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1.
Reprod Biomed Online ; 2019 Aug 16.
Artigo em Inglês | MEDLINE | ID: mdl-31680062

RESUMO

RESEARCH QUESTION: Does oral contraceptive pretreatment impact IVF-embryo transfer cycle outcomes in women following the gonadotrophin-releasing hormone agonist (GnRHa) protocol? DESIGN: This retrospective study was designed to compare cycle outcomes after oral contraceptive pretreatment versus the standard protocol in women within the GnRHa long protocol or the GnRHa short protocol. A total of 2052 women undergoing their first IVF treatment with the GnRHa long protocol and 3557 women with the GnRHa short protocol between 2012 and 2017 were enrolled. RESULTS: No significant differences in the rates of clinical pregnancy (long protocol: 49.2% versus 46.7%; short protocol: 39.4% versus 38.0%) or live birth (long protocol: 44.3% versus 41.3%; short protocol: 32.8% versus 31.4%) after fresh embryo transfer were observed between the oral contraceptive group and the control group in either the long protocol or the short protocol. CONCLUSIONS: Oral contraceptive pretreatment has no effect on IVF outcomes in either the GnRHa long protocol or short protocol.

2.
Diabetologia ; 2019 Nov 05.
Artigo em Inglês | MEDLINE | ID: mdl-31690989

RESUMO

AIMS/HYPOTHESIS: Insulin resistance in skeletal muscle and liver plays a major role in the pathophysiology of type 2 diabetes. The hyperinsulinaemic-euglycaemic clamp is considered the gold standard for assessing peripheral and hepatic insulin sensitivity, yet it is a costly and labour-intensive procedure. Therefore, easy-to-measure, cost-effective approaches to determine insulin sensitivity are needed to enable organ-specific interventions. Recently, evidence emerged that plasma cathepsin D (CTSD) is associated with insulin sensitivity and hepatic inflammation. Here, we aimed to investigate whether plasma CTSD is associated with hepatic and/or peripheral insulin sensitivity in humans. METHODS: As part of two large clinical trials (one designed to investigate the effects of antibiotics, and the other to investigate polyphenol supplementation, on insulin sensitivity), 94 overweight and obese adults (BMI 25-35 kg/m2) previously underwent a two-step hyperinsulinaemic-euglycaemic clamp (using [6,6-2H2]glucose) to assess hepatic and peripheral insulin sensitivity (per cent suppression of endogenous glucose output during the low-insulin-infusion step, and the rate of glucose disappearance during high-insulin infusion [40 mU/(m2 × min)], respectively). In this secondary analysis, plasma CTSD levels, CTSD activity and plasma inflammatory cytokines were measured. RESULTS: Plasma CTSD levels were positively associated with the proinflammatory cytokines IL-8 and TNF-α (IL-8: standardised ß = 0.495, p < 0.001; TNF-α: standardised ß = 0.264, p = 0.012). Plasma CTSD activity was negatively associated with hepatic insulin sensitivity (standardised ß = -0.206, p = 0.043), independent of age, sex, BMI and waist circumference, but it was not associated with peripheral insulin sensitivity. However, plasma IL-8 and TNF-α were not significantly correlated with hepatic insulin sensitivity. CONCLUSIONS/INTERPRETATION: We demonstrate that plasma CTSD activity, but not systemic inflammation, is inversely related to hepatic insulin sensitivity, suggesting that plasma CTSD activity may be used as a non-invasive marker for hepatic insulin sensitivity in humans.

3.
Am J Chin Med ; 47(6): 1405-1418, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31488033

RESUMO

Baicalein (BAI) is a natural flavonoid. It has been shown that BAI has anticancer effects, but the molecular mechanism is still unclear. The aim of the current study was to confirm whether or not BAI triggers autophagy and induces AMPK activation in glioma U251 cells. The Ad-mcherry-GFP-LC3B adenovirus experiments indicated that BAI induces glioma cell autophagy. Western blotting showed that the level of LC3II expression increased with the time and concentration of BAI. Following treatment with chloroquine, the expression of LC3 was enhanced Immunofluorescence also confirmed this result. At the same time, cleaved caspase-3, DAPI staining, and JC-1 staining revealed that apoptosis was also induced in the induction of autophagy. In addition, we found that BAI activates phosphorylation of AMPK, which is further confirmed using compound C in this process. When the phosphorylation of AMPK was inhibited, autophagy, and apoptosis were also inhibited. In conclusion, BAI induces autophagy and apoptosis through AMPK pathway. Surprisingly, our research provides new insight with the function of anticancer of BAI, and the potential of the promotion in glioma cell apoptosis might be related to autophagy activation. These results demonstrate the anticancer activity of BAI, which can be used as potential therapeutic agents for cancer therapy.

