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1.
Zhonghua Yi Xue Za Zhi ; 101(28): 2203-2209, 2021 Jul 27.
Artigo em Chinês | MEDLINE | ID: mdl-34333932

RESUMO

Objective: To explored the effect of preoperative antiviral therapy on the prognosis of microvascular tumor thrombi patients, and to established a prognostic prediction model for these patients after radical resection of liver cancer. Methods: The clinicopathological and survival data of hepatocellular carcinoma patients with microvascular tumor thrombus who underwent radical resection in the Third Affiliated Hospital of Sun Yat-sen University from January 1, 2013 to December 31, 2015 were retrospectively collected. Kaplan-Meier method was used to calculate the survival curve, and log-rank test was used to compare the prognosis of patients with and without antiviral treatment before operation. Univariate and multivariate Cox proportional hazard regression model was used to screen predictive factors. R software was used to make predictive nomogram, and discrimination and calibration degree were used to evaluate the prediction model. Results: Among all 153 patients, 22 were female and 131 were male, aged (51.3±11.7) years. The preoperative antiviral therapy significantly improved overall survival and recurrence-free survival (χ2=41.423, 54.389; both P<0.001). According to the results of multivariate and regression analysis, preoperative antiviral therapy (HR=0.301,95%CI:0.171-0.532,P<0.001), alpha fetoprotein (HR=1.226,95%CI:1.157-1.776,P=0.032) and tumor size (HR=1.008,95%CI:1.001-1.016,P=0.02) were important prognostic factors for overall survival. The area under curve value of 3-year survival prediction model was 0.749(95%CI: 0.712-0.782), and that of 5-year survival prediction model was 0.755(95%CI: 0.724-0.793), with good calibration. Conclusions: Preoperative anti hepatitis B virus(HBV) therapy can significantly improve the prognosis of patients with hepatocellular carcinoma complicated with microvascular tumor thrombus, we develope the prediction models of 3-year and 5-year survival rate that can improve the reference for clinical work and benefit patients.


Assuntos
Carcinoma Hepatocelular , Neoplasias Hepáticas , Trombose , Carcinoma Hepatocelular/cirurgia , Feminino , Hepatectomia , Vírus da Hepatite B , Humanos , Neoplasias Hepáticas/cirurgia , Masculino , Recidiva Local de Neoplasia , Prognóstico , Estudos Retrospectivos
2.
Zhonghua Shao Shang Za Zhi ; 37(4): 333-339, 2021 Apr 20.
Artigo em Chinês | MEDLINE | ID: mdl-33745255

RESUMO

Objective: To establish a predictive model for acute respiratory distress syndrome (ARDS) in critical burn patients with the screened independent risk factors, and to validate its predictive value. Methods: Totally 131 critical burn patients (101 males and 30 females, aged 18-84 years) who met the inclusion criteria were admitted to the Department of Burns of the Second Affiliated Hospital of Zhejiang University School of Medicine from January 2018 to December 2019. A retrospective case-control study was conducted. The patients were divided into ARDS group (54 cases) and non-ARDS group (77 cases) according to whether ARDS occurred or not. The statistics of patients in the two groups were recorded including the gender, age, burn index, combination of inhalation injury, smoking history, delayed resuscitation, indwelling nasogastric tube, and complication of sepsis, and the data were statistically analyzed with independent sample t test, chi-square test, and Fisher's exact probability test. The multivariate logistic regression analysis was performed on the indicators with statistically significant differences between the two groups to screen the independent risk factors for developing ARDS in critical burn patients, and the corresponding nomograph prediction model for the risk of ARDS in critical burn patients was established. The risk scores for patients developing ARDS were therefore obtained based on the above-mentioned nomograph, and the corresponding receiver operating characteristic (ROC) curve was drawn to calculate the area under the curve. The internal validation of the above-mentioned ARDS prediction model was performed using the Bootstrap method, and the area under the ROC curve was calculated for modeling group (79 cases) and validation group (52 cases), respectively. A calibration curve was drawn to assess the predictive conformity of the above-mentioned ARDS prediction model for the occurrence of ARDS in critical burn patients. Results: The burn index, proportion of combination of inhalation injury, and proportion of complication of sepsis of patients were significantly higher in ARDS group than in non-ARDS group (t=0.36, χ2=33.78, 49.92, P<0.01). The gender, age, smoking history, delayed resuscitation, and indwelling nasogastric tube of patients in ARDS group were close to those in non-ARDS group (P>0.05). The multivariate logistic regression analysis showed that the burn index, combination of inhalation injury, and complication of sepsis were the independent risk factors for developing ARDS in critical burn patients (odds ratio=1.05, 15.33, 5.02, 95% confidence interval=1.01-1.10, 2.65-88.42, 1.28-19.71, P<0.05 or P<0.01). The overall area under the ROC curve of the above-mentioned ARDS prediction model was 0.92 (95% confidence interval=0.88-0.97), and the area under the ROC curve was 0.95 and 0.91 (95% confidence interval=0.90-1.00, 0.86-0.97) for validation group and modeling group, respectively. When applying the above-mentioned ARDS prediction model for ARDS incidence prediction, there might be some risk of overestimating ARDS incidence when the prediction probability was <35.0% or >85.0%, and some risk of underestimating ARDS incidence when the prediction probability was 35.0%-85.0%. Conclusions: The burn index, inhalation injury, and sepsis are the independent risk factors for the occurrence of ARDS in critical burn patients. The risk prediction model for ARDS based on these three indicators has good predictive ability for ARDS in critical burn patients.


