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Objective: To explore the risk factors of short-term prognosis of severe Budd-Chiari syndrome (BCS) patients,established and verified the nomogram prediction model for these BCS patients and evaluated its clinical application value. Methods: This study is a retrospective cohort study. The clinical data of 171 patients with severe BCS diagnosed were retrospectively analyzed in the Department of Hepatopancreatobiliary Surgery First Affiliated Hospital of Zhengzhou University from January 2018 to December 2023. There were 105 males and 66 females, aged (52.1±12.8) years (range: 18 to 79 years). The patients were divided into two groups based on whether they died within 28 days: the death group (n=38) and the survival group (n=133). The risk factors for short-term death of patients were analyzed,and independent risk factors were screened by univariate and multivariate analysis. Furthermore,these factors were used to establish the nomogram prediction model. The area under the curve(AUC),the Bootstrap Resampling,the Hosmer-Lemeshow test and the Decision Curve Analysis(DCA) were used to verify the model's differentiation,internal verification,calibration degree and clinical effectiveness,respectively. Results: Univariate and multivariate Logistics regression analysis showed that the history of hepatic encephalopathy,white blood cell,glomerular filtration rate and prothrombin time were independent risk factors (P<0.05). The above factors were used to successfully establish the prediction model with 0.908 of AUC and 0.895 of the internal verification of AUC,indicating that the predictive model was valuable. The 0.663 P-values in the Hosmer-Lemeshow test indicated the high calibration degree of the model. The clinical effectiveness of the model was proved by the 18% clinical benefit population using the DCA curve with the 17% probability threshold. Conclusions: The independent risk factors are the history of hepatic encephalopathy,white blood cell,glomerular filtration rate and prothrombin time. An adequate basis was acquired by establishing a nomogram prediction model of the short-term prognosis of severe BCS,which was helpful for early clinical screening and identification of high-risk patients with severe BCS who could die in the short term and timely providing timely intervention measures for improving the prognosis.
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Síndrome de Budd-Chiari , Nomogramas , Humanos , Feminino , Masculino , Pessoa de Meia-Idade , Síndrome de Budd-Chiari/diagnóstico , Síndrome de Budd-Chiari/cirurgia , Estudos Retrospectivos , Prognóstico , Fatores de Risco , Adulto , Idoso , Adolescente , Adulto JovemRESUMO
The purpose of this study was to explore the reasonable dose of low molecular weight heparin (LMWH) in hemodialysis (HD) and the strategy of preventing extracorporeal circuit coagulation (ECC). A retrospective case-control study included patients who used LMWH for anticoagulation during maintenance hemodialysis (MHD) in the Hemodialysis Center of Beijing Hospital from December 2020 to January 2021. Basic data such as weight, height, basic kidney disease, dialysis age and anti-â ©a factor activity before, during and after dialysis were collected. A total of 46 patients were enrolled in this study, including 5 patients in coagulation group (10.9%) and 41 patients in non-coagulation group (89.1%). The anti-â ©a factor activity reached its peak at 0.5 h after the start of HD. The level of anti-â ©a factor was incorporated into the receiver operating characteristic curve (ROC curve). The results showed that the area under the ROC curve (AUC) was 0.802 (95% confidence interval: 0.651-0.54, P=0.029), and the cutoff was 0.31 IU/ml (sensitivity 1, specificity 0.683). It is suggested that the body surface area should be used as the basis to estimate the anticoagulant dose of LMWH in HD, and the activity of HD 4 h anti-â ©a factor ≤0.31 IU/ml, which is of diagnostic value for ECC. In addition, the results of binary logistic regression analysis showed that dialysis age was an independent risk factor for ECC (OR value 1.319, 95%CI 1.052-1.654, P=0.017). In summary, this study reveals that dialysis age may be a risk factor for ECC and that the activity of HD 4 h anti-â ©a factor ≤0.31 IU/ml can be used as a potential diagnostic cut-off point for ECC in HD patients, which provides a scientific basis for monitoring strategies to prevent blood coagulation in HD filters.
