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1.
J Immunol ; 2021 Apr 05.
Artículo en Inglés | MEDLINE | ID: mdl-33820854

RESUMEN

RUNX1 overlapping RNA (RUNXOR) is a long noncoding RNA and a key regulator of myeloid-derived suppressor cells (MDSCs) via targeting runt-related transcription factor 1 (RUNX1). We and others have previously reported MDSC expansion and inhibition of host immune responses during viral infections; however, the mechanisms regulating MDSC differentiation and suppressive functions, especially the role of RUNXOR-RUNX1 in the regulation of MDSCs in people living with HIV (PLHIV), remain unknown. In this study, we demonstrate that RUNXOR and RUNX1 expressions are upregulated in MDSCs that expand and accumulate in human PBMCs derived from PLHIV. We found that the upregulation of RUNXOR and RUNX1 is associated with the expressions of several key immunosuppressive molecules, including arginase 1, inducible NO synthase, STAT3, IL-6, and reactive oxygen species. RUNXOR and RUNX1 could positively regulate each other's expression and control the expressions of these suppressive mediators. Specifically, silencing RUNXOR or RUNX1 expression in MDSCs from PLHIV attenuated MDSC expansion and immunosuppressive mediator expressions, whereas overexpressing RUNXOR in CD33+ myeloid precursors from healthy subjects promoted their differentiation into MDSCs and enhanced the expression of these mediators. Moreover, loss of RUNXOR-RUNX1 function in MDSCs improved IFN-γ production from cocultured autologous CD4 T cells derived from PLHIV. These results suggest that the RUNXOR-RUNX1 axis promotes the differentiation and suppressive functions of MDSCs via regulating multiple immunosuppressive signaling molecules and may represent a potential target for immunotherapy in conjunction with antiviral therapy in PLHIV.

2.
Zhongguo Zhen Jiu ; 41(3): 335-8, 2021 Mar 12.
Artículo en Chino | MEDLINE | ID: mdl-33798321

RESUMEN

It is to determine the effect mechanism and therapeutic method of the idea as "guiding meridian sinew qi along with meridian running course" for meridian sinew disorders so as to provide the reference for clinical treatment of these disorders. "Guiding meridian sinew qi along with meridian running course" is the summary for the approach to meridian sinew disorders by YANG Shang-shan, recorded in Huangdi Mingtang Jing (The Yellow Emperor's Acupoints Canon of Mingtang ), but the concrete statement on it had been lost. By investigating the existing ancient works, the authors discussed the specific meaning of jinqi (meridian sinew qi ), the relationship between jingjin (meridian sinew) and jingmai (meridian), the method of "guiding meridian sinew qi along with meridian running course" and its preferable acupoint selection for treatment of meridian sinew disorders with both the primary and the secondary considered.


Asunto(s)
Terapia por Acupuntura , Meridianos , Carrera , Puntos de Acupuntura , Qi
3.
Autism ; : 13623613211004054, 2021 Apr 12.
Artículo en Inglés | MEDLINE | ID: mdl-33845648

RESUMEN

LAY ABSTRACT: The Autism Spectrum Rating Scale is a behavioural rating scale completed by parents and teachers that is useful for identifying children with an autism spectrum disorder. The development of a modified Autism Spectrum Rating Scale suitable for use in China is important for the identification of children in China with an autism spectrum disorder. In this study, we examined the Modified Chinese Autism Spectrum Rating Scale using a statistical technique known as Rasch analysis. Rasch analysis tests whether the questionnaire meets the standards for modern scientific measurement. We used Rasch analysis to examine data from 2013 children in China including 420 diagnosed with an autism spectrum disorder who had been rated by a parent or grandparent. After removing a small number of items (questions), the Modified Chinese Autism Spectrum Rating Scale met the stringent criteria for Rasch measurement. The availability of a reliable and precise tool for assessing behaviours characteristic of an autism spectrum disorder in Chinese children will improve the identification and diagnosis of autism spectrum disorder in China, thus enabling better provision of support services.

