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1.
Eur J Neurosci ; 2024 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-39138595

RESUMO

Mathematical learning and ability are crucial for individual and national economic and technological development, but the neural mechanisms underlying advanced mathematical learning remain unclear. The current study used functional magnetic resonance imaging (fMRI) to investigate how brain networks were involved in advanced mathematical learning and transfer. We recorded fMRI data from 24 undergraduate students as they learned the advanced mathematical concept of a commutative mathematical group. After learning, participants were required to complete learning and transfer behavioural tests. Results of single-trial interindividual brain-behaviour correlation analysis found that brain activity in the semantic and visuospatial networks, and the functional connectivity within the semantic network during advanced mathematical learning were positively correlated with learning and transfer effects. Additionally, the functional connectivity between the semantic and visuospatial networks was negatively correlated with the learning and transfer effects. These findings suggest that advanced mathematical learning relies on both semantic and visuospatial networks.

2.
Obes Surg ; 34(8): 3105-3110, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-39034373

RESUMO

Sleeve gastrectomy (SG) is widely recognized as the leading bariatric procedure worldwide. However, leakage, its major complication, remains a significant concern. This study focuses on the challenges of managing leakage, especially when conventional endoscopic treatments are ineffective. Although a novel one-step approach as reported by Pulimuttil James Zachariah from Wei-Jei Lee's team has demonstrated promise, further investigations and reports on its efficacy are currently insufficient. Between January 2021 and November 2023, we analyzed five patients treated at our center for SG leakage. Patient data include demographics, comorbidities, surgical details, and outcomes. The study details Laparo-Endoscopic Gastrostomy procedures performed post-SG leakage diagnosis, highlighting differences between acute and chronic instances. The study effectively implemented Zachariah's one-step approach, achieving favorable results in all five cases. Patient characteristics, presentation, postoperative progression, and additional treatments were documented. The outcome supports Zachariah's assertion that the one-step approach is a simple, safe, and cost-effective approach for SG leakage, avoiding digestive tract reconstruction. Despite potential limitations, including challenges in closing large defects and extended healing times, the procedure's effectiveness in decompression, drainage, and nutritional support significantly contributes to its elevated healing rate. The study emphasizes the importance of timely abdominal drain removal based on clinical conditions, challenging traditional practices for better clinical outcomes.


Assuntos
Fístula Anastomótica , Gastrectomia , Gastrostomia , Laparoscopia , Obesidade Mórbida , Humanos , Feminino , Gastrectomia/métodos , Gastrectomia/efeitos adversos , Adulto , Obesidade Mórbida/cirurgia , Masculino , Fístula Anastomótica/cirurgia , Fístula Anastomótica/etiologia , Gastrostomia/métodos , Pessoa de Meia-Idade , Laparoscopia/métodos , Resultado do Tratamento , Cirurgia Bariátrica/métodos , Cirurgia Bariátrica/efeitos adversos
3.
BMC Surg ; 24(1): 215, 2024 Jul 24.
Artigo em Inglês | MEDLINE | ID: mdl-39048984

RESUMO

BACKGROUND: Obesity is closely associated with upper gastrointestinal disorders. The recommendations for routine preoperative esophagogastroduodenoscopy (EGD) before bariatric surgery remains a topic of debate. This study aimed to describe the pathological endoscopic findings in individuals qualified for bariatric surgery. METHODS: Retrospective analysis was conducted on preoperative gastroscopy reports of patients who underwent bariatric surgery at our hospital between October 2022 and October 2023. RESULTS: A total of 405 patients were included in the study. The two most prevalent endoscopic findings during EGD in this patient cohort were chronic superficial gastritis (326/405, 80.5%) and reflux esophagitis (82/405, 20.2%). Some patients exhibited two or more abnormalities. Patients with reflux esophagitis were older, had a higher proportion of men, higher BMI, higher rates of smoking and drinking compared to those without it (P = 0.033, P < 0.001, P = 0.003, P = 0.001, and P = 0.003, respectively). Morbid obesity (P = 0.037), smoking habits (P = 0.012), and H. pylori infection (P = 0.023) were significant risk factors for reflux esophagitis in male patients, while age (P = 0.007) was the sole risk factor in female patients. No statistically significant differences were observed in surgical procedures between LA-A and B groups (P = 0.382), but statistically significant differences were noted between the nondiabetic and diabetic groups (P < 0.001). CONCLUSIONS: Preoperative EGD can unveil a broad spectrum of pathologies in patients with obesity, suggesting the need for routine examination before bariatric surgery. The findings of this study can guide bariatric surgeons in developing tailored treatments and procedures, thus significantly enhancing prognosis. Gastroscopy should be performed routinely in Chinese patients planning to undergo bariatric surgery.


