Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 71
Filtrar
1.
Zhonghua Yi Xue Za Zhi ; 103(47): 3816-3821, 2023 Dec 19.
Artigo em Chinês | MEDLINE | ID: mdl-38123222

RESUMO

Objective: To investigate the surgical efficacy of neurosurgery robot deep brain stimulation(DBS) in the treatment of elderly Parkinson's disease(PD). Methods: The clinical data of elderly patients (≥75 years) with PD who underwent neurosurgical robot-assisted DBS surgery in the Department of Neurosurgery of the General Hospital of Northern Theater Command from September 2016 to September 2022 were collected retrospectively. Operation time, electrode implantation duration, postoperative pneumocephalus volume, electrode implantation accuracy, the Tao's DBS surgery scale, perioperative complications were analyzed.The unified Parkinson's disease rating scales (UPDRS), UPDRS-Ⅲ, tremor, rigidity, bradykinesia, axial, Barthel Activities of Daily Living (ADL-Barthel), Levodopa Equivalent Daily Dose (LEDD), Montreal Cognitive Assessment (MoCA), Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD) scores and mortality were assessed respectively before operation, 6, 12 and 24 months after operation and last follow-up. Results: A total of 25 elderly patients were enrolled, including 14 males and 11 females, aged(78.3±3.2) years. Nine patients had underlying diseases. Nine patients (36%) underwent bilateral Globus Pallidus pars Interna deep brain stimulation (GPi-DBS) and 16 patients (64%) underwent bilateral subthalamic nucleus deep brain stimulation (STN-DBS).The operation time was (1.56±0.19) hours, the electrode implantation duration was (1.01±0.19) hours, the pneumocephalus volume was 9.8(4.7, 23.3) cm3, and the electrode implantation accuracy was (0.84±0.24) mm, the Tao's DBS surgery scale was (80.2±6.2).The follow-up time [M(Q1, Q3)] was 57.3(27.9, 75.7) months. No serious complications such as intracranial hemorrhage, infection or poor wound healing occurred during the perioperative period. The improvement rate of UPDRS, UPDRS-Ⅲ, rigidity, bradykinesia, and LEDD at 6 months after surgery was significantly higher than that at 24 months after surgery and at the last follow-up (all P<0.05); the improvement rate of axial symptoms, ADL-Barthel score, and MoCA score at 6 months after surgery was significantly higher than that at the last follow-up (P<0.05). HAMD and HAMA scores showed no significant improvement during follow-up after surgery (both P>0.05). At the last follow-up, 12 patients died, with death time of (35.1±20.2) months after operation, and the death age of [M(Q1, Q3)] 80(79, 83)years. Conclusions: Robot-assisted DBS surgery for elderly patients with PD is accurate and safe, and the postoperative symptoms are significantly improved, and they can benefit from neuromodulation for long term, and the risks are controllable.


Assuntos
Estimulação Encefálica Profunda , Doença de Parkinson , Pneumocefalia , Robótica , Idoso , Masculino , Feminino , Humanos , Doença de Parkinson/tratamento farmacológico , Estudos Retrospectivos , Atividades Cotidianas , Hipocinesia/tratamento farmacológico , Pneumocefalia/tratamento farmacológico , Resultado do Tratamento , Levodopa/uso terapêutico
2.
Med Educ Online ; 27(1): 2100039, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-35818325

RESUMO

Medical student research engagement has been considered as a critical component of undergraduate medical education. However, evidence on the association between medical student research engagement with learning outcomes is lacking. The objectives of our study are: (1) to outline the landscape of medical student research engagement in China; (2) to explore the association between medical student research engagement and learning outcomes, and whether this association is different among students with different characteristics. A paper questionnaire was developed, piloted, and administered to medical students at 33 medical schools in China. Research engagement was measured by the times students engaged in research projects while learning outcomes referred to learning outcomes contained in the Standards for Basic Medical Education in China. Chi-square tests were used to measure statistical significance between research engagement and the characteristics of participants. We analysed relationships between research engagement and learning outcomes using multivariate linear regression with medical school fixed effects. The overall response rate was 86.7%. 10,062 medical students completed the questionnaire, 55.5% of which had participated in one or more research projects. Research engagement differed by the length of the program, gender, and academic performance. Research engagement was also positively associated with students' overall learning outcomes, especially in the Science and Scholarship domain (once, ß = 0.20, P < 0.001; twice or more, ß = 0.43, P < 0.001) and the Professionalism domain (once, ß = 0.12, P < 0.05; twice or more, ß = 0.25, P < 0.01). The relationships between research engagement and learning outcomes differed significantly by gender. Medical student research engagement is significantly positively associated with medical students' learning outcomes, especially in the Science and Scholarship domain and the Professionalism domain. Besides, men benefit more from engaging in research projects, particularly in the Science and scholarship domain.


