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1.
Int J Surg ; 2020 Feb 17.
Artigo em Inglês | MEDLINE | ID: mdl-32081714

RESUMO

PURPOSE: Radical nephroureterectomy (RNU) is the primary treatment strategy for upper urinary tract urothelial carcinoma (UTUC); however, the prognosis is poor and recurrences are common. The risk factors for intravesical recurrence (IVR) remain inconsistent and unclear. Thus, we have identified the risk factors for IVR in patients with organ-confined UTUC. METHODS: We retrospectively studied 229 patients with UTUC who underwent RNU combined with bladder cuff resection at our center between 1 January 2010 and 31 December 2015. After propensity score-matching, 204 patients were included in our study. Patient demographics, co-morbidities, and peri-operative data were recorded. Univariate and multivariate Cox proportional hazard regression were used to estimate the hazard ratio and 95% confidence intervals. Overall (OS) and cancer-specific survival (CSS) were measured using the Kaplan-Meier curve with a log-rank test. A p-value <0.05 was considered statistically significant. RESULTS: Of the 229 patients, 42 (18.3%) had IVR after 40 months (range, 24-56 months) follow-up. In the matched group, the independent risk factors for IVR were tumor diameter (HR=2.690, p=0.038) and tumor stage (T3 vs. T1, HR=3.363, p=0.019; T2 vs. T1, HR=2.835, p=0.022). OS and CSS were poor in patients with IVR than patients without IVR (p<0.0001). CONCLUSIONS: In this propensity score-matched case-control study, tumor diameter and tumor stage were shown to be independent risk factors for IVR in patients with organ-confined UTUC. Moreover, patients with IVR had poor prognosis than patients without IVR. Thus, more active postoperative surveillance and treatment strategies should be adopted for these patients, which may help improve treatment outcomes.

2.
Endocr J ; 67(1): 81-89, 2020 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-31597814

RESUMO

Although currently the primary strategy for the treatment of pheochromocytomas is surgery, it is associated with a high risk of intraoperative hemodynamic instability (IHD), even with adequate preoperative medical preparation, which may result in life-threatening situations. The aim of this study was to develop and validate a nomogram for preoperative prediction of IHD related to pheochromocytoma surgery. The development cohort consisted of 283 patients with pheochromocytoma who underwent unilateral laparoscopic or open adrenaletomy at our center between January 1, 2007 and December 31, 2016. The clinicopathological characteristics of each patient were recorded. The least absolute shrinkage and selection operator binary logistic regression model was used for data dimension reduction and feature selection, while multivariable logistic regression analysis was used to develop the prediction model. An independent cohort consisting of 119 consecutive patients from January 1, 2017 to December 31, 2018 was used for validation. The performance of the prediction model was assessed in regards to discrimination, calibration, and clinical usefulness. The predictors of this model included body mass index, coronary heart disease, tumor size, and preoperative use of crystal/colloid fluid. For the validation cohort, the model showed good discrimination with an area under the receiver operating characteristic of 0.767 (95% CI, 0.667-0.857) and good calibration (unreliability test, p = 0.852; Hosmer-Lemeshow test, p = 0.9309). Decision curve analysis demonstrated that the model was clinically useful. This nomogram to facilitate preoperative individualized prediction of IHD in patients with pheochromocytoma may help to improve the perioperative strategy and treatment outcome.

