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1.
Zhonghua Wai Ke Za Zhi ; 57(12): 902-907, 2019 Dec 01.
Artigo em Chinês | MEDLINE | ID: mdl-31826593

RESUMO

Objectives: To evaluate the efficacy of minimally invasive surgery in patients with late severe tricuspid regurgitation after cardiac surgery, and to evaluate the role of leaflets augmentation technique in tricuspid valvuloplasty. Methods: From January 2015 to June 2019, 85 patients undergoing tricuspid valve repair procedure with minimally invasive approach at Department of Cardiovascular Surgery, Guangdong provincial People's Hospital were enrolled. There were 22 males and 63 females, aging of (53.6±12.4) years (range: 15 to 75 years). The interval between the prior and current operations was (16.0±7.3) years (range: 0.2 to 35.0 years). The diameter of right atrium and right ventricle was (77.3±17.2) mm and (61.0±8.4) mm, respectively. Tricuspid regurgitation was severe or extremely severe, the tricuspid regurgitation area was (19.0±10.3) cm(2). All patients underwent minimally invasive tricuspid valvuloplasty or tricuspid valve replacement on beating-heart with totally endoscopic technique and port-access approach through right chest wall. The operations included tricuspid valve replacement and tricuspid valvuloplasty, the technique of tricuspid valvuloplasty including leaflets augmentation with patch, ring implantation, chordae tendineaes reconstruction, release of papillary muscle, edge to edge method, etc. Postoperative hospitalization days, the time of ICU stay, blood transfusion rate, ventilator time and the results of echocardiography were recorded. Follow-up was completed regularly by WeChat, telephone and outpatient visit. Results: Sixty-five patients underwent tricuspid valve repair, and 20 patients underwent tricuspid valve replacement because of prosthetic failure and plasty failure. Five patients died during hospitalization, with mortality rate 5.9%. One patient was transferred to local hospital for anti-infection treatment, the other 79 patients were discharged from hospital in well condition and followed-up. The postoperative hospitalization time was 7.0 (5.5) days (M(Q(R))) days, the mean ventilator time was 18.0 (16.2) hours, and the mean ICU stay time was 68.0 (75.5) hours. There were 35 patients without blood conduction transfusion, the transfusion rate was only 58.9% (50/85). Four cases of severe, 9 cases of moderate and 67 cases of mild to zero tricuspid regurgitation were examined before being discharged, with tricuspid regurgitation area of (2.8±3.5) cm(2) (range: 0 to 19.1 cm(2)). The follow-up time was 1 to 38 months. Two patients died during follow-up, one patient died from infective endocarditis and mitral perivalvular leakage, the other one died of intractable right heart failure. One patient was implanted with permanent pacemaker due to Ⅲ atrioventricular block. Valvular re-replacement was performed in 2 patients who were re-admitted for the artificial valve infection and mechanical valve obstruction. No re-operation of tricuspid valve. Conclusions: Totally endoscopic minimally invasive technique provided satisfactory surgical outcomes for critically sick patients with severe tricuspid regurgitation following cardiac surgery. The application of leaflets augmentation technique achieved ideal repair effect for previously unrepairable lesions.


Assuntos
Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Insuficiência da Valva Tricúspide/cirurgia , Adolescente , Adulto , Idoso , Procedimentos Cirúrgicos Cardíacos/métodos , Feminino , Implante de Prótese de Valva Cardíaca/efeitos adversos , Implante de Prótese de Valva Cardíaca/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Minimamente Invasivos/efeitos adversos , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Reoperação , Resultado do Tratamento , Valva Tricúspide/cirurgia , Insuficiência da Valva Tricúspide/etiologia , Adulto Jovem
2.
Zhonghua Xin Xue Guan Bing Za Zhi ; 47(7): 539-543, 2019 Jul 24.
Artigo em Chinês | MEDLINE | ID: mdl-31365994