Assuntos
Educação de Graduação em Medicina , Estudantes de Medicina , Currículo , Humanos , Aprendizagem , Masculino , Faculdades de Medicina
3.
J Econ Behav Organ ; 195: 122-139, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35075314

RESUMO

This research examines the intention of undergraduate medical students to withdraw from the medical profession and pursue a career in a different field upon graduation during COVID-19. We leverage the first and most comprehensive nationwide survey for medical education in China, which covered 98,668 enrolled undergraduate students from 90 out of 181 Chinese medical schools in 2020. We focus on these students' self-reported intention to leave the healthcare industry (the "dropout intention") before and after the outbreak of the epidemic. We also designed a randomized experiment to test whether and to what extent medical students dropout intention responded to an information nudge that highlighted the prosociality of health professionals in the fight against the virus. Results from a difference-in-differences model and a student fixed effect model suggest that after the onset of COVID-19, the proportion of Chinese undergraduate medical students with a dropout intention declined from 13.7% to 6.8%. Furthermore, the nudge information reduced the intent-to-drop-out probability by 0.8 additional percentage points for students in their early college years. There was large heterogeneity underneath the treatment effect. Specifically, we find that prior dropout intention and exposures to COVID-19-related information tended to mitigate the nudge effects. Data on students' actual dropout outcomes support our findings.

4.
BMC Med Educ ; 21(1): 584, 2021 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-34789210

RESUMO

BACKGROUND: During the early stage of COVID-19 outbreak in China, most medical undergraduate programs have to eventually embrace the maneuver of transferring to nearly 100% online-learning as a new routine for different curricula. And there is a lack of empirical evidence of effective medical education curriculum that has been completely implemented in an online format. This study summarizes medical students' perspectives regarding online-learning experience during the COVID-19 outbreak and presents reflection on medical education. METHODS: From February 21st to March 14th, 2020, the authors conducted survey of a nationally representative sample of undergraduate medical students from 90 medical schools in China. Participant demographics and responses were tabulated, and independent sample t-tests as well as multiple logistic regression models were used to assess the associations of demographic characteristics, prior online learning experience, and orientation with students' perspectives on the online learning experience. RESULTS: Among 118,030 medical students participated in the survey (response rate 52.4%), 99,559 provided valid data for the analysis. The sample is fairly nationally representative. 65.7% (65,389/99,559) supported great orientation and 62.1% (61,818/99,559) reported that they were satisfied with the ongoing online-learning experience. The most common problem students would encounter was the network congestion (76,277/99,559; 76.6%). Demographics, learning phases, and academic performance were associated with online-learning engagement and perceptions. Formal orientation and prior PU (perceived usefulness of online learning) were significantly positively associated with the satisfaction and evaluation of the online learning experience (p <  0.001). CONCLUSIONS: Data from this national survey indicates a relatively positive role of online learning as a formal teaching/learning approach in medical education. Considerations should be made regarding such application in aspects of students' different learning phases. We suggest that further policy interventions should be taken from technological, organizational, environmental, as well as individual aspects, to help improve the outcome of online learning for future doctors.


Assuntos
COVID-19 , Educação a Distância , Estudantes de Medicina , China/epidemiologia , Surtos de Doenças , Humanos , SARS-CoV-2
5.
Med Educ Online ; 26(1): 1981198, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34569433

