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1.
Front Pediatr ; 10: 860990, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35498770

RESUMO

Objective: To report a rare case of cystinosis with a novel CTNS pathogenic variant in the Chinese population. Methods: Retrospective analysis of the clinical manifestations, laboratory results, and gene detection data of a child with cystinosis. Results: A Chinese Zang ethnic girl could not stand or walk until 3 years old, with additional symptoms including a loss of appetite. Since then, the girl gradually exhibited "X" leg, double wrist joints, a bilateral ankle deformity, and rickets. At the age of 9 years, the girl was hospitalized. Laboratory testing showed that her blood phosphorus, blood calcium and blood potassium levels were significantly decreased. At the same time, the girl's urine glucose and urine protein were positive, although her fasting blood glucose, glycosylated hemoglobin, and 75 g glucose tolerance were not significantly abnormal. Further, blood gas analysis showed metabolic acidosis. These symptoms corresponded to Fanconi syndrome. Gene analysis showed that there was a homozygous pathogenic variant c.140 ≤ 5G > A (p.?) in the CTNS gene, which was a small variation in the intron region. To our knowledge, this is the first report of the rare variant. Conclusion: Attention should be paid to the differential diagnosis of cystinosis by gene analysis in children whose clinical manifestations include exercise dysplasia, renal damage, or multiple organ damage (including bone, thyroid, etc) and who cannot be firmly diagnosed for the time being.

2.
mSystems ; : e0029722, 2022 May 02.
Artigo em Inglês | MEDLINE | ID: mdl-35491831

RESUMO

Clostridium inhabiting pit mud (PM) is one of the important bacterial populations for synthesizing flavor compounds of Chinese strong-flavor baijiu. The long-term cereal fermentation with sorghum as the main raw material creates an environment rich in starch, ethanol, and organic acids (mainly lactic acid). However, the genetic factors underpinning Clostridium's adaptation to PM remain poorly understood. Here, we performed comparative genomic analysis between 30 pit mud-associated (PMA) and 100 non-pit mud-associated (NPMA) Clostridium strains. Comparison analysis of the enrichment of KEGG pathways between PMA and NPMA Clostridium strains showed two-component system, flagellar assembly, and bacterial chemotaxis pathways related to environmental adaptation were enriched in PMA strains. The number of genes encoding alcohol dehydrogenase and l-lactate dehydrogenase in PMA Clostridium strains was significantly higher than that in NPMA, which is helpful for them to adapt to the ethanol- and lactic acid-rich environment. The analysis of carbohydrate-active enzymes demonstrated that glycoside hydrolases (GHs) was the most abundant family in all Clostridium strains, and genes encoding GH4 and GH13, involved in starch and sucrose metabolism, were enriched in PMA Clostridium. Horizontal gene transfer analysis revealed that multiple genes encoding the enzymes involved in carbohydrate and amino acid metabolism were transferred from Bacillus to Clostridium in pit mud. Most of the PMA Clostridium strains had good potential for butyric acid synthesis from ethanol, lactic acid, and starch. Collectively, this study furthers our understanding of the habitat adaptation and metabolic potential of PMA Clostridium strains. IMPORTANCE Pit mud is a typical artificial ecosystem for Chinese liquor production. Clostridium inhabiting pit mud plays essential roles in the flavor formation of strong-flavor baijiu. The relative abundance of Clostridium increased with pit mud quality, further influencing the quality of baijiu. So far, the ecological adaptation of Clostridium to a pit mud-associated lifestyle is largely unknown. Here, comparative genomic analysis of pit mud-associated (PMA) and non-pit mud-associated (NPMA) Clostridium strains was performed. We found genes related to the metabolism of starch, ethanol, and lactic acid were enriched in PMA Clostridium strains, which facilitated their adaptation to the unique brewing environment. In addition, horizontal gene transfer contributed to the adaptation of Clostridium to pit mud. Our findings provide genetic insights on PMA Clostridium strains' ecological adaptation and metabolic characteristics.

