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2.
Zhonghua Yi Xue Za Zhi ; 104(8): 566-570, 2024 Feb 27.
Artículo en Chino | MEDLINE | ID: mdl-38389235

RESUMEN

The management of acute type A aortic dissection (aTAAD) with mesenteric malperfusion (MMP) is quite challenging as it is often associated with high mortality and poor outcomes, and an optimal treatment strategy is lack of consensus for this critically ill condition. Emergent open surgical repair of the ascending aorta is a life-saving operation and remains the standard of care for aTAAD with MMP, but is associated with a high rate of mortality. In recent years, reperfusion of superior mesenteric artery (SMA) by endovascular repair as the first treatment strategy in the treatment of aTAAD with MMP has been concerned and reported. Only endovascular repair and conservative medical treatment are also introduced in few cases with poor outcomes. There are many urgent issues that need to be addressed in current strategies. The optimal management strategies remain controversial, and further investigation and research are needed. These issues were addressed in this article.


Asunto(s)
Aneurisma de la Aorta , Disección Aórtica , Procedimientos Endovasculares , Isquemia Mesentérica , Humanos , Aneurisma de la Aorta/complicaciones , Aneurisma de la Aorta/cirugía , Procedimientos Endovasculares/efectos adversos , Factores de Riesgo , Isquemia Mesentérica/cirugía , Enfermedad Aguda , Resultado del Tratamiento , Disección Aórtica/complicaciones , Disección Aórtica/cirugía
3.
Zhonghua Zhong Liu Za Zhi ; 45(6): 464-470, 2023 Jun 23.
Artículo en Chino | MEDLINE | ID: mdl-37355464

RESUMEN

Conventional tumor culture models include two-dimensional tumor cell cultures and xenograft models. The former has disadvantages including lack of tumor heterogeneity and poor clinical relevance, while the latter are limited by the slow growth, low engraftment successful rate, and high cost. In recent years, in vitro three-dimensional (3D) tumor models have emerged as the tool to better recapitulate the spatial structure and the in vivo environment of tumors. In addition, they preserve the pathological and genetic features of tumor cells and reflect the complex intracellular and extracellular interactions of tumors, which have become a powerful tool for investigating the tumor mechanism, drug screening, and personalized cancer treatment. 3D tumor model technologies such as spheroids, organoids, and microfluidic devices are maturing. Application of new technologies such as co-culture, 3D bioprinting, and air-liquid interface has further improved the clinical relevance of the models. Some models recapitulate the tumor microenvironment, and some can even reconstitute endogenous immune components and microvasculature. In recent years, some scholars have combined xenograft models with organoid technology to develop matched in vivo/in vitro model biobanks, giving full play to the advantages of the two technologies, and providing an ideal research platform for individualized precision therapy for specific molecular targets in certain subtypes of tumors. So far, the above technologies have been widely applied in the field of colorectal cancer research. Our research team is currently studying upon the application of patient-derived tumor cell-like clusters, a self-assembly 3D tumor model, in guiding the selection of postoperative chemotherapy regimens for colorectal cancer. A high modeling success rate and satisfactory results in the drug screening experiments have been achieved. There is no doubt that with the advancement of related technologies, 3D tumor models will play an increasingly important role in the research and clinical practice of colorectal cancer.


Asunto(s)
Neoplasias Colorrectales , Organoides , Humanos , Organoides/patología , Técnicas de Cultivo de Célula , Neoplasias Colorrectales/tratamiento farmacológico , Neoplasias Colorrectales/patología , Microambiente Tumoral
4.
J Aerosol Sci ; 163: 105995, 2022 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-35382445

RESUMEN

During the COVID-19 pandemic, WHO and CDC suggest people stay 1 m and 1.8 m away from others, respectively. Keeping social distance can avoid close contact and mitigate infection spread. Many researchers suspect that suggested distances are not enough because aerosols can spread up to 7-8 m away. Despite the debate on social distance, these social distances rely on unobstructed respiratory activities such as coughing and sneezing. Differently, in this work, we focused on the most common but less studied aerosol spread from an obstructed cough. The flow dynamics of a cough jet blocked by the backrest and gasper jet in a cabin environment was characterized by the particle image velocimetry (PIV) technique. It was proved that the backrest and the gasper jet can prevent the front passenger from droplet spray in public transportation where maintaining social distance was difficult. A model was developed to describe the cough jet trajectory due to the gasper jet, which matched well with PIV results. It was found that buoyancy and inside droplets almost do not affect the short-range cough jet trajectory. Infection control measures were suggested for public transportation, including using backrest/gasper jet, installing localized exhaust, and surface cleaning of the backrest.