Assuntos
Queimaduras , Síndrome do Desconforto Respiratório , Queimaduras/complicações , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Prognóstico , Curva ROC , Síndrome do Desconforto Respiratório/epidemiologia , Estudos Retrospectivos
3.
Artigo em Chinês | MEDLINE | ID: mdl-33535332

RESUMO

Objective: To analyze the status and its influencing factors of job burnout among female workers of labor-intensive enterprises. Methods: A total of 750 female workers from 5 labor-intensive enterprises in Guangdong Province were selected as the study subjects by random cluster sampling method in August, 2019. 665 valid questionnaires were collected, and the effective recovery rate was 88.67%. The Maslach Burnout Inventory-General Survey was used to assess job burnout and its influencing factors were analyzed. Results: Among 665 female workers, 429 (64.51%) found to have different levels of burnout, among which 380 (57.14%) were mild to moderate burnout and 49 (7.37%) were severe burnout. The comprehensive scores of job burnout in different age, marital status, current post working age, working time per week, personal monthly income, working system and occupational stress groups were statistically significant (P<0.01) . There were significant differences in the score of emotional exhaustion in different age, marital status, current working age, working time per week, personal monthly income and occupational stress groups (P<0.05) . There were significant differences in the dimensions of depersonalization in different age, weekly work time, personal monthly income, working system and occupational stress groups (P<0.05) . There were significant differences in the dimensions of low individual achievement in different education levels, weekly work time, working system and occupational stress groups (P<0.05) . Conclusion: The female workers of labor-intensive enterprises are generally have mild to moderate job burnout. The main influencing factors of job burnout are weekly work time and occupational stress.


Assuntos
Esgotamento Profissional , Estresse Ocupacional , Esgotamento Profissional/epidemiologia , Estudos Transversais , Emoções , Emprego , Feminino , Humanos , Satisfação no Emprego , Estresse Ocupacional/epidemiologia , Inquéritos e Questionários
4.
Anim Genet ; 52(1): 78-89, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33301219

RESUMO

DNA methylation was one of the earliest discovered epigenetic modifications in vertebrates, and is an important epigenetic mechanism involved in the expression of genes in many biological processes, including muscle growth and development. Its effects on economically important traits are evidenced in reported differences in meat quality traits between Chinese indigenous pig breeds (Wannanhua pig) and Western commercial pig breeds (Yorkshire pig), and this presents a unique model for analyzing the effects of DNA methylation on these traits. In the present study, a whole genome DNA methylation analysis was performed on the two breeds using methylated DNA immunoprecipitation. GO functional enrichment and pathway enrichment analyses identified differentially methylated genes primarily associated with fatty acid metabolism, biological processes of muscle development and signaling pathways related to muscle development and pork quality. Differentially methylated genes were verified by sodium pyrosequencing, and the results were consistent with the sequencing results. The results of the integrative analysis between DNA methylation and gene expression revealed that the DNA methylation levels showed a significantly negative correlation with gene expression levels around the transcription start site of genes. In total, 41 genes were both differentially expressed and methylated; these genes were related to fat metabolism, lipid metabolism and skeletal muscle development. This study could help further explore the molecular mechanisms and phenotypic differences in pig growth and development among different breeds.