3.
Mater Today Bio ; 14: 100253, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35464741

RESUMO

Retinal prostheses offer viable vision restoration therapy for patients with blindness. However, a critical requirement for maintaining the stable performance of electrical stimulation and signal transmission is the biocompatibility of the electrode interface. Here, we demonstrated a functionalized electrode-neuron biointerface composed of an annealed graphene oxide-collagen (aGO-COL) composite and neuronal cells. The aGO-COL exhibited an electroactive 3D crumpled surface structure and enhanced the differentiation efficiency of PC-12 â€‹cells. It is integrated into a photovoltaic self-powered retinal chip to develop a biohybrid retinal implant that facilitates biocompatibility and tissue regeneration. Moreover, aGO-COL micropatterns fabricated via 3D bioprinting can be used to create neuronal cell microarrays, which supports the possibility of retaining the high spatial resolution achieved through electrical stimulation of the retinal chip. This study paves the way for the next generation of biohybrid retinal implants based on biointerfaces.

4.
Metab Brain Dis ; 2022 Apr 30.
Artigo em Inglês | MEDLINE | ID: mdl-35488942

RESUMO

Machado-Joseph disease (MJD), also known as spinocerebellar ataxia type 3 (SCA3), is an autosomal dominant neurodegenerative disease. This disorder is caused by polyglutamine (polyQ)-containing mutant ataxin-3, which tends to misfold and aggregate in neuron cells. We previously demonstrated a protective function of carbonic anhydrase 8 (CA8) in MJD disease models and a decreased glycolytic activity associated with down-regulated CA8 in a human osteosarcoma (OS) cell model. Given that a reduction in body weight accompanied by gait and balance instability was observed in MJD patients and transgenic (Tg) mice, in this study, we aimed to examine whether metabolic defects are associated with MJD and whether CA8 expression is involved in metabolic dysfunction in MJD. Our data first showed that glucose uptake ability decreases in cells harboring mutant ataxin-3, but increases in cells overexpressing CA8. In addition, the expressions of glucose transporter 3 (GLUT3) and phosphofructokinase-1 (PFK1) were significantly decreased in the presence of mutant ataxin-3. Consistently, immunohistochemistry (IHC) showed that GLUT3 was less expressed in cerebella of aged MJD Tg mice, indicating that the dysfunction of GLUT3 may be associated with late-stage disease. On the other hand, transient down-regulation of CA8 revealed decreased expressions of GLUT3 and PFK1 in HEK293 cells harboring wild-type (WT) ataxin-3, but no further reduction of GLUT3 and PFK1 expressions were observed in HEK293 cells harboring mutant ataxin-3. Moreover, immunoprecipitation (IP) and immunofluorescence (IF) demonstrated that interactions exist between ataxin-3, CA8 and GLUT3 in MJD cellular and Tg models. These lines of evidence suggest that CA8 plays an important role in glucose metabolism and has different impacts on cells with or without mutant ataxin-3. Interestingly, the decreased relative abundance of Firmicutes/Bacteroidetes (F/B) ratio in the feces of aged MJD Tg mice coincided with weight loss and metabolic dysfunction in MJD. Taken together, our results are the first to demonstrate the effects of CA8 on glucose metabolism and its involvement in the metabolic defects in MJD disease. Further investigations will be required to clarify the underlying mechanisms for the metabolic defects associated with MJD.

5.
Front Pharmacol ; 13: 857361, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35450037

RESUMO

Background: Damp-heat jaundice syndrome (DHJS) is a diagnostic model of traditional Chinese medicine (TCM) that refers to jaundice caused by damp-heat pathogen invasion. DHJS is the most common clinical manifestation of TCM, with yellow skin, yellow eyes and anorexia. ZhiziBaipi Decoction (ZBD) is a classic TCM formula that is effective at treating DHJS and various liver diseases. However, the effective components of ZBD in the context of DHJS and the underlying mechanism are unclear. Purpose: This study of ZBD using the DHJS rat model aimed to elucidate the pathobiology of DHJS and the metabolic targets of therapeutic ZBD, construct the network relationship between the components of ZBD and endogenous biomarkers, and clarify the underlying mechanism of ZBD in preventing and treating DHJS. Methods: Using chinmedomics as the core strategy, an animal model was generated, and the therapeutic effect of ZBD was evaluated based on behavioral, histopathological and biochemical indicators. Metabonomics tools were used to identify biomarkers of DHJS, TCM-based serum pharmacochemistry was used to analyze the effective constituents of ZBD, and chinmedomics technology was used to identify ZBD components highly related to DHJS biomarkers. Results: A total of 42 biomarkers were preliminarily identified, and ZBD significantly affected the levels of 29 of these biomarkers. A total of 59 compounds in ZBD were characterized in vivo. According to chinmedomics analysis, the highly correlated components found in blood were isoformononetin, 3-O-feruloylquinic acid, glycyrrhizic acid, oxyberberine, obaculactone and five metabolites. Conclusions: Chinmedomics combined with UPLC-MS/MS was used to study the targets and effective constituents of ZBD for the treatment of DHJS.

