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1.
Front Oncol ; 11: 651553, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34745932

RESUMO

Background: Immune checkpoint inhibitors (ICIs) have dramatically altered the treatment landscape for patients with melanoma. However, their use also generates unique immune-related adverse effects (irAEs). We performed a systematic review and network meta-analysis to compare the risk of pneumonitis associated with ICIs for patients with advanced or metastatic melanoma. Methods: Phase II/III randomized clinical trials (RCTs) with ICIs were identified through comprehensive searches of multiple databases. An NMA was conducted to compare the risk of pneumonitis associated with ICIs and all-grade (grade 1-5) and high-grade (grade 3-5) immune-related pneumonitis (IRP) were estimated by odds ratios (ORs). Results: A total of 10 randomized clinical trials involving 5,335 patients were enrolled in this study. Conventional chemotherapy was associated with a lower risk of grade 1-5 IRP compared with ICIs monotherapy (OR, 0.14, 95% CI, 0.03 to 0.73) and dual ICIs combination (OR, 0.03, 95% CI, 0.00 to 0.19). In addition, dual ICIs combination showed a noticeably higher risk than ICI monotherapy (OR, 4.45, 95% CI, 2.14 to 9.25) of grade 1-5 IRP. No significant difference in grade 1-5 IRP was observed between cytotoxic T lymphocyte-associated protein 4 (CTLA-4) and programmed cell death protein 1 (PD-1) inhibitors. As to grade 3-5 IRP, no statistically significant difference was found among different ICIs-based regimens. Conclusion: These findings revealed that ICIs could increase the risk of all-grade pneumonitis for patients with advanced melanoma, compared with conventional chemotherapy. Dual ICIs combination could further increase the risk of all-grade pneumonitis than ICIs monotherapy. There was no significant difference in the risk of pneumonia between CTLA-4 and PD-1 inhibitors.

2.
Front Oncol ; 11: 667655, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34568007

RESUMO

Purpose: To characterize clinical features and identify baseline prognostic factors for survival in young adults with advanced gastric cancer (YAAGC). Materials and Methods: A total of 220 young inpatients (age less than or equal to 40 years) with an initial diagnosis of advanced gastric cancer were retrospectively enrolled in this study. Results: Of a consecutive cohort of 220 patients with YAAGC, the median overall survival (OS) time was 16.3 months. One-year survival rate was 43.6% (95% CI: 36.5 to 50.7). In this cohort, a female (71.4%, n = 157) predominance and a number of patients with poorly differentiated tumors (95.9%, n = 211) were observed. In the univariate analysis, OS was significantly associated with neutrophil-lymphocyte ratio (NLR) (≥3.12), hypoproteinemia (<40 g/L), presence of peritoneal or bone metastases, and previous gastrectomy of primary tumor or radical gastrectomy. In multivariate Cox regression analysis, hypoproteinemia [hazard ratio (HR) 1.522, 95% CI 1.085 to 2.137, p = 0.015] and high NLR level (HR 1.446, 95% CI 1.022 to 2.047, p = 0.021) were two independent poor prognostic factors, while previous radical gastrectomy was associated with a favorable OS (HR 0.345, 95% CI 0.205 to 0.583, p = 0.000). A three-tier prognostic index was constructed dividing patients into good-, intermediate-, or poor-risk groups. Median OS for good-, intermediate-, and poor-risk groups was 36.43, 17.87, and 11.27 months, respectively. Conclusions: Three prognostic factors were identified, and a three-tier prognostic index was devised. The reported prognostic index may aid clinical decision-making, patient risk stratification, and planning of future clinical studies on YAAGC.

3.
Front Oncol ; 11: 700228, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34395268

RESUMO

Background: Hepatocellular carcinoma (HCC) is one of the most serious consequences of chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) infection. This study sought to investigate long-term outcomes after liver resection for HCC among patients with HBV/HCV co-infection (HBV/HCV-HCC) compared with patients with HBV infection (HBV-HCC). Methods: Patients who underwent curative-intent liver resection for HCC were identified from a multicenter Chinese database. Using propensity score matching (PSM), patients with HBV/HCV-HCC were matched one-to-one to patients with HBV-HCC. Overall survival (OS) and recurrence-free survival (RFS) were compared between the two groups before and after PSM. Results: Among 2,467 patients identified, 93 (3.8%) and 2,374 (96.2%) patients had HBV/HCV-HCC and HBV-HCC, respectively. Compared with patients with HBV-HCC, patients with HBV/HCV-HCC were older, have poorer liver-related characteristics but better tumor-related characteristics. PSM created 88 pairs of patients with comparable liver- and tumor-related characteristics (all P > 0.2). In the PSM cohort, the 3- and 5-year RFS rates in patients with HBV/HCV-HCC were 48.3% and 38.9%, which were significantly poorer than patients with HBV-HCC (61.8% and 49.2%, P = 0.037). Meanwhile, the 3- and 5-year OS rates in patients with HBV/HCV-HCC were also poorer than patients with HBV-HCC (65.4% and 51.1% vs. 73.7% and 63.0%), with a difference close to be significant between them (P = 0.081). Conclusion: Comparing to patients with HBV-HCC, liver resection resulted in relatively poorer long-term surgical outcomes in patients with HBV/HCV-HCC.

