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4.
Zhonghua Fu Chan Ke Za Zhi ; 56(12): 842-848, 2021 Dec 25.
Artículo en Chino | MEDLINE | ID: mdl-34954962

RESUMEN

Objective: To investigate the clinical features and long-term prognosis of patients co-existing with ovarian endometrioma (OMA) and deep infiltrating endometriosis (DIE). Methods: Totally 358 OMA patients were retrospectively analyzed, who had a minimum of 8 years follow-up after laparoscopic cystectomy, which was performed by one professional endometriosis surgery team at Peking Union Medical College Hospital from January 2009 to April 2013. All women were divided into DIE group and non-DIE group, and analysis was performed in preoperative characteristics, surgical findings and postoperative outcomes during follow-up. Results: A total of 358 OMA patients were included, of which 190 patients (53.1%, 190/358) were in the DIE group, while other 168 patients (46.9%, 168/358) in the non-DIE group. The average ages between the two groups were (33.7±5.4), (32.5±5.3) years (P=0.047), the average parity was (0.4±0.6) times vs (0.3±0.5) times (P=0.079). There were significant differences in the proportions of moderate to severe dysmenorrhea [67.4% (128/190) vs 56.5% (95/168)], chronic pelvic pain [24.2% (46/190) vs 7.7% (13/168)], and the increase in CA125 [79.9% (139/190) vs 65.2% (101/168)] between the two groups (all P<0.05). The average operation time in the DIE and non-DIE groups was (75±21) vs (39±36) minutes (P<0.01). There was a significant difference in adenomyosis presence between the two groups [41.6% (79/190) vs 22.0% (37/168); P=0.001]. All patients were followed up for at least 8 years. At the end of the follow-up, though the DIE group was with higher total rate of disease relapse, yet no significant difference was found between the two groups in statistical comparison [21.6% (41/190) vs 16.1% (27/168); P=0.185]. A total of 41 cases in the DIE group recurred, the recurrence rate of pain was 15.8% (30/190), and the recurrence rate of cyst was 8.4% (16/190); 27 cases had recurrence after operation in the non-DIE group, the recurrence rate of pain was 8.9% (15/168), and the recurrence rate of cyst was 10.7% (18/168). There were no significant differences in the pain recurrence rate (P=0.067) and cyst recurrence rate (P=0.460) between the two groups. As for the successfully pregnant patients, live birth rates were 100.0% (65/65) vs 94.4% (68/72) between DIE group and non-DIE groups (P=0.120). Conclusions: Compared with the non-DIE group, OMA patients with concurrent DIE might have severe pain symptoms, higher probability of abnormal CA125 levels and more severe pelvic adhesions. Although there are no significant differences in the total recurrence rate and the recurrence rate of various types between the two groups, the proportion of pain recurrence in the DIE group is higher than that in the non-DIE group. In terms of fertility outcomes, patients in the DIE group are with lower likelihood of pregnancy after surgery during the long-time follow-up. DIE has no significant influence on the fertility outcome.


Asunto(s)
Adenomiosis , Endometriosis , Laparoscopía , Endometriosis/complicaciones , Endometriosis/cirugía , Femenino , Humanos , Dolor Pélvico/epidemiología , Dolor Pélvico/etiología , Embarazo , Estudios Retrospectivos
6.
Zhonghua Fu Chan Ke Za Zhi ; 55(6): 402-407, 2020 Jun 25.
Artículo en Chino | MEDLINE | ID: mdl-32842247

