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1.
Nutrition ; 70: 110498, 2019 Apr 26.
Artigo em Inglês | MEDLINE | ID: mdl-31655470

RESUMO

OBJECTIVE: Although there is international consensus regarding the importance of cachexia, no tools exist, to our knowledge, for cachexia screening among patients with cancer. The aim of this study was to evaluate whether patients with cancer and cachexia could be identified using the four most commonly used nutritional screening tools: the Malnutrition Universal Screening Tool (MUST), the Nutritional Risk Screening (NRS)-2002, the Malnutrition Screening Tool (MST), and the Short Nutritional Assessment Questionnaire (SNAQ). METHODS: Clinical data were prospectively collected for patients who underwent elective radical gastrectomy for gastric cancer in two large centers between August 2014 and February 2018. Patients were also screened using the MUST, NRS-2002, MST, and SNAQ tools. The screening results were subsequently compared with the international consensus diagnostic criteria for cancer cachexia. RESULTS: A total of 1001 patients were evaluated, including 363 patients (36.3%) with cancer cachexia. Among the patients "at nutritional risk" based on each tool, the proportions of cachexia were 87.3% for the MUST tool, 84.3% for the MST tool, 76.6% for the NRS-2002 tool, and 54.3% for the SNAQ tool. The MST tool provided the largest area under the curve for identifying cancer cachexia (0.914; P < 0.001). CONCLUSION: Among the tools examined, the MST had the greatest ability to detect cancer cachexia among patients with gastric cancer.

2.
Elife ; 82019 09 03.
Artigo em Inglês | MEDLINE | ID: mdl-31478830

RESUMO

Gene copy number alterations, tumor cell stemness, and the development of platinum chemotherapy resistance contribute to high-grade serous ovarian cancer (HGSOC) recurrence. Stem phenotypes involving Wnt-ß-catenin, aldehyde dehydrogenase activities, intrinsic platinum resistance, and tumorsphere formation are here associated with spontaneous gains in Kras, Myc and FAK (KMF) genes in a new aggressive murine model of ovarian cancer. Adhesion-independent FAK signaling sustained KMF and human tumorsphere proliferation as well as resistance to cisplatin cytotoxicity. Platinum-resistant tumorspheres can acquire a dependence on FAK for growth. Accordingly, increased FAK tyrosine phosphorylation was observed within HGSOC patient tumors surviving neo-adjuvant chemotherapy. Combining a FAK inhibitor with platinum overcame chemoresistance and triggered cell apoptosis. FAK transcriptomic analyses across knockout and reconstituted cells identified 135 targets, elevated in HGSOC, that were regulated by FAK activity and ß-catenin including Myc, pluripotency and DNA repair genes. These studies reveal an oncogenic FAK signaling role supporting chemoresistance.

3.
Cancer Lett ; 461: 31-43, 2019 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31301319

RESUMO

Leukemia stem cells (LSCs) are deemed to the mainspring for treatment failure in acute myeloid leukemia (AML). Conventional chemotherapeutic drugs fail to eradicate leukemia stem cells, which becomes the root of drug resistance and disease recurrence. Hence, new therapeutic strategies targeting LSCs are supposed to be critical for patients with AML. Here we report that combination of Bcl-2 inhibitor AT-101 and chemotherapeutic drug idarubicin (IDA) results in synergistic lethality in CD34+CD38- leukemia stem-like cells sorted from KG-1α and Kasumi-1 AML cell lines and primary CD34+ AML cells in vitro while sparing the normal counterparts. In addition, combinatorial treatment also significantly inhibits the growth of patient-derived xenograft (PDX) mouse models generated from FLT3-ITDmut AML patient in vivo. Mechanistically, the synergistic effects of AT-101 with IDA to induce cell death are closely associated with blockage of DNA damage repair and thus activates the intrinsic apoptotic pathway. In summary, these findings suggest that combinatorial therapy with AT-101 and IDA selectively eliminates leukemia stem-like cells both in vitro and in vivo, representing a potent and alternative salvage therapy for the treatment of relapsed and refractory patients with AML.