4.
Clin Res Hepatol Gastroenterol ; 45(6): 101695, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34147661

RESUMO

BACKGROUND: Preoperative serum carbohydrate antigen 125 (CA125) is used to judge the diagnosis and prognosis of various tumors. However, the relationship between preoperative serum CA125 and prognosis of hilar cholangiocarcinoma (HCCA) has not been proven. This study aims to evaluate preoperative serum CA125 in predicting the prognosis of HCCA after resection. METHODS: A total of 233 patients after radical resection of HCCA were included. The associations between the levels of preoperative serum CA125 and the clinicopathological characteristics of patients were analyzed. Survival curves were calculated using the Kaplan-Meier method. Univariate and multivariate Cox regression models were used to identify independent risk factors associated with recurrence-free survival (RFS) and overall survival (OS). RESULTS: Among 233 patients, 198 (84.97%) with normal CA125 levels (≤35 U/mL) had better OS and RFS than 35 (15.02%) patients with higher CA125 levels (>35 U/mL). Preoperative serum CA125 was significantly correlated with tumor size, Bismuth-Corlette classification, microvascular invasion and carcinoembryonic antigen (CEA) (p < 0.001, p = 0.040, p = 0.019 and p = 0.042, respectively). The results of multivariable Cox regression showed that preoperative serum CA125 >35 U/mL (p = 0.002, HR = 1.910 for OS; p = 0.006, HR = 1.755 for RFS), tumor classification (p < 0.001, HR = 2.110 for OS; p = 0.006, HR = 1.730 for RFS), lymph node metastasis (p < 0.001, HR = 1.795 for OS; p < 0.001, HR = 1.842 for RFS) and major vascular invasion (p = 0.002, HR = 1.639 for OS; p = 0.005, HR = 1.547 for RFS) were independent risk factors for both OS and RFS. CONCLUSIONS: Preoperative serum CA125 is a good tumor marker for predicting prognosis after radical surgery for HCCA.

5.
Small ; 17(25): e2100525, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34032362

RESUMO

Mn alloying in thermoelectrics is a long-standing strategy for enhancing their figure-of-merit through optimizing electronic transport properties by band convergence, valley perturbation, or spin-orbital coupling. By contrast, mechanisms by which Mn contributes to suppressing thermal transports, namely thermal conductivity, is still ambiguous. A few precedent studies indicate that Mn introduces a series of hierarchical defects from the nano- to meso-scale, leading to effective phonon scattering scoping a wide frequency spectrum. Due to insufficient insights at the atomic level, the theory remains as phenomenological and cannot be used to quantitatively predict the thermal conductivity of Mn-alloyed thermoelectrics. Herein, by choosing the SnTe as a case study, aberration-corrected transmission electron microscopy (TEM)/scanning transmission electron microscopy (STEM) to characterize the lattice complexity of Sn1.02- x Mnx Te is employed. Mn as a "dynamic" dopant that plays an important role in SnTe with respect to different alloying levels or post treatments is revealed. The results indicate that Mn precipitates at x = 0.08 prior to reaching solubility (≈10 mol%), and then splits into MnSn substitution and γ-MnTe hetero-phases via mechanical alloying. Understanding such unique crystallography evolution, combined with a modified Debye-Callaway model, is critical in explaining the decreased thermal conductivity of Sn1.02- x Mnx Te with rational phonon scattering pathways, which should be applicable for other thermoelectric systems.

