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1.
BMC Public Health ; 24(1): 1387, 2024 May 23.
Artículo en Inglés | MEDLINE | ID: mdl-38783252

RESUMEN

BACKGROUND: The association between bone fracture and cardiovascular diseases is examined in this study. While basic research has established a connection between fractures and heart attacks through the linkage between bones and arteries, population studies have not provided clear evidence. The aim of the present study is to investigate the association between bone fracture and the occurrence of myocardial infarction in a natural population during long-term follow-up. METHODS: A total of 13,196 adult participants with bone fracture history at baseline from the China Health and Nutrition Survey (CHNS) prospective cohort were included in this study. Baseline investigation was performed in 1997-2009 and the outcome was followed up till 2015. Hazard ratios (HRs) and their corresponding 95% confidence intervals (CIs) were calculated using Cox proportional hazards models. RESULTS: From 1997 to 2015, a total of 329 incident myocardial infarction cases were identified. In univariate and multivariate Cox regression analysis, a history of bone fracture was associated with an increased risk of myocardial infarction incidence in the total population (for the crude model: HR = 2.56, 95% CI 1.83-3.53, P < 0.001; for the multivariate model: HR = 1.43, 95% CI 1.02-1.99, P = 0.036). In the stratified analysis, bone fracture was not associated with an increased risk of incident myocardial infarction in subjects with age < 50 years (HR = 0.71, 95% CI 0.34-1.47, P = 0.356), but significantly associated with an increased risk of incident myocardial infarction in subjects with age ≥ 50 years (HR = 1.80, 95% CI 1.23-2.63, P = 0.003). CONCLUSIONS: It is suggested by the present study that bone fracture may be associated with an increased risk of incident myocardial infarction in the elderly population during long-term follow-up.


Asunto(s)
Fracturas Óseas , Infarto del Miocardio , Humanos , Infarto del Miocardio/epidemiología , Masculino , Femenino , Persona de Mediana Edad , China/epidemiología , Fracturas Óseas/epidemiología , Incidencia , Estudios de Seguimiento , Adulto , Estudios Prospectivos , Anciano , Factores de Riesgo , Modelos de Riesgos Proporcionales , Encuestas Nutricionales
2.
Chemistry ; : e202401008, 2024 Apr 16.
Artículo en Inglés | MEDLINE | ID: mdl-38624085

RESUMEN

Here we report B(C6F5)3/CPA-catalyzed enantioselective aza-Diels-Alder reaction of 3,3-difluoro-2-Aryl-3H-indoles with unactivated dienes to access chiral 10,10-difluoro-tetrahydropyrido[1,2-a]indoles. This protocol allows the formation of pyrazole-based C2-quaternary indolin-3-ones with high enantioselectivities and regioselectivities. Moreover, gram-scale synthesis of the 10,10-difluoro-tetrahydropyrido[1,2-a]indole skeleton was successfully achieved without any reduction in both yield and enantioselectivity.

3.
Sci Rep ; 14(1): 8005, 2024 04 05.
Artículo en Inglés | MEDLINE | ID: mdl-38580695

RESUMEN

The association between high blood pressure and fracture showed obvious discrepancies and were mostly between hypertension with future fracture, but rarely between fracture and incident hypertension. The present study aims to investigate the associations of hypertension with future fracture, and fracture with incident hypertension. We included adult participants from the China Health and Nutrition Survey (CHNS) prospective cohort in 1997-2015 (N = 10,227), 2000-2015 (N = 10,547), 2004-2015 (N = 10,909), and 2006-2015 (N = 11,121) (baseline in 1997, 2000, 2004, 2006 respectively and outcome in 2015). Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% CIs. In the analysis of the association between hypertension and future fracture, the adjusted HRs (95% CIs) were 1.34 (0.95-1.90) in 1997-2015, 1.40 (1.04-1.88) in 2000-2015, 1.32 (0.98-1.78) in 2004-2015, and 1.38 (1.01-1.88) in 2006-2015. In the analysis of the association between fracture and incident hypertension, the adjusted HRs (95% CIs) were 1.28 (0.96-1.72) in 1997-2015, 1.18 (0.94-1.49) in 2000-2015, 1.12 (0.89-1.40) in 2004-2015, and 1.09 (0.85-1.38) in 2006-2015. The present study showed that hypertension history was associated with increased risk of future fracture, but not vice versa.