4.
Biomed Res Int ; 2019: 5652935, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31080823

RESUMO

To establish a nomogram for predicting the overall survival (OS) of patients with newly diagnosed multiple myeloma (MM), 304 patients with newly diagnosed MM were recruited between June 1, 2010, and June 30, 2015, from the Beijing Chaoyang Hospital, Capital Medical University, and randomly divided into training (n=214) and validation (n=90) cohorts. The Kaplan-Meier method and the Cox proportional hazards regression model were used to evaluate the prognostic effects of multiple clinical and laboratory parameters on survival. Significant prognostic factors were combined to build a nomogram. The discriminative ability and predictive accuracy of the nomogram were evaluated using the index of concordance (C-index) and calibration curves and compared with the five staging systems currently used for MM. Multivariate analysis of the training cohort revealed that the age at diagnosis, clonal bone marrow plasma cells, serum lactate dehydrogenase, serum ß2-microglobulin, and del (17p) were independent risk factors for OS and were used to establish the nomogram. The C-index value of the nomogram for predicting OS was 0.749, which was significantly higher than the C-indices of the five most common staging systems currently used for MM. In the validation cohort, the C-index for nomogram-based predictions was 0.711 for OS, and the nomogram discrimination was better than the above mentioned five staging systems (P<0.001). All calibration curves revealed good consistency between predicted and actual survivals. The proposed nomogram is more accurate in predicting the prognoses of patients with newly diagnosed MM.


Assuntos
Mieloma Múltiplo/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Feminino , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Mieloma Múltiplo/metabolismo , Estadiamento de Neoplasias/métodos , Nomogramas , Prognóstico , Modelos de Riscos Proporcionais
5.
Surgery ; 166(3): 297-304, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31072665

RESUMO

BACKGROUND: Increasing evidence has suggested that sarcopenia is linked with cancer prognosis, but only limited data have focused on the impact of myosteatosis on cancer outcomes. This study evaluates the influence of myosteatosis on postoperative complications and survival in those patients who underwent radical resection of gastric carcinoma. METHODS: Patients who underwent elective radical gastrectomy for gastric cancer and had computed tomographic images available were identified from a prospectively collected database between 2008 and 2013. Myosteatosis was diagnosed by the cutoff values obtained from the method of optimum stratification. To obtain 2 well-balanced cohorts for available variables influencing clinical outcomes, the myosteatosis group was matched 1:1 with nonmyosteatosis group by using a propensity score match. RESULTS: Of 973 patients, 584 were matched for analyses. Compared with the nonmyosteatosis group, the myosteatosis group manifested significantly higher severe postoperative complications rates, shorter overall survival, and disease-free survival. Before matching, multivariate analyses identified that myosteatosis was an independent risk factor for severe postoperative complications, and Cox proportions hazards model showed that myosteatosis was an independent predictor for shorter overall survival and disease-free survival. In addition, subgroup analyses of each muscle phenotype showed that patients with both sarcopenia and myosteatosis had a poorer overall survival and disease-free survival than other patients. CONCLUSION: Myosteatosis in gastric cancer is associated with poor prognosis. Classifying the skeletal muscle into subranges of radio density is a promising strategy to understand the impact of skeletal muscle on unfavorable surgical outcomes in gastric cancer patients.

6.
Leukemia ; 33(9): 2341, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31097784

RESUMO

In the original version of this article the author name Xiaolei Chen was published incorrectly. This has been corrected to Xiao Lei Chen.

8.
Nano Lett ; 19(3): 1719-1727, 2019 03 13.
Artigo em Inglês | MEDLINE | ID: mdl-30724087

RESUMO

Protein nanocages are promising multifunctional platforms for nanomedicine owing to the ability to decorate their surfaces with multiple functionalities through genetic and/or chemical modification to achieve desired properties for therapeutic and diagnostic purposes. Here, we describe a model antigen (OVA peptide) that was conjugated to the surface of a naturally occurring hepatitis B core protein nanocage (HBc NC) by genetic modification. The engineered OVA-HBc nanocages (OVA-HBc NCs), displaying high density repetitive array of epitopes in a limited space by self-assembling into symmetrical structure, not only can induce bone marrow derived dendritic cells (BMDC) maturation effectively but also can be enriched in the draining lymph nodes. Naïve C57BL/6 mice immunized with OVA-HBc NCs are able to generate significant and specific cytotoxic T lymphocyte (CTL) responses. Moreover, OVA-HBc NCs as a robust nanovaccine can trigger preventive antitumor immunity and significantly delay tumor growth. When combined with a low-dose chemotherapy drug (paclitaxel), OVA-HBc NCs could specifically inhibit progression of an established tumor. Our findings support HBc-based nanocages with modularity and scalability as an attractive nanoplatform for combination cancer immunotherapy.