6.
Am J Surg ; 222(4): 751-758, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33741185

RESUMO

BACKGROUND: Hepatocellular carcinoma (HCC) is common among adolescents and young adults (AYAs) in areas with endemic hepatitis B virus infection. We sought to characterize clinical features and long-term outcomes among AYAs versus older adults (OAs) who underwent HCC resection. METHODS: From a Chinese multicenter database, patients were categorized as AYA (aged 13-39 years) versus OA (aged ≥40 years). Patient clinical features, perioperative outcomes, overall survival (OS) and time-to-recurrence (TTR) were compared. Multivariable Cox-regression analyses were performed to identify the impact of age on OS and TTR. RESULTS: Among 1952 patients, 354(22.2%) were AYAs. AYAs were less likely to have cirrhosis yet were likely to have advanced tumor pathological characteristics than OAs. Postoperative morbidity and mortality were comparable. Compared with OAs, AYAs had a comparable OS but a decreased TTR. Multivariable analyses identified that young age (<40 years) was independently associated with poorer TTR. CONCLUSIONS: Compared with OAs, AYAs had a higher incidence of recurrence following liver resection among patients with HCC, suggesting that enhanced surveillance for postoperative recurrence may be required among AYAs.


Assuntos
Carcinoma Hepatocelular/cirurgia , Carcinoma Hepatocelular/virologia , Hepatite B/epidemiologia , Neoplasias Hepáticas/cirurgia , Neoplasias Hepáticas/virologia , Adolescente , Adulto , Carcinoma Hepatocelular/mortalidade , China/epidemiologia , Feminino , Humanos , Neoplasias Hepáticas/mortalidade , Masculino , Recidiva Local de Neoplasia , Fatores de Risco , Taxa de Sobrevida
7.
Carbohydr Polym ; 260: 117832, 2021 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-33712170

RESUMO

Vagina atrophy is a common symptom in women after menopause owing to decreasing estrogen levels. The most conventional treatment for this condition is estrogen cream. The shortcoming is its weak adhesion to the vagina mucus, thus requiring frequent daily application. In this study, BDDE was selected to crosslink and graft chitosan with thioglycolic acid, to form thiolated chitosan (CT) and improve the mucoadhesive properties of chitosan. Genistein was selected as the bioactive molecule that could exhibit estrogen-like properties for long-term treatment of vaginal atrophy. The efficacies of the materials were characterized and evaluated both in vitro and in vivo. Results showed that the mucoadhesive property of CT was approximately two-fold stronger against the constant flow than unmodified chitosan. CT with genistein (CT-G) was administered intravaginally every three days in vivo. It showed that the developed CT-G recover 54 % of the epithelium thickness of an atrophic vagina and ease vaginal atrophy.


Assuntos
Vaginite Atrófica/tratamento farmacológico , Quitosana/química , Genisteína/uso terapêutico , Hidrogéis/química , Tioglicolatos/química , Animais , Vaginite Atrófica/patologia , Células CACO-2 , Adesão Celular/efeitos dos fármacos , Sobrevivência Celular/efeitos dos fármacos , Portadores de Fármacos/química , Feminino , Genisteína/química , Genisteína/metabolismo , Genisteína/farmacologia , Humanos , Hidrogéis/síntese química , Hidrogéis/farmacologia , Camundongos , Ratos , Ratos Sprague-Dawley , Vagina/patologia
8.
J Nanosci Nanotechnol ; 21(9): 4792-4796, 2021 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-33691868

RESUMO

The presence of malachite green dye in wastewater has a great negative impact on the environment. At present, industrial wastewater is treated using adsorption, electrolysis and membrane separation, among which the adsorption method is the most widely used wastewater treatment. In this study mesoporous silica nanoparticles (MSNs) were prepared using the sol-gel method and modified with the natural polymer urushiol (U) to obtain MSN@Us, which have a core-shell structure. This is the first use of urushiol in dye adsorption. The structures and chemical properties of the MSNs and MSN@Us were characterized. The adsorption of malachite green by the MSNs and MSN@Us showed that the adsorption rate of MSN@Us was higher than that of MSNs, with an adsorption rate greater than 90%. This study provides a new research direction for the use of urushiol in the treatment of contaminated wastewater.


Assuntos
Nanopartículas , Dióxido de Silício , Adsorção , Catecóis , Porosidade , Corantes de Rosanilina
9.
Polymers (Basel) ; 12(11)2020 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-33139654

RESUMO

Tendon healing after injury is relatively slow, mainly because of the weak activity and metabolic properties of tendon cells (tenocytes). Bletilla striata polysaccharide (BSP) has been reported to enhance cell proliferation. Here, we aimed to increase tendon cell proliferation by BSP treatment. We isolated tenocytes from the flexor tendon of human origin. Moreover, we improved the process of extracting BSP. When human tenocytes (HTs) were treated with 100 µg/mL BSP, the MEK/ERK1/2 and PI3K/Akt signaling pathways were activated, thereby enhancing the proliferation ability of tenocytes. BSP treatment also increased the migration of HTs and their ability to secrete the extracellular matrix (Col-I and Col-III). In conclusion, BSP was successfully extracted from a natural Chinese herbal extract and was shown to enhance tenocytes proliferation, migration and collagen release ability. This study is the first to demonstrate improved healing of tendons using BSP.