6.
Methods ; 2022 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-35436513

RESUMO

As a common cause of hydronephrosis in children, ureteropelvic junction obstruction (UPJO) may lead to a series of progressive renal dysfunction. Ultrasonography is a primary screening of UPJO, yet its further examinations are laborious, time-consuming, and mostly radioactive. The deep learning based automatic diagnosis algorithms on UPJO or hydronephrosis ultrasound images are still rare and performance remains unsatisfactory owning to limitation of manually identified region of interest, small dataset and labels from single institution. To relieve the burden of children, parents, and doctors, and avoid wasting every bit information in all datasets, we hence designed a deep learning based mutual promotion model for the auto diagnosis of UPJO. This model consists of a semantic segmentation section and a classification section, they shared a mutual usage of a transformation structure by separately training the encoder and decoder and loop this circle. Thorough comparative experiments are conducted and situations are explored by ablation experiments, results shown our methods outperformed classic networks with an accuracy of 0.891 and an F1-score of 0.895. Our design can jointly utilize different supervisions and maximize the use of all the characteristics of each dataset, and automatically diagnose the severity of UPJO on the basis of ultrasound images by first segmentate then classify the images, moreover, not only is the final result excellent, but also the midway segmentation result is also very accurate and have smooth edges that are convenient for doctors to recognize with their naked eyes. All in all, our proposed method can be an important auxiliary tool for smart healthcare.

7.
Cell Rep ; 39(3): 110724, 2022 04 19.
Artigo em Inglês | MEDLINE | ID: mdl-35443189

RESUMO

PTEN is known as a tumor suppressor and plays essential roles in brain development. Here, we report that PTEN in primary sensory neurons is involved in processing itch and thermal information in adult mice. Deletion of PTEN in the dorsal root ganglia (DRG) is achieved in adult Drg11-CreER: PTENflox/flox (PTEN CKO) mice with oral administration of tamoxifen, and CKO mice develop pathological itch and elevated itch responses on exposure to various pruritogens. PTEN deletion leads to ectopic expression of TRPV1 and MrgprA3 in IB4+ non-peptidergic DRG neurons, and the TRPV1 is responsive to capsaicin. Importantly, the elevated itch responses are no longer present in Drg11-CreER: PTENflox/flox: TRPV1flox/flox (PTEN: TRPV1 dCKO) mice. In addition, thermal stimulation is enhanced in PTEN CKO mice but blunted in dCKO mice. PTEN-involved regulation of itch-related gene expression in DRG neurons provides insights for understanding molecular mechanism of itch and thermal sensation at the spinal level.


Assuntos
Prurido , Canais de Cátion TRPV , Animais , Capsaicina/farmacologia , Gânglios Espinais/metabolismo , Camundongos , Camundongos Endogâmicos C57BL , Prurido/patologia , Células Receptoras Sensoriais/metabolismo , Canais de Cátion TRPV/genética , Canais de Cátion TRPV/metabolismo
8.
Pathol Res Pract ; 233: 153879, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35405623