RESUMO

The purpose of this scoping review is to update the recent progress of EPAs research in GME, focusing on the topical concern of EPAs effectiveness, and to provide a reference for medical researchers in countries/regions interested in introducing EPAs. Guided by Arksey and O'Malley's framework regarding scoping reviews, the researchers, in January 2021, conducted a search in five databases to ensure the comprehensiveness of the literature. After the predetermined process, 29 articles in total were included in this study. The most common areas for the implementation and evaluation of EPAs were Surgery (n = 7,24.1%), Pediatric (n = 5,17.2%) and Internal medicine (n = 4,13.8%), a result that shows a relatively large change in the research trend of EPAs in the last two years. Prior to 2018, EPAs research focused on internal medicine, psychiatry, family medicine, and primary care. The articles in the category of EPAs implementation and evaluation had four main themes: (1) validation of EPAs (n = 16,55.2%); (2) describing the experience of implementing EPAs (n = 11,37.9%); (3) examining the factors and barriers that influence the implementation and evaluation of EPAs (n = 6,20.6%); and (4) researching the experiences of faculty, interns, and other relevant personnel in using EPAs. Training programs were the most common EPAs implementation setting (n = 26,89.6%); direct observation and evaluation (n = 12,41.4%), and evaluation by scoring reports (n = 5,17.2%) were the two most common means of assessing physicians' EPA levels; 19 papers (65.5%) used faculty evaluation, and nine of these papers also used self-assessment (31.0%); the most frequently used tools in the evaluation of EPAs were mainly researcher-made instruments (n = 37.9%), assessment form (n = 7,24.1%), and mobile application (n = 6,20.7%). Although EPAs occupy an increasingly important place in international medical education, this study concludes that the implementation and diffusion of EPAs on a larger scale is still difficult.


Assuntos
Educação Baseada em Competências , Internato e Residência , Criança , Competência Clínica , Educação de Pós-Graduação em Medicina , Humanos , Medicina Interna/educação
6.
Med Educ ; 55(12): 1419-1427, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34061389

RESUMO

CONTEXT: Funding is an essential requirement for ensuring the quality of health professional education worldwide. Adequate funding is of immense significance in training health professionals. Due to the difficulty of accessing relevant data, quantitative research of the kind is scarce. OBJECTIVES: This study aims at analysing the trends of funding levels and funding sources for health professional institutions in China spanning the past 20 years and making a global comparison. METHODS: We used data from Ministry of Education (MOE) of the People's Republic of China to analyse its funding level and structure of funding sources of health professional education in China during 1998-2017. When analysing funding level, we used two indicators: total funding and funding per student. We chose the United States, and analysed its funding level and structure to allow easy comparison to the situation in China. The data from a Lancet report (Lancet, 376, 2010, 1923) were also used to analyse global funding status to make an international comparison. RESULTS: Funding levels of health professional institutions in China has increased significantly in the past 20 years, while the average annual growth rate of funding per student (4.5%) is lower than that of total funding (19.9%). In terms of the structure of funding sources, fiscal appropriation accounts for 51.1% on average, and tuition, fees and scientific research income explains 37.0%. CONCLUSION: From 1998 to 2017, the total funding and funding per student of HPE in China increased continuously, and the total funding increased at a faster rate. The increase in funding of HPE in China is closely related to the efforts of the Chinese government and the implementation of relevant policies. Even so, funding of HPE in China is likely to remain relatively low compared to other countries.


Assuntos
Educação Profissionalizante , China , Saúde Global , Humanos
7.
J Phys Condens Matter ; 33(22)2021 May 05.
Artigo em Inglês | MEDLINE | ID: mdl-33607633

RESUMO

Graphene nano-flakes (GNFs) are predicted to host spin-polarized metallic edge states, which are envisioned for exploration of spintronics at the nanometer scale. To date, experimental realization of GNFs is only in its infancy because of the limitation of precise cutting or synthesizing methods at the nanometer scale. Here, we use low temperature scanning tunneling microscope to manipulate coronene molecules on a Cu(111) surface to build artificial triangular and hexagonal GNFs with either zigzag or armchair type of edges. We observe that an electronic state at the Dirac point emerges only in the GNFs with zigzag edges and localizes at the outmost lattice sites. The experimental results agree well with the tight-binding calculations. Our work renders an experimental confirmation of the predicated edge states of the GNFs.

8.
Inorg Chem ; 60(1): 167-174, 2021 Jan 04.
Artigo em Inglês | MEDLINE | ID: mdl-33326743

RESUMO

Anionic metal-organic frameworks (MOFs) have attracted increasing attention due to the enhanced electrostatic interactions between their anionic frameworks and counter-ionic guests. Owing to these special host-guest interactions, anionic MOFs are beginning to have a large impact in the field of absorption and separation of ionic molecules and selective sensing of metal ions. Herein, two mesoporous anionic metal-organic frameworks, namely, [(CH3)2NH2]6[In6(OX)6(TCA)4]·solvents (JOU-11) and [(CH3)2NH2]6[In6(OX)6(TCPA)4]·solvents (JOU-12) (H3TCA = tricarboxytriphenylamine; H3TCPA = tris((4-carboxyl)phenylduryl)amine; OX = oxalate), have been synthesized by using wheel-type [In6(OX)6(COO)12]6- as building blocks. Structural analyses show that JOU-11 and JOU-12 show isoreticular three-dimensional frameworks with pyr topology. Due to their anionic frameworks and tunable pore window sizes, both compounds can be exploited for absorbing and separating cationic organic dyes. In addition, JOU-11 can be developed as a fluorescence "turn-off" sensor for selectively sensing Fe3+, whereas JOU-12 can be used for fluorescence "turn-on" sensing of Cu2+ and Co2+ ions.