10.
Cancer Manag Res ; 12: 9929-9939, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33116850

RESUMO

Background: A normal albumin-to-globulin ratio (NAGR) in serum is greater than 1. Inversed albumin-to-globulin ratio (IAGR < 1) indicates poor synthetic liver function or malnutrition. The aim of this study is to evaluate whether preoperative IAGR was associated with worse oncologic survival after hepatectomy for hepatocellular carcinoma (HCC). Patients and Methods: Patients who underwent curative hepatectomy for HCC between 2009 and 2016 in four centers were divided into the IAGR and NAGR groups based on their preoperative levels, and their clinical characteristics and long-term survival outcomes were compared. Univariable and multivariable Cox regression analyses were performed to identify risk factors of overall survival (OS) and recurrence-free survival (RFS). Results: Of 693 enrolled patients, 136 (19.6%) were in the IAGR group. Their 5-year OS and RFS rates were 31.6% and 21.3%, respectively, which were significantly worse than the NAGR group (43.4% and 28.7%, both P < 0.001). The area under the receiver operating characteristic curves in predicting 5-year OS and RFS using the albumin-to-globulin ratio were 0.68 and 0.67, respectively, which were significantly higher than albumin (0.60 and 0.59), globulin (0.56 and 0.57), Child-Pugh grading (0.61 and 0.60), Model for End-Stage Liver Disease Score (0.59 and 0.58), and Albumin-Bilirubin grading (0.64 and 0.63). Multivariable analyses identified that preoperative IAGR was independently associated with worse OS (HR: 1.444, 95% confidence interval (CI): 1.125-1.854, P = 0.004) and RFS (HR: 1.463, 95% CI: 1.159-1.848, P = 0.001). Conclusion: Preoperative IAGR was useful in predicting worse OS and RFS in patients who underwent curative hepatectomy for HCC.

11.
Carbohydr Polym ; 250: 116981, 2020 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-33049868

RESUMO

Peripheral nerve injuries mainly occur in the extremities and result in functional deficits, and recovery after microsurgical repair is slow (<1 mm/day) and frustrating. To improve the results of nerve repair, it is crucial to promote local Schwann cell (SC) function, neurite outgrowth, and to reduce perineural adhesion. In this study, a nerve wrap electrospun with Bletilla striata polysaccharide (BSP) and waterborne polyurethane (WPU) was designed to wrap around the repaired nerve to achieve the goal. In SC proliferation/migration tests and neurite outgrowth assay, BSP/WPU revealed considerable improvement. In rabbit sciatic nerve repair model, BSP/WPU exhibited significantly higher compound muscle action potential, muscle contraction force, and reduced perineural adhesion. The downstream fascicles of the BSP/WPU group exhibited a 50 % increase in diameter and 100 % increase in myelin thickness compared with the control group. In vitro and in vivo experiments indicated the positive effect of BSP/WPU nerve wrap on nerve regeneration.


Assuntos
Cicatriz/prevenção & controle , Nanofibras/química , Regeneração Nervosa , Orchidaceae/química , Polissacarídeos/farmacologia , Nervo Isquiático/citologia , Animais , Eletricidade , Masculino , Coelhos , Ratos , Ratos Sprague-Dawley
12.
J Surg Oncol ; 122(7): 1418-1425, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32794267

RESUMO

BACKGROUND: Body mass index (BMI) has been widely used as a prognostic indicator. The association between preoperative BMI and postoperative morbidity in patients with hilar cholangiocarcinoma (HCCA) has not been proved. This study aimed to identify the association between preoperative BMI and postoperative morbidity following radical resection of HCCA. METHODS: Patients were divided into three groups according to preoperative BMI: low BMI (≤18.4 kg/m2 ), normal BMI (18.4-24.9 kg/m2 ), and high BMI (≥24.9 kg/m2 ). Baseline characteristics, operative variables, postoperative 30-day mortality, and morbidity were compared. Risk factors associated with postoperative morbidity were assessed using univariable and multivariable logistic analyses. RESULTS: Among 260 patients, 183 (70.4%) had normal BMI, 32 (12.3%) had low BMI, and 45 (17.3%) had high BMI. Compared to the patients with normal-BMI, both low and high BMI patients exhibited a significantly higher postoperative morbidity (87.5% and 82.2% vs 63.9%, P = .019 and P = .025, respectively). Additionally, the multivariable analysis revealed that both low and high BMI patients remained independently associated with an increased risk of postoperative morbidity. (OR: 3.707, 95% CI: 1.080-12.725, P = .037; and OR: 2.858, 95% CI: 1.167-7.002, P = .022, respectively). CONCLUSION: BMI is an independent risk factor for higher postoperative morbidity in patients who undergo surgical treatment of hilar cholangiocarcinoma.