Assuntos
Metilação de DNA , Epigênese Genética , Músculo Esquelético/metabolismo , Suínos/genética , Animais , Cruzamento , Feminino , Estudos de Associação Genética , Metabolismo dos Lipídeos/genética , Desenvolvimento Muscular/genética , Carne de Porco , Transdução de Sinais , Transcriptoma
5.
Zhonghua Yu Fang Yi Xue Za Zhi ; 54(11): 1184-1189, 2020 Nov 06.
Artigo em Chinês | MEDLINE | ID: mdl-33147914

RESUMO

Objective: To develop the Core Occupational Stress Scale (COSS) for key occupational populations, and to assess the reliability and validity of COSS in China. Methods: According to the literature review, in-depth interview and expert evaluation, the item pool of COSS was established. A total of 20 981 employees (3 703 employees from 2018 and 17 178 employees from 2019) of manufacturing, medical, and traffic polices, etc. from Beijing, Tianjin, Shanghai, Chongqing, Jiangsu, Shandong, Zhejiang, Hunan, Guangdong and Hubei were investigated using convenient sampling of those participating in general or occupational health examination of the day. Item differential test and exploratory factor analysis (EFA) were used to screen items from the item pool; confirmatory factor analysis (CFA) was used to test structure validity; criterion and convergent validity were tested by Pearson correlation. Cronbach's α coefficient was used to test the reliability of the scale. Results: The EFA suggested a four-factor structure for a 17-item version of COSS, which were social support, organization and reward, demand and effort, and control. It explained 62.06% of the total variance and factor loadings ranged from 0.447 to 0.918. The CFA confirmed the hypothesized four-factor model (GFI=0.904, CFI=0.912, RMSEA=0.079). The COSS scores were positively correlated with burnout, depressive symptoms, and effort-reward imbalance scores with r ranging from 0.357 to 0.567 (P<0.05). The total COSS and each dimension of Cronbach's α coefficients were 0.772-0.896. Conclusions: The COSS has good reliability and validity and can be used as an occupation stress assessment for occupational populations in China.


Assuntos
Estresse Ocupacional , Pequim , China , Humanos , Psicometria , Reprodutibilidade dos Testes , Inquéritos e Questionários
6.
Zhonghua Shao Shang Za Zhi ; 36(7): 582-586, 2020 Jul 20.
Artigo em Chinês | MEDLINE | ID: mdl-32842404

RESUMO

Objective: To retrieve, evaluate, and summarize the best evidence for postoperative hypothermia rewarming in adults with severe burns. Methods: Foreign language databases including Cochrane Library, Joanna Briggs Institute Evidence-Based Health Care Center Database, PubMed, Ovid-Medline, BMJ Best Practice, and Web of Science were retrieved with the search terms of " severe burn/major burn/severe degree burn" , " hypothermia/warming intervention/hypothermia/temperature/body temperature change" , and " postoperative /perioperative/peri-operative/post-operative" and Chinese databases including Chinese Journal Full-Text Database, Wanfang Database, and VIP Database were retrieved with the search terms of "//" , "/" , and "" to obtain all the publicly published evidence for postoperative hypothermia rewarming in adults with severe burns from the establishment of each database to April 2018, including systematic evaluations, guidelines, expert consensus, evidence summary, and original research closely related to the evidence. The literatures were screened and evaluated for their quality, the evidences were extracted from them, evaluated, classified in order to summarize the best evidences. Results: A total of 8 literatures were included, including one systematic evaluation, three guidelines, one expert consensus, and three evidence summaries. Finally, the best evidences in 8 aspects including the body temperature monitoring site, body temperature monitoring frequency, surface heating, in vivo heating, rewarming start, multi-strategy rewarming, equipment, and personnel training were summarized. Conclusions: Based in the evidence-based nursing method, this study retrieves and evaluates the literature, summarizes the evidence analysis and evaluation, and obtains the best evidences of postoperative hypothermia rewarming in adult patients with severe burns, which provides a strong reference for the clinical implementation of rewarming.


Assuntos
Queimaduras , Hipotermia , Adulto , Temperatura Corporal , Queimaduras/terapia , Humanos , Reaquecimento
7.
Zhonghua Shao Shang Za Zhi ; 36(7): 600-602, 2020 Jul 20.
Artigo em Chinês | MEDLINE | ID: mdl-32842409

