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1.
Biomed Res Int ; 2021: 1549712, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34734080

RESUMO

Background: The association between sleep disturbance and the menstruation in the young women population has been scarcely studied. The aim of this study is to assess the association between sleep status and phase of the menstrual cycle in healthy, young, ovulating women. Methods: This cross-sectional study used the data collected from healthy young, ovulating Chinese females from September to December 2018. The association was analyzed by using linear regression and binary logistic analyses. Results: 2260 women aged 17 to 30 were included in the analysis. The average sleep duration of the respondents was 7.24 hours (SD = 0.92). 61.7% of them admitted that they were accompanied by at least one of sleep symptoms including difficulty initiating sleep, difficulty maintaining sleep, dreaminess, early morning awakening, and somnolence. Sleep quality was significantly associated with dysmenorrhea (OR [95%CI] = 1.74 [1.40-2.17], P < 0.001) and self-awareness menstrual regularity (OR [95%CI] = 1.29 [1.06-1.56], P = 0.011). Conclusion: This study found that poor sleep quality is significantly associated with dysmenorrhea and self-awareness menstrual irregularity among healthy, young, ovulating, Chinese females.

2.
Environ Sci Technol ; 2021 Nov 09.
Artigo em Inglês | MEDLINE | ID: mdl-34751029

RESUMO

Ozone (O3) removal has important implications for environmental protection and human health, and Ag-Mn catalysts have shown promising O3 decomposition. Catalysts with Ag supported on porous cube-like α-Mn2O3 (Ag/Mn-C) with high utilization of Ag were prepared by the impregnation method and showed excellent O3 decomposition activity. Physicochemical characterizations demonstrated that metallic Ag nanoparticles (Agn0) were mainly anchored on manganese vacancies, forming Ag-O-Mn bonds between Agn0 and α-Mn2O3-C. The abundant manganese vacancies of α-Mn2O3-C can lead to Agn0 with a smaller particle size and more uniform dispersion, thereby resulting in markedly enhanced O3 decomposition performance compared to Agn0 with a large particle size and uneven distribution on rod-like α-Mn2O3 (Ag/Mn-R). Under a relative humidity of 65% and a space velocity of 1,110,000 h-1, the conversion of 40 ppm O3 over the 2%Ag/Mn-C catalyst within 6 h (98%) at 30 °C was more than twice as high as that of the 2%Ag/Mn-R catalyst (42%). The study provides guidance for the design of highly efficient Ag-based catalysts and the understanding of the microstructure of supported catalysts.

3.
Atmos Chem Phys ; 21(20): 15809-15826, 2021 Oct 22.
Artigo em Inglês | MEDLINE | ID: mdl-34804135

RESUMO

We compare Community Multiscale Air Quality (CMAQ) model predictions with measured nitrous acid (HONO) concentrations in Beijing, China for December 2015. The model with the existing HONO chemistry in CMAQ severely under-estimates the observed HONO concentrations with a normalized mean bias of -97%. We revise the HONO chemistry in the model by implementing six additional heterogeneous reactions in the model: reaction of nitrogen dioxide (NO2) on ground surfaces, reaction of NO2 on aerosol surfaces, reaction of NO2 on soot surfaces, photolysis of aerosol nitrate, nitric acid displacement reaction, and hydrochloric acid displacement reaction. The model with the revised chemistry substantially increases HONO predictions and improves the comparison with observed data with a normalized mean bias of -5%. The photolysis of HONO enhances day-time hydroxyl radical by almost a factor of two. The enhanced hydroxyl radical concentrations compare favourably with observed data and produce additional sulfate via the reaction with sulfur dioxide, aerosol nitrate via the reaction with nitrogen dioxide, and secondary organic aerosols via the reactions with volatile organic compounds. The additional sulfate stemming from revised HONO chemistry improves the comparison with observed concentration; however, it does not close the gap between model prediction and the observation during polluted days.