4.
Mol Nutr Food Res ; 63(20): e1801380, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31378007

RESUMO

SCOPE: The anti-neuroinflammatory effect of a novel quinolyl-substituted analogue of resveratrol (RV01) on lipopolysaccharide (LPS)-induced microglial activation is investigated, as well as the possible underlying mechanisms. METHODS AND RESULTS: Cell viability is measured using an MTT assay. Nitric oxide (NO) release is determined by nitrite assay. The interaction between RV01 and inducible nitric oxide synthase (iNOS) is studied using molecular docking. Free radical scavenging activity and reactive oxygen species (ROS) production are determined by DPPH reduction assay and DCFH-DA assay. Pretreatment with RV01 (1-30 µm) prior to LPS (1 µg mL-1 ) stimulation decreased NO release and iNOS expression without observable cytotoxicity. RV01 reduced the mRNA levels and secretion of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6). RV01 also inhibited LPS-induced ROS production and nicotinamide adenine dinucleotide phosphate (NADPH) oxidase activation. Furthermore, RV01 decreases the protein expression of toll-like receptor 4 (TLR4) and inhibits the LPS-induced activation of the mitogen-activated protein kinase (MAPK) and nuclear transcription factor-κB (NF-κB) signaling pathways. Additionally, conditioned medium from microglia co-treated with LPS and RV01 alleviates the death of SH-SY5Y cells induced by conditioned medium from activated N9 microglial cells. Lastly, a mouse neuroinflammation model is further used to confirm the effect of RV01 in vivo. CONCLUSION: These results show that RV01 suppresses microglia-mediated neuroinflammation and protects neurons from inflammatory damage, which indicates that RV01 has great potential as a nutritional preventive strategy for neuroinflammation-related diseases.

5.
Biosci Rep ; 39(5)2019 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-31064817

RESUMO

Background: Circulating microRNAs (miRNA) are steady preserved in blood plasma. Multiple evidences have shown that miRNAs play a crucial role in cardiovascular disease including miRNA-378, which has been illustrated to participate in diverse physiological and pathological processes of cardiovascular disease. In the present study, we aim to explore the expression of plasma miRNA-378 and its clinical significance in patients with coronary artery disease (CAD).Methods: MiRNA-378 expression in blood plasma was performed by quantitative real-time PCR (qRT-PCR) in 215 CAD patients and 52 matched controls of healthy populations. Medical information of all patients including the results of coronary angiography (CAG) was acquired through hospital information system (HIS). Spearman's correlation, binary linear regression, and covariance analysis were used to examine the association between miRNA-378 and relative clinical risk factors. Receiver operating characteristic curve analysis was applied to evaluate the value of miRNA-378 in predicting the disease severity of coronary lesion.Results: Plasma miR-378 expression was significantly down-regulated in CAD patients compared with healthy controls. Relative miR-378 level was shown conversely correlated with Gensini score, which present the severity of coronary artery lesions. Moreover, it is indicated that miR-378 expression can effectively distinguish patients with or without coronary artery stenosis.Conclusions: Plasma miR-378 levels appear to be a promising non-invasive biomarker, but require to be further validated by a large cohort study in future.

6.
Oncol Lett ; 16(3): 3805-3811, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30127992

RESUMO

Programmed cell death 4 (PDCD4) has been recognized as a novel tumor suppressor gene, which inhibits the activation and translation of activator protein (AP)-1. Dysregulated expression of PDCD4 is also involved in various human tumors and is linked to tumor progression and development. However, the function and clinical implication of PDCD4 in giant cell tumors of the bone (GCTBs) has not been previously investigated. In the present study, PDCD4 expression was determined in 83 samples of GCTBs at mRNA and protein levels by quantitative reverse transcription-polymerase chain reaction, western blotting and immunohistochemistry. The results demonstrated that PDCD4 mRNA expression was reduced in 63% of GCTB samples (17/27) and protein expression was decreased in 65% of samples (54/83), compared with adjacent non-tumor tissues. Furthermore, decreased expression of PDCD4 was significantly associated with certain clinicopathological characteristics, including the Campanacci grade and recurrence. A strong negative correlation was determined between PDCD4 expression and the Ki-67 positive rate in GCTBs (r=-0.6392; P<0.001). The results of the present study suggest that PDCD4 may serve a role in the malignant progression of human GCTBs and may be an important prediction factor for prognosis.

