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1.
Nature ; 629(8010): 105-113, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38632407

RESUMO

Arctic and alpine tundra ecosystems are large reservoirs of organic carbon1,2. Climate warming may stimulate ecosystem respiration and release carbon into the atmosphere3,4. The magnitude and persistency of this stimulation and the environmental mechanisms that drive its variation remain uncertain5-7. This hampers the accuracy of global land carbon-climate feedback projections7,8. Here we synthesize 136 datasets from 56 open-top chamber in situ warming experiments located at 28 arctic and alpine tundra sites which have been running for less than 1 year up to 25 years. We show that a mean rise of 1.4 °C [confidence interval (CI) 0.9-2.0 °C] in air and 0.4 °C [CI 0.2-0.7 °C] in soil temperature results in an increase in growing season ecosystem respiration by 30% [CI 22-38%] (n = 136). Our findings indicate that the stimulation of ecosystem respiration was due to increases in both plant-related and microbial respiration (n = 9) and continued for at least 25 years (n = 136). The magnitude of the warming effects on respiration was driven by variation in warming-induced changes in local soil conditions, that is, changes in total nitrogen concentration and pH and by context-dependent spatial variation in these conditions, in particular total nitrogen concentration and the carbon:nitrogen ratio. Tundra sites with stronger nitrogen limitations and sites in which warming had stimulated plant and microbial nutrient turnover seemed particularly sensitive in their respiration response to warming. The results highlight the importance of local soil conditions and warming-induced changes therein for future climatic impacts on respiration.


Assuntos
Respiração Celular , Ecossistema , Aquecimento Global , Tundra , Regiões Árticas , Carbono/metabolismo , Carbono/análise , Ciclo do Carbono , Conjuntos de Dados como Assunto , Concentração de Íons de Hidrogênio , Nitrogênio/metabolismo , Nitrogênio/análise , Plantas/metabolismo , Estações do Ano , Solo/química , Microbiologia do Solo , Temperatura , Fatores de Tempo
2.
Public Health ; 227: 282-290, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38238130

RESUMO

OBJECTIVES: To assess the prevalence, all-cause mortality and determinants of advanced HIV disease (AHD) or severe immunosuppression (SIS) in the rural-urban communities of Southwestern China. STUDY DESIGN: Retrospective cohort study. METHOD: Data on HIV/AIDS cases reported in 2005-20 were collected from Case Report System. A binary logistic regression model assessed the risk factors of AHD/SIS prevalence. Survival curves across rural-urban regions were compared using Kaplan-Meier estimates and log-rank tests. Determinants of all-cause mortality were identified using the Cox proportional hazard model. RESULTS: Among 14,533 newly diagnosed HIV/AIDS patients, 7497 (51.6%) presented with AHD and 2564 (17.6%) with SIS. Compared with urban patients, rural patients had a higher prevalence of AHD (56.7% vs 40.7%) and SIS (20.1% vs 12.4%), all-cause mortality (AHD 12.3 vs 5.6, SIS 16.3 vs 5.5, per 100 person-years). Their 5-year survival probability (AHD 59.5% vs 77.1%; SIS 54.4% vs 76.3%) and mean survival time (AHD 106.5 vs 140.6 months, SIS 95.3 vs 144.2 months, p < 0.0001) were lower. Rural patients had an increased risk of SIS prevalence (adjusted odds ratios 1.45, 95% confidence interval [CI] 1.28-1.64; p < 0.0001) and mortality of the total cohort (adjusted hazard ratios 1.41, 95% CI 1.29-1.55; p < 0.0001), AHD cohort (1.38, 1.24-1.54; p < 0.0001), and SIS cohort (1.49, 1.23-1.81; p < 0.0001). CONCLUSIONS: A high prevalence of AHD/SIS was a severe phenomenon that caused high mortality in rural areas. A regional point-of-care strategy targeting AHD/SIS detection and management is essential for reducing the mortality risk.


Assuntos
Síndrome da Imunodeficiência Adquirida , Infecções por HIV , Humanos , Estudos Retrospectivos , Infecções por HIV/epidemiologia , Infecções por HIV/diagnóstico , Fatores de Risco , Modelos de Riscos Proporcionais
3.
Nat Commun ; 14(1): 2088, 2023 Apr 12.
Artigo em Inglês | MEDLINE | ID: mdl-37045846

RESUMO

Kinetic Alfvén waves (KAWs) are ubiquitous throughout the plasma universe. Although they are broadly believed to provide a potential approach for energy exchange between electromagnetic fields and plasma particles, neither the detail nor the efficiency of the interactions has been well-determined yet. The primary difficulty has been the paucity of knowledge of KAWs' spatial structure in observation. Here, we apply a particle-sounding technique to Magnetospheric Multiscale mission data to quantitatively determine the perpendicular wavelength of KAWs from ion gyrophase-distribution observations. Our results show that KAWs' perpendicular wavelength is statistically 2.4[Formula: see text] times proton thermal gyro-radius. This observation yields an upper bound of the energy the majority proton population can reach in coherent interactions with KAWs, that is, roughly 5.76 times proton perpendicular thermal energy. Therefore, the method and results shown here provide a basis for unraveling the effects of KAWs in dissipating energy and accelerating particles in a number of astrophysical systems, e.g., planetary magnetosphere, astrophysical shocks, stellar corona and wind, and the interstellar medium.