4.
Environ Sci Technol ; 2021 Nov 22.
Artigo em Inglês | MEDLINE | ID: mdl-34806377

RESUMO

The understanding at a molecular level of ambient secondary organic aerosol (SOA) formation is hampered by poorly constrained formation mechanisms and insufficient analytical methods. Especially in developing countries, SOA related haze is a great concern due to its significant effects on climate and human health. We present simultaneous measurements of gas-phase volatile organic compounds (VOCs), oxygenated organic molecules (OOMs), and particle-phase SOA in Beijing. We show that condensation of the measured OOMs explains 26-39% of the organic aerosol mass growth, with the contribution of OOMs to SOA enhanced during severe haze episodes. Our novel results provide a quantitative molecular connection from anthropogenic emissions to condensable organic oxidation product vapors, their concentration in particle-phase SOA, and ultimately to haze formation.

5.
J Nat Prod ; 84(11): 2937-2944, 2021 Nov 26.
Artigo em Inglês | MEDLINE | ID: mdl-34730370

RESUMO

Phrymarolin II, a furofuran lignan isolated from Phryma leptostachya L., features a 3,7-dioxabicyclo[3.3.0]octane skeleton. Herein, we report an alternative total synthesis of (±)-phrymarolin II (2), which was performed in 9 steps from commercially available sesamol. The key steps of the synthesis included a zinc-mediated Barbier-type allylation and a copper-catalyzed anomeric O-arylation. Our total synthesis allowed the synthesis of analogues of (±)-phrymarolin II. Most derivatives displayed good to excellent in vivo activity against tobacco mosaic virus (TMV). (±)-Phrymarolin II (2) and compounds (±)-31d and (±)-31g exhibited similar or higher activity than commercial ningnanmycin, which indicated that phrymarolin lignans are a promising new class of plant virus inhibitors.

6.
Front Microbiol ; 12: 749783, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34803970

RESUMO

We developed an ultrafast one-step RT-qPCR assay for SARS-CoV-2 detection, which can be completed in only 30 min on benchtop Bio-Rad CFX96. The assay significantly reduces the running time of conventional RT-qPCR: reduced RT step from 10 to 1 min, and reduced the PCR cycle of denaturation from 10 to 1 s and extension from 30 to 1 s. A cohort of 60 nasopharyngeal swab samples testing showed that the assay had a clinical sensitivity of 100% and a clinical specificity of 100%.

7.
Environ Sci Technol ; 2021 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-34779625

RESUMO

Cu-SSZ-39 exhibits excellent hydrothermal stability and is expected to be used for NOx purification in diesel vehicles. In this work, the selective catalytic reduction (SCR) activities in the presence or absence of NO2 were tested over Cu-SSZ-39 catalysts with different Cu contents. The results showed that the NOx conversion of Cu-SSZ-39 was improved by NO2 when NO2/NOx = 0.5, especially for the catalysts with low Cu loadings. The kinetic studies showed two kinetic regimes for fast SCR from 150 to 220 °C due to a change in the rate-controlling mechanism. The activity test and diffuse reflectance infrared Fourier transform spectra demonstrated that the reduction of NO mainly occurred on the Cu species in the absence of feed NO2, and when NO2/NO = 1, NO could react with NH4NO3 on the Brønsted acid sites in addition to undergoing reduction on Cu species. Thus, NO2 can promote the SCR reaction over Cu-SSZ-39 by facilitating the formation of surface nitrate species.