4.
Biomed Res Int ; 2021: 6648078, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33824874

RESUMEN

Purpose: This study is aimed at investigating the expression, underlying biological function, and clinical significance of coatomer protein complex subunit beta 2 (COPB2) in hepatocellular carcinoma (HCC). Methods: HCC-related data were extracted from The Cancer Genome Atlas (TCGA) database, International Cancer Genome Consortium (ICGC) database, and Gene Expression Omnibus (GEO) database. A logistic regression module was applied to analyze the relationship between the expression of COPB2 and clinicopathologic characteristics. The Cox proportional hazard regression model and Kaplan-Meier method were used for survival analysis. Gene set enrichment analysis (GSEA) was used to annotate the underlying biological functions. Loss-of-function experiments were conducted to determine the underlying mechanisms. Results: COPB2 was overexpressed in HCC, and high expression of COPB2 was significantly correlated with higher alpha fetoprotein (AFP) (odds ratio (OR) = 1.616, >20 vs. ≤20, p < 0.05), stage (OR = 1.744, III vs. I, p < 0.05), and grade (OR = 1.746, G4+G3 vs. G2+G1, p < 0.05). Kaplan-Meier survival analysis showed that HCC patients with high COPB2 expression had a worse prognosis than those with low COPB2 expression (p < 0.0001 for TCGA cohort, p < 0.05 for ICGC cohort). The univariate Cox (hazard ratio (HR) = 1.068, p < 0.0001) and multivariate Cox (HR = 2.011, p < 0.05) regression analyses suggested that COPB2 was an independent risk factor. GSEA showed that mTOR and other tumor-related signaling pathways were differentially enriched in the high COPB2 expression phenotype. Silencing of COPB2 inhibited the proliferation, migration, and invasion abilities by suppressing epithelial-mesenchymal transition and mTOR signaling. Conclusion: COPB2 is a novel prognostic biomarker and a promising therapeutic target for HCC.

5.
Microb Ecol ; 2021 Apr 03.
Artículo en Inglés | MEDLINE | ID: mdl-33811505

RESUMEN

Diversity of microbial eukaryotes is estimated largely based on sequencing analysis of the hypervariable regions of 18S rRNA genes. But the use of different regions of 18S rRNA genes as molecular markers may generate bias in diversity estimation. Here, we compared the differences between the two most widely used markers, V4 and V9 regions of the 18S rRNA gene, in describing the diversity of epipelagic, bathypelagic, and hadal picoeukaryotes in the Challenger Deep of the Mariana Trench, which is a unique and little explored environment. Generally, the V9 region identified more OTUs in deeper waters than V4, while the V4 region provided greater Shannon diversity than V9. In the epipelagic zone, where Alveolata was the dominant group, picoeukaryotic community compositions identified by V4 and V9 markers are similar at different taxonomic levels. However, in the deep waters, the results of the two datasets show clear differences. These differences were mainly contributed by Retaria, Fungi, and Bicosoecida. The primer targeting the V9 region has an advantage in amplifying Bicosoecids in the bathypelagic and hadal zone of the Mariana Trench, and its high abundance in V9 dataset pointed out the possibility of Bicosoecids as a dominant group in this environment. Chrysophyceae, Fungi, MALV-I, and Retaria were identified as the dominant picoeukaryotes in the bathypelagic and hadal zone and potentially play important roles in deep-sea microbial food webs and biogeochemical cycling by their phagotrophic, saprotrophic, and parasitic life styles. Overall, the use of different markers of 18S rRNA gene allows a better assessment and understanding of the picoeukaryotic diversity in deep-sea environments.

6.
Sensors (Basel) ; 21(6)2021 Mar 18.
Artículo en Inglés | MEDLINE | ID: mdl-33803673

RESUMEN

Robot grasping is an important direction in intelligent robots. However, how to help robots grasp specific objects in multi-object scenes is still a challenging problem. In recent years, due to the powerful feature extraction capabilities of convolutional neural networks (CNN), various algorithms based on convolutional neural networks have been proposed to solve the problem of grasp detection. Different from anchor-based grasp detection algorithms, in this paper, we propose a keypoint-based scheme to solve this problem. We model an object or a grasp as a single point-the center point of its bounding box. The detector uses keypoint estimation to find the center point and regress to all other object attributes such as size, direction, etc. Experimental results demonstrate that the accuracy of this method is 74.3% in the multi-object grasp dataset VMRD, and the performance on the single-object scene Cornell dataset is competitive with the current state-of-the-art grasp detection algorithm. Robot experiments demonstrate that this method can help robots grasp the target in single-object and multi-object scenes with overall success rates of 94% and 87%, respectively.