RESUMO

BACKGROUND: Colorectal cancer (CRC) is a familiar malignancy accompanied by higher morbidity and mortality. The deubiquitination enzyme USP20 has been discovered to be one key factor in several cancers progression. SOX4 is a critical transcription factor to regulate the expression of various genes, and participates into the occurrence and progression of cancers. In this study, it was aimed to illustrate the role of USP20 and the regulatory relationship between USP20 and SOX4 in CRC. METHODS: The protein expressions of USP20, SOX4, E-cadherin, N-cadherin, Snail and slug were tested through western blot. The cell proliferation ability was verified through CCK-8 assay. The migration and invasion abilities were detected through Transwell assay. The mRNA expression of SOX4 was confirmed through RT-qPCR. The interaction between USP20 and SOX4 was notarized through Co-IP assay. RESULT: Our study demonstrated that USP20 displayed higher expression, and facilitated CRC progression through regulating cell proliferation, migration, invasion and EMT process markers. USP20 was found to modulate SOX4 protein expression. Next, it was verified that USP20 regulated SOX4 degradation through deubiquitination. Finally, through rescue assays, we revealed that USP20 mediated SOX4 expression to accelerate CRC progression. CONCLUSIONS: In this study, USP20 regulated the stability of EMT transcription factor SOX4 and aggravated colorectal cancer metastasis. This finding might highlight the function of USP20 in the treatment of CRC.


Assuntos
Neoplasias Colorretais , Fatores de Transcrição , Western Blotting , Proliferação de Células , Neoplasias Colorretais/genética , Regulação da Expressão Gênica , Humanos , Fatores de Transcrição SOXC/genética , Ubiquitina Tiolesterase
9.
Colloids Surf B Biointerfaces ; 215: 112473, 2022 Mar 23.
Artigo em Inglês | MEDLINE | ID: mdl-35367745

RESUMO

The aim of this study is to develop a dual-functional ingredient with antioxidant activity and emulsification. The emulsion stability of ovalbumin (OVA) was improved by procyanidins (PC). The interactions between OVA and PC were investigated using multi-spectroscopy and molecular docking. Furthermore, the effect of the addition of the OVA-PC mixture on emulsion stability was evaluated as well. The fluorescence results showed that the quenching mechanism of PC to OVA's endogenous fluorescence was static quenching, and the binding ratio of OVA and PC was 1:1. Circular dichroism (CD) and Fourier Transform Infrared Spectrometer (FT-IR) showed that the addition of PC promoted the unfolding of OVA, and transformed the secondary structure of OVA from α-helix to ß-sheet. The main driving force of OVA and PC was hydrogen bonding, according to molecular docking analysis. Among all the samples, the stability of the emulsion of OVA-PC at a ratio of 1:30 exhibited extremely high stability and the smallest particle size. In comparison with individual OVA emulsions, the OVA-PC emulsions had excellent physical stabilities. Meanwhile, the oxidation degree of protein and oil for the OVA-PC emulsions was lower than that of the native OVA emulsion after 8-day storage. Our work provides important insights for understanding the interaction between OVA and expanding the application of OVA-PC.

10.
Int J Appl Comput Math ; 8(2): 87, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35372640

RESUMO

The aim of this paper is to provide a deep learning based method that can solve high-dimensional Fredholm integral equations. A deep residual neural network is constructed at a fixed number of collocation points selected randomly in the integration domain. The loss function of the deep residual neural network is defined as a linear least-square problem using the integral equation at the collocation points in the training set. The training iteration is done for the same set of parameters for different training sets. The numerical experiments show that the deep learning method is efficient with a moderate generalization error at all points. And the computational cost does not suffer from "curse of dimensionality" problem.

11.
J Hazard Mater ; 434: 128895, 2022 Apr 11.
Artigo em Inglês | MEDLINE | ID: mdl-35429752

RESUMO

Microplastics (MPs) are ubiquitous in aquatic environments, which are important carriers of emerging contaminants (ECs). Biofilms can be attached to the surface of MPs in a natural aquatic environment, which may influence chemical adsorption; however, knowledge of its impact is still limited. This study investigated the effect of biofilms on MPs on the adsorption of ECs through field-laboratory exposure experiments. Three types of MPs were naturally colonized with biofilms in lake. Then, biofilm-absent/biofilm-attached MPs were exposed to nine EC solutions at a concentration of 8 µg/L of each compound in laboratory. Most compounds exhibited 3.8 times lower concentrations on biofilm-attached MPs than on biofilm-absent MPs; only a few compounds showed enhanced adsorption. Pseudo-equilibrium was achieved within 72 h based on adsorption kinetics, implying fast adsorption of ECs on biofilm-attached MPs. The partition coefficients (Kd) for biofilm-attached MPs were 0.14 (diclofenac) to 535 (miconazole) L/kg and were positively correlated with octanol/water partition coefficients (Kow). This indicated that chemical properties (such as Kow) of the compounds determined their final adsorption amounts on MPs, although these were influenced by the presence of the biofilm. Hence, multiple influencing factors should be considered when evaluating the carrier potential of MPs for ECs in aquatic environments.