4.
Zhonghua Xin Xue Guan Bing Za Zhi ; 50(12): 1214-1219, 2022 Dec 24.
Artigo em Chinês | MEDLINE | ID: mdl-36517443

RESUMO

Objective: To analyze the feasibility and safety of bridge therapy with active fixed electrodes connected to external permanent pacemakers (AFLEP) for patients with infective endocarditis after lead removal and before permanent pacemaker implantation. Methods: A total of 44 pacemaker-dependent patients, who underwent lead removal due to infective endocarditis in our center from January 2015 to January 2020, were included. According to AFLEP or temporary pacemaker option during the transition period, patients were divided into AFLEP group or temporary pacemaker group. Information including age, sex, comorbidities, indications and types of cardial implantable electionic device (CIED) implantation, lead age, duration of temporary pacemaker or AFLEP use, and perioperative complications were collected through Haitai Medical Record System. The incidence of pacemaker perception, abnormal pacing function, lead perforation, lead dislocation, lead vegetation, cardiac tamponade, pulmonary embolism, death and newly infection of implanted pacemaker were compared between the two groups. Pneumothorax, hematoma and the incidence of deep vein thrombosis were also analyzed. Results: Among the 44 patients, 24 were in the AFLEP group and 20 in the temporary pacemaker group. Age was younger in the AFLEP group than in the temporary pacemaker group (57.5(45.5, 66.0) years vs. 67.0(57.3, 71.8) years, P=0.023). Male, prevalence of hypertension, diabetes mellitus, chronic renal dysfunction and old myocardial infarction were similar between the two groups (all P>0.05). Lead duration was 11.0(8.0,13.0) years in the AFLEP group and 8.5(7.0,13.0) years in the temporary pacemaker group(P=0.292). Lead vegetation diameter was (8.2±2.4)mm in the AFLEP group and (9.1±3.0)mm in the temporary pacemaker group. Lead removal was successful in all patients. The follow-up time in the AFLEP group was 23.0(20.5, 25.5) months, and the temporary pacemaker group was 17.0(14.5, 18.5) months. In the temporary pacemaker group, there were 2 cases (10.0%) of lead dislocation, 2 cases (10.0%) of sensory dysfunction, 2 cases (10.0%) of pacing dysfunction, and 2 cases (10.0%) of death. In the AFLEP group, there were 2 cases of abnormal pacing function, which improved after adjusting the output voltage of the pacemaker, there was no lead dislocation, abnormal perception and death. Femoral vein access was used in 8 patients (40.0%) in the temporary pacemaker group, and 4 patients developed lower extremity deep venous thrombosis. There was no deep venous thrombosis in the AFLEP group. The transition treatment time was significantly longer in the AFLEP group than in the temporary pacemaker group (19.5(16.0, 25.8) days vs. 14.0(12.0, 16.8) days, P=0.001). During the follow-up period, there were no reinfections with newly implanted pacemakers in the AFLEP group, and reinfection occurred in 2 patients (10.0%) in the temporary pacemaker group. Conclusions: Bridge therapy with AFLEP for patients with infective endocarditis after lead removal and before permanent pacemaker implantation is feasible and safe. Compared with temporary pacemaker, AFLEP is safer in the implantation process and more stable with lower lead dislocation rate, less sensory and pacing dysfunction.


Assuntos
Endocardite Bacteriana , Marca-Passo Artificial , Humanos , Masculino , Terapia Ponte , Estudos de Viabilidade , Endocardite Bacteriana/etiologia , Eletrodos , Remoção de Dispositivo
5.
Zhonghua Xin Xue Guan Bing Za Zhi ; 50(11): 1069-1073, 2022 Nov 24.
Artigo em Chinês | MEDLINE | ID: mdl-36418274