7.
J Matern Fetal Neonatal Med ; : 1-6, 2018 Apr 12.
Artigo em Inglês | MEDLINE | ID: mdl-29649918

RESUMO

OBJECTIVE: To evaluate the impact of unicornuate uterus on perinatal outcomes after in vitro fertilization and/or intracytoplasmic sperm injection (IVF/ICSI) cycles. METHODS: We performed a retrospective cohort study including 160 women with unicornuate uterus and 1:1 matched controls with normally shaped uterus. They received IVF/ICSI treatment during January 2009 and December 2011. The perinatal outcomes were followed up till December 2014. RESULTS: There were no significant differences in pregnancy rate, clinical pregnancy rate or live birth rate (53.6 versus 52.7, 41.4 versus 43.5, 33.8% versus 31.8%) between unicornuate uterus group and controls. Their biochemical pregnancy rate (22.8 versus 17.5%) and miscarriage rate (16.0 versus 18.8%) were similar. No significant differences were identified in preterm birth rate (18.3 versus 11.8%), birthweight (3.24 ± 0.60 versus 3.33 ± 0.54 kg) or birth length (50.47 ± 2.33 versus 50.06 ± 2.40 cm) among the singletons. However, lower gestational age (35.56 ± 2.68 versus 36.71 ± 1.73, p = .019), higher preterm birth rate (55.0 versus 34.4%, p = .038), lower birthweight (2.33 ± 0.58 versus 2.69 ± 0.38 kg, p = .001), lower birth length (45.33 ± 2.46 versus 48.88 ± 2.06 cm, p = .000), as well as higher rate of very low birthweight (13.2% versus 0, p = .007) were found for the twins from unicornuate uterus group. CONCLUSIONS: The results indicated unimpaired pregnancy and perinatal outcomes for women with unicornuate uterus conceiving one fetus. However, close attention should be paid to twin pregnancy in unicornuate uterus owing to increased risks of prematurity and low birthweight. Selected single embryo transfer is recommended for women with unicornuate uterus undergoing IVF/ICSI cycles.

8.
Biosci Trends ; 12(1): 79-86, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29553106

RESUMO

One aim of the current study was to track end-of-life care using individual data in Shanghai, China to profile hospital costs for decedents and those for the entire population. A second aim of this study was to clarify the effect of proximity to death. Data from the Information Center of the Shanghai Municipal Commission of Health and Family Planning (SMCHFP) were examined. For decedents who died in medical facilities in 2015, inpatient care was tracked for 1 year before death. A total of 43,765 decedents were included in the study, accounting for 35% of total deaths in 2015 in Shanghai. Hospital costs were higher for people who died before the age of 45 (14,228.62 USD) than for those aged 90 or older (8,696.34 USD). The ratio of costs for decedents to the entire population declined significantly with age. Women received less care than men in the last year of life (t = -15.1244, p < 0.05). Average tertiary hospital costs per decedent declined significantly with age, whereas average secondary hospital costs increased slightly with age. Among the top 14 causes of death classified using the ICD-10, rectal cancer incurred the greatest costs (13,973 USD per decedent). Over 43% of hospital costs were incurred during the month before death. Declining costs in the last year of life with age as well as with distance to death demonstrate the existence of a proximity to death phenomenon in health care expenses. Disease-specific studies should be conducted and attention should be paid to gender equity when examining end-of-life medical costs in the future.


Assuntos
Custos Hospitalares , Assistência Terminal/economia , Fatores Etários , Idoso , Causas de Morte , China , Feminino , Instalações de Saúde , Humanos , Masculino
9.
Biosci Trends ; 12(1): 87-93, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29553107

