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1.
Sci Rep ; 11(1): 9226, 2021 Apr 29.
Artículo en Inglés | MEDLINE | ID: mdl-33927297

RESUMEN

We evaluated the serum levels of (1-3)-beta-D-glucan (BG) and lactate dehydrogenase (LDH) as a tool to support pneumocystis pneumonia (PCP) diagnostic procedures in non-HIV patients. We retrospectively collected non-HIV (human immunodeficiency virus) patients presenting clinical features of PCP between April 1st, 2013, and December 31st, 2018. A total of 225 included patients were tested for Pneumocystis jirovecii by polymerase chain reaction (PCR) and methenamine silver staining. Based on different exclusion criteria, 179 cases were included in the BG group, and 196 cases were included in the LDH group. In each group, cases with positive immunofluorescence (IF) microscopy and PCR were considered proven PCP, while cases with only positive PCR were considered probable PCP. Fifty patients with negative IF and PCR results and proven to be non-PCP infection were chosen randomly as the control group. The cut-off levels of BG and LDH to distinguish non-PCP from probable PCP were 110 pg/mL and 296 U/L with 88% sensitivity and 86% specificity, and 66% sensitivity and 88% specificity, respectively. The cut-off levels of BG and LDH to distinguish non-PCP from proven PCP were 285.8 pg/mL and 379 U/L with 92% sensitivity and 96% specificity, and 85% sensitivity and 77% specificity, respectively. The cut-off levels of BG and LDH to distinguish non-PCP from proven/probable PCP were 144.1 pg/mL and 363 U/L with 90% sensitivity, 86% specificity and 80% sensitivity, 76% specificity respectively. BG and LDH are reliable indicators for detecting P. jirovecii infection in HIV-uninfected immunocompromised patients.

2.
Exp Mol Pathol ; 120: 104631, 2021 Mar 17.
Artículo en Inglés | MEDLINE | ID: mdl-33744280

RESUMEN

BACKGROUND: Preeclampsia is a life-threatening hypertensive disorder during pregnancy, while underlying pathogenesis and its diagnosis are incomplete. METHODS: In this study, we utilized the Robust Rank Aggregation method to integrate 6 eligible preeclampsia microarray datasets from Gene Expression Omnibus database. We used linear regression to assess the associations between significant differentially expressed genes (DEGs) and blood pressure. Functional annotation, protein-protein interaction, Gene Set Enrichment Analysis (GSEA) and single sample GSEA were employed for investigating underlying pathogenesis in preeclampsia. RESULTS: We filtered 52 DEGs and further screened for 5 hub genes (leptin, pappalysin 2, endoglin, fms related receptor tyrosine kinase 1, tripartite motif containing 24) that were positively correlated with both systolic blood pressure and diastolic blood pressure. Receiver operating characteristic indicated that hub genes were potential biomarkers for diagnosis and prognosis in preeclampsia. GSEA for single hub gene revealed that they were all closely related to angiogenesis and estrogen response in preeclampsia. Moreover, single sample GSEA showed that the expression levels of 5 hub genes were correlated with those of immune cells in immunologic microenvironment at maternal-fetal interface. CONCLUSIONS: These findings provide new insights into underlying pathogenesis in preeclampsia; 5 hub genes were identified as biomarkers for diagnosis and prognosis in preeclampsia.

3.
Bioresour Technol ; 329: 124919, 2021 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-33676353

RESUMEN

Links between synergy and microbial community characteristics in co-digestion of food waste (FW), cattle manure (CM) and corn straw (CS) were investigated. Mono-digestion of FW and CS were inhibited by organic acids. Co-digestion of FW with CM achieved greater synergistic rates (18.5% and 22.3%) than CM with CS (14.8% and 12.3%). Synergy resulted from coupling effects of improving nutrient balance, dilution of toxic compounds, higher buffering capacity, detoxification based on co-metabolism, which ultimately reflected in microbial community functions. Although co-digestion of FW with CS exhibited lowest synergistic rates (7.9% and 4.9%), detoxification based on co-metabolism of syntrophic communities of Syntrophomonadaceae with hydrogenotrophic methanogens accelerated system recovery. Digester with the greatest synergy (65% FW + 35% CM) maintained dominant growth of hydrogenotrophic methanogens (68.9%), highest methanogenic community diversity and relative abundance of Methanosarcina (14.6%), which sustained more diverse and switchable methanogenic pathways therefore ensured powerful methanogenic functions and vigorous methanogenic capability.


