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1.
J Diabetes Investig ; 2020 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-32506801

RESUMO

AIMS/INTRODUCTION: To systematically review the risk factors for new-onset diabetes after kidney transplantation and to provide a theoretical basis for the prevention and management of new diabetes after kidney transplantation. MATERIALS AND METHODS: We searched PubMed, Web of Science, Embase, the Cochrane Library databases, and other databases for case-control studies related to risk factors for new-onset diabetes mellitus after kidney transplantation published between January 2005 and July 2019. A meta-analysis of data on risk factors for new-onset diabetes mellitus after kidney transplantation from the included studies was performed. A narrative review of risk factors for new-onset diabetes mellitus after kidney transplantation was also performed. RESULTS: A total of 24 case-control studies were included in the meta-analysis, with a total of 6127 patients. There were 1598 patients with new-onset diabetes mellitus after kidney transplantation and 5542 patients without new-onset diabetes mellitus after kidney transplantation. The meta-analysis results showed that age, polycystic kidney disease, family history of diabetes, body mass index (BMI), acute rejection, tacrolimus use, hepatitis B virus (HBV) infection, hepatitis C virus (HCV) infection, and hypertension were associated with new-onset diabetes mellitus after kidney transplantation, whereas sex, sirolimus use, cyclosporin A use, steroid use, and cytomegalovirus infection were not associated with new-onset diabetes mellitus after kidney transplantation. CONCLUSIONS: Older age, BMI, family history of diabetes, tacrolimus use, history of hypertension, polycystic kidney disease, acute rejection, HBV infection, and HCV infection are risk factors for new-onset diabetes mellitus after kidney transplantation. Therefore, the clinical implications of these factors warrant attention.

2.
J Pharm Biomed Anal ; 185: 113221, 2020 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-32145538

RESUMO

Puerarin, an important isoflavone, has been widely used for the treatment of angina and hypertension. In this work, we developed a novel electrochemical sensor for the detection of puerarin based on the hybrid of reduced graphene oxide (RGO) and molecularly imprinted polymer (MIP). The RGO/MIP sensor functions by target puerarin recognition and electro-oxidization via a two-proton and two-electron process, enabling the detection of puerarin with good selectivity and high sensitivity. The MIP layer was integrated on the surface of RGO by the electro-co-polymerization of o-phenylenediamine (monomer) and puerarin (template), resulting in high surface area, binding capacity, good conductivity and faster mass transfer. The nanostructure of the RGO/MIP hybrid was demonstrated using scanning electron microscopy (SEM) and atomic force microscopy (AFM). Experimental conditions involved in the sensor fabrication process were evaluated. Under the optimized condition, a wide linear range (0.02 µM ∼ 40 µM) and a low detection limit (0.006 µM) were achieved. The sensor was applied to detect puerarin in human urine and injection samples, and the result was comparable with that of the gold standard method of high-performance liquid chromatography (HPLC), indicating a promise in the further application to pharmacokinetics or therapeutic drug monitoring.

3.
J Colloid Interface Sci ; 562: 518-528, 2020 Mar 07.
Artigo em Inglês | MEDLINE | ID: mdl-31785934

RESUMO

A novel three-dimensional (3D) flower-like ZnO@Ag composite is successfully synthesized through a simple and facile process, which is characterized by X-ray diffraction (XRD), scanning electron microscopy (SEM) and X-ray photoelectron spectroscopy (XPS).When evaluated as an anodic material for nickel-zinc alkaline secondary batteries, the 3D flower-like ZnO@Ag composite exhibits the high discharge capacity (627 mAh g-1) and long cycle life (830 cycles). The outstanding electrochemical performance is ascribed to the Ag nanoparticles enhancing electron conductivity and the uniform flower-like structure providing enough electrochemical reaction sites, so as to reduce electrode polarization and improve cell efficiency. Furthermore, the possible growth mechanism of 3D flower-like ZnO@Ag composite has been proposed. The effect of silver content on formation of ZnO@Ag composites was also investigated in detail, indicating the appropriate silver content plays a key role in forming a defined 3 D flower-like structure for the ZnO@Ag composite.