RESUMO

The aim of this study was to use data from the Information Center of the Shanghai Municipal Commission of Health and Family Planning (SMCHFP) to determine the factors affecting end-of-life hospital costs of patients. A total number of 43,806 decedents who died in medical facilities in 2015 were examined. These individuals, accounted for 34.85% of all deaths in 2015 in Shanghai. Descriptive analysis and multiple linear regression analysis were performed using STATA 13.0. Results indicated that 88.94% of the decedents who died in medical facilities were over age 60. Males accounted for 55.57% of decedents, and the insured were mostly covered by Urban Employee Basic Medical Insurance (UEBMI) (81.93%). Cancer and circulatory disease were the main causes of death, causing 34.53% and 26.19% of deaths. Hospital costs were higher for males (male vs. female: 9,013 USD vs. 7,844 USD), individuals insured by UEBMI (8,784 USD), and individuals with cancer (10,156USD). Twenty-nine-point-zero-three percent of admissions occurred in the month before death and accounted for 37.82% of costs. Multiple linear regression analysis indicated that hospital costs were correlated with gender, cause of death (cancer, circulatory disease, or respiratory disease), time-to-death, insurance schemes, level of medical facilities, and length of stay (LOS) (p < 0.05 for all). After controlling for other factors, age was not a significant factor (p > 0.05). A proximity-to-death (PTD) phenomenon was evident in Shanghai. This study suggested that the PTD should be considered when predicting medical cost. Primary medical care should be enhanced and gaps in insurance coverage should be reduced to improve the efficiency and equity of medical funding. More attention should be paid to the population with a heavier disease burden.


Assuntos
Custos Hospitalares , Assistência Terminal/economia , Idoso , China , Feminino , Instalações de Saúde/economia , Humanos , Masculino , Análise de Regressão
10.
Biosci Trends ; 11(6): 619-631, 2018 Jan 09.
Artigo em Inglês | MEDLINE | ID: mdl-29225282

RESUMO

This study shed light on the amount and structure of utilization and medical expenses on Shanghai permanent residents based on big data, simulated lifetime medical expenses through combining of expenses data and life table model, and explored the dynamic pattern of aging on medical expenditures. 5 years were taken as the class interval, the study collected and did the descriptive analysis on the medical services utilization and medical expenses information for all ages of Shanghai permanent residents in 2015, simulated lifetime medical expenses by using current life table and cross-section expenditure data. The results showed that in 2015, outpatient and emergency visits per capita in the elderly group (aged 60 and over) was 4.1 and 4.5 times higher than the childhood group (aged 1-14), and the youth and adult group (aged 15-59); hospitalization per capita in the elderly group was 3.0 and 3.5 times higher than the childhood group, and the youth and adult group. People survived in the 60-64 years group, their expected whole medical expenses (105,447 purchasing power parity Dollar) in the rest of their lives accounted for 75.6% of their lifetime. A similar study in Michigan, US showed that the expenses of the population aged 65 and over accounted for 1/2 of lifetime medical expenses, which is much lower than Shanghai. The medical expenses of the advanced elderly group (aged 80 and over) accounted for 38.8% of their lifetime expenses, including 38.2% in outpatient and emergency, and 39.5% in hospitalization, which was slightly higher than outpatient and emergency. There is room to economize in medical expenditures of the elderly people in Shanghai, especially controlling hospitalization expenses is the key to saving medical expenses of elderly people aged over 80 and over.


Assuntos
Assistência Ambulatorial/estatística & dados numéricos , Serviços Médicos de Emergência/estatística & dados numéricos , Custos de Cuidados de Saúde/tendências , Gastos em Saúde/tendências , Hospitais/estatística & dados numéricos , Tábuas de Vida , Fatores Etários , China , Cidades , Bases de Dados Factuais , Custos de Cuidados de Saúde/estatística & dados numéricos , Gastos em Saúde/estatística & dados numéricos , Humanos
11.
Biomacromolecules ; 19(2): 555-562, 2018 02 12.
Artigo em Inglês | MEDLINE | ID: mdl-29284258

RESUMO

The clinical translation of protein drugs that act intracellularly is limited by the absence of safe and efficient intracellular protein delivery vehicles. Here, pH-sensitive coiled-coil peptide-cross-linked hyaluronic acid nanogels (HA-cNGs) were designed and investigated for targeted intracellular protein delivery to CD44 overexpressing MCF-7 breast cancer cells. HA-cNGs were obtained with a small size of 176 nm from an equivalent mixture of hyaluronic acid conjugates with GY(EIAALEK)3GC (E3) and GY(KIAALKE)3GC (K3) peptides, respectively, at pH 7.4 by nanoprecipitation. Circular dichroism (CD) proved the formation of coiled-coil structures between E3 and K3 peptides at pH 7.4 while fast uncoiling at pH 5.0. HA-cNGs showed facile loading of cytochrome C (CC) and greatly accelerated CC release under mild acidic conditions (18.4%, 76.8%, and 91.4% protein release in 24 h at pH 7.4, 6.0, and 5.0, respectively). Confocal microscopy and flow cytometry displayed efficient internalization of CC-loaded HA-cNGs and effective endosomal escape of CC in MCF-7 cancer cells. Remarkably, HA-cNGs loaded with saporin, a ribosome inactivating protein, exhibited significantly enhanced apoptotic activity to MCF-7 cells with a low IC50 of 12.2 nM. These coiled-coil peptide-cross-linked hyaluronic acid nanogels have appeared as a simple and multifunctional platform for efficient intracellular protein delivery.


