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1.
Int Immunopharmacol ; 128: 111469, 2024 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-38211480

RESUMO

Osteoarthritis (OA) is a prevalent joint disorder pathologically correlated to chondrocyte ferroptosis. Gamma-oryzanol (γ-Ory), as a first-line drug for autonomic disorders, aroused our interest because of its antioxidant, lipid-lowering, and hypoglycemic potential. The purpose of this study was to investigate the potential impact and mechanism of γ-Ory in treating OA. And the inhibition of γ-Ory in extracellular matrix molecule (ECM) degradation, ferroptosis, and Keap1-Nrf2 binding in IL-1ß-exposed chondrocytes was detected via immunoblotting, immunofluorescence, and co-immunoprecipitation. Micro-CT, SO staining, and immunofluorescence have been conducted to assess the impact of γ-Ory treatment on ACLT-mediated OA in rats at both imaging and histological stages. We found that γ-Ory dose-dependently suppressed IL-1ß-induced ECM deterioration and chondrocyte ferroptosis. Our animal experiments revealed that γ-Ory delayed ACLT-mediated OA development. Mechanistically, γ-Ory interfered with the binding of Keap1 to Nrf2 to promote the latter's nuclear import, thereby increasing the expression of detoxification enzymes. Summarily, our works support γ-Ory's potential as a candidate drug for the treatment of OA.


Assuntos
Ferroptose , Osteoartrite , Fenilpropionatos , Animais , Ratos , Condrócitos/metabolismo , Interleucina-1beta/metabolismo , Proteína 1 Associada a ECH Semelhante a Kelch/metabolismo , Fator 2 Relacionado a NF-E2/metabolismo , Osteoartrite/tratamento farmacológico , Fenilpropionatos/uso terapêutico
2.
Phytomedicine ; 125: 155342, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38295665

RESUMO

BACKGROUND: Type 2 diabetes is often linked with osteoporosis (T2DOP), a condition that accelerates bone degeneration and increases the risk of fractures. Unlike conventional menopausal osteoporosis, the diabetic milieu exacerbates the likelihood of fractures and osteonecrosis. In particular poliumoside (Pol), derived from Callicarpa kwangtungensis Chun, has shown promising anti-oxidant and anti-inflammatory effects. Yet, its influence on T2DOP remains to be elucidated. PURPOSE: The focus of this study was to elucidate the influence of Pol in HGHF-associated ferroptosis and its implications in T2DOP. STUDY DESIGN: A murine model of T2DOP was established using a minimal dosage of streptozotocin (STZ) through intraperitoneal infusion combined with a diet high in fat and sugar. Concurrently, to mimic the diabetic condition in a lab environment, bone mesenchymal stem cells (BMSCs) were maintained in a high-glucose and high-fat (HGHF) setting. METHODS: The impact of Pol on BMSCs in an HGHF setting was determined using methods, such as BODIPY-C11, FerroOrange staining, mitochondrial functionality evaluations, and Western blot methodologies, coupled with immunoblotting and immunofluorescence techniques. To understand the role of Pol in a murine T2DOP model, techniques including micro-CT, hematoxylin and eosin (H&E) staining, dual-labeling with calcein-alizarin red, and immunohistochemistry were employed for detailed imaging and histological insights. RESULTS: Our findings suggest that Pol acts against HGHF-induced bone degradation and ferroptosis, as evidenced by an elevation in glutathione (GSH) and a decline in malondialdehyde (MDA) levels, lipid peroxidation, and mitochondrial reactive oxygen species (ROS). Furthermore, Pol treatment led to increased bone density, enhanced GPX4 markers, and reduced ROS in the distal femur region. On investigating the underlying mechanism of action, it was observed that Pol triggers the Nrf2/GPX4 pathway, and the introduction of lentivirus-Nrf2 negates the beneficial effects of Pol in HGHF-treated BMSCs. CONCLUSION: Pol is effective in treating T2DOP by activating the Nrf2/GPX4 signaling pathway to inhibit ferroptosis.