5.
Travel Med Infect Dis ; 47: 102285, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35314345

RESUMEN

BACKGROUND: Expiratory droplets cause high infection risk to nearby passengers via airborne route. METHODS: We built a two-row four-seat setup to simulate a public transport cabin. A cough generator and a nebulizer were used to simulate the cough and talk processes respectively. Exposure and infection risk of nearby passengers was studied. The effect of gasper jet and backrest on risk mitigation was investigated. RESULTS: For the activity of coughing, the front passenger has much higher infection risk, which was around four times of that of other passengers, because of the concentration surge in the inhalation zone. For talking, the nearby passengers have similar infection risk because nearby passengers were all exposed to concentration surges with similar peak value. Gasper jet of the infected passenger and higher backrest can extinguish or reduce the concentration surge of front passengers and reduce the infection risk due to coughing and talking droplets. CONCLUSION: The passengers near the infected passenger have very high infection risk. The overhead gasper and a higher backrest can reduce the exposure and mitigate the risk of infection. It is believed that the control measures to protect nearby passengers are urgently needed in public transport cabins.


Asunto(s)
Tos , Control de Infecciones , Humanos
6.
Zhonghua Wai Ke Za Zhi ; 59(6): 443-446, 2021 Jun 01.
Artículo en Chino | MEDLINE | ID: mdl-34102725

RESUMEN

In recent years, the endovascular procedures has considerably evolved in concepts, technologies, materials and devices on cardiovascular surgery, and influenced the development and the future direction of cardiovascular surgery technology. Endovascular aorta repair is well recognized as the optimal therapy for patients presenting with acute or chronic pathology of distal aortic arch, descending aorta and thoraco-abdominal aorta. The use of catheter-based endovascular repair in the ascending aorta pathology including aneurysms, pseudoaneurysms, penetrating aortic ulcers and acute or chronic Stanford type A aortic dissection has been concerned and reported. Comparing to the open surgical procedures for ascending aorta and aortic root disease with high perioperative mortality and morbidity, the catheter-based endovascular repair has minimally invasive, expanding the alternative treatment of ascending aorta disease, especially for patients with high-risk profiles. However, due to the complex anatomy and functional properties, materials and devices, the use of this technique in ascending aorta and aortic root is still questionable. In addition, the long-term and reliable clinical research results is still inadequate, and the safety and effectiveness need further research.


Asunto(s)
Aneurisma de la Aorta Torácica , Enfermedades de la Aorta , Implantación de Prótesis Vascular , Procedimientos Endovasculares , Aorta/cirugía , Aorta Torácica/cirugía , Aneurisma de la Aorta Torácica/cirugía , Enfermedades de la Aorta/cirugía , Catéteres , Humanos , Stents , Resultado del Tratamiento
7.
Zhonghua Wai Ke Za Zhi ; 58(12): 929-935, 2020 Dec 01.
Artículo en Chino | MEDLINE | ID: mdl-33249811

RESUMEN

Objective: To examine the clinical treatment methods and short- and mid-term results of traumatic aortic injury (TAI). Methods: The clinical data of 30 patients suffering from TAI who were admitted to Department of Cardiothoracic Surgery, General Hospital of Eastern Theater Command from January 2010 to December 2018 were summarized and analyzed retrospectively. All patients were diagnosed as TAI by aortic CT angiography. There were 20 males and 10 females, aging (46.4±15.2) years (range: 17 to 76 years). One patient was diagnosed as extensive intramural hematoma (IMH). The other 29 cases had aortic intimal injury, and the primary intimal tear of all these patients was located in the isthmus of descending aorta. There were 2 cases of ulcer-like changes combined with IMH, and 27 cases of traumatic aortic dissection (TAD) including 23 cases of localized TAD and 4 cases of extensive TAD. Endovascular repair, artificial vascular replacement or conservative treatment were performed according to the patient's specific condition. The patients were followed up in outpatient or by telephone. The clinical data of all the patients of the in-hospital treatment and during follow-up period was analyzed retrospectively. Results: One patient with IMH was treated conservatively. Surgical intervention was performed in 29 cases with intimal injury, of which 14 cases underwent emergency surgery on the day of admission or the next day, and 15 cases underwent elective surgery. Twenty-seven cases underwent thoracic endovascular aortic repair (TEVAR), and 2 cases underwent artificial vascular replacement. Nine cases suffered combined operations in early or late stage. All patients were cured and discharged with in-hospital stay of (13.2±5.4) days (range: 7 to 30 days). There was no in-hospital death. Two patients underwent tracheotomy, and the rest had no serious complications. Up to the last follow-up in June 2019, 4 patients were lost to follow-up, and the remaining 26 patients were followed up for (50.6±34.1) months (range: 6 to 112 months) and survived healthily without new aortic events. Conclusions: Most of TAD cases are ascribed to Stanford type B aortic dissection, and a satisfactory short-term and mid-term result can be achieved by emergency TEVAR in most patients. Some patients can achieve good long-term results by open surgery with artificial vascular replacement.