Assuntos
Neoplasias dos Ductos Biliares/cirurgia , Índice de Massa Corporal , Colangiocarcinoma/cirurgia , Adulto , Idoso , Neoplasias dos Ductos Biliares/mortalidade , Ductos Biliares Intra-Hepáticos , Colangiocarcinoma/mortalidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Morbidade , Complicações Pós-Operatórias/mortalidade
13.
Pharmaceutics ; 12(5)2020 Apr 28.
Artigo em Inglês | MEDLINE | ID: mdl-32354067

RESUMO

Neovascularization (NV) of the cornea disrupts vision which leads to blindness. Investigation of antiangiogenic, slow-release and biocompatible approaches for treating corneal NV is of great importance. We designed an eye drop formulation containing gelatin/epigallocatechin-3-gallate (EGCG) nanoparticles (NPs) for targeted therapy in corneal NV. Gelatin-EGCG self-assembled NPs with hyaluronic acid (HA) coating on its surface (named GEH) and hyaluronic acid conjugated with arginine-glycine-aspartic acid (RGD) (GEH-RGD) were synthesized. Human umbilical vein endothelial cells (HUVECs) were used to evaluate the antiangiogenic effect of GEH-RGD NPs in vitro. Moreover, a mouse model of chemical corneal cauterization was employed to evaluate the antiangiogenic effects of GEH-RGD NPs in vivo. GEH-RGD NP treatment significantly reduced endothelial cell tube formation and inhibited metalloproteinase (MMP)-2 and MMP-9 activity in HUVECs in vitro. Topical application of GEH-RGD NPs (once daily for a week) significantly attenuated the formation of pathological vessels in the mouse cornea after chemical cauterization. Reduction in both vascular endothelial growth factor (VEGF) and MMP-9 protein in the GEH-RGD NP-treated cauterized corneas was observed. These results confirm the molecular mechanism of the antiangiogenic effect of GEH-RGD NPs in suppressing pathological corneal NV.

14.
Qual Life Res ; 29(9): 2395-2402, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32314125

RESUMO

PURPOSE: To evaluate the health-related quality of life (HRQoL) of knee osteoarthritis (KOA) patients in China, compare their HRQoL with norm population, and examine the associations between the potential influencing factors and HRQoL. METHODS: A cross-sectional study was conducted in 912 KOA patients from 4 provinces between March and November 2017. All participants were diagnosed according to the National Institute for Health and Care Excellence (NICE)'s criterion or the Chinese Medical Association (CMA)'s criterion. Recruited patients were surveyed for HRQoL using the 12-item Short Form (SF-12) and sociodemographic, disease-related factors. We assessed the associations between potential influencing factors and HRQoL using multiple linear regression models. RESULTS: Among the KOA patients, the mean physical component summary (PCS) of HRQoL was 40.91 ± 11.62, lower than norm (P < 0.001). And the mean mental component summary (MCS) was 50.25 ± 11.99, similar to the norm. Patients who were older (ß = - 0.155, P = 0.001), women (ß = - 4.589, P < 0.001), had ever been treated (ß = - 2.426, P = 0.006), had longer course of KOA (ß = - 0.164, P = 0.012), and were in early stage (ß = - 2.968, P = 0.001) or progressive/late stage (ß = - 7.636, P < 0.001) showed lower scores of PCS. Patients who lived in Hunan (ß = 4.988, P < 0.001) and had education levels of junior high school (ß = 3.134, P = 0.012) or senior high school and above (ß = 3.050, P = 0.010) had better mental status. Those suffered from non-knee pains (ß = - 2.308, P = 0.027) and with progressive or late KOA (ß = - 4.690, P = 0.016) had lower MCS scores. CONCLUSION: KOA patients had worse physical condition. The mental and physical health of patients were affected by different factors. Targeted management measures should be taken to improve their HRQoL.