4.
Sci Rep ; 9(1): 19690, 2019 12 23.
Artigo em Inglês | MEDLINE | ID: mdl-31873102

RESUMO

Ecosystem issues have been severely concerned and studied when the coal resource is one of major energy generators, and green mining innovation techniques involving artificial-restorations have addressed and significantly lessened negative impacts on the ecological environment. The ecosystem of a coal-mined area, however, is able to naturally restore with the processes of natural succession, similar to the human body system that has the immune ability to self-heal a wound over time if the wound does not deeply hurt the health. Here we analyze multiple discipline real data from two mining sites, and evidently show an ability of nature that the coal mining related problems such as geological cracks, damaged aquifers and destroyed soils in Quaternary period can naturally recover around a half-year after the end of mining. Our results temporally and spatially demonstrate that the damaged ecosystem has a capability of unaided nature-remediation from the ground to the subsurface, which is very useful to the countries worldwide with abundant coal reserves and intense energy demands for their development.

6.
J Am Chem Soc ; 141(33): 13028-13032, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31386354

RESUMO

The self-assembly of nanoparticles, a process whereby nanocrystal building blocks organize into even more ordered superstructures, is of great interest to nanoscience. Here we report the layer-by-layer assembly of 2D perovskite nanosheet building blocks. Structural analysis reveals that the assembled superlattice nanocrystals match with the layered Ruddlesden-Popper perovskite phase. This assembly proves reversible, as these superlattice nanocrystals can be reversibly exfoliated back into their building blocks via sonication. This study demonstrates the opportunity to further understand and exploit thermodynamics to increase order in a system of nanoparticles and to study emergent optical properties of a superlattice from 2D, weakly attracted, perovskite building blocks.

7.
PLoS One ; 14(7): e0219116, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31260468

RESUMO

BACKGROUND: Patients after total knee arthroplasty (TKA) often develop moderate to severe pain. This study compared the analgesic effect of low-dose epidural morphine vs. a comparable saline injection in patients following TKA surgery. METHODS: This randomized, double-blinded, and placebo-controlled trial was conducted in a tertiary hospital in Beijing between July 1, 2017 and May 30, 2018. One hundred and ten patients following TKA under combined spinal-epidural anesthesia were randomized to receive either epidural morphine (2 mg diluted to 5 ml normal saline, the epidural morphine group) or placebo (5 ml normal saline, the placebo group). For all patients, single-injection femoral nerve block was performed, and a supplementary patient-controlled intravenous analgesia pump was provided. The severity of pain was assessed with the numerical rating scale (NRS, an 11-point scale where 0 = no pain and 10 = the worst pain) at 6, 12, 24, 36, and 48 hours after surgery. The primary endpoint was moderate to severe pain (NRS pain score ≥4) within 48 hours after surgery. RESULTS: The percentage with moderate to severe pain within 48 hours was lower in the epidural morphine group than in the placebo group (58.2% [32/55] with epidural morphine vs. 76.4% [42/55] with placebo; OR 0.43, 95% CI 0.19-0.98; p = 0.042). Furthermore, the cumulative morphine consumption within 48 hours was lower (18.4±6.1 mg vs. 22.4±7.3 mg; p = 0.002) whereas the mental component summary score of 30-day quality of life was higher (63.8±2.9 vs. 61.9±4.2; p = 0.008) in the epidural morphine group than in the placebo group. CONCLUSIONS: For patients following TKA, the addition of epidural morphine to single-injection femoral nerve block improves the quality of analgesia within 48 hours, without increasing adverse events. TRIAL REGISTRATION: ClinicalTrials.gov NCT03203967.