Asunto(s)
Aorta/lesiones , Aorta/cirugía , Lesiones del Sistema Vascular/cirugía , Adolescente , Adulto , Anciano , Aorta/diagnóstico por imagen , Prótesis Vascular , Implantación de Prótesis Vascular , Angiografía por Tomografía Computarizada , Procedimientos Endovasculares , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Resultado del Tratamiento , Procedimientos Quirúrgicos Vasculares , Lesiones del Sistema Vascular/diagnóstico por imagen , Adulto Joven
8.
Mol Biol (Mosk) ; 54(3): 457-468, 2020.
Artículo en Ruso | MEDLINE | ID: mdl-32492009

RESUMEN

TWIK-related acid-sensitive potassium channel-1 (TASK-1) is a "leak" potassium channel sensitive to extracellular protons. It contributes to setting the resting potential in mammalian neurons. TASK-1 channels are widely expressed in respiratory-related neurons in the central nervous system. Inhibition of TASK-1 by extracellular acidosis can depolarize and increase the excitability of these cells. Here we describe the distribution of TASK-1 in the rat brainstem and show that TASK-1 mRNAs are present in respiratory-related nuclei in the ventrolateral medulla, which have been proposed as neural substrates for central chemo-reception in rats. After inhalation of 8% CO2 for 30 and 60 min, TASK-1 mRNA levels in positive-expression neurons were remarkably upregulated. Injection of the TASK-1 blocker anandamide (AEA) into the rat lateral cerebral ventricle, showed a significant excitement of respiratory at 10 min posttreatment, with a marked decrease in inspiratory and expiratory durations and an increased frequency of respiration. We suggest that TASK-1 channel may serve as a chemosensor for in central respiration and may contribute to pH-sensitive respiratory effects. TASK-1 channel might be an attractive candidate for sensing H^(+)/CO2 in several respiratory-related nuclei in the brainstem. It is likely that TASK-1 participates in pH-sensitive chemical regulation in the respiratory center under physiological and pathological conditions.


Asunto(s)
Proteínas del Tejido Nervioso/fisiología , Neuronas/fisiología , Canales de Potasio de Dominio Poro en Tándem/fisiología , Centro Respiratorio/fisiología , Animales , Ácidos Araquidónicos/farmacología , Endocannabinoides/farmacología , Concentración de Iones de Hidrógeno , Potenciales de la Membrana , Proteínas del Tejido Nervioso/antagonistas & inhibidores , Alcamidas Poliinsaturadas/farmacología , Canales de Potasio de Dominio Poro en Tándem/antagonistas & inhibidores , Ratas
9.
Zhonghua Wei Chang Wai Ke Za Zhi ; 22(11): 1027-1033, 2019 Nov 25.
Artículo en Chino | MEDLINE | ID: mdl-31770833