Asunto(s)
Microbiota , Eliminación de Residuos , Anaerobiosis , Animales , Biocombustibles , Reactores Biológicos , Bovinos , Digestión , Alimentos , Estiércol , Metano , Zea mays
4.
Int J Clin Pharm ; 2021 Feb 24.
Artículo en Inglés | MEDLINE | ID: mdl-33625653

RESUMEN

BACKGROUND: Drug-related problems (DRPs) prevent patients from fully benefiting from drug treatment. Unrelieved pain in patients with cancer is still widespread. Pharmacists can play a role in closely monitoring cancer patients, pain control maintenance, and patient consultation. OBJECTIVE: To evaluate the clinical effects and changes in drug costs of pharmacists' interventions on patients with DRPs related to cancer pain. SETTING: An academic teaching hospital in Shanghai, China. METHODS: Patients with cancer pain admitted to Shanghai Tongren Hospital from October 2018 to February 2019 were randomized into the intervention and control groups. The Pharmaceutical Care Network Europe classification V8.02 was used to categorize DRPs treated with analgesics. Patients' pain relief, the occurrence of adverse drug reactions, and drug cost-saving through the resolution of DRPs were evaluated. MAIN OUTCOME MEASURE: Problems and causes of drug-related problems, interventions proposed, and outcome of pharmacy recommendations. RESULTS: A total of 172 patients were enrolled and randomized into the intervention group (n = 86) and the control group (n = 86). The pharmacist detected 66 DRPs in 48 patients (55.8%) of the intervention group, an average of 0.8 DRPs per patient. A total of 149 interventions were proposed by the pharmacist. Compared to the control group, the drug intervention produced more pain relief on the third day of analgesic treatment. In the intervention group, a total of 33 DRP interventions resulted in cost changes, saving a drug cost of $489.90, averaging $11.94 per intervention. CONCLUSION: Our study suggests that pharmacy service in patients with cancer pain can resolve drug-related problems and reduce drug costs.

5.
Medicine (Baltimore) ; 100(2): e24070, 2021 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-33466165

RESUMEN

ABSTRACT: Locally invasive thyroid carcinoma (TC) often involves trachea. In such patients, the trachea needs to be reconstructed after surgery. We discuss the postoperative outcome and complications after trachea reconstruction by free myocutaneous flap (FMF) and pedicled myocutaneous flap (PMF).From January 2009 to September 2019, the clinical data of 38 patients with TC were retrospectively analyzed. Demographics, pathologic results, neoplasm staging, surgical protocol, decannulation, subjective speech function, and complications were documented.A total of 38 patients were analyzed (22 FMFs and 16 PMFs). Of the 38 patients, there is a similar rate of decannulation (81.8% in FMF and 75% in PMF), subjective speech function and complications.The FMF reconstruction and the PMF reconstruction have a similar result in terms of postoperative outcome and complications.


Asunto(s)
Carcinoma/cirugía , Procedimientos Quirúrgicos Reconstructivos/métodos , Colgajos Quirúrgicos , Neoplasias de la Tiroides/cirugía , Tráquea/cirugía , Adulto , Anciano , Femenino , Colgajos Tisulares Libres , Humanos , Masculino , Persona de Mediana Edad , Colgajo Miocutáneo , Complicaciones Posoperatorias/etiología , Estudios Retrospectivos , Resultado del Tratamiento , Adulto Joven
6.
Dysphagia ; 2021 Jan 03.
Artículo en Inglés | MEDLINE | ID: mdl-33389179