Assuntos
Antineoplásicos , Neoplasias da Mama/tratamento farmacológico , Sistemas de Liberação de Medicamentos , Receptores de Hialuronatos/metabolismo , Ácido Hialurônico , Proteínas de Neoplasias/metabolismo , Peptídeos , Antineoplásicos/química , Antineoplásicos/farmacocinética , Antineoplásicos/farmacologia , Neoplasias da Mama/metabolismo , Neoplasias da Mama/patologia , Feminino , Géis , Humanos , Ácido Hialurônico/química , Ácido Hialurônico/farmacocinética , Ácido Hialurônico/farmacologia , Células MCF-7 , Peptídeos/química , Peptídeos/farmacocinética , Peptídeos/farmacologia
12.
Stroke Vasc Neurol ; 2(1): 7-14, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28959485

RESUMO

OBJECTIVE: The aim of this systematic review and meta-analysis was to provide evidence that biomarkers of large artery atherosclerosis, including arterial stenosis and greater carotid intima-media thickness (cIMT), may serve as clinical markers of subclinical haemorrhage-prone cerebral small vessel disease, reflected by cerebral microbleeds (CMBs). METHODS: We searched PubMed, MEDLINE, Web of Science, EMBASE and the Cochrane Library to identify relevant studies published before 1 July 2016. The association between arterial stenosis and CMBs was estimated by the OR and 95% CI. The association of cIMT and CMBs was calculated using the standardised mean difference (SMD). Heterogeneity and publication bias were explored. RESULTS: 8 studies including a total of 7160 participants were pooled in the meta-analysis. 6 of the included studies were cross-sectional, except that 2 were prospective. We found a significant association between arterial stenosis >50% and the presence of CMBs (OR 1.95, 95% CI 1.13 to 3.36, I2=56.1%). A fixed-effects model suggested that patients with CMBs were more likely to have a greater cIMT (SMD 0.20, 95% CI 0.11 to 0.28, I2=24.7%). CONCLUSIONS: This systematic review and meta-analysis found that there is a relationship between large artery atherosclerosis and CMBs. Future studies are needed to confirm the impact of atherosclerosis on the CMBs, which may have potential therapeutic implications.

14.
Gynecol Endocrinol ; 33(7): 560-563, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-28266227

RESUMO

Kisspeptin is a polypeptide that plays an important role in reproductive endocrine regulation. The aim of present study was to investigate the dynamic trend of kisspeptin levels during the menstrual cycle and to elucidate the relationship between kisspeptin ovulation. First, 15 female volunteers with regular menstrual cycles were recruited to detect the change in serum and urine kisspeptin levels over one menstrual cycle within each individual. Subsequently, 114 serum samples and 79 urine samples from 114 individuals were randomly collected at the outpatient department to better ascertain the results. Kisspeptin levels showed a distinctive stage-specific pattern during the normal menstrual cycle in both serum and urine. It was low during the first 5 days, while the first surge appeared on the 11th day (the diameter of the dominant follicle was approximately 1.2 cm). Later, a second smaller surge appeared around the 14th day and the same changes were identified in serum and urine. Furthermore, serum kisspeptin levels were positively related to 17-ß estradiol (E2) level increase. Thus, kisspeptin surge in serum and urine may be used as a marker for dominant follicle development and pre-ovulation. Moreover, kisspeptin may also play a vital role in female reproduction through regulating hormonal state.