Assuntos
Ácidos Cafeicos , Diabetes Mellitus Tipo 2 , Ferroptose , Glicosídeos , Osteoporose , Animais , Camundongos , Diabetes Mellitus Tipo 2/tratamento farmacológico , Fator 2 Relacionado a NF-E2 , Espécies Reativas de Oxigênio , Osteoporose/tratamento farmacológico , Osteoporose/prevenção & controle
3.
Phytomedicine ; 114: 154739, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-37004404

RESUMO

BACKGROUND: Osteoporosis is a prevalent bone metabolic disease in menopause, and long-term medication is accompanied by serious side effects. Estrogen deficiency-mediated hyperactivated osteoclasts is the initiating factor for bone loss, which is regulated by nuclear factor-κB (NF-κB) signaling. Safranal (Saf) is a monoterpene aldehyde produced from Saffron (Crocus sativus L.) and possesses multiple biological properties, particularly the anti-inflammatory property. However, Saf's role in osteoporosis remains unknown. PURPOSE: This study aims to validate the role of Saf in osteoporosis and explore the potential mechanism. STUDY DESIGN: The RANKL-exposed mouse BMM (bone marrow monocytes) and the castration-mediated osteoporosis model were applied to explore the effect and mechanism of Saf in vitro and in vivo. METHOD: The effect of Saf on osteoclast formation and function were assessed by TRAcP staining, bone-resorptive experiment, qPCR, immunoblotting and immunofluorescence, etc. Micro-CT, HE, TRAcP and immunohistochemical staining were performed to estimate the effects of Saf administration on OVX-mediated osteoporosis in mice at imaging and histological levels. RESULTS: Saf concentration-dependently inhibited RANKL-mediated osteoclast differentiation without affecting cellular viability. Meanwhile, Saf-mediated anti-osteolytic capacity and Sirt1 upregulation were also found in ovariectomized mice. Mechanistically, Saf interfered with NF-κB signaling by activating Sirt1 to increase p65 deacetylation and inactivating IKK to decrease IκBα degradation. CONCLUSION: Our results support the potential application of Saf as a therapeutic agent for osteoporosis.


Assuntos
Osteoporose , Animais , Camundongos , Camundongos Endogâmicos C57BL , Osteoporose/tratamento farmacológico , Osteoporose/metabolismo , Estrogênios/deficiência , Estrogênios/metabolismo , Feminino , Osteoclastos , Reabsorção Óssea/tratamento farmacológico , Reabsorção Óssea/metabolismo , Ovariectomia , NF-kappa B/metabolismo , Acetilação
4.
Int Immunopharmacol ; 117: 109893, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-36842234

RESUMO

Osteoporosis is a prevalent bone metabolic disease in menopause, and long-term medication is accompanied by serious side effects. Ginger, a food spice and traditional medicine with ancient history, exhibits the potential to alleviate osteoporosis in preclinical experiments, whereas its complex composition leads to ambiguous pharmacological mechanisms. The purpose of this study was to investigate the effect and mechanism of Ced in estrogen-deficient osteoporosis, a sesquiterpene alcohol recently discovered from Ginger with multiple pharmacological properties. RANKL was stimulated BMM (bone marrow macrophages) differentiation into osteoclasts in vitro. And the osteoclast activity and number were assessed by TRAcP and SEM. We found that Ced mitigated RANKL-induced osteoclastogenesis by descending the ROS content and obstructing NFATc1, NF-κB, and MAPK signaling. Also, Ced-mediated anti-osteolytic property was found in ovariectomized mice by Micro-CT scanning and histological staining. Summarily, our works demonstrated the anti-osteoporotic potential of Cedrol in Ginger for the first time, which also offered more pharmacological evidence for Ginger as food or medicine used for bone metabolic disease.