8.
Adv Mater ; : e2106677, 2021 Nov 03.
Artigo em Inglês | MEDLINE | ID: mdl-34729827

RESUMO

The optimization of MgO-based adsorbents as advanced CO2 capture materials is predominantly focused on their molten salt modification for which theoretical and experimental contributions provide great insights for their high CO2 -capture performance. The underlying mechanism of the promotion effect of the molten salt on CO2 capture, however, is a topic of controversy among several theoretical approaches. Herein, advanced experimental characterization techniques, including in situ eTEM, in situ CO2 -DRIFTS, transient 18 O-isotopic exchange, and Density Functional Theory are employed to elucidate the mechanism of CO2 interaction with molten salt-modified MgO in the 250-400 °C range. Herein, eTEM studies using low (2-3 mbar) and high (700 mbar) CO2 pressures illustrate the dynamic evolution of the molten NaNO3 salt-promoted and unpromoted MgO carbonation with high magnification (< 50 nm). The formation of 18 O-NaNO3 (use of 18 O2 ), and that of C16 O18 O following CO2 interaction, verifies for the first time the proposed theoretical (DFT) reaction path: Conversion of NO3 - (NO3 - → NO2 + + O2- ), adsorption of NO2 + on MgO with significant weakening of CO2 adsorption strength, and formation of [Mg2+ … O2- ] ion pairs preventing the development of an impermeable MgCO3 shell, which largely increases the rate of bulk MgO carbonation compared to the unmodified MgO. This article is protected by copyright. All rights reserved.

9.
BMC Oral Health ; 21(1): 559, 2021 Nov 02.
Artigo em Inglês | MEDLINE | ID: mdl-34727912

RESUMO

BACKGROUND: Antibodies to PD-1 and PD-L1 have remarkably improved the overall survival of many patients with advanced solid tumors. SHR-1210 is an anti-PD-1 monoclonal antibody. Dermatologic reactive capillary hemangiomas (RCH) were the most common and unique drug-related AEs of SHR-1210, but rare on oral mucosa and gastrointestinal mucosa. Herein we report a case of RCH occurred in oral mucosa during the clinical trials of SHR-1210 in the treatment of non-small cell lung cancer. CASE PRESENTATION: A male in his 60 s with a history of non-small cell lung cancer received injection of anti-PD-1 monoclonal antibodies SHR-1210. The patient developed drug-related RCH on skin after the first injection and began to have gingival hyperplasia one year after the first injection which gradually increased in size and affect eating and speaking. Anti-PD-1 treatments were continued. After periodontal treatment, two oral lesions and one skin lesion were surgically removed. Similar histological manifestation was found in all three lesions as reactive capillary hemangiomas. All lesions had a good prognosis without recurrence on oral mucosa within one year after surgery. CONCLUSIONS: Oral reactive capillary hemangiomas could be induced by SHR-1210 in the treatment of non-small cell lung cancer. Surgical resection is an effective treatment with a good prognosis.

10.
Disabil Rehabil ; : 1-16, 2021 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-34757862

RESUMO

PURPOSE: This systematic review and meta-analysis aims to synthesise the evidence of the effectiveness of self-management interventions with action-taking components in improving self-efficacy, health-related quality of life, basic and instrumental activities of daily living, and depression for adult stroke survivors. MATERIALS AND METHODS: Nine electronic databases were searched for relevant studies, including grey literature and ongoing studies. Randomised controlled trials targeting adult stroke survivors comparing health-related outcomes of patients receiving self-management interventions with action-taking components to usual care, placebo, or no-treatment were included. Screening, data extraction, and methodological quality assessment were conducted by two reviewers. Meta-analyses were performed. Overall quality of evidence was assessed using the GRADE tool. RESULTS: A total of seventeen studies were included. Meta-analyses showed that the intervention may result in a slight increase in self-efficacy (SMD = 0.29, 95% CI [0.07-0.52], p = 0.010, I2 = 47%) and basic activities of daily living (SMD = 0.31, 95% CI [0.16-0.46], p < 0.001, I2 = 0%), but not for the other outcomes. CONCLUSIONS: Self-management interventions with action-taking components may result in a slight improvement in self-efficacy and rehabilitation of basic activities of daily living. Future research should investigate which core self-management skill, or combination of them, is most effective in improving short-term and long-term outcomes.IMPLICATIONS FOR REHABILITATIONStroke can be a chronic condition as approximately half of stroke survivors suffer from permanent disabilities.Self-management interventions are one form of rehabilitation programmes available to stroke survivors.Self-management interventions with action-taking components may result in a slight increase in patient self-efficacy and carrying out basic activities of daily living compared to usual care given.