12.
Metab Brain Dis ; 2022 Apr 21.
Artigo em Inglês | MEDLINE | ID: mdl-35445959

RESUMO

Schizophrenia stands out as one of the most devastating psychiatric disorders. Previous findings have shown that schizophrenia is a polygenic genetic disorder. Thus, abnormal neurodevelopment and neurogenesis may be associated with the etiology of schizophrenia, so genes which affect these processes may be potential candidate genes of schizophrenia. Mitogen-activated protein kinase kinase kinase 4 (MAP3K4) gene is a member of the mitogen-activated protein kinase family. Taking into account previous findings, MAP3K4 plays a crucial role in the fundamental pathology of various nervous system diseases. In the present study, we aim to explore the association of MAP3K4 and schizophrenia in an independent case-control sample including 627 schizophrenic patients and 1175 healthy controls from a Northeast Chinese Han population. Both the allelic and genotypic association analyses showed that 6 SNPs in MAP3K4 were significantly associated with schizophrenia (rs590988, rs625977, rs9295134, rs12110787, rs1001808 and rs9355870). After rigorous Bonferroni correction, 4 SNPs (rs9295134, rs12110787, rs1001808 and rs9355870) were still significantly associated with the disease. The haplotype composed of these four SNPs also showed significantly global and individual association with schizophrenia. These results suggest that MAP3K4 is a susceptibility gene for schizophrenia in the Northeast Chinese Han population.

13.
Front Aging Neurosci ; 14: 808518, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35391750

RESUMO

Parkinson's disease (PD) is a common neurodegenerative disease. PD misdiagnosis can occur in early stages. Gait impairment in PD is typical and is linked with an increased fall risk and poorer quality of life. Applying machine learning (ML) models to real-world gait has the potential to be more sensitive to classify PD compared to laboratory data. Real-world gait yields multiple walking bouts (WBs), and selecting the optimal method to aggregate the data (e.g., different WB durations) is essential as this may influence classification performance. The objective of this study was to investigate the impact of environment (laboratory vs. real world) and data aggregation on ML performance for optimizing sensitivity of PD classification. Gait assessment was performed on 47 people with PD (age: 68 ± 9 years) and 52 controls [Healthy controls (HCs), age: 70 ± 7 years]. In the laboratory, participants walked at their normal pace for 2 min, while in the real world, participants were assessed over 7 days. In both environments, 14 gait characteristics were evaluated from one tri-axial accelerometer attached to the lower back. The ability of individual gait characteristics to differentiate PD from HC was evaluated using the Area Under the Curve (AUC). ML models (i.e., support vector machine, random forest, and ensemble models) applied to real-world gait showed better classification performance compared to laboratory data. Real-world gait characteristics aggregated over longer WBs (WB 30-60 s, WB > 60 s, WB > 120 s) resulted in superior discriminative performance (PD vs. HC) compared to laboratory gait characteristics (0.51 ≤ AUC ≤ 0.77). Real-world gait speed showed the highest AUC of 0.77. Overall, random forest trained on 14 gait characteristics aggregated over WBs > 60 s gave better performance (F1 score = 77.20 ± 5.51%) as compared to laboratory results (F1 Score = 68.75 ± 12.80%). Findings from this study suggest that the choice of environment and data aggregation are important to achieve maximum discrimination performance and have direct impact on ML performance for PD classification. This study highlights the importance of a harmonized approach to data analysis in order to drive future implementation and clinical use. Clinical Trial Registration: [09/H0906/82].