Assuntos
Osteoporose , Zingiber officinale , Feminino , Animais , Camundongos , Espécies Reativas de Oxigênio/metabolismo , Osteoclastos , Osteoporose/tratamento farmacológico , Osteoporose/metabolismo , Osteogênese , NF-kappa B/metabolismo , Estrogênios/metabolismo , Ligante RANK/metabolismo , Fatores de Transcrição NFATC/metabolismo , Diferenciação Celular
5.
China Tropical Medicine ; (12): 954-2022.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-979974

RESUMO

@#Abstract: Objective To compare the mosquito trapping effect of BG-trap mosquito trap using carbon dioxide versus BG-lure attractant under filed conditions. Methods In August and September 2020, two areas were set with a distance of 100 m. Two sites were set at each area, and one mosquito trap BG trap was set with a distance of 5 m. Each site was set with different flow of CO2 and different amount of BG-lure attractants. The BG-trap mosquito traps on the same area would exchange positions every other day. The mosquitoes captured by each mosquito trap was collected and classified. and the species, sex and number of mosquitoes captured were recorded and counted. Results The densities of Aedes albopictus captured by BG+/CO2-and BG-/CO2+were 14 and 31, and that of Culex pipiens pallens were 2 and 16, respectively. The differences were statistically significant (Aedes albopictus, t=-2.675, P<0.05; Culex pipiens pallens, t=-4.873, P<0.05). With BG-lure attractant, the females of Aedes albopictus and Culex pipiens pallens in the CO2+group were 2.6 (25/9.5) and 12.0 (12 /1) times higher than those in the CO2-group, and the differences were statistically significant (female Aedes albopictus, t=-4.119, P<0.01; female Culex pipiens pallens, t=-4.592, P<0.01), suggesting that the most important attractant to female mosquitoes is CO2. With BG-lure attractant, the male Aedes albopictus in the CO2+ group was 3.0 (12/4) times higher than that in the CO2-group, and the difference was statistically significant (male Aedes albopictus, t=-3.284, P<0.01). Without BG-lure attractant, female Aedes albopictus and female Culex pipiens pallens in the CO2 + group were 1.8 (18 / 10) and 15.5 (15.5/1.0) times higher than those in the CO2-group, and the difference was statistically significant (female Aedes albopictus, t=-2.868, P<0.05; female Culex pipiens pallens, t=-5.259, P<0.05). Without BG-lure attractant, the male Aedes albopictus in the CO2+group was 2.0 (9.0/4.5) times higher than that in the CO2-group, with a statistically significant difference (t=-2.508, P<0.05). With CO2, Aedes albopictus and Culex pipiens pallens in the BG + attractant group were 1.4 (43.5/31) and 0.78 (12.5/16.0) times higher than those in the BG-attractant group, and the differences were not statistically significant (Aedes albopictus, t=-0.943, P>0.05 ; Culex pipiens pallens, t=0.709, P>0.05). Without CO2, Aedes albopictus and Culex pipiens pallens in the BG + attractant group were 1.0 (14/14) and 2.0 (2.0/1.0) times higher than those in the BG + attractant group, and the differences were not statistically significant (Aedes albopictus, t=-0.500, P>0.05; Culex pipiens pallens, t=-1.000, P>0.05). Without BG-lure attractant, the densities of female Aedes albopictus captured by adding 0, 1 and 2 parts of dry ice were 10, 17.5 and 18 respectively, and the difference was statistically significant among the three groups (F=3.942, P<0.05). The densities of female Culex pipiens pallens captured were 1, 13 and 18 respectively, and the difference was statistically significant among the three groups (F=13.881, P<0.05). However, there was no significant difference between the capture of female Aedes albopictus and female Culex pipiens pallens by adding 1 part of dry ice and 2 parts of dry ice (female Aedes albopictus, t=0.112, P>0.05; female Culex pipiens pallens, t=-0.540, P>0.05). Without CO2, 10, 10, 9.5 and 1, 1 and 1.5 female Aedes albopictus and Culex pipiens pallens were captured by adding 0, 1 and 2 portions of BG-lure attractants, respectively. There were no significant differences between the three groups (female Aedes albopictus, F=0.120, P>0.05; female Culex pipiens pallens, F=0.477, P>0.05). Conclusions In the monitoring of BG-trap mosquito trap, the mosquito trapping effect of CO2 is better than that of BG-lure attractant. When the same monitoring effect is obtained, the use of CO2 (100 mL/min) can save the use cost.