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Anticoagulantes , Heparina de Baixo Peso Molecular , Humanos , Heparina de Baixo Peso Molecular/uso terapêutico , Estudos Retrospectivos , Estudos de Casos e Controles , Anticoagulantes/uso terapêutico , Diálise RenalRESUMO
Objective: To further elucidate the clinical efficacy and safety of a combination regimen based on the BTK inhibitor zebutanil bridging CD19 Chimeric antigen receptor T cells (CAR-T cells) in the treatment of relapsed/refractory diffuse large B-cell lymphoma (r/r DLBCL) . Methods: Twenty-one patients with high-risk r/r DLBCL were treated with a zanubrutinib-based regimen bridging CAR-T between June 2020 and June 2023 at the Department of Hematology, Tongji Hospital, Tongji University and the Second Affiliated Hospital of Zhejiang University, and the efficacy and safety were retrospectively analyzed. Results: All 21 patients were enrolled, and the median age was 57 years (range: 38-76). Fourteen patients (66.7%) had an eastern cooperative oncology group performance status score (ECOG score) of ≥2. Eighteen patients (85.7%) had an international prognostic index (IPI) score of ≥3. Three patients (14.3%) had an IPI score of 2 but had extranodal infiltration. Fourteen patients (66.7%) had double-expression of DLBCL and seven (33.3%) had TP53 mutations. With a median follow-up of 24.8 (95% CI 17.0-31.6) months, the objective response rate was 81.0%, and 11 patients (52.4%) achieved complete remission. The median progression-free survival (PFS) was 12.8 months, and the median overall survival (OS) was not reached. The 1-year PFS rate was 52.4% (95% CI 29.8% -74.3%), and the 1-year OS rate was 80.1% (95% CI 58.1% -94.6%). Moreover, 18 patients (85.7%) had grade 1-2 cytokine-release syndrome, and two patients (9.5%) had grade 1 immune effector cell-associated neurotoxicity syndrome. Conclusion: Zanubrutinib-based combination bridging regimen of CAR-T therapy for r/r DLBCL has high efficacy and demonstrated a good safety profile.
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Linfoma Difuso de Grandes Células B , Receptores de Antígenos Quiméricos , Humanos , Pessoa de Meia-Idade , Receptores de Antígenos Quiméricos/uso terapêutico , Estudos Retrospectivos , Imunoterapia Adotiva/efeitos adversos , Linfoma Difuso de Grandes Células B/tratamento farmacológico , Terapia Baseada em Transplante de Células e Tecidos , Antígenos CD19/efeitos adversosRESUMO
The value of combined detection of neutrophil apolipoprotein (HNL), serum amyloid A (SAA), procalcitonin (PCT) and C-reactive protein (CRP) in the differential diagnosis of bacterial and viral infectious diseases. A retrospective study was conducted to collect the clinical data of infected patients and healthy people in the clinical department of Shaanxi Provincial People's Hospital from September to December in 2022. 100 patients with confirmed infection were divided into bacterial infection group (n=50) and virus infection group (n=50), and 50 healthy people were selected as control group (n=50). Fasting venous blood was collected at the initial stage of admission or on the day of physical examination. HNL was detected by double antibody sandwich method, SAA and CRP were detected by nephelometry, and PCT was detected by chemiluminescence method. The efficacy of infection markers in the differential diagnosis of bacterial infection and viral infection in infected patients was evaluated. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic efficacy of HNL, SAA, PCT and CRP in bacterial and viral infectious diseases; Logistic regression was used to analyze the influence of each index on the diagnostic efficiency. The results showed that the levels of HNL (126.60±33.32) ng/ml, PCT (28.02±11.37) ng/ml and CRP (36.13±14.37) mg/L in bacterial infection group were significantly higher than those of HNL (47.72±15.94) ng/ml, PCT (1.27±0.40) ng/ml, CRP (18.77±10.66) mg/L in virus group and HNL (38.21±12.53) ng/ml, PCT (0.38±0.12) ng/ml and CRP (4.13±1.07) mg/L in control group. The level of HNL increased most significantly (F=89.228, P<0.05). The area under ROC curve (AUC) from large to small was HNL+SAA+PCT+CRP (0.976), HNL (0.907), PCT (0.885), CRP (0.856), SAA (0.790), SAA/CRP (0.733). The level of SAA/CRP in virus infection group (94.05±3.75) was significantly higher than that in bacteria group (17.70±3.69) and control group (3.89±1.50) (F=84.005, P<0.05). The area under ROC curve (AUC) from large to small was HNL+SAA+PCT+CRP (0.986), SAA/CRP (0.956), SAA (0.878), HNL (0.768), CRP (0.742), PCT (0.730). In conclusion, HNL has the best auxiliary diagnostic efficacy in bacterial infection, followed by PCT; SAA/CRP has the best auxiliary diagnostic efficacy in viral infection, followed by SAA; the combined detection of serum HNL, SAA, PCT and CRP may be helpful for the differential diagnosis of bacterial and viral infections.