9.
Med Educ Online ; 26(1): 1854066, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33280546

RESUMO

Universities worldwide are pausing in an attempt to contain COVID-19's spread. In February 2019, universities in China took the lead, cancelling all in-person classes and switching to virtual classrooms, with a wave of other institutes globally following suit. The shift to online platform poses serious challenges to medical education so that understanding best practices shared by pilot institutes may help medical educators improve teaching. Provide 12 tips to highlight strategies intended to help on-site medical classes moving completely online under the pandemic. We collected 'best practices' reports from 40 medical schools in China that were submitted to the National Centre for Health Professions Education Development. Experts' review-to-summary cycle was used to finalize the best practices in teaching medical students online that can benefit peer institutions most, under the unprecedented circumstances of the COVID-19 outbreak. The 12 tips presented offer-specific strategies to optimize teaching medical students online under COVID-19, specifically highlighting the tech-based pedagogy, counselling, motivation, and ethics, as well as the assessment and modification. Learning experiences shared by pilot medical schools and customized properly are instructive to ensure a successful transition to e-learning.


Assuntos
COVID-19/epidemiologia , Educação a Distância/organização & administração , Educação Médica/organização & administração , China , Docentes de Medicina/educação , Docentes de Medicina/organização & administração , Humanos , Pandemias , Aprendizagem Baseada em Problemas , SARS-CoV-2 , Desenvolvimento de Pessoal/organização & administração , Ensino
10.
BMJ Open ; 10(10): e041886, 2020 10 29.
Artigo em Inglês | MEDLINE | ID: mdl-33122327

RESUMO

OBJECTIVES: (1) Understanding the characteristics of online learning experiences of Chinese undergraduate medical students; (2) Investigating students' perceptions of ongoing online education developed in response to COVID-19 and (3) Exploring how prior online learning experiences are associated with students' perceptions. DESIGN: Students' familiarity with online learning modes and corresponding perceived usefulness (PU) according to their previous experiences were investigated using an online survey. The survey also collected data on students' perceptions through their evaluation of and satisfaction with current online learning. SETTING: In response to the educational challenges created by COVID-19, medical schools in China have adopted formal online courses for students. PARTICIPANTS: The questionnaire was sent to 225 329 students, of whom 52.38% (118 080/225 329) replied, with valid data available for 44.18% (99 559/225 329). METHODS: Pearson correlations and t-tests were used to examine the relationship between familiarity and PU. Multiple linear regression and logistic regression analyses were used to determine the impact of prior learning experiences and its interactions with gender, area, learning phase and academic performance on students' perceptions. RESULTS: Students' PU had a significant positive correlation with their familiarity with online learning modes (p<0.01). Students' evaluation of and satisfaction with their current online education were positively associated with their familiarity (ß=0.46, 95% CI 0.45 to 0.48, p<0.01; OR 1.14, 95% CI 1.13 to 1.14, p<0.01) with and PU (ß=3.11, 95% CI 2.92 to 3.30, p<0.01; OR 2.55, 95% CI 2.37 to 2.75, p<0.01) of online learning. Moreover, the higher the students' learning phases, the lower the associations between PU and students' evaluation of and satisfaction with ongoing online education. CONCLUSIONS: Medical students in China have experiences with various online learning modes. Prior learning experiences are positively associated with students' evaluation of and satisfaction with current online education. Higher learning phases, in which clinical practices are crucial, and high academic performance led to lower evaluation and satisfaction scores.