RESUMEN

Simultaneous reconstructions of entire circumference pharyngoesophageal defect and external neck skin defect are challenges for head and neck surgeons. A 57-year old man, who underwent radical tumor resection, suffered with an advanced metachronous second primary esophageal squamous cell carcinoma (SPESCC). Our modified operative technique (mALT-TAAP), a combination of modified free anterolateral thigh (ALT) flap (a fasciocutaneous flap with an extension of fascia) and pedicled thoracoacromial artery perforator (TAAP) flap, was utilized to reconstruct the entire circumference of pharyngoesophageal and external neck skin defect reconstructions. The modified ALT flap, TAAP flap and donor wounds recovered well postoperatively. No morbidity of the donor site or operation-related complication was observed. The postoperative recovery of swallowing function was satisfactory. Our mALT-TAAP reconstruction method could be a decent option for simultaneous reconstructions of entire circumference of pharyngoesophageal defect and external neck skin defect.

7.
BMC Musculoskelet Disord ; 22(1): 1, 2021 Jan 04.
Artículo en Inglés | MEDLINE | ID: mdl-33397351

RESUMEN

BACKGROUND: To compare the efficacy of three different fixation methods of fibula combined with external fixation of tibia for the treatment of extra-articular open fractures of distal tibia and fibula. METHODS: From January 2017 to July 2019, 91 cases of open fractures of distal tibia and fibula were treated with external fixator, and the fibula was fixed with non-fixation (group A, n = 35), plate-screw (group B, n = 30) and Kirschner wire (group C, n = 26). The operation time, intraoperative blood loss, surgical and implants costs, fracture healing time, postoperative complications, and American Orthopaedic Foot and Ankle surgery (AOFAS) scores were compared among the groups. RESULTS: Four patients were lost to follow-up, and 87 patients were followed up for 5-35 months (average, 14.2 months). The operation time of group C (114.92 ± 36.09 min) was shorter than that of group A (142.27 ± 47.05 min) and group B (184.00 ± 48.56 min) (P < 0.05). There was no difference in intraoperative blood loss among the three groups (P > 0.05). The surgical and implants costs in group C (5.24 ± 1.21, thousand dollars) is lower than that in group A (6.48 ± 1.11, thousand dollars) and group B (9.37 ± 2.16, thousand dollars) (P < 0.05). The fracture healing time of group C (5.67 ± 1.42 months) was significantly less than that of group A (6.90 ± 1.33 months) and group B (6.70 ± 1.12 months) (P < 0.05). The postoperative complications such as fractures delayed union and nonunion in group C (2 cases, 8.00%) is less than that in group A (13 cases, 39.39%) and group B (11cases, 37.93%) (P < 0.05). The wound infection and needle-tract infection did not differ among the three groups (P > 0.05). The excellent or good rate of ankle function was 69.70% in group A, 72.41% in group B and 84.00% in group C, with no statistical difference among the three groups (P > 0.05). CONCLUSION: Compared with simple external fixator fixation and external fixator combined with plate-screw osteosynthesis, external fixator combined with K-wire intramedullary fixation shortens the operative time and fracture healing time, reduced costs and complications of fracture healing, while the blood loss, infection complications and ankle function recovery showed no difference with the other two groups. External fixator combined with plate-screw osteosynthesis had no advantage in treating extra-articular open fractures of distal tibia and fibula when compared with simple external fixation.

8.
Artículo en Chino | MEDLINE | ID: mdl-33254323

RESUMEN

Objective:To investigate the treatment efficacy of electronic endoscope-Guided botulinum toxin injection in Adductor Spasmodic Dysphonia Patients. Method:Clinical characteristics of forty- three cases were retrospectively analyzed. The disease were diagnosed with adductor spasmodic dysphonia and graded according to the severity of the disease by experienced voice specialist. All the cases were treated by electronic endoscope-guided botulinum toxin type A injection in bilateral thyroarytenoid muscles. All the subjects underwent stroboscopic laryngoscope examination and filled in the Voice Handicap Index-10(VHI-10). They also filled in the VAS score of Voice related symptoms by self evaluation and other evaluation . One month Later, the patients and someone they lived with filled in the VAS score of Voice related symptoms again. Result:After the first injection, the voice-related symptoms of 35 patients improved to varying degrees..All The average onset time of drug was(2.33±1.86) days. The duration of curative effect ranged from 1 to 6 months, the average duration was(2.42±1.65) months. After injection, no one had serious or persistent adverse reactions. There were significant differences in the total score of VHI-10, physiology(P) and function(F) dimensions in VHI-10 of moderate and severe SD patients before and after injection(P<0.05) in all patients. For moderate cases, no significant change in speech articulation(P>0.05), overall evaluation of voice quality and any other subprojects are statistically significant(P<0.05) in the VAS score of Voice related symptoms; For severe cases, the degree of squeezing and effort during vocalization are no statistically significant(P>0.05), overall evaluation of voice quality and any other subitems are statistically significant(P<0.05) in the VAS score of Voice related symptoms. Conclusion:In the absence of LEMG, electronic endoscope-guided botulinum toxin injection in adductor spasmodic dysphonia patients can significantly improve the voice quality and quality of life of adductive SD patients. The method is simple to operate, less traumatic, safe and effective, and easy to carry out outpatients service.