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Infecções Bacterianas , Doenças Transmissíveis , Viroses , Humanos , Proteína C-Reativa , Pró-Calcitonina , Proteína Amiloide A Sérica , Estudos Retrospectivos , Viroses/diagnóstico , Bactérias , Infecções Bacterianas/diagnósticoRESUMO
Objective: To examine the effect of thrombolytic therapy of Budd-Chiari syndrome (B-CS) with inferior vena cava (IVC) thrombosis, and the prognosis factors of it. Methods: The clinical data of 67 patients of B-CS with IVC thrombosis treated in the Department of Hepatopancreatobiliary Surgery, the First Affiliated Hospital of Zhengzhou University from January 2013 to August 2020 were analyzed retrospectively. There were 30 males and 37 females. The age was (47.7±11.1) years(range: 18 to 72 years). All patients received catheter directed thrombolysis, and the thrombolysis process, complications and outcomes were analyzed. All patients received IVC balloon angioplasty after thrombolytic therapy. The t test, χ2 test, Mann-Whitney U test were used for univariate analysis of the prognosis factors of thrombolysis effects, while unconditional Logistic regression model were used for multivariate analysis. Results: In the 67 patients, 47 cases succerssed in thrombolytic therapy. The successful rates of thrombolysis at 1-, 2-, 3- and 4-week were 9.0%, 29.9%, 64.2% and 70.1%, respectively. The rates of thrombolytic catheter-related infection at 1-, 2-, 3- and 4-week were 1.5%, 4.5%, 14.9% and 31.3%, respectively. No serious complications such as symptomatic and acute pulmonary embolism occurred during perioperative period of IVC balloon angioplasty. Univariate analysis showed that differences in thrombus length ((36.7±18.1) mm vs. (52.0±16.4) mm, t=-3.234, P=0.002), Child-Pugh classification (class A/B/C: 37/8/2 vs. 10/8/2, Z=-2.310, P=0.021) and pre-opening IVC proportion (68.1% (32/47) vs. 35.0% (7/20), χ²=6.313, P=0.012) were statistically significant. The thrombus length (OR=0.948, 95%CI: 0.913 to 0.984, P=0.005), pre-opening IVC (OR=5.451, 95%CI: 1.469 to 20.228, P=0.011) were independent prognosis factors of thrombolytic effect. Conclusions: Thrombolytic therapy for B-CS with IVC thrombosis were satisfactory, and the thrombolysis duration should be confined within 3 weeks. IVC balloon angioplasty is safe and effective for patients failing in thrombolysis, and pre-opening IVC is an important method to improve the thrombolytic effect.
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Síndrome de Budd-Chiari , Trombose , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Terapia Trombolítica , Resultado do Tratamento , Veia Cava Inferior , Adulto JovemRESUMO
OBJECTIVE: The cartilage degeneration that accompanies subchondral bone necrosis plays an important role in the development of osteonecrosis of femoral head (ONFH). To better understand the molecular basis of cartilage degradation in ONFH, we compared the proteomic profiles of ONFH cartilage with that of fracture control. DESIGN: Hip cartilage samples were collected from 16 ONFH patients and 16 matched controls with femoral neck fracture. Proteomics analysis was conducted using tandem mass tag-based quantitation technique. Gene ontology (GO) analysis, KEGG pathway and protein-protein interaction analysis were used to investigate the functions of the altered proteins and biological pathways. Differentially expressed proteins including alpha-2-HS-glycoprotein (AHSG) and Cytokine-like protein 1 (Cytl1) were validated by Western blot (WB) and immunohistochemistry (IHC). RESULTS: 303 differentially expressed proteins were identified in ONFH cartilage with 72 up-regulated and 231 down-regulated. Collagen turnover, glycosaminoglycan biosynthesis, metabolic pathways, and complement and coagulation cascades were significantly modified in ONFH cartilage. WB and IHC confirmed the increased expression of AHSG and decreased expression of Cytl1 in ONFH cartilage. CONCLUSIONS: Our results reveal the implication of altered protein expression in the development of ONFH, and provide novel clues for pathogenesis studies of cartilage degradation in ONFH.