3.
Pharm Biol ; 58(1): 72-79, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31875760

RESUMO

Context: Cisplatin-based chemotherapy was widely used in treating human malignancies. However, side effects and chemoresistance remains the major obstacle.Objective: To verify whether natural borneol (NB) can enhance cisplatin-induced glioma cell apoptosis and explore the mechanism.Materials and methods: Cytotoxicity of cisplatin and/or NB towards U251 and U87 cells were determined with the MTT assay. Cells were treated with 0.25-80 µg/mL cisplatin and/or 5-80 µM NB for 48 h. The effects of NB and/or cisplatin on apoptosis and cell cycle distribution were quantified by flow cytometric analysis. Protein expression was detected by western blotting. ROS generation was conducted by measuring and visualising an oxidation-sensitive fluorescein DCFH-DA.Results: NB synergistically enhanced the anticancer efficacy of cisplatin in human glioma cells. Co-treatment of 40 µg/mL NB and 40 µg/mL cisplatin significantly inhibited U251 cell viability from 100% to 28.2% and increased the sub-G1 population from 1.4% to 59.3%. Further detection revealed that NB enhanced cisplatin-induced apoptosis by activating caspases and triggering reactive oxygen species (ROS) overproduction as evidenced by the enhancement of green fluorescence intensity from 265% to 645%. ROS-mediated DNA damage was observed as reflected by the activation of ATM/ATR, p53 and histone. Moreover, MAPKs and PI3K/AKT pathways also contributed to co-treatment-induced U251 cell growth inhibition. ROS inhibition by antioxidants effectively improved MAPKs and PI3K/AKT functions and cell viability, indicating that NB enhanced cisplatin-induced cell growth in a ROS-dependent manner.Discussion and conclusions: Natural borneol had the potential to sensitise human glioma cells to cisplatin-induced apoptosis with potential application in the clinic.

4.
Artigo em Inglês | MEDLINE | ID: mdl-31831408

RESUMO

This paper presents regional attraction of line segment maps, and hereby poses the problem of line segment detection (LSD) as a problem of region coloring. Given a line segment map, the proposed regional attraction first establishes the relationship between line segments and regions in the image lattice. Based on this, the line segment map is equivalently transformed to an attraction field map (AFM), which can be remapped to a set of line segments without loss of information. Accordingly, we develop an end-to-end framework to learn attraction field maps for raw input images, followed by a squeeze module to detect line segments. Apart from existing works, the proposed detector properly handles the local ambiguity and does not rely on the accurate identification of edge pixels. Comprehensive experiments on the Wireframe dataset and the YorkUrban dataset demonstrate the superiority of our method. In particular, we achieve an F-measure of 0.831 on the Wireframe dataset, advancing the state-of-the-art performance by 10.3 percent.

5.
Pathol Oncol Res ; 2019 Oct 23.
Artigo em Inglês | MEDLINE | ID: mdl-31643022

RESUMO

Although radical nephroureterectomy is the standard treatment method for upper urinary tract urothelial carcinoma, it is associated with a high risk of intravesical recurrence. There are no models for predicting IVR after RNU in patients with organ-confined UTUC. Therefore, we developed and validated a model for postoperative prediction of IVR after RNU. The development cohort consisted of 416 patients who underwent RNU with bladder cuff excision at our center between 1 January 2007 and 31 December 2015. Patient clinicopathologic data were recorded. Multivariate Cox proportional hazard ratio regression was used to build a predictive model with regression coefficients, backward step-wise selection was applied, and the likelihood ratio test with Akaike's information criterion was used as the stopping rule. An independent cohort consisting of 152 consecutive patients from 1 January 2016 and 31 December 2017 was used for validation. The performance of this predictive model was assessed with respect to discrimination, calibration, and clinical usefulness. The predictors in this model included tumor stage, tumor diameter, tumor location, and tumor grade. In the validation cohort, the model showed good discrimination, with a concordance index of 0.689 (95% CI, 0.629 to 0.748) and good calibration. Decision curve analysis demonstrated that the model was also clinically useful. This study presents a good model that may facilitate individualized postoperative prediction of IVR after RNU in patients with organ-confined UTUC, and thus, may help improve postoperative strategies and facilitate treatment outcomes.

