow pollution index illustrated that the comprehensive pollution degree of the soil was clean to moderate pollution, and the overall pollution was light pollution. Based on the PMF model, we could conclude that soil heavy metals in the study area were affected by natural sources, industrial deposition sources, industrial sources, traffic sources, and comprehensive sources, and the contribution rates were 29.28%, 25.86%, 20.13%, 16.5%, and 8.23%, respectively. The specific source-integrated ecological risk assessment model found that the industrial deposition source contributed the most to the ecological risk in the study area and could be regarded as the priority control pollution source, and Hg was considered to be the priority control pollution element for ecological risk.

4.
Radiology ; 312(1): e232387, 2024 07.
Artículo en Inglés | MEDLINE | ID: mdl-39012251

RESUMEN

Background Preoperative local-regional tumor staging of gastric cancer (GC) is critical for appropriate treatment planning. The comparative accuracy of multiparametric MRI (mpMRI) versus dual-energy CT (DECT) for staging of GC is not known. Purpose To compare the diagnostic accuracy of personalized mpMRI with that of DECT for local-regional T and N staging in patients with GC receiving curative surgical intervention. Materials and Methods Patients with GC who underwent gastric mpMRI and DECT before gastrectomy with lymphadenectomy were eligible for this single-center prospective noninferiority study between November 2021 and September 2022. mpMRI comprised T2-weighted imaging, multiorientational zoomed diffusion-weighted imaging, and extradimensional volumetric interpolated breath-hold examination dynamic contrast-enhanced imaging. Dual-phase DECT images were reconstructed at 40 keV and standard 120 kVp-like images. Using gastrectomy specimens as the reference standard, the diagnostic accuracy of mpMRI and DECT for T and N staging was compared by six radiologists in a pairwise blinded manner. Interreader agreement was assessed using the weighted κ and Kendall W statistics. The McNemar test was used for head-to-head accuracy comparisons between DECT and mpMRI. Results This study included 202 participants (mean age, 62 years ± 11 [SD]; 145 male). The interreader agreement of the six readers for T and N staging of GC was excellent for both mpMRI (κ = 0.89 and 0.85, respectively) and DECT (κ = 0.86 and 0.84, respectively). Regardless of reader experience, higher accuracy was achieved with mpMRI than with DECT for both T (61%-77% vs 50%-64%; all P < .05) and N (54%-68% vs 51%-58%; P = .497-.005) staging, specifically T1 (83% vs 65%) and T4a (78% vs 68%) tumors and N1 (41% vs 24%) and N3 (64% vs 45%) nodules (all P < .05). Conclusion Personalized mpMRI was superior in T staging and noninferior or superior in N staging compared with DECT for patients with GC. Clinical trial registration no. NCT05508126 © RSNA, 2024 Supplemental material is available for this article. See also the editorial by Méndez and Martín-Garre in this issue.


Asunto(s)
Estadificación de Neoplasias , Neoplasias Gástricas , Tomografía Computarizada por Rayos X , Humanos , Neoplasias Gástricas/diagnóstico por imagen , Neoplasias Gástricas/patología , Neoplasias Gástricas/cirugía , Masculino , Femenino , Persona de Mediana Edad , Estudios Prospectivos , Anciano , Tomografía Computarizada por Rayos X/métodos , Gastrectomía/métodos , Adulto , Imagen por Resonancia Magnética/métodos , Imágenes de Resonancia Magnética Multiparamétrica/métodos
5.
Anaesthesia ; 79(10): 1072-1080, 2024 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-39037325