9.
Medicine (Baltimore) ; 99(46): e22617, 2020 Nov 13.
Artículo en Inglés | MEDLINE | ID: mdl-33181646

RESUMEN

INTRODUCTION: Esophageal window defect in patients with esophageal resection could be challenging to repair. In this case report, a free posterior tibial artery perforator flap (FPTAPF) was used for semi-circumference patch esophagoplasty. PATIENT CONCERNS: For this 47-year-old male patient with recurrent laryngeal nerve schwannoma invading cervical and upper thoracic esophagus, cervical and upper thoracic esophageal reconstruction following tumor resection was needed DIAGNOSIS:: Pathologic result demonstrated recurrent laryngeal nerve schwannoma. Ultrasound examination detected a tumor (7 cm × 6 cm × 3 cm) located behind the right thyroid lobe, and contrast-enhanced computed tomography scan revealed that tumor was located between the cervical esophagus and trachea, and compressed these structures. INTERVENTIONS: The tumor had a size of 7 cm × 6 cm × 3 cm, and the semi-circumference defect of the cervical and upper thoracic esophagus was about 7 cm in length after complete tumor resection. A 7 cm × 4 cm FPTAPF was designed and harvested for esophageal reconstruction. OUTCOMES: The posterior tibial flap survived well and satisfactory recovery of esophageal function was obtained with no significant complications. No local tumor relapse was indicated by computed tomography during the 2-year postoperative follow-up. CONCLUSION: This case highlights the stable performance of FPTAPF when used for the reconstruction of large esophageal window defect.


Asunto(s)
Esófago/cirugía , Neurilemoma/cirugía , Procedimientos Quirúrgicos Reconstructivos/métodos , Colgajos Quirúrgicos/cirugía , Arterias Tibiales/trasplante , Trastornos de Deglución/etiología , Trastornos de Deglución/cirugía , Esófago/trasplante , Humanos , Masculino , Persona de Mediana Edad , Neurilemoma/complicaciones , Colgajos Quirúrgicos/trasplante , Arterias Tibiales/cirugía
10.
Front Psychiatry ; 11: 559729, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33101081

RESUMEN

Objective: Decreased homotopic connectivity of brain networks such as the cortico-striato-thalamo-cortical (CSTC) circuits may contribute to the pathophysiology of obsessive-compulsive disorder (OCD). However, little is known about interhemispheric functional connectivity (FC) at rest in OCD. In this study, the voxel-mirrored homotopic connectivity (VMHC) method was applied to explore interhemispheric coordination at rest in OCD. Methods: Forty medication-free patients with OCD and 38 sex-, age-, and education level-matched healthy controls (HCs) underwent a resting-state functional magnetic resonance imaging. The VMHC and support vector machine (SVM) methods were used to analyze the data. Results: Patients with OCD had remarkably decreased VMHC values in the orbitofrontal cortex, thalamus, middle occipital gyrus, and precentral and postcentral gyri compared with HCs. A combination of the VMHC values in the thalamus and postcentral gyrus could optimally distinguish patients with OCD from HCs. Conclusions: Our findings highlight the contribution of decreased interhemispheric FC within and outside the CSTC circuits in OCD and provide evidence to the pathophysiology of OCD.