RESUMEN

Objective: To further understand the current status of diagnosis and treatment of endometriosis in China, the implementation of guideline in different levels of hospitals, and the need for continuing education in endometriosis among primary doctors. Methods: The survey was conducted in the form of convenience sampling questionnaire among the Wechat public platform. The doctors were free to participate in the investigation without any reward. All questions answered were assessed as valid questionnaire. The datas were collected on the questionnaire network platform and analyzed by SPSS 19.0. Results: Totally 1 494 valid questionnaires were collected in this survey. 60.17% (899/1 494) of them were from tertiary hospital, and 32.60% (487/1 494) were from grade two hospital. Only the hospitals where 9.97% (149/1 494) participants based opened the specialist clinic for endometriosis. 70.35% (1 051/1 494) of participants said they had read the second edition of guideline for the diagnosis and treatment of endometriosis which published in 2015. The American Society for Reproductive Medicine (ASRM) staging system was adopted in the clinical practices of only 25.03% (374/1 494) participants. And 18.74% (280/1 494) participants used the endometriosis fertility index (EFI) scoring during the laparoscopic surgery for endometriosis with infertility. 45.18% (675/1 494) of participants said they had not attended any academic conference on endometriosis in the past six months. 64.46% (963/1 494) of the participants believed their diagnosis and treatment in practice should be improved and standardized. 87.15% (1 302/1 494) of the participants expressed the hope that more conferences or workshops on endometriosis would be held. Conclusions: At presents, the diagnosis and treatment of endometriosis in China has been greatly improved, but the implementation of guidelines and the new concept is still a long-term job. The specialist clinic are held only in a few hospitals. It's the expectation and voice of primary doctors to the association to organize the more academic congresses on endometriosis.


Asunto(s)
Endometriosis/patología , Endometriosis/terapia , Infertilidad Femenina/etiología , Dolor Pélvico/patología , China , Endometriosis/complicaciones , Femenino , Fertilidad , Humanos , Infertilidad Femenina/patología , Dolor Pélvico/etiología , Encuestas y Cuestionarios
7.
Zhonghua Yi Xue Za Zhi ; 100(29): 2263-2267, 2020 Aug 04.
Artículo en Chino | MEDLINE | ID: mdl-32746595

RESUMEN

Objective: To discuss the imaging, clinical features and management of diffuse uterine leiomyomatosis (DUL). Methods: Six cases of DUL confirmed in Peking Union Medical College Hospital from August 2009 to September 2019 were reviewed on their image and clinical data. Retrospective analysis was conducted on their perioperative and postoperative follow-up data. Results: The average age of the first diagnosis of DUL was (27±3) years old. All of the patients complained menorrhagia and three patients suffered moderate to severe anemia. Three patients were diagnosed infertility. Pelvic ultrasound and MRI showed symmetrical enlarged uterus with complete replacement of the myometrium by innumerable, confluent leiomyomas.Four patients were treated with GnRH-a before operation to reduce the volume of myoma and correct anemia. Among the six patients, five had undergone myomectomy because of DUL before visiting Peking Union Medical College Hospital. Three patients underwent open myomectomy. The number of resected myoma was 188-300 and the bleeding volume was 1 200-2 500 ml. Two of them suffered recurrence at 51 and 40 months after operation. One received sirolimus for 20 months without recurrence until now. Other three patients underwent hysterectomy. One patient underwent partial small bowel resection and partial omentum resection because of severe pelvic adhesion during hysterectomy, and the blood loss was 2 000 ml. Conclusions: Pelvic imaging especially MRI is helpful for early recognition and preoperative evaluation for DUL. Fertility preservation is a great challenge for DUL patients. The risk of recurrence after myomectomy is high. Hysterectomy is the last choice to completely cure DUL at present.


Asunto(s)
Leiomiomatosis/cirugía , Miomectomía Uterina , Neoplasias Uterinas/cirugía , Adulto , Femenino , Humanos , Histerectomía , Recurrencia Local de Neoplasia , Estudios Retrospectivos , Adulto Joven
9.
Anim Microbiome ; 2(1): 38, 2020 Oct 14.
Artículo en Inglés | MEDLINE | ID: mdl-33499996