RESUMEN

BACKGROUND: Postoperative nausea and vomiting occur frequently following thyroid and parathyroid surgery and are associated with worse patient outcomes. We hypothesised that opioid-free propofol anaesthesia would reduce the incidence of postoperative nausea and vomiting compared with opioid-inclusive propofol anaesthesia in patients undergoing these procedures. METHODS: We conducted a randomised, double-blinded controlled trial in adult patients scheduled to undergo thyroid and parathyroid surgery at two medical centres in mainland China. Patients were allocated randomly (1:1, stratified by sex and trial site) to an opioid-free anaesthesia group (esketamine, lidocaine, dexmedetomidine and propofol) or an opioid-inclusive group (sufentanil and propofol). Propofol infusions were titrated to bispectral index 45-55. Patients received prophylaxis for nausea and vomiting using dexamethasone and ondansetron and multimodal analgesia with paracetamol and flurbiprofen axetil. The primary outcome was the incidence of postoperative nausea and vomiting in the first 48 h after surgery. RESULTS: We assessed 557 patients for eligibility and 394 completed this trial. The incidence of postoperative nausea and vomiting in the first postoperative 48 h was lower in the opioid-free anaesthesia group (10/197, 5%) compared with opioid-inclusive group (47/197, 24%) (OR (95%CI) 0.17 (0.08-0.35), p < 0.001), yielding a number needed to treat of 5.3. Additionally, opioid-free propofol anaesthesia was associated with a reduced need for rescue anti-emetics, lower rates of hypotension and desaturation after tracheal extubation, and higher patient satisfaction. Time to tracheal extubation was prolonged slightly in the opioid-free group. The two groups had similar postoperative pain scores and 30-day outcomes. DISCUSSION: Opioid-free propofol anaesthesia reduced postoperative nausea and vomiting in patients undergoing thyroid and parathyroid surgery. An opioid-free anaesthetic regimen can optimise anaesthetic care during thyroid and parathyroid surgery.


Asunto(s)
Analgésicos Opioides , Anestésicos Intravenosos , Náusea y Vómito Posoperatorios , Propofol , Humanos , Náusea y Vómito Posoperatorios/prevención & control , Náusea y Vómito Posoperatorios/epidemiología , Femenino , Masculino , Persona de Mediana Edad , Método Doble Ciego , Analgésicos Opioides/uso terapéutico , Analgésicos Opioides/administración & dosificación , Anestésicos Intravenosos/efectos adversos , Adulto , Anciano , Tiroidectomía/efectos adversos , Glándulas Paratiroides/cirugía , Glándula Tiroides/cirugía , Paratiroidectomía/efectos adversos
6.
Org Lett ; 26(27): 5776-5781, 2024 Jul 12.
Artículo en Inglés | MEDLINE | ID: mdl-38934518

RESUMEN

Organophosphorus-fluorine compounds are of significant utility across biology, pharmacy, and chemical synthesis. Here, we introduce a photocatalyzed oxidative-fluorination approach employing SF6 as a formal electrophilic fluorinating reagent. It offers an innovative pathway to forge P(O)-F bonds. Notably, sulfur hexafluoride plays a dual role as both the oxidant and the fluorinating reagent under mild conditions in this transformation. Meanwhile, this method contributes to environmental sustainability by consuming a notorious greenhouse gas, underscoring the ecological benefits of our approach.

7.
Org Lett ; 26(27): 5652-5656, 2024 Jul 12.
Artículo en Inglés | MEDLINE | ID: mdl-38941116

RESUMEN

A visible-light-mediated decarboxylative coupling reaction of phenylacetic acid derivatives, featuring sulfur hexafluoride (SF6) as the oxidant, has been developed. This metal-free method allows for the synthesis of a series of bibenzyl derivatives and complex all-carbon skeletons, facilitating efficient utilization and degradation of the greenhouse gas SF6.

8.
Org Lett ; 26(21): 4548-4553, 2024 May 31.
Artículo en Inglés | MEDLINE | ID: mdl-38757610

RESUMEN

gem-Difluoroalkenes and monofluorinated cycloalkenes have emerged as basic structural units in a variety of bioactive molecules and natural products. Thus, developing straightforward and efficient methods for synthesizing fluorinated alkene compounds is of considerable significance. Herein, we disclose a visible-light-induced defluorination of 2-trifluoromethyl-1-alkene via a 1,5-HAT process using N-alkoxyphtalimides as both radical precursor and potential nucleophile. The mild and stepwise reaction leads to a variety of structurally diverse gem-difluoroalkenes and monofluorinated cyclooctenes with high efficiency, respectively.