Asunto(s)
Fracturas Óseas , Hipertensión , Adulto , Humanos , Estudios Prospectivos , Factores de Riesgo , Encuestas Epidemiológicas , Presión Sanguínea , Modelos de Riesgos Proporcionales
4.
Front Oncol ; 14: 1376502, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38628672

RESUMEN

Purpose: Dysregulated expression of microRNA (miRNAs) in lung cancer has been wildly reported. The clinicopathologic significance of miR-9-5p in non-small-cell lung cancer (NSCLC) patients and its effect on NSCLC progression were explored in this study. Patients and methods: A total of 76 NSCLC patients were included. miR-9-5p expression was evaluated by real-time quantitative polymerase chain reaction (RT-qPCR). Then, in vitro experiments including cell growth curve assays, colony formation assays, and transwell migration assays were performed. Further clinicopathological and prognostic values were explored using bioinformatics analysis of the TCGA database. Results: miR-9-5p expression was significantly increased in tumor tissues (both P < 0.0001). miR-9-5p expression was relatively higher in larger tumors (P = 0.0327) and in lung squamous carcinoma (LUSC) (P = 0. 0143). In addition, miR-9-5p was significantly upregulated in the normal lung tissues of cigarette smokers (P = 0.0099). In vitro, miR-9-5p was correlated with cell proliferation and migration. After that, bioinformatics analysis of the TCGA database indicated that miR-9-5p was correlated with tumor size (P = 0.0022), lymphatic metastasis (P = 0.0141), LUSC (P < 0.0001), and smoking history (P < 0.0001). Finally, a prognostic study indicated high miR-9-5p expression was correlated with poor prognosis in LUAD (P = 0.0121). Conclusion: Upregulation of miR-9-5p may have an oncogenic effect in NSCLC and may be related to smoking. The conclusion of this study may help find new prognostic and therapeutic targets for NSCLC and the exploration of the relationship between smoking and lung cancer.

5.
J Inflamm Res ; 17: 313-330, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38250143

RESUMEN

Apelin is the native ligand for the G protein-coupled receptor APJ. Numerous studies have demonstrated that the Apelin/APJ system has positive inotropic, anti-inflammatory, and anti-apoptotic effects and regulates fluid homeostasis. The Apelin/APJ system has been demonstrated to play a protective role in sepsis and may serve as a promising therapeutic target for the treatment of sepsis. Better understanding of the mechanisms of the effects of the Apelin/APJ system will aid in the development of novel drugs for the treatment of sepsis. In this review, we provide a brief overview of the physiological role of the Apelin/APJ system and its role in sepsis.

6.
Pharmacogenomics ; 25(1): 21-28, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-38131213

RESUMEN

The study analyzes the risk factors associated with antituberculosis drug-induced liver injury (ATB-DILI), and the relationship between ATB-DILI and NAT2 gene polymorphisms. Out of the 324 included patients, 57 (17.59%) developed ATB-DILI. Age, history of liver disease, alcohol consumption and timing of antituberculosis (ATB) treatment were independent risk factors for ATB-DILI in the patients with tuberculosis (TB; p < 0.05). There was a significant difference in the distribution of NAT2 metabolic phenotypes between the study group and the control group (p < 0.05). The ATB drug treatment for pulmonary TB can cause a high incidence of ATB-DILI. Age, history of liver disease, alcohol consumption and timing of ATB treatment are independent risk factors for ATB-DILI in patients with TB.


Asunto(s)
Arilamina N-Acetiltransferasa , Enfermedad Hepática Inducida por Sustancias y Drogas , Tuberculosis , Humanos , Antituberculosos/efectos adversos , Arilamina N-Acetiltransferasa/genética , Enfermedad Hepática Inducida por Sustancias y Drogas/epidemiología , Enfermedad Hepática Inducida por Sustancias y Drogas/genética , Tuberculosis/tratamiento farmacológico , Tuberculosis/genética , Tuberculosis/complicaciones , Genotipo , Factores de Riesgo
7.
Curr Med Imaging ; 2023 Nov 06.
Artículo en Inglés | MEDLINE | ID: mdl-37936442