RESUMO

Objective: To investigate the risk factors of postoperative acute kidney injury (AKI) in patients aged between 40 and 50 years old undergoing cardiac valvular surgery and the impact on outcome. Methods: The clinical data of 286 patients aged between 40 and 50 years old undergoing cardiac valve surgery in Guangdong Provincial People's Hospital from January 2012 to December 2016 were analyzed retrospectively. Preoperative coronary angiography was performed in all patients. All patients enrolled were divided into AKI group and non-AKI group according to the existence or not of postoperative AKI. Patients with AKI were further divided into AKI stage 1, stage 2, and stage 3 groups according to KDIGO guideline. Demographic characteristics, preoperative clinical data including serum creatinine, estimated glomerular filtration rate, hemoglobin, uric acid, urinary protein, presence or absence of chronic kidney disease, left ventricular ejection fraction, pulmonary artery pressure, New York Heart Association (NYHA) functional classification, preoperative co-morbidity (hypertension, diabetes, anemia, cerebrovascular disease, peripheral artery disease), preoperative medication(vasoactive drugs, diuretic, renin-angiotensin system inhibitor (RASI), surgical data (contrast dosage in coronary angiography, type of cardiac valve surgery) were recorded and analyzed in this retrospective study. The risk factors for postoperative AKI and its impact on clinical outcomes (mortality, hospitalization expenses and Intensive Care Unit stay duration) were evaluated. Logistic regression analysis was used to determine the risk factors for postoperative AKI and the adjusted variables with P<0.2 were selected for the multivariate logistic regression analysis to define the independent determinants for AKI. Results: AKI was defined in 106 out of 286 enrolled patients, including 96 patients with AKI stage 1, 10 patients with AKI stage 2 and no patients with AKI stage 3. The proportion of coexisting cerebrovascular diseases was higher in AKI group than in non-AKI group (9(8.49%) and 5(2.78%), χ(2)=4.677, P=0.031), while there was no difference among other baseline data between the two groups. Multivariate logistic regression analysis showed that preoperative complications of cerebral vascular disease was an independent risk factor of postoperative AKI (OR=3.578, 95%CI 1.139-11.242, P=0.029). Five out of 106 AKI patients died during hospitalization while there was only 1 patient died among 180 patients without AKI. Patients with AKI after cardiac valve operation experienced higher mortality than patients without AKI (χ(2)=5.625, P=0.028). Further analysis showed that there was no difference in hospitalization mortality between patients with AKI stage 2 and stage (χ(2)=0.686, P=0.408) while the hospitalization mortality in patients with AKI stage 2 was higher than those without AKI (χ(2)=8.113, P=0.004). The hospitalization expenses in patients with AKI were 10.38(8.59,12.54) ×10(4) RMB, significantly higher than that in patients without AKI (9.72(8.03,11.93) ×10(4) RMB)(P=0.043). There was no difference in hospitalization expenses between patients with AKI stage 1 and without AKI (P=0.635). The hospitalization expenses in patients with AKI stage 2 was higher than those without AKI (P=0.023). Intensive Care Unit stay duration in patients with AKI was 3(1,4) days, significantly higher than those without AKI (P=0.044). There was no difference in Intensive Care Unit stay duration in patients with AKI stage 1 and without AKI (P=0.978), while Intensive Care Unit stay duration in patients with AKI stage 2 was significantly longer than those without AKI (P=0.006). Conclusions: Preoperative complications of cerebral vascular disease is an independent risk factor of postoperative AKI. Non-senile patients with AKI after cardiac valvular surgery is associated with a higher proportion of mortality, hospitalization expenses and Intensive Care Unit stay duration as compared patients without postoperative AKI.


Assuntos
Lesão Renal Aguda , Adulto , Valvas Cardíacas , Humanos , Tempo de Internação , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Estudos Retrospectivos , Fatores de Risco
3.
Climacteric ; 22(5): 448-453, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30712399

RESUMO

Purpose: This study conducted confirmatory factor analysis (CFA) to examine the measurement structure of the Women's Health Questionnaire (WHQ) and how its components were organized. Methods: Participants were 448 postmenopausal women, with a mean age of 63.3 years. CFA was conducted to test how well several proposed measurement models fit the data. Results: The single-factor model performed poorly, indicating the presence of multiple factors. The model with seven correlated factors fit the data well, although the varying degrees of inter-factor correlations suggested grouping of similar factors. The hierarchical measurement structure, with seven first-order factors organized under two second-order factors of physical health and mental health functioning, demonstrated a good fit with the data (χ2(367) = 694.05, p < 0.001; root mean square error of approximation = 0.05; comparative fit index = 0.95) and a meaningful pattern. The Mental Health factor was represented by Depressed Mood, Anxiety/Fear, Memory/Concentration Problems, and Sleep Problems. The Physical Health factor was manifested mainly by Somatic Symptoms, Menstrual Symptoms, and Vasomotor Symptoms, and, to a lesser extent, also by Sleep Problems and Memory/Concentration Problems. Conclusion: Findings suggested that, in addition to a global index and subscale scores, the WHQ may produce summary scores of physical health and mental health functioning in evaluation of well-being among postmenopausal women.