7.
J Immunol ; 206(8): 1858-1865, 2021 Apr 15.
Artículo en Inglés | MEDLINE | ID: mdl-33771933

RESUMEN

Dominant infiltration of neutrophils is a hallmark of many inflammatory diseases, especially in septic shock. IL-1ß as one of the most early released proinflammatory cytokine in neutrophil, plays a pivotal role in the progress of sepsis. In this study, we built a high-throughput-compatible drug screen assay platform based on our newly constructed reporter C57BL/6 mice, pIL1-DsRed, expressing the DsRed gene under the control of the IL-1ß promoter. After screening 1200 U.S. Food and Drug Administration-approved compounds, we found that pinaverium bromide (PVB) significantly suppressed the DsRed expression of primed neutrophil and improved the survival rate of mice given LPS in an endotoxin challenge analogous to sepsis, regardless of whether PVB was administered before or after LPS. PVB also protected the liver and lung from LPS-induced damage and reduced organ-specific inflammatory responses. PVB decreased the production of IL-1ß, IL-6, and CXCL1 mRNA in the lungs of LPS-treated mice and decreased the serum levels of liver transaminases (alanine aminotransferase and aspartate aminotransferase) at multiple time points and doses tested. PVB can significantly suppress primed neutrophil-specific respiratory bursts and migration as well. Lastly, PVB affected neutrophils' gene expression and phenotypic changes during neutrophil priming. PVB downregulated GM-CSF-induced expression of CD54 and dectin-2 (markers of fully primed neutrophils) at both mRNA and protein levels during late-phase neutrophil priming. In summary, we demonstrated that PVB can be used as a potential therapeutic agent for sepsis by inhibiting neutrophil priming.

8.
Bioresour Technol ; 329: 124887, 2021 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-33647603

RESUMEN

Rechargeable microbial electrochemical systems can be used as renewable energy storage systems or as potable bioelectronics devices. In this study, a bioelectrode capable of bidirectional extracellular electron transfer was firstly introduced to construct the rechargeable microbial fuel cell (MFC). The performance of rechargeable MFC was enhanced with the increase of charge/discharge cycles, and a maximum energy efficiency of 4.5 ± 0.2% and Coulombic efficiency of 29.4 ± 4.1% were obtained. H2 was the main charge carrier, while the accumulated acetate was only about 10 mg L-1. The charge time under constant current mode largely affected the energy recovery. A decreased abundance of Mycobacteria, Geobacter, and Azospirillum, accompanied by an increase of Azonexus and Rhodococcus was observed in the rechargeable MFC, compared to control tests fueled with acetate. This study demonstrates the potential of bioelectrode for energy storage and recovery.


Asunto(s)
Fuentes de Energía Bioeléctrica , Geobacter , Electrodos , Transporte de Electrón , Electrones
9.
Theor Appl Genet ; 2021 Mar 25.
Artículo en Inglés | MEDLINE | ID: mdl-33768281

RESUMEN

KEY MESSAGE: Genomic prediction with special weight of major genes is a valuable tool to populate bio-digital resource centers. Phenotypic information of crop genetic resources is a prerequisite for an informed selection that aims to broaden the genetic base of the elite breeding pools. We investigated the potential of genomic prediction based on historical screening data of plant responses against the Barley yellow mosaic viruses for populating the bio-digital resource center of barley. Our study includes dense marker data for 3838 accessions of winter barley, and historical screening data of 1751 accessions for Barley yellow mosaic virus (BaYMV) and of 1771 accessions for Barley mild mosaic virus (BaMMV). Linear mixed models were fitted by considering combinations for the effects of genotypes, years, and locations. The best linear unbiased estimations displayed a broad spectrum of plant responses against BaYMV and BaMMV. Prediction abilities, computed as correlations between predictions and observed phenotypes of accessions, were low for the marker-assisted selection approach amounting to 0.42. In contrast, prediction abilities of genomic best linear unbiased predictions were high, with values of 0.62 for BaYMV and 0.64 for BaMMV. Prediction abilities of genomic prediction were improved by up to ~ 5% using W-BLUP, in which more weight is given to markers with significant major effects found by association mapping. Our results outline the utility of historical screening data and W-BLUP model to predict the performance of the non-phenotyped individuals in genebank collections. The presented strategy can be considered as part of the different approaches used in genebank genomics to valorize genetic resources for their usage in disease resistance breeding and research.