RESUMEN

Objective: To understand the prevalence, diagnosis and treatment of chronic critical illness (CCI) in China. Methods: The clinical data of 472 adult patients admitted to ICU in 53 hospitals, including basic information, disease-related data, nutrition program, etc., were collected on May 10, 2019, by means of multi-center cross-sectional study. If surgical intervention was needed or the occurrence of the disease was directly related to the surgery, ICU patients were regarded as surgical ICU cases (n=211). In this study, the diagnostic criteria for CCI were: (1) admission to ICU >14 days;(2) combined with persistent organ dysfunction. The prevalence,distribution and treatment of CCI and surgery-related CCI were recorded and analyzed. The Mann-Whitney U test, chi-square test or Fisher exact test were used for comparative analysis. Results: Among the 472 ICU patients from 53 hospitals, 326 were male (69.1%) and 146 were female (30.9%). The prevalence of CCI was 30.7% (145/472). Among 211 surgery-related ICU patients, 57 developed CCI with a prevalence of 27.0%. As compared to non-CCI patients, higher APACHE II score [median (IQR) 13.5 (10.0, 18.3) vs. 11.0 (7.0, 16.0), U=2970.000, P=0.007], higher Charlson comorbidity index [median (IQR) 4.0 (2.0, 7.0) vs. 3.0 (1.0, 5.0), U= 3570.000, P=0.036] and higher ratio of breath dysfunction [68.4% (39/57) vs. 48.1% (74/154), χ(2)=6.939, P=0.008] and renal dysfunction [42.1% (24/57) vs. 18.2% (28/154), χ(2)=12.821, P<0.001] were found in surgery-related CCI patients. While SOFA score, Glasgow coma score and other visceral function were not significantly different between surgery-related CCI and non-CCI patients (all P>0.05). NUTRIC score showed that surgery-related CCI patients had higher nutritional risk [43.9% (25/57) vs. 26.6%(41/154), U=5.750, P=0.016] and higher ratio of mechanical ventilation [66.7% (38/57) vs. 52.3% (79/154), χ(2)=3.977, P=0.046] than non-CCI patients. On the survey day, the daily caloric requirements of 50.2% (106/211) of surgery-related ICU patients were calculated according to the standard adult caloric intake index (104.6 to 125.5 kJ·kg(-1)·d(-1), 1 kJ=0.239 kcal), and the daily caloric requirements of 46.4% (98/211) of patients were calculated by physicians according to the severity of the patient's condition. 60.2% (127/211) of nutritional support therapy was enteral nutrition (including a combination of enteral and parenteral nutrition), while the remaining patients received parenteral nutrition (24.6%, 52/211), simple glucose infusion (9.0%, 19/211), or oral diet (6.2%, 13/211). The target calorie of CCI group was 104.6 (87.9, 125.5) kJ·kg(-1)·d(-1), and the actual calorie intake accounted for 0.98 (0.80, 1.00) of the target calory. In the non-CCI group, the target calorie was 104.6 (87.9, 125.5) kJ·kg(-1)·d(-1), and the actual calorie consumed accounted for 0.91 (0.66, 1.00) of the target calorie. There was no statistically significant difference between two groups (P=0.248, P=0.150). Conclusion: The prevalence of CCI and surgery-related CCI in ICU is high, along with severe complications, respiratory and renal dysfunction and mechanical ventilation. Surgical patients admitted to ICU are at high nutritional risk, and active and correct nutritional support is essential for such patients.


Asunto(s)
Enfermedad Crítica/epidemiología , Enfermedad Crítica/terapia , Adulto , China/epidemiología , Enfermedad Crónica/epidemiología , Enfermedad Crónica/terapia , Estudios Transversales , Femenino , Humanos , Unidades de Cuidados Intensivos/estadística & datos numéricos , Masculino , Apoyo Nutricional/estadística & datos numéricos , Procedimientos Quirúrgicos Operativos/efectos adversos
10.
Eur Rev Med Pharmacol Sci ; 23(6): 2505-2512, 2019 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-30964177

RESUMEN

OBJECTIVE: This study is designed as prospective and observational research of patients with sepsis. It was carried out in the intensive care unit (ICU). We investigated the shape change index (SCI) of inferior vena cava (IVC) measured with trans-abdominal ultrasound to detect the signs of septic shock. The aim of this research was to find the most effective tool in predicting shock in patients compared with that of other parameters such as brain natriuretic peptide (BNP), lactate, variation index of inferior vena cava IVC-VI, and extravascular lung water index (EVLWI). PATIENTS AND METHODS: We suppose that SCI can be used as the safest and most sensitive tool in the early recognition of septic dysfunction. The observational study was conducted in the Department of ICU, Shandong Provincial Hospital Affiliated to Shandong University from January 2016 to December 2017. SCI of IVC, serum lactate, BNP, IVC-VI, and EVLWI concentrations were measured in 30 sepsis patients. All studied biomarkers were analyzed and contrasted according to the score of the Sequential Organ Failure Assessment (SOFA). Pearson correlation analysis was analyzed to statistic the relationship between variables. RESULTS: We showed the correlation of BNP value, lactic acid value, IVC-VI, EVLWI, and SCI of IVC in sick patients suffering septic shock. Positive correlation was observed in the BNP value, lactic acid value, IVC-VI, EVLWI, and SCI of IVC (r=0.447, p=0.013; r=0.484, p=0.007; r=0.423, p=0.023; r=0.638, p<0.001; r=0.599, p<0.001; respectively). However, the SCI and EVLWI showed a stronger correlation with the SOFA than the others. SCI of IVC, as estimated by transabdominal ultrasound, was more accurate than the other commonly used non-invasive predictors. EVLWI, as an accurate and classical predictor, was an invasive predictor. SCI of IVC was faster, more convenient and safer than the other. CONCLUSIONS: SCI of IVC was faster, more convenient and safer than the other commonly used non-invasive predictors. Early recognition and diagnosis of sepsis may improve patient outcome.