RESUMEN

BACKGROUND: Anthelmintic treatment is a risk factor for intestinal disease in the horse, known as colic. However the mechanisms involved in the onset of disease post anthelmintic treatment are unknown. The interaction between anthelmintic drugs and the gut microbiota may be associated with this observed increase in risk of colic. Little is known about the interaction between gut microbiota and anthelmintics and how treatment may alter microbiome function. The objectives of this study were: To characterise (1) faecal microbiota, (2) feed fermentation kinetics in vitro and (3) metabolic profiles following moxidectin administration to horses with very low (0 epg) adult strongyle burdens. HYPOTHESIS: Moxidectin will not alter (1) faecal microbiota, (2) feed fermentation in vitro, or, (3) host metabolome. RESULTS: Moxidectin increased the relative abundance of Deferribacter spp. and Spirochaetes spp. observed after 160 h in moxidectin treated horses. Reduced in vitro fibre fermentation was observed 16 h following moxidectin administration in vivo (P = 0.001), along with lower pH in the in vitro fermentations from the moxidectin treated group. Metabolic profiles from urine samples did not differ between the treatment groups. However metabolic profiles from in vitro fermentations differed between moxidectin and control groups 16 h after treatment (R2 = 0.69, Q2Y = 0.48), and within the moxidectin group between 16 h and 160 h post moxidectin treatment (R2 = 0.79, Q2Y = 0.77). Metabolic profiles from in vitro fermentations and fermentation kinetics both indicated altered carbohydrate metabolism following in vivo treatment with moxidectin. CONCLUSIONS: These data suggest that in horses with low parasite burdens moxidectin had a small but measurable effect on both the community structure and the function of the gut microbiome.

11.
Appl Environ Microbiol ; 86(1)2019 12 13.
Artículo en Inglés | MEDLINE | ID: mdl-31676474

RESUMEN

The intestinal microbiota of the horse, an animal of huge economic and social importance worldwide, is essential to the health of the animal. Understanding the intestinal ecosystem and its dynamic interaction with diet and dietary supplements currently requires the use of experimental animals, with consequent welfare and financial constraints. Here, we describe the development and assessment, using multiple analytical platforms, of a three-vessel, continuous-flow, in vitro model of the equine hindgut. After inoculation of the model with fresh horse feces, the bacterial communities established in each vessel had a taxonomic distribution similar to that of the source animal. Short-chain fatty acid (SCFA) and branched-chain fatty acid (BCFA) production within the model at steady state was consistent with the expected bacterial function, although higher concentrations of some SCFA/BCFA relative to those in the ex vivo gut content were apparent. We demonstrate the intermodel repeatability and the ability of the model to capture some aspects of individual variation in bacterial community profiles. The findings of this proof-of-concept study, including recognition of the limitions of the model, support its future development as a tool for investigating the impact of disease, nutrition, dietary supplementation, and medication on the equine intestinal microbiota.IMPORTANCE The equine gut model that we have developed and describe has the potential to facilitate the exploration of how the equine gut microbiota is affected by diet, disease, and medication. It is a convenient, cost-effective, and welfare-friendly alternative to in vivo research models.


Asunto(s)
Fermentación/fisiología , Microbioma Gastrointestinal/fisiología , Intestino Grueso/microbiología , Modelos Biológicos , Animales , Ácidos Grasos/metabolismo , Ácidos Grasos Volátiles/metabolismo , Heces/microbiología , Caballos , Técnicas In Vitro/métodos , Intestino Grueso/química , Intestino Grueso/fisiología
12.
Diabet Med ; 36(12): 1679-1685, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31407386

RESUMEN

AIM: To evaluate the relationship between maternal thyroid-stimulating hormone levels during the first trimester and gestational diabetes risk. METHODS: In Tianjin, China, 7258 women underwent a thyroid-stimulating hormone screening test within 12 gestational weeks and then had a glucose challenge test at 24-28 weeks of gestational age. The women with a glucose challenge test ≥7.8 mmol/l underwent a 75 g oral glucose tolerance test. Gestational diabetes was diagnosed following International Association of Diabetes and Pregnancy Study Group criteria. Restricted cubic spline analysis was performed to explore full-range risk associations of thyroid-stimulating hormone levels with gestational diabetes. Logistic regression was performed to obtain odds ratios and 95% confidence intervals. RESULTS: In all, 594 women (8.2%) had gestational diabetes. Among women with thyroid-stimulating hormone ≤3.2 mIU/l, a positive association between thyroid-stimulating hormone levels and gestational diabetes risk was found (adjusted OR: 1.13, 95% CI: 1.00-1.27). There was no relationship between thyroid-stimulating hormone levels and gestational diabetes risk in univariable and multivariable analyses among women with thyroid-stimulating hormone >3.2 mIU/l. In subgroup analyses, among women with thyroid-stimulating hormone ≤3.2 mIU/l and BMI ≥25 kg/m2 , the adjusted odds ratio for thyroid-stimulating hormone levels with gestational diabetes was enhanced to 1.25 (95% CI: 1.02-1.53). CONCLUSIONS: In pregnant Chinese women, thyroid-stimulating hormone levels even within normal range in the first trimester were positively related to gestational diabetes risk, especially for pre-pregnancy overweight/obese women.