6.
Zhongguo Zhong Yao Za Zhi ; 44(14): 2947-2952, 2019 Jul.
Artigo em Chinês | MEDLINE | ID: mdl-31602838

RESUMO

The aim of this paper was to discuss the protective effect and mechanism of Acanthopanax senticosus polysaccharides( ASPs) on immunological liver injury caused by conanavalin A( Con A). BALB/c mice were randomly divided into seven groups: control group,model group( Con A),low-,medium-,and high-dose( 36. 25,72. 5,145 mg·kg~(-1)) ASPs groups,bifendate( 200 mg·kg~(-1),positive drug) group and pyrrolidinedithiocarbamate( PDTC,NF-κB inhibitor,200 mg·kg~(-1)) group. ASPs groups and bifendate group were given with corresponding drugs by ig administration once daily for 7 d. Control group,model group and PDTC group were given with normal saline by ig administration once daily for 7 d. After the last ig administration,PDTC was given in DTC group by iv administration( 200 mg·kg~(-1)); 0. 5 h after that,Con A( 20 mg·kg~(-1)) was injected via the tail vein to induce immunological liver injury in all the mice except normal control group. The mice were killed 8 h later and their liver tissues were collected for histopathological examination. The contents of nitric oxide( NO),superoxide dismutase( SOD),malondialdehyde( MDA),reduced glutathione( GSHPX),interleukin( IL-1ß) and tumor necrosis factor( TNF-α) in liver tissues were detected by kit assay. Western blot method was used to detect TNF-α,intercellular cell adhesion molecule-1( ICAM-1),inducible nitric oxide synthase( i NOS) and nuclear factor( NF-κB) protein expression in liver tissues. As compared with model group,ASPs not only could reduce the activity of MDA,NO,IL-1ß and TNF-α,but also increase the content of GSH-PX and SOD; at the same time,the protein expression levels of TNF-α,ICAM-1,i NOS and NF-κB were reduced in liver tissues; in addition,inflammatory cell infiltration was alleviated,hepatocyte cytoplasm was loose and swollen,and nuclear condensation and staining were improved. ASPs has a protective effect on immunological liver injury,and the mechanism may be associated with regulating secretion of inflammatory cytokines and the expression of adhesion factor through NF-κB signaling pathway.


Assuntos
Doença Hepática Induzida por Substâncias e Drogas/tratamento farmacológico , Citocinas/metabolismo , Eleutherococcus/química , Polissacarídeos/farmacologia , Animais , Fígado/efeitos dos fármacos , Camundongos , Camundongos Endogâmicos BALB C , NF-kappa B/metabolismo , Peptídeos Cíclicos , Distribuição Aleatória , Transdução de Sinais
7.
BMC Med Educ ; 19(1): 338, 2019 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-31488118

RESUMO

BACKGROUND: Effective doctor-patient communication (DPC) is important to improve the quality of care and treatment outcomes. This study aimed to evaluate the effectiveness of a modified DPC training programme designed for surgical residents in China. METHODS: A total of 210 surgical residents from 7 specialties were recruited to participate in a communication skills training programme. The extended SEGUE scale was administered to supervisors, and a visual analogue scale (VAS) was administered to standardized patients (SPs) and trainees. Evaluations were conducted by comparing the pre-post scale scores (before, immediately after and 1 month after the programme). Training effects were assessed using the Friedman test and the intraclass correlation coefficient (ICC). RESULTS: Compared to the extended SEGUE scale total scores before the programme, the scores both immediately after and 1 month after the program increased significantly (15.88 ± 1.93 vs. 26.40 ± 1.47 and 26.15 ± 1.36, respectively, p < 0.001). The scores of five of the six dimensions in the extended SEGUE scale significantly increased (p < 0.001), except for the patient's perspective dimension score, which had no change (p = 0.162). With respect to this dimension, a subgroup analysis by gender indicated an increase among females (p < 0.001) and a decrease among males (p < 0.001). The VAS scores, which were evaluated for the SPs and trainees, increased significantly compared to the scores before the program, both immediately after and 1 month after the programme (4.31 ± 1.35 vs. 7.36 ± 1.62 and 7.34 ± 1.24, p < 0.001; 7.31 ± 1.25 vs. 8.39 ± 1.32 and 8.30 ± 1.24, p < 0.001, respectively). The consistency of the VAS between the SPs and surgical residents was 0.26 (p < 0.001), 0.70 (p < 0.001), and 0.70 (p < 0.001) before, immediately after and 1 month after the programme, respectively. CONCLUSION: This training programme improved the DPC competency of surgical residents, effectively increased the levels of satisfaction of both SPs and surgical residents, and improved the consistency of evaluation between SPs and surgical residents during doctor-patient encounters. The registration UIN is ChiCTR1800019790 from November 28, 2018.