Asunto(s)
Agua Pulmonar Extravascular/diagnóstico por imagen , Ácido Láctico/sangre , Péptido Natriurético Encefálico/metabolismo , Choque Séptico/diagnóstico por imagen , Vena Cava Inferior/diagnóstico por imagen , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , China , Diagnóstico Precoz , Agua Pulmonar Extravascular/metabolismo , Femenino , Humanos , Unidades de Cuidados Intensivos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Sensibilidad y Especificidad , Ultrasonografía , Adulto Joven
12.
Rhinology ; 56(4): 336-342, 2018 Dec 01.
Artículo en Inglés | MEDLINE | ID: mdl-30052693

RESUMEN

BACKGROUND: Olfactory dysfunction significantly impairs the life quality of patients. Therefore, a model needs to be developed for anosmia. Chitosan is a biodegradable natural polysaccharide that has been widely studied for regenerative purposes in the nervous system. However, whether chitosan promotes differentiation of olfactory receptor neurons or regulates formation of neurospheres in the olfactory system remains unexplored. METHODOLOGY: Olfactory neuroepithelial cells were isolated from embryonic wistar rats on day 17, and cultured on controls and chitosan films for 12 days. The effects of treatment were assessed using immunocytochemistry, quantitative polymerase chain reaction and western blots following culturing. The substrate of poly-L-lysine-co-laminin was adopted as a control. RESULTS: In contrast to the flat layer on controls, olfactory neuroepithelial cells form olfactory neurospheres on chitosan films with steadily increasing diameter. The olfactory neurospheres contain basal cells, as well as immature and mature olfactory receptor neurons. The expression level of olfactory marker protein is higher on chitosan films than those on controls in gene and protein levels, and the olfactory transduction elements also express a similar trend. Mature olfactory receptor neurons are found predominantly at the periphery of the olfactory neurospheres. CONCLUSIONS: Chitosan films not only facilitate formation of olfactory neurospheres, but also promote differentiation of olfactory receptor neurons. Chitosan is a potential biomaterial to establish an in vitro culture model to treat olfactory dysfunction in future.


Asunto(s)
Diferenciación Celular/efectos de los fármacos , Quitosano/farmacología , Neuronas Receptoras Olfatorias/citología , Neuronas Receptoras Olfatorias/efectos de los fármacos , Células Madre/citología , Células Madre/efectos de los fármacos , Animales , Western Blotting , Células Cultivadas , Inmunohistoquímica , Microscopía Electrónica de Rastreo , Ratas , Ratas Wistar
14.
Clin Otolaryngol ; 43(2): 463-469, 2018 04.
Artículo en Inglés | MEDLINE | ID: mdl-28950051

RESUMEN

OBJECTIVES: Nasopharyngeal cancer (NPC) is an endemic disease in Taiwan. Prognostic factors the anatomical TNM stage are important for its prognostic stratification. An elevated neutrophil-to-lymphocyte ratio (NLR) has been reported to be associated with poor prognosis in various solid tumours. In this study, we analysed the prognostic impact of the NLR in NPC in Taiwan. DESIGN: Single-institution retrospective study. SETTING: Medical centre. PARTICIPANTS: One hundred and eighty patients with NPC treated at the Far Eastern Memorial Hospital, Taiwan, from January 2007 to December 2013. MAIN OUTCOME MEASURES: The association between the clinical or haematological presentations and the prognosis. RESULTS: The majority of the 180 patients included in this study were men (80%) and were <65 years old (91.7%). A neck mass (55.6%) was the most common clinical presentation, followed by nasal (39.4%) and aural (30.6%) symptoms. In addition, the majority (75.4%) of patients had advanced stage (III and IV) disease. Patients with a high NLR (≧3.6) had significantly lower progression-free survival, overall survival and disease-specific survival rates. The association between high NLR and poor prognosis was more pronounced in patients with advanced disease than in those with early-stage NPC. The results of a multivariate analysis revealed that advanced age, clinical symptoms including headache, diplopia and facial numbness, advanced disease stage, and high NLR were independent prognostic factors. CONCLUSION: A high NLR is an independent poor prognostic factor of NPC in Taiwan.