10.
Aging (Albany NY) ; 132021 Mar 19.
Artículo en Inglés | MEDLINE | ID: mdl-33744846

RESUMEN

Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In this study, we collected open access data to analyze the mechanisms associated with SARS-CoV-2 infection. Gene set enrichment analysis (GSEA) revealed that apoptosis-related pathways were enriched in the cells after SARS-CoV-2 infection, and the results of differential expression analysis showed that biological functions related to endoplasmic reticulum stress (ERS) and lipid metabolism were disordered. TMBIM6 was identified as a potential target for SARS-CoV-2 in host cells through weighted gene coexpression network analysis (WGCNA) of the time course of expression of host and viral proteins. The expression and related functions of TMBIM6 were subsequently analyzed to illuminate how viral proteins interfere with the physiological function of host cells. The potential function of viral proteins was further analyzed by GEne Network Inference with Ensemble of trees (GENIE3). This study identified TMBIM6 as a target protein associated with the pathogenesis of SARS-CoV-2, which might provide a novel therapeutic approach for COVID-19 in the future.

12.
Glob Chang Biol ; 2021 Mar 11.
Artículo en Inglés | MEDLINE | ID: mdl-33709545

RESUMEN

Temperature sensitivity (Q10 ) of soil organic matter (SOM) decomposition is a crucial parameter to predict the fate of soil carbon (C) under global warming. Nonetheless, the response pattern of Q10 to continuous warming and the underlying mechanisms are still under debate, especially considering the complex interactions between Q10 , SOM quality, and soil microorganisms. We examined the Q10 of SOM decomposition across a mean annual temperature (MAT) gradient from -1.9 to 5.1°C in temperate mixed forest ecosystems in parallel with SOM quality and bioavailability, microbial taxonomic composition, and functional genes responsible for organic carbon decomposition. Within this temperature gradient of 7.0°C, the Q10 values increased with MAT, but decreased with SOM bioavailability. The Q10 values increased with the prevalence of K-strategy of soil microbial community, which was characterized by: (i) high ratios of oligotrophic to copiotrophic taxa, (ii) ectomycorrhizal to saprotrophic fungi, (iii) functional genes responsible for degradation of recalcitrant to that of labile C, and (iv) low average 16S rRNA operon copy number. Because the recalcitrant organic matter was mainly utilized by the K-strategists, these findings independently support the carbon quality-temperature theory from the perspective of microbial taxonomic composition and functions. A year-long incubation experiment was performed to determine the response of labile and recalcitrant C pools to warming based on the two-pool model. The decomposition of recalcitrant SOM was more sensitive to increased temperature in southern warm regions, which might attribute to the dominance of K-selected microbial communities. It implies that climate warming would mobilize the larger recalcitrant pools in warm regions, exacerbating the positive feedback between increased MAT and CO2 efflux. This is the first attempt to link temperature sensitivity of SOM decomposition with microbial eco-strategies by incorporating the genetic information and disentangling the complex relationship between Q10 and soil microorganisms.

13.
Lancet Respir Med ; 2021 Mar 26.
Artículo en Inglés | MEDLINE | ID: mdl-33780662

RESUMEN

BACKGROUND: Furmonertinib (AST2818) is a third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) targeting both sensitising EGFR and EGFR Thr790Met (T790M) mutations. This study aimed to assess the efficacy and safety of furmonertinib in patients with EGFR T790M mutated advanced non-small-cell lung cancer (NSCLC). METHODS: This study was a single-arm, open-label, phase 2b study at 46 hospitals across mainland China. Patients with locally advanced or metastatic NSCLC with centrally confirmed EGFR T790M mutations in tumour tissue who progressed after first or second generation EGFR TKIs or with primary EGFR T790M mutations received furmonertinib 80 mg orally once daily. The primary endpoint was objective response rate. Efficacy was assessed by blinded independent central review as per the Response Evaluation Criteria in Solid Tumors (version 1.1) in all patients who had measurable disease at baseline and received at least one dose of furmonertinib. Safety was assessed as per the Common Terminology Criteria for Adverse Events (version 4.03) in all patients who received at least one dose of furmonertinib with at least one safety assessment during follow-up. This study is registered with ClinicalTrials.gov (NCT03452592) and is ongoing for survival follow-up. FINDINGS: From Jun 4, 2018, to Dec 8, 2018, 220 patients received furmonertinib treatment. All 220 patients were included in the efficacy and safety analyses. At the data cutoff point of Jan 29, 2020, 71 (32%) patients remained on treatment. The median duration of follow-up was 9·6 months (range 0·7-19·4). The objective response rate was 74% (163 of 220 [95% CI 68-80]). Grade 3 or higher adverse events occurred in 58 (26%) patients and treatment-related grade 3 or higher adverse events occurred in 25 (11%) patients. The most common all-cause grade 3 or higher adverse events were increased γ-glutamyltransferase (five; 2%), increased aspartate aminotransferase, increased alanine aminotransferase, hyponatraemia, hypertension, pulmonary infection, hypermagnesaemia, and pericardial effusion (three each; 1%). Treatment-related diarrhoea was reported in ten (5%) patients and rashes were reported in 16 (7%) patients, all grade 1-2. Serious adverse events were reported in 52 (24%) patients, of which 12 (5%) were possibly treatment-related as evaluated by the investigator. INTERPRETATION: Furmonertinib has promising efficacy and an acceptable safety profile for the treatment of patients with EGFR T790M mutated NSCLC. Furmonertinib is expected to become a new treatment option after first or second generation EGFR TKIs in the Chinese population. FUNDING: Shanghai Allist Pharmaceutical Technology, Ministry of Science and Technology of the People's Republic of China, and Chinese Academy of Medical Sciences. TRANSLATION: For the Chinese translation of the abstract see Supplementary Materials section.