9.
J Nat Med ; 78(3): 633-643, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38704807

RESUMEN

Hepatocellular carcinoma (HCC) is a malignant tumor with extremely high mortality. The tumor microenvironment is the "soil" of its occurrence and development, and the inflammatory microenvironment is an important part of the "soil". Bile acid is closely related to the occurrence of HCC. Bile acid metabolism disorder is not only directly involved in the occurrence and development of HCC but also affects the inflammatory microenvironment of HCC. Yinchenhao decoction, a traditional Chinese medicine formula, can regulate bile acid metabolism and may affect the inflammatory microenvironment of HCC. To determine the effect of Yinchenhao decoction on bile acid metabolism in mice with HCC and to explore the possible mechanism by which Yinchenhao decoction improves the inflammatory microenvironment of HCC by regulating bile acid metabolism, we established mice model of orthotopic transplantation of hepatocellular carcinoma. These mice were treated with three doses of Yinchenhao decoction, then liver samples were collected and tested. Yinchenhao decoction can regulate the disorder of bile acid metabolism in liver cancer mice. Besides, it can improve inflammatory reactions, reduce hepatocyte degeneration and necrosis, and even reduce liver weight and the liver index. Taurochenodeoxycholic acid, hyodeoxycholic acid, and taurohyodeoxycholic acid are important molecules in the regulation of the liver inflammatory microenvironment, laying a foundation for the regulation of the liver tumor inflammatory microenvironment based on bile acids. Yinchenhao decoction may improve the inflammatory microenvironment of mice with HCC by ameliorating hepatic bile acid metabolism.


Asunto(s)
Ácidos y Sales Biliares , Carcinoma Hepatocelular , Medicamentos Herbarios Chinos , Neoplasias Hepáticas , Microambiente Tumoral , Animales , Medicamentos Herbarios Chinos/farmacología , Medicamentos Herbarios Chinos/uso terapéutico , Carcinoma Hepatocelular/tratamiento farmacológico , Carcinoma Hepatocelular/metabolismo , Ratones , Ácidos y Sales Biliares/metabolismo , Microambiente Tumoral/efectos de los fármacos , Neoplasias Hepáticas/tratamiento farmacológico , Neoplasias Hepáticas/metabolismo , Masculino , Hígado/efectos de los fármacos , Hígado/metabolismo , Hígado/patología , Inflamación/tratamiento farmacológico , Inflamación/metabolismo
10.
BMC Infect Dis ; 24(1): 485, 2024 May 10.
Artículo en Inglés | MEDLINE | ID: mdl-38730327

RESUMEN

BACKGROUND: Neurobrucellosis (NB) is a rare and serious complication of brucellosis. Its clinical manifestations vary, with no obvious specificity. At present, there is no clear clinical diagnosis or treatment for reference. In this study, we retrospectively analyzed the clinical data for 21 patients with NB to provide reference data for its further study. METHODS: We analyzed the epidemiological and clinical manifestations, laboratory tests, imaging examinations, cerebrospinal fluid, and treatment plans of 21 patients diagnosed with NB in the Department of Neurology, Xuanwu Hospital, Capital Medical University Beijing, China. RESULTS: The ages of the patients ranged from 15 to 60 years old (mean age 40.1 ± 13.33 years), the male: female ratio was 4.25:1. Thirteen patients had a history of animal (sheep, cattle) contact, three had no history of animal contact, and the contact status of four was unknown. Brucella can invade various systems of the body and show multi-system symptoms, the main general manifestations were fever (66.67%), fatigue (57.14%) and functional urination or defecation disturbance (42.86%). The main nervous system manifestations were limb weakness (52.38%) and hearing loss (47.62%).The main positive signs of the nervous system included positive pathological signs (71.43%), sensory abnormalities (52.38%), limb paralysis (42.86%). Nervous system lesions mainly included spinal cord damage (66.67%), cranial nerve involvement (61.90%), central demyelination (28.57%) and meningitis (28.57%). In patients with cranial nerve involvement, 69.23% of auditory nerve, 15.38% of optic nerve and 15.38% of oculomotor nerve were involved. The blood of eight patients was cultured for Brucella, and three (37.5%) cultures were positive and five (63.5%) negative. The cerebrospinal fluid (CSF) of eight patients was cultured for Brucella, and two (25.00%) cultures were positive and six (75.00%) negative. Nineteen of the patients underwent a serum agglutination test (SAT), 18 (94.74%) of whom were positive and one (5.26%) of whom were negative. A biochemical analysis of the CSF was performed in 21 patients, and the results were all abnormal. Nineteen patients underwent magnetic resonance imaging (MRI). Twenty-one patients were treated with doxycycline and/or rifampicin, combined with ceftriaxone, quinolone, aminoglycoside, or minocycline. After hospitalization, 15 patients improved (71.43%), two patients did not recover, and the status of four patients was unknown. CONCLUSIONS: The clinical manifestations, CSF parameters, and neurological imaging data for patients with NB show no significant specificity or correlations. When patients with unexplained neurological symptoms accompanied by fever, fatigue, and other systemic manifestations in a brucellosis epidemic area or with a history of contact with cattle, sheep, animals, or raw food are encountered in clinical practice, the possibility of NB should be considered. Treatment is based on the principles of an early, combined, and long course of treatment, and the general prognosis is good.