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Cartilagem Articular/metabolismo , Necrose da Cabeça do Fêmur/metabolismo , Articulação do Quadril/metabolismo , Proteínas/metabolismo , Adulto , Estudos de Casos e Controles , Cromatografia Líquida , Regulação para Baixo , Feminino , Humanos , Masculino , Espectrometria de Massas , Pessoa de Meia-Idade , Proteômica , Regulação para CimaRESUMO
Objective: To analyze the distribution characteristics of the anterior corneal astigmatism in 140 000 cataract patients from 18 hospitals in China. Methods: Retrospective study. A total of 143 889 patients (143 889 right eyes) over the age of 40 years with age-related catarac were admitted to 18 Aier eye hospitals in China from July 2015 to October 2018. The average values of the three measurements of the magnitude of anterior corneal astigmatism, the meridian of corneal astigmatism, anterior chamber depth, corneal refractive power, and axial length measured by IOLMaster 500 were obtained. The data acquisition method of each sub-center was to collect and analyze the electronic case data in accordance with the inclusion and exclusion criteria, and to provide them for the sponsor Wuhan Aier Eye Hospital. Non-normal distribution data are presented as M (P25, P75). Mann-Whitney test, Kruskal-Wallis test, Chi-square test were used to analyze the distribution differences of the magnitude of corneal astigmatism and the meridian of corneal astigmatism in gender, age, anterior chamber depth, corneal refractive power and axial length. Results: Among the 143 889 patients, 84 319 were females and 59 570 were males, the median age was 72 (65, 78) years old, the median corneal astigmatism was 0.84 (0.51, 1.33) D; the corneal astigmatism was ≥0.75 D in 80 895 patients (56.22%) and was ≥1.00 D in 57 304 patients (39.83%). The median corneal astigmatism was 0.87 (0.53, 1.37) D in women and 0.82 (0.50, 1.29) D in men; with statistical difference (U=-14.891; P<0.05). The proportion of with-the-rule (WTR) astigmatism was 33.26% (28 046/84 319) for women and 34.26% (20 408/59 570) for men; The proportion of against-the-rule (ATR) astigmatism was 49.08% (41 385/84 319) for women and 46.91% (27 945/59 570) for men, with statistical difference (χ²=70.913; P<0.05). With the increase of age, the magnitude of corneal astigmatism first decreased from 0.94 (0.57, 1.48) D to 0.75 (0.46, 1.18) D, and then increased to 1.19 (0.74, 1.79) D, with statistical difference (H=1 263.438; P<0.05), and the change was at 61 to 70 years old. With the increase of age, the proportion of WTR astigmatism decreased from 77.50% (396/511) to 12.50% (3/24), the proportion of ATR astigmatism increased from 11.15% (57/511) to 79.07% (34/43), and the proportion of oblique astigmatism changed little from 17.02% (16/94) to 19.92% (245/1 230), the distribution difference was significant (χ²=10 174.496; P<0.05). As the anterior chamber became shallow, the magnitude of corneal astigmatism significantly increased from 0.82 (0.51, 1.31) D to 1.05 (0.61, 1.56) D, and the proportion of ATR astigmatism increased from 47.32% (60 207/127 227) to 51.69% (184/356) (H=409.961, χ²=120.995, both P<0.05). With the corneal refractive power rising, the magnitude of corneal astigmatism increased from 0.80 (0.49, 1.33) D to 0.95 (0.58, 1.53) D, the proportion of ATR astigmatism decreased from 52.84% (4 963/9 392) to 39.97% (9 023/22 577); the difference was significant (H=808.562, χ²=752.147, both P<0.05). When the axial length was>25.00 mm, the magnitude of corneal astigmatism was highest [1.04 (0.62, 1.65) D], and the proportion of ATR astigmatism was also highest [49.00% (10 964/22 376)]; the difference was significant (H=2 071.198, χ²=131.130, all P<0.05). Conclusions: The meridian of corneal astigmatism in middle-aged and elderly cataract patients is mainly ATR astigmatism. With the increasing of age, the magnitude of corneal astigmatism decreases first and then increases. The turning point from the proportion of WTR astigmatism to the proportion of ATR astigmatism is 65 years old. The shallower the anterior chamber is, the more the magnitude of corneal astigmatism and the proportion of ATR astigmatism increase. When the axial length is>25.00 mm, both the magnitude of corneal astigmatism and the proportion of ATR astigmatism reach the peak. (Chin J Ophthalmol, 2021, 57: 56-62).