6.
Sci Rep ; 6: 20141, 2016 Jan 29.
Artigo em Inglês | MEDLINE | ID: mdl-26821752

RESUMO

Wnt-induced secreted protein-1 (WISP1) is an extracellular matrix protein that has been reported in cancer researches. Our previous studies on WISP1 implied it could be a harmful mediator in septic mice. However, its role in liver ischemia reperfusion (I/R) injury is unknown. This study investigated the effects of WISP1 on liver I/R damage. Male C57BL/6 wild-type mice were used to undergo 60 min segmental (70%) ischemia. WISP1 expression was measured after indicated time points of reperfusion. Anti-WISP1 antibody was injected intraperitoneally to mice. Toll-like receptor 4 (TLR4) knockout mice and TIR-domain-containing adaptor inducing interferon-ß (TRIF) knockout mice were adopted in this study. WISP1 was significantly enhanced after 6 h of reperfusion when compared with sham treated mice and significantly decreased either by TLR4 knockout mice or TRIF knockout mice. Anti-WISP1 antibody significantly decreased serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), pathological changes and pro-inflammatory cytokine levels in the mice following I/R. Furthermore, significantly increased serum transaminase levels were found in C57 wild-type mice treated with recombinant WISP1 protein, but not found in TLR4 knockout or TRIF knockout mice subjected to liver I/R. Taken together, WISP1 might contribute to hepatic ischemia reperfusion injury in mice and possibly depends on TLR4/TRIF signaling.


Assuntos
Proteínas de Sinalização Intercelular CCN/biossíntese , Regulação da Expressão Gênica , Fígado/metabolismo , Proteínas Proto-Oncogênicas/biossíntese , Traumatismo por Reperfusão/metabolismo , Transdução de Sinais , Receptor 4 Toll-Like/metabolismo , Proteínas Adaptadoras de Transporte Vesicular/genética , Proteínas Adaptadoras de Transporte Vesicular/metabolismo , Animais , Proteínas de Sinalização Intercelular CCN/genética , Fígado/patologia , Masculino , Camundongos , Camundongos Knockout , Proteínas Proto-Oncogênicas/genética , Traumatismo por Reperfusão/genética , Traumatismo por Reperfusão/patologia , Receptor 4 Toll-Like/genética
7.
Int J Clin Exp Med ; 8(1): 368-76, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25785007

RESUMO

Early post-operative mobilization is important both to reduce immobility-related complications and to get the best functional result following surgery on knee. We hypothesized that saphenous nerve block would reduce pain in this patient category compared with placebo injection. In this study, two reviewers independently searched the databases of PubMed, EMBASE, and Cochrane Library (last performed on 12 October, 2014) to retrieve eligible randomized controlled clinical trials. The primary outcomes were visual analog scale (VAS) pain scores within 24 hours after operation when at rest and at an active flexion of knee. Mean difference (MD) or odds ratio (OR) with 95% confidence intervals (CIs) was calculated for each end point. Subgroup analysis was calculated to evaluate potential sources of heterogeneity. Nine randomized controlled trials were retrieved and analyzed. We found that VAS pain scores at rest within postoperative 24 hours were significantly decreased in saphenous nerve block group than that in placebo group (MD = -0.79; 95% CI -1.35 to -0.22; P = 0.007), as well as VAS pain scores at an active flexion of knee within postoperative 24 hours (MD = -0.92; 95% CI -1.61 to -0.22; P = 0.010). In addition, compared to placebo injection group, saphenous nerve block resulted in significantly less morphine consumption during the first postoperative 24 hours (MD = -6.56; 95% CI -11.26 to -1.86; P = 0.006). To conclude, this meta-analysis suggests that saphenous nerve block has an advantage in pain relief both at an active flexion of knee and at rest after knee surgery. Further studies are still wanted to validate these conclusions.