8.
Immunotherapy ; 11(15): 1303-1313, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31478420

RESUMO

Aim: To investigate whether and how CD4+ T cells contribute to ILC2 activation during respiratory syncytial virus (RSV) infection. Methods: The methods of flow cytometry, quantitative PCR and ELISA were used in the present study. Results: Depletion of CD4+ T cells diminished the numbers of lung ILC2s as well as their ability to produce type 2 cytokines. CD4+ T cell-mediated ILC2 activation is related to IL-2. The main cellular source of IL-2 was CD4+ T cells. Depletion of CD4+ T cells decreased IL-2 levels in the lungs of RSV-infected mice. IL-2 can directly stimulate ILC2 proliferation and promote ILC2s to produce cytokines. Treatment of mice with neutralizing anti-IL-2 monoclonal antibodies diminished ILC2 activation. Conclusion: These results suggest that CD4+ T cells contribute to RSV-induced ILC2 activation partly via producing IL-2.

9.
J Dig Dis ; 20(10): 547-556, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31448533

RESUMO

OBJECTIVE: Lactulose is effective in the treatment and prevention of overt hepatic encephalopathy (OHE), but there are limited data on its use on microbiota in relations to minimal hepatic encephalopathy (MHE) recovery. The present study aimed to assess the efficacy of lactulose in recovery of MHE in aspects of cognitive function, quality of life, and impact on intestinal microbiota. METHODS: This multicenter, open-label randomized controlled trial was conducted in 11 teaching hospitals in China. Participants were randomly allocated on a 2:1 basis to receive lactulose (Gp-L) or no therapy as control (Gp-NL) for 60 days. The primary endpoint was the MHE reversal rate. Gut microbiota were compared between MHE patients and healthy volunteers, as well as lactulose-responders and non-responders. RESULTS: A total of 98 cirrhotic patients were included in the study, with 31 patients in the Gp-NL group and 67 patients in the Gp-L group. At day 60, the MHE reversal rate in Gp-L (64.18%) was significantly higher than that in Gp-NL (22.58%) (P = .0002) with a relative risk of 0.46 (95% confidence interval 0.32-0.67). Number needed to treat was 2.4. Further, there was significantly more improvement in physical functioning in Gp-L (4.62 ± 6.16) than in Gp-NL (1.50 ± 5.34) (P = .0212). Proteobacteria was significantly higher in MHE patients compared with healthy volunteers (12.27% vs 4.65%, P < .05). Significant differences were found between lactulose responders and non-responders in Actinobacteria, Bacteroidetes, Firmicutes, and Proteobacteria. CONCLUSIONS: Treatment with lactulose significantly improves MHE recovery rate, and gut microbiota change in MHE patients can modulate the effectiveness of this therapy. Chinese Clinical Trial Register (ChiCTR) (ID: ChiCTR-TRC-12002342).

10.
Artigo em Inglês | MEDLINE | ID: mdl-31420312

RESUMO

Perioperative coagulopathy and bleeding are common complications in cardiovascular surgery with cardiopulmonary bypass and result in an increased rate of allogeneic blood transfusion. Both bleeding and transfusion can increase postoperative mortality and morbidity. Patient blood management can significantly reduce allogeneic blood transfusions, improve clinical outcomes, and conserve blood resources; however, measures to protect platelets from destruction by cardiopulmonary bypass still are lacking. As an unusual method of autologous blood transfusion, autologous platelet-rich plasmapheresis can effectively protect platelets from damage and has been used successfully in cardiovascular surgery. This narrative review aims to address some major clinical applications and debates of using autologous platelet-rich plasmapheresis in cardiovascular surgery. In addition, this review summarizes the application of autologous platelet gel, a product developed from autologous platelet-rich plasma, in cardiac surgery.