RESUMO

Objective: For patients with paroxysmal atrial fibrillation, superior vena cava isolation on the basis of pulmonary vein isolation may further improve the long-term success rate of radiofrequency ablation. We aimed to explore the efficacy and safety of superior vena cava isolation by high-power and short-duration (HPSD) ablation plus conventional radiofrequency ablation (RA) in patients with paroxysmal atrial fibrillation. Methods: It was a prospective randomized controlled study. From January 1, 2019 to June 1, 2020, 180 patients who underwent radiofrequency ablation for paroxysmal atrial fibrillation in our center were consecutively screened. Patients were eligible if there was a trigger potential and the muscle sleeve length was greater than 3 cm. A total of 60 eligible patients were finally included and randomly divided into HPSD group (HPSD plus RA) and common power and duration (CPD) group (CPD plus RA) by random number table method (n=30 in each group). Efficacy was evaluated by ablation points, isolation time and ablation time. Safety was evaluated by the incidence of POP, cardiac tamponade, phrenic nerve injury, sinoatrial node injury and all-cause. Results: Superior vena cava isolation was achieved by 14 (13, 15) points in the HPSD group, which was significantly less than that in the CPD group (20(18, 22), P<0.001). The superior vena cava isolation time was 8 (7, 9) minutes in the HPSD group, which was significantly shorter than in the CPD group (17(14, 20) minutes, P<0.001). The average ablation time significantly shorter in HPSD group than in CPD group (78.0(71.1, 80.0) s vs. 200(167.5, 212.5)s, P<0.001). The average impedance drop was more significant in the HPSD group than in the CPD group (20.00(18.75, 21.00)Ω (and the percentage of impedance drop was 15%) vs. 12.00(11.75, 13.25)Ω (the percentage of impedance decrease was 12%), P<0.001). There was 1 POP (3.3%) in the HPSD group, and 3 POPs (10.0%) in the CPD group (P>0.05). There was no cardiac tamponade, phrenic nerve injury, sinoatrial node injury and death in both groups. Conclusions: HPSD technique for the isolation of superior vena cava is safe and effective in patients with paroxysmal atrial fibrillation undergoing conventional radiofrequency ablation.


Assuntos
Fibrilação Atrial , Ablação por Radiofrequência , Humanos , Fibrilação Atrial/cirurgia , Veia Cava Superior/cirurgia , Estudos Prospectivos , Resultado do Tratamento
6.
Zhonghua Xin Xue Guan Bing Za Zhi ; 50(8): 799-804, 2022 Aug 24.
Artigo em Chinês | MEDLINE | ID: mdl-35982013

RESUMO

Objective: To evaluate the effect of Li's catheter in cardiac resynchronization therapy (CRT) implantation. Methods: This study was a retrospective cohort study. Patients with indications for CRT implantation who visited the Department of Cardiology, Peking University People's Hospital from January 1, 2016 to January 1, 2022 were enrolled. Patients were divided into Li's catheter group (CRT implantation with Li's catheter) and control group (CRT implantation with the traditional method). The general clinical data of the patients were obtained through the electronic medical record system. Li's catheter is a new type of coronary sinus angiography balloon catheter independently developed by Dr. Li Xuebin (patent number: 201320413174.1). The primary outcome was the success rate of CRT device implantation, and the secondary outcomes included efficacy and safety parameters. Efficacy indicators included operation time, coronary sinus angiography time, left ventricular lead implantation time, X-ray exposure time, left ventricular lead threshold, and diaphragm stimulation. Safety outcomes included incidence of coronary sinus dissection, cardiac tamponade, and pericardial effusion. Results: A total of 170 patients were enrolled in this study, including 90 in Li's catheter group and 80 in control group. Age, male proportion of patients, proportion of patients with ischemic cardiomyopathy, hypertension, diabetes mellitus, chronic renal insufficiency, New York Heart Association (NYHA) functional classification, left ventricular ejection fraction, left ventricular end-diastolic diameter, proportion of left bundle branch block, and preoperative QRS wave width were similar between the two groups (all P>0.05). In Li's catheter group, 34 cases (37.8%) implanted with CRT defibrillators, and 28 cases (35.0%) implanted with CRT defibrillators in control group, the difference was not statistically significant (P=0.710). The success rate of CRT device implantation in Li's catheter group was 100% (90/90), which was significantly higher than that in control group (93.8%, 75/80, P=0.023).The operation time was 57.0 (52.0, 62.3) minutes, the time to complete coronary sinus angiography was 8.0 (6.0, 9.0) minutes, and the time of left ventricular electrode implantation was 8.0 (7.0, 9.0) minutes in Li's catheter group, and was 91.3 (86.3, 97.0), 18.0 (16.0, 20.0), 25.0 (22.0, 27.7) minutes respectively in control group, all significantly shorter in Li's catheter group (all P<0.05). The exposure time of X-ray was 15.0 (14.0, 17.0) minutes in Li's catheter group, which was also significantly shorter than that in control group (32.5 (29.0, 36.0) minutes, P<0.001). There was no coronary sinus dissection and cardiac tamponade in Li's catheter group, and 1 patient (1.1%) had diaphragmatic stimulation in Li's catheter group. In control group, 6 patients (6.7%) had coronary sinus dissection, and 1 patient (1.1%) developed pericardial effusion, and 3 patients (3.3%) had diaphragmatic stimulation. The incidence of coronary sinus dissection in Li's catheter group was significantly lower than that in control group (P=0.011). The postoperative left ventricular thresholds in Li's catheter group and control group were similar (1.80 (1.60, 2.38) V/0.5 ms vs. 1.80 (1.60, 2.40) V/0.5 ms, P=0.120). Conclusions: Use of Li's catheter is associated with higher success rate of CRT implantation, short time of coronary sinus angiography and left ventricular electrode implantation, reduction of intraoperative X-ray exposure, and lower incidence of coronary vein dissection in this patient cohort.