4.
Sci Rep ; 8(1): 11283, 2018 Jul 26.
Artigo em Inglês | MEDLINE | ID: mdl-30050070

RESUMO

We report on the fabrication of spherical Au spheres by pulsed laser treatment using a KrF excimer laser (248 nm, 25 ns) under ambient conditions as a fast and high throughput fabrication technique. The presented experiments were realized using initial Au layers of 100 nm thickness deposited on optically transparent and low cost Borofloat glass or single-crystalline SrTiO3 substrates, respectively. High (111)-orientation and smoothness (RMS ≈ 1 nm) are the properties of the deposited Au layers before laser treatment. After laser treatment, spheres with size distribution ranging from hundreds of nanometers up to several micrometers were produced. Single-particle scattering spectra with distinct plasmonic resonance peaks are presented to reveal the critical role of optimal irradiation parameters in the process of laser induced particle self-assembly. The variation of irradiation parameters like fluence and number of laser pulses influences the melting, dewetting and solidification process of the Au layers and thus the formation of extremely well shaped spherical particles. The gold layers on Borofloat glass and SrTiO3 are found to show a slightly different behavior under laser treatment. We also discuss the effect of substrates.

5.
Eye (Lond) ; 31(4): 566-571, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-27935601

RESUMO

PurposeTo investigate the incidence of cystoid macular edema (CME) after scleral buckling (SB) and verify the possible risk factors of CME.MethodsA retrospective, non-comparative, interventional case series study was conducted. Clinical charts of 130 consecutive patients who were underwent successful SB for primary retinal detachment (RD) from 2009 to 2013 were reviewed. Optical coherence tomography (OCT) was applied to detect CME. Data pertaining to patient demographics, pre- and postoperative visual acuity, surgical procedures, and postoperative OCT findings were recorded. Factors associated with CME were also analyzed.ResultsThe incidence of CME was 9/130 (6.9%). Risk factors for developing CME were older age (non-CME vs CME: 44.8±14.8 vs 57.3±5.3 years, P<0.05), more extensive RD (RD extent by clock hours; non-CME vs CME: 4.61±1.57 vs 5.78±1.39, P<0.05), macular detachment (non-CME vs CME: 51.2 vs 88.9%, P<0.05), and external drainage (non-CME vs CME: 38.8% vs 77.8%, P<0.05). There was no significant difference between patient with and without CME regarding the use of gas tamponade and the lens status. In patients with more extensive RD (macular detachment plus RD of more than 3 clock hours before surgery), 8 of 68 patients had CME after SB and only older age and external drainage factors were associated with CME.ConclusionsThe risk factors associated with CME after SB were older age, more extended RD, macular detachment, and external drainage. External drainage should be used with caution in older patients with more extensive RD.


Assuntos
Edema Macular/etiologia , Edema Macular/fisiopatologia , Complicações Pós-Operatórias/fisiopatologia , Descolamento Retiniano/cirurgia , Recurvamento da Esclera/efeitos adversos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Drenagem , Feminino , Angiofluoresceinografia , Seguimentos , Humanos , Incidência , Edema Macular/epidemiologia , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Descolamento Retiniano/epidemiologia , Descolamento Retiniano/fisiopatologia , Estudos Retrospectivos , Fatores de Risco , Recurvamento da Esclera/métodos , Taiwan/epidemiologia , Tomografia de Coerência Óptica , Resultado do Tratamento , Adulto Jovem
7.
Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi ; 34(10): 746-749, 2016 Oct 20.
Artigo em Chinês | MEDLINE | ID: mdl-28043246

RESUMO

Objective: To investigate the exposure to benzene, methylbenzene, and dimethylbenzene in workers in a petrochemical enterprise in Shanghai, China, and to conduct occupational hazard risk assessment. Methods: The environmental monitoring data on benzene series in the workplace of this petrochemical enterprise from 2010 to 2014 were collected, as well as workers' general status. The inhalation risk assessment model developed by United States Environmental Protection Agency (EPA) was used for risk assessment to determine the occupational hazard risk level of benzene, methylbenzene, and dimethylbenzene. Results: The pass rate of the monitoring concentration of benzene, methylbenzene, and dimethylbenzene in the workplace of this petrochemical enterprise was 100%. The results of the EPA model showed that benzene had a high carcinogenic risk, benzene and dimethylbenzene had a high non-carcinogenic risk, and methylbenzene had a low non-carcinogenic risk. Conclusion: The workers exposed to benzene in this petrochemical enterprise have a high health risk, and the EPA model can be used for occupational hazard risk assessment in chemical industry.