11.
Int Immunopharmacol ; 76: 105784, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31470268

RESUMO

CD4+T cells are crucial cellular source of type 2 cytokines and responsible for RSV-induced asthma-like symptoms and asthma exacerbations. However, the mechanism for regulating the activation of CD4+T cells during RSV infection is not clear completely. We show in this study that infection with RSV may induce an expansion and activation of CD4+T cells in the lungs of BALB/c mice. RSV-induced CD4+T cell expansion and activation seems to depend upon the pulmonary group 2 innate lymphoid cells (ILC2s), since adoptive transfer of lung ILC2s can enhance not only the numbers of CD4+T cells but also the cytokine production by CD4+T cells. Interestingly, blockade of the contact between ILC2s and CD4+T cells, may significantly diminish the CD4+T cell expansion and cytokine production, suggesting that membrane molecules may be involved in ILC2-regulated CD4+T cell activation. In fact, infection with RSV resulted in an increase in the numbers of OX40+CD4+T cells as well as OX40L+ILC2s in the lungs of mice. Moreover, the mRNA expressions of OX40 and OX40L as well as the levels of OX40 and OX40L proteins in the lung CD4+T cells and ILC2s were elevated respectively. When co-culture of CD4+T cells with ILC2s in the presence of anti-OX40L antibody, the cytokine productions by CD4+T cells were reduced markedly, suggesting that lung ILC2s may regulate RSV-induced CD4+T cell expansion and activation perhaps via OX40/OX40L interaction.

12.
Biomed Pharmacother ; 118: 109261, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31374355

RESUMO

Doxorubicin (DOX) as a first-line chemotherapeutic drug has been widely used for therapy of human cancers. However, side effects and chemo-resistance severely blocked its clinic application. Herein, natural borneol (NB) as a novel monoterpenoid chemosensitizer was found to have the potential to increase the blood brain barrier (BBB) permeability and intracellular uptake of DOX in vitro, and synergistically enhanced DOX-induced cytotoxicity in human glioma cells. NB treatment significantly potentiated DOX-induced G2/M cell cycle arrest by triggering reactive oxygen species (ROS)-mediated DNA damage. NB also enhanced DOX-induced dysfunction of MAPKs and PI3 K/AKT pathways. Furthermore, U251 human glioma xenograft growth in vivo was also effectively inhibited by combined treatment of DOX with NB through induction of G2/M-phase arrest and antiangiogenesis. Taken together, our finding validated that NB could act as novel chemosensitizer to enhance DOX-induced anticancer efficacy, and strategy of using NB and DOX could be a high efficient way in therapy of human cancers.

13.
Clin Endocrinol (Oxf) ; 91(4): 490-497, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31278868

RESUMO

OBJECTIVE: Although surgical resection is the primary treatment method for pheochromocytoma, it carries a high risk of morbidity, especially cardiovascular-related morbidity. There are no models for predicting cardiovascular morbidity after pheochromocytoma surgery. Thus, we developed and validated a model for the preoperative prediction of cardiovascular morbidity after pheochromocytoma surgery. DESIGN: The development cohort consisted of 262 patients who underwent unilateral laparoscopic or open pheochromocytoma surgery at our centre between 1 January 2007 and 31 December 2016. Patient's clinicopathologic data were recorded. The LASSO regression was used for data dimension reduction and feature selection; then, multivariable logistic regression analysis was used to develop the prediction model. An independent cohort consisting of 112 consecutive patients from 1 January 2017 and 31 December 2018 was used for validation. The performance of this prediction model was assessed with respect to discrimination, calibration and clinical usefulness. RESULTS: The predictors in this prediction model included body mass index, history of coronary heart disease, tumour size, intraoperative hemodynamic instability and use of crystal/colloid fluids preoperatively. In the validation cohort, the model showed good discrimination with an AUROC of 0.869 (95% CI, 0.797, 0.940) and good calibration (unreliability test, P = .852). Decision curve analysis demonstrated that the model was also clinically useful. CONCLUSION: This study presented a good nomogram that could facilitate the preoperative individualized prediction of cardiovascular morbidity after pheochromocytoma surgery, which may help improve perioperative strategy and good treatment outcomes.