Assuntos
Terapia de Ressincronização Cardíaca , Tamponamento Cardíaco , Insuficiência Cardíaca , Derrame Pericárdico , Terapia de Ressincronização Cardíaca/métodos , Tamponamento Cardíaco/terapia , Catéteres , Insuficiência Cardíaca/terapia , Humanos , Masculino , Estudos Retrospectivos , Volume Sistólico , Resultado do Tratamento , Função Ventricular Esquerda
7.
Zhonghua Yi Xue Za Zhi ; 101(48): 3938-3943, 2021 Dec 28.
Artigo em Chinês | MEDLINE | ID: mdl-34954995

RESUMO

Objective: To investigate the related factors of thrombosis in patients with non-valvular atrial fibrillation (NVAF), and whether the combination of D-dimer, left atrial anteroposterior diameter and CHA2DS2-VASc score can be used to exclude left atrial thrombosis. Methods: A total of 75 NVAF patients with left atrial thrombosis confirmed by transesophageal echocardiography in Peking University People's Hospital from January 1, 2015 to December 31, 2019 were enrolled as the thrombus group. From January 1 to October 31, 2019, 80 patients with NVAF without left atrial thrombosis were enrolled as the control group. The clinical data, CHA2DS2-VASc score, hematological biomarkers, ultrasound data of two groups were compared. The independent factors associated with left atrial thrombosis were screened by univariate analysis and multivariate logistic regression analysis. The positive predictive value and negative predictive value for the diagnosis of left atrial thrombosis were gained by the score calculated based on the independent related factors. Results: There were no significant differences in age, gender, proportion of persistent atrial fibrillation and duration of atrial fibrillation between the two groups. The CHA2DS2-VASc score [M (Q1, Q3)] of the thrombus group was higher than that of the control group [2.5 (1.0, 3.0) vs 1.8 (1.0, 3.0), P=0.012]. The prothrombin time activity [M (Q1, Q3)] of the thrombus group was 81.1 (72.0, 93.0)%, which was lower than that of the control group 88.8 (83.0,96.0)% (P=0.008). The activated partial thromboplastin time (APTT) of the thrombus group was longer than that of the control group [(32.1±4.8) s vs (30.2±3.7) s, P=0.006]. D-dimer [M (Q1, Q3)] of the thrombus group was 231.0 (71.5, 272.2) ng/ml, which was higher than that of the control group 121.7 (49.0, 140.0) ng/ml (P<0.001). The left atrial anteroposterior diameter in thrombus group was larger [(44.6±6.6) mm vs (38.9±5.3) mm, P<0.001], the proportion of mitral regurgitation was higher (58.1% vs 26.8%, P<0.001). The left ventricular ejection fraction [M (Q1, Q3)] of the thrombus group was 56.7% (45.8%, 66.3%), which was lower than that of the control group 63.3% (60.5%, 70.2%) (P=0.003). Multivariate logistic regression analysis showed that the factor related to left atrial thrombosis was left atrial anteroposterior diameter (OR=4.480, 95%CI: 1.616-12.423). The negative predictive value of the new scoring system combined with D-dimer, left atrial anteroposterior diameter and CHA2DS2-VASc score for left atrial thrombosis was 100%. Conclusions: In NVAF patients, the factor independently associating with left atrial thrombosis is left atrial anteroposterior diameter. The combination of D-dimer, left atrial anteroposterior diameter, and CHA2DS2-VASc score can help exclude left atrial thrombosis before ablation of NVAF.