Assuntos
Antígenos de Neoplasias/administração & dosagem , Antígenos do Núcleo do Vírus da Hepatite B/imunologia , Nanoconjugados/administração & dosagem , Neoplasias/terapia , Animais , Antígenos de Neoplasias/imunologia , Bioengenharia/métodos , Proliferação de Células/efeitos dos fármacos , Células Dendríticas/efeitos dos fármacos , Células Dendríticas/imunologia , Epitopos/genética , Epitopos/imunologia , Hepatite B/imunologia , Antígenos do Núcleo do Vírus da Hepatite B/administração & dosagem , Humanos , Imunoterapia/métodos , Camundongos Endogâmicos C57BL , Neoplasias/imunologia , Linfócitos T Citotóxicos/efeitos dos fármacos , Linfócitos T Citotóxicos/imunologia
9.
Clin Neurol Neurosurg ; 175: 149-154, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30447607

RESUMO

OBJECTIVE: Cervical spondylotic myelopathy (CSM) is the most common cause of spinal cord dysfunction. Our study aims to explore the correlation of osteoprotegerin (OPG) gene polymorphisms and the risk factors and severity of CSM. PATIENTS AND METHODS: The peripheral blood samples from 494 CSM patients and 515 healthy individuals were collected for detecting the 950T/C, 1181G/C and 163A/G genotypes and genetic equilibrium of OPG in the CSM and control groups and analyzing the genotype distribution and allele frequency. The severity of CSM and the impaired segments were evaluated by the Japanese Orthopedic Association (JOA) scoring combined with cervical magnetic resonance imaging (MRI), in order to investigate the relations between the three genotypes of OPG promoter gene loci (950T/C, 163A/G and 1181G/C) and occurrence as well as severity of CSM. RESULTS: The risk rate of TC genotype carrier suffered from CSM was 0.46, of TT genotype carrier was 0.27. The risk rate of T allele carrier suffered from CSM was 0.37. In 950T/C single nucleotide polymorphism (SNP), patients with TC, TT and T genotypes had lower risk to suffer from CSM. CONCLUSION: Taken together, OPG 950T/C SNP protects against CSM, and it is correlated with the severity of CSM, providing a new idea for the prevention and treatment of CSM.

10.
Medicine (Baltimore) ; 97(34): e11702, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30142758

RESUMO

Glioma is the most common tumor among central nervous system tumors; surgical intervention presents difficulties. This is especially the case for gliomas in so-called "eloquent areas," as surgical resection threatens vital structures adjacent to the tumor. Intraoperative magnetic resonance imaging (iMRI) combined with multimodal neuronavigation may prove beneficial during surgery. This study explored the applicability of 3.0 T high field iMRI combined with multimodal neuronavigation in the resection of gliomas in eloquent brain areas.We reviewed 40 patients with a glioma located in the eloquent brains areas who underwent treatment in the Neurosurgery Department of Peking University International Hospital between December 2015 and August 2017. The experimental group included 20 patients treated using iMRI assistance technology (iMRI group). The remaining 20 patients underwent treatment by conventional neuronavigation (non-iMRI group). Tumor resection degree, preoperative and postoperative ability of daily living scale (Barthel index), infection rate, and operative time were compared between the 2 groups.No difference in infection rate was observed between the 2 groups. However, compared with the non-iMRI group, the iMRI group had a higher resection rate (96.55 ±â€Š4.03% vs 87.70 ±â€Š10.98%, P = .002), postoperative Barthel index (90.75 ±â€Š12.90 vs 9.25 ±â€Š16.41, P = .018), as well as a longer operation time (355.85 ±â€Š61.40 vs 302.45 ±â€Š64.09, P = .011).The use of iMRI technology can achieve a relatively higher resection rate among cases of gliomas in eloquent brain areas, with less incidence of postoperative neurological deficits. Although the operative time using iMRI was longer than that taken to perform conventional navigation surgery, the surgical infection rate in these 2 procedures showed no significant difference.