14.
Sci Total Environ ; 686: 753-763, 2019 Oct 10.
Artigo em Inglês | MEDLINE | ID: mdl-31195283

RESUMO

Sediment dredging is a controversial technology for lake eutrophication control. A lengthy and holistic assessment is important to understand the effects of a dredging project on a lake ecosystem. In this study, a dredging project was followed for 5 years. To understand the variations of lake ecosystems before, during and after the project, water quality, phytoplankton, zooplankton and benthic animal biomass were monitored; Four subindicators, including eco-exergy (Ex), structural eco-exergy (Exst), buffer capacity of total phosphorus for phytoplankton (ß(TP)(phyto)) and trophic level index (TLI) were calculated and developed to an integrated ecosystem health indicator (EHI). The monitoring results showed that the dredging project caused many short-term positive effects such as decreased total nitrogen, total phosphorus, permanganate index and phytoplankton biomass throughout the entire lake water, increased Secchi disk depth in the whole lake and increased benthonic animal biomass in the nondredged regions. However, these positive effects disappeared overtime. Water chemistry and biomass returned to the initial state before dredging. EHI showed that the dredging project caused negative effects on the lake health in the dredged region at first. Subsequently, the health status of the entire lake, including the dredged and nondredged regions, improved until 1-2 years after the project finished. Because of the lack of other timely ecological restoration measures, the lake gradually returned to its initial health status. However, the health status in the dredged regions was only slightly better than before dredging and often worse than that of the nondredged regions. Our study suggested that dredging projects may only cause short-term positive effects on lake ecosystem health. The external interception and dredging ratio were important. A dredging project should be combined with other ecological lake restoration measures when the project has caused positive effects in a lake.


Assuntos
Ecossistema , Monitoramento Ambiental , Lagos/química , Animais , Biomassa , Ecologia , Eutrofização , Nitrogênio/análise , Fósforo/análise , Fitoplâncton , Poluentes Químicos da Água/análise , Qualidade da Água , Zooplâncton
15.
Zhongguo Gu Shang ; 32(5): 439-443, 2019 May 25.
Artigo em Chinês | MEDLINE | ID: mdl-31248239

RESUMO

OBJECTIVE: To investigate the hidden blood loss and related risk factors of osteoporotic vertebral compression fractures after percutaneous kyphoplasty. METHODS: The clinical data of 153 patients with osteoporotic vertebral compression fractures who underwent percutaneous kyphoplasty from March 2015 to December 2017 were retrospectively analyzed, including 55 males and 98 females, aged 68 to 87(78.6±11.4) years old. Erythrocyte specific volume was collected before and after operation to calculate the hidden blood loss. The influence of sex, age, body mass index, bone mineral density, diabetes mellitus and hypertension, operation mode (unilateral or bilateral), operation time, operative segment and number, loss height of vertebral body and recovery height ratio on hidden blood loss was analyzed by multiple linear regression model. RESULTS: Postoperative hidden blood loss was (287.7±68.5) ml. Multivariate linear regression analysis showed that the history of diabetes mellitus (ß=2.405, P=0.012), the mode of operation(ß=3.042, P<0.001), the time of operation (ß=2.043, P=0.038), the operative segment (ß=1.993, P=0.043), the number (ß=0.374, P<0.001), the loss of vertebral height (ß=2.785, P=0.003) and the recovery ratio(ß=7.301, P<0.001) were correlated with occult hemorrhage. CONCLUSIONS: There is a certain degree of occult hemorrhage in kyphoplasty for osteoporotic vertebral compression fractures. The risk factors of hidden hemorrhage are diabetes history, operation method, operation time, operative segment and number, loss of vertebral height and recovery ratio.


Assuntos
Fraturas por Compressão , Cifoplastia , Fraturas por Osteoporose , Fraturas da Coluna Vertebral , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Estudos Retrospectivos , Resultado do Tratamento
16.
Anal Chem ; 91(8): 5424-5432, 2019 Apr 16.
Artigo em Inglês | MEDLINE | ID: mdl-30869868

RESUMO

Idiopathic pulmonary fibrosis (IPF) is a lung-limited and progressive fibrotic disease. The early diagnosis and therapies of IPF are still full of clinical challenges. Glutathione S-transferase (GSTs) plays significant roles in promoting the formation of pulmonary fibrosis. Herein, we report a fluorescent probe (Cy-GST) for the detection of GSTs concentration fluctuations in cells and in mice models. The probe can selectively and sensitively respond to GSTs with an "off-on" type fluorescence switch. Our results demonstrated that the level of intracellular GSTs increase in the pulmonary fibrosis cells and mice models. And the IPF patients hold high levels of GSTs concentrations. Thus, GSTs are likely to play important roles in pulmonary fibrosis. The inhibitor of GSTs TLK117 can reduce the severity of pulmonary fibrosis. The synergistic treatment of TLK117 and pirfenidone have better therapeutic effects than only using pirfenidone in pulmonary fibrosis mice models. The level of GSTs in IPF may be a new potential marker for IPF diagnosis. And the inhibition of GSTs may be a new therapeutic strategy for IPF treatment.