8.
Int J Clin Exp Med ; 7(9): 2966-75, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25356170

RESUMO

BACKGROUND: The increasing use of the transversus abdominis plane (TAP) block, as a form of pain relief after laparoscopic surgery, warrants evaluation of its effectiveness, when compared with other analgesic techniques. METHODS: We searched online databases of MEDLINE, EMBASE, Google scholar and The Cochrane Database of Systematic Review. Mean differences (MD) were formulated for continuous data; odds ratios (OR) were calculated for dichotomous data. Results were produced with a random effects model with 95% confidence intervals (CI). RESULTS: 14 trials with a total of 905 patients were included for the analysis, TAP block resulted in significantly less postoperative analgesic consumption at 24 h (MD = -25.46, 95% CI [-32.22, -18.69], P < 0.00001), and less number of patients requiring analgesic postoperatively (OR = 0.16, 95% CI 0.03-0.87, P = 0.03). Meanwhile, pain sores were significantly different at 2 h (MD = -1.55, 95% CI [-2.50, -0.59], P < 0.00001), a borderline difference between the groups seen at 6 hours ( MD = -1.13, 95% CI [-1.69, -0.56], P = 0.05), and there was not affect pain at 24 h (MD = -0.33, 95% CI [-0.08, 0.15], P = 0.14) with TAP block groups compared with the groups without TAP block. There was a significant difference in postoperative nausea and vomiting (random effects model: OR = 2.04, 95% CI [1.19-3.48], P = 0.34). CONCLUSION: TAP block would result in less analgesic consumption, less requirement of analgesic, and less pain at 2 h and slightly at 6 h but at 24 h after laparoscopic surgery in comparison with usual care alone or placebo block. In addition TAP block can increase the incidence of postoperative nausea and vomiting.

9.
Zhejiang Da Xue Xue Bao Yi Xue Ban ; 43(4): 413-9, 2014 07.
Artigo em Chinês | MEDLINE | ID: mdl-25187455

RESUMO

OBJECTIVE: To investigate the relationship between pre B cell leukemia transcription factor 2 (PBX2)/Ets domain transcription factor 2 (ELF2) expression with prognosis of non-small cell lung cancer (NSCLC). METHODS: Expressions of ELF2 and PBX2 were examined in 206 patients of NSCLC by immunohistochemistry. The correlation of PBX2/ELF2 expression with valosin-containing protein (VCP) expression and clinicopathologic factors of NSCLC patients was analyzed. Chi-square test, Fisher's exact test and Cox's regression were used for statistical analysis. RESULTS: The level of PBX2/ELF2 expression was associated with VCP expression (P=0.0126). Univariate analysis showed that 5-y disease free survival and overall survival (OS) of NSCLC were correlated with expression of PBX2, PBX2/ELF2 and VCP, tumor size, histological differentiation, visceral pleural invasion, N and T in pTNM grades, and clinical stages (P<0.05). The 5-y OS was also related to vascular invasion (P=0.0322). Multivariate analysis revealed that the expression level of PBX2/ELF2 and histological differentiation were independent predictors for NSCLC. CONCLUSION: The level of PBX2/ELF2 expression is related to VCP expression, indicating that PBX2/ELF2-VCP pathway may be associated with the prognosis of NSCLC patients.


Assuntos
Carcinoma Pulmonar de Células não Pequenas/metabolismo , Proteínas de Homeodomínio/metabolismo , Neoplasias Pulmonares/metabolismo , Proteínas Proto-Oncogênicas/metabolismo , Fatores de Transcrição/metabolismo , Adenosina Trifosfatases/metabolismo , Adulto , Idoso , Carcinoma Pulmonar de Células não Pequenas/diagnóstico , Proteínas de Ciclo Celular/metabolismo , Feminino , Humanos , Neoplasias Pulmonares/diagnóstico , Masculino , Pessoa de Meia-Idade , Prognóstico , Proteína com Valosina
10.
Int J Clin Exp Med ; 7(6): 1558-68, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25035780