Assuntos
Neoplasias Encefálicas/cirurgia , Encéfalo/cirurgia , Glioma/cirurgia , Imagem por Ressonância Magnética/métodos , Neuronavegação/métodos , Adulto , Neoplasias Encefálicas/diagnóstico por imagem , Feminino , Glioma/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Monitorização Intraoperatória , Imagem Multimodal , Procedimentos Neurocirúrgicos , Resultado do Tratamento
11.
Medicine (Baltimore) ; 97(34): e11746, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30142761

RESUMO

This study aimed to summarize the clinical experiences and postoperative effects of microsurgical approaches for craniopharyngioma.A total of 183 craniopharyngioma patients who underwent microsurgical treatment since March 2009 to March 2015 in our hospital were included in current research. Surgical approaches were selected based on preoperative evaluations, including tumor locations, sizes, and growth patterns. Active measurements to manage water-electrolyte disorder and insipidus were taken for postoperative treatments. During the follow-up, patients were monitored for residual or recurrent tumor by postoperative contrast MRI scans done 1 to 3 months after surgery.The used surgical approaches were as follows: frontopterional approach (76 cases), anterior interhemispheric approach (58 cases), transcallosal approach (10 cases), transsphenoidal approach (15 cases), unilateral subfrontal approach (15 cases), and combined approaches (9 cases). Around 124 cases (72.7%) received total tumor resection, 37 patients (20.2%) underwent subtotal resection, and 13 patients (7.1%) underwent partial removal. No significant difference was found on the postoperative complications among the different microsurgical approaches (all, P > .05). A total of 111 cases had an intact pituitary stalk preservation and 26 cases had partially preserved stalks during surgery. Visual improvement was achieved in 54 patients and visual deterioration occurred in 22 cases. Postoperative insipidus appeared in 114 cases and water-electrolyte disorder occurred in 99 cases. The postsurgical follow-up ranged from 3 to 69 months with a mean duration of 27.3 months and 23 patients suffered recurrence.Based on careful preoperative evaluation, microsurgical treatments may be safe and effective approach to improve postoperative outcomes of craniopharyngioma patients.


Assuntos
Craniofaringioma/cirurgia , Procedimentos Neurocirúrgicos/métodos , Neoplasias Hipofisárias/cirurgia , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Craniofaringioma/diagnóstico por imagem , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Microcirurgia , Pessoa de Meia-Idade , Procedimentos Neurocirúrgicos/efeitos adversos , Procedimentos Neurocirúrgicos/classificação , Neoplasias Hipofisárias/diagnóstico por imagem , Complicações Pós-Operatórias/classificação , Complicações Pós-Operatórias/epidemiologia , Resultado do Tratamento , Adulto Jovem
12.
J Neurooncol ; 139(1): 61-68, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29574566

RESUMO

This study was to evaluate the diagnostic performance of fractional anisotropy (FA) and apparent diffusion coefficient (ADC) parameters derived from diffusion tensor imaging in the differentiation between grade II and III gliomas. The records of 60 patients (30 women, 30 men; mean age, 45.4 years) suspected of having gliomas who underwent an ADC image-guided stereotactic biopsy were retrospectively reviewed. The values of FA and ADC were measured, and the sensitivity, specificity, accuracy and area under the curve (AUC) of those parameters were calculated based on the receiver operating characteristic curve analysis. A predictive diagnostic equation was also constructed and evaluated. Significant differences in minimum ADC values were found in the quantitative analysis between the grade III and II glioma groups. The sensitivity, specificity, positive predictive values (PPV), negative predictive values (NPV), accuracy and AUC for identifying grade III and II gliomas at the optimum cut-off value of 0.895 × 10-3 mm2/s of minimum ADC were 81.0, 89.1, 77.3, 91.1, 86.6 and 0.87, respectively. The predictive diagnostic equation was superior to the single minimum ADC indicator with a sensitivity of 90.5%, a specificity of 84.8%, a PPV of 73.1%, an NPV of 95.1%, and an accuracy of 86.6%, respectively. The study provides evidence that minimum ADC values have a superior diagnostic performance in differentiating grade III and II gliomas, and the predictive diagnostic equation may be helpful in the differentiation.