17.
Endocr J ; 66(2): 165-173, 2019 Feb 28.
Artigo em Inglês | MEDLINE | ID: mdl-30518721

RESUMO

Surgical resection is the primary treatment strategy for pheochromocytoma; however, it carries a high risk of morbidity and mortality, especially with respect to cardiovascular complications, which is the most common kinds of morbidity. The risk factors for morbidity remain unclear and require further exploration, moreover no studies focus on risk factors for cardiovascular morbidity. Herein we identified the risk factors for cardiovascular morbidity after pheochromocytoma surgery in Chinese patients. We retrospectively reviewed 262 patients who underwent unilateral surgical resection of pheochromocytoma at our center between 1 January 2007 and 31 December 2016. Patient demographics and extensive perioperative data were recorded and evaluated. Adjusted odds ratios and 95% confidence intervals were determined by multivariate logistic regression. Cut-off values and the area under the curve for continuous risk factors were calculated based on receiver operating characteristic curve analysis. A p-value <0.05 was considered statistically significant. Of the 262 patients, 63 (24.0%) had cardiovascular morbidity. The independent risk factors for cardiovascular morbidity were low body mass index, large radiographic tumor size, coronary heart disease, no preoperative crystal/colloid administration, and intraoperative hemodynamic instability; the corresponding odds ratio were 0.762 (p < 0.001), 1.208 (p = 0.010), 2.378 (p = 0.012), 2.720 (p = 0.011), and 4.764 (p = 0.001), respectively. The optimal cut-off values for body mass index and radiographic tumor size were 24.59 kg/m2 and 6.05 cm. We found that cardiovascular morbidity is common in patients after pheochromocytoma surgery. We identified five independent risk factors for cardiovascular morbidity. Identification of these risk factors may help to improve treatment strategies.


Assuntos
Neoplasias das Glândulas Suprarrenais/cirurgia , Adrenalectomia/efeitos adversos , Doenças Cardiovasculares/etiologia , Feocromocitoma/cirurgia , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Estudos Retrospectivos , Fatores de Risco
18.
Int J Surg ; 61: 26-32, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30503601

RESUMO

BACKGROUND: Surgical resection is the main treatment strategy for pheochromocytoma. Whether laparoscopic techniques are feasible for large pheochromocytoma treatments is controversial. The aim of this study was to evaluate the feasibility and safety of transperitoneal laparoscopic adrenalectomy (LA) compared with open adrenalectomy (OA). METHODS: We retrospectively studied 182 patients with radiographic tumor sizes ≥ 6 cm who underwent adrenalectomy at our center between 1 January 2007 and 31 December 2017. After propensity score-matching to balance baseline variables, 82 patients treated with LA and 100 patients treated with OA were grouped into 64 pairs. Patient demographics, and extensive peri-operative and oncologic data were recorded and compared. RESULTS: In the matched group, the incidence of intra-operative hemodynamic instability, transfusion rate, prolonged hypotension, and cardiovascular morbidity in the LA group were lower than the OA group (25.0% vs. 48.4%, 29.7% vs. 46.9%, 4.7% vs. 23.4%, and 14.1% vs. 37.5%, respectively). The estimated blood loss was less (100 ml vs. 300 ml) and bowel recovery was quicker (1.9 d vs. 2.3 d) in the LA group. The proportion of patients in whom blood pressure returned to normal (P = 0.184), had recurrences (P = 0.197), and survived (P = 0.763) were equivalent. The surgical approach (OA vs. LA) was an independent risk factor for IHD, prolonged hypotension, cardiovascular morbidity, and longer bowel recovery. CONCLUSIONS: This propensity score-matched cohort study showed that LA was feasible, safe, and superior to OA for patients with large pheochromocytoma, meanwhile LA had comparable oncological outcomes compared with OA after a lengthy follow-up.