14.
RSC Adv ; 12(18): 11413-11419, 2022 Apr 07.
Artigo em Inglês | MEDLINE | ID: mdl-35425064

RESUMO

A single feature set is often unable to effectively classify complex biological samples due to their similar morphology and sizes. This paper proposes a protocol for the fast identification of seed medicinal materials based on micro-structural and infrared spectroscopic characteristics. Three different feature datasets, namely micro-CT, FTIR, and mixed datasets, were established via principal component analysis (PCA) and competitive adaptive reweighted sampling (CARS) and then used to train a back-propagation neural network. The mixed dataset consists of 34-dimensional micro-CT eigenvalues and 13-dimensional FTIR eigenvalues, optimized by PCA and CARS processing and then used to train a BP neural network. The results showed that the classification accuracy reached 89.5% for the micro-CT dataset and 93.3% for the FTIR dataset, and the classification accuracy of the mixed dataset achieved 99.2%, much higher than those of the traditional single feature datasets. This study provides a new protocol for multi-dimensional characteristic architecture with excellent performance for the classification and identification of Chinese medicinal materials.

15.
Front Neurosci ; 16: 795417, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35310098

RESUMO

Background: This study aimed to describe a synchronized intracranial electroencephalogram (EEG) recording and motion capture system, which was designed to explore the neural dynamics during walking of Parkinson's disease (PD) patients with freezing of gait (FOG). Preliminary analysis was performed to test the reliability of this system. Methods: A total of 8 patients were enrolled in the study. All patients underwent bilateral STN-DBS surgery and were implanted with a right subdural electrode covering premotor and motor area. Synchronized electrophysiological and gait data were collected using the Nihon Kohden EEG amplifier and Codamotion system when subjects performed the Timed Up and Go (TUG) test. To verify the reliability of the acquisition system and data quality, we calculated and compared the FOG index between freezing and non-freezing periods during walking. For electrophysiological data, we first manually reviewed the scaled (five levels) quality during waking. Spectra comprising broadband electrocorticography (ECoG) and local field potential (LFP) were also compared between the FOG and non-FOG states. Lastly, connectivity analysis using coherence between cortical and STN electrodes were conducted. In addition, we also use machine learning approaches to classified FOG and non-FOG. Results: A total of 8 patients completed 41 walking tests, 30 of which had frozen episodes, and 21 of the 30 raw data were level 1 or 2 in quality (70%). The mean ± SD walking time for the TUG test was 85.94 ± 47.68 s (range: 38 to 190.14 s); the mean ± SD freezing duration was 12.25 ± 7.35 s (range: 1.71 to 27.50 s). The FOG index significantly increased during the manually labeled FOG period (P < 0.05). The beta power of STN LFP in the FOG period was significantly higher than that in the non-FOG period (P < 0.05), while the band power of ECoG did not exhibit a significant difference between walking states. The coherence between the ECoG and STN LFP was significantly greater in high beta and gamma bands during the FOG period compared with the shuffled surrogates (P < 0.05). Lastly, STN-LFP band power features showed above-chance performance (p < 0.01, permutation test) in identifying FOG epochs. Conclusion: In this study, we established and verified the synchronized ECoG/LFP and gait recording system in PD patients with FOG. Further neural substrates underlying FOG could be explored using the current system.

16.
BMC Med Educ ; 22(1): 219, 2022 Mar 30.
Artigo em Inglês | MEDLINE | ID: mdl-35354454

RESUMO

BACKGROUND: Overseas study trips can enhance healthcare students' intercultural communication competence. An opportunity to immerse in the new culture enables them to develop their ability to offer services to people from different countries. However, the role that open-mindedness (i.e., a personality trait) can play in this process has not been explored. METHODS: The present study adopted a mixed-method design to identify how open-mindedness trait affected this overseas learning process. Thirty-two undergraduate healthcare students in Australia took part in the study. Questionnaires, which measured socio-demographic information, intercultural communication competence and open-mindedness trait were administered to the participants before and after their overseas trip. Half of the participants (n = 16) were interviewed after the overseas trip. RESULTS: The correlational analysis showed that the open-mindedness trait was correlated with cultural skills, a component of intercultural communication competence, but not significant with the other three components. Three themes emerging from the qualitative data indicated that the open-mindedness trait affected students' cultural exposure. This trait enabled participants to be actively involved in the immersion in the local culture. They were willing to learn from peer fellows, and keen to embrace novel challenges. CONCLUSION: It is concluded that open-mindedness trait is vital for increasing cultural immersion, and hence promote intercultural communication skills.