Assuntos
Cirurgia Bariátrica , Obesidade Mórbida , Humanos , Masculino , Feminino , Estudos Retrospectivos , Adulto , Pessoa de Meia-Idade , Obesidade Mórbida/cirurgia , Obesidade Mórbida/complicações , Cuidados Pré-Operatórios/métodos , Fatores de Risco , Endoscopia do Sistema Digestório/métodos , Gastrite/diagnóstico , Gastrite/epidemiologia , Gastrite/etiologia , Esofagite Péptica/etiologia , Esofagite Péptica/diagnóstico , Esofagite Péptica/epidemiologia
4.
Med ; 5(8): 863-885, 2024 Aug 09.
Artigo em Inglês | MEDLINE | ID: mdl-38964334

RESUMO

Intestinal bacteria help keep humans healthy by regulating lipid and glucose metabolism as well as the immunological and neurological systems. Oral treatment using intestinal bacteria is limited by the high acidity of stomach fluids and the immune system's attack on foreign bacteria. Scientists have created coatings and workarounds to overcome these limitations and improve bacterial therapy. These preparations have demonstrated promising outcomes, with advances in synthetic biology and optogenetics improving their focused colonization and controlled release. Engineering bacteria preparations have become a revolutionary therapeutic approach that converts intestinal bacteria into cellular factories for medicinal chemical synthesis. The present paper discusses various aspects of engineering bacteria preparations, including wrapping materials, biomedical uses, and future developments.


Assuntos
Microbioma Gastrointestinal , Humanos , Probióticos/uso terapêutico , Bactérias/metabolismo
5.
J Epidemiol ; 2024 Jul 20.
Artigo em Inglês | MEDLINE | ID: mdl-39034109

RESUMO

BACKGROUND: A recent systematic review showed Japan's mortality from chronic obstructive pulmonary disease (COPD) is the lowest among 204 countries, despite notably higher smoking rates in men in Japan than in the US. This study aims to compare (1) trends in smoking rates, (2) trends in COPD mortality, and (3) the spirometry-based COPD prevalence in the general adult population between Japan and the US. METHODS: Age- and sex-specific smoking rates from the 1980s through 2010s and COPD mortality from 1999 through 2019 were obtained from national surveys and official statistics (International Classification of Diseases-10th codes J40-44), respectively. A systematic review and meta-analysis was performed to estimate COPD prevalence in Japan, while the National Health and Nutrition Examination Survey 2007-2012 was used for the US. A fixed ratio of 0.7 of forced expiratory volume in the first second of forced vital capacity was used to define COPD. RESULTS: Over the past four decades, men in Japan consistently had 20-30% higher smoking rates than their US counterparts. From 1999-2019, age-adjusted COPD mortality in men in Japan was only a third of the US, whereas that in women was less than a tenth in 2019. Synthesizing data from 11 studies, involving 89,955 participants, Japan's COPD prevalence was more than 10% lower than in the US in almost all age groups for both sexes. CONCLUSIONS: This study showed markedly lower rates of COPD in Japan than in the US. Investigating factors contributing to the paradoxical observations could lead to advancing COPD risk reduction strategies.