11.
Front Cell Infect Microbiol ; 11: 739496, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34778103

RESUMO

Diutina catenulata (Candida catenulata) is an ascomycete yeast species widely used in environmental and industrial research and capable of causing infections in humans and animals. At present, there are only a few studies on D. catenulata, and further research is required for its more in-depth characterization and analysis. Eleven strains of D. catenulata collected from China Hospital Invasive Fungal Surveillance Net (CHIF-NET) and the CHIF-NET North China Program were identified using matrix-assisted laser desorption ionization-time of flight mass spectrometry and internal transcribed spacer sequencing. The antifungal susceptibility of the Diutina catenulata strains was tested using the Clinical and Laboratory Standards Institute broth microdilution method and Sensititre YeastOne™. Furthermore, ERG11 and FKS1 were sequenced to determine any mutations related to azole and echinocandin resistance in D. catenulata. All isolates exhibited low minimum inhibitory concentration (MIC) values for itraconazole (0.06-0.12 µg/ml), posaconazole (0.06-0.12 µg/ml), amphotericin B (0.25-1 µg/ml), and 5-flucytosine (range, <0.06-0.12 µg/ml), whereas four isolates showed high MICs (≥4 µg/ml) for echinocandins. Strains with high MIC values for azoles showed common ERG11 mutations, namely, F126L/K143R. In addition, L139R mutations may be linked to high MICs of fluconazole. Two amino acid alterations reported to correspond to high MIC values of echinocandin, namely, F621I (F641) and S625L (S645), were found in the hot spot 1 region of FKS1. In addition, one new amino acid alteration, I1348S (I1368), was found outside of the FKS1 hot spot 2 region, and its contribution to echinocandin resistance requires future investigation. Diutina catenulata mainly infects patients with a weak immune system, and the high MIC values for various antifungals exhibited by these isolates may represent a challenge to clinical treatment.


Assuntos
Antifúngicos , Farmacorresistência Fúngica , Antifúngicos/farmacologia , Antifúngicos/uso terapêutico , Candida , Humanos , Testes de Sensibilidade Microbiana , Saccharomycetales
12.
Environ Sci Technol ; 55(22): 15063-15071, 2021 11 16.
Artigo em Inglês | MEDLINE | ID: mdl-34705458

RESUMO

Atmospheric hydrogen peroxide (H2O2), as an important oxidant, plays a key role in atmospheric sulfate formation, affecting the global radiation budget and causing acid rain deposition. The disproportionation reactions of hydroperoxyl radicals (HO2) in both gas and aqueous phases have long been considered as dominant sources for atmospheric H2O2. However, these known sources cannot explain the significant formation of H2O2 in polluted areas under the conditions of high NO levels and low ambient relative humidity (RH). Here, we show that under relatively dry conditions during daytime, atmospheric fine particles directly produce abundant gas-phase H2O2. The formation of H2O2 is verified to be by a reaction between the particle surface -OH group and HO2 radicals formed by photooxidation of chromophoric dissolved organic matters (CDOMs), which is slightly influenced by the presence of high NO levels but remarkably accelerated by water vapor and O2. In contrast to aqueous-phase chemistry, transition metal ions (TMIs) are found to significantly suppress H2O2 formation from the atmospheric fine particles. The H2O2 formed from relatively dry particles can be directly involved in in situ SO2 oxidation, leading to sulfate formation. As CDOMs are ubiquitous in atmospheric fine particles, their daytime photochemistry is expected to play important roles in formation of H2O2 and sulfate worldwide.