RESUMO

The aim of this study is to compare the operative parameters and outcomes of conventional CO2-pneumoperitoneum (PP) versus gasless abdominal wall-lifting (AWL) for laparoscopic surgery. The literature databases of PubMed, Google Scholar and Cochrane Library were searched for randomized controlled trials (RCTs) that had compared the CO2-PP approach with that of gasless AWL for laparoscopic surgery and which had been published between 1995 and 2012. Data for the operative parameters (i.e. surgery duration, intraoperative heart rate (HR), perioperative complications, and postoperative duration of hospital stay and time to activity) and outcomes (postoperative shoulder pain, nausea/vomiting (PONV), partial pressure of CO2 in the blood (PaCO2), blood pH, and serum levels of the inflammatory cytokine interleukin (IL)-6) were extracted from the identified RCTs. RevMan software, version 5.2, was used for data synthesis and statistical analysis. Nineteen RCTs were selected for the meta-analysis, involving a total of 791 patients who had undergone laparoscopic operations with CO2-PP (n = 399) or gasless AWL (n = 392). Sub-group analysis indicated that the patients who underwent gasless AWL had significantly shorter postoperative time to activity (weighted mean difference (WMD) = -0.23 d, 95% confidence interval (CI): -0.37 to -0.09; P = 0.001), lower incidence of PONV (odds ratio (OR) = 0.24, 95% CI: 0.10 to 0.57; P = 0.001) and lower postoperative PaCO2 level (WMD = -3.09 mmHg, 95% CI: -4.66 to -1.53; P = 0.0001), compared to the patients who underwent CO2-PP. However, the CO2-PP method was associated with a significantly shorter surgery duration than the gasless AWL method (WMD = 8.61, 95% CI: 3.19 to 14.03; P = 0.002). There were no significant advantages detected for either approach with respect to the intraoperative HR, the perioperative complication rate, or the postoperative parameters of duration of hospital stay, shoulder pain, blood pH, or serum IL-6 level. We concluded form present study that the gasless AWL method has the features of shorter time, lower postoperative PaCO2, and lower PONV incidence while the CO2-PP method for laparoscopy requires shorter surgical time.

12.
J Zhejiang Univ Sci B ; 13(3): 168-75, 2012 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-22374608

RESUMO

OBJECTIVE: In this study, we investigated the interrelationship between clinicopathologic findings and pre-B-cell leukemia transcription factor 2 (PBX2) expression in gingival squamous cell carcinoma (GSCC). METHODS: Expression level of PBX2 was immunohistochemically examined in 66 GSCC subjects (30 men and 36 women) with ages ranging from 42 to 85 (median 64.5) years, in which staining intensity in tumor cells was categorized as either weaker (level 1) or equal to/stronger (level 2) than that in the endothelial cells. RESULTS: PBX2 expression is correlated with valosin-containing protein (VCP) expression. Univariate and multivariate analyses revealed a high level of PBX2 expression to be a poor prognosticator for disease-free survival (DFS) and overall survival (OS), and PBX2 expression was an independent prognostic factor for both DFS and OS in GSCC. CONCLUSIONS: PBX2 expression level in GSCC is prognostic. PBX2 may be a useful marker to identify the potential for progression in GSCC.


Assuntos
Biomarcadores Tumorais/metabolismo , Carcinoma de Células Escamosas/metabolismo , Neoplasias Gengivais/metabolismo , Proteínas de Homeodomínio/metabolismo , Proteínas Proto-Oncogênicas/metabolismo , Adenosina Trifosfatases/metabolismo , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores Tumorais/genética , Carcinoma de Células Escamosas/genética , Carcinoma de Células Escamosas/patologia , Proteínas de Ciclo Celular/metabolismo , Progressão da Doença , Intervalo Livre de Doença , Feminino , Expressão Gênica , Neoplasias Gengivais/genética , Neoplasias Gengivais/patologia , Proteínas de Homeodomínio/genética , Humanos , Imuno-Histoquímica , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Prognóstico , Proteínas Proto-Oncogênicas/genética , RNA Mensageiro/genética , RNA Mensageiro/metabolismo , RNA Neoplásico/genética , RNA Neoplásico/metabolismo , Proteína com Valosina
13.
Clinics (Sao Paulo) ; 66(1): 119-24, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21437447