RESUMEN

BACKGROUND: Type 2 diabetes mellitus (T2DM) and hypertension (HT) are the two most common underlying diseases worldwide, and they often coexist. The long-term existence of both may lead to left ventricular dysfunction. Therefore, evaluating the cardiac function of T2DM patients with HT is vital to guide treatment and improve prognosis. Left ventricular pressure strain loops (LVPSL) combine left ventricular strain and afterload, which can quantify left ventricular energy expenditure and detect left ventricular subclinical systolic dysfunction. Many studies have focused on myocardial work (MW) in uncomplicated T2DM patients or simple HT patients, but a few have focused on T2DM patients with HT. OBJECTIVE: The study aimed to evaluate the MW changes in T2DM patients with HT using LVPSL and to find independent related factors of MW parameters. METHODS: 40 T2DM patients, 35 HT patients, 40 T2DM patients with HT (T2DM+HT group), and 35 controls were enrolled. The differences between clinical data, conventional ultrasound parameters, and MW parameters were analyzed among the four groups. RESULTS: The global longitudinal strain (GLS) of the T2DM group, HT group, and T2DM+HT group was lower than the control group (P<0.05). The global work index (GWI) and global constructive work (GCW) in the T2DM group were lower than other groups (P<0.05). The GWI of the HT group was higher than other groups (P<0.05), while GCW was only higher than the T2DM group and T2DM+HT group (P<0.05). The GWI and GCW of the T2DM+HT group were higher than the T2DM group and were lower than the HT group(P<0.05), while there was no significant difference with the control group. HT group and T2DM+HT group had higher global work waste (GWW) (P<0.05). The global work efficiency (GWE) of the T2DM+HT group was lower than other groups (P<0.05). Systolic blood pressure (SBP) and glycosylated hemoglobin (HbA1c) were independent factors of each MW parameter. CONCLUSION: LVPSL can recognize left ventricular subclinical systolic dysfunction early in patients with T2DM and HT. Compared to simple T2DM or HT, the combination of T2DM and HT had greater damage to left ventricular systolic function. SBP and HbA1c are two factors that have a considerable impact on MW parameters. The impact of afterload on MW parameters should be paid more attention to.

8.
Org Lett ; 25(48): 8666-8671, 2023 Dec 08.
Artículo en Inglés | MEDLINE | ID: mdl-38014969

RESUMEN

Fluoroalkylated compounds are of high interest in drug discovery and have inspired the evolution of diverse C-F bond activation methodologies. However, the selective activation of polyfluorinated compounds remains challenging. Herein, we describe an unprecedented strategy for synthesizing enantioenriched fluorofuro[3,2-b]indolines through the organocatalytic aza-Friedel-Crafts reaction coupled with selective C-F bond activation. These reactions feature excellent enantioselectivities (≤96% ee) and yields (≤96%) as well as good functional group compatibility. Mechanistic investigations by means of 19F nuclear magnetic resonance experiments provided sufficient support for silica gel as the key medium in this transformation.

9.
Cell Host Microbe ; 31(11): 1882-1897.e10, 2023 11 08.
Artículo en Inglés | MEDLINE | ID: mdl-37848029

RESUMEN

Epstein-Barr virus (EBV) is a global public health concern, as it is known to cause multiple diseases while also being etiologically associated with a wide range of epithelial and lymphoid malignancies. Currently, there is no available prophylactic vaccine against EBV. gB is the EBV fusion protein that mediates viral membrane fusion and participates in host recognition, making it critical for EBV infection in both B cells and epithelial cells. Here, we present a gB nanoparticle, gB-I53-50 NP, that displays multiple copies of gB. Compared with the gB trimer, gB-I53-50 NP shows improved structural integrity and stability, as well as enhanced immunogenicity in mice and non-human primate (NHP) preclinical models. Immunization and passive transfer demonstrate a robust and durable protective antibody response that protects humanized mice against lethal EBV challenge. This vaccine candidate demonstrates significant potential in preventing EBV infection, providing a possible platform for developing prophylactic vaccines for EBV.