Assuntos
Analgesia Epidural , Artroplastia do Joelho/efeitos adversos , Morfina/administração & dosagem , Dor Pós-Operatória/tratamento farmacológico , Idoso , Idoso de 80 Anos ou mais , Analgesia Controlada pelo Paciente , Método Duplo-Cego , Feminino , Nervo Femoral , Humanos , Masculino , Pessoa de Meia-Idade , Bloqueio Nervoso , Medição da Dor , Qualidade de Vida , Resultado do Tratamento
8.
J Anesth ; 33(2): 295-303, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30820749

RESUMO

In patients undergoing major surgery, complete handover of intraoperative anesthesia care is associated with adverse postoperative outcomes including high mortality and more major complications. The purpose of this study was to explore the association between the intraoperative complete handover between anesthesiologists and the occurrence of postoperative delirium. This was a secondary analysis of the database of a previously published clinical trial. Seven hundred patients aged 65 years or older, who were admitted to the intensive care unit after noncardiac surgery, were included. Delirium was assessed with the Confusion Assessment Method for the Intensive Care Unit twice daily during the first 7 postoperative days. Other postoperative outcomes were also monitored. The association between the intraoperative complete handover of anesthesia care and the development of postoperative delirium was analyzed with a logistic regression model. Of the 700 enrolled patients, 111 (15.9%) developed postoperative delirium within 7 days. After correction for confounding factors, intraoperative complete handover between anesthesiologists was associated with an increased risk of postoperative delirium (OR 1.787, 95% CI 1.012-3.155, P = 0.046). Patients with intraoperative complete handover also had higher incidence of non-delirium complications (P = 0.003) and stayed longer in hospital after surgery (P = 0.002). For elderly patients admitted to the intensive care unit after noncardiac surgery, intraoperative complete handover of anesthesia care was associated with an increased risk of postoperative delirium. Chinese Clinical Trial Registry ( http://www.chictr.org.cn ): ChiCTR-TRC-10000802.


Assuntos
Anestesia/métodos , Delírio/epidemiologia , Transferência da Responsabilidade pelo Paciente , Complicações Pós-Operatórias/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Anestesia/efeitos adversos , Feminino , Humanos , Incidência , Unidades de Terapia Intensiva , Masculino , Fatores de Risco
9.
Dig Dis Sci ; 64(7): 1830-1843, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-30560340

RESUMO

BACKGROUND: HIV progression is characterized by immune activation and microbial translocation from the gut. Short-chain fatty acids (SCFAs) are essential for gut homeostasis. Decreased intestinal SCFAs play a role in rapid HIV progression. AIMS: To compare the SCFA profile, intestinal microbiome, and intestinal mucosal injury between patients with HIV (but not AIDS) and healthy controls. METHODS: This was a prospective study of 15 patients without AIDS and 10 controls conducted between July 2016 and January 2017 at the Institute of Dermatology and Venereology (Sichuan Academy of Medical Sciences). Stool specimens were collected to analyze the microbiome and SCFAs. Blood I-FABP and D-lactate (gut injury markers) were measured as well as T cells in HIV-positive patients. Intestinal mucosa was observed by colonoscopy. RESULTS: Rikenellaceae, Microbacteriaceae, Roseburia, Lachnospiraceae, Alistipes, and Ruminococcaceae were decreased, while Moraxellaceae and Psychrobacter were increased in HIV-positive patients. Butyric acid (p = 0.04) and valeric acid (p = 0.03) were reduced in HIV-positive patients. Colonoscopy revealed no visible damage in all subjects. There were no differences in I-FABP and D-lactate between groups. Butyric and valeric acids mainly positively correlated with Rikenellaceae, Ruminococcaceae, Alistipes, Roseburia, and Lachnospiraceae. CD8+ cells were positively correlated with Proteobacteria. CD4+ cells, and CD4/CD8 were negatively correlated with acetic acid. CD8+ cells were positively correlated with valeric acid. CONCLUSION: The differences in the distribution of intestinal flora between HIV-infected and healthy individuals, especially some SCFAs, suggest that there is already a predisposition to intestinal mucosa damage in HIV-infected individuals.