13.
Dig Dis Sci ; 63(6): 1620-1630, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29549473

RESUMO

BACKGROUND: With the increased prevalence of obesity and sarcopenia, those patients with both visceral obesity and sarcopenia were at higher risk of adverse outcomes. AIM: The aim of this study was to ascertain the combined impact of visceral obesity and sarcopenia on short-term outcomes in patients undergoing colorectal cancer surgery. METHODS: We conducted a prospective study from July 2014 to February 2017. Patients' demographic, clinical characteristics, physical performance, and postoperative short-term outcomes were collected. Patients were classified into four groups according to the presence of sarcopenia or visceral obesity. Clinical variables were compared. Univariate and multivariate analyses evaluating the risk factors for postoperative complications were performed. RESULTS: A total of 376 patients were included; 50.8 and 24.5% of the patients were identified as having "visceral obesity" and "sarcopenia," respectively. Patients with sarcopenia and visceral obesity had the highest incidence of total, surgical, and medical complications. Patients with sarcopenia or/and visceral obesity all had longer hospital stays and higher hospitalization costs. Age ≥ 65 years, visceral obesity, and sarcopenia were independent risk factors for total complications. Rectal cancer and visceral obesity were independent risk factors for surgical complications. Age ≥ 65 years and sarcopenia were independent risk factors for medical complications. Laparoscopy-assisted operation was a protective factor for total and medical complications. CONCLUSION: Patients with both visceral obesity and sarcopenia had a higher complication rate after colorectal cancer surgery. Age ≥ 65 years, visceral obesity, and sarcopenia were independent risk factors for total complications. Laparoscopy-assisted operation was a protective factor.


Assuntos
Colectomia , Neoplasias Colorretais/cirurgia , Laparoscopia , Obesidade Abdominal/epidemiologia , Sarcopenia/epidemiologia , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Distribuição de Qui-Quadrado , China/epidemiologia , Colectomia/efeitos adversos , Colectomia/economia , Colectomia/métodos , Neoplasias Colorretais/economia , Neoplasias Colorretais/epidemiologia , Comorbidade , Feminino , Custos Hospitalares , Humanos , Incidência , Laparoscopia/efeitos adversos , Laparoscopia/economia , Tempo de Internação , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Obesidade Abdominal/economia , Razão de Chances , Complicações Pós-Operatórias/economia , Complicações Pós-Operatórias/epidemiologia , Prevalência , Modelos de Riscos Proporcionais , Estudos Prospectivos , Fatores de Proteção , Fatores de Risco , Sarcopenia/economia , Fatores de Tempo , Resultado do Tratamento
14.
J Transl Med ; 16(1): 47, 2018 Feb 28.
Artigo em Inglês | MEDLINE | ID: mdl-29490645

RESUMO

BACKGROUND: Acute lymphoblastic leukemia (ALL) is a clonal malignant disorder characterized by an uncontrolled proliferation of immature B or T lymphocytes. Extensive studies have suggested an involvement of angiogenesis signaling in ALL progression and resistance to treatment. Thus, targeting angiogenesis with anti-angiogenic drugs may be a promising approach for ALL treatment. In this study, we investigated the effectiveness of Apatinib, a novel receptor tyrosine kinase inhibitor selectively targeting VEGFR-2 in ALL cells. METHOD: ALL cell lines were treated with different concentration of Apatinib and then CCK8 assay, flow cytometry were used to determine the IC50 value and cell apoptosis, respectively. The effect of Apatinib against primary ALL cells from 11 adult patients and normal counterparts were also analyzed by apoptosis with flow cytometry. Next, we used western bolting and mass cytometry (CyTOF) assay to explore the underlying mechanism of the cytotoxicity of Apatinib. Finally, the anti-leukemia activity was further evaluated in an in vivo xenograft model of ALL. RESULTS: Our results showed that Apatinib significantly inhibited cell growth and promoted apoptosis in both B and T lineage ALL cell lines in a dose- and time-dependent manner. The IC50 values of Apatinib against Nalm6, Reh, Jurkat and Molt4 for 48 h were 55.76 ± 13.19, 51.53 ± 10.74, 32.43 ± 5.58, 39.91 ± 9.88 µmol/L, and for 72 h were 30.34 ± 2.65, 31.96 ± 3.92, 17.62 ± 5.90, and 17.65 ± 2.17 µmol/L respectively. Similarly, Apatinib shows cytotoxic activity against primary adult ALL cells while sparing their normal counterparts in vitro. Moreover, Apatinib suppressed ALL growth and progression in an in vivo xenograft model. Mechanistically, Apatinib-induced cytotoxicity was closely associated with inhibition of VEGFR2 and its downstream signaling cascades, including the PI3 K, MAPK and STAT3 pathways. CONCLUSION: Our study indicates that Apatinib exerts its anti-leukemia effect by inducing apoptosis through suppressing the VEGFR2 signaling pathway, supporting a potential role for Apatinib in the treatment of ALL.