Asunto(s)
Infecciones por Virus de Epstein-Barr , Vacunas , Cricetinae , Animales , Ratones , Herpesvirus Humano 4 , Infecciones por Virus de Epstein-Barr/prevención & control , Formación de Anticuerpos , Células CHO , Anticuerpos Neutralizantes , Anticuerpos Antivirales
10.
Front Pharmacol ; 14: 1171353, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37719844

RESUMEN

Background: Considering the genetic characteristics of people with anti-tuberculosis (TB)-drug-induced liver injury (ATDILI), genetic factors and their consequences for treatment need to be studied. Objective: The correlation between N-acetyltransferase 2 (NAT2) genetic polymorphisms and ATDILI was analysed. Methods: In this study, the liver and coagulation functions of 120 patients with TB were monitored dynamically for at least 3 months. The genetic polymorphisms of patients were detected by pyrosequencing, and the acetylation types of liver damage and the distribution of NAT2 genetic polymorphisms were compared and analysed. Results: The results showed that there were significant differences in the distribution of alleles and acetylation types among different groups (p < 0.05). In patients with grade 4 liver injury (liver failure), any two alleles were included, i.e., *6 and *7. Specifically, patients with fast acetylation genotypes accounted for 42.4% (14/33), those with intermediate acetylated genotypes accounted for 55.2% (32/58), and patients with slow acetylation genotypes accounted for 65.5% (19/29). Conclusion: Patients with slow acetylation genotypes had higher rates of liver failure and liver injury than those with intermediate and fast acetylation genotypes, and patients with slow acetylation genotypes containing any two alleles (*6 and *7) had a higher rate of liver failure than those with other alleles. In summary, the time of liver injury in patients with slow acetylation genotypes was earlier than the total average time, and the time of liver function recovery in patients with fast acetylation genotypes was shorter than the total average time.

11.
Ying Yong Sheng Tai Xue Bao ; 34(4): 883-891, 2023 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-37078305

RESUMEN

We examined the effects of fertile soil layer construction technology on soil fertility and maize yield with a 3-year field experiment in Albic soil in Fujin, Heilongjiang Province. There were five treatments, including conventional tillage (T15, without organic matter return) and fertile soil layer construction methods [deep tillage (0-35 cm) with straw return, T35+S; deep tillage with organic manure, T35+M; deep tillage with straw and organic manure return, T35+S+M; deep tillage with straw, organic manure return and chemical fertilizer, T35+S+M+F]. The results showed that: 1) compared with the T15 treatment, maize yield was significantly increased by 15.4%-50.9% under fertile layer construction treatments. 2) There was no significant difference of soil pH among all treatments in the first two years, but fertile soil layer construction treatments significantly increased soil pH of topsoil (0-15 cm soil layer) in the third year. The pH of subsoil (15-35 cm soil layer) significantly increased under T35+S+M+F, T35+S+M, and T35+M treatments, while no significant difference was observed for T35+S treatment, compared with T15 treatment. 3) The fertile soil layer construction treatments could improve the nutrient contents of the topsoil and subsoil layer, especially in the subsoil layer, with the contents of organic matter, total nitrogen, available phosphorus, alkali-hydrolyzed nitrogen and available potassium being increased by 3.2%-46.6%, 9.1%-51.8%, 17.5%-130.1%, 4.4%-62.8%, 22.2%-68.7% under the subsoil layer, respectively. The fertility richness indices were increased in the subsoil layer, and nutrient contents of the subsoil layer were close to those of topsoil layer, indicating that 0-35 cm fertile soil layer had been constructed. 4) Soil organic matter contents in the 0-35 cm layer were increased by 8.8%-23.2% and 13.2%-30.1% in the second and third years of fertile soil layer construction, respectively. Soil organic carbon storage was also gradually increased under fertile soil layer construction treatments. 5) The carbon conversion rate of organic matter was 9.3%-20.9% under T35+S treatment, and 10.6%-24.6% under T35+M, T35+S+M, and T35+S+M+F treatments. The carbon sequestration rate was 815.7-3066.4 kg·hm-2·a-1 in fertile soil layer construction treatments. The carbon sequestration rate of T35+S treatment increased with experimental periods, and soil carbon content under T35+M, T35+S+M and T35+S+M+F treatments reached saturation point in the experimental second year. Construction of fertile soil layers could improve the fertility of topsoil and subsoil and maize yield. In term of economic benefits, combination application of maize straw, organic material and chemical fertilizer within 0-35 cm soil, cooperating with conservation tillage, is recommended for the Albic soil fertility improvement.