Assuntos
Peróxido de Hidrogênio , Sulfatos , Aerossóis , Oxirredução , Fotoquímica
13.
Ying Yong Sheng Tai Xue Bao ; 32(8): 2666-2674, 2021 Aug.
Artigo em Chinês | MEDLINE | ID: mdl-34664438

RESUMO

Cover crops are grown in temporal and spatial gaps of agricultural production to reduce or avoid soil exposure. As it can protect farmland soil from wind erosion, water erosion and human disturbance, planting cover crops is considered as a new type of conservation tillage practice. Here, we briefly introduced the planting management of cover crops, including crop species, planting modes, and the returning to farmland after their termination, which could provide a reference for efficiently planting cover crops at large scale during the fallow period. Based on domestic and foreign studies, we summarized the benefits of cover crops on agroecosystem, including cash crops, soil quality, weed control, greenhouse gas emission, and soil microbes. Our review illustrated their importance in improving soil quality and achieving sustainable agricultural development, despite the limitation of cover crops, including unobvious benefits in the short-term and the reduction of crop yield caused by improper management.


Assuntos
Gases de Efeito Estufa , Solo , Agricultura , Produtos Agrícolas , Humanos
14.
Ying Yong Sheng Tai Xue Bao ; 32(8): 2675-2684, 2021 Aug.
Artigo em Chinês | MEDLINE | ID: mdl-34664439

RESUMO

Agricultural tillage practices significantly affect the structure and function of soil micro-bial community, as well as its control over soil carbon cycling. Conservation tillage practice based on no-tillage and crop straw returning is an important measure to improve soil carbon sequestration and fertility, in which soil microorganisms play a key role. Although many previous studies focus on the structure and function of microbial communities under conservation tillage, our overall understanding of soil microbial responses at community level upon conservation tillage is still lacking, due to the complexity of the soil, environmental factors and the different selections of microbial research methods. Furthermore, previous studies paid more attention to the role of soil microorganisms as decomposers and the contribution of plant-derived carbon to the formation of soil carbon pool, but ignored the contribution of microbial-derived carbon to the formation and stability of soil carbon pool. We summarized the paradigm shift in soil organic matter formation and stability theories, reviewed the research methods of soil microbial community, focused on the effects of conservation tillage on soil microbial biomass, community diversity and composition, carbon metabolism, as well as microbial-derived carbon storage, and proposed suggestions for future study, aiming to provide support for future studies regarding microbial responses and its control over soil carbon dynamics in agroecosystem.


Assuntos
Microbiota , Solo , Agricultura , Carbono , Microbiologia do Solo
15.
Ying Yong Sheng Tai Xue Bao ; 32(8): 2685-2692, 2021 Aug.
Artigo em Chinês | MEDLINE | ID: mdl-34664440

RESUMO

We examined carbon chemical composition and stability along soil depth (topsoil 0-5 cm, mid-soil 20-40 cm, and deep soil 60-100 cm) in a no-tillage (NT) agricultural system with various amount of corn stover as mulch for 8 years, including 0 (NT0), 33% (NT33), 67% (NT67) and 100% (NT100), in Northeast China, using mid-infrared spectroscopy. The results showed that, relative to NT0, the treatments of NT33 and NT100 increased polysaccharide content of the top layer and mid-layer soils, the former decreased topsoil carbon component diversity, while the latter maintained soil carbon stability of three soil layers. NT67 increased carbon stability at the deep layer soil. Our results demonstrated that if corn stover resources were sufficient, NT with 100% corn stover mulch could both be beneficial to carbon availability at 0-40 cm soil layer and stability of the whole soil profile. The nonlinear relationship between the amount of corn stover mulch and the mid-infrared spectral characteristics of the soil called for further research on the microbial-control mechanism over soil carbon cycling under different amounts of corn stover mulch.