RESUMO

On February 6, 2017, one male patient aged 25 years with total burn area of 99% total body surface area (TBSA) and full-thickness burn area of 95% TBSA was transferred from a primary hospital to the Second Affiliated Hospital of Zhejiang University School of Medicine one day post injury. On admission, the patient was clearly conscious, with tracheotomy ventilator assisted ventilation, and received rehydration, antishock, anti-infection, nutritional support, debridement, skin grafting, and negative pressure treatment. During the hospitalization, the patient was in critical condition and 28 central venous catheterizations and 1 peripherally inserted central catheter were performed.Based on multidisciplinary cooperation and on the premise of full risk assessment, nurses focused on strengthening the nursing of central venous catheter related infection. The measures for central venous catheter care were improved after detection of carbapenems resistant Klebsiella pneumoniae from catheter tip attachment, wound exudate, and blood culture, active prevention measure targeted at thrombosis around central venous catheter was performed, and prevention of unplanned extubation was emphasized during the use of rotating bed, soaking bath, and agitation of patient. On the 171st day of admission, peripherally inserted central venous catheter was performed by intravenous therapy nurse specialist on the scar formation site of the right upper arm. The catheter was withdrawn after indwelling for 55 days and the patient recovered and was discharged. During follow-up of 18 months, the patient recovered well.


Assuntos
Queimaduras , Cateterismo Venoso Central , Adulto , Superfície Corporal , Cateterismo Periférico , Humanos , Masculino , Estudos Retrospectivos
8.
Zhonghua Shao Shang Za Zhi ; 36(6): 488-492, 2020 Jun 20.
Artigo em Chinês | MEDLINE | ID: mdl-32594709

RESUMO

Objective: To explore the role of continuous quality improvement measures based on the American hospital evaluation standard of the Joint Commission International (JCI) in prevention and control of nosocomial infection in Burn Department of the Second Affiliated Hospital of Zhejiang University School of Medicine (hereinafter referred to as the author' s department). Methods: From 2013 to 2018, based on 11 JCI standards related to infection prevention and control and the current situation of the author' s department, more than 50 doctors, nurses, and nursing assistants from the author' s department participated in continuous improvement of the three-level management system of nosocomial infection in the author' s department, focusing on implementing of management of patient with multidrug resistant bacteria infection, optimizing the infection control management of instrument and cloth, and implementing target management on 5 indicators such as hand hygiene implementation rate, and carrying out inspection, quality management, and improvement on 11 items of prevention and control of nosocomial infection. The implementation rate of hand hygiene from 2013 to 2018 and the accuracy rate of hand hygiene from 2016 to 2018 of medical staff in the author' s department, and incidences of catheter-related bloodstream infection (CRBSI) of central venous, catheter-associated urinary tract infection (CAUTI), and ventilator associated pneumonia (VAP) of burn intensive care unit in the author's department from 2013 to 2018 were monitored.The following 7 indicators were monitored from 2013 to 2018, including false negative rate of nosocomial infection, incidence of hyperglycemia during intensive insulin treatment for severely burned patients, the implementation rate of CRBSI preventive measures, the specification rate of surface fixation of indwelling catheter, the implementation rate of VAP preventive measures, the accuracy rate of bed temperature during the use of suspended bed, and the implementation rate of hand hygiene of standardized training medical staff in the author' s department before and after improvement. Data were statistically analyzed with chi-square test. Results: The implementation rate of hand hygiene of medical staff in the author' s department was 88.0%-89.5% from 2013 to 2018, the correct rate of hand hygiene of medical staff in the author' s department was 95.10%-97.35%, and both reached the target values. The incidences of CRBSI in 2015, VAP in 2017, and CAUTI in 2013, 2014, and 2017 of burn intensive care unit failed to reach the respective target value and reached the respective target value after quality improvement, and the above-mentioned 3 indicators reached the respective target value in other years. From 2013 to 2018, the false negative rate of nosocomial infection and the incidence of hyperglycemia during intensive insulin treatment of severely burned patients in the author' s department after improvement were significantly lower than those before improvement (χ(2)=24.50, 4.74, P<0.05 or P<0.01), the implementation rate of CRBSI preventive measures, the specification rate of surface fixation of indwelling catheter, the implementation rate of VAP preventive measures, and the accuracy rate of bed temperature during the use of suspended bed after improvement in the author' s department were significantly higher than those before improvement (χ(2)=13.78, 6.50, 20.37, 13.92, P<0.05 or P<0.01), and the implementation rate of hand hygiene of standardized training medical staff in the author' s department after improvement was similar to that before improvement (χ(2)=1.71, P>0.05). Conclusions: The introduction of JCI standard can improve the implementation rate and accuracy rate of hand hygiene of medical staff in burn department, reduce the incidences of CRBSI, CAUTI, and VAP, and improve the effect of prevention and control of nosocomial infection in burn department.