Asunto(s)
Agricultura , Suelo , Suelo/química , Agricultura/métodos , Zea mays , Carbono/análisis , Fertilizantes , Estiércol , Nitrógeno/análisis , China
12.
Zool Res ; 44(3): 505-521, 2023 May 18.
Artículo en Inglés | MEDLINE | ID: mdl-37070575

RESUMEN

Bacterial or viral infections, such as Brucella, mumps virus, herpes simplex virus, and Zika virus, destroy immune homeostasis of the testes, leading to spermatogenesis disorder and infertility. Of note, recent research shows that SARS-CoV-2 can infect male gonads and destroy Sertoli and Leydig cells, leading to male reproductive dysfunction. Due to the many side effects associated with antibiotic therapy, finding alternative treatments for inflammatory injury remains critical. Here, we found that Dmrt1 plays an important role in regulating testicular immune homeostasis. Knockdown of Dmrt1 in male mice inhibited spermatogenesis with a broad inflammatory response in seminiferous tubules and led to the loss of spermatogenic epithelial cells. Chromatin immunoprecipitation sequencing (ChIP-seq) and RNA sequencing (RNA-seq) revealed that Dmrt1 positively regulated the expression of Spry1, an inhibitory protein of the receptor tyrosine kinase (RTK) signaling pathway. Furthermore, immunoprecipitation-mass spectrometry (IP-MS) and co-immunoprecipitation (Co-IP) analysis indicated that SPRY1 binds to nuclear factor kappa B1 (NF-κB1) to prevent nuclear translocation of p65, inhibit activation of NF-κB signaling, prevent excessive inflammatory reaction in the testis, and protect the integrity of the blood-testis barrier. In view of this newly identified Dmrt1- Spry1-NF-κB axis mechanism in the regulation of testicular immune homeostasis, our study opens new avenues for the prevention and treatment of male reproductive diseases in humans and livestock.


Asunto(s)
Fertilidad , Homeostasis , FN-kappa B , Testículo , FN-kappa B/metabolismo , Fertilidad/genética , Fertilidad/inmunología , Humanos , Masculino , Testículo/inmunología , Testículo/metabolismo , Homeostasis/inmunología , Animales , Ratones , Células HEK293 , Espermatogénesis , Inflamación , Regiones Promotoras Genéticas/genética , Activación Transcripcional , Técnicas de Silenciamiento del Gen
13.
Chin J Integr Med ; 29(11): 971-979, 2023 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-37118531

RESUMEN

OBJECTIVE: To analyze the factors related to pregnancy of endometriosis and whether Chinese herbal medicines (CHMs) can improve pregnancy outcomes in patients with endometriosis in long-term management. METHODS: This multicenter cohort study retrospectively analyzed the clinical data of endometriosis patients with fertility needs from January 2019 to November 2019. A total of 252 patients with endometriosis from 5 level-III Grade A hospitals in Beijing were included in this study. Univariate and multivariate logistic regression analysis were performed for the relevant factors. The propensity score matching (PSM) function of SPSS software was used to match the CHMs group with the non-CHMs group. The pregnancy rate and live birth rate were analyzed. RESULTS: The results of univariate analysis showed that age, disease course, presence of infertility, presence of adenomyosis, time after surgery or use of gonadotropin-releasing hormone agonist (GnRH-a), use of CHMs and follow-up time were influencing factors of pregnancy in endometriosis patients (P<0.05). The results of multivariate analysis showed that age, presence of adenomyosis, time after surgery or use of GnRH-a, use of CHMs and follow-up time were independent factors affecting pregnancy in endometriosis patients, among which, age ⩾35 years old, presence of adenomyosis and follow-up time >6 months were independent risk factors (OR=0.445, 0.348, 0.140, respectively, P<0.05), time after surgery or use of GnRH-a ⩽6 months and use of CHMs were independent protective factors (OR=3.839, 3.842, respectively, P<0.05). After PSM, 99 pairs of two groups were matched successfully. The pregnancy rate of the CHMs group was higher than that of the non-CHMs group [55.56% (55/99) vs. 36.36% (36/99), P<0.05]. The live birth rate of the CHMs group was higher than that of the non-CHMs group [49.49% (49/99) vs. 35.35% (35/99), P<0.05]. CONCLUSION: CHMs can effectively improve clinical pregnancy rate and live birth rate of patients with endometriosis in the chronic disease management.