Assuntos
Infecções por Coronavirus , Educação a Distância/métodos , Educação de Graduação em Medicina , Modelos Educacionais , Avaliação das Necessidades , Pandemias , Pneumonia Viral , Betacoronavirus , COVID-19 , China , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Educação de Graduação em Medicina/organização & administração , Educação de Graduação em Medicina/tendências , Feminino , Humanos , Masculino , Modelos Organizacionais , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Pesquisa Qualitativa , SARS-CoV-2 , Percepção Social , Estudantes de Medicina/psicologia , Adulto Jovem
11.
J Biol Regul Homeost Agents ; 34(1): 25-37, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32264665

RESUMO

Neuropathic pain (NP) after spinal cord injury (SCI) leads to compromised physical and cognitive functions in a majority of patients. Aberrant miRNA expression plays vital roles in the pathogenesis of SCI. This study aims to investigate the effect of miR-331-3p in rats following SCI. Microarray assay was performed in SCI- and sham-operated rats to evaluate the expression of miR-331-3p. Assigned SCI rats were treated with miR-331-3p agomiR alone or miR-331-3p agomiR plus RAP1A-expressing lentivirus or control agomiR. Rat locomotor performance was evaluated by BBB locomotor rating scale. Neuronal tissue damage and apoptosis were detected by histological analyses and Western blot. Inflammation in spinal cord was determined by detection of the expression of inflammatory genes with qRT-PCR, and ELISA. Downstream expression of RAP1A was measured by Western blot. The results showed that SCI induced the downregulation of miR-331-3p in the spinal cord of SCI rats. Overexpression of miR-331-3p improved the locomotor performance, reduced tissue damage, neuronal apoptosis and inflammation in rat SCI model. Rap1a (Ras-related protein Rap-1A) was predicted as a downstream target for miR-331-3p, and upregulation of RAP1A impaired the beneficial effect of miR-331-3p post- SCI, which was shown as worse locomotor activity, more severe tissue damage, as well as promoting apoptosis and inflammation in SCI rats. Furthermore, miR-331-3p reduced the activation of RAP1A downstream genes via inhibiting RAP1A expression. These findings indicate a protective role of miR- 331-3p in the development of SCI via the modulation of RAP1A, and may help to develop novel therapy against SCI-induced complications.


Assuntos
MicroRNAs/genética , Neuralgia/genética , Traumatismos da Medula Espinal/patologia , Proteínas rap1 de Ligação ao GTP/genética , Animais , Ratos , Ratos Sprague-Dawley , Medula Espinal
12.
Eur Rev Med Pharmacol Sci ; 24(5): 2525-2538, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32196603

RESUMO

OBJECTIVE: The present study aimed to determine the expression of long non-coding RNA (lncRNA) FOXD3 antisense RNA 1 (FOXD3-AS1) in lung cancer tissues and to explore its underlying mechanisms in mediating non-small cell lung cancer (NSCLC) progression. MATERIALS AND METHODS: Gene expression levels were determined by quantitative real-time PCR; lung cancer cell proliferation and invasion were determined by in vitro functional assays; protein levels were determined by Western blot assay; xenograft nude mice model was used to evaluate the in vivo tumor growth of lung cancer cells; Luciferase reporter assay determined the interactions among FOXD3-AS1, miR-127-3p, and mediator complex subunit 28 (MED28). RESULTS: Data mining and analysis of the clinical sample showed that FOXD3-AS1 expression was significantly up-regulated in lung cancer tissues. In vitro functional assays demonstrated that FOXD3-AS1 overexpression promoted NSCLC cell proliferation and invasion, while FOXD3-AS1 knockdown exerted tumor-suppressive effects on NSCLC cells. Moreover, FOXD3-AS1 interacted with miR-127-3p by acting as a competing endogenous RNA to suppress miR-127-3p expression, while miR-127-3p repressed MED28 expression by targeting MED28 3' untranslated region in NSCLC cells. Mechanistically, the oncogenic effects of FOXD3-AS1 overexpression were significantly attenuated by miR-127-3p overexpression and MED28 knockdown in NSCLC cells. In the xenograft mice model, FOXD3-AS1 knockdown suppressed in vivo tumor growth of A549 cells, and also up-regulated miR-127-3p expression and repressed MED28 expression in the xenograft tumors. In the clinical aspect, the downregulation of miR-127-3p and up-regulation of MED28 were respectively detected in lung cancer tissues. CONCLUSIONS: Our findings provided new evidence that the FOXD3-AS1 regulated NSCLC progression via targeting the miR-127-3p/MED28 axis.