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Astigmatismo , Catarata , Idoso , Astigmatismo/epidemiologia , Biometria , Catarata/epidemiologia , China/epidemiologia , Córnea , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos RetrospectivosRESUMO
Objective: To evaluate the clinical characteristics and prognosis of gallbladder cancer (GBC) patients in China. Methods: This retrospective multicenter cohort study enrolled 3 528 consecutive GBC patients diagnosed between January 2010 to December 2017 in 15 hospitals from 10 provinces. There were 1 345 (38.12%) males and 2 183 (61.88%) females.The age of diagnosis was (63.7±10.8) years old (range: 26 to 99 years old) .There were 213 patients (6.04%) in stage 0 to â , whereas 1 059 (30.02%) in stage â ¡ to â ¢, 1 874 (53.12%) in stage â £, and 382 (10.83%) unavailable. Surgery was performed on 2 255 patients (63.92%) . Three hundred and thirty-six patients received chemotherapy or radiotherapy (9.52%; of which 172 were palliative); 1 101 (31.21%) received only supportive treatment.The patient source, treatment and surgery, pathology, concomitant gallstone, and prognosis were analyzed. Results: Among the 3 528 GBC patients, 959 (27.18%) were from East China, 603 (17.09%) from East-North China, 1 533 (43.45%) from Central China, and 433(12.27%) from West China. Among the 1 578 resectable tumor, 665 (42.14%) underwent radical surgery, 913 (57.86%) underwent surgery that failed to follow the guidelines.Eight hundred and ninety-one (56.46%) patients were diagnosed before surgery, 254 (16.10%) during surgery, and 381 (24.14%) after surgery (time point of diagnosis couldn't be determined in 52 patients) .Among the 1 578 patients with resectable tumor, 759 (48.10%) had concomitant gallstone.Among the 665 patients underwent radical surgery, 69 (10.4%) showed positive resection margin, 510 (76.7%) showed negative resection margin, and 86 (12.9%) unreported margin status.The 5-year overall survival rate (5yOS) for the 3 528-patient cohort was 23.0%.The 5yOS for patients with resectable tumor was 39.6%, for patients with stage â £B tumor without surgery was 5.4%, and for patients with stage â £B tumor underwent palliative surgery was 4.7%. Conclusions: More than half GBC patients in China are diagnosed in stage â £.Curative intent surgery is valuable in improving prognosis of resectable GBC.The treatment of GBC needs further standardization.Effective comprehensive treatment for GBC is in urgent need.
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Neoplasias da Vesícula Biliar/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , China , Feminino , Neoplasias da Vesícula Biliar/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Prognóstico , Estudos RetrospectivosRESUMO
OBJECTIVE: Osteoarthritis (OA) is a common chronic bone and joint disease. Circular RNA is a type of non-coding RNA that forms a circular structure with covalent bonds. There is growing evidence that circRNA can function as a functional RNA and play an important role in the occurrence and development of osteoarthritis chondrocytes. However, the exact role of circRNA on OA remains to be studied. PATIENTS AND METHODS: Quantificational real-time polymerase chain reaction (qRT-PCR) was used to determine the expression levels of CircPSM3 and miRNA-296-5p in OA chondrocytes. Cell proliferation was detected by the Cell Counting Kit (CCK8), and BMP2, BMP4, BMP6 and RUN2 molecular levels in OA chondrocytes were detected by qRT-PCR and Western Blot (WB). Direct targets of CircPSM3 and miRNA-296-5p in OA chondrocytes were measured by Luciferase reporter assay. RESULTS: CircPSM3 expression was upregulated in OA cartilage tissue and cells. Low expression of CircPSM3 promoted the proliferation and cell differentiation of OA chondrocytes. Meanwhile, miRNA-296-5p was down-regulated in OA cartilage tissue and cells. The Luciferase reporter gene showed that CircPSM3 could target miRNA-296-5p. The expression level of CircPSM3 and miRNA-296-5p showed a negative correlation. Further research found that a high expression of miRNA-296-5p could effectively promote the proliferation and cell differentiation of OA chondrocytes. Furthermore, miRNA-296-5p inhibitors reversed the effect of si-CircPSM3 on the proliferation and differentiation of OA chondrocytes, while miRNA-296-5p inhibitors enhanced the effect of si-CircPSM3 on the proliferation and differentiation of OA chondrocytes. CONCLUSIONS: CircPSM3 was upregulated in OA chondrocytes. CircPSM3 participated in the proliferation and differentiation of OA chondrocytes through targeted binding to miRNA-296-5p. CircPSM3 may become a potential therapeutic target for osteoarthritis treatment.
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Condrócitos/metabolismo , Osteoartrite/metabolismo , RNA Circular/metabolismo , RNA Longo não Codificante/metabolismo , Adulto , Diferenciação Celular , Proliferação de Células , Células Cultivadas , Condrócitos/patologia , Feminino , Humanos , Masculino , Osteoartrite/diagnóstico , RNA Circular/genética , RNA Longo não Codificante/genéticaRESUMO
Prevention and control about the situation of 2019 coronavirus disease (COVID-19) are grim at present. In addition to supporting the frontline actively, medical workers in general surgery spare no efforts in making good diagnosis and treatment of specialized diseases by optimizing treatment process, providing medical advice online, mastering indications of delayed operation and emergency operation reasonably, etc. Budd-Chiari syndrome is a complex disorder, and severity of the disease varies, serious cases can be life threatening. While fighting the epidemic, medical workers should also ensure the medical needs of patients. However, instead of continuing the traditional treatment, a new management system should be developed. Based on the characteristics of Budd-Chiari syndrome patients in China and our experience, patients are divided into ordinary cases and critical cases, and treatment strategies suitable for the epidemic period of COVID-19 are put forward for reference and discussion by physicians.