Assuntos
Competência Cultural , Atenção à Saúde , Austrália , Comunicação , Humanos , Inquéritos e Questionários
17.
World J Surg Oncol ; 20(1): 102, 2022 Mar 30.
Artigo em Inglês | MEDLINE | ID: mdl-35354489

RESUMO

BACKGROUND: To investigate the learning curve of conformal sphincter preservation operation (CSPO) in the treatment of ultralow rectal cancer and to further explore the influencing factors of operation time. METHODS: From August 2011 to April 2020, 108 consecutive patients with ultralow rectal cancer underwent CSPO by the same surgeon in the Department of Colorectal Surgery of Changhai Hospital. The moving average and cumulative sum control chart (CUSUM) curve were used to analyze the learning curve. The preoperative clinical baseline data, postoperative pathological data, postoperative complications, and survival data were compared before and after the completion of learning curve. The influencing factors of CSPO operation time were analyzed by univariate and multivariate analysis. RESULTS: According to the results of moving average and CUSUM method, CSPO learning curve was divided into learning period (1-45 cases) and learning completion period (46-108 cases). There was no significant difference in preoperative clinical baseline data, postoperative pathological data, postoperative complications, and survival data between the two stages. Compared with the learning period, the operation time (P < 0.05), blood loss (P < 0.05), postoperative flatus and defecation time (P < 0.05), liquid diet time (P < 0.05), and postoperative hospital stay (P < 0.05) in the learning completion period were significantly reduced, and the difference was statistically significant. Univariate and multivariate analysis showed that distance of tumor from anal verge (≥ 4cm vs. < 4cm, P = 0.039) and T stage (T3 vs. T1-2, P = 0.022) was independent risk factors for prolonging the operation time of CSPO. CONCLUSIONS: For surgeons with laparoscopic surgery experience, about 45 cases of CSPO are needed to cross the learning curve. At the initial stage of CSPO, beginners are recommended to select patients with ultralow rectal cancer whose distance of tumor from anal verge is less than 4 cm and tumor stage is less than T3 for practice, which can enable beginners to reduce the operation time, accumulate experience, build self-confidence, and shorten the learning curve on the premise of safety.


Assuntos
Procedimentos Cirúrgicos do Sistema Digestório , Laparoscopia , Neoplasias Retais , Humanos , Laparoscopia/métodos , Curva de Aprendizado , Duração da Cirurgia , Neoplasias Retais/cirurgia
18.
Oxid Med Cell Longev ; 2022: 1193734, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35265258

RESUMO

Background: Obesity and type 2 diabetes mellitus (DM) contribute to a higher mortality rate in patients with septic acute kidney injury (AKI) during sepsis. Reactive oxygen species (ROS) is the major injury factor for sepsis. This study was aimed at exploring the potential therapeutic drug for septic AKI targeting on ROS. Methods: A murine septic AKI model was established in both wild-type and high-fat diet-fed (HFD) mice. NADPH oxidase inhibitor Vas2870 was used in vivo to explore the role of NADPH oxidase in ROS release in septic AKI in diabetic mice. Ferrostatin-1 was administered to investigate the role of ferroptosis in ROS accumulation during NADPH oxidase activating in septic AKI in diabetic mice. Results: Compared to chow diet-fed mice, HFD diabetic mice which were subjected to LPS exhibited aggravated renal function (blood urea nitrogen, creatinine clearance, and serum cystatin C) and oxidative stress (malondialdehyde, 4-HNE, ROS, 8-OHdG, and NADPH oxidase), thus resulting in a higher mortality rate. Septic renal injury was significantly attenuated by the ferroptosis inhibitor Fer-1 in HFD-challenged mice. Furthermore, ferroptosis accumulation and related protein expression (ASCL4, FTH1, and GPX4) were altered by LPS stimulation in HFD-challenged mice and suppressed by NADPH oxidase inhibition via Vas2870 in vivo. In summary, NADPH inhibition restored septic renal function from injury by suppressing ferroptosis accumulation in HFD-challenged mice. Conclusion: These results suggest that targeting NADPH-mediated ROS release and ferroptosis accumulation is a novel therapeutic strategy to protect the kidney from septic injury in patients with obesity and type 2 DM.