Assuntos
Fibrilação Atrial , Trombose , Produtos de Degradação da Fibrina e do Fibrinogênio , Humanos , Medição de Risco , Fatores de Risco , Volume Sistólico , Função Ventricular Esquerda
8.
Zhonghua Xue Ye Xue Za Zhi ; 41(9): 756-761, 2020 Sep 14.
Artigo em Chinês | MEDLINE | ID: mdl-33113608

RESUMO

Objective: This study aims to evaluate the prognostic effect of peripheral blood cells in multiple myeloma (MM) patients treated with bortezomib. Methods: The clinical data of 155 newly diagnosed MM patients in two blood disease treatment centers from January 2014 to December 2016 were retrospectively studied. All patients received bortezomib as the first-line treatment. The results of the peripheral blood cell counts, including absolute neutrophil count, absolute monocyte count (AMC) , hemoglobin level, mean corpuscular volume (MCV) , and platelet count, and other clinical features were analyzed. Results: AMC (>0.6×10(9)/L) , MCV (>99.1 fl) , and platelet count (<150×10(9)/L) significantly affected patients' PFS and OS. The above three factors were assigned 1 point, respectively, to form the blood cell score. The analysis showed that 64 cases (41.3% ) had a score of 0, 57 cases (36.8% ) had 1, 32 cases (20.6% ) had 2, and 2 cases (1.3% ) had 3. The median PFS of the four groups were 42.8 m, 26.5 m, 15.8 m, and 6.4 m, respectively (P<0.001) . The median OS were NR, 48.2 m, 31.1 m, and 31.4 m, respectively (P=0.001) . Multivariate analysis suggested that the blood cell score (2-3 vs 0-1) and the proportion of marrow plasma cells (>30% ) were independent prognostic factors for PFS (HR=1.95 and 1.76, respectively) , while age (>65y vs ≤65y) , R-ISS stage (3 vs 1-2) , and blood cell score (2-3 vs 0-1) were independent prognostic factors for OS (HR=2.08, 2.13 and 2.12, respectively) . Conclusion: As an easy-to-access biomarker, the blood cell score can be used to evaluate the prognosis of newly diagnosed MM patients in the era of new drugs, but it is still necessary to expand the cases and make further confirmation in the prospective study.


Assuntos
Bortezomib/uso terapêutico , Mieloma Múltiplo , Células Sanguíneas , Intervalo Livre de Doença , Humanos , Mieloma Múltiplo/tratamento farmacológico , Prognóstico , Estudos Retrospectivos
11.
Nat Commun ; 10(1): 1040, 2019 03 04.
Artigo em Inglês | MEDLINE | ID: mdl-30833556

RESUMO

Magnetic cavities (sometimes referred to as magnetic holes) at electron kinetic scale are thought to be one of the extremely small intermittent structures formed in magnetized turbulent plasmas, where the turbulence energy cascaded down to electron scale may finally be dissipated and consequently energize the electrons. However, the geometry and formation of these structures remain not definitively resolved. Here we discuss an electron scale magnetic cavity embedded in a proton scale magnetic cavity observed by the MMS spacecraft in the magnetosheath. By applying an innovative particle sounding technique, we directly depict the boundary of the electron scale magnetic cavity and uncover the geometry. We find that this structure is nearly circular with a radius of 10.0 km and its formation is due to the diamagnetic current. Investigation of the electron scale structure is only recently made possible by the high spatial and temporal resolution provided by MMS observations.

12.
Eur Rev Med Pharmacol Sci ; 22(19): 6475-6484, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30338817

RESUMO

OBJECTIVE: The myocardial ischemia/reperfusion (I/R) injury is a significant challenge, and the clinical significance of remote ischemic postconditioning (RIPostC) in cardioprotection has been confirmed. However, the molecular mechanism remains unclear. We aimed to explore the regulatory mechanism of RIPostC in myocardial I/R. MATERIALS AND METHODS: A mouse model of myocardial I/R injury and cell model of oxygen-glucose deprivation (OGD)/re-oxygenation (OGD/R) injury were constructed. Infarct size was measured by Evans blue dye staining and TTC staining. mRNA and protein expression levels of aldehyde dehydrogenase 2 (ALDH2) were determined by RT-qPCR and Western blot analysis, respectively. Cell viability, p53 expression, apoptotic cells, expression of proteins related to apoptosis, and reactive oxygen species (ROS) generation were evaluated by CCK-8 assay, Western blot analysis, flow cytometry assay, Western blot analysis, and DCFH-DA staining, respectively. ALDH2 in H9c2 cells was knocked down, and its effects on cells treated with OGD/R and RIPostC were tested. How RIPostC affected ALDH2 expression was finally studied. RESULTS: RIPostC reduced infarct size in mice and attenuated OGD/R-induced H9c2 cell injury. Myocardial I/R-induced down-regulation of ALDH2 was abrogated by RIPostC. Moreover, the effects of RIPostC on OGD/R-treated H9c2 cells were significantly reversed by ALDH2 silence. Finally, we found RIPostC-induced up-regulation of ALDH2 in OGD/R-treated cells could be bated by activation of PI3K and/or mTOR. CONCLUSIONS: RIPostC exerted cardioprotective role against myocardial I/R both in vivo and in vitro. Up-regulation of ALDH2 might be a reason for the cardioprotection, and RIPostC might regulate ALDH2 expression via the PI3K/mTOR pathway.