Asunto(s)
Antibacterianos , Brucelosis , Humanos , Masculino , Femenino , Persona de Mediana Edad , Brucelosis/tratamiento farmacológico , Brucelosis/microbiología , Brucelosis/líquido cefalorraquídeo , Brucelosis/diagnóstico , Brucelosis/epidemiología , Adulto , Antibacterianos/uso terapéutico , Estudios Retrospectivos , Adolescente , Adulto Joven , China/epidemiología , Resultado del Tratamiento , Brucella/aislamiento & purificación , Animales
11.
Huan Jing Ke Xue ; 45(5): 3107-3118, 2024 May 08.
Artículo en Chino | MEDLINE | ID: mdl-38629571

RESUMEN

The rapid development of society and economy has resulted in a substantial increase in energy consumption, consequently exacerbating pollution issues. Current research predominantly focuses on energy-saving and emission reduction in road transportation within individual cities or the three major economic regions of China:the Yangtze River Delta, the Pearl River Delta, and the Beijing-Tianjin-Hebei Region. However, there is a dearth of studies addressing the southeastern coastal economic region. Located at the heart of China's southeastern coastal economic development, the provinces of Guangdong, Fujian, and Zhejiang unavoidably face challenges associated with energy consumption and emissions while pursuing economic growth. To address these challenges, this study employed a LEAP model to construct various scenarios for road transportation in the key coastal cities of Guangdong, Fujian, and Zhejiang from 2015 to 2035. These scenarios included a baseline scenario (BAU), an existing policy scenario (EPS), and an improved policy scenario (MPS). The MPS and EPS encompassed vehicle structure optimization (VSO), improved fuel economy (IFE), and reduced annual average mileage (RDM). By simulating and evaluating these scenarios, the energy-saving and emission reduction potentials of road transportation in the key coastal cities were assessed. The results indicated that, in the primary scenario, the MPS exhibited the most significant improvements in energy-saving, carbon reduction, and pollutant reduction effects. By 2035, the MPS achieved a remarkable 75% energy-saving rate compared to that in the baseline scenario, accompanied by reductions of 68%, 59%, 66%, 70%, and 64% in CO2, CO, NOx, PM2.5, and SO2 emissions, respectively. In the secondary scenario, the improved scenario of enhancing fuel economy achieved a notable 30% reduction in energy consumption. Additionally, the scenarios involving vehicle structure adjustment (yielding reductions of 36%, 30%, 36%, 26%, and 40%) and annual average mileage reduction (resulting in reductions of 37%, 37%, 36%, 37%, and 36%) demonstrated significant reductions in CO2, CO, NOx, PM2.5, and SO2 emissions.

12.
Abdom Radiol (NY) ; 49(10): 3309-3318, 2024 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-38634880

RESUMEN

PURPOSE: To explore whether dual-energy CT (DECT) quantitative parameters could provide analytic value for the diagnosis of patients with occult peritoneal metastasis (OPM) in advanced gastric cancer preoperatively. MATERIALS AND METHODS: This retrospective study included 219 patients with advanced gastric cancer and DECT scans. The patient's clinical data and DECT related iodine concentration (IC) parameters and effective atomic number (Zeff) were collated and analyzed among noun-peritoneal metastasis (NPM), OPM and radiologically peritoneal metastasis (RPM) groups. The predictive performance of the DECT parameters was compared with that of the conventional CT features and clinical characteristics through evaluating area under curve of the precision-recall (AUC-PR), F1 score, balanced accuracy, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV). RESULTS: Borrmann IV type diagnosed on CT and serum tumor indicator CA125 index were statistically different between the NPM and OPM groups. DECT parameters included IC, normalized IC (NIC), and Zeff of PM group were lower than the NPM group. The DECT predictive nomogram combined three independent DECT parameters produced a better diagnostic performance than the conventional CT feature Borrmann IV type and serum CA125 index in AUC-PR with 0.884 vs 0.368 vs 0.189, but similar to the combined indicator which was based on the DECT parameters, the conventional CT feature, and serum CA125 index in AUC-PR with 0.884 vs 0.918. CONCLUSION: The lower quantitative NIC, IC ratio, and Zeff on DECT was associated with peritoneal metastasis in advanced gastric cancer and was promising to identify patients with OPM noninvasively.