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Síndrome de Budd-Chiari/terapia , Infecções por Coronavirus , Pandemias , Administração dos Cuidados ao Paciente/normas , Pneumonia Viral , Betacoronavirus , COVID-19 , China , Humanos , SARS-CoV-2RESUMO
BACKGROUND: This research examined multimodal analgesia and the use of nonsteroidal anti-inflammatory drugs (NSAIDs) for early analgesic effect and rehabilitation after total knee arthroplasty (TKA). METHODS: A total of 110 patients who were scheduled to undergo TKA were randomly divided into two groups, experimental group and control group. The experimental group received a periarticular multimodal drug injection containing 200 mg ropivacaine, 30 mg ketorolac tromethamine, 0.3 mg epinephrine, and 5 mg hexadecadrol during surgery. The control group received an equal volume of normal saline. All the patients received an analgesia pump and moderate NSAIDs. Resting and motion numeric rating scale (NRS) scores, knee joint range of motion, length of postoperative hospital stay, patient satisfaction, total nonsteroidal anti-inflammatory consumption, and side effects were recorded. RESULTS: The experimental group exhibited significant improvement in pain NRS scores during rest and exercise several days postoperatively. The range of joint motion was more flexible in the experimental group, and the length of postoperative hospital stay was shorter (9.25 ± 1.99 days vs. 10.44 ± 2.62 days, P < 0.05). Patients in the experimental group consumed fewer NSAIDs (965 mg vs. 1325 mg, P < 0.05) and reported greater satisfaction with the surgery. CONCLUSION: Intraoperative periarticular injection with multimodal drugs significantly relieved pain after surgery and reduced the requirements for NSAIDs. This injection also improved patient satisfaction and the range of joint motion with no apparent risks following TKA.
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Analgesia , Anti-Inflamatórios não Esteroides/uso terapêutico , Artroplastia do Joelho/reabilitação , Dor Pós-Operatória/tratamento farmacológico , Assistência Perioperatória/métodos , Idoso , Anestésicos Locais , Feminino , Humanos , Injeções Intra-Articulares , Masculino , Pessoa de Meia-Idade , Avaliação de Processos e Resultados em Cuidados de Saúde , Medição da Dor , Período PerioperatórioRESUMO
BACKGROUND: Human airway smooth muscle cells (ASMCs) may have a pro-inflammatory role through the release of inflammatory mediators. Increasing evidence indicates that human ß-defensins (HBDs) are related to pathogenesis of asthma. OBJECTIVES: To examine the plasma level of HBD-1, HBD-2 and HBD-3 in asthmatic patients and the expression of their mouse orthologues in the lung tissue of a mouse model of chronic severe asthma. Further to investigate the effect of HBD-3 on the release of the pro-inflammatory cytokine IL-8 and to explore the mechanisms. METHODS: The plasma levels of HBD-1, HBD-2 and HBD-3 from 34 healthy controls and 25 asthmatic patients were determined by ELISA. The expression of mouse ß-defensins MBD-1, MBD-3 and MBD-14 in the lung tissue of asthmatic mice was detected by Western blot. The ASMCs were cultured with HBD-3 for 24 hour, and then the supernatant level of IL-8 was evaluated by ELISA and the cell viability was examined by WST-1 assay. The signalling pathway was investigated with blocking antibodies or pharmacological inhibitors. RESULTS: The plasma levels of HBD-1 and HBD-3 were elevated in asthmatic patients, and the expression of MBD-14, the mouse orthologue for HBD-3, was increased in asthmatic mice. HBD-3-induced IL-8 production in a CCR6 receptor-specific manner and was dependent on multiple signalling pathways. Moreover, HBD-3-induced cell apoptosis concurrently, which was dependent on the ERK1/2 MAPK pathway. Mitochondrial ROS regulated both HBD-3-induced IL-8 production and cell apoptosis. CONCLUSIONS AND CLINICAL RELEVANCE: These observations provide clear evidence of an important new mechanism for the promotion of airway inflammation and tissue remodelling with potential relevance for the treatment of asthma.