11.
Artículo en Chino | MEDLINE | ID: mdl-33040517

RESUMEN

After treatment, patients with head and neckmalignant tumors may suffer from dysphagia, which may lead to aspiration pneumonia, cough and other complications, even threaten life, seriously affecting patients'quality of life. Through comprehensive evaluation of patients' swallowing function, clinicians can make corresponding rehabilitation plans to improve patients' quality of life.This paper summarizes a variety of subjective and objective evaluation methods for evaluating swallowing function of head and neck malignant tumors.


Asunto(s)
Trastornos de Deglución , Neoplasias de Cabeza y Cuello , Neumonía por Aspiración , Deglución , Trastornos de Deglución/etiología , Humanos , Calidad de Vida
12.
Mol Cell Biochem ; 2020 Aug 26.
Artículo en Inglés | MEDLINE | ID: mdl-32845436

RESUMEN

Mesenchymal stem cells (MSCs) can alleviate acute respiratory distress syndrome (ARDS), but the mechanisms involved are unclear, especially about their specific effects on cellular mitochondrial respiratory function. Thirty mice were allocated into the Control, LPS, and LPS + Bone marrow mesenchymal stem cell (BMSC) group (n = 10/group). Mouse alveolar epithelial cells (MLE-12) and macrophage cells (RAW264.7) were divided into the same groups. Pathological variation, inflammation-related factors, reactive oxygen species (ROS), ATP levels, and oxygen consumption rate (OCR) were analyzed. Pathologic features of ARDS were observed in the LPS group and were significantly alleviated by BMSCs. The trend in inflammation-related factors among the three groups was the LPS group > LPS + BMSC group > Control group. In the MLE-12 co-culture system, IL-6 was increased in the LPS group but not significantly reduced in the LPS + BMSC group. In the RAW264.7 co-culture system, IL-1ß, TNF-α, and IL-10 levels were all increased in the LPS group, IL-1ß and TNF-α levels were reduced by BMSCs, while IL-10 level kept increasing. ROS and ATP levels were increased and decreased respectively in both MLE-12 and RAW264.7 cells in the LPS groups but reversed by BMSCs. Basal OCR, ATP-linked OCR, and maximal OCR were lower in the LPS groups. Impaired basal OCR and ATP-linked OCR in MLE-12 cells were partially restored by BMSCs, while impaired basal OCR and maximal OCR in RAW264.7 cells were restored by BMSCs. BMSCs improved the mitochondrial respiration dysfunction of macrophages and alveolar epithelial cells induced by LPS, alleviated lung tissue injury, and inflammatory response in a mouse model of ARDS.

13.
Bioresour Technol ; 315: 123796, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-32682261

RESUMEN

Role of trace elements (TEs) in long-term anaerobic digestion of food waste (FW) under fixed and stepwise increasing loads and under early and medium volatile fatty acid (VFA) inhibition was investigated. Digesters under high load suffered VFA inhibition. Mismatch between scarce TEs in FW and essential TEs for sustainable methanogenesis suppressed Methanosaeta causing blocked aceticlastic methanogenesis and shift to CO2 reduction pathway, as indicated by decreased Methanosaeta from above 70.0% to below 42.0% and enriched hydrogenotrophic methanogens (Methanospirillum, Methanoculleus, Methanobacterium) from below 15.0% to above 53.6%. Dual stresses of VFA inhibition and TEs deficiency resulted in recession of syntrophic Bacteria Syntrophomonadaceae. Conversely, digesters with TEs supplementation maintained high activity of Syntrophomonadaceae and ensured predominant aceticlastic methanogenesis and powerful methanogenic community functions. Early and medium VFA inhibition were reversed by TEs supplementation or coupling with pH adjustment by stimulating VFAs degradation via syntrophic metabolism and unclogging acetate conversion via aceticlastic methanogenesis.