Asunto(s)
Neoplasias Peritoneales , Imagen Radiográfica por Emisión de Doble Fotón , Sensibilidad y Especificidad , Neoplasias Gástricas , Tomografía Computarizada por Rayos X , Humanos , Neoplasias Gástricas/diagnóstico por imagen , Neoplasias Gástricas/patología , Neoplasias Peritoneales/diagnóstico por imagen , Neoplasias Peritoneales/secundario , Masculino , Femenino , Estudios Retrospectivos , Persona de Mediana Edad , Tomografía Computarizada por Rayos X/métodos , Imagen Radiográfica por Emisión de Doble Fotón/métodos , Anciano , Adulto , Medios de Contraste , Valor Predictivo de las Pruebas , Anciano de 80 o más Años
13.
Abdom Radiol (NY) ; 49(8): 2574-2584, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-38662208

RESUMEN

PURPOSE: The purpose of our study is to investigate image quality, efficiency, and diagnostic performance of a deep learning-accelerated single-shot breath-hold (DLSB) against BLADE for T2-weighted MR imaging (T2WI) for gastric cancer (GC). METHODS: 112 patients with GCs undergoing gastric MRI were prospectively enrolled between Aug 2022 and Dec 2022. Axial DLSB-T2WI and BLADE-T2WI of stomach were scanned with same spatial resolution. Three radiologists independently evaluated the image qualities using a 5-scale Likert scales (IQS) in terms of lesion delineation, gastric wall boundary conspicuity, and overall image quality. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated in measurable lesions. T staging was conducted based on the results of both sequences for GC patients with gastrectomy. Pairwise comparisons between DLSB-T2WI and BLADE-T2WI were performed using the Wilcoxon signed-rank test, paired t-test, and chi-squared test. Kendall's W, Fleiss' Kappa, and intraclass correlation coefficient values were used to determine inter-reader reliability. RESULTS: Against BLADE, DLSB reduced total acquisition time of T2WI from 495 min (mean 4:42 per patient) to 33.6 min (18 s per patient), with better overall image quality that produced 9.43-fold, 8.00-fold, and 18.31-fold IQS upgrading against BALDE, respectively, in three readers. In 69 measurable lesions, DLSB-T2WI had higher mean SNR and higher CNR than BLADE-T2WI. Among 71 patients with gastrectomy, DLSB-T2WI resulted in comparable accuracy to BLADE-T2WI in staging GCs (P > 0.05). CONCLUSIONS: DLSB-T2WI demonstrated shorter acquisition time, better image quality, and comparable staging accuracy, which could be an alternative to BLADE-T2WI for gastric cancer imaging.


Asunto(s)
Aprendizaje Profundo , Imagen por Resonancia Magnética , Estadificación de Neoplasias , Neoplasias Gástricas , Neoplasias Gástricas/diagnóstico por imagen , Neoplasias Gástricas/patología , Humanos , Femenino , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Anciano , Imagen por Resonancia Magnética/métodos , Adulto , Reproducibilidad de los Resultados , Interpretación de Imagen Asistida por Computador/métodos , Contencion de la Respiración , Anciano de 80 o más Años , Relación Señal-Ruido
14.
J Comput Assist Tomogr ; 48(5): 734-742, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38595104

RESUMEN

OBJECTIVE: The purpose of this study is to identify the presence of occult peritoneal metastasis (OPM) in patients with advanced gastric cancer (AGC) by using clinical characteristics and abdominopelvic computed tomography (CT) features. METHODS: This retrospective study included 66 patients with OPM and 111 patients without peritoneal metastasis (non-PM [NPM]) who underwent preoperative contrast-enhanced CT between January 2020 and December 2021. Occult PMs means PMs that are missed by CT but later diagnosed by laparoscopy or laparotomy. Patients with NPM means patients have neither PM nor other distant metastases, indicating there is no evidence of distant metastases in patients with AGC. Patients' clinical characteristics and CT features such as tumor marker, Borrmann IV, enhancement patterns, and pelvic ascites were observed by 2 experienced radiologists. Computed tomography features and clinical characteristics were combined to construct an indicator for identifying the presence of OPM in patients with AGC based on a logistic regression model. Receiver operating characteristic curves and the area under the receiver operating characteristic curve (AUC) were generated to assess the diagnostic performance of the combined indicator. RESULTS: Four independent predictors (Borrmann IV, pelvic ascites, carbohydrate antigen 125, and normalized arterial CT value) differed significantly between OPM and NPM and performed outstandingly in distinguishing patients with OPM from those without PM (AUC = 0.643-0.696). The combined indicator showed a higher AUC value than the independent risk factors (0.820 vs 0.643-0.696). CONCLUSIONS: The combined indicator based on abdominopelvic CT features and carbohydrate antigen 125 may assist clinicians in identifying the presence of CT OPMs in patients with AGC.