15.
Br J Neurosurg ; 32(4): 372-380, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29260585

RESUMO

BACKGROUND: For stereotactic brain biopsy involving motor eloquent regions, the surgical objective is to enhance diagnostic yield and preserve neurological function. To achieve this aim, we implemented functional neuro-navigation and intraoperative magnetic resonance imaging (iMRI) into the biopsy procedure. The impact of this integrated technique on the surgical outcome and postoperative neurological function was investigated and evaluated. METHOD: Thirty nine patients with lesions involving motor eloquent structures underwent frameless stereotactic biopsy assisted by functional neuro-navigation and iMRI. Intraoperative visualisation was realised by integrating anatomical and functional information into a navigation framework to improve biopsy trajectories and preserve eloquent structures. iMRI was conducted to guarantee the biopsy accuracy and detect intraoperative complications. The perioperative change of motor function and biopsy error before and after iMRI were recorded, and the role of functional information in trajectory selection and the relationship between the distance from sampling site to nearby eloquent structures and the neurological deterioration were further analyzed. RESULTS: Functional neuro-navigation helped modify the original trajectories and sampling sites in 35.90% (16/39) of cases to avoid the damage of eloquent structures. Even though all the lesions were high-risk of causing neurological deficits, no significant difference was found between preoperative and postoperative muscle strength. After data analysis, 3mm was supposed to be the safe distance for avoiding transient neurological deterioration. During surgery, the use of iMRI significantly reduced the biopsy errors (p = 0.042) and potentially increased the diagnostic yield from 84.62% (33/39) to 94.87% (37/39). Moreover, iMRI detected intraoperative haemorrhage in 5.13% (2/39) of patients, all of them benefited from the intraoperative strategies based on iMRI findings. CONCLUSIONS: Intraoperative visualisation of functional structures could be a feasible, safe and effective technique. Combined with intraoperative high-field MRI, it contributed to enhance the biopsy accuracy and lower neurological complications in stereotactic brain biopsy involving motor eloquent areas.

16.
Eur J Gastroenterol Hepatol ; 30(2): 136-142, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29227327

RESUMO

BACKGROUND/AIM: The aim of this prospective double-center study was to explore the effect of nutritional risk on short-term outcomes in the patients who had gastric cancer and underwent a laparoscopic-assisted gastrectomy. PATIENTS AND METHODS: We conducted a study of patients who underwent laparoscopic-assisted gastrectomy in two large centers between June 2014 and April 2017. Patients' demographic and clinical characteristics and postoperative short-term outcomes were prospectively analyzed. Patients were divided into two groups depend on the preoperative presence of nutritional risk. Clinical variables were compared. Univariate analyses and multivariate logistic regression analyses evaluating the risk factors for postoperative complications were performed. RESULTS: A total of 256 patients, comprising 187 males and 69 females, met the inclusion criteria and were included in this study. The mean age was 61.81 years, the average BMI was 22.44 kg/m, and the average preoperative serum albumin was 39.42 g/l. Older age (P=0.001), higher tumor stage (P=0.047), lower BMI (P<0.001), lower preoperative serum albumin (P=0.005), and lower hemoglobin (P=0.013) were more common in the nutritional risk group. There were no significant differences in the short-term postoperative outcomes between nutritional risk and non-nutritional risk groups. Advanced age (P=0.024) and hypoalbuminemia (P=0.004) were independent risk factors for postoperative complications after laparoscopic-assisted gastrectomy. CONCLUSION: Nutritional risk may not be a clinical predictor of short-term outcomes after laparoscopic-assisted gastrectomy. Advanced age and preoperative hypoalbuminemia were independent risk factors for grade II or more postoperative complications.