Asunto(s)
Adenomiosis , Endometriosis , Embarazo , Femenino , Humanos , Adulto , Resultado del Embarazo , Endometriosis/complicaciones , Endometriosis/tratamiento farmacológico , Endometriosis/cirugía , Estudios Retrospectivos , Estudios de Cohortes , Hormona Liberadora de Gonadotropina , Extractos Vegetales , Fertilización In Vitro
14.
J Clin Med ; 12(2)2023 Jan 05.
Artículo en Inglés | MEDLINE | ID: mdl-36675362

RESUMEN

BACKGROUND: Ischemia reperfusion injury (IRI) remains a major problem in patients with acute ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). We have developed a novel reperfusion strategy for PCI and named it "volume-controlled reperfusion (VCR)". The aim of the current study was to assess the safety and feasibility of VCR in patients with STEMI. METHODS: Consecutive patients admitted to Beijing Chaoyang Hospital with STEMI were prospectively enrolled. The feasibility endpoint was procedural success. The safety endpoints included death from all causes, major vascular complications, and major adverse cardiac event (MACE), i.e., a composite of cardiac death, myocardial reinfarction, target vessel revascularization (TVR), and heart failure. RESULTS: A total of 30 patients were finally included. Procedural success was achieved in 28 (93.3%) patients. No patients died during the study and no major vascular complications or MACE occurred during hospitalization. With the exception of one patient (3.3%) who underwent TVR three months after discharge, no patient encountered death (0.0%), major vascular complications (0.0%), or and other MACEs (0.0%) during the median follow-up of 16 months. CONCLUSION: The findings of the pilot study suggest that VCR has favorable feasibility and safety in patients with STEMI. Further larger randomized trials are required to evaluate the effectiveness of VCR in STEMI patients.

15.
IEEE Trans Neural Netw Learn Syst ; 34(10): 8102-8107, 2023 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-35044923

RESUMEN

This brief addresses the adaptive neural asymptotic tracking issue for uncertain non-strict feedback systems subject to full-state constraints. By introducing the significant nonlinear transformed function (NTF), the command filtered technology, and the boundary estimation method into control design, a novel command filtered backstepping adaptive controller is proposed. The proposed control scheme is able to not only deal with full-state constraints but also avoid the "explosion of complexity" issue. By means of a Lyapunov stability analysis, we prove that: 1) the tracking error asymptotically converges to zero; 2) all the variables in the controlled systems are bounded; and 3) all the states are constrained in the asymmetric predefined sets. Finally, a numerical simulation is used to demonstrate the validity of the proposed algorithm.

16.
Health Promot Int ; 38(4)2023 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-34897425

RESUMEN

Access to appropriate healthcare among disadvantaged populations in countries with universal healthcare requires a critical understanding of the relationships between poverty, social exclusion and health in the local context. The qualitative study explored the experiences of healthcare utilization in an inner-city impoverished community living in slum conditions in Hong Kong. Interviews with 40 slum residents in one of the poorest neighbourhoods in the city explored the following domains: experience and perceptions of the community, housing conditions, informal social capital and support system, interactions with community workers, and experiences in utilizing social and healthcare services. Framework analysis was conducted to identify local themes under the model of healthcare utilization: approachability, acceptability, availability and accommodation, affordability and appropriateness. Despite the subsidized public healthcare system, multiple barriers were identified. Low literacy of healthcare systems was prevalent. Specifically, structural barriers relating mainly to the availability, accommodation and affordability of health services were salient to impede access to healthcare. The barriers related to healthcare providers primarily stemmed from the interactions of healthcare providers, perceived stigma and the lack of patient-centred care. In addition, poverty-related sociocultural norms and personal beliefs of healthcare were found to be significant barriers to healthcare access. Despite the well-established subsidized public healthcare system, healthcare inequity was evident. Lack of quality healthcare access needs to be addressed by providing social and educational resources that facilitate collective efficacy for healthcare, community engagement from public sectors and person-centred care with healthcare providers.