Asunto(s)
Antígeno Ca-125 , Neoplasias Peritoneales , Neoplasias Gástricas , Tomografía Computarizada por Rayos X , Humanos , Femenino , Masculino , Neoplasias Gástricas/diagnóstico por imagen , Neoplasias Gástricas/patología , Persona de Mediana Edad , Tomografía Computarizada por Rayos X/métodos , Estudios Retrospectivos , Neoplasias Peritoneales/diagnóstico por imagen , Neoplasias Peritoneales/secundario , Antígeno Ca-125/sangre , Anciano , Adulto , Pelvis/diagnóstico por imagen , Anciano de 80 o más Años , Medios de Contraste
15.
Zhen Ci Yan Jiu ; 49(4): 367-375, 2024 Apr 25.
Artículo en Inglés, Chino | MEDLINE | ID: mdl-38649204

RESUMEN

OBJECTIVES: To investigate the effect of electroacupuncture (EA) on Rho/Rho-associated coiled-coil-forming kinases (ROCK) signaling pathway of uterus tissue in rats with dysmenorrhea, so as to explore the underlying mechanism of EA treating primary dysmenorrhea (PD) and uterine smooth muscle spasm, and to observe whether there is a difference in the effect of meridian acupoints in Conception Vessel (CV) and Governer Vessel (GV). METHODS: Sixty female SD rats were randomly divided into saline, model, CV, GV, and non-acupoint groups, with 12 rats in each group. The dysmenorrhea model was established by subcutaneous injection of estradiol diphenhydrate combined with intraperitoneal injection of oxytocin (OT). EA (2 Hz) was applied to "Qihai" (CV6) and "Zhongji" (CV3) for CV group, "Mingmen" (GV4) and "Yaoshu" (GV2) for GV group, "non-acupoint 1" and "non-acupoint 3" on the left side for non-acupoint group, and manual acupuncture was applied to "Guanyuan" (CV4) for CV group, "Yaoyangguan" (GV3) for GV group, "non-acupoint 2" on the left side for non-acupoint group. The treatment was conducted for 20 min each time, once daily for 10 days. The writhing score was evaluated. The smooth myoelectric signals of rats' uterus in vivo were recorded by multi-channel physiological recorder. The uterine histopathological changes were observed by HE staining. The contents of prostaglandin F2α (PGF2α), OT and calcium ion (Ca2+) in uterine tissue of rats were detected by ELISA. The protein and mRNA expression levels of smooth muscle 22-α (SM22-α), RhoA and ROCKⅡ in uterine tissue were detected by Western blot and fluorescence quantitative PCR, respectively. RESULTS: Compared with the saline group, the writhing score of rats in the model group was increased (P<0.01), the amplitude voltage of uterine smooth muscle in vivo was elevated (P<0.01), the contents of PGF2α, OT and Ca2+, the protein and mRNA expression of SM22-α, RhoA and ROCK Ⅱ in uterine tissue were all increased (P<0.01). Compared with the model and the non-acupoint groups, the writhing scores of the CV and the GV groups were decreased (P<0.01, P<0.05), the amplitude voltage of uterine smooth muscle was decreased (P<0.01), the contents of PGF2α, OT and Ca2+ in uterine tissue were decreased (P<0.01, P<0.05), and the protein expression and mRNA expression of SM22-α, RhoA and ROCKⅡ in uterine tissue were decreased (P<0.01, P<0.05). HE staining showed extensive exfoliation of uterine intima with severe edema and increased glandular secretion in the model group, which was alleviated in the CV and GV groups. CONCLUSIONS: EA at acupoints of CV and GV can significantly reduce the writhing score, uterine smooth muscle amplitude voltage, pathological injury degree of uterus, and relieve spasm of uterine smooth muscle in dysmenorrhea rats, which may be related to its effect in regulating PGF2α and OT contents, inhibiting the Rho/ROCK signaling pathway, and reducing the SM22-α, RhoA, ROCKⅡ protein and mRNA expression, and Ca2+ content in uterine tissue.