Assuntos
Infecção Hospitalar , Infecções Relacionadas a Cateter , Humanos , Controle de Infecções , Unidades de Terapia Intensiva , Pneumonia Associada à Ventilação Mecânica , Estados Unidos , Infecções Urinárias
9.
Eur Rev Med Pharmacol Sci ; 23(8): 3533-3541, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31081110

RESUMO

OBJECTIVE: To investigate the effect of Lactobacillus rhamnosus GR-1 on atherosclerotic progression in apolipoprotein-E knockout (ApoE-/-) mice fed with a high-fat diet and the underlying mechanisms of its action. MATERIALS AND METHODS: Eight-week-old ApoE-/- mice were treated with Lactobacillus rhamnosus GR-1 daily for 12 weeks. ApoE-/- mice in the vehicle group and wild type (WT) mice were treated with normal saline. Serum lipid levels, histopathological analysis of the aorta, oxidative and inflammatory indexes and activation of the nuclear factor-kappa B (NF-κB) signaling pathway were examined. RESULTS: Compared to ApoE-/- mice in the vehicle group, no changes in body weight or serum lipid levels were found in ApoE-/- mice treated with Lactobacillus rhamnosus GR-1. However, the administration of GR-1 slowed down the development of atherosclerosis and reduced plaque formation. Additionally, GR-1 attenuated the development of oxidative stress and chronic inflammation in a dose-dependent manner in ApoE-/- mice fed a high-fat diet. Furthermore, in ApoE-/- mice treated with GR-1, GR-1 was demonstrated to have a role in inhibiting the translocation of NF-κB p65 from the cytoplasm to the nucleus and suppressing the degradation of IκB-α. CONCLUSIONS: We showed that the administration of GR-1 decreased atherosclerotic lesion size in ApoE-/- mice by reducing oxidative stress and inflammation. Additionally, the NF-κB signaling pathway might mediate these effects.


Assuntos
Aterosclerose/dietoterapia , Lactobacillus rhamnosus , Placa Aterosclerótica/dietoterapia , Probióticos/administração & dosagem , Animais , Aterosclerose/etiologia , Dieta Hiperlipídica/efeitos adversos , Modelos Animais de Doenças , Humanos , Masculino , Camundongos , Camundongos Knockout para ApoE , NF-kappa B/metabolismo , Estresse Oxidativo , Placa Aterosclerótica/etiologia , Transdução de Sinais
11.
Zhonghua Yi Xue Za Zhi ; 98(43): 3524-3527, 2018 Nov 20.
Artigo em Chinês | MEDLINE | ID: mdl-30481903

RESUMO

Objective: To explore the effect of microwave ablation on thyroid nodules cell activity by the reaction of key enzyme of cell activation. Methods: From November 2017 to February 2018, 104 patients with 120 thyroid nodules underwent ultrasound-guided microwave ablation at Super-minimally Invasive Medicals, Shanghai International Medical Center, aged 14-55 years, 42 males and 62 females.Twice core needle biopsy were performed before and after thermal ablation.The specimen were using hematoxylin and eosin (HE) staining and enzyme histochemical staining with include succinate dehydrogenase (SDH) and nicotinamide adeninedinucleotide phosphate diaphorase (NADPH-d), respectively, and observe under microscope. Results: Enzyme histochemical staining showed that the positive rate of SDH and NADPH-d in the marginal region and transitional region were 100% before ablation, and were 0% immediately after ablation.The positive rate of SDH and NADPH-d histochemical staining in the same area before and immediately after ablation was statistically significant (P<0.05). Shortly after microwave ablation, the tissue structure and cell morphology showed no obvious alteration in HE stained sections, but in sections with enzyme histochemical staining, the activity of SDH and NADPH-d in ablated tissue disappeared.The accuracy rate of pathologic diagnosis was 100% after ablation. Conclusions: SDH and NADPH-d enzyme activity may be better in evaluating the short-term efficacy of microwave ablation of thyroid nodules than HE staining.


Assuntos
Micro-Ondas , Nódulo da Glândula Tireoide , Adolescente , Adulto , Ablação por Cateter , China , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Adulto Jovem
12.
Artigo em Chinês | MEDLINE | ID: mdl-30248733