Assuntos
Bactérias/metabolismo , Colo , Ácidos Graxos/metabolismo , Microbioma Gastrointestinal , Infecções por HIV , Mucosa Intestinal , Adolescente , Adulto , Bactérias/isolamento & purificação , Estudos de Casos e Controles , China , Colo/imunologia , Colo/metabolismo , Colo/microbiologia , Colo/patologia , Fezes/química , Fezes/microbiologia , Feminino , Infecções por HIV/imunologia , Infecções por HIV/metabolismo , Infecções por HIV/microbiologia , Infecções por HIV/patologia , Interações Hospedeiro-Patógeno , Humanos , Imunidade Celular , Hospedeiro Imunocomprometido , Mucosa Intestinal/imunologia , Mucosa Intestinal/metabolismo , Mucosa Intestinal/microbiologia , Mucosa Intestinal/patologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Adulto Jovem
10.
Nano Lett ; 18(8): 5329-5334, 2018 08 08.
Artigo em Inglês | MEDLINE | ID: mdl-30011211

RESUMO

Reducing the diameter of silver nanowires has been proven to be an effective way to improve their optoelectronic performance by lessening light attenuation. The state-of-the-art silver nanowires are typically around 20 nm in diameter. Herein we report a modified polyol synthesis of silver nanowires with average diameters as thin as 13 nm and aspect ratios up to 3000. The success of this synthesis is based on the employment of benzoin-derived radicals in the polyol approach and does not require high-pressure conditions. The strong reducing power of radicals allows the reduction of silver precursors to occur at relatively low temperatures, wherein the lateral growth of silver nanowires is restrained because of efficient surface passivation. The optoelectronic performance of as-prepared 13 nm silver nanowires presents a sheet resistance of 28 Ω sq-1 at a transmittance of 95% with a haze factor of ∼1.2%, comparable to that of commercial indium tin oxide (ITO).

11.
Nat Mater ; 17(3): 261-267, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-29358645

RESUMO

Smart photovoltaic windows represent a promising green technology featuring tunable transparency and electrical power generation under external stimuli to control the light transmission and manage the solar energy. Here, we demonstrate a thermochromic solar cell for smart photovoltaic window applications utilizing the structural phase transitions in inorganic halide perovskite caesium lead iodide/bromide. The solar cells undergo thermally-driven, moisture-mediated reversible transitions between a transparent non-perovskite phase (81.7% visible transparency) with low power output and a deeply coloured perovskite phase (35.4% visible transparency) with high power output. The inorganic perovskites exhibit tunable colours and transparencies, a peak device efficiency above 7%, and a phase transition temperature as low as 105 °C. We demonstrate excellent device stability over repeated phase transition cycles without colour fade or performance degradation. The photovoltaic windows showing both photoactivity and thermochromic features represent key stepping-stones for integration with buildings, automobiles, information displays, and potentially many other technologies.

12.
J Crit Care ; 44: 45-50, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-29055835

RESUMO

PURPOSE: To explore the association between the severity of preoperative hypoalbuminemia and the occurrence of postoperative delirium. MATERIALS AND METHODS: This was a secondary analysis of the database from a previously conducted clinical trial. 700 elderly patients (age ≥65years) who were admitted to intensive care unit (ICU) after noncardiac surgery were included. Delirium was assessed with the Confusion Assessment Method for the ICU twice daily during the first 7days postoperatively. Other outcomes were also monitored. The relationship between preoperative albumin level and postoperative delirium were analyzed using a logistic regression model. RESULTS: 111 of 700 patients (15.9%) developed postoperative delirium. When compared with normal albumin level (>40.0g/L), severe (≤30.0g/L: OR 2.727, 95% CI 1.283-5.797, P=0.009), but not mild (35.1-40.0g/L: OR 1.175, 95% CI 0.679-2.032, P=0.565) or moderate (30.1-35.0g/L: OR 1.674, 95% CI 0.897-3.122, P=0.105) hypoalbuminemia was associated with an increased risk of postoperative delirium. Preoperative severe hypoalbuminemia was also associated with prolonged mechanical ventilation, increased non-delirium complications, and prolonged ICU and hospital stay after surgery. CONCLUSIONS: Preoperative severe hypoalbuminemia (≤30.0g/L) was associated with an increased risk of postoperative delirium and worse outcomes. TRIAL REGISTRATION: Chinese Clinical Trial Registry, www.chictr.org.cn, ChiCTR-TRC-10000802.