14.
Materials (Basel) ; 14(4)2021 Feb 15.
Artículo en Inglés | MEDLINE | ID: mdl-33672091

RESUMEN

The impact toughness of low-Cr heat-resistant steel weld metal is an important problem to broaden the application of low-Cr heat-resistant steel. In this study, the microstructure and impact toughness of 12Cr1MoVR low-alloy heat-resistant steel weld metals with various boron contents (B1 = 0.0028%, B2 = 0.0054%, and B3 = 0.0079%) were investigated. The microstructures of all weld metals were composed of block ferrite, carbides, and inclusions. Results indicated that with increased B content, prior austenite grain sizes decreased, and minor microstructure changes could be found. With the increase in B content from 0.0028% to 0.0054% to 0.0079%, the ductile-brittle transition temperature of the weld metals decreased from 30 to 0 to -14 °C, the toughness of weld metal increased, and the hardness slightly decreased, all of which are directly related to the refinement of prior austenite grain size because of the addition of B content. However, on the top-shelf zone, such as at the testing temperature of 80 °C, ductile fracture dominates the fracture surface; with the increase in B content, the size and density of inclusions increased gradually, which led to the decrease of the impact toughness at 80 °C when the B content was 0.0079%.

15.
Sci Total Environ ; 771: 144912, 2021 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-33736162

RESUMEN

Nematodes generally occupy multiple trophic levels in detrital food webs, which play a vital role in energy flow, material conversion and nematodes community structure stability in the underground ecosystem. Sulfur (S) is one of the important soil nutrients, and it plays an important role in the nutrient cycle of grassland ecosystem. However, the impacts of S on soil fauna and subsurface detrital food webs in grassland ecosystems were rarely studied. Accordingly, to investigate the effects of sulfur deposition on soil nematodes and detrital food webs, we conducted a S addition experiment with distinct intensities from 0 to 50 g S m-2 yr-1 (S 0, S 1, S 2, S 5, S 10, S 15, S 20, and S 50) to simulated sulfur deposition in a meadow steppe of northern China. We documented a significant effect of S addition on the diversity and richness of nematodes, and the species richness of soil nematodes was high in the study site. But S addition had no significant effect on the total abundance and dominant species of nematodes (Cervidellus and Aphelenchus). Results of correlation analysis and structural equation modeling consistently indicated that omnivores-predators were significantly affected by sulfur addition. A significant increase in the Structural Index (which indicates food web structure) suggested increased top-down forces and changed community structure, although bacterivores, fungivores, plant parasites did not significantly. The present results suggest that sulfur deposition would change the composition of nematode community, affect the stability of nematode community structure, and increase the disturbance to the underground ecosystem. The study provides that the detailed information of the response of nematode to S deposition can be used to analyze the process of global change affecting the underground ecosystem.