Asunto(s)
Pueblo Asiatico , Recuento de Linfocitos , Carcinoma Nasofaríngeo/sangre , Carcinoma Nasofaríngeo/mortalidad , Neoplasias Nasofaríngeas/sangre , Neoplasias Nasofaríngeas/mortalidad , Neutrófilos , Adulto , Anciano , Supervivencia sin Enfermedad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Carcinoma Nasofaríngeo/diagnóstico , Neoplasias Nasofaríngeas/diagnóstico , Pronóstico , Estudios Retrospectivos , Tasa de Supervivencia , Taiwán , Adulto Joven
15.
Clin Otolaryngol ; 43(1): 124-130, 2018 02.
Artículo en Inglés | MEDLINE | ID: mdl-28556524

RESUMEN

OBJECTIVE: Office-based laryngeal procedures (OBLPs) are emerging as effective alternative modalities for vocal disorders. This study systematically investigates the haemodynamic status of patients, specifically focusing on the potential effects of underlying comorbidity and medication use. DESIGN: Prospective cohort study. SETTING: Tertiary referral centre. PARTICIPANTS: We prospectively recruited 214 consecutive patients who received OBLPs during January-December 2015. All procedures were performed under local anaesthesia without sedation, in an upright (sitting) position. MAIN OUTCOME MEASURES: We measured heart rate (HR), systolic and diastolic blood pressure, and oxygen saturations at baseline (before procedure), immediately after local anaesthesia to the pharynx and larynx, immediately after completing of procedure, and 20 minutes after the procedure. RESULTS: Systolic, diastolic blood pressures and HR all significantly increased after local anaesthesia, and gradually decreased after the procedure (P<.01). Oxygen concentration remained unchanged. Patients with comorbidity and those receiving vasoactive medications showed significantly higher perioperative blood pressures than the other patients (P<.05), but the trend remained similar. Prominent hypertension (systolic ≥160 mm Hg or diastolic ≥100 mm Hg) was noted in 17 patients, more commonly in patients with older age, higher baseline blood pressures and receiving vasoactive medications. Only 2% of patients with normal baseline measurements developed prominent hypertension perioperatively. Tachycardia (HR≥100 bpm) developed in 22 patients, more frequently in patients with higher baseline HRs, and perceiving greater discomforts. CONCLUSION: This study revealed that routine haemodynamic monitoring may not be necessary for all the OBLPs, but should be considered for older patients, those with higher baseline blood pressure or HR, sensitive patients who might be more susceptible to perioperative discomfort, and those receiving vasoactive medications.


Asunto(s)
Antihipertensivos/uso terapéutico , Hemodinámica/fisiología , Hipertensión/epidemiología , Enfermedades de la Laringe/epidemiología , Laringoscopía , Adulto , Anciano , Anciano de 80 o más Años , Comorbilidad/tendencias , Femenino , Estudios de Seguimiento , Humanos , Hipertensión/tratamiento farmacológico , Hipertensión/fisiopatología , Enfermedades de la Laringe/terapia , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Taiwán/epidemiología , Adulto Joven
16.
Zhonghua Wai Ke Za Zhi ; 54(10): 761-765, 2016 Oct 01.
Artículo en Chino | MEDLINE | ID: mdl-27686640

RESUMEN

Objective: To summarize the short- and mid-term results on endovascular repair of primary retrograde Stanford type A aortic dissection with an entry tear in distal aortic arch or descending aorta. Methods: Between December 2009 and December 2014, 21 male patients of primary retrograde Stanford type A aortic dissection with a mean age of (52±9) years received endovascular repair in Department of Cardiothoracic Surgery, Jinling Hospital. Among the 21 cases, 17 patients were presented as ascending aortic intramural hematoma, 4 patients as active blood flow in false lumen and partial thrombosis, 8 patients as ulcer on descending aorta combined intramural hematoma in descending aorta, and 13 patients as typical dissection changes. All patients received endovascular stent-graft repair successfully, with 15 cases in acute phase and 6 cases in chronic phase. Results: Cone stent was implanted in 13 cases, while straight stent in 8 cases, including 1 case of left common carotid-left subclavian artery bypass surgery and 1 case of restrictive bare-metal stent implantation. No perioperative stroke, paraplegia, stent fracture or displacement, limbs or abdominal organ ischemia or other severe complications occured, except for tracheotomy in 2 patients. Active blood flow in ascending aorta or aortic arch disappeared, and intramural hematoma started being absorbed on CT angiography images before discharge. All patients were alive during follow-up (6 to 72 months), and intramural hematoma in ascending aorta and aortic arch was absorbed thoroughly. Type Ⅰ endoleak and ulcer expansion were found in 1 patient, and type Ⅳ endoleak in distal stent was found in another one patient. Secondary ascending aortic dissection was found in 1 case two years later, which was cured by hybrid procedure with cardiopulmonary bypass. Conclusion: Endovascular repair of primary retrograde Stanford type A aortic dissection was safe and effective, which correlated with favorable short- and mid-term results.