Asunto(s)
Microbiota , Eliminación de Residuos , Oligoelementos , Anaerobiosis , Reactores Biológicos , Metano
14.
J Orthop Surg Res ; 15(1): 281, 2020 Jul 25.
Artículo en Inglés | MEDLINE | ID: mdl-32711563

RESUMEN

PURPOSE: The purpose of this study is to come up with new methods to quantitate the blood loss under endoscope and explore the influence of blood loss on percutaneous endoscopic lumbar discectomy (PELD). METHODS: Clinical research and in vitro experiment are combined. In the in vitro experiment, 2.0-ml blood was diluted in different ratio to simulate the rinse solution of PELD, the hematocrit method (HCT-M) and red blood cell count method (RBC-M) were came up to estimate blood loss and the new methods were calibrated with the direct measurement method (Direct-M). In clinical research, 74 patients with L5/S1 disk herniation were treated with PELD, and HCT-M and the empirical method (EMP-M) were used to estimate the blood loss under endoscope. According to blood loss, all patients were divided into group A (≤ 10 ml) and group B (> 10 ml). The blood loss, operation time, fluoroscopy frequency, visual analog scale (VAS), and Oswestry Disability Index (ODI) scores were compared between the two groups. RESULTS: In the in vitro experiment, the hematocrit of the rinse solution was always stable over time. The estimated blood loss by HCT-M was stable and quite approximate to actual blood volume (2.0 ml) whatever the blood dilution ratio, while according to RBC-M, the estimated blood loss was close to the actual blood volume only when the dilution ratio was greater than 300 times. In clinical research, the blood loss estimated by HCT-M was higher than that by EMP-M in both groups (P < 0.05). There was a significant difference between group A and group B in blood loss (7.40 ± 1.61 vs 19.91 ± 10.94 ml), operation time (80.51 ± 34.70 vs 136.51 ± 41.88 min), and fluoroscopy frequency (6.92 ± 1.52 vs 11.11 ± 2.32 times) (P < 0.05). The VAS and ODI scores in group B were higher than that in group A 1 week after operation (P < 0.05); however, the scores were not different between the two groups at pre-operation (P > 0.05). CONCLUSION: HCT-M is a reliable method to estimate endoscopic blood loss in PELD. The amount of endoscopic blood loss affects the operative procedure in operation time and fluoroscopy frequency, as well as clinical effects in VAS and ODI scores after operation in short term.

15.
BMC Mol Cell Biol ; 21(1): 51, 2020 Jul 03.
Artículo en Inglés | MEDLINE | ID: mdl-32620073

RESUMEN

BACKGROUND: Methotrexate (MTX) is an antifolate agent which is widely used in clinic for treating malignancies, rheumatoid arthritis and ectopic pregnancy. As reported, MTX has side effects on gastrointestinal system, nervous system and reproductive system, while its potential damages on oocyte quality are still unclear. It is known that oocyte quality is essential for healthy conception and the forthcoming embryo development. Thus, this work studied the effects of MTX on the oocyte quality. RESULTS: We established MTX model mice by single treatment with 5 mg/Kg MTX. Both morphological and molecular biology studies were performed to assess the in-vivo matured oocytes quality and to analyze the related mechanisms. The in-vivo matured oocytes from MTX-treated mice had poor in-vitro fertilization ability, and the resulting embryo formation rates and blastocyst quality were lower than the control group. We found that the in-vivo matured MTX-treated mouse oocytes displayed abnormal transcript expressions for genes of key enzymes in the folate cycles. MTX increased the rate of abnormal chromosome alignment and affected the regulation of chromosome separation via disrupting the spindle morphology and reducing the mRNA expressions of MAD2 and Sgo1. MTX reduced the DNA methylation levels in the in-vivo matured oocytes, and further studies showed that MTX altered the expressions of DNMT1 and DNMT 3b, and may also affect the levels of the methyl donor and its metabolite. CONCLUSIONS: MTX impaired the in-vivo matured mouse oocyte quality by disturbing folate metabolism and affecting chromosome stability and methylation modification.