Assuntos
Medição de Risco , Benzeno , Carcinógenos , Indústria Química , China , Monitoramento Ambiental , Humanos , Exposição Ocupacional , Tolueno , Estados Unidos , United States Environmental Protection Agency , Local de Trabalho , Xilenos
9.
Domest Anim Endocrinol ; 54: 68-75, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26521202

RESUMO

The melanocortin-4 receptor (MC4R) is a critical regulator of mammalian food intake and energy expenditure, with receptor activation resulting in decreased food intake and increased energy expenditure. Recently, studies on role of MC4R in regulation of food intake have been extended to other species, such as chicken. Functional study of mutant MC4Rs is important in proving the causal link between MC4R mutation and production traits. Herein, we cloned chicken MC4R (cMC4R) complementary DNA and generated 4 mutant cMC4Rs (Q18H, G21R, S76L, and L299P) by site-directed mutagenesis and measured their expression by flow cytometry. Pharmacologic characteristics were analyzed with binding and signaling assays using 3 agonists. We showed that G21R had decreased cell surface and total expression (P < 0.05), whereas the other 3 mutants had similar total and cell surface expression levels as wild-type cMC4R. The 4 mutants had either decreased (Q18H, G21R, S76L; P < 0.05) or no (L299P) binding to radiolabeled [Nle(4), D-Phe(7)]-α-melanocyte-stimulating hormone (MSH). In signaling assays, Q18H was constitutively active. Q18H, G21R, and S76L had decreased responses to α-MSH stimulation (P < 0.05). L299P had decreased basal and ligand-stimulated signaling (P < 0.01). Nle(4), D-Phe(7)-MSH was the most potent agonist for cMC4R and therefore would be better suited for further in vivo studies. We conclude that the cloned cMC4R was a functional receptor and provided detailed functional data for these mutations, contributing to a better understanding of cMC4R variants associated with production traits.


Assuntos
Proteínas Aviárias/genética , Galinhas , Mutação , Receptor Tipo 4 de Melanocortina/genética , Animais , Proteínas Aviárias/metabolismo , Clonagem Molecular , AMP Cíclico/biossíntese , DNA Complementar/genética , Ingestão de Alimentos/fisiologia , Metabolismo Energético/fisiologia , Expressão Gênica , Células HEK293 , Humanos , Mutagênese Sítio-Dirigida , Receptor Tipo 4 de Melanocortina/metabolismo , Transdução de Sinais , Transfecção , alfa-MSH/farmacologia
10.
Eur Rev Med Pharmacol Sci ; 19(15): 2928-33, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-26241550

RESUMO

OBJECTIVE: Observe the expression and distribution of HMGB1 in Sombati's cell model and kainic acid-induced epileptic rats' model. MATERIALS AND METHODS: Dissociated hippocampal neurons from neonatal SD rats and cultured those for 9 days, then changed medium to Mg2+-free medium for 3 hours to induce Sombati's cell model. The expression level of HMGB1 in the neurons was detected at 24h and 72h by Western Blotting. Appropriate kainic acid was injected into the lateral ventricles to induced epileptic rats' model in vivo trial, the expression level and distribution of HMGB1 at 24h and 72h were established by immunohistochemistry. RESULTS: The expression level of HMGB1 showed significantly different between model group and control group both in vitro and in vivo trials. At 24h, the expression level of HMGB1 in the model group was lower than the control group (p < 0.05), and became higher than the control group at 72h (p < 0.05). From the in vivotrial, a nucleus-to-cytoplasm translocation was also discovered. CONCLUSIONS: This investigation indicates that HMGB1 plays a crucial role in the pathophysiology of epilepsy, by altering its quantity and distribution.


Assuntos
Modelos Animais de Doenças , Epilepsia/metabolismo , Proteína HMGB1/biossíntese , Ácido Caínico/toxicidade , Animais , Animais Recém-Nascidos , Células Cultivadas , Epilepsia/induzido quimicamente , Epilepsia/patologia , Regulação da Expressão Gênica , Proteína HMGB1/análise , Hipocampo/química , Hipocampo/metabolismo , Hipocampo