Assuntos
Carbono , Solo , Ecossistema , Análise Espectral , Zea mays
16.
Ann N Y Acad Sci ; 2021 Oct 20.
Artigo em Inglês | MEDLINE | ID: mdl-34671981

RESUMO

Recently, interleukin-38 (IL-38) was identified as an important anti-inflammatory and immunosuppressive factor, but its functional role in temporomandibular joint (TMJ) inflammation remains unknown. This study aimed to elucidate how IL-38 affects chondrocytes and the underlying mechanism that contributes to anti-inflammatory processes in the TMJ. Western blotting, quantitative real-time PCR, enzyme-linked immunosorbent assay, and immunofluorescence analysis were used to verify that IL-38 has anti-inflammatory effects on chondrocytes, and the related key pathways were analyzed by western blotting. SiRNA-IL-38, siRNA-NLRP3, and MCC950 were used to investigate the mechanism underlying the anti-inflammatory effects of IL-38. Inflammation models were induced by injection of complete Freund's adjuvant in TMJ with mouse recombinant IL-38 in in vivo studies. Histological and immunohistochemical analyses were used to investigate histological changes in the cartilage. The results showed that IL-38 inhibited the expression of inflammatory cytokines and MMPs. IL-38 limited inflammation by inhibiting the expression of MAPKs/NF-κB and the NLRP3/caspase-1 pathway. In vivo, IL-38 reduced chondrocyte inflammation and limited cartilage degeneration. This study shows for the first time that IL-38 plays a protective role in TMJ cartilage. IL-38 exerts anti-inflammatory effects through the NLRP3/caspase-1 pathway and may be a promising agent for treating TMJ inflammation.

17.
Bioorg Med Chem ; 49: 116438, 2021 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-34610571

RESUMO

Liver fibrosis is one of the most common pathological consequences of chronic liver diseases (CLD). To develop effective antifibrotic strategies, a novel class of 1-(substituted phenyl)-1,8-naphthalidine-3-carboxamide derivatives were designed and synthesized. By means of the collagen type I α 1 (COL1A1)-based screening and cytotoxicity assay in human hepatic stellate cell (HSC) line LX-2, seven compounds were screened out from total 60 derivatives with high inhibitory effect and relatively low cytotoxicity for further COL1A1 mRNA expression analysis. It was found that compound 17f and 19g dose-dependently inhibited the expression of fibrogenic markers, including α-smooth muscle actin (α-SMA), matrix metalloprotein 2 (MMP-2), connective tissue growth factor (CTGF) and transforming growth factor ß1 (TGFß1) on both mRNA and protein levels. Further mechanism studies indicated that they might suppress the hepatic fibrogenesis via inhibiting both PI3K/AKT/Smad and non-Smad JAK2/STAT3 signaling pathways. Furthermore, 19g administration attenuated hepatic histopathological injury and collagen accumulation, and reduced fibrogenesis-associated protein expression in liver tissues of bile duct ligation (BDL) rats, showing significant antifibrotic effect in vivo. These findings identified 1,8-naphthalidine derivatives as potent anti-hepatic fibrosis agents, and provided valuable information for further structure optimization.

18.
Ying Yong Sheng Tai Xue Bao ; 32(8): 2653-2665, 2021 Aug.
Artigo em Chinês | MEDLINE | ID: mdl-34664437

RESUMO

More attention has been paid to the monitoring, assessment, prediction, early warning and sustainable management of regional ecological environment and the changes of ecosystem state in recent years. It is an important scientific and technological task to develop quantitative methods and numerical simulation techniques for ecosystem modelling, and to construct the continental scale numerical simulator with the characteristics of multi-process coupling, multi-technology integration, and multi-objective application for stimulating research on ecosystem and global change and its resources, environment and disaster effects, based on the in-depth understanding of the components, processes, functions, patterns, and their interaction mechanism of terrestrial ecosystem. Here, we reviewed the current status and future direction of terrestrial ecosystem models, and discussed the conceptual framework of developing the simulation system of dynamic change and spatial variation in large-scale terrestrial ecosystems and its resource and environment effect, as well as basic issues on the function orientation and structure design of the simulation system, which would provide reference for constructing Chinese terrestrial ecosystem numerical simulator.