Asunto(s)
Diabetes Gestacional/sangre , Tirotropina/sangre , Adulto , Índice de Masa Corporal , China , Femenino , Edad Gestacional , Humanos , Obesidad/complicaciones , Oportunidad Relativa , Sobrepeso/complicaciones , Embarazo , Complicaciones del Embarazo/sangre , Primer Trimestre del Embarazo
13.
Zhonghua Wei Chang Wai Ke Za Zhi ; 22(6): 550-559, 2019 Jun 25.
Artículo en Chino | MEDLINE | ID: mdl-31238634

RESUMEN

Objective: To understand the perceptions, attitudes and treatment selection of Chinese surgeons on the "watch and wait" strategy for rectal cancer patients after achieving a clinical complete response (cCR) following neoadjuvant chemoradiotherapy (nCRT). Methods: A cross-sectional survey was used in this study. Selection of subjects: (1) Domestic public grade III A (provincial and prefecture-level) oncology hospitals or general hospitals possessing the radiotherapy department and the diagnosis and treatment qualifications for colorectal cancer. (2) Surgeons of deputy chief physician or above. Using the "Questionnaire Star" online survey platform to create a questionnaire about cognition, attitude and treatment choice of the "watch and wait" strategy after cCR following nCRT for rectal cancer. The questionnaire contained 32 questions, such as the basic information of doctor, the current status of rectal cancer surgery, the management of pathological complete remission (ypCR) after nCRT for rectal cancer, the selection of examination items for diagnosis of cCR, the selection of suitable people undergoing "watch and wait" approach, the nCRT mode for promotion of cCR, the choice of evaluation time point, the willingness to perform "watch and wait" approach and the treatment choice, and the risk and monitoring of "watch and wait" approach. A total of 116 questionnaires were sent to the respondents via WeChat between January 31 and February 19, 2019. Statistical analysis was performed using Fisher's exact test for categorical variables. Results: Forty-eight hospitals including 116 surgeons meeting criteria were enrolled, of whom 77 surgeons filled the questionnaire with a response rate of 66.4%. "Watch and wait" strategy was carried out in 76.6% (59/77) of surgeons. Seventy surgeons (90.9%) were aware of the ypCR rate of rectal cancer after preoperative nCRT and 49 surgeons (63.6%) knew the 3-year disease-free survival of patients with ypCR in their own hospitals. Fifty-five surgeons (71.4%) believed that patients with ypCR undergoing radical surgery met the treatment criteria and were not over-treated. Three most necessary examinations in diagnosing cCR were colonoscopy (96.1%, 74/77), digital rectal examination (DRE) (90.9%,70/77) and DWI-MRI (83.1%, 64/77). Responders preferred to consider a "watch and wait" strategy for patients with baseline characteristics as mrN0 (77.9%, 60/77), mrT2 (68.8%, 53/77) and well-differentiated adenocarcinoma (68.8%, 53/77). Sixty-six surgeons (85.7%) believed that long-term chemoradiotherapy (LCRT) with combination or without combination of induction and/or consolidation of the CapeOX regimen (capecitabine + oxaliplatin) should be the first choice as a neoadjuvant therapy to achieve cCR. Forty-one surgeons (53.2%) believed that a reasonable interval of judging cCR after nCRT should be ≥ 8 weeks. Forty-four surgeons (57.1%) routinely, or in most cases, informed patient the possibility of cCR and proposed to "watch and wait" strategy in the initial diagnosis of patients with non-metastatic rectal cancer. Thirteen surgeons (16.9%) would take the "watch and wait" strategy as the first choice after the patient having cCR. Fifty-two surgeons (67.5%) would be affected by the surgical method, that was to say, "watch and wait" approach would only be recommended to those patients who would achieve cCR and could not preserve the anus or underwent difficult anus-preservation surgery. Sixteen surgeons (20.8%) demonstrated that "watch and wait" strategy would not be recommended to patients with cCR regardless of whether the surgical procedure involved anal sphincter. Eleven surgeons (14.3%) believed that the main risk of "watch and wait" approach came from distant metastasis rather than local recurrence or regrowth. Twenty-nine of surgeons (37.7%) did not understand the difference between "local recurrence" and "local regrowth" during the period of "watch and wait". Twenty-six surgeons (33.8%) thought that the monitoring interval for the first 3 years of "watch and wait" strategy was 3 months, and the follow-up monitoring interval could be 6 months to 5 years. Surgeons from cancer specialist hospitals had higher approval rate, notification rate, and referral rate of "watch and wait" strategy than those from general hospitals. Thirty-one surgeons (42.5%) considered that the difficulty and concern of carrying out "watch and wait" approach in the future was the disease progress leading to medical disputes. Twenty-six surgeons (35.6%) demonstrated that their concern was lack of uniform evaluation standard for cCR. Conclusions: Chinese surgeons seem to have inadequate knowledge of non-operative management for rectal cancer patients achieving cCR after nCRT and show relatively conservative attitudes toward the strategy. Chinese consensus needs to be formed to guide the non-operative management in selected patients. Chinese Watch & Wait Database (CWWD) is also needed to establish and provide more evidence for the use of alternative procedure after a cCR following nCRT.