Assuntos
Aldeído-Desidrogenase Mitocondrial/biossíntese , Apoptose , Artéria Femoral/cirurgia , Pós-Condicionamento Isquêmico/métodos , Infarto do Miocárdio/prevenção & controle , Traumatismo por Reperfusão Miocárdica/prevenção & controle , Miócitos Cardíacos/enzimologia , Aldeído-Desidrogenase Mitocondrial/genética , Animais , Proteínas Reguladoras de Apoptose/metabolismo , Hipóxia Celular , Linhagem Celular , Modelos Animais de Doenças , Indução Enzimática , Artéria Femoral/fisiopatologia , Glucose/deficiência , Ligadura , Masculino , Camundongos Endogâmicos C57BL , Infarto do Miocárdio/enzimologia , Infarto do Miocárdio/patologia , Traumatismo por Reperfusão Miocárdica/enzimologia , Traumatismo por Reperfusão Miocárdica/patologia , Miócitos Cardíacos/patologia , Fosfatidilinositol 3-Quinase/metabolismo , Espécies Reativas de Oxigênio/metabolismo , Fluxo Sanguíneo Regional , Transdução de Sinais , Serina-Treonina Quinases TOR/metabolismo , Proteína Supressora de Tumor p53/metabolismo
13.
Zhonghua Xue Ye Xue Za Zhi ; 39(12): 989-993, 2018 Dec 14.
Artigo em Chinês | MEDLINE | ID: mdl-30612399

RESUMO

Objective: To study the effect of WT1 expression on the prognosis of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in acute leukemia (AL) and its significance as molecular marker to dynamically monitor minimal residual disease (MRD) . Methods: Retrospectively analyzed those AL patients who underwent allo-HSCT in the First Hospital Affiliated to Zhejiang University School of Medicine during Jan 2016 to Dec 2017, a total number of 314 cases, 163 males and 151 females, median age was 30 (9-64) years old. Comparing the difference of WT1 expression at diagnosed, pre-HSCT and after HSCT. Using the receiver operating characteristic (ROC) curve to determine the WT1 threshold at different time so as to predict relapse. The threshold of WT1 expression before transplantation was 1.010%, within 3 months after HSCT was 0.079% and 6 months after HSCT was 0.375%. According to these thresholds, WT1 positive patients were divided into low expression groups and high expression groups. Analyzed the relationship between overall survival (OS) , disease-free survival (DFS) , cumulative incidence of relapse (CIR) and WT1 expression. Results: The OS and DFS of high expression group pre-HSCT were lower than low expression group [69.2% (9/13) vs 89.1% (57/64) , χ(2)=4.086, P=0.043; 53.8% (7/13) vs 87.5% (56/64) , χ(2)=9.766, P=0.002], CIR was higher than low expression group [30.8% (4/13) vs 7.8% (5/64) , P=0.017]. There was no significant difference of OS and DFS between high expression and low expression group of 3 months after HSCT (P=0.558, P=0.269) . The OS and DFS of high expression group of 6 months after transplantation were both lower than low expression group (P=0.049, P=0.035) . Multivariate analysis showed that WT1>0.375% when 6 months after transplantation was the only independent prognostic factor for shorter DFS (P=0.022) . There was no statistically significant difference in CIR between the high-expression group and the low-expression group 3 months after transplantation and 6 months after transplantation (P=0.114, P=0.306) . Conclusion: High expression of WT1 before and after HSCT was an adverse prognosis factor. It is of clinical practical value to use WT1 as a transplant recommendation index for patients with acute leukemia and as a marker to monitor MRD dynamically.


Assuntos
Transplante de Células-Tronco Hematopoéticas , Leucemia Mieloide Aguda/terapia , Adolescente , Adulto , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasia Residual , Prognóstico , Estudos Retrospectivos , Transplante Homólogo , Proteínas WT1 , Adulto Jovem
15.
Zhonghua Xue Ye Xue Za Zhi ; 38(5): 379-383, 2017 May 14.
Artigo em Chinês | MEDLINE | ID: mdl-28565735