Assuntos
Neoplasias das Glândulas Suprarrenais/cirurgia , Adrenalectomia/métodos , Laparoscopia/métodos , Feocromocitoma/cirurgia , Adrenalectomia/efeitos adversos , Adulto , Transfusão de Sangue/estatística & dados numéricos , Estudos de Coortes , Estudos de Viabilidade , Feminino , Seguimentos , Humanos , Laparoscopia/efeitos adversos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/epidemiologia , Peritônio/cirurgia , Pontuação de Propensão , Estudos Retrospectivos , Fatores de Risco , Resultado do Tratamento
19.
Urology ; 125: 138-145, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30445122

RESUMO

OBJECTIVE: To evaluate the feasibility and safety of reproductive organ preserving radical cystectomy (ROPRC) compared to radical cystectomy (RC) for elderly female patients with muscle-invasive bladder cancer. METHODS: We retrospectively studied 135 elderly female patients (aged ≥75 years) who underwent RC followed by cutaneous ureterostomies at our center between January 1, 2007 and December 31, 2017. Eighty-four patients treated with RC, and 51 patients treated with ROPRC, were grouped into 45 pairs. Patient demographics, extensive peri-operative, and oncological data were then recorded and evaluated. RESULTS: In the matched group, the incidence of short-term and long-term complications in the ROPRC group were lower than the RC group (18.0% vs 28.0%, P = .035; 12.0% vs 22.0%, P = .030). Furthermore, operative time was shorter, estimated blood loss was lower, and bowel recovery was quicker in the ROPRC group (207.5 minutes vs 267.9 minutes, P < .001; 500 mL vs 600 mL, P = .024; 3.0 days vs 4.0 days, P < .001, respectively) compared to the RC group. The recurrence free survival (P = .658), overall survival (P = .604), and cancer-specific survival (P = .361) were all equivalent when compared between the 2 groups with a median follow-up period of 34.0 and 38.0 months, respectively. The surgical approach (RC vs ROPRC) was an independent risk factor for short-term complications (P = .045), duration of operative time (P < .001), estimated blood loss (P = .004), and bowel recovery (P < .001). CONCLUSION: This propensity score-matched cohort study showed that ROPRC was both feasible and safe for elderly female patients with muscle-invasive bladder cancer compared to RC, and also had comparable oncological outcomes after a lengthy follow-up period.


Assuntos
Cistectomia/métodos , Genitália Feminina , Tratamentos com Preservação do Órgão , Neoplasias da Bexiga Urinária/cirurgia , Idoso , Estudos de Coortes , Cistectomia/efeitos adversos , Estudos de Viabilidade , Feminino , Seguimentos , Humanos , Invasividade Neoplásica , Complicações Pós-Operatórias/epidemiologia , Pontuação de Propensão , Estudos Retrospectivos , Neoplasias da Bexiga Urinária/patologia
20.
J Colloid Interface Sci ; 535: 41-49, 2019 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-30278328

RESUMO

Photocatalytic degradation of environmental pollutants by using semiconductor-based photocatalysts offers great potential for remediation of toxic chemicals. For an economical and eco-friendly method to eliminate hexavalent chromium (Cr(VI)), favourable catalysts own high efficiency, stability and capability of harvesting light. Combination of metal with semiconductor is a promising route to improve the photocatalytic performance for Cr(VI) reduction. Herein, well-dispersed platinum (Pt) nanocubes (NCs) were synthesized by a facile one-step hydrothermal method with poly-l-lysine (PLL) as the growth-directing agent, followed by their uniform dispersion on graphitic carbon nitride (g-C3N4). Their morphology, crystal structure, chemical composition, and formation mechanism were mainly characterized by transmission electron microscopy (TEM), X-ray photoelectron spectroscopy (XPS), and X-ray diffraction (XRD). The hybrid nanocomposite was further explored for photocatalytic reduction of Cr(VI) to trivalent chromium (Cr(III)) under visible light at room temperature, by using formic acid (HCOOH) as a reducing agent, showing great improvement in photocatalytic activity and reusability, outperforming the referenced g-C3N4 and home-made Pt black/g-C3N4 catalysts. The effects of various experimental parameters and the proposed mechanism are discussed in detail.

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