Assuntos
Gastrectomia/métodos , Estado Nutricional , Complicações Pós-Operatórias/etiologia , Neoplasias Gástricas/patologia , Neoplasias Gástricas/cirurgia , Fatores Etários , Idoso , Índice de Massa Corporal , Feminino , Gastrectomia/efeitos adversos , Hemoglobinas/metabolismo , Humanos , Hipoalbuminemia/sangue , Hipoalbuminemia/complicações , Laparoscopia , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Avaliação Nutricional , Período Pré-Operatório , Estudos Prospectivos , Fatores de Risco , Albumina Sérica/metabolismo , Fatores de Tempo , Resultado do Tratamento
17.
Biomed Res Int ; 2018: 9434637, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30599001

RESUMO

The survival of individuals with tumors may be predicted by the peripheral blood lymphocyte-to-monocyte ratio (LMR) upon diagnosis in recent studies. For patients with multiple myeloma (MM) in the era of novel agents, the prognostic significance of LMR remains unclear. In this study, the prognostic impact of LMR is evaluated by 285 patients with MM who are treated with proteasome inhibitor and/or immunomodulatory drug. LMR is a proven predictor of survival using the receiver operating characteristic curve, with 4.2 as the cutoff point. Patients with LMR ≤ 4.2 at diagnosis had poorer overall survival (OS) and progression-free survival (PFS) than those with LMR > 4.2. In addition, multivariate analysis showed that LMR less than 4.2 is an independent predictor for the OS (hazard ratio [HR]: 1.703; 95% confidence interval [CI]: 1.020-2.842; P = 0.042) and PFS (HR: 1.831; 95% CI: 1.098-3.053; P = 0.021). According to the test, the LMR at diagnosis, which functions as a simple index reflecting host systemic immunity, can predict clinical outcomes in patients with MM who are treated with new agents.


Assuntos
Leucócitos Mononucleares/patologia , Linfócitos/patologia , Monócitos/patologia , Mieloma Múltiplo/patologia , Idoso , Intervalo Livre de Doença , Feminino , Humanos , Contagem de Linfócitos/métodos , Masculino , Análise Multivariada , Prognóstico , Modelos de Riscos Proporcionais
18.
Ann Clin Lab Sci ; 48(6): 743-750, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30610044

RESUMO

Bone marrow mesenchymal stromal cells (BMSCs) have positive therapeutic effects on inflammation associated diseases. However, the underlying mechanism is largely unknown. This study was conducted to investigate whether BMSCs could alleviate the inflammation reaction in lipopolysaccaride (LPS)-induced acute kidney injury (septic-AKI) of rats via inhibition of toll-like receptors (TLR4)-nuclear factor-kappa B (NF-κB) signaling pathway. The septic-AKI rat model was established by injecting the 1ml/mg LPS through the femoral vein. Based on this model, rats were subjected to BMSC transplantation, PDTC (a kind of NF-κB inhibitor) administration alone, and combined treatment of the first two together. Results showed that LPS treatment caused the increases of the concentration of blood urea nitrogen (BUN) and serum creatinine (SCr), accompanied by tissue injury and the up-regulation of TLR4 and NF-κB, that was its key downstream signaling molecule, in both mRNA and protein level. Notably, it has been found that BMSCs transplantation significantly reversed the already upregulated concentration of BUN and SCr, dramatically attenuated the event of the tissue injury, and prominently reduced mortality after AKI. These were paralleled by down-regulation of the level of TLR4 and NF-κB. These effects of BMSCs transplantation were similar to those of PDTC treatment. Importantly, the effects in the combination therapy of BMSCs transplantation and PDTC group were much stronger than those of either BMSCs or PDTC used alone. These findings suggest that BMSCs transplantation contributes to therapeutic effects in LPS-induced AKI rat model, and that the most obvious effects occurred in the combined treatment group, with BMSCs and PDTC together, which was tightly associated with inhibition of the TLR4-NF-κB signaling pathway.


Assuntos
Lesão Renal Aguda/complicações , Inflamação/etiologia , Inflamação/cirurgia , Transplante de Células-Tronco Mesenquimais/métodos , Transdução de Sinais/fisiologia , Lesão Renal Aguda/induzido quimicamente , Análise de Variância , Animais , Antioxidantes/uso terapêutico , Nitrogênio da Ureia Sanguínea , Modelos Animais de Doenças , Feminino , Regulação da Expressão Gênica/fisiologia , Lipopolissacarídeos/toxicidade , Células-Tronco Mesenquimais/fisiologia , Camundongos Endogâmicos C57BL , NF-kappa B/genética , NF-kappa B/metabolismo , Prolina/análogos & derivados , Prolina/uso terapêutico , RNA Mensageiro/metabolismo , Ratos , Tiocarbamatos/uso terapêutico , Receptor 4 Toll-Like/genética , Receptor 4 Toll-Like/metabolismo , Fator de Necrose Tumoral alfa/genética , Fator de Necrose Tumoral alfa/metabolismo
19.
J Surg Res ; 218: 58-66, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28985878