Assuntos
Clima , Ecossistema , Simulação por Computador
19.
J Clin Periodontol ; 48(12): 1559-1569, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34605060

RESUMO

AIM: The present study aimed to investigate the salivary proteome profiles of pregnant women with gingivitis (PG) or without gingivitis (HP) and non-pregnant healthy controls (HC) by employing iTRAQ-based proteomics. MATERIALS AND METHODS: Saliva samples were collected from 30 Chinese women comprising 10 subjects in each of the three groups (PG, HP, and HC). The samples were subjected to iTRAQ-based proteomics analysis, and ELISA was performed to validate the results. The subsequent observations were validated in a cohort of 48 subjects. RESULTS: Pathways associated with neutrophil-mediated immune response and antioxidant defence mechanism were significantly higher in PG than HC. The abundance of salivary cystatins (S, SA, and SN) and antimicrobials were significantly decreased in PG and HP, while cystatin C and D were additionally decreased in PG. Cystatin C was mapped to all the major catabolic pathways and was the most re-wired protein in pregnancy gingivitis. Further validation demonstrated cystatin C to be significantly lower in PG than HC. CONCLUSIONS: While the decrease in levels of salivary cystatins and antimicrobial proteins may predispose healthy pregnant women to pregnancy gingivitis, it may cause persistence of inflammation in pregnant women with gingivitis.

20.
Dermatology ; : 1-9, 2021 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-34657035

RESUMO

BACKGROUND: Photodynamic therapy is an established treatment option for Bowen's disease. Our meta-analysis was aimed at evaluating the efficacy and recurrence of photodynamic therapy or other topical treatments (5-fluorouracil, cryotherapy) and of photodynamic therapy alone or in combination with other therapies (ablative fractional CO2 laser or plum-blossom needle) for the treatment of Bowen's disease. METHODS: Trials that met our inclusion criteria were identified from PubMed, EMBASE, Web of Science, and Cochrane Library databases, and meta-analyses were conducted with RevMan V.5.4. The risk of bias was estimated with the Cochrane Collaboration's risk of bias tools. Complete response rate, recurrence, pain/visual analogue scale score, cosmetic outcome, and adverse events were considered as outcomes. RESULTS: Of the 2,439 records initially retrieved, 8 randomized controlled trials were included in this meta-analysis. According to our analyses, photodynamic therapy exhibited a significantly higher complete response rate (RR = 1.36, 95% CI [1.01, 1.84], I2 = 86%, p = 0.04), less recurrence (RR = 0.53, 95% CI [0.30, 0.95], I2 = 0%, p = 0.03), and better cosmetic outcome (RR = 1.34, 95% CI [1.15, 1.56], I2 = 0%, p = 0.0002) compared with other treatments. Moreover, there was a significant difference between the complete response rate of photodynamic therapy combined with ablative fractional CO2 laser and that of photodynamic therapy (RR = 1.85, 95% CI [1.38, 2.49], I2 = 0%, p < 0.0001). Photodynamic therapy combined with ablative fractional CO2 laser or plum-blossom needle also showed significantly less recurrence (RR = 0.21, 95% CI [0.09, 0.51], I2 = 0%, p = 0.0005) and a lower visual analogue scale score (RR = 0.51, 95% CI [0.06, 0.96], I2 = 0%, p = 0.03) than photodynamic therapy alone. However, there was no significant difference in the complete response rate between photodynamic therapy combined with ablative continuous CO2 laser and photodynamic therapy combined with ablative fractional CO2 laser (RR = 1.00, 95% CI [0.54, 1.86], I2 not applicable, p = 1.00). CONCLUSIONS: This meta-analysis shows that photodynamic therapy can be used in the treatment of Bowen's disease with better efficacy, less recurrence, and better cosmetic outcomes than cryotherapy and 5-FU. Some methods, including ablative fractional CO2 laser, can be applied in combination with photodynamic therapy to improve efficacy. However, which laser-assisted photodynamic therapy scheme has the most advantages in the treatment of Bowen's disease warrants further exploration.

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