Assuntos
Kisspeptinas/metabolismo , Ciclo Menstrual/metabolismo , Adulto , Biomarcadores/metabolismo , Estradiol/sangue , Feminino , Humanos , Kisspeptinas/sangue , Kisspeptinas/urina , Ciclo Menstrual/sangue , Ciclo Menstrual/urina , Reprodução/fisiologia , Adulto Jovem
15.
PLoS One ; 12(1): e0169837, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28121989

RESUMO

OBJECTIVE: To compare the risk of ectopic pregnancy (EP) after embryo transfer on day 3(D3-ET) and day 5(D5-ET). DESIGN: Meta-analysis. PATIENTS: Women with pregnancy resulting from in vitro undergoing in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI). RESULT(S): Twenty-two studies were identified through research conducted using the PubMed, Embase, and Cochrane databases and ClinicalTrials.gov. All studies were conducted prior to October 2016. Adding the reproductive data from our center, a total of 143 643 pregnancies were reviewed(D3-ET: n = 62027,D5-ET:n = 81616). A lower EP rate was found in women undergoing D5-ET than in those undergoing D3-ET [relative risk (RR), 0.67;95% confidence interval (CI), 0.54-0.85;143643 pregnancies in 23 studies; I2 = 67%]. These results were validated in subgroups of fresh embryo-transfer (Fre-ET) cycles [RR, 0.78; 95%CI, 0.69-0.88; 91 871 pregnancies in 21 studies; I2 = 29%] and frozen-thawed embryo-transfer (Fro-ET) cycles [RR, 0.43; 95%CI, 0.36-0.51; 51 772 pregnancies in 10 studies; I2 = 33%]. After separating out the randomized controlled trials (RCTs), a significant difference was found in the retrospective studies in both subgroups [both Fre-ET (RR,0.78;95% CI 0.69-0.88);91182 pregnancies in 14 studies; I2 = 45%] and Fro-ET(RR,0.43;95% CI 0.36-0.51; 51751pregnancies in 9 studies;I2 = 33%)], while the RCTs showed no statistical significance for Fre-ET cycles[RR,0.86;95% CI 0.32-2.26); 689 pregnancies in 7 studies; I2 = 0%]. CONCLUSION(S): The present study indicates that D5-ET reduces the risk for EP in cycles that use IVF or ICSI, compared with D3-ET. It suggests that D5-ET may be a better choice for decreasing the EP rate in assisted reproductive technology. Further high-quality randomized controlled trials are anticipated.


Assuntos
Transferência Embrionária/métodos , Fertilização In Vitro/métodos , Gravidez Ectópica/epidemiologia , Transferência Embrionária/efeitos adversos , Feminino , Fertilização In Vitro/efeitos adversos , Humanos , Incidência , Gravidez , Taxa de Gravidez , Gravidez Ectópica/etiologia , Fatores de Risco , Fatores de Tempo
16.
Gynecol Minim Invasive Ther ; 6(3): 103-107, 2017 Jul-Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30254890

RESUMO

Objective: To evaluate the effects of different treatment methods for previous ectopic pregnancies (EP) on cryopreserved embryo transfer (CET) outcomes. Materials and Methods: This was a retrospective cohort study. Patients with EP histories were divided into four groups based on their previous EP treatments: Group 1-unilateral tubal removal; Group: 2-bilateral tubal removal or unilateral tubal removal with contralateral tubal ligation; Group: 3-conservative surgery group; and Group 4-conservative medication group. A total of 1333 women with previous histories of being admitted to the hospital for CET treatment were consecutively enrolled between January 2009 and December 2014. Results: Patients who underwent bilateral tubal ligation or removal had a lower miscarriage rate [8.88% vs. 3.46%, p = 0.006, odds ratio = 2.718, 95% confidence interval (CI) = 1.301-5.677] than those who underwent unilateral tubal removal. No significant difference was observed in the rate of EP after CET in the four groups in women with EP histories. (p1 = 0.258, 95%CI = 0.113-1.836; p2 = 0.137, 95%CI = 0.975-0.997; p3 = 0.314, 95%CI = 0.987-1.001; p4 = 0.198, 95%CI = 0.987-1.001). The groups were not different with regard to other pregnancy outcomes. Conclusion: There was no significant difference among EP treatment methods with regard to their impacts on CET outcomes in women with EP histories. Bilateral tubal ligation or removal surgery can decrease the miscarriage rate after CET.