Asunto(s)
Quimioradioterapia Adyuvante/métodos , Terapia Neoadyuvante , Neoplasias del Recto/terapia , Espera Vigilante/métodos , Actitud del Personal de Salud , Estudios Transversales , Encuestas de Atención de la Salud , Conocimientos, Actitudes y Práctica en Salud , Humanos , Recurrencia Local de Neoplasia , Encuestas y Cuestionarios
14.
Eur Rev Med Pharmacol Sci ; 23(8): 3527-3532, 2019 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-31081109

RESUMEN

OBJECTIVE: The aim of this study was to investigate the role of dexmedetomidine (Dex) in lactate signaling cascade and myocardial ischemia/reperfusion (I/R) injury in mice. MATERIALS AND METHODS: The left anterior descending of the coronary artery was ligatured for 30 min and then reperfused for 6 h to induce myocardial I/R injury in mice. Heart samples were collected and the levels of lactate, SOD and MDA were measured. Infarct size and myocardium were stained with triphenyltetrazolium chloride and TUNEL, respectively. In addition, the expression levels of MCT1, cytochrome c, cleaved caspase-9 and -3 were detected by Western blot. RESULTS: The myocardial infarct size, lactate and MDA levels of the I/R group were significantly increased, whereas the SOD activity was decreased. However, Dex significantly reduced the myocardial infarct size, as well as lactate and MDA levels in contrast to the I/R group. Meanwhile, the SOD activity was remarkably increased. The expression levels of MCT1, cytochrome c, cleaved caspase-9 and -3 were significantly increased in the I/R group. In addition, Dex administration further increased the expression of MCT1, whereas decreased the expressions of cytochrome c, cleaved caspase-9 and -3 in contrast to the I/R group. CONCLUSIONS: Dex elevated the expression of mitochondrial MCT1 and inhibited oxidative stress and the activation of mitochondria-dependent apoptosis in mice. This indicated that Dex attenuated myocardial I/R injury by regulating lactate signaling cascade.


Asunto(s)
Dexmedetomidina/farmacología , Ácido Láctico/metabolismo , Daño por Reperfusión Miocárdica/tratamiento farmacológico , Transducción de Señal/efectos de los fármacos , Animales , Caspasa 3/metabolismo , Caspasa 9/metabolismo , Vasos Coronarios/efectos de los fármacos , Vasos Coronarios/patología , Citocromos c/metabolismo , Dexmedetomidina/uso terapéutico , Modelos Animales de Enfermedad , Humanos , Masculino , Ratones , Mitocondrias/efectos de los fármacos , Mitocondrias/patología , Transportadores de Ácidos Monocarboxílicos/metabolismo , Daño por Reperfusión Miocárdica/patología , Miocardio/citología , Miocardio/patología , Estrés Oxidativo/efectos de los fármacos , Simportadores/metabolismo
15.
Eur Rev Med Pharmacol Sci ; 23(1): 155-161, 2019 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-30657557