Assuntos
Nível de Saúde , Osteoartrite do Joelho/psicologia , Qualidade de Vida/psicologia , Adulto , Idoso , China , Estudos Transversais , Feminino , Humanos , Articulação do Joelho/patologia , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Osteoartrite do Joelho/patologia , Inquéritos e Questionários
15.
HPB (Oxford) ; 22(12): 1722-1731, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32284280

RESUMO

BACKGROUND: Iatrogenic biliary injury (IBI) following laparoscopic cholecystectomy (LC) is the most serious iatrogenic complications. Little is known whether LC-IBI would lead to surgeon's severe mental distress (SMD). METHODS: A cross-sectional survey in the form of electronic questionnaire was conducted among Chinese general surgeons who have caused LC-IBI. The six collected clinical features relating to mental distress included: 1) feeling burnout, anxiety, or depression, 2) avoiding performing LC, 3) having physical reactions when recalling the incidence, 4) having the urge to quit surgery, 5) taking psychiatric medications, and 6) seeking professional psychological counseling. Univariable and multivariable analyses were performed to identify risk factors of SMD, which was defined as meeting ≥3 of the above-mentioned clinical features. RESULTS: Among 1466 surveyed surgeons, 1236 (84.3%) experienced mental distress following LC-IBI, and nearly half (49.7%, 614/1236) had SMD. Multivariable analyses demonstrated that surgeons from non-university affiliated hospitals (OR:1.873), patients who required multiple repair operations (OR:4.075), patients who required hepaticojejunostomy/partial hepatectomy (OR:1.859), existing lawsuit litigation (OR:10.491), existing violent doctor-patient conflicts (OR:4.995), needing surgeons' personal compensation (OR:2.531), and additional administrative punishment by hospitals (OR:2.324) were independent risk factors of surgeon's SMD. CONCLUSION: Four out of five surgeons experienced mental distress following LC-IBI, and nearly half had SMD. Several independent risk factors of SMD were identified, which could help to make strategies to improve surgeons' mental well-being.

16.
BMC Psychiatry ; 19(1): 216, 2019 07 10.
Artigo em Inglês | MEDLINE | ID: mdl-31291931

RESUMO

BACKGROUND: Data on the pharmacological management of acute agitation in schizophrenia are scarce. The aim of this study is to investigate the prescription practices in the treatment of agitation in Chinese patients with schizophrenia. METHODS: We conducted a large, multicenter, observational study in 14 psychiatry hospitals in China. Newly hospitalized schizophrenia patients with the PANSS-EC total score ≥ 14 and a value ≥4 on at least one of its five items were included in the study. Their drug treatments of the first 2 weeks in hospital were recorded by the researchers. RESULTS: Eight hundred and 53 patients enrolled in and 847 (99.30%) completed the study. All participants were prescribed antipsychotics, 40 (4.72%) were prescribed benzodiazepine in conjunction with antipsychotics and 81 were treated with modified electric convulsive therapy (MECT). Four hundred and 12 (48.64%) patients were prescribed only one antipsychotic, in the order of olanzapine (120 patients, 29.13%), followed by risperidone (101 patients, 24.51%) and clozapine (41 patients, 9.95%). About 435 (51.36%) participants received antipsychotic polypharmacy, mostly haloperidol + risperidone (23.45%), haloperidol+ olanzapine (17.01%), olanzapine+ ziprasidone (5.30%), haloperidol + clozapine (4.37%) and haloperidol + quetiapine (3.90%). Binary logistic regression analysis suggests that a high BARS score (OR 2.091, 95%CI 1.140-3.124), severe agitation (OR 1.846, 95%CL 1.266-2.693), unemployment or retirement (OR 1.614, 95%CL 1.189-2.190) and aggressiveness on baseline (OR 1.469, 95%CL 1.032-2.091) were related to an increased antipsychotic polypharmacy odds. Male sex (OR 0.592, 95%CL 0.436-0.803) and schizophrenia in older persons (age ≥ 55 years, OR 0.466, 95%CL 0.240-0.902) were less likely to be associated with antipsychotic polypharmacy. CONCLUSION: The present study demonstrates that monotherapy and polypharmacy display equally common patterns of antipsychotic usage in managing agitation associated with schizophrenia in China. The extent and behavioral activities of agitation and several other factors were associated with polypharmacy.