RESUMO

BACKGROUND: Gastrectomy results in a significant loss of body composition in the long term, but the acute skeletal muscle wasting after gastrectomy has been rarely investigated. Moreover, the association between postoperative muscle wasting and quality of life (QOL) has never been reported. In the present study, we aimed to investigate the risk factors for acute muscle wasting after gastric cancer surgery and its effect on QOL and short-term postoperative outcomes. METHODS: We conducted a prospective study of patients who underwent curative gastrectomy for gastric cancer between June 2015 and December 2015. Skeletal muscle mass was measured by computed tomography within 1 month before and 1 week after surgery. QOL was assessed 1, 3, and 6 months postoperatively. Univariate and multivariate analyses were performed to identify the risk factors for clinically relevant muscle wasting (muscle wasting ≥10%). RESULTS: A total of 110 patients were included, in which 35 patients had muscle wasting ≥10% within 1 week after surgery. Age ≥65 years and diabetes were independent risk factors for muscle wasting ≥10%. Patients with muscle wasting ≥10% had a poorer QOL in terms of fatigue and physical functioning at 1 and 3 months postoperatively, as well as a higher incidence of postoperative complications, a higher incidence of handgrip strength reduction ≥10%, longer hospital stays, and higher costs. CONCLUSIONS: Age ≥65 years and diabetes were independently associated with clinically relevant muscle wasting within 1 week after gastric cancer surgery. Clinically relevant muscle wasting was associated with a poorer QOL and short-term outcomes after surgery.


Assuntos
Atrofia Muscular/etiologia , Complicações Pós-Operatórias/etiologia , Qualidade de Vida , Neoplasias Gástricas/cirurgia , Doença Aguda , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Atrofia Muscular/diagnóstico por imagem , Atrofia Muscular/epidemiologia , Complicações Pós-Operatórias/diagnóstico por imagem , Complicações Pós-Operatórias/epidemiologia , Estudos Prospectivos , Fatores de Risco , Adulto Jovem
20.
Tumour Biol ; 39(6): 1010428317710030, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28631566

RESUMO

This study is to measure the diagnostic examination quality of magnetic resonance spectroscopy in differentiating high-grade gliomas from metastases. PubMed, Embase, and Chinese Biomedical databases were systematically searched for relevant studies published through 10 July 2016. Based on the data from eligible studies, heterogeneity and threshold effect tests were performed; pooled sensitivity, specificity, and areas under summary receiver-operating characteristic curve of magnetic resonance spectroscopy were calculated. Finally, seven studies with a total of 261 patients were included. Quantitative synthesis of studies showed that pooled sensitivity/specificity of Cho/NAA and Cho/Cr ratio in peritumoral region was 0.85 (95% confidence interval: 0.79-0.90)/0.93 (95% confidence interval: 0.80-0.99) and 0.86 (95% confidence interval: 0.76-0.92)/0.86 (95% confidence interval: 0.73-0.94). The area under the curve of the summary receiver-operating characteristic curve was 0.95 and 0.90. Pooled sensitivity, specificity, and area under the curve of magnetic resonance spectroscopy to identify high-grade gliomas from metastases were 0.85 (95% confidence interval: 0.79-0.90), 0.84 (95% confidence interval: 0.75-0.90), and 0.90, respectively. We concluded that magnetic resonance spectroscopy demonstrated moderate diagnostic performance in distinguishing high-grade gliomas from metastases. Furthermore, Cho/NAA ratio showed higher specificity and higher value of area under the curve than Cho/Cr ratio in peritumoral region. We suggest that Cho/NAA ratio of peritumoral region should be used to improve diagnostic accuracy of magnetic resonance spectroscopy for differentiating high-grade gliomas from metastases.


Assuntos
Neoplasias Encefálicas/diagnóstico , Glioma/diagnóstico , Espectroscopia de Ressonância Magnética , Neoplasias Encefálicas/diagnóstico por imagem , Neoplasias Encefálicas/patologia , Neoplasias Encefálicas/secundário , Diagnóstico Diferencial , Feminino , Glioma/diagnóstico por imagem , Glioma/patologia , Humanos , Imagem por Ressonância Magnética/métodos , Masculino , Gradação de Tumores
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