RESUMO

Objective: To evaluate the efficacy and safety of maintenance therapy with reduced dose of rhTPO in the patients with primary immune thrombocytopenia (ITP) who attained stable platelet (PLT) counts after daily administration of rhTPO. Methods: Treatment was started with a daily administration of rhTPO (300 U/kg) for 2 consecutive weeks. Patients who attained stable PLT≥50×10(9)/L were enrolled to maintenance therapy starting with every other day administration of rhTPO, then adjusted dose interval to maintain platelet count (30-100) ×10(9)/L. Results: A total of 91 eligible patients were enrolled. Fourteen patients discontinued the study due to noncompliance (12/14) and investigator decision (2/14) . Among 77 patients who completed the study, 38 patients with the administration of rhTPO at every other day or less could maintain PLT≥30×10(9)/L for 12 weeks. The percentage of patients with a platelet response (PLT≥30×10(9)/L) at 4(th) week, 8(th) week and 12(th) week of maintain therapy was 92.6% (63/68) , 82.7% (43/52) and 85.0% (34/40) , respectively. Median platelet counts remained in the range of (70-124) ×10(9)/L. The overall incidence of rhTPO-related adverse events was 7.7%. All the adverse events were generally mild. Conclusion: Extending the dose interval of rhTPO is feasible to maintain stable platelet count in the patients with ITP, but the optimal dose interval is uncertain and might vary with individuals.


Assuntos
Púrpura Trombocitopênica Idiopática , Plaquetas , Humanos , Contagem de Plaquetas , Estudos Prospectivos , Proteínas Recombinantes , Trombopoetina
16.
Hum Exp Toxicol ; 36(4): 386-394, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-27198676

RESUMO

The primary hepatocytes were extracted and purified from mice through improved Seglen two-step perfusion method. Ethanol-induced injury hepatocytes model in mice was used to investigate the importance of glutathione S-transferase A1 (GSTA1) in hepatocytes injury by comparison with other indicators, such as alanine aminotransferase, aspartate aminotransferase, malondialdehyde, glutathione and superoxide dismutase. The release of GSTA1 was demonstrated to be an earlier and more sensitive indicator of hepatocytes injury than other indicators. Significant increases in GSTA1 were detected at 2 h after ethanol exposure, while other indicators were undetected at this time. A markedly difference in other indicators were observed at 6 and 8 h. The release of GSTA1 was significantly increased at a concentration of 50 mmol/L ethanol, the lowest exposure concentration than that in other indicators. In contrast, other indicators release was not statistically significant until concentrations of 75 mmol/L and 100 mmol/L ethanol. These results suggest that GSTA1 can be detected at the early stage of low concentration ethanol exposure and that GSTA1 is more sensitive and reliable marker in ethanol-induced hepatic injury.


Assuntos
Etanol/toxicidade , Glutationa Transferase/metabolismo , Hepatócitos/efeitos dos fármacos , Isoenzimas/metabolismo , Alanina Transaminase/metabolismo , Animais , Aspartato Aminotransferases/metabolismo , Células Cultivadas , Glutationa/metabolismo , Hepatócitos/metabolismo , Masculino , Malondialdeído/metabolismo , Camundongos , Superóxido Dismutase/metabolismo
17.
Eur Rev Med Pharmacol Sci ; 20(20): 4322-4327, 2016 10.
Artigo em Inglês | MEDLINE | ID: mdl-27831640

RESUMO

OBJECTIVE: To provide selectable microRNA for intervening diabetes mellitus diseases, NOD mice's expression of microRNA in pancreas tissues and blood under the exendin-4 intervention of was observed and the difference of microRNA target gene was screened. MATERIALS AND METHODS: Forty clean NOD mice were randomly divided into four groups (in each group, n = 10): One is blank control group D which is intervened with normal saline, and the other three groups were divided into low-dose group A, middle-dose group B, and high-dose group C according to the different exendin-4 dosage 2, 4, and 8 µg/kg·d. After the 8-week intervention, these four groups were killed, and the pancreatic tissue and blood were left to prepare specimens for morphology and molecular biology analysis. The specimen with differential expression microRNA in pancreas tissue and blood should be screened out after detected with the locked nucleic acid array system (LNATM) microRNA expression profile chip. The primers should be designed, and the ABI7500 real-time fluorescent quantitative PCR should be applied to amplify, analyze, and verify according to the screen results of the microRNA chip in order to screen out the significant differentially expressed microRNA. RESULTS: Histological detection showed that the pancreas of the mice in control group D was fibrosis gradually and the islet frame was relatively disordered and significantly atrophied. Groups A, B, and C have no islet hypertrophy or atrophy and the degree of fibrosis of the pancreas has reduced. According to the gene chip detection, there are four significantly differently expressed microRNAs in pancreas tissue and blood among the group A, B, and C, among which miR-19a, miR-19b, and miR-22 were downregulated expressed while the miRNA-1 was upregulated expressed. Bioinformatics analysis showed that the target genes of 4 differentially regulated microRNA genes were related to cell proliferation, apoptosis, glucose metabolism, and angiogenesis. The expression of microRNA in pancreatic tissue and blood of NOD rats was highly consistent. CONCLUSIONS: MicroRNA expression file of pancreatic tissue and blood can be changed during the intervention of the NOD rat model with exendin-4. MicroRNA that indicates the differential expression may take part in the recovering process of the NOD pancreatic trauma. At the same time, the administration of exendin-4 can protect NOD mice, reduce its pancreatic tissue fibrosis, and regulate molecular markers of pancreatic cells in size and pancreatic mast cells. This may be one of the main mechanisms of pancreatic injury in diabetes prevention.