Asunto(s)
Puntos de Acupuntura , Dismenorrea , Electroacupuntura , Ratas Sprague-Dawley , Transducción de Señal , Útero , Quinasas Asociadas a rho , Animales , Femenino , Dismenorrea/terapia , Dismenorrea/metabolismo , Dismenorrea/genética , Quinasas Asociadas a rho/metabolismo , Quinasas Asociadas a rho/genética , Ratas , Humanos , Útero/metabolismo , Músculo Liso/metabolismo , Espasmo/terapia , Espasmo/genética , Espasmo/metabolismo , Espasmo/fisiopatología
16.
Ying Yong Sheng Tai Xue Bao ; 35(2): 489-500, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38523107

RESUMEN

The expansion of roads exacerbates the fragmentation of ecological networks and obstructs landscape connectivity. Scientific analysis of the impacts of different grades of roads on landscape connectivity and ecological networks is crucial for guiding road planning and ecological conservation. Based on the data of 2020 road network, land cover types, and digital elevation models, we used morphological spatial pattern analysis and circuit theory to construct ecological networks within different species dispersal distances (1, 3, 5, 10 km) in Fuzhou. We analyzed the impacts of roads of different grades (motorway, urban expressway, primary and secondary highway) on landscape connectivity at the landscape-patch-corridor scale. The results showed that at the landscape scale, overall landscape connectivity was significantly positively correlated with species dispersal distance. The motorway, urban expressway, primary and secondary highway had the lowest decline rate of overall landscape connectivity within a 10 km species dispersal range, being reduced by 15.6%, 5.3%, 1.5% and 5.2%, respectively. At the patch scale, in the comparison of roads of different grades, motorway led to the highest decline rate of patch connectivity within 1 and 5 km species dispersal range, while primary highway led to the highest decline rate of patch connectivity within 3 and 10 km species dispersal range. At the corridor scale, urban expressway led the highest increase rate of indices. The cost-weighted distance of the overall least-cost path, the ratio of cost-weighted distance to length, ove-rall effective resistance, and total corridor length within 5 km species dispersal range were increased by 43.4%, 33.2%, 57.3%, and 7.3%, respectively. As the distance of species dispersal increased, the patches with high importance were reduced from the northern, central, and northwestern regions to the northern regions, leading to a decrease in the living space of species, and the key corridors were gradually extending from the northwestern and southern regions to the central regions. Our results can guide the construction and optimization of Fuzhou's ecological network from an overall perspective, and provide a scientific basis for biodiversity conservation, ecological restoration, and road network planning under the context of limited land resource utilization.


Asunto(s)
Conservación de los Recursos Naturales , Ecosistema , Conservación de los Recursos Naturales/métodos , Ciudades , Biodiversidad , China
17.
World J Hepatol ; 16(2): 241-250, 2024 Feb 27.
Artículo en Inglés | MEDLINE | ID: mdl-38495270

RESUMEN

BACKGROUND: Portal vein thrombosis (PVT) is a commonthsn complication after splenectomy in patients with cirrhosis. However, the predictors of postoperative PVT are not known. AIM: To investigate the predictors of PVT after splenectomy in patient with cirrhosis. METHODS: A total of 45 patients with cirrhosis who underwent splenectomy were consecutively enrolled from January 2017 to December 2018. The incidence of PVT at 1 months, 3 months, and 12 months after splenectomy in patients with cirrhosis was observed. The hematological indicators, biochemical and coagulation parameters, and imaging features were recorded at baseline and at each observation point. The univariable, multivariable, receiver operating characteristic curve and time-dependent curve analyses were performed. RESULTS: The cumulative incidence of PVT was 40.0%, 46.6%, and 48.9% at 1 months, 3 months, and 12 months after splenectomy. Multivariable analysis showed that portal vein diameter (PVD) ≥ 14.5 mm and monthsdel end-stage liver disease (MELD) score > 10 were independent predictors of PVT at 1 months, 3 months, and 12 months after splenectomy (P < 0.05). Time-dependent curve showed that the cumulative incidence of PVT was significantly different between patients with MELD score ≤ 10 and > 10 (P < 0.05). In addition, the cumulative incidence of PVT in the PVD ≥ 14.5 mm group was significantly higher than that in the PVD < 14.5 mm group (P < 0.05). CONCLUSION: Wider PVD and MELD score > 10 were independent predictors of PVT at 1 months, 3 months, and 12 months after splenectomy in patient with cirrhosis.