17.
Int J Nanomedicine ; 11: 5709-5727, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27843313

RESUMO

Targeted delivery by the folate ligand is an effective way to enhance an anti-breast carcinoma effect, due to its high affinity for the folate receptor, which is overexpressed in many tumor cells. In this study, we firstly synthesized a folic acid (FA)-targeted and polyethylene glycol (PEG)-modified TiO2 nanocarrier. Then, an FA-PEG-TiO2 nanoparticle (NP) codelivery system loaded with curcumin and salvianolic acid B were prepared by emulsion evaporation-solidification at low temperature. The obtained folate-targeted NPs (FA-NPs) showed more cytotoxicity on MCF7 cells and MDA-MB-231 cells than a nontargeted NP group. Apart from a synergistic anti-breast cancer effect with curcumin, salvianolic acid B protects the cardiovascular system from oxidative injury by the TiO2 nanocarrier. With coumarin 6 as a fluorescent probe to observe cellular uptake of NPs, the results of in vitro cellular uptake demonstrated FA-NPs exhibited higher cellular uptake and accumulation in MCF7 cells and MDA-MB-231 cells than nontargeted NPs. Then, in vivo biodistribution of NPs was further qualitatively and quantitatively confirmed by in vivo imaging. More importantly, the animal study further suggested that FA-NPs had significantly stronger antitumor effects via receptor-mediated targeted delivery. Consequently, FA-PEG-TiO2 NPs loaded with curcumin and salvianolic acid B could be a promising drug-delivery system to treat breast cancer.


Assuntos
Benzofuranos/farmacologia , Neoplasias da Mama/tratamento farmacológico , Curcumina/farmacologia , Sistemas de Liberação de Medicamentos/métodos , Ácido Fólico/metabolismo , Infarto do Miocárdio/tratamento farmacológico , Polietilenoglicóis/química , Titânio/toxicidade , Animais , Antineoplásicos/farmacologia , Neoplasias da Mama/patologia , Portadores de Fármacos/toxicidade , Feminino , Humanos , Células MCF-7 , Camundongos Endogâmicos BALB C , Camundongos Nus , Infarto do Miocárdio/induzido quimicamente , Infarto do Miocárdio/patologia , Nanopartículas/administração & dosagem , Nanopartículas/toxicidade , Distribuição Tecidual
18.
In Vivo ; 30(4): 479-83, 2016 Jul-Aug.
Artigo em Inglês | MEDLINE | ID: mdl-27381612

RESUMO

AIM: In the present study, a non-aqueous ibuprofen-phospholipid complex was developed to reduce the gastrointestinal (GI) toxicity of ibuprofen. MATERIALS AND METHODS: A non-aqueous ibuprofen-phospholipid complex (IBU-PC) was prepared by mixing phosal-35SB and ibuprofen. In vitro release behavior was studied using a dissolution apparatus. Irritation to gastrointestinal (GI) tract and pharmacokinetics of IBU-PC were studied in rats. RESULTS: Rapid release of drug occurred with approximately 85% of ibuprofen released from the composition within the first 30 min. The GI injury in IBU-PC-treated rats was minimal compared to those of Advil Liqui-gels-treated group. There was no significant difference between IBU-PC and Motrin-treated groups. The area under the concentration-time curve (AUC0~24) of IBU-PC and Motrin were 366±115 and 391±105 µg/h/ml, respectively. The relative bioavailability of IBU-PC was 94.2%. CONCLUSION: IBU-PC can decrease GI adverse reaction induced by ibuprofen.


Assuntos
Anti-Inflamatórios não Esteroides/farmacocinética , Composição de Medicamentos , Trato Gastrointestinal/metabolismo , Ibuprofeno/farmacocinética , Fosfolipídeos/química , Animais , Anti-Inflamatórios não Esteroides/química , Disponibilidade Biológica , Absorção Gastrointestinal , Ibuprofeno/química , Masculino , Ratos , Ratos Sprague-Dawley , Equivalência Terapêutica
19.
PLoS One ; 11(2): e0149593, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26900696

RESUMO

BACKGROUND: Enlarged perivascular spaces (EPVS) correlate with cognitive impairment and incident dementia. However, etiologies for severe basal ganglia EPVS (BG-EPVS) are still unclear. Our aim was to investigate the independent risk factors for severe BG-EPVS in patients with acute lacunar stroke. METHODS: We prospectively identified patients with lacunar stroke (diameter on DWI ≤ 20mm) from Jan 2011 to May 2015. Patients with severe BG-EPVS were identified on T2 weighted MRI. Age (± 1 year) and sex matched controls were also recruited in the same population (two controls for one case). Vascular risk factors, clinical data, EPVS in centrum semiovale (rated 0 to 4), white matter hyperintensities (WMH) (by Fazekas scale), brain atrophy (rated 0 to 6) were compared between two groups. Logistic regression was performed to determine independent risk factors for severe BG-EPVS. RESULTS: During study period, 89 patients with severe BG-EPVS and 178 matched controls were included. Vascular risk factors did not differ between two groups. Patients with severe BG-EPVS had lower level of HbA1c and diastolic BP at admission, but presented with larger infarct size, more severe WMH (including total WMH, periventricular WMH and deep WMH) and brain atrophy. In logistic regression, brain atrophy (OR = 1.40; 95%CI 1.13, 1.73) and deep WMH (OR = 1.88; 95%CI 1.24, 2.83) were independent risk factors for severe BG-EPVS. CONCLUSIONS: Brain atrophy and deep WMH are independent risk factors for severe BG-EPVS, supporting the hypothesis that brain atrophy may be associated with the development of EPVS in basal ganglia.