Assuntos
Diabetes Mellitus , MicroRNAs/genética , Peptídeos , Peçonhas , Animais , Modelos Animais de Doenças , Exenatida , Camundongos , Camundongos Endogâmicos NOD , Pâncreas , Ratos
18.
Eur Rev Med Pharmacol Sci ; 20(17): 3642-7, 2016 09.
Artigo em Inglês | MEDLINE | ID: mdl-27649665

RESUMO

OBJECTIVE: Growth hormone deficiency (GHD) is the most common cause for childhood dwarfism. Currently, the significance of insulin-like growth factor-1 (IGF-1) in diagnosis of GHD is still debatable. Due to the possible correlation between leptin (LEP) and GHD pathogenesis, this study investigated the gene polymorphism of LEP and its receptor (LEPR) genes, along with serum IGF-1 and LEP levels in GHD patients. This study attempted to illustrate the correlation between gene polymorphism and GHD pathogenesis. PATIENTS AND METHODS: A case-control study was performed using 180 GHD children in addition to 160 healthy controls. PCR-DNA sequencing method was employed for genotyping various polymorphism loci of LEP and LEPR genes in both GHD and healthy individuals. Serum IGF-1 and LEP levels were also determined. RESULTS: Results revealed a statistically significant difference between the levels of IGF-1 and LEP in the serum samples collected from patients in the GHD and the control groups. Both IGF-1 and LEP levels were found to be correlated with polymorphism at rs7799039 loci of LEP gene, in which GG and GA genotypes carriers had higher serum IGF-1 levels when compared to AA genotype carriers. CONCLUSIONS: GHD pathogenesis is well correlated with the LEP and IGF-1 levels in the both of which were mediated by the gene polymorphism at rs7799039 loci of LEP gene.


Assuntos
Hormônio do Crescimento/deficiência , Fator de Crescimento Insulin-Like I/genética , Leptina/sangue , Receptores para Leptina/genética , Estudos de Casos e Controles , Criança , Feminino , Genótipo , Hormônio do Crescimento Humano , Humanos , Masculino
20.
Bone Marrow Transplant ; 49(2): 241-7, 2014 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-24121213

RESUMO

Owing to ethnicity of the population, those best confirmed polymorphisms in the TLR (toll-like receptor)4 and NOD2 genes with significantly prognostic impact on allogeneic hematopoietic SCT (allo-HSCT) seem to be more applicable to Europeans and are nonpolymorphic in the Asian population. The influence of innate immunity gene polymorphisms on the outcomes of allo-HSCT in those populations has been questioned. We evaluated the influence of 10 candidate single nucleotide polymorphisms (SNPs) in the TLR1, TLR2, TLR3, TLR8 and TLR9 genes on the outcomes of allo-HSCT in a Chinese population including 138 pairs of patients and unrelated donors and a second cohort of 102 pairs of patients and HLA-identical sibling donors. We found that two tagSNPs in the TLR9 gene in the donor side, +1174 A/G (rs352139) and +1635 C/T (rs352140), influenced the risk of acute GVHD (aGVHD) and CMV reactivation. Furthermore, the presence of the susceptible haplotype (A-C) in donor may be an informative predicator of worse OS at 5 years compared with those with the G-C and G-T haplotypes (58% vs 82.9%, P=0.024). Our data suggested an unrecognized association between donor TLR9 tagSNPs and the risk of HSCT-related complications in a population without polymorphisms in the TLR4 and NOD2 genes.


Assuntos
Transplante de Células-Tronco Hematopoéticas/métodos , Proteína Adaptadora de Sinalização NOD2/genética , Receptor 4 Toll-Like/genética , Condicionamento Pré-Transplante/métodos , Feminino , Genótipo , Doença Enxerto-Hospedeiro/etiologia , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Humanos , Masculino , Proteína Adaptadora de Sinalização NOD2/metabolismo , Polimorfismo Genético , Polimorfismo de Nucleotídeo Único , Doadores de Tecidos , Receptor 4 Toll-Like/metabolismo , Condicionamento Pré-Transplante/efeitos adversos , Resultado do Tratamento
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