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Apoptose , Interleucina-8/metabolismo , Miócitos de Músculo Liso/metabolismo , beta-Defensinas/metabolismo , Alérgenos , Animais , Asma/imunologia , Asma/metabolismo , Asma/patologia , Biomarcadores , Estudos de Casos e Controles , Modelos Animais de Doenças , Humanos , Sistema de Sinalização das MAP Quinases , Camundongos , Mitocôndrias Musculares/metabolismo , Modelos Biológicos , NF-kappa B/metabolismo , Espécies Reativas de Oxigênio , Receptores CCR6/metabolismo , Sistema Respiratório/citologia , Sistema Respiratório/metabolismo , Transdução de Sinais , beta-Defensinas/sangueRESUMO
Topological insulators are very interesting from a fundamental point of view, and their unique properties may be useful for electronic and spintronic device applications. From the point of view of applications it is important to understand the decay behavior of carriers injected in the band gap of the topological insulator, which is determined by its complex band structure (CBS). Using first-principles calculations, we investigate the dispersion and symmetry of the complex bands of Bi2Se3 family of three-dimensional topological insulators. We compare the CBS of a band insulator and a topological insulator and follow the CBS evolution in both when the spin-orbit interaction is turned on. We find significant differences in the CBS linked to the topological band structure. In particular, our results demonstrate that the evanescent states in Bi2Se3 are non-trivially complex, i.e. contain both the real and imaginary contributions. This explains quantitatively the oscillatory behavior of the band gap obtained from Bi2Se3 (0 0 0 1) slab calculations.
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Mitochondrial genomes of five Laotian Rock Rat (Laonastes aenigmamus) samples from Vietnam and Laos were sequenced using an Illumina platform. After de novo assembly, 13 protein-coding genes and two rRNA (12S and 16S) of the five genomes were aligned and analyzed with those from other related species under maximum likelihood and Bayesian inferences. Both methods revealed congruent tree topologies, which support two independently evolving clades of L. aenigmamus from Laos and Vietnam. The relaxed time calibration analysis showed that the two major lineages of the Laotian Rock Rat split about 8 million years ago, which was consistent with the results from previous studies using only cytochrome b sequences. Such a deep divergence time suggests the recognition of two rock rat species, but further nuclear DNA and morphological data are needed to solve the taxonomy of this taxon.
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STUDY DESIGN: Experimental dog model of spinal cord shortening. OBJECTIVES: To clarify the relationship between the amount of shortening of the spinal cord and the degree of injury it may induce, and to determine the safe range of the shortening. SETTING: Xi'an Jiaotong University, China. METHODS: Thirty adult dogs were randomly allocated to five groups. Dogs in Group A (sham operation control) underwent spondylectomy to have two-thirds of the thirteenth thoracic segment (T13) resected, without bone-to-bone contact of the adjacent vertebral bodies. Those in Group B, C, D and E had one-third, half, two-thirds and total of their T13 resected, respectively, with bone-to-bone contact. Somatosensory-evoked potentials (SEP) and spinal cord blood flow (SCBF) were detected. The histopathologic changes of spinal cord tissue were observed by hematoxylin and eosin stain and electron microscope. RESULTS: The shortening of the spinal cord < half of a vertebral segment height caused a reversible change of SEP. Whereas, the changes resulted from the shortening of more than two-thirds of a vertebral segment height did not return to the normal level. SCBF increased temporarily when the shortening was within two-thirds of a vertebral segment height; whereas, it decreased progressively when the length of the shortening was equal to one vertebral segment height. More serious hemorrhage occurred as the shortening increased. CONCLUSION: Shortening of half of a vertebral segment height will not induce spinal cord injury (SCI), while that between half and two-thirds of a vertebral segment may lead to incomplete SCI.
Assuntos
Procedimentos Neurocirúrgicos/efeitos adversos , Procedimentos Ortopédicos/efeitos adversos , Medula Espinal/irrigação sanguínea , Coluna Vertebral/cirurgia , Animais , Modelos Animais de Doenças , Cães , Potenciais Somatossensoriais Evocados , Procedimentos Neurocirúrgicos/métodos , Procedimentos Ortopédicos/métodos , Medula Espinal/patologia , Medula Espinal/fisiopatologia , Traumatismos da Coluna Vertebral/cirurgiaRESUMO
The house fly, Musca domestica L. (Diptera: Muscidae), is involved in phoretic movement of pathogenic agents, but it has a very efficient defense mechanism against infection. It is believed that antimicrobial peptides play a significant role in the defense system of the house fly. Here, we isolated a peptide from the immunized house fly pupae, measured its molecular mass (3987.6 Da) by matrix-assisted laser desorption ionization/time of flight-mass spectrometry, and determined its amino acid sequence by using the Procise Protein Sequencing System (Applied Biosystems, Foster City, CA). The peptide was confirmed as a member of the insect defensin family. It displayed high activity against gram-positive bacteria but lower activity against gram-negative bacteria and fungi. Reverse transcription-polymerase chain reaction showed that the house fly defensin gene was constitutively expressed in naive pupae and strongly up-regulated after immunization. House fly defensin is an amphiphilic peptide with a structure similar to that of the CSalphabeta scaffold of insect defensin A from the flesh fly, Phormia terraenovae Robineau-Desvoidy. To our knowledge, this is the first isolated and characterized house fly antimicrobial peptide, and our work may provide useful information for developing pharmacologically active antimicrobial agents.