RESUMEN

OBJECTIVE: To investigate the effects of epigallocatechin-3-gallate (EGCG) on proliferation and apoptosis of human gastric cancer SGC7901 cells under a hypoxic state. MATERIALS AND METHODS: Human gastric cancer SGC7901 cells were sub-cultured, and the cobalt chloride (CoCl2) hypoxia model was established. The blank control group (normoxia group), hypoxia control group (hypoxia group) and hypoxia + different concentrations of EGCG subgroups (20, 40, 60, 80, 100 µg/mL EGCG) were set up. Cell viability was detected via methyl thiazolyl tetrazolium (MTT) assay, apoptosis was detected via flow cytometry, and expressions of hypoxia-inducible factor-1α (HIF-1α) and vascular endothelial growth factor (VEGF) were detected via reverse transcription-polymerase chain reaction (RT-PCR) and Western blotting. RESULTS: Relatively low concentrations of EGCG (20-80 µg/mL) presented no significant inhibiting effect on SGC7901 cell growth within a short time (24 h) (p>0.05). The increasing concentration of EGCG inhibited cell proliferation under a hypoxia state (p<0.05). EGCG induced apoptosis in a dose-dependent manner under hypoxia (p<0.05). EGCG could significantly impede expressions of HIF-1α and VEGF proteins (p<0.05), and down-regulate the level of VEGF mRNA (p<0.05), but it showed no significant effect on the HIF-1α mRNA expression (p>0.05). CONCLUSIONS: EGCG inhibited cell proliferation under hypoxia via the downregulation of HIF-1α and its downstream target gene VEGF levels, providing a theoretical basis for the early diagnosis and treatment of gastric cancer in clinic.


Asunto(s)
Catequina/análogos & derivados , Subunidad alfa del Factor 1 Inducible por Hipoxia/metabolismo , Neoplasias Gástricas/tratamiento farmacológico , Factor A de Crecimiento Endotelial Vascular/metabolismo , Apoptosis/efectos de los fármacos , Catequina/farmacología , Catequina/uso terapéutico , Hipoxia de la Célula , Línea Celular Tumoral , Proliferación Celular/efectos de los fármacos , Supervivencia Celular/efectos de los fármacos , Regulación hacia Abajo/efectos de los fármacos , Ensayos de Selección de Medicamentos Antitumorales , Humanos , Neoplasias Gástricas/patología
16.
Artículo en Inglés | MEDLINE | ID: mdl-34113778

RESUMEN

Following a 1983 chromic acid (hexavalent chromium [CrVI]) spill from a Garfield, NJ electroplating plant, CrVI-contaminated water was found in a local firehouse basement in 1993. An ATSDR public health advisory was issued for the plant site in 2010, and from 2008-2015, fourteen residential properties have required remediation to address CrVI-contaminated dust in the basements. As part of the Community Outreach and Engagement Core of the NYU NIEHS Center, seventytwo Garfield residents aged 18-65 years, participated in a community survey with the goal of identifying concerns related to environmental and community health. Thirty-two percent responded that they 'didn't know' if they were exposed to chemicals or pollutants where they live. This finding suggests a limited awareness of environmental chemical exposures, chromium contamination and/or potential exposure to CrVI. Furthermore, toenail clippings were collected from forty-seven Garfield residents and analyzed for total chromium levels to assess potential long-term exposure. On average, residents living on/inside the contaminated plume area had higher total chromium levels in their toenail clippings than residents living outside the plume area. However, chromium levels for all participants were within the range of historical normal. This study highlights the value of partnerships between environmentally-impacted community's and academic scientists working together to identify potential contaminant exposures and address public health concerns through research and environmental health education.