Assuntos
Delírio/etiologia , Hipoalbuminemia/complicações , Complicações Pós-Operatórias/etiologia , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Período Pré-Operatório , Fatores de Risco
13.
Biochem Biophys Res Commun ; 490(2): 302-308, 2017 08 19.
Artigo em Inglês | MEDLINE | ID: mdl-28619509

RESUMO

Keloids are benign dermal fibroproliferative tumors that develop as a result of several dysregulated processes. Emerging evidence has revealed that miRNAs contribute to keloid formation. However, the molecular mechanisms of keloid pathogenesis remain unclear. In our study, we found that miR-141-3p in keloid tissues and keloid fibroblasts was significantly decreased compared with the levels in normal tissues and normal skin fibroblasts, respectively. miR-141-3p overexpression resulted in significantly decreased proliferation and migration and the promotion of apoptosis in keloid fibroblasts, whereas miR-141-3p knockdown in keloid fibroblasts yielded the opposite results. Growth factor receptor binding 2-associated binding protein 1 (GAB1) was identified and confirmed as a direct target of miR-141-3p. The expression of GAB1 was up-regulated in keloid tissues, and the restoration of GAB1 partially reversed the inhibitory effects of miR-141-3p on the proliferation and migration of keloid fibroblasts. All data suggested that miR-141-3p decreased the proliferation and migration of keloid fibroblasts by repressing GAB1 expression, providing a useful target for keloid management.


Assuntos
Proteínas Adaptadoras de Transdução de Sinal/genética , Movimento Celular/genética , Proliferação de Células/genética , Fibroblastos/citologia , Queloide/metabolismo , MicroRNAs/genética , Proteínas Adaptadoras de Transdução de Sinal/deficiência , Apoptose/genética , Ciclo Celular/genética , Células Cultivadas , Fibroblastos/metabolismo , Humanos
14.
J Am Chem Soc ; 139(21): 7348-7354, 2017 05 31.
Artigo em Inglês | MEDLINE | ID: mdl-28482149

RESUMO

Copper nanowire networks are considered a promising alternative to indium tin oxide as transparent conductors. The fast degradation of copper in ambient conditions, however, largely overshadows their practical applications. Here, we develop the synthesis of ultrathin Cu@Au core-shell nanowires using trioctylphosphine as a strong binding ligand to prevent galvanic replacement reactions. The epitaxial overgrowth of a gold shell with a few atomic layers on the surface of copper nanowires can greatly enhance their resistance to heat (80 °C), humidity (80%) and air for at least 700 h, while their optical and electrical performance remained similar to the original high-performance copper (e.g., sheet resistance 35 Ω sq-1 at transmittance of ∼89% with a haze factor <3%). The precise engineering of core-shell nanostructures demonstrated in this study offers huge potential to further explore the applications of copper nanowires in flexible and stretchable electronic and optoelectronic devices.