Asunto(s)
Aneurisma de la Aorta Torácica/cirugía , Disección Aórtica/cirugía , Implantación de Prótesis Vascular , Procedimientos Endovasculares , Adulto , Anciano , Aorta , Aneurisma de la Aorta , Endofuga , Humanos , Masculino , Persona de Mediana Edad , Stents , Accidente Cerebrovascular , Trombosis , Resultado del Tratamiento , Cicatrización de Heridas
17.
Eur Rev Med Pharmacol Sci ; 20(2): 355-62, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-26875908

RESUMEN

OBJECTIVE: This study is to evaluate the effect of high-volume hemofiltration (HVHF) and early goal-directed therapy (EGDT) on alveolar-arterial oxygen exchange in patients with refractory septic shock. PATIENTS AND METHODS: Patients were classified into two groups by a prospective cohort study: 86 received both HVHF and EGDT (the HVHF group), and 81 treated with EGDT only (the control group). Alveolar-arterial oxygen pressure was taken at baseline and at days 1, 3, and 7, and respiratory index (RI, ratio of P(a)O2 alveolar-arterial oxygen pressure difference (P(A-a)DO2) to arterial oxygen pressure (P(a)O2) was calculated. RESULTS: At day 7, the levels of central venous and arterial blood oxygen content were significantly higher in the HVHF vs. the control group (both with p < 0.05). The level of oxygen extraction ratio (O2ER) was significantly higher in the HVHF than the control group (p < 0.01). The levels of P(A-a)DO2 and RI were significantly lower in the HVHF than the control group (p < 0.05 and p < 0.01, respectively). RI and the ratio of P(a)O2 to the fraction of inspired oxygen were significantly higher in the HVHF than the control group (p < 0.05 and p < 0.01, respectively). The acute physiology and chronic health evaluation score and the sequential organ failure assessment score in the HVHF group were significantly lower compared to the control group (p < 0.01 and p < 0.05, respectively). At day 28, the mortality rate was lower in the HVHF vs. the control group (p < 0.01). CONCLUSIONS: These findings demonstrated that HVHF, when used as an adjunctive therapy to the EGDP protocol, could improve alveolar-arterial oxygen exchange, clinical outcome and survival in patients with refractory septic shock.


Asunto(s)
Presión Arterial , Hemofiltración/métodos , Oxígeno/sangre , Adulto , Anciano , Análisis de los Gases de la Sangre , Femenino , Hemodinámica , Humanos , Masculino , Persona de Mediana Edad , Puntuaciones en la Disfunción de Órganos , Estudios Prospectivos , Choque Séptico/terapia
18.
Genet Mol Res ; 14(4): 16521-34, 2015 Dec 09.
Artículo en Inglés | MEDLINE | ID: mdl-26662451

RESUMEN

Hepatitis B virus genotype C (HBV/C) has the largest number of subgenotypes (C1-C16) that vary with geography and isolates. HBV/C prevails in Southeast Asia (C1, C5-C16), East Asia (C2), Oceania (C3), and Australia (C4). Suitable reference strains for different subgenotypes could greatly facilitate research into HBV/C, but unfortunately they are scarce. We retrieved 974 HBV/C full-length sequences from the GenBank database and subgenotyped them by phylogenetic analysis. Reference sequences of each subgenotype from different locations were established with the most frequent nucleotide present at each position of the isolates that belonged to the same subgenotype. The reference sequences of subgenotypes C1, C2, C5, and C6 have been constructed and deposited in GenBank (KM999990-KM999993). The homology between the reference sequences and almost all the isolates belonging to the corresponding subgenotype was higher than 96%. Similarly, bootstrap values in phylogenetic trees supported clustering of reference strains with isolates belonging to the same subgenotypes. Moreover, both homology and phylogeny analyses showed that reference sequences had significant heterogeneity with isolates from other genotypes and subgenotypes. Sequence analysis further revealed that the mutation rate in the basal core promoter (BCP) region was extremely high in HBV/C2, relatively high in HBV/C1, but lower in HBV/C5 and HBV/C6. Mutations in the pre-core (Pre-C) region were common in HBV/C but the mutation rate was lower than in the BCP. HBV/ C5 has the oldest ancestral age, followed by C6, which is much more ancient than C1 and C2. This study successfully established references for HBV/C subgenotypes.