Assuntos
Antipsicóticos/uso terapêutico , Prescrições de Medicamentos/estatística & dados numéricos , Hospitalização/estatística & dados numéricos , Padrões de Prática Médica/estatística & dados numéricos , Esquizofrenia/tratamento farmacológico , Adulto , Idoso , Idoso de 80 Anos ou mais , Agressão/efeitos dos fármacos , China , Quimioterapia Combinada , Feminino , Humanos , Pacientes Internados/psicologia , Pacientes Internados/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Polimedicação
17.
Int J Mol Sci ; 20(7)2019 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-30939838

RESUMO

Peritendinous adhesion is a major complication after tendon injury and the subsequent repairs or reconstructions. The degree of adhesion can be reduced by the interposition of a membranous barrier between the traumatized tendon and the surrounding tissue. In the present study, electrospun water-borne polyurethane (WPU) nanofibrous membranes (NFMs) were created for use after the reparation or reconstruction of tendons to reduce adhesion. In the electrospinning process, water was employed as the solvent for WPU, and this solvent was ecofriendly and nontoxic. The nanofibrous architecture and pore size of the WPU NFMs were analyzed. Their microporosity (0.78⁻1.05 µm) blocked the penetration of fibroblasts, which could result in adhesion and scarring around the tendon during healing. The release of WPU mimicked the lubrication effect of the synovial fluid produced by the synovium around the tendon. In vitro cell studies revealed that the WPU NFMs effectively reduced the number of fibroblasts that became attached and that there was no significant cytotoxicity. In vivo studies with the rabbit flexor tendon repair model revealed that WPU NFMs reduced the degree of peritendinous adhesion, as determined using a gross examination; a histological cross section evaluation; and measurements of the range of motion of interphalangeal joints (97.1 ± 14.7 and 79.0 ± 12.4 degrees in proximal and distal interphalangeal joints respectively), of the length of tendon excursion (11.6 ± 1.9 cm), and of the biomechanical properties.


Assuntos
Adesão Celular , Membranas Artificiais , Nanofibras/química , Complicações Pós-Operatórias/prevenção & controle , Traumatismos dos Tendões/cirurgia , Animais , Células Cultivadas , Fibroblastos/fisiologia , Humanos , Procedimentos Ortopédicos/efeitos adversos , Procedimentos Ortopédicos/métodos , Poliuretanos/química , Coelhos
18.
Oncol Rep ; 41(6): 3377-3385, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30942457

RESUMO

Serratia marcescens are considered to be abundant and optimal resources for obtaining prodigiosin, which can be isolated from soil, water, plants and air but rarely from insects. In the present study, a strain of Serratia marcescens named WA12­1­18 was isolated from the gut of Periplaneta americana, which was capable of producing high levels of pigment reaching 2.77 g/l via solid fermentation and was identified as prodigiosin by ultraviolet, high performance liquid chromatography (LC), Fourier­transform infrared spectroscopy, LC­mass spectroscopy and nuclear magnetic resonance. The apoptotic tumor cells treated with prodigiosin were examined by 4',6­diamidino­2­phenylindole (DAPI) staining assays and transmission electron microscopy. Flow cytometry (FCM) was utilized to measure the apoptotic rate with Annexin V staining and the expression levels of proteins involved in apoptosis, including B­cell lymphoma 2 (Bcl­2), Bcl­2­associated X (Bax) and caspase­3 were determined by western blot analysis and reverse transcription­quantitative polymerase chain reaction (RT­qPCR). The experimental results revealed that prodigiosin could inhibit the proliferation of HeLa cells and the half­maximal inhibitory concentration values of prodigiosin in HeLa were 2.1, 1.2 and 0.5 µg/ml over 24, 48 and 72 h, respectively. Furthermore, DAPI staining assays and transmission electron microscopy clearly demonstrated that prodigiosin could induce HeLa cell apoptosis. FCM results revealed that the cell apoptotic rates were 19.7±1.4, 23.7±2.4 and 26.2±2.3% following the treatment with 0.5, 1.0 and 2.0 µg/ml prodigiosin for 48 h, respectively. Western blot analysis and RT­qPCR revealed that prodigiosin could activate apoptosis­associated molecules including Bcl­2, Bax and caspase­3. Therefore, the results of the present study demonstrated that the prodigiosin could induce apoptosis in HeLa cells, which may be associated with the upregulation of Bax and caspase­3, the concomitant downregulation of Bcl­2 levels and also triggering the extrinsic apoptotic signaling pathway.