15.
J Am Chem Soc ; 139(8): 3027-3032, 2017 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-28141927

RESUMO

In this work, we report a new, general synthetic approach that uses heat driven benzoin radicals to grow ultrathin copper nanowires with tunable diameters. This is the first time carbon organic radicals have been used as a reducing agent in metal nanowire synthesis. In-situ temperature dependent electron paramagnetic resonance (EPR) spectroscopic studies show that the active reducing agent is the free radicals produced by benzoins under elevated temperature. Furthermore, the reducing power of benzoin can be readily tuned by symmetrically decorating functional groups on the two benzene rings. When the aromatic rings are modified with electron donating (withdrawing) groups, the reducing power is promoted (suppressed). The controllable reactivity gives the carbon organic radical great potential as a versatile reducing agent that can be generalized in other metallic nanowire syntheses.

16.
Nano Lett ; 17(2): 1312-1317, 2017 02 08.
Artigo em Inglês | MEDLINE | ID: mdl-28094953

RESUMO

Copper is uniquely active for the electrocatalytic reduction of carbon dioxide (CO2) to products beyond carbon monoxide, such as methane (CH4) and ethylene (C2H4). Therefore, understanding selectivity trends for CO2 electrocatalysis on copper surfaces is critical for developing more efficient catalysts for CO2 conversion to higher order products. Herein, we investigate the electrocatalytic activity of ultrathin (diameter ∼20 nm) 5-fold twinned copper nanowires (Cu NWs) for CO2 reduction. These Cu NW catalysts were found to exhibit high CH4 selectivity over other carbon products, reaching 55% Faradaic efficiency (FE) at -1.25 V versus reversible hydrogen electrode while other products were produced with less than 5% FE. This selectivity was found to be sensitive to morphological changes in the nanowire catalyst observed over the course of electrolysis. Wrapping the wires with graphene oxide was found to be a successful strategy for preserving both the morphology and reaction selectivity of the Cu NWs. These results suggest that product selectivity on Cu NWs is highly dependent on morphological features and that hydrocarbon selectivity can be manipulated by structural evolution or the prevention thereof.


Assuntos
Dióxido de Carbono/química , Cobre/química , Técnicas Eletroquímicas/métodos , Hidrocarbonetos/química , Nanofios/química , Catálise , Eletrodos , Oxirredução , Tamanho da Partícula , Propriedades de Superfície
17.
Cell Physiol Biochem ; 40(3-4): 796-806, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27915346

RESUMO

BACKGROUND/AIMS: Keloids are fibrous overgrowths induced by cutaneous injury. MicroRNAs (miRNAs) have recently emerged as post-transcriptional gene repressors and participants in a diverse array of pathophysiological processes leading to skin disease. The purpose of the current study was to explore the precise functions of miR-181a in human keloid development and the underlying mechanisms. METHODS: A miRNA microarray analysis was performed to compare expression profiles between keloid and normal skin tissues. Quantitative real-time PCR was conducted to estimate miR-181a expression. Cell proliferation was determined using the cell counting kit-8 (CCK-8) and 5-ethynyl-2-deoxyuridine (EdU) assays, and cell cycle and apoptosis were detected with flow cytometry. Direct targets of miR-181a were identified using the luciferase reporter assay. RESULTS: miR-181a was significantly upregulated in human keloid tissues and fibroblasts, compared with their control counterparts. Overexpression of miR-181a enhanced keloid fibroblast DNA synthesis and proliferation and inhibited apoptosis, whereas miR-181a suppression triggered the opposite effects. Moreover, miR-181a suppressed the expression of PH domain leucine-rich repeat protein phosphatase 2 (PHLPP2) through direct interactions with its 3'UTR region and subsequently enhanced AKT activation. Overexpression of PHLPP2 without its 3'UTR attenuated the effects of miR-181a on cell proliferation and apoptosis in keloid fibroblast cells. Furthermore, miR-181a mimics increased normal skin fibroblast proliferation. CONCLUSIONS: Our results highlight a novel pathway mediated by miR-181a, which may be effectively used as a therapeutic target for treatment of keloids.