6.
Obes Surg ; 34(8): 3091-3096, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38898311

RESUMO

Splenic abscess is a rare complication often associated with sleeve gastrectomy (SG) due to factors including local infections, distant infections, tumors, ischemia, and trauma, which presents substantial challenges. We report four cases of gastrosplenic fistula and/or splenic abscess after SG. Patient data, including demographics, comorbidities, diagnostic procedures, treatments, and outcomes, were recorded. Surgical techniques for SG adhered to established protocols. Four patients had a male-to-female ratio of 2:2, with an average age of 39.8 years and an average preoperative BMI of 38.9 kg/m2. All patients were readmitted due to recurrent fever and chills caused by splenic abscesses detected on CT scans, with an average admission duration of 16.5 weeks. Treatments varied from fasting and antibiotics to percutaneous drainage and surgical interventions. The average treatment duration post-diagnosis of splenic abscess was 37.25 weeks. Managing gastrosplenic fistula and/or splenic abscess is complex, underscoring the significance of prompt diagnosis and proper treatment. This highlights the need for heightened awareness among healthcare professionals to promptly recognize and manage this rare complication after SG.


Assuntos
Abscesso , Gastrectomia , Fístula Gástrica , Esplenopatias , Humanos , Feminino , Masculino , Esplenopatias/etiologia , Esplenopatias/cirurgia , Adulto , Fístula Gástrica/etiologia , Fístula Gástrica/cirurgia , Gastrectomia/efeitos adversos , Abscesso/etiologia , Pessoa de Meia-Idade , Obesidade Mórbida/cirurgia , Complicações Pós-Operatórias/etiologia , Drenagem , Antibacterianos/uso terapêutico , Resultado do Tratamento , Tomografia Computadorizada por Raios X , Abscesso Abdominal/etiologia
7.
Materials (Basel) ; 17(3)2024 Jan 29.
Artigo em Inglês | MEDLINE | ID: mdl-38591506

RESUMO

With the miniaturization and high integration of electronic devices, high-performance thermally conductive composites have received increasing attention. The construction of hierarchical structures is an effective strategy to reduce interfacial thermal resistance and enhance composite thermal conductivity. In this study, by decorating carbon fibers (CF) with needle-like ZnO nanowires, hierarchical hybrid fillers (CF@ZnO) were rationally designed and synthesized using the hydrothermal method, which was further used to construct oriented aligned filler networks via the simple freeze-casting process. Subsequently, epoxy (EP)-based composites were prepared using the vacuum impregnation method. Compared with the pure CF, the CF@ZnO hybrid fillers led to a significant increase in thermal conductivity, which was mainly due to the fact that the ZnO nanowires could act as bridging links between CF to increase more thermally conductive pathways, which in turn reduced interfacial thermal resistance. In addition, the introduction of CF@ZnO fillers was also beneficial in improving the thermal stability of the EP-based composites, which was favorable for practical thermal management applications.

8.
Front Oncol ; 14: 1342998, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38577341

RESUMO

Background: DNMT3A mutations can be detected in premalignant hematopoietic stem cells and are primarily associated with clonal hematopoiesis of indeterminate potential; however, current evidence does not support assigning them to a distinct European Leukemia Net (ELN) prognostic risk stratification. CD7 is a lymphoid antigen expressed on blasts in approximately 30% of acute myeloid leukemia (AML), and its role in AML remains unclear and depends on subgroup evaluation. This study investigated the prognostic value of DNMT3A mutation combined with CD7 expression in AML. Methods: We retrospectively analyzed the clinical data of 297 newly diagnosed non-M3 AML patients. According to the DNMT3A mutation and CD7 expression in AML cells, patients were divided into the DNMT3A-mutated/CD7-positive (CD7+), DNMT3A-mutated/CD7-negative (CD7-), DNMT3A-wild-type/CD7+, and DNMT3A-wild-type/CD7- groups. Results: The DNMT3A-mutated/CD7+ group had lower complete remission rates and higher relapse rates. Importantly, these patients had significantly shorter overall survival (OS) and relapse-free survival (RFS). Furthermore, multivariate analysis showed that CD7+ with DNMT3A mutation was an independent risk factor for OS and RFS. Conclusion: CD7+ with DNMT3A mutation predicts a poor prognosis in AML patients, and the immunophenotype combined with molecular genetic markers can help to further refine the current risk stratification of AML.