Assuntos
Apoptose/efeitos dos fármacos , Proliferação de Células/efeitos dos fármacos , Prodigiosina/isolamento & purificação , Serratia marcescens/química , Animais , Sobrevivência Celular/efeitos dos fármacos , Cromatografia Líquida , Citometria de Fluxo , Microbioma Gastrointestinal , Regulação Neoplásica da Expressão Gênica/efeitos dos fármacos , Células HeLa , Humanos , Indóis/química , Proteínas de Neoplasias/genética , Periplaneta/microbiologia , Prodigiosina/farmacologia , Espectroscopia de Infravermelho com Transformada de Fourier
19.
Psychiatry Clin Neurosci ; 73(4): 179-186, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30565342

RESUMO

AIM: Transcutaneous electrical acupoint stimulation (TEAS) has the potential to alleviate post-traumatic stress disorder (PTSD). The purpose of this study was to determine whether adding TEAS to sertraline or cognitive behavioral therapy (CBT) could improve the anti-PTSD efficacy. METHODS: In this randomized controlled trial, 240 PTSD patients (60 in each group) were assigned to receive simulated TEAS combined with sertraline (group A) or with CBT (group B), active TEAS combined with CBT (group C), or active TEAS combined with CBT plus sertraline (group D) for 12 weeks. The outcomes were measured using the Clinician-Administered PTSD Scale, PTSD Check List-Civilian Version, and 17-item Hamilton Rating Scale for Depression. RESULTS: While PTSD symptoms reduced over time in all patients, groups C and D had markedly greater improvement in both PTSD and depressive measures than groups A and B in all post-baseline measurement points, with moderate to very large effect sizes of 0.484-2.244. Groups C and D also had a significantly higher rate than groups A and B on clinical response (85.0% and 95.0% vs 63.3% and 60.0%, P < 0.001) and on remission (15.0% and 25.0% vs 3.3% and 1.7%, P < 0.001). The incidence of adverse events was similar between groups A and D and between groups B and C. CONCLUSIONS: Additional TEAS augments the anti-PTSD and antidepressant efficacy of antidepressants or CBT, without increasing the incidence of adverse effects. TEAS could serve as an effective intervention for PTSD and comorbid depression. This trial was registered with www.chictr.org (no.: ChiCTR1800017255).


Assuntos
Pontos de Acupuntura , Terapia Cognitivo-Comportamental/métodos , Depressão/terapia , Avaliação de Resultados em Cuidados de Saúde , Inibidores de Captação de Serotonina/farmacologia , Sertralina/farmacologia , Transtornos de Estresse Pós-Traumáticos/terapia , Estimulação Elétrica Nervosa Transcutânea/métodos , Adulto , Terapia Combinada , Depressão/tratamento farmacológico , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inibidores de Captação de Serotonina/administração & dosagem , Sertralina/administração & dosagem , Transtornos de Estresse Pós-Traumáticos/tratamento farmacológico
20.
J Affect Disord ; 246: 285-289, 2019 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-30594041

RESUMO

BACKGROUND: Little is known about the demographic and clinical features of the atypical subtype of major depressive disorder (MDD) patients in China. This study set out to investigate the prevalence of atypical depression in MDD patients in China, and identify its demographic and clinical features. METHODS: The study was conducted in 13 major psychiatric hospitals or in the psychiatric units of general hospitals in China, and recruited a sample of 1172 patients diagnosed with MDD. The patients' demographic and clinical features and prescriptions of psychotropic drugs were collected using a standardized questionnaire designed for the study. RESULTS: The prevalence of atypical depression was 15.3%. In multiple logistic regression analyses, compared to the non-atypical depression patients, the atypical depression patients were more likely to have depressive episodes with suicide ideation and attempts (OR = 1.49, 95% CI = 1.06, 2.10, P = 0.023), depressive episodes with psychotic features (OR = 2.15, 95% CI = 1.43, 3.22, P < 0.001), seasonal depressive episodes (OR = 1.77, 95% CI = 1.12, 2.78, P = 0.014), an earlier age of onset (OR = 0.98, 95% CI = 0.96, 0.99, P = 0.001), and lifetime depressive episodes (OR = 1.07, 95% CI = 1.01, 1.13, P = 0.020). LIMITATIONS: The assessment of atypical features was not based on a validated rating scale. CONCLUSION: Our results indicate that atypical depression is common in Chinese patients with MDD. MDD with atypical features may be more severe and debilitating than patients with non-atypical features.


Assuntos
Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/epidemiologia , Adulto , Idade de Início , China/epidemiologia , Transtorno Depressivo Maior/tratamento farmacológico , Transtorno Depressivo Maior/psicologia , Feminino , Hospitais Psiquiátricos , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Psicotrópicos/uso terapêutico , Ideação Suicida , Inquéritos e Questionários
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