Assuntos
Apoptose/genética , Fibroblastos/metabolismo , Queloide/patologia , MicroRNAs/metabolismo , Fosfoproteínas Fosfatases/metabolismo , Proteínas Proto-Oncogênicas c-akt/metabolismo , Transdução de Sinais , Sequência de Bases , Proliferação de Células , DNA/biossíntese , Fibroblastos/patologia , Perfilação da Expressão Gênica , Humanos , MicroRNAs/genética , Regulação para Cima/genética
18.
Lancet ; 388(10054): 1893-1902, 2016 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-27542303

RESUMO

BACKGROUND: Delirium is a postoperative complication that occurs frequently in patients older than 65 years, and presages adverse outcomes. We investigated whether prophylactic low-dose dexmedetomidine, a highly selective α2 adrenoceptor agonist, could safely decrease the incidence of delirium in elderly patients after non-cardiac surgery. METHODS: We did this randomised, double-blind, placebo-controlled trial in two tertiary-care hospitals in Beijing, China. We enrolled patients aged 65 years or older, who were admitted to intensive care units after non-cardiac surgery, with informed consent. We used a computer-generated randomisation sequence (in a 1:1 ratio) to randomly assign patients to receive either intravenous dexmedetomidine (0·1 µg/kg per h, from intensive care unit admission on the day of surgery until 0800 h on postoperative day 1), or placebo (intravenous normal saline). Participants, care providers, and investigators were all masked to group assignment. The primary endpoint was the incidence of delirium, assessed twice daily with the Confusion Assessment Method for intensive care units during the first 7 postoperative days. Analyses were done by intention-to-treat and safety populations. This study is registered with Chinese Clinical Trial Registry, www.chictr.org.cn, number ChiCTR-TRC-10000802. FINDINGS: Between Aug 17, 2011, and Nov 20, 2013, of 2016 patients assessed, 700 were randomly assigned to receive either placebo (n=350) or dexmedetomidine (n=350). The incidence of postoperative delirium was significantly lower in the dexmedetomidine group (32 [9%] of 350 patients) than in the placebo group (79 [23%] of 350 patients; odds ratio [OR] 0·35, 95% CI 0·22-0·54; p<0·0001). Regarding safety, the incidence of hypertension was higher with placebo (62 [18%] of 350 patients) than with dexmedetomidine (34 [10%] of 350 patients; 0·50, 0·32-0·78; p=0·002). Tachycardia was also higher in patients given placebo (48 [14%] of 350 patients) than in patients given dexmedetomidine (23 [7%] of 350 patients; 0·44, 0·26-0·75; p=0·002). Occurrence of hypotension and bradycardia did not differ between groups. INTERPRETATION: For patients aged over 65 years who are admitted to the intensive care unit after non-cardiac surgery, prophylactic low-dose dexmedetomidine significantly decreases the occurrence of delirium during the first 7 days after surgery. The therapy is safe. FUNDING: Braun Anaesthesia Scientific Research Fund and Wu Jieping Medical Foundation, Beijing, China. Study drugs were manufactured and supplied by Jiangsu Hengrui Medicine Co, Ltd, Jiangsu, China.


Assuntos
Agonistas de Receptores Adrenérgicos alfa 2/uso terapêutico , Cuidados Críticos/métodos , Delírio/diagnóstico , Delírio/prevenção & controle , Dexmedetomidina/uso terapêutico , Prevenção Primária/métodos , Procedimentos Cirúrgicos Operatórios/efeitos adversos , Agonistas de Receptores Adrenérgicos alfa 2/administração & dosagem , Idoso , Analgésicos não Entorpecentes/uso terapêutico , China/epidemiologia , Confusão/diagnóstico , Confusão/etiologia , Confusão/prevenção & controle , Delírio/epidemiologia , Delírio/etiologia , Dexmedetomidina/administração & dosagem , Método Duplo-Cego , Esquema de Medicação , Medicina Baseada em Evidências , Feminino , Humanos , Incidência , Infusões Intravenosas , Unidades de Terapia Intensiva/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Respiração Artificial/efeitos adversos , Fatores de Tempo , Resultado do Tratamento
19.
Anesthesiology ; 125(5): 979-991, 2016 11.
Artigo em Inglês | MEDLINE | ID: mdl-27571256