Access to appropriate healthcare among disadvantaged populations in countries with universal healthcare requires a critical understanding of the relationships between poverty, social exclusion and health in the local context. This study explored the experiences and views of healthcare access among residents living in slum conditions in an inner-city impoverished community in Hong Kong. The findings indicated that in addition to low functional health literacy that is rooted in structural barriers of public resources, a lack of patient-centred care was prevalent due to stigma attached to poverty. Poor quality interactions with healthcare providers and systems resulted in fatalistic beliefs in health promotion. Social and educational resources should be provided to the disadvantaged to enhance collective efficacy to build a resilient health community.


Asunto(s)
Determinantes Sociales de la Salud , Poblaciones Vulnerables , Humanos , Hong Kong , Aceptación de la Atención de Salud , Accesibilidad a los Servicios de Salud , Investigación Cualitativa , Inequidades en Salud
17.
Chin J Integr Med ; 29(2): 119-126, 2023 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-35840852

RESUMEN

OBJECTIVE: To study effects of Shenmai Injection on hypertensive heart failure and its mechanism for inhibiting myocardial fibrosis. METHODS: Salt-sensitive (Dahl/SS) rats were fed with normal diet (0.3% NaCl) and the high-salt diet (8% NaCl) to observe the changes in blood pressure and heart function, as the control group and the model group. Salt-insensitive rats (SS-13BN) were fed with the high-salt diet (8% NaCl) as the negative control group. After modeling, the model rats were randomly divided into heart failure (HF) group, Shenmai Injection (SMI) group and pirfenidone (PFD) group by a random number table, with 6 rats in each group. They were given sterilized water, SMI and pirfenidone, respectively. Blood pressure, cardiac function, fibrosis and related molecular expression were detected by sphygmomanometer, echocardiogram, enzyme linked immunosorbent assay (ELISA), hematoxylin-eosin staining, Masson staining, immunofluorescence and qPCR analysis. RESULTS: After high-salt feeding, compared with the control and negative control group, in the model group the blood pressure increased significantly, the left ventricular ejection fraction (LVEF) and left ventricular fraction shortening (LVFS) were significantly reduced, and the serum NT-proBNP concentration increased significantly (all P<0.05); furthermore, the arrangement of myocardial cells was disordered, the edema was severe, and the degree of myocardial fibrosis was also significantly increased (P<0.05); the protein and mRNA expressions of collagen type I (Col I) were up-regulated (P<0.05), and the mRNA expressions of transforming growth factor ß 1 (TGF- ß 1), Smad2 and Smad3 were significantly up-regulated (P<0.05). Compared with HF group, after intervention of Shenmai Injection, LVEF and LVFS increased, myocardial morphology was improved, collagen volume fraction decreased significantly (P<0.05), and the mRNA expressions of Col I, TGF- ß 1, Smad2 and Smad3, as well as Col I protein expression, were all significantly down-regulated (all P<0.05). CONCLUSION: Myocardial fibrosis is the main pathological manifestation of hypertensive heart failure, and Shenmai Injection could inhibit myocardial fibrosis and effectively improve heart failure by regulating TGF-ß 1/Smad signaling pathway.


Asunto(s)
Insuficiencia Cardíaca , Hipertensión , Ratas , Animales , Volumen Sistólico , Cloruro de Sodio , Ratas Endogámicas Dahl , Función Ventricular Izquierda , Factor de Crecimiento Transformador beta1/metabolismo , Fibrosis , ARN Mensajero
18.
Acta Pharmacol Sin ; 44(4): 780-790, 2023 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-36038765

RESUMEN

Increasing evidence shows that smoking-obtained nicotine is indicated to improve cognition and mitigate certain symptoms of schizophrenia. In this study, we investigated whether chronic nicotine treatment alleviated MK-801-induced schizophrenia-like symptoms and cognitive impairment in mice. Mice were injected with MK-801 (0.2 mg/kg, i.p.), and the behavioral deficits were assessed using prepulse inhibition (PPI) and T-maze tests. We showed that MK-801 caused cognitive impairment accompanied by increased expression of PDZ and LIM domain 5 (Pdlim5), an adaptor protein that is critically associated with schizophrenia, in the prefrontal cortex (PFC). Pretreatment with nicotine (0.2 mg · kg-1 · d-1, s.c., for 2 weeks) significantly ameliorated MK-801-induced schizophrenia-like symptoms and cognitive impairment by reversing the increased Pdlim5 expression levels in the PFC. In addition, pretreatment with nicotine prevented the MK-801-induced decrease in CREB-regulated transcription coactivator 1 (CRTC1), a coactivator of CREB that plays an important role in cognition. Furthermore, MK-801 neither induced schizophrenia-like behaviors nor decreased CRTC1 levels in the PFC of Pdlim5-/- mice. Overexpression of Pdlim5 in the PFC through intra-PFC infusion of an adreno-associated virus AAV-Pdlim5 induced significant schizophrenia-like symptoms and cognitive impairment. In conclusion, chronic nicotine treatment alleviates schizophrenia-induced memory deficits in mice by regulating Pdlim5 and CRTC1 expression in the PFC.