Assuntos
Injúria Renal Aguda/terapia , Ferroptose/genética , NADPH Oxidases/antagonistas & inibidores , Espécies Reativas de Oxigênio/metabolismo , Sepse/terapia , Animais , Diabetes Mellitus Experimental , Humanos , Masculino , Camundongos
19.
J Neuroinflammation ; 19(1): 70, 2022 Mar 26.
Artigo em Inglês | MEDLINE | ID: mdl-35337341

RESUMO

BACKGROUND: The etiology of Rasmussen's encephalitis (RE), a rare chronic neurological disorder characterized by CD8+ T cell infiltration and unihemispheric brain atrophy, is still unknown. Various human herpes viruses (HHVs) have been detected in RE brain, but their contribution to RE pathogenesis is unclear. METHODS: HHVs infection and relevant immune response were compared among brain tissues from RE, temporal lobe epilepsy (TLE) and traumatic brain injury (TBI) patients. Viral antigen or genome, CD8+ T cells, microglia and innate immunity molecules were analyzed by immunohistochemical staining, DNA dot blot assay or immunofluorescence double staining. Cytokines were measured by multiplex flow cytometry. Cell apoptosis was visualized by TUNEL staining. Viral infection, immune response and the severity of unihemispheric atrophy were subjected to correlation analysis. RESULTS: Antigens of various HHVs were prevalent in RE and TLE brains, and the cumulative viral score of HHVs positively correlated with the unihemispheric atrophy in RE patients. CD8+ T cells infiltration were observed in both RE and TLE brains and showed co-localization with HHV antigens, but their activation, as revealed by Granzyme B (GZMB) release and apoptosis, was found only in RE. In comparison to TLE, RE brain tissues contained higher level of inflammatory cytokines, but the interferon-ß level, which was negatively correlated with cumulative viral score, was relatively lower. In line with this, the DNA sensor STING and IFI16, rather than other innate immunity signaling molecules, were insufficiently activated in RE. CONCLUSIONS: Compared with TBI, both RE and TLE had prevalently HHV infection and immune response in brain tissues. However, in comparison to TLE, RE showed insufficient activation of antiviral innate immunity but overactivation of cytotoxic T cells. Our results show the relatively lower level of antiviral innate immunity and overactivation of cytotoxic T cells in RE cases upon HHV infection, the overactivated T cells might be a compensate to the innate immunity but the causative evidence is lack in our study and need more investigation in the future.


Assuntos
Encefalite , Epilepsia do Lobo Temporal , Vírus , Encéfalo/metabolismo , Encefalite/patologia , Epilepsia do Lobo Temporal/patologia , Humanos , Interferon beta , Vírus/metabolismo
20.
J Clin Pharm Ther ; 2022 Mar 02.
Artigo em Inglês | MEDLINE | ID: mdl-35233796

RESUMO

WHAT IS KNOWN AND OBJECTIVE: This study aimed to explore methods to optimize the function of Drug and Therapeutics Committees (DTCs) in controlling irrational drug use. Clinical pharmacologists contribute their specific knowledge and skills to DTCs and help guide rational therapeutics. The DTC is the highest organization of hospital pharmacy management. METHODS: From January 2016 to August 2021, the DTC promoted the optimization of clinical drug treatment schemes and reduced unreasonable drug use by improving the organizational framework, clarifying the division of functions, regularly monitoring drug use, organizing expert comments, scientific decision-making and functional intervention. During this time, we statistically analysed typical management cases, irrational drug use and drug cost to evaluate the effectiveness of the DTC's management. RESULTS AND DISCUSSION: The DTC's intervention led to a significant reduction in prescribing errors (65.98%, p < 0.05); the intervention acceptance rate increased by 16.37%; and the rate of problem resolution increased by 45.84% (p < 0.05). The level of drug treatment was improved, and the proportion of patients' drug expenses was reduced. WHAT IS NEW AND CONCLUSION: The DTC carried out a series of continuous improvement work that played a significant normative role in clinical drug use. Giving more power to the DTCs can significantly improve the level of drug treatment and reduce unreasonable drug use, which reduces unnecessary drug expenses.

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