RESUMO

Objective: To compare the knowledge and behavior toward hearing protection among workers in different workplaces and investigate its influence factors. Methods: 2 manufacturing companies with obvious noise hazard in workplace were selected into the study. Health management level was distinguished through field investigation and verification. Questionnaire focus on basic knowledge of hearing health, acceptance level of noise hazard, comfort of wearing hearing protectors and atmosphere in workplace was designed and was used to investigate the knowledge and behavior toward hearing protection. Results: Hearing protectors that meet the level of protection are distributed throughout the workplaces. Although company A has a lower noise hazards level, the health management system was poorly executed. The proportion of workers persisting in wearing hearing protectors throughout the work shift in company A was lower than B (P<0.01) . Workers in company A intended to underestimate the noise level (P<0.01) and the health effect of hearing loss (P<0.01) . All the workers were worry about suffering from hearing loss (P>0.05) , but those in company B had more positive attitude toward the protection of hearing protector (P<0.01) and relied on the protector (P<0.01) . The awareness of protection, in turn, help workers adapt attitude and get used to wearing hearing protectors consciously in workplace (P<0.01) . Conclusion: Health management performance play a key role in help workers form good knowledge and behavior. To protect workplace health, employers need to creative a healthy supportive environment for workers.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Perda Auditiva Provocada por Ruído/prevenção & controle , Ruído Ocupacional/prevenção & controle , Doenças Profissionais/prevenção & controle , Local de Trabalho , Dispositivos de Proteção das Orelhas , Humanos , Ruído Ocupacional/efeitos adversos , Saúde do Trabalhador
13.
Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi ; 31(14): 1123-1126, 2017 Jul 20.
Artigo em Chinês | MEDLINE | ID: mdl-29798256

RESUMO

Objective:To investigate the effect of Cetylpyridinium Chloride Buccal Tablets on perioperative application of OSAHS patients.Method:Sixty patients of OSAHS were randomly divided into treatment group and control group according to the ratio of 1:1, using randomized single-blind controlled trial. The treatment group was treated with Cetylpyridinium Chloride Buccal Tablets in perioperative period and the control group was not. All patients accepted UPPP. Pharyngeal pain, pharyngeal edema, levels of IL-1, IL-8 and TNF-α in saliva were analyzed on the first day, third day and fifth day after surgery.Result:Compared with control group, the pharyngeal pain of treatment group was slighter on the third day and fifth day (P< 0.05). The levels of IL-1ß, IL-8 and TNF-α in saliva were lower on the third day and fifth day (P< 0.05).Conclusion:Applying Cetylpyridinium Chloride Buccal Tablets during perioperative period can effectively relieve postoperative pharyngeal pain and inflammatory response in patients with OSAHS.


Assuntos
Anti-Infecciosos Locais/uso terapêutico , Cetilpiridínio/uso terapêutico , Apneia Obstrutiva do Sono/tratamento farmacológico , Humanos , Faringe/patologia , Método Simples-Cego , Comprimidos
14.
Clin Exp Obstet Gynecol ; 44(3): 461-463, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29949294

RESUMO

A case of a woman with twin pregnancy having placenta percreta involving the colon, showed hematochezia symptoms, experienced bleeding which caused the patient's mortality. Placenta percreta with bowel involvement is a very serious complication of pregnancy. Symptoms are very atypical and it is very difficult to diagnose.


Assuntos
Colo , Placenta Acreta/cirurgia , Gravidez de Gêmeos , Adulto , Feminino , Humanos , Histerectomia , Placenta Acreta/patologia , Gravidez
15.
Zhonghua Yi Xue Za Zhi ; 97(47): 3711-3715, 2017 Dec 19.
Artigo em Chinês | MEDLINE | ID: mdl-29325324

RESUMO

Objective: To identify whether pregnancy outcomes vary by the severity of pulmonary hypertension. Methods: A retrospective study was conducted on 78 cases of pregnancies complained with pulmonary hypertension who delivered in the First Affiliated Hospital, Sun Yat-sen University from 2006 to 2016.The selected cases were divided into three groups according to severity of pulmonary hypertension: mild pulmonary hypertension group (mild PAH group) was defined as a mean pulmonary artery pressure 30-49 mmHg, moderate pulmonary hypertension (moderate PAH group) as mean pulmonary artery pressure 50-69 mmHg and severe pulmonary hypertension (severe PAH group) as mean pulmonary artery pressure 70 mmHg or greater.The clinical features, risk pregnant complication, maternal and neonatal outcomes were described between these three groups.Analysis of variance, Chi-square test was used for statistical analysis. Results: The average age of mild, moderate and severe PAH group were (31±5) years old, (31±5) years old and (27±3) years old, respectively (P=0.050). The rate of natural fertilization (P=0.414), parity (P=0.527) and gestational age (P=0.165) were similar in these three groups. In 78 pregnancies with pulmonary hypertension, 64.9% of pregnancies in mild PAH group was NYHA Ⅰ, 50.0% of moderate PAH group was NYHA Ⅱ and 54.5% of severe PAH group was NYHA Ⅲ(P<0.001). There was no significant difference in the incidence of gestational diabetes mellitus (GDM, P=0.589), preeclampsia (P=0.942), premature rupture of membrane (PROM, P=0.276), scarred uterus (P=0.493) and postpartum hemorrhage (P=0.424). The cesarean section rate was 84.2%, 90.0% and 63.6% in three groups (P=0.208). However, neuraxial anesthesia was performed in 82.5% of cases in mild PAH and 90.0% of cases in moderate PAH, while 27.3% of cases of severe PAH underwent neuraxial anesthesia (P<0.001). The fetal outcome was similar in there groups.But the rate of admission of NICU was significantly different in three groups (P=0.011). Conclusions: Maternal and neonatal outcomes was similar in different severity of pulmonary hypertension.But the severity of pulmonary hypertension affect the type of anesthesia.Close monitoring during pregnancy and timely termination of pregnancy can improve the outcome of pregnancy.