16.
Medicine (Baltimore) ; 99(22): e20274, 2020 May 29.
Artículo en Inglés | MEDLINE | ID: mdl-32481394

RESUMEN

Sepsis is a life-threatening disease in the intensive care unit (ICU). The current diagnostic criteria for sequential organ failure assessment (SOFA) scores do not reflect the current understanding of sepsis. We developed a novel and convenient score to aid early prognosis.Retrospective multivariable regression analysis of 185 infected emergency ICU (EICU) patients was conducted to identify independent variables associated with death, to develop the new "STAPLAg" score; STAPLAg was then validated in an internal cohort (n = 106) and an external cohort (n = 78) and its predictive efficacy was compared with that of the initial SOFA score.Age, and initial serum albumin, sodium, PLR, troponin, and lactate tests in the emergency department were independent predictors of death in infected EICU patients, and were used to establish the STAPLAg score (area under the curve [AUC] 0.865). The initial SOFA score on admission was predictive of death (AUC 0.782). Applying the above categories to the derivation cohort yielded mortality risks of 7.7% for grade I, 56.3% for grade II, and 75.0% for grade III. Internal (AUC 0.884) and external (AUC 0.918) cohort validation indicated that the score had good predictive power.The STAPLAg score can be determined early in infected EICU patients, and exhibited better prognostic capacity than the initial SOFA score on admission in both internal and external cohorts. STAPLAg constitutes a new resource for use in the clinical diagnosis of sepsis and can also predict mortality in infected EICU patients. REGISTRATION NUMBER:: ChinCTR-PNC-16010288.


Asunto(s)
Puntuación de Alerta Temprana , Unidades de Cuidados Intensivos , Puntuaciones en la Disfunción de Órganos , Sepsis/diagnóstico , Factores de Edad , Anciano , Femenino , Humanos , Ácido Láctico/sangre , Recuento de Linfocitos , Masculino , Persona de Mediana Edad , Recuento de Plaquetas , Pronóstico , Estudios Retrospectivos , Sepsis/sangre , Sepsis/mortalidad , Albúmina Sérica/análisis , Sodio/sangre , Troponina/sangre
17.
Front Psychiatry ; 11: 98, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32194450

RESUMEN

Abnormal functional connectivity (FC) within discrete brain networks is involved in the pathophysiology of obsessive-compulsive disorder (OCD) with inconsistent results. In the present study, we investigated the FC patterns of 40 drug-naive patients with OCD and 38 healthy controls (HCs) through an unbiased voxel-wise global brain FC (GFC) analysis at rest. Compared with HCs, patients with OCD showed decreased GFC within the default mode network (DMN) (i.e., left posterior cingulate cortex/lingual gyrus) and sensorimotor network (i.e., left precentral gyrus/postcentral gyrus) and increased GFC within the executive control network (ECN) (i.e., left dorsal lateral prefrontal cortex and left inferior parietal lobule). Receiver operating characteristic curve analyses further indicated that the altered GFC values within the DMN, ECN, and sensorimotor network may be used as neuroimaging markers to differentiate patients with OCD from HCs. These findings indicated the aberrant FC patterns of the DMN, ECN, and sensorimotor network associated with the pathophysiology of OCD and provided new insights into the changes in brain organization function in OCD.

18.
Medicine (Baltimore) ; 99(5): e18810, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32000381

RESUMEN

Complex reconstruction skills in advanced head and neck cancer (HNC) could resolve the key problem of large defects after tumor resection. We combined the anterolateral thigh free flap, fascia lata flap, and greater saphenous vein graft in the reconstruction process of salvage surgery. Seven patients suffering from advanced HNC who experienced the failure of multiple therapeutic methods were enrolled in our study between June 2017 and January 2018. They all agreed to voluntarily undergo the tumor excision and complex reconstruction procedure we developed. The total flap size ranged from 20 × 13 cm to 30 × 15 cm. The length of the greater saphenous vein graft ranged from 4 to 11 cm. The hospitalization period ranged from 7 to 33 days. All of the flaps were viable, but in 1 patient, oral flap edge infection and necrosis necessitated partial debridement on day 7 postoperatively. All donor sites were closed primarily. We report our experience with this surgical method for complex reconstruction in advanced HNC patients.