17.
Zhonghua Fu Chan Ke Za Zhi ; 53(10): 683-688, 2018 Oct 25.
Artículo en Chino | MEDLINE | ID: mdl-30369124

RESUMEN

Objective: To evaluate the impact of gonadotropin-releasing hormone agonist (GnRH-a) used before surgery on natural pregnancy rates in patients with ovarian endometriomas. Methods: In this retrospective study, 57 patients with ovarian endometriomas who had a consecutive laparoscopic surgery between June, 2010 to September, 2015 in Peking Union Medical College Hospital were included. Those patients were divided into preoperative GnRH-a treatment group (n=31) and non-GnRH-a treatment group (n=26) . There were no differences in patients' characteristics between the two groups. All of them had a desire for natural pregnancy postoperatively. GnRH-a was no longer used after surgery. After the surgical procedure, the patients were observed over a period of 12 months, during which the frequency of natural pregnancy was assessed. The two groups were compared in terms of natural pregnancy rates. Results: Totally 33 patients had natural pregnancy after surgery. The univariate analysis showed that the pregnancy rates of age, r-AFS stage, infertility, preoperative use of GnRH-a, tumor size, tumor side, deep infiltrating endometriosis and adenomyosis did not have statistically significant differences (all P>0.05) . The two classified logistic regression showed that OR for preoperative use of GnRH-a was 0.250 (95%CI: 0.064-0.978) with a statistical difference (P=0.046) . Conclusion: The use of GnRH-a preoperatively may have a negative effect on natural pregnancy rates of patients after surgery with ovarian endometriomas.


Asunto(s)
Endometriosis , Femenino , Hormona Liberadora de Gonadotropina , Humanos , Laparoscopía , Embarazo , Índice de Embarazo , Estudios Retrospectivos
18.
Zhonghua Bing Li Xue Za Zhi ; 47(3): 180-185, 2018 Mar 08.
Artículo en Chino | MEDLINE | ID: mdl-29534357

RESUMEN

Objective: To investigate the diagnostic value of some antibodies in peritoneal fluid of patients with gastric cancer and malignant epithelioid mesothelioma in serous effusion. Methods: One hundred and eighty-two cases of serous effusion were collected at Jilin Cancer Hospital, from July 2012 to July 2016. The expression of GLUT1, CDX2, Villin, calretinin and WT1 was evaluated using SP immunocytochemical technique in peritoneal fluid samples collected from 98 patients with gastric cancer and 74 patients with reactive mesothelial cells. The expression of GLUT1, calretinin and WT1 was also evaluated in serous effusion from 10 patients with mesothelioma. Results: The sensitivity of GLUT1, CDX2 and Villin in adenocarcinoma cells was 91.8%(90/98), 68.4% (67/98) and 88.8%(87/98), respectively. The specificity was 95.9% (71/74), 100.0%(74/74) and 100.0% (74/74), respectively. The sensitivity of calretinin and WT1 for reactive mesothelium was 93.2% (69/74) and 79.7% (59/74), respectively. The specificity was 96.9% (95/98) and 100.0% (98/98), respectively. The sensitivity of GLUT1, calretinin and WT1 for mesothelioma was 9/10, 9/10 and 7/10. The reactivity of GLUT1, CDX2, Villin, calretinin and WT1 showed a significant difference (P<0.01) between adenocarcinoma cells and reactive mesothelium. The reactivity of GLUT1 showed a significant difference (P<0.01) between mesothelioma and reactive mesothelium. Conclusions: The optimal combination is a panel of GLUT1, CDX2, Villin, calretinin and WT1 for differential diagnosis between adenocarcinoma cells and reactive mesothelium in peritoneal fluid of patients with gastric cancer. Whereas GLUT1, calretinin and WT1 is the best for differential diagnosis between reactive mesothelium and mesothelioma in serous effusions.