9.
Curr Med Imaging ; 2024 Mar 07.
Artigo em Inglês | MEDLINE | ID: mdl-38462830

RESUMO

BACKGROUND: The performance of automatic liver segmentation and manual sampling MRI strategies needs be compared to determine interchangeability. OBJECTIVE: To compare automatic liver segmentation and manual sampling strategies (manual whole liver segmentation and standardized manual region of interest) for performance in quantifying liver volume and MRI-proton density fat fraction (MRI-PDFF), identifying steatosis grade, and time burden. METHODS: Fifty patients with obesity who underwent liver biopsy and MRI between December 2017 and November 2018 were included. Sampling strategies included automatic and manual whole liver segmentation and 4 and 9 large regions of interest. Intraclass correlation coefficient (ICC), Bland-Altman, linear regression, receiver operating characteristic curve, and Pearson correlation analyses were performed. RESULTS: Automatic whole liver segmentation liver volume and manual whole liver segmentation liver volume showed excellent agreement (ICC=0.97), high correlation (R2=0.96), and low bias (3.7%, 95% limits of agreement, -4.8%, 12.2%) in liver volume. There was the best agreement (ICC=0.99), highest correlation (R2=1.00), and minimum bias (0.84%, 95% limits of agreement, -0.20%, 1.89%) between automated whole liver segmentation MRI-PDFF and manual whole liver segmentation MRI-PDFF. There was no difference of each paired comparison of receiver operating characteristic curves for detecting steatosis (P=0.07-1.00). The minimum time burden for automatic whole liver segmentation was 0.32 s (0.32-0.33 s). CONCLUSION: Automatic measurement has similar effects to manual measurement in quantifying liver volume, MRI-PDFF, and detecting steatosis. Time burden of automatic whole liver segmentation is minimal among all sampling strategies. Manual measurement can be replaced by automatic measurement to improve quantitative efficiency.

10.
Heliyon ; 10(6): e27461, 2024 Mar 30.
Artigo em Inglês | MEDLINE | ID: mdl-38515732

RESUMO

Introduction: Leeches are flesh-eating and bloodsucking parasitic worms. They are being used as a traditional Chinese medicine for centuries in activating blood and dissolving statis, dreging the meridims and tick. Hirudin, an active peptide product present in leech, has blood anticoagulant property and can assist in the treatment of thrombosis and diseases related to blood circulation. The efficacy and potential mechanism of action of leeches in such diseases should be further explored. Materials and methods: First, network pharmacology was used to screen the predicted potential targets of the active constituents of leech and AS. The common targets of the active constituents of leech and AS were obtained using Venn diagram. Further, the drug-active-constituent-target network diagram, protein-protein interaction, and GO and KEGG pathway enrichment analyses were used to construct the active-constituent-AS target-pathway network diagram. Subsequently, the protein-drug molecule docking model was drawn. Finally, the results of network pharmacology were validated using a mouse model of AS. Results: In total, 34 active constituents of leech and 1172 AS-related gene targets were selected, took the drug action targets and potential disease targets to get the common targets, and took the top 10 of degree value as the main active constituents for the treatment of atherosclerosis. There were 89 common targets and 12 core targets. The main targets included MAPK, EGFR, PIK3CB, etc. Potential regulatory pathways included cancer pathways, EGFR tyrosine kinase inhibitor resistance, Rap1 signaling pathway, PPAR signaling pathway, PI3K-Akt signaling pathway, C-type lectin receptor signaling pathway, and AGE-RAGE signaling pathway in diabetic complications. Animal experiments using mouse model of AS confirmed that AS plaques were smaller after treatment with leeches. SRC level was measured using western blotting. Expression of SRC in myocardial tissue was remarkably lower in the mice treated with leech than in the mice from model group fed on high-fat chow. Conclusions: To the best of our knowledge, this is the first study to explore the mechanism of action of the active components of leech in AS prevention. The active components of leeches play a coordinated role in preventing AS through multicomponent, multitarget, and multichannel mechanism of action related to inflammatory response, oxidative stress, and lipid metabolism. This study provided a reference for subsequent cellular and animal experiments.