Asunto(s)
Fascia Lata/trasplante , Colgajos Tisulares Libres , Neoplasias de Cabeza y Cuello/cirugía , Procedimientos Quirúrgicos Reconstructivos/métodos , Vena Safena/trasplante , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad
19.
Oncol Lett ; 19(2): 1223-1234, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31966052

RESUMEN

Gastric cancer is one of the most prevalent malignant tumors worldwide. Immunological checkpoint inhibitors of the programmed death 1 (PD-1)/programmed cell death-ligand 1 (PD-L1) signaling pathway are effective in the treatment of various malignant tumor types, but the potential of such immunotherapeutic techniques for the treatment of gastric cancer is yet to be elucidated. The purpose of the present study was to investigate the methylation of the PD-L1 gene promoter and its clinical significance in advanced gastric cancer, as this may suggest the use of PD-L1 promoter methylation as a novel biomarker for gastric cancer progression. In a total of 70 samples, the methylation rate of the PD-L1 gene promoter region was significantly higher in gastric cancer tissues compared with adjacent tissues. A high level of PD-L1 promoter methylation was associated with lymph node staging, and resulted in poorer prognoses in patients with advanced gastric cancer. A total of 26 patients exhibited highly methylated PD-L1; in this group, the median progression-free survival time of patients receiving platinum/fluorouracil chemotherapy was 4.2 months longer than those receiving paclitaxel/fluorouracil chemotherapy, and the risk of disease progression in patients receiving paclitaxel/fluorouracil chemotherapy was 5.009 times higher compared with patients who received platinum/fluorouracil chemotherapy. Additionally, PD-L1 promoter methylation was significantly correlated with PD-L1 expression, and the progression of advanced gastric cancer. In conclusion, high methylation levels of the PD-L1 promoter region may be a faciliatory mechanism enabling gastric cancer tumorigenesis, and may also represent an independent prognostic factor for chemotherapeutic efficacy in patients with advanced gastric cancer.

20.
Int J Mol Med ; 45(1): 115-130, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31939611

RESUMEN

tRNA­derived small RNAs (tsRNAs) have been shown to play regulatory roles in many physiological and pathological processes. However, their roles in hypertrophic scars remain unclear. The present study investigated differentially expressed tsRNAs in human hypertrophic scar fibroblasts and normal skin fibroblasts via high­throughput sequencing. Several dysregulated tsRNAs were validated by reverse transcription­quantitative polymerase chain reaction (RT­qPCR). Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment, target prediction, coexpression networks and competing endogenous RNA (ceRNA) networks were evaluated to discover the principal functions of significantly differentially expressed tsRNAs. In total, 67 differentially expressed tsRNAs were detected, of which 27 were upregulated and 40 downregulated in hypertrophic scar fibroblasts. The GO analysis indicated that the dysregulated tsRNAs are associated with numerous biological functions, including 'nervous system development', 'cell adhesion', 'focal adhesion', 'protein binding', 'angiogenesis' and 'actin binding'. KEGG pathway analysis revealed that the most altered pathways include 'Ras signaling pathway', 'Rap1 signaling pathway' and 'cGMP­PKG signaling pathway'. The target genes of the differentially expressed tsRNAs participate in several signaling pathways important for scar formation. The results of RT­qPCR were consistent with those of sequencing. MicroRNA (miR)­29b­1­5p was identified as a target of tsRNA­23678 and was downregulated in hypertrophic scar fibroblasts, constituting a negative regulatory factor for scar formation. Furthermore, tsRNA­23761 acted as a ceRNA and bound to miR­3135b to regulate the expression of miR­3135b targets, including angiotensin­converting enzyme. Collectively, these findings reveal that tsRNAs are differentially expressed in human hypertrophic scar fibroblasts, and may contribute to the molecular mechanism and treatment of hypertrophic scars.


Asunto(s)
Cicatriz Hipertrófica/genética , Cicatriz Hipertrófica/patología , Fibroblastos/metabolismo , Fibroblastos/patología , ARN de Transferencia/metabolismo , Adulto , Niño , Femenino , Perfilación de la Expresión Génica , Ontología de Genes , Redes Reguladoras de Genes , Humanos , MicroARNs/genética , MicroARNs/metabolismo , ARN Mensajero/genética , ARN Mensajero/metabolismo , ARN de Transferencia/aislamiento & purificación , Reproducibilidad de los Resultados , Adulto Joven
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