Assuntos
Peptídeos Catiônicos Antimicrobianos/metabolismo , Peptídeos Catiônicos Antimicrobianos/farmacologia , Dípteros/imunologia , Dípteros/metabolismo , Animais , Peptídeos Catiônicos Antimicrobianos/isolamento & purificação , Bactérias/efeitos dos fármacos , Fungos/efeitos dos fármacosRESUMO
Phosphorylation affects several biological functions of connexin43 (Cx43), although its role on Cx43-mediated inhibition of DNA synthesis is not known. Previous studies showed increased Cx43 phosphorylation on serine in response to growth factor stimulation of cardiomyocytes, mediated by protein kinase C-epsilon (PKCepsilon). Here we report that activation of PKCepsilon is also necessary for stimulation of cardiomyocyte DNA synthesis and mitosis. We have investigated the participation of specific serine residues that are putative PKC targets in producing phosphorylated Cx43 species and also in regulating DNA synthesis in cardiomyocytes. Interference with the PKC signaling system and/or the phosphorylation of specific amino-acids of Cx43 may allow regulation of the mitogenic response.
Assuntos
Conexina 43/metabolismo , Fator 2 de Crescimento de Fibroblastos/farmacologia , Mitose/efeitos dos fármacos , Fosforilação/efeitos dos fármacos , Proteína Quinase C/metabolismo , Animais , Células Cultivadas , Clonagem Molecular , Conexina 43/genética , Replicação do DNA , Ativação Enzimática/efeitos dos fármacos , Células HeLa , Humanos , Mutação , Miócitos Cardíacos/metabolismo , Proteína Quinase C-épsilon , Ratos , Serina/metabolismoRESUMO
OBJECTIVE: To establish a method for the determination of notoginsenoside R1 in Radix Notoginseng. METHOD: The HPLC-ELSD method was used for the determination. Chromatographic conditions: Shimpack CLC-ODS column(6.0 mm x 150 mm), acetonitrile-water(30:70) as the mobile phase, and Shimadzu LC-6A with SEDEX 55 ELSD detector. RESULT: The recovery rate is 101.57% and relative standard deviation 1.98%. CONCLUSION: The method is reliable for the quality control of Radix Notoginseng.
Assuntos
Ginsenosídeos/análise , Panax/química , Plantas Medicinais/química , Cromatografia Líquida de Alta Pressão/métodos , Ginsenosídeos/normas , Raízes de Plantas/química , Controle de QualidadeRESUMO
OBJECTIVE: To provide the theoretical value for the treatment and prognostic judgement of APN. METHODS: All cases were scored on the pathologic change of glomeruli and tubules. RESULTS: The pathologic scores of glomeruli in 30 cases were as follows: no one on Grade 0; 6(20%) on Grade 1; 17(56.7%) on Grade 2 and 7 (23.3%) on Grade 3. The pathologic scores of tubule were: Grade 0 was 2(6.7%); Grade 1 was 6(20%); Grade 2 was 14(46.7%); Grade 3 was 8(26.7%). There was positive correlation between glomerulus and tubule pathologic degree(r = 0.783, P < 0.01). The pathologic score of nephrotic syndrome in clinical manifestation was higher than that of non-nephrotic syndrome(P < 0.01). There was no significant difference in glomerular pathologic score between the simple urinary protein group and acute glomerulonephritis(AGN) group(P > 0.05), but tubular pathologic score in simple urinary proteins group was higher than that of AGN and essential hematuria group (P < 0.01, P < 0.05). The pathologic score of kidney(including glomerulus and tubule) was positively correlated with the disease course(r = 0.563, P < 0.01), but not with serum urea nitrogen and creatinine(r = 0.281, r = 0.236, P > 0.05). CONCLUSION: Serious tubular pathologic changes(not only glomerular pathologic change, but also tubular pathologic change in the APN children) were found in the patients with nephrotic syndrome and simple urinary proteins. Long-term urinary protein and the recurrence of the disease may be the important risk factor in kidney pathologic of APN.