Assuntos
Carcinoma Pulmonar de Células não Pequenas/metabolismo , Fatores de Transcrição Forkhead/metabolismo , Neoplasias Pulmonares/metabolismo , Complexo Mediador/metabolismo , MicroRNAs/metabolismo , RNA Longo não Codificante/metabolismo , Carcinoma Pulmonar de Células não Pequenas/genética , Carcinoma Pulmonar de Células não Pequenas/patologia , Células Cultivadas , Fatores de Transcrição Forkhead/genética , Humanos , Neoplasias Pulmonares/genética , Neoplasias Pulmonares/patologia , Complexo Mediador/genética , MicroRNAs/genética , RNA Longo não Codificante/genética
13.
Cell Transplant ; 28(9-10): 1155-1160, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31137960

RESUMO

Multiple sclerosis is a disease characterized by inflammation and demyelination located in the central nervous system. Experimental autoimmune encephalomyelitis (EAE) is the most common animal model for multiple sclerosis (MS). Although the roles of T cells in MS/EAE have been well investigated, little is known about the functions of other immune cells in the neuroinflammation model. Here we found that an essential cytokine transforming growth factor ß (TGF-ß) which could mediate the differentiation of Th17/regulatory T cells was implicated in the natural killer (NK) cells' activity in EAE. In EAE mice, TGF-ß expression was first increased at the onset and then decreased at the peak, but the expressions of TGF-ß receptors and downstream molecules were not affected in EAE. When we immunized the mice with MOG antigen, it was revealed that TGF-ß treatment reduced susceptibility to EAE with a lower clinical score than the control mice without TGF-ß. Consistently, inflammatory cytokine production was reduced in the TGF-ß treated group, especially with downregulated pathogenic interleukin-17 in the central nervous system tissue. Furthermore, TGF-ß could increase the transcription level of NK cell marker NCR1 both in the spleen and in the CNS without changing other T cell markers. Meanwhile TGF-ß promoted the proliferation of NK cell proliferation. Taken together, our data demonstrated that TGF-ß could confer protection against EAE model in mice through NK cells, which would be useful for the clinical therapy of MS.


Assuntos
Encefalomielite Autoimune Experimental/imunologia , Células Matadoras Naturais/imunologia , Esclerose Múltipla/imunologia , Fator de Crescimento Transformador beta/imunologia , Animais , Antígenos Ly/imunologia , Encefalomielite Autoimune Experimental/patologia , Regulação da Expressão Gênica/imunologia , Interleucina-17/imunologia , Células Matadoras Naturais/patologia , Camundongos , Esclerose Múltipla/patologia , Receptor 1 Desencadeador da Citotoxicidade Natural/imunologia , Linfócitos T Reguladores/imunologia , Linfócitos T Reguladores/patologia , Células Th17/imunologia , Células Th17/patologia , Transcrição Gênica/imunologia
15.
Lupus ; 27(10): 1742-1752, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30060721

RESUMO

Objectives To investigate the mortality and causes of death in Chinese patients with systemic lupus erythematosus. Methods We collected the clinical data of all consecutive adult systemic lupus erythematosus patients at the Rheumatology department of Peking University First Hospital between January 2007 and December 2015. The primary causes of death were identified, the standardized mortality ratio and years of life lost were calculated, and the survival and variables associated with mortality were determined by Kaplan-Meier and Cox regression analysis respectively. Results The mean age of all 911 patients (814 females and 97 males) was 37.8 ± 14.7 years, the median disease duration at recruitment was 2.6 (0.5-7.0) years, and the median follow-up duration was 3.0 (1.4-5.1) years. Among the 911 patients who were successfully followed up, 45 patients died. Infection (31.1%) was the leading cause of death followed by renal failure, pulmonary arterial hypertension and cerebrovascular diseases. The overall age and sex-adjusted standardized mortality ratio was 3.2 (95% confidence interval 2.4-4.0), and the years of life lost for women and men were 29.8 and 9.4 respectively. Overall survival at 1, 5 and 10 years was 98.2%, 95.3% and 93.7% respectively. Older age at disease onset, infection, autoimmune hemolytic anemia, thrombocytopenia and pulmonary arterial hypertension were independent risk factors for the mortality of systemic lupus erythematosus patients, and longer disease duration at recruitment was an independent protective factor. Conclusions Mortality of systemic lupus erythematosus patients in China was substantial, especially in females, with infection the leading cause of death. Older age at disease onset, infection, autoimmune hemolytic anemia, thrombocytopenia and pulmonary arterial hypertension were associated with poor outcomes.