11.
Health Data Sci ; 4: 0087, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38500551

RESUMO

Background: The cumulative effect of body mass index (BMI) on brain health remains ill-defined. The effects of overweight on brain health across different age groups need clarification. We analyzed the effect of cumulative BMI on neuroimaging features of brain health in adults of different ages. Methods: This study was based on a multicenter, community-based cohort study. We modeled the trajectories of BMI over 16 years to evaluate cumulative exposure. Multimodality neuroimaging data were collected once for volumetric measurements of the brain macrostructure, white matter hyperintensity (WMH), and brain microstructure. We used a generalized linear model to evaluate the association between cumulative BMI and neuroimaging features. Two-sample Mendelian randomization analysis was performed using summary level of BMI genetic data from 681,275 individuals and neuroimaging genetic data from 33,224 individuals to analyze the causal relationships. Results: Clinical and neuroimaging data were obtained from 1,074 adults (25 to 83 years). For adults aged under 45 years, brain volume differences in participants with a cumulative BMI of >26.2 kg/m2 corresponded to 12.0 years [95% confidence interval (CI), 3.0 to 20.0] of brain aging. Differences in WMH were statistically substantial for participants aged over 60 years, with a 6.0-ml (95% CI, 1.5 to 10.5) larger volume. Genetic analysis indicated causal relationships between high BMI and smaller gray matter and higher fractional anisotropy in projection fibers. Conclusion: High cumulative BMI is associated with smaller brain volume, larger volume of white matter lesions, and abnormal microstructural integrity. Adults younger than 45 years are suggested to maintain their BMI below 26.2 kg/m2 for better brain health. Trial Registration: This study was registered on clinicaltrials.gov (Clinical Indicators and Brain Image Data: A Cohort Study Based on Kailuan Cohort; No. NCT05453877; https://clinicaltrials.gov/ct2/show/NCT05453877).

12.
Obes Surg ; 34(3): 1004-1017, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38342815

RESUMO

Obesity and related comorbidities have negative impacts on cognitive function. Weight loss seems to be associated with the improvement of cognitive function and the recovery of brain structure, but the underlying mechanism is not clear. This meta-analysis aimed to explore the status of cognitive function including memory, executive function, attention and language ability in patients with obesity, and to further investigate whether bariatric surgery can improve overall cognitive function in these patients. A total of 11 literatures with 728 subjects were included after retrieval and exclusion. The meta-analysis showed significant improvements in memory, attention and executive function scores after undergoing bariatric surgery in the patients with obesity. However, there was no significant improvement in language ability.


Assuntos
Cirurgia Bariátrica , Obesidade Mórbida , Humanos , Obesidade Mórbida/cirurgia , Obesidade/complicações , Obesidade/cirurgia , Obesidade/psicologia , Cognição , Função Executiva
13.
J Diabetes ; 2023 Dec 27.
Artigo em Inglês | MEDLINE | ID: mdl-38149757