Assuntos
Gânglios da Base/patologia , Acidente Vascular Cerebral Lacunar/patologia , Idoso , Idoso de 80 Anos ou mais , Atrofia , Feminino , Humanos , Angiografia por Ressonância Magnética , Imagem por Ressonância Magnética , Masculino , Estudos Prospectivos , Fatores de Risco , Índice de Gravidade de Doença , Acidente Vascular Cerebral Lacunar/diagnóstico , Acidente Vascular Cerebral Lacunar/etiologia
20.
Fertil Steril ; 105(5): 1330-1337.e3, 2016 05.
Artigo em Inglês | MEDLINE | ID: mdl-26868993

RESUMO

OBJECTIVE: To investigate the expression and clinical significance of programmed cell death 4 (PDCD4), a novel metabolism-associated gene, during polycystic ovary syndrome (PCOS) pathogenesis. DESIGN: Case-control study. SETTING: University hospital. PATIENT(S): A total of 77 PCOS patients and 67 healthy women as matched controls. INTERVENTION(S): PDCD4 expression in peripheral blood mononuclear cells analyzed by quantitative real-time polymerase chain reaction, and apoptosis of granulosa cells (GCs) detected by flow cytometry, terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL), and small-interfering RNA. MAIN OUTCOME MEASURE(S): PDCD4 expression, body mass index (BMI), insulin 0, insulin 120, glucose 120, homeostasis model assessment for insulin resistance (HOMA-IR), homeostasis model assessment for ß-cell function (HOMA-ß), triglycerides, high-density lipoprotein (HDL), and GC apoptosis. RESULT(S): The PCOS patients had higher PDCD4 expression, but BMI was similar as matched with the obese group, which positively correlated with BMI, insulin 0, insulin 120, glucose 120, HOMA-IR, HOMA-ß, triglycerides and negatively correlated with HDL (P<.05). After metformin treatment, PDCD4 expression was distinctly down-regulated for the obese women with PCOS with insulin resistance. Compared with the healthy controls, the apoptosis percentage of GCs was higher in the PCOS group and was decreased by knocking down PDCD4. Furthermore, expression of proapotosis factor Bax and the Bax/Bcl-2 ratio were lower, whereas the expression of antiapoptosis factor Bcl-2 was increased. In a multivariate logistic regression analysis, the level of PDCD4 expression independently related to the odds of PCOS risk after controlling for estradiol and insulin 120 (odds ratio 1.318). CONCLUSION(S): Our study suggests for the first time that higher PDCD4 expression might play an important role in PCOS pathogenesis by affecting obesity, insulin resistance, lipid metabolism disorders, and GC apoptosis.


Assuntos
Proteínas Reguladoras de Apoptose/sangue , Células da Granulosa/metabolismo , Resistência à Insulina/fisiologia , Transtornos do Metabolismo dos Lipídeos/sangue , Obesidade/sangue , Síndrome do Ovário Policístico/sangue , Proteínas de Ligação a RNA/sangue , Apoptose/fisiologia , Proteínas Reguladoras de Apoptose/biossíntese , Proteínas Reguladoras de Apoptose/genética , Estudos de Casos e Controles , Feminino , Regulação da Expressão Gênica , Humanos , Transtornos do Metabolismo dos Lipídeos/diagnóstico , Transtornos do Metabolismo dos Lipídeos/genética , Obesidade/diagnóstico , Obesidade/genética , Síndrome do Ovário Policístico/diagnóstico , Síndrome do Ovário Policístico/genética , Proteínas de Ligação a RNA/biossíntese , Proteínas de Ligação a RNA/genética , Adulto Jovem
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