Asunto(s)
Genotipo , Virus de la Hepatitis B/genética , Hepatitis B/virología , Asia Sudoriental , Secuencia de Bases , Evolución Molecular , Genoma Viral , Hepatitis B/diagnóstico , Virus de la Hepatitis B/clasificación , Humanos , Datos de Secuencia Molecular , Mutación , Filogenia , Filogeografía , Alineación de Secuencia , Análisis de Secuencia de ADN
19.
Genet Mol Res ; 14(4): 15683-96, 2015 Dec 02.
Artículo en Inglés | MEDLINE | ID: mdl-26634536

RESUMEN

The voltage-dependent anion channel (VDAC), also known as a mitochondrial porin, plays an important role in the regulation of metabolic and energetic functions of mitochondria, as well as in mitochondria-mediated apoptosis. Cytoplasmic male sterility (CMS) is of major economic importance for commercial hybrid production and a research model for the interaction be-tween nuclear and cytoplasmic genomes. Recent research has revealed that CMS is associated with programmed cell death. Here, we used the Honglian (HL)-CMS line of rice (Oryza sativa) as material to investigate the association of O. sativa VDAC (OsVDAC) expression to CMS. Eight VDACs were extracted from rice in this study. Bioinformatic analysis of the rice VDACs was conducted at the DNA, cDNA, and protein level. Expression patterns of OsVDACs were analyzed in different organs and during different stages of pollen development using sterile line YuetaiA (YTA), and its maintainer line YuetaiB (YTB). Differential expression of OsVDACs between YTA and YTB was observed, suggesting that VDACs may be involved in the formation of HL-CMS.


Asunto(s)
Regulación de la Expresión Génica de las Plantas , Genómica , Familia de Multigenes , Oryza/genética , Canales Aniónicos Dependientes del Voltaje/genética , Mapeo Cromosómico , Análisis por Conglomerados , Biología Computacional/métodos , Duplicación de Gen , Perfilación de la Expresión Génica , Orden Génico , Redes Reguladoras de Genes , Sitios Genéticos , Genoma de Planta , Oryza/clasificación , Oryza/metabolismo , Filogenia , Canales Aniónicos Dependientes del Voltaje/metabolismo
20.
Genet Mol Res ; 14(4): 13746-53, 2015 Oct 29.
Artículo en Inglés | MEDLINE | ID: mdl-26535690

RESUMEN

Sepsis is a major cause of morbidity and mortality in critically ill patients. The sepsis syndrome results from a dysregulated inflammatory response to infection that leads to multiple-organ failure, but the underlying mechanisms remain poorly understood. More and more reports show that microRNAs (miRNAs) play an important role in sepsis. In the progression of this syndrome, cells change their behavior in response to cytokines stimulated by sepsis, such as interleukin-10 (IL-10). IL-10 can activate JAK2-STAT3 in the cells to protect them from damage. miR-29a is a potential miRNA directly targeting STAT3. In this study, we investigate the role of miR-29a in targeting STAT3 during sepsis. When cells were treated with IL-10, STAT3 was activated in monocytes, as determined using western blotting. It was verified that STAT3 was a new target gene of miR-29a. miR-29a could inhibit IL-10-induced cytokine release by targeting JAK-STAT3 in monocytes. In conclusion, this study demonstrates for the first time that miR-29a inhibits STAT3 in human monocytes during sepsis.


Asunto(s)
Apoptosis/genética , MicroARNs/genética , Monocitos/metabolismo , Interferencia de ARN , Factor de Transcripción STAT3/genética , Sepsis/genética , Apoptosis/efectos de los fármacos , Secuencia de Bases , Sitios de Unión , Línea Celular , Expresión Génica , Regulación de la Expresión Génica , Genes Reporteros , Humanos , Interleucina-10/sangre , Interleucina-10/genética , Interleucina-10/metabolismo , Interleucina-10/farmacología , MicroARNs/química , Monocitos/efectos de los fármacos , ARN Mensajero/química , ARN Mensajero/genética
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