RESUMO

AIMS: Bariatric surgery results in rapid recovery of glucose control in subjects with type 2 diabetes mellitus. However, the underlying mechanisms are still largely unknown. The present study aims to clarify how bariatric surgery modifies pancreatic cell subgroup differentiation and transformation in the single-cell RNA level. METHODS: Male, 8-week-old Zucker diabetic fatty (ZDF) rats with obesity and diabetes phenotypes were randomized into sleeve gastrectomy (Sleeve, n = 9), Roux-en-Y gastric bypass (RYGB, n = 9), and Sham (n = 7) groups. Two weeks after surgery, the pancreas specimen was further analyzed using single-cell RNA-sequencing technique. RESULTS: Two weeks after surgery, compared to the Sham group, the metabolic parameters including fasting plasma glucose, plasma insulin, and oral glucose tolerance test values were dramatically improved after RYGB and Sleeve procedures (p < .05) as predicted. In addition, RYGB and Sleeve groups increased the proportion of pancreatic ß cells and reduced the ratio of α cells. Two multiple hormone-expressing cells were identified, the Gcg+/Ppy + and Ins+/Gcg+/Ppy + cells. The pancreatic Ins+/Gcg+/Ppy + cells were defined for the first time, and further investigation indicates similarities with α and ß cells, with unique gene expression patterns, which implies that pancreatic cell transdifferentiation occurs following bariatric surgery. CONCLUSIONS: For the first time, using the single-cell transcriptome map of ZDF rats, we reported a comprehensive characterization of the heterogeneity and differentiation of pancreatic endocrinal cells after bariatric surgery, which may contribute to the underlying mechanisms. Further studies will be needed to elucidate these results.

14.
Polymers (Basel) ; 15(22)2023 Nov 16.
Artigo em Inglês | MEDLINE | ID: mdl-38006153

RESUMO

With the miniaturization of current electronic products, ceramic/polymer composites with excellent thermal conductivity have become of increasing interest. Traditionally, higher filler fractions are required to obtain a high thermal conductivity, but this leads to a decrease in the mechanical properties of the composites and increases the cost. In this study, silicon nitride nanowires (Si3N4NWs) with high aspect ratios were successfully prepared by a modified carbothermal reduction method, which was further combined with AlN particles to prepare the epoxy-based composites. The results showed that the Si3N4NWs were beneficial for constructing a continuous thermal conductive pathway as a connecting bridge. On this basis, an aligned three-dimensional skeleton was constructed by the ice template method, which further favored improving the thermal conductivity of the composites. When the mass fraction of Si3N4NWs added was 1.5 wt% and the mass fraction of AlN was 65 wt%, the composites prepared by ice templates reached a thermal conductivity of 1.64 W·m-1·K-1, which was ~ 720% of the thermal conductivity of the pure EP (0.2 W·m-1·K-1). The enhancement effect of Si3N4NWs and directional filler skeletons on the composite thermal conductivity were further demonstrated through the actual heat transfer process and finite element simulations. Furthermore, the thermal stability and mechanical properties of the composites were also improved by the introduction of Si3N4NWs, suggesting that prepared composites exhibit broad prospects in the field of thermal management.

15.
Chem Commun (Camb) ; 59(84): 12577-12580, 2023 Oct 19.
Artigo em Inglês | MEDLINE | ID: mdl-37789818

RESUMO

By depositing silver nanoparticles (AgNPs) on the surface of aluminum nitride whiskers (AlNw), an AlNw-AgNPs heterogeneous structural filler was rationally designed from the perspective of interface engineering, which was further combined with nanofibrillated cellulose (NFC) to prepare anisotropic composite films by a facile vacuum-assited filtration method. Due to the synergistic effect of cross-linking AlNw and "thermal conducting micro-bridges" of AgNPs, the composite films exhibited an extraordinary in-plane thermal conductivity of 31.329 W m-1 K-1, showing a promising application as thermal management materials.