Assuntos
Lúpus Eritematoso Sistêmico/mortalidade , Adulto , Distribuição por Idade , Fatores Etários , Povo Asiático , Causas de Morte , China/epidemiologia , Comorbidade , Feminino , Humanos , Lúpus Eritematoso Sistêmico/diagnóstico , Lúpus Eritematoso Sistêmico/etnologia , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Distribuição por Sexo , Fatores Sexuais , Fatores de Tempo , Adulto Jovem
16.
Am J Physiol Heart Circ Physiol ; 313(4): H810-H827, 2017 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-28710068

RESUMO

Cardiac fibroblasts (CFs) are known to regulate cardiomyocyte (CM) function in vivo and in two-dimensional in vitro cultures. This study examined the effect of CF activation on the regulation of CM electrical activity in a three-dimensional (3-D) microtissue environment. Using a scaffold-free 3-D platform with interspersed neonatal rat ventricular CMs and CFs, Gq-mediated signaling was selectively enhanced in CFs by Gαq adenoviral infection before coseeding with CMs in nonadhesive hydrogels. After 3 days, the microtissues were analyzed by signaling assay, histological staining, quantitative PCR, Western blots, optical mapping with voltage- or Ca2+-sensitive dyes, and microelectrode recordings of CF resting membrane potential (RMPCF). Enhanced Gq signaling in CFs increased microtissue size and profibrotic and prohypertrophic markers. Expression of constitutively active Gαq in CFs prolonged CM action potential duration (by 33%) and rise time (by 31%), prolonged Ca2+ transient duration (by 98%) and rise time (by 65%), and caused abnormal electrical activity based on depolarization-induced automaticity. Constitutive Gq activation in CFs also depolarized RMPCF from -33 to -20 mV and increased connexin 43 and connexin 45 expression. Computational modeling confers that elevated RMPCF and increased cell-cell coupling between CMs and CFs in a 3-D environment could lead to automaticity. In conclusion, our data demonstrate that CF activation alone is capable of altering action potential and Ca2+ transient characteristics of CMs, leading to proarrhythmic electrical activity. Our results also emphasize the importance of a 3-D environment where cell-cell interactions are prevalent, underscoring that CF activation in 3-D tissue plays a significant role in modulating CM electrophysiology and arrhythmias.NEW & NOTEWORTHY In a three-dimensional microtissue model, which lowers baseline activation of cardiac fibroblasts but enables cell-cell, paracrine, and cell-extracellular matrix interactions, we demonstrate that selective cardiac fibroblast activation by enhanced Gq signaling, a pathophysiological trigger in the diseased heart, modulates cardiomyocyte electrical activity, leading to proarrhythmogenic automaticity.


Assuntos
Potenciais de Ação/fisiologia , Fibroblastos/fisiologia , Subunidades alfa Gq-G11 de Proteínas de Ligação ao GTP/fisiologia , Miócitos Cardíacos/fisiologia , Animais , Animais Recém-Nascidos , Conexina 43/biossíntese , Conexinas/biossíntese , Junções Comunicantes/fisiologia , Potenciais da Membrana/fisiologia , Miócitos Cardíacos/ultraestrutura , Técnicas de Patch-Clamp , Ratos , Ratos Sprague-Dawley
18.
Neuroscience ; 325: 39-49, 2016 06 14.
Artigo em Inglês | MEDLINE | ID: mdl-27012608

RESUMO

Increasing evidence suggests that microRNAs (miRs) play a significant role in the pathogenesis of Parkinson's disease (PD). MiR-133b, which is significantly decreased in the PD midbrain, has recently been shown to promote neurite outgrowth and enhance neural functional recovery. However, the role of miR-133b in PD has not been clearly established. Here, using a well-established PD model culture based on the neurotoxin 1-methyl-4-phenyl-pyridinium (MPP(+)), we demonstrated that miR-133b could promote axon outgrowth in dopaminergic neurons (DNs) and ameliorated MPP(+)-induced axon degeneration. Additional experiments suggested that the mechanisms of this miR-133b-mediated effect might rely on RhoA inhibition. We demonstrated that RhoA, an inhibitor of axonal growth, was increased in DNs under MPP(+) treatment, and this increase could be attenuated by miR-133b overexpression. Moreover, we demonstrated that the induced expression of miR-133b could inhibit α-synuclein, which is critically involved in the pathological process of PD. Furthermore, we found that overexpression of miR-133b abrogated the MPP(+)-induced decrease in the Bcl-2/Bax ratio and upregulated phosphorylated Akt (p-Akt), which is a pro-survival kinase. Together these findings reveal novel roles for miR-133b in the pathogenesis of PD and provide new therapeutic avenues for the treatment of the disease.