Asunto(s)
Adenocarcinoma/química , Líquido Ascítico/química , Neoplasias Pulmonares/química , Mesotelioma/química , Proteínas de Neoplasias/análisis , Neoplasias Gástricas/química , Adenocarcinoma/diagnóstico , Biomarcadores de Tumor/análisis , Factor de Transcripción CDX2/análisis , Calbindina 2/análisis , Diagnóstico Diferencial , Epitelio/química , Transportador de Glucosa de Tipo 1/análisis , Humanos , Inmunohistoquímica , Neoplasias Pulmonares/diagnóstico , Mesotelioma/diagnóstico , Mesotelioma Maligno , Proteínas de Microfilamentos/análisis , Sensibilidad y Especificidad , Neoplasias Gástricas/diagnóstico , Proteínas WT1/análisis
19.
Dalton Trans ; 47(8): 2662-2669, 2018 Feb 20.
Artículo en Inglés | MEDLINE | ID: mdl-29410986

RESUMEN

DFT calculations confirmed that the rearrangement of a PCP-Rh-H pincer to a CCP-Rh-phosphane pincer occured by C-P oxidative addition (ΔG‡ = 29.5 kcal mol-1, rate-determining step), followed by P-H reductive elimination (ΔG‡ = 4.8 kcal mol-1). The oxidative addition proceeded via a 3-centered transition state and is accelerated by electron-withdrawing substituents p- to the reacting C-P bond, resulting in a reaction constant (ρ) of 2.12 for ΔG‡ and 2.76 for ΔH‡ in a Hammett-type linear free energy relationship. AIM wavefunction analyses indicated a decrease in the negative charge on the carbon bonded to Rh with a concomitant increase in the positive charge on the latter. The electronic density at the Rh-P bond critical point and the atomic charge on Rh correlate well with the Hammett constants (σ) of the p-substituents. The replacement of the Rh-bound hydride with other anions (CH3, Ph, t-Bu, OH, F, Cl, and CN) results in a decrease in the OA barrier only for CH3, which is in accordance with the experimental results. The reductive elimination occurs via a 3-centered (Rh, H, P) transition state, which adopts a conformation wherein the steric clash between the i-Pr groups is minimized, followed by recomplexation of Rh and the newly formed (i-Pr)2PH by a conformational twist around the Rh-P axis.

20.
Appl Clin Inform ; 9(1): 122-128, 2018 01.
Artículo en Inglés | MEDLINE | ID: mdl-29466818

RESUMEN

BACKGROUND: Identifying pneumonia using diagnosis codes alone may be insufficient for research on clinical decision making. Natural language processing (NLP) may enable the inclusion of cases missed by diagnosis codes. OBJECTIVES: This article (1) develops a NLP tool that identifies the clinical assertion of pneumonia from physician emergency department (ED) notes, and (2) compares classification methods using diagnosis codes versus NLP against a gold standard of manual chart review to identify patients initially treated for pneumonia. METHODS: Among a national population of ED visits occurring between 2006 and 2012 across the Veterans Affairs health system, we extracted 811 physician documents containing search terms for pneumonia for training, and 100 random documents for validation. Two reviewers annotated span- and document-level classifications of the clinical assertion of pneumonia. An NLP tool using a support vector machine was trained on the enriched documents. We extracted diagnosis codes assigned in the ED and upon hospital discharge and calculated performance characteristics for diagnosis codes, NLP, and NLP plus diagnosis codes against manual review in training and validation sets. RESULTS: Among the training documents, 51% contained clinical assertions of pneumonia; in the validation set, 9% were classified with pneumonia, of which 100% contained pneumonia search terms. After enriching with search terms, the NLP system alone demonstrated a recall/sensitivity of 0.72 (training) and 0.55 (validation), and a precision/positive predictive value (PPV) of 0.89 (training) and 0.71 (validation). ED-assigned diagnostic codes demonstrated lower recall/sensitivity (0.48 and 0.44) but higher precision/PPV (0.95 in training, 1.0 in validation); the NLP system identified more "possible-treated" cases than diagnostic coding. An approach combining NLP and ED-assigned diagnostic coding classification achieved the best performance (sensitivity 0.89 and PPV 0.80). CONCLUSION: System-wide application of NLP to clinical text can increase capture of initial diagnostic hypotheses, an important inclusion when studying diagnosis and clinical decision-making under uncertainty.


Asunto(s)
Servicio de Urgencia en Hospital , Procesamiento de Lenguaje Natural , Neumonía/diagnóstico , Neumonía/terapia , United States Department of Veterans Affairs , Estudios de Cohortes , Humanos , Curva ROC , Reproducibilidad de los Resultados , Procesamiento de Señales Asistido por Computador , Estados Unidos
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