Assuntos
Hipertensão Pulmonar/complicações , Complicações na Gravidez , Resultado da Gravidez , Aborto Induzido , Adulto , Cesárea , Feminino , Idade Gestacional , Humanos , Gravidez , Estudos Retrospectivos
16.
Braz J Med Biol Res ; 49(10): e5531, 2016 Sep 22.
Artigo em Inglês | MEDLINE | ID: mdl-27683823

RESUMO

Invasive pulmonary fungal infection (IPFI) is a potentially fatal complication in patients with connective tissue disease (CTD). The current study aimed to uncover the clinical characteristics and risk factors of patients with IPFI-CTD. The files of 2186 CTD patients admitted to a single center in northern China between January 2011 and December 2013 were retrospectively reviewed. A total of 47 CTD patients with IPFI were enrolled into this study and assigned to the CTD-IPFI group, while 47 uninfected CTD patients were assigned to the control group. Clinical manifestations were recorded, and risk factors of IPFI were calculated by stepwise logistical regression analysis. Forty-seven (2.15%) CTD patients developed IPFI. Systemic lupus erythematosus patients were responsible for the highest proportion (36.17%) of cases with IPFI. Candida albicans (72.3%) accounted for the most common fungal species. CTD-IPFI patients had significantly elevated white blood cell count, erythrocyte sedimentation rate, C-reactive protein and fasting glucose values compared to controls (P<0.05). Cough, sputum and blood in phlegm were the most common symptoms. Risk factors of IPFI in CTD included maximum prednisone dose ≥30 mg/day within 3 months prior to infection, anti-microbial drug therapy, and interstitial pneumonia. CTD patients who have underlying interstitial pneumonia, prior prednisone or multiple antibiotics, were more likely to develop IPFI.

17.
Clin Exp Obstet Gynecol ; 43(1): 134-6, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27048036

RESUMO

The laparoscopic subtotal hysterectomy (LSH) was given to a patient whose uterus was about seven-month pregnanacy because of fibroids. The biggest problem was the operation space and visual field was too narrow. Different from the usual procedure we do, we morcellated the uterus at the beginning to expand the space. Loop ligature of the uterine isthmus was adopted to block uterine ateries before morcellating the uterus. After the adnexa exposed totally, we started to cut off the round ligaments, proper ligaments and fallopian tubes like usual. It was the first time we did LSH for so giant uterus in our hospital, although which was usually suitable for the uterus smaller than four-month pregnancy. But if the uterine ateries can be blocked effectively at the beginning, the uterus can be morcellated and the space will be enlarged. The laparoscopic subtotal hysterectomy will also be completed successfully.


Assuntos
Histerectomia/métodos , Laparoscopia/métodos , Leiomioma/cirurgia , Neoplasias Uterinas/cirurgia , Animais , Feminino , Humanos , Leiomioma/diagnóstico , Pessoa de Meia-Idade , Gravidez , Índice de Gravidade de Doença , Neoplasias Uterinas/diagnóstico
18.
Zhonghua Fu Chan Ke Za Zhi ; 51(3): 204-8, 2016 Mar.
Artigo em Chinês | MEDLINE | ID: mdl-27030500