Asunto(s)
Disfunción Cognitiva , Maleato de Dizocilpina , Ratones , Animales , Maleato de Dizocilpina/metabolismo , Maleato de Dizocilpina/farmacología , Nicotina/farmacología , Disfunción Cognitiva/inducido químicamente , Disfunción Cognitiva/tratamiento farmacológico , Disfunción Cognitiva/metabolismo , Corteza Prefrontal/metabolismo , Cognición , Factores de Transcripción/metabolismo
19.
J Knee Surg ; 36(12): 1297-1301, 2023 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-36049773

RESUMEN

The study aimed to compare the midterm outcomes of medialization and anteromedialization tibial tubercle osteotomies when used in the management of recurrent patellofemoral instability. The hypothesis is that both techniques would result in significant improvement for patellofemoral instability, but anteromedialization would result in a lower incidence of early osteoarthritis. In the cohort study, all skeletally mature patients aged 18 years old or younger who underwent tibial tubercle osteotomy for recurrent patellofemoral instability within a 10-year period in a single institution were included. All patients underwent either medialization or anteromedialization tibial tubercle osteotomy. The preoperative and postoperative outcomes of the tibial tubercle osteotomies were compared. All patients included in the study had a minimum of 5-year follow-up duration before the conclusion of the study. There was no statistically significant difference in the rates of preoperative and postoperative patellofemoral dislocation when either technique was employed (p = 0.999). Additionally, both the preoperative and postoperative Kujala scores were similar (p = 0.166 and p = 0.554, respectively). The knees did not have a statistically significant difference in their patellar tilt angles and tibial tubercle-trochlear groove distances preoperatively or postoperatively when either technique was used (p = 0.165 and 0.149, respectively). There was also no incidence of osteoarthritis identified in either of the groups (p = 0.999). Both anteriorization and anteromedialization tibial tubercle osteotomies were effective surgical management for patellofemoral instability when combined with medial patellofemoral ligament reconstruction. There were no significant differences in clinical, functional, and radiological outcomes when either medialization or anteromedialization tibial tubercle osteotomy was performed.


Asunto(s)
Inestabilidad de la Articulación , Osteoartritis , Luxación de la Rótula , Articulación Patelofemoral , Humanos , Adolescente , Luxación de la Rótula/cirugía , Articulación Patelofemoral/cirugía , Estudios de Cohortes , Inestabilidad de la Articulación/cirugía , Recurrencia , Tibia/cirugía , Ligamentos Articulares/cirugía , Osteotomía/métodos , Estudios Retrospectivos
20.
Carbohydr Polym ; 300: 120229, 2023 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-36372501

RESUMEN

Hydrogels as flexible sensor have attracted significant attention due to its conductivity, stretchability and flexibility. However, it is still a great challenge to prepare hydrogels that simultaneously possess high strength, anti-fatigue, self-adhesion, and anti-freezing. Herein, a multifunctional dual-network hydrogel was prepared by in situ polymerization of acrylic monomer in chitosan chains, and coordinated with aluminum chloride and glycerol. Based on chain entanglement, hydrogen bonding and coordination interactions, this dual-network hydrogel exhibited excellent mechanical properties, good fatigue resistance, and excellent adhesion performance. It can be used as a strain sensor for its stable conductivity and high sensitivity, which could monitor both large human motions and subtle motions. Due to the presence of glycerol, the hydrogel showed outstanding freezing resistance and still kept flexible and conductive even at low temperatures (-20 °C). This hydrogel can be applied as a flexible wearable sensor for monitoring human motion in extreme low-temperature condition.


Asunto(s)
Adhesivos , Hidrogeles , Humanos , Cementos de Resina , Glicerol , Conductividad Eléctrica
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