RESUMO

OBJECTIVES: Recent guidelines recommend that all cirrhotic patients should undergo endoscopic screening for esophageal varices. That identifying cirrhotic patients with esophageal varices by noninvasive predictors would allow for the restriction of the performance of endoscopy to patients with a high risk of having varices. This study aimed to develop a decision model based on classification and regression tree analysis for the prediction of large esophageal varices in cirrhotic patients. METHODS: 309 cirrhotic patients (training sample, 187 patients; test sample 122 patients) were included. Within the training sample, the classification and regression tree analysis was used to identify predictors and prediction model of large esophageal varices. The prediction model was then further evaluated in the test sample and different Child-Pugh classes. RESULTS: The prevalence of large esophageal varices in cirrhotic patients was 50.8%. A tree model that was consisted of spleen width, portal vein diameter and prothrombin time was developed by classification and regression tree analysis achieved a diagnostic accuracy of 84% for prediction of large esophageal varices. When reconstructed into two groups, the rate of varices was 83.2% for high-risk group and 15.2% for low-risk group. Accuracy of the tree model was maintained in the test sample and different Child-Pugh classes. CONCLUSIONS: A decision tree model that consists of spleen width, portal vein diameter and prothrombin time may be useful for prediction of large esophageal varices in cirrhotic patients.


Assuntos
Árvores de Decisões , Varizes Esofágicas e Gástricas/diagnóstico , Cirrose Hepática/complicações , Endoscopia Gastrointestinal/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Tamanho do Órgão , Contagem de Plaquetas , Veia Porta/patologia , Valor Preditivo dos Testes , Prognóstico , Tempo de Protrombina/métodos , Análise de Regressão , Reprodutibilidade dos Testes , Fatores de Risco , Baço/patologia , Esplenomegalia/complicações , Estatísticas não Paramétricas
14.
Clinics ; 66(1): 119-124, 2011. ilus, tab
Artigo em Inglês | LILACS | ID: lil-578607

RESUMO

OBJECTIVES: Recent guidelines recommend that all cirrhotic patients should undergo endoscopic screening for esophageal varices. That identifying cirrhotic patients with esophageal varices by noninvasive predictors would allow for the restriction of the performance of endoscopy to patients with a high risk of having varices. This study aimed to develop a decision model based on classification and regression tree analysis for the prediction of large esophageal varices in cirrhotic patients. METHODS: 309 cirrhotic patients (training sample, 187 patients; test sample 122 patients) were included. Within the training sample, the classification and regression tree analysis was used to identify predictors and prediction model of large esophageal varices. The prediction model was then further evaluated in the test sample and different Child-Pugh classes. RESULTS: The prevalence of large esophageal varices in cirrhotic patients was 50.8 percent. A tree model that was consisted of spleen width, portal vein diameter and prothrombin time was developed by classification and regression tree analysis achieved a diagnostic accuracy of 84 percent for prediction of large esophageal varices. When reconstructed into two groups, the rate of varices was 83.2 percent for high-risk group and 15.2 percent for low-risk group. Accuracy of the tree model was maintained in the test sample and different Child-Pugh classes. CONCLUSIONS: A decision tree model that consists of spleen width, portal vein diameter and prothrombin time may be useful for prediction of large esophageal varices in cirrhotic patients.


Assuntos
Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Árvores de Decisões , Varizes Esofágicas e Gástricas/diagnóstico , Cirrose Hepática/complicações , Endoscopia Gastrointestinal/métodos , Tamanho do Órgão , Contagem de Plaquetas , Valor Preditivo dos Testes , Prognóstico , Veia Porta/patologia , Tempo de Protrombina/métodos , Análise de Regressão , Reprodutibilidade dos Testes , Fatores de Risco , Estatísticas não Paramétricas , Baço/patologia , Esplenomegalia/complicações
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