RESUMO

OBJECTIVE: To determine the effects of adiponectin on high glucose induced BeWo cell proliferation in vitro. METHODS: BeWo cells were seeded in 96-well plates at the appropriate density. After treatments with high glucose (25 mmol/L), western blot analysis of cyclin D1 and a colorimetric assay (cell counting kit-8, CCK-8) were used to analyse BeWo cells' proliferation, and western blot was used to detect the expression of adiponectin. Moreover, we added adiponectin (20 µg/ml) in the culture medium and three methods were utilized for cell proliferation analysis: CCK-8, cell cycle analysis (by flow cytometry) and proliferating cell nuclear antigen (PCNA) immunocytochemical staining. RESULTS: Compared to BeWo cells cultured by normal glucose and high mannitol, the proliferation of BeWo cells treated by high glucose increased (P<0.05). Compared with BeWo cells cultured by high mannitol, the expression of adiponectin in BeWo cells treated by high glucose decreased. After added adiponectin in the culture medium, the proliferation of BeWo cells treated by adiponectin+high glucose decreased than that of cells treated by high glucose (0.770±0.050 versus 0.990±0.070, P<0.05); the proportion of G2+S phases of BeWo cells treated by adiponectin+high glucose decreased than that of cells treated by high glucose [(40.7±2.1)% versus (44.9± 3.9)%, P<0.05]; the rate of PCNA positive cell in BeWo cells treated by adiponectin+high glucose decreased than that of cells treated by high glucose [(28±5)% versus (44±5)%, P<0.05]. CONCLUSION: Adiponectin could inhibit proliferation of high glucose induced BeWo cells in vitro.


Assuntos
Adiponectina/metabolismo , Proliferação de Células/fisiologia , Antígeno Nuclear de Célula em Proliferação/metabolismo , Western Blotting , Ciclo Celular , Citometria de Fluxo , Glucose
19.
Braz. j. med. biol. res ; 49(10): e5531, 2016. tab
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-951653

RESUMO

Invasive pulmonary fungal infection (IPFI) is a potentially fatal complication in patients with connective tissue disease (CTD). The current study aimed to uncover the clinical characteristics and risk factors of patients with IPFI-CTD. The files of 2186 CTD patients admitted to a single center in northern China between January 2011 and December 2013 were retrospectively reviewed. A total of 47 CTD patients with IPFI were enrolled into this study and assigned to the CTD-IPFI group, while 47 uninfected CTD patients were assigned to the control group. Clinical manifestations were recorded, and risk factors of IPFI were calculated by stepwise logistical regression analysis. Forty-seven (2.15%) CTD patients developed IPFI. Systemic lupus erythematosus patients were responsible for the highest proportion (36.17%) of cases with IPFI. Candida albicans (72.3%) accounted for the most common fungal species. CTD-IPFI patients had significantly elevated white blood cell count, erythrocyte sedimentation rate, C-reactive protein and fasting glucose values compared to controls (P<0.05). Cough, sputum and blood in phlegm were the most common symptoms. Risk factors of IPFI in CTD included maximum prednisone dose ≥30 mg/day within 3 months prior to infection, anti-microbial drug therapy, and interstitial pneumonia. CTD patients who have underlying interstitial pneumonia, prior prednisone or multiple antibiotics, were more likely to develop IPFI.

20.
Genet Mol Res ; 13(4): 9558-68, 2014 Nov 12.
Artigo em Inglês | MEDLINE | ID: mdl-25501165

RESUMO

DNA polymerase d is not only the major replicative enzyme in eukaryotic chromosomal DNA synthesis but is also the primary polymerase for most DNA repair pathways. However, the subunit composition of polymerase d varies in different organisms. While polymerase d in many eukaryotic species has all 4 subunits (POLD1, 2, 3, and 4), many other organisms do not possess POLD4. Whether POLD4 is indispensable and why these differences exist are unknown. In the present study, we identified the POLD4 protein sequences of 218 eukaryotic species and determined the POLD1, 2, and 3 protein sequences of 55 species representing various taxonomic groups. No insect and nematode species examined possessed POLD4. Approximately 80% of protozoan species did not contain POLD4. Nearly 50% of fungal species did not contain POLD4. Other animal and plant species are expected to contain POLD4. Phylogenetic analyses of POLD1, 2, 3, and 4 sequences revealed that most animal and plant species inherited DNA polymerase d from protozoa, whereas some other animal and plant species may have inherited polymerase d directly from fungi. Because a large number of protozoan and fungal species do not possess POLD4, current insect and nematode species lacking POLD4 may have evolved from ancestor protozoan species lacking POLD4; thus, other protozoan and animal species lacking POLD4 may share a similar evolutionary history. Future studies should examine the origin and indispensability of POLD4 in various organisms.


Assuntos
DNA Polimerase III/genética , Eucariotos/enzimologia , Eucariotos/genética , Genoma , Filogenia , Subunidades Proteicas/genética , Motivos de Aminoácidos , Sequência de Aminoácidos , Animais , Sequência de Bases , Sequência Conservada/genética , DNA Polimerase III/química , Humanos , Dados de Sequência Molecular , Subunidades Proteicas/química , Alinhamento de Sequência
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