16.
Sci Total Environ ; 905: 166995, 2023 Dec 20.
Artigo em Inglês | MEDLINE | ID: mdl-37717761

RESUMO

Biodiversity is crucial for human health, but previous methods of measuring biodiversity require intensive resources and have other limitations. Crowdsourced datasets from citizen scientists offer a cost-effective solution for characterizing biodiversity on a large spatial scale. This study has two aims: 1) to generate fine-resolution plant species diversity maps in California urban areas using crowdsourced data and extrapolation methods; and 2) to examine their associations with sociodemographic factors and identify subpopulations with low biodiversity exposure. We used iNaturalist observations from 2019 to 2022 to calculate species diversity metrics by exploring the sampling completeness in a 5 × 5-km2 grid and then computing species diversity metrics for grid cells with at least 80 % sample completeness (841 out of 4755 grid cells). A generalized additive model with ordinary kriging (GAM OK) provided moderately reliable estimates, with correlations of 0.64-0.66 between observed and extrapolated metrics, relative mean absolute errors of 21 %-23 %, and relative root mean squared errors of 27 %-30 % for grid cells with ≥80 % sample completeness from 10-fold cross-validation. GAM OK was further applied to extrapolate species diversity metrics from saturated grid cells (N = 841) to the remaining grid cells with <80 % sample completeness (N = 3914) and generate diversity maps that cover the grid. Further, generalized linear mixed models were used to examine the associations between species diversity and sociodemographic indicators at census tract level. The wild vascular plant species diversity metrics were inversely associated with neighborhood socioeconomic status (i.e., unemployment, linguistic isolation, educational attainment, and poverty rate). Minority populations (i.e., African American, Asian American, and Hispanic) and children had significantly lower diversity exposure in their neighborhoods. Crowdsourcing data offers a cost-effective solution for characterizing large-scale biodiversity in urban areas.


Assuntos
Crowdsourcing , Traqueófitas , Criança , Humanos , Disparidades Socioeconômicas em Saúde , Plantas , Biodiversidade , Análise Espacial
17.
Chin Med J (Engl) ; 136(16): 1967-1976, 2023 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-37525550

RESUMO

BACKGROUND: Management of gastric leak after sleeve gastrectomy (SG) is challenging due to its unpredictable outcomes. We aimed to summarize the characteristics of SG leaks and analyze interventions and corresponding outcomes in a real-world setting. METHODS: To retrospectively review of 15,721 SG procedures from 2010 to 2020 based on a national registry. A cumulative sum analysis was used to identify a fitting curve of gastric leak rate. The Kaplan-Meier method and log-rank tests were performed to calculate and compare the probabilities of relevant outcomes. The logistic regression analysis was conducted to determine the predictors of acute leaks. RESULTS: A total of 78 cases of SG leaks were collected with an incidence of 0.5% (78/15,721) from this registry (6 patients who had the primary SG in non-participating centers). After accumulating 260 cases in a bariatric surgery center, the leak rate decreased to a stably low value of under 1.17%. The significant differences presented in sex, waist circumference, and the proportion of hypoproteinemia and type 2 diabetes at baseline between patients with SG leak and the whole registry population ( P = 0.005, = 0.026, <0.001, and = 0.001, respectively). Moreover, 83.1% (59/71) of the leakage was near the esophagogastric junction region. Leakage healed in 64 (88.9%, 64/72) patients. The median healing time of acute and non-acute leaks was 5.93 months and 8.12 months, respectively. Acute leak (38/72, 52.8%) was the predominant type with a cumulative reoperation rate >50%, whereas the cumulative healing probability in the patients who required surgical treatment was significantly lower than those requring non-surgical treatment ( P = 0.013). Precise dissection in the His angle area was independently associated with a lower acute leak rate, whereas preservation ≥2 cm distance from the His angle area was an independent risk factor. CONCLUSIONS: Male sex, elevated waist circumference, hypoproteinaemia, and type 2 diabetes are risk factors of gastric leaks after SG. Optimizing surgical techniques, including precise dissection of His angle area and preservation of smaller gastric fundus, should be suggested to prevent acute leaks.


Assuntos
Diabetes Mellitus Tipo 2 , Laparoscopia , Obesidade Mórbida , Humanos , Masculino , Estudos Retrospectivos , Diabetes Mellitus Tipo 2/complicações , Fístula Anastomótica/cirurgia , Fístula Anastomótica/epidemiologia , Gastrectomia/efeitos adversos , Gastrectomia/métodos , Reoperação/efeitos adversos , Reoperação/métodos , Sistema de Registros , Laparoscopia/métodos , Resultado do Tratamento
18.
J Cancer Res Clin Oncol ; 149(15): 13889-13904, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37540256