Asunto(s)
Nematodos , Suelo , Animales , China , Ecosistema , Azufre
16.
Anim Biotechnol ; : 1-11, 2021 Mar 22.
Artículo en Inglés | MEDLINE | ID: mdl-33752552

RESUMEN

Totally, 315 42-day-old male Xueshan chickens were allocated into 3 caging densities, 14, 21 and 28 birds/m2. Each treatment was represented by 5 replicates. The body weight (BW), slaughter performance, meat quality, behavioral assessment, and the cecal microorganisms were detected at the market age. The results showed that the BW of broilers in the low- and medium-density groups was significantly higher (p < 0.05) than that of the high-density group from the age of 10 weeks. Only the feather quality of the broilers in the low-density group improved significantly (p < 0.05) compared with those of the other two groups. And, the abdominal fat percentage and the fat content of thigh muscle of broilers in the low- and medium-density groups were higher (p < 0.05) than those in the high-density group. No significant difference (p > 0.05) was noted in the other traits. The abundance of some microbial like Akkermansiaceae, Lactobacillaceae and Faecalibacterium may be correlated with the BW and fat content of broilers. The findings of this study suggest that increasing the stocking density decreased the final BW, fat content and the feather quality, whereas no evidence was found that stocking density caused changes in other parameters.

17.
Ecology ; : e03348, 2021 Mar 23.
Artículo en Inglés | MEDLINE | ID: mdl-33755986

RESUMEN

Natural abundance of carbon (C) and nitrogen (N) stable isotope ratios (δ13 C and δ15 N) has been used to indicate ecosystem C and N status and cycling; however, use of this approach to infer plant and microbial N preference under projected ecosystem N enrichment is limited. Here, we investigated natural abundance δ13 C and δ15 N of five dominant plant species, and soil δ15 N of microbial biomass and available N forms under N addition in a meadow steppe. Additional N, applied as urea, led to decreases in δ15 N of soil NO3 - (δ15 Nnitrate , from 3.0 to 0.4‰) and increases in δ15 N of soil NH4 + (δ15 Nammonium , from -1.3 to 11‰) and dissolved organic N (δ15 NDON , from 8.5 to 15‰) that reflected increased net nitrification rates, a possible increase in NH3 volatilization, and greater availability of the three N forms. An overall increase in δ15 N of soil total N (δ15 NTN ) from 7.1 to 7.9‰ indicated accelerated and greater openness of soil N cycling that was also partially revealed by enhanced net N mineralization rates. Plant δ15 N, which ranged from -1.8 to 2.1‰, generally decreased with N addition, indicating a greater reliance on soil NO3 - under N-enrichment conditions. Nitrogen addition decreased δ15 N of microbial biomass N (from 14 to 2.8‰), possibly due to a shift in preferential N form (DON to NO3 - ), that indicated a convergence of plant and microbial preferential N forms and an increase in plant-microbial N competition. Microbes were thus more flexible than plants in the use of different forms of N. Addition of N decreased plant litter δ13 C, while plant species δ13 C remained unaffected, likely due to a shift in the abundance of dominant species with a greater proportion of biomass coming from δ13 C-depleted species. Enrichment factor (the difference in plant δ15 N relative to δ15 NTN ) of four non-legume species was negatively related to soil inorganic N availability, net nitrification rate, and net N mineralization rate, and was proven to be a good indicator of ecosystem N status. Our study highlights the importance of natural abundance of 15 N as an indicator of plant-microbial N competition and ecosystem N cycling in meadow steppe grasslands under projected ecosystem N enrichment.

18.
Stroke Vasc Neurol ; 2021 Mar 16.
Artículo en Inglés | MEDLINE | ID: mdl-33727409

RESUMEN

BACKGROUNDS: Increased blood pressure (BP) for patients who had an acute ischaemic stroke is associated with poor functional outcome, however the optimal timing of antihypertensive therapy is unknown. AIMS: We aim to compare early antihypertensive treatment to delayed antihypertensive treatment for reducing the risk of composite major disability and mortality at 3 months in acute ischaemic stroke. DESIGN: The China Antihypertensive Trial in Acute Ischemic Stroke II (CATIS-2) trial is a multicentre, randomised, open-label, blinded-endpoints trial that will be conducted in 100 hospitals in China. The primary outcome is the composite of death and major disability (modified Rankin Scale score ≥3) at 3 months of randomisation. Antihypertensive treatment will be received immediately after randomisation in the early treatment group, aimed at average systolic BP by 10%-20% reduction within the first 24 hours, and achieving an average BP level of <140/90 mm Hg within 5 days. Patients in the delayed treatment group will discontinue any antihypertension medications for the first 7 days of randomisation, and will receive antihypertensive therapy achieving a BP goal of <140/90 mm Hg after 7 days. CONCLUSION: The CATIS-2 trial will be testing the hypotheses that early BP lowering leads to improved functional outcome without any other harms, and developing clinical guidelines of the BP management for patients who had an acute ischaemic stroke. TRIAL REGISTRATION NUMBER: NCT03479554.