RESUMO

BACKGROUND: Patients admitted to the intensive care unit (ICU) after surgery often develop sleep disturbances. The authors tested the hypothesis that low-dose dexmedetomidine infusion could improve sleep architecture in nonmechanically ventilated elderly patients in the ICU after surgery. METHODS: This was a pilot, randomized controlled trial. Seventy-six patients age 65 yr or older who were admitted to the ICU after noncardiac surgery and did not require mechanical ventilation were randomized to receive dexmedetomidine (continuous infusion at a rate of 0.1 µg kg h; n = 38) or placebo (n = 38) for 15 h, i.e., from 5:00 PM on the day of surgery until 8:00 AM on the first day after surgery. Polysomnogram was monitored during the period of study-drug infusion. The primary endpoint was the percentage of stage 2 non-rapid eye movement (stage N2) sleep. RESULTS: Complete polysomnogram recordings were obtained in 61 patients (30 in the placebo group and 31 in the dexmedetomidine group). Dexmedetomidine infusion increased the percentage of stage N2 sleep from median 15.8% (interquartile range, 1.3 to 62.8) with placebo to 43.5% (16.6 to 80.2) with dexmedetomidine (difference, 14.7%; 95% CI, 0.0 to 31.9; P = 0.048); it also prolonged the total sleep time, decreased the percentage of stage N1 sleep, increased the sleep efficiency, and improved the subjective sleep quality. Dexmedetomidine increased the incidence of hypotension without significant intervention. CONCLUSIONS: In nonmechanically ventilated elderly patients who were admitted to the ICU after noncardiac surgery, the prophylactic low-dose dexmedetomidine infusion may improve overall sleep quality.


Assuntos
Cuidados Críticos/métodos , Dexmedetomidina/farmacologia , Hipnóticos e Sedativos/farmacologia , Complicações Pós-Operatórias/prevenção & controle , Sono/efeitos dos fármacos , Método Duplo-Cego , Feminino , Humanos , Unidades de Terapia Intensiva , Masculino , Projetos Piloto
20.
Biochem Biophys Res Commun ; 474(2): 315-320, 2016 05 27.
Artigo em Inglês | MEDLINE | ID: mdl-27107696

RESUMO

Aberrant microRNAs (miRNAs) contribute to metastasis of various cancer types, including melanoma. miR-542-3p has been characterized as a tumor suppressor in several cancers. However, the exact expression patterns of miR-542-3p and the precise molecular mechanisms underlying its role in melanoma require further exploration. In the current study, we demonstrated that miR-542-3p is significantly downregulated in melanoma cell lines and clinical specimens. Exogenous expression of miR-542-3p resulted in marked inhibition of melanoma cell migration, invasion and epithelial-mesenchymal transition (EMT) in vitro and lung metastasis in vivo. The proto-oncogene serine/threonine protein kinase, PIM1, was identified as a direct target of miR-542-3p using luciferase reporter assay, qRT-PCR and western blot analyses. Overexpression of PIM1 partially rescued miR-542-3p-mediated suppression of cell migration, invasion and EMT. Our results collectively indicate that miR-542-3p serves as a metastasis suppressor in melanoma, supporting its utility as a promising therapeutic candidate.


Assuntos
Melanoma/metabolismo , Melanoma/secundário , MicroRNAs/metabolismo , Proteínas Proto-Oncogênicas c-pim-1/metabolismo , Neoplasias Cutâneas/metabolismo , Neoplasias Cutâneas/patologia , Animais , Biomarcadores Tumorais/metabolismo , Linhagem Celular Tumoral , Transição Epitelial-Mesenquimal , Humanos , Melanoma/patologia , Camundongos , Camundongos Endogâmicos C57BL , Invasividade Neoplásica
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