Assuntos
1-Metil-4-fenilpiridínio/toxicidade , Axônios/patologia , Neurônios Dopaminérgicos/metabolismo , MicroRNAs/metabolismo , Doença de Parkinson/metabolismo , Proteína rhoA de Ligação ao GTP/metabolismo , Animais , Apoptose/efeitos dos fármacos , Axônios/efeitos dos fármacos , Células Cultivadas , Neurônios Dopaminérgicos/efeitos dos fármacos , Neuritos/efeitos dos fármacos , Neuritos/patologia , Fosforilação , Proteínas Proto-Oncogênicas c-akt/metabolismo , Ratos , Ratos Sprague-Dawley , Transdução de Sinais/efeitos dos fármacos
19.
Genet Mol Res ; 14(4): 13812-22, 2015 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-26535696

RESUMO

The aim of this study was to understand the effect of autologous bone powder graft repair of partial mandibular defects of rabbits by the quantitative detection of bone formation. New Zealand rabbits (N = 18) were selected as the test objects, and subjected to bilateral partial mandibular defect induction. One side of the mandibular defect acted as the test group, upon which the autologous bone powder backfilling graft was performed; the other side was put aside and acted as the negative control group. All used an autogenous control. At the twelfth postoperative week, the animals were sacrificed, and semi-automatic image analysis was used to conduct bone histomorphometric detection. Immediately subsequent, quantitative detection of bone formation was performed in the test group. Fluorescent perimeter percent, mineralization apposition rate, and bone formation rate were selected as the dynamic indicators; and trabecular area percent, trabecular thickness, trabecular number, and trabecular separation degree were selected as the static indicators for single factorial variance testing. It was found that the values of P are less than 0.05 between the test group and the control group, indicating that the effect of autologous bone powder graft repair on partial mandibular defects in rabbits was positive.


Assuntos
Transplante Ósseo , Traumatismos Mandibulares/diagnóstico , Traumatismos Mandibulares/cirurgia , Osteogênese , Cicatrização , Animais , Transplante Ósseo/métodos , Modelos Animais de Doenças , Coelhos
20.
Mol Biol (Mosk) ; 48(6): 875-80, 2014.
Artigo em Russo | MEDLINE | ID: mdl-25845228

RESUMO

Altered interactions between the extracellular matrix and cells play an important part in tumorigenesis and metastasis. As a member of matricellular glycoprotein, fibulin-5 is expressed in elastin-rich tissues and organizes the matrix structures by interacting with many extracellular proteins. Fibulin-5 expression is closely associated with normal embryonic development and organogenesis. Mice deficient for the fibulin-5 gene exhibit systemic elastic fiber defects with manifestation of loose skin, emphysematous lung and tortuous vessels. Additionally, fibulin-5 null mice exhibited increased angiogenesis after wound healing or PVA sponge implantation and matrigel implantation experiments show fibulin-5 inhibited vessel formation, suggesting fibulin-5 functions as an angiogenesis inhibitor. Fibulin-5 also plays critical roles in proliferation, migration and invasion of certain tumors, and the effect of fibulin-5 on tumorigenesis appears to be largely context-dependent. This effect might involve the inhibiting action of fibulin-5 on angiogenesis. This review focuses on recent advances in our understanding of the roles of fibulin-5 in tumorigenesis: both tumor promoting and suppressing activity of fibulin-5 are reviewed, and the emerging evidences of its promising potential as therapeutic options and/or targets in the treatment of cancer also highlighted.


Assuntos
Proteínas da Matriz Extracelular/genética , Regulação Neoplásica da Expressão Gênica , Neoplasias/genética , Proteínas Recombinantes/genética , Inibidores da Angiogênese , Animais , Transformação Celular Neoplásica/genética , Transformação Celular Neoplásica/metabolismo , Transformação Celular Neoplásica/patologia , Tecido Elástico/metabolismo , Tecido Elástico/patologia , Transição Epitelial-Mesenquimal/genética , Proteínas da Matriz Extracelular/química , Proteínas da Matriz Extracelular/deficiência , Proteínas da Matriz Extracelular/metabolismo , Fibroblastos/metabolismo , Fibroblastos/patologia , Regulação da Expressão Gênica no Desenvolvimento , Humanos , Camundongos , Camundongos Knockout , Neoplasias/metabolismo , Neoplasias/patologia , Ligação Proteica , Proteínas Recombinantes/química
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...