19.
Respir Care ; 2021 Mar 27.
Artículo en Inglés | MEDLINE | ID: mdl-33774597

RESUMEN

Background: Until now, transfusion-related acute lung injury (TRALI) has been considered to be the leading cause of blood transfusion-related diseases and death. And there is no clinically effective treatment plan for TRALI. The aim of this study was to systematically summarize the literature on risk factors for TRALI in critical patients.Methods: Electronic searches (up to March 2020) were performed in the Cochrane Library, Web of Knowledge, Embase, and PubMed databases. We included studies reporting on the risk factors of TRALI for critical patients and extracted the risk factors. Finally, thirteen studies met the inclusion criteria.Results: We summarized and analyzed the potential risk factors of TRALI for critical patients in 13 existing studies. The host-related factors were age (odds ratio (OR) [95% confidence interval] = 1.16 [1.08-1.24]), female sex (OR = 1.26 [1.16-1.38]), tobacco use status (OR = 3.82 [1.91-7.65]), chronic alcohol abuse (OR = 3.82 [2.97-26.83]), positive fluid balance (OR = 1.24 [1.08-1.42]), shock before transfusion (OR = 4.41 [2.38-8.20]), and ASA score of the recipients (OR = 2.72 [1.43-5.16]). The transfusion-related factors were the number of transfusions (OR = 1.40 [1.14-1.72]) and fresh frozen plasma (FFP) units (OR = 1.21 [1.01-1.46]). The device-related factor was mechanical ventilation (OR = 4.13 [2.20-7.76]).Conclusions: The risk factors for TRALI in this study included Number of transfusions and FFP units were positively correlated with TRALI. Age, female sex, tobacco use, chronic alcohol abuse, positive fluid balance, shock before transfusion, ASA score and mechanical ventilation may be potential risk factors for TRALI. Our study suggests that host-related risk factors may play a more important role in the occurrence and development of TRALI than blood transfusion-related risk factors.

20.
J Int AIDS Soc ; 24(2): e25667, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33586841

RESUMEN

INTRODUCTION: This study explores the preference for daily versus on-demand pre-exposure prophylaxis (PrEP) among men who have sex with men (MSM) in developing countries when both regimens are available. METHODS: From 11 December 2018 to 19 October 2019, we recruited MSM for an open-label real-world PrEP demonstration study in four major cities in China. Subjects selected their preferred PrEP (oral tenofovir/emtricitabine) regimen (daily vs. on-demand) at recruitment and underwent on-site screening before initiation of PrEP. We used logistic regression to assess preference for daily PrEP and correlates. RESULTS: Of 1933 recruited MSM, the median age was 29 years, 7.6% was currently married to or living with a female; the median number of male sexual partners was four and 6.1% had used post-exposure prophylaxis (PEP) in the previous six months. HIV infection risk was subjectively determined as very high (>75%) in 7.0% of subjects, high (50% to 75%) in 13.3%, moderate (25% to 49%) in 31.5% and low or none (0% to 24%) in 48.1%. On average, participants preferred on-demand PrEP over daily PrEP (1104 (57.1%) versus 829 (42.9%)) at recruitment. In multivariable analysis, currently being married to or living with a female was associated with 14.6 percentage points lower preference for daily PrEP (marginal effect = -0.146 [95% CI: -0.230, -0.062], p = 0.001); whereas the number of male sexual partners (marginal effect = 0.003 [95% CI: 0.000, 0.005], p = 0.034) and a subjective assessment of being very high risk of HIV infection (vs. low and no risk, marginal effect size = 0.105 [95% CI: 0.012, 0.198], p = 0.027) were associated with increased preference for daily versus on-demand PrEP. Among the 1933 potential participants, 721 (37.3%) did not attend the subsequent on-site screening. Lower-income, lower education level, lower subjective expected risk of HIV infection risk and younger age positively correlated with the absence of on-site screening. CONCLUSIONS: MSM in China prefer both daily and on-demand PrEP when both regimens are provided free. Social structural factors and subjective risk of HIV infection have significant impacts on PrEP preference and use. The upcoming national PrEP guideline should consider incorporating both regimens and the correlates to help implement PrEP in China.

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