RESUMO

BACKGROUND: It is unknown how the cell cycle plays a role in breast cancer (BC). This study aimed to establish a clinically applicable predictive model to predict the therapeutic responses and overall survival in BC patients. MATERIALS AND METHODS: Cell cycle-related genes (CCGs) were identified within the Cancer Genome Atlas cohort (n is equal to 1001) and the Gene Expression Omnibus cohort (n is equal to 3265). An analysis of univariate and multivariate Cox was then conducted to develop a nomogram based on CCGs. After validating the nomogram, risk cohort stratification was established and the predictive value was examined. Finally, immune cell infiltration and therapeutic responses were analysed. RESULTS: Based on 15 CCGs, 4 prognostic predictors were identified and entered into the nomogram. According to the curves of calibration, the estimated and observed value of the nomogram is in optimal agreement. Subsequently, stratification into two risk cohorts showed that the predictive value, immune cell infiltration and overall survival were better among patients with low risk. Immune checkpoint expression in patients with BC at higher risk was downregulated. Furthermore, the results of the study revealed that doxorubicin, paclitaxel, docetaxel, cisplatin and vinorelbine all had higher IC50 values in patients with high-risk BC. CONCLUSION: The nomogram based on CCG could assess tumour immune micro-environment regulation and therapeutic responses of immunotherapy in BC. Moreover, it may provide novel information on the control of immune micro-environment infiltration in BC and aid in the development of targeted immunotherapy.

19.
Brain Topogr ; 36(6): 890-900, 2023 11.
Artigo em Inglês | MEDLINE | ID: mdl-37540333

RESUMO

The role of the visuospatial network in mathematical processing has been established, but the role of the semantic neural network in mathematical processing is still poorly understood. The current study used high-definition transcranial direct current stimulation (HD-tDCS) to examine whether the semantic network supports mathematical processing. Using a single-blind, randomized, sham-controlled experimental design, 48 participants were randomly assigned to receive either anodal or sham HD-tDCS on the left middle temporal gyrus (LMTG), a core region of the semantic network. A number series completion task was used to measure mathematical reasoning and an arithmetical computation task was used as a control condition. Both tasks were administered before and after the 20 min HD-tDCS. The results showed that anodal HD-tDCS on the LMTG enhanced performance on the number series completion task, but not on the arithmetical computation task. Trial-level analysis further showed greater improvement at the more difficult problems of the number series completion task. These results demonstrate that the semantic network plays an important role in mathematical processing.


Assuntos
Estimulação Transcraniana por Corrente Contínua , Humanos , Estimulação Transcraniana por Corrente Contínua/métodos , Método Simples-Cego , Lobo Temporal , Semântica
20.
ACS Appl Mater Interfaces ; 15(27): 32885-32894, 2023 Jul 12.
Artigo em Inglês | MEDLINE | ID: mdl-37392172

RESUMO

As the rapid development of advanced foldable electronic devices, flexible and insulating composite films with ultra-high in-plane thermal conductivity have received increasing attention as thermal management materials. Silicon nitride nanowires (Si3N4NWs) have been considered as promising fillers for preparing anisotropic thermally conductive composite films due to their extremely high thermal conductivity, low dielectric properties, and excellent mechanical properties. However, an efficient approach to synthesize Si3N4NWs in a large scale still need to be explored. In this work, large quantities of Si3N4NWs were successfully prepared using a modified CRN method, presenting the advantages of high aspect ratio, high purity, and easy collection. On the basis, the super-flexible PVA/Si3N4NWs composite films were further prepared with the assistance of vacuum filtration method. Due to the highly oriented Si3N4NWs interconnected to form a complete phonon transport network in the horizontal direction, the composite films exhibited a high in-plane thermal conductivity of 15.4 W·m-1·K-1. The enhancement effect of Si3N4NWs on the composite thermal conductivity was further demonstrated by the actual heat transfer process and finite element simulations. More significantly, the Si3N4NWs enabled the composite film presenting good thermal stability, high electrical insulation, and excellent mechanical strength, which was beneficial for thermal management applications in modern electronic devices.

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