18.
Huan Jing Ke Xue ; 45(3): 1724-1738, 2024 Mar 08.
Artículo en Chino | MEDLINE | ID: mdl-38471884

RESUMEN

Assessments of the soil environmental quality of farmland and pollution source apportionment are the foundation for ensuring national food security and agricultural sustainable development, as well as an important prerequisite for the pursuit to keep our lands clean. This study evaluated the characteristics of heavy metal pollution in farmland soils in the Yellow River Basin from 2000 to 2023, based on the data of heavy metal contents including As, Cd, Cr, Cu, Hg, Ni, Pb, and Zn, using the geo-accumulation index method. Source apportionment was conducted by employing a positive matrix factorization (PMF) model. The probabilistic health risks were evaluated by coupling Monte Carlo simulation with a human health risk assessment model, and priority pollution sources and elements were identified. The results showed that:① the average content of all heavy metals in farmland soils within the study area was lower than the screening values specified in the soil environment quality risk control standard for soil contamination of agriculture land (GB 15618-2018) (pH>7.5). However, the contents of Cd, As, and Zn in the samples exceeded their screening values, with percentages of 21.69%, 5.56%, and 1.23%, respectively, with Cd having the highest rate of exceedance. ② Hg and Cd were moderately polluted, Cu and Pb were slightly polluted, and the other elements were not polluted. ③ The main sources of heavy metals in farmland soil were traffic-industrial sources, natural-agricultural sources, industrial-natural sources, and agricultural-industrial sources, with contribution rates of 37.04%, 26.69%, 21.72%, and 14.55%, respectively. ④ Heavy metals in farmland soil posed carcinogenic health risks to adults and children but did not have non-carcinogenic risks; As and Cd were priority control elements for human health risks, and industrial-natural sources and agricultural-industrial sources were priority control sources in the study area.


Asunto(s)
Mercurio , Metales Pesados , Contaminantes del Suelo , Adulto , Niño , Humanos , Suelo , Granjas , Ríos , Cadmio , Plomo , Monitoreo del Ambiente/métodos , Contaminantes del Suelo/análisis , Metales Pesados/análisis , Medición de Riesgo , China
19.
Nat Commun ; 15(1): 2327, 2024 Mar 14.
Artículo en Inglés | MEDLINE | ID: mdl-38485966

RESUMEN

Polymerization-driven removal of pollutants in advanced oxidation processes (AOPs) offers a sustainable way for the simultaneous achievement of contamination abatement and resource recovery, supporting a low-carbon water purification approach. However, regulating such a process remains a great challenge due to the insufficient microscopic understanding of electronic structure-dependent reaction mechanisms. Herein, this work probes the origin of catalytic pollutant polymerization using a series of transition metal (Cu, Ni, Co, and Fe) single-atom catalysts and identifies the d-band center of active site as the key driver for polymerization transfer of pollutants. The high-valent metal-oxo species, produced via peroxymonosulfate activation, are found to trigger the pollutant removal via polymerization transfer. Phenoxyl radicals, identified by the innovative spin-trapping and quenching approaches, act as the key intermediate in the polymerization reactions. More importantly, the oxidation capacity of high-valent metal-oxo species can be facilely tuned by regulating their binding strength for peroxymonosulfate through d-band center modulation. A 100% polymerization transfer ratio is achieved by lowering the d-band center. This work presents a paradigm to dynamically modulate the electronic structure of high-valent metal-oxo species and optimize pollutant removal from wastewater via polymerization.

20.
Angew Chem Int Ed Engl ; 63(15): e202400308, 2024 Apr 08.
Artículo en Inglés | MEDLINE | ID: mdl-38299744

RESUMEN

The construction of the SCF3-containing 1,1-diaryl tertiary carbon stereocenters with high enantioselectivities is reported via a nickel-catalyzed asymmetric C-C coupling strategy. This method demonstrates simple operations, mild conditions and excellent functional group tolerance, with newly designed SCF3-containing synthon, which can be easily obtained from commercially available benzyl bromide and trifluoromethylthio anion in a two-step manner. Further substrate exploration indicated that the reaction system could be extended to diverse perfluoroalkyl sulfide (SC2F5, SC3F7, SC4F9, SCF2CO2Et)-substituted 1,1-diaryl compounds with excellent enantioselectivities. The synthetic utility of this transformation was further demonstrated by convenient derivatization to optical SCF3-containing analogues of bioactive compounds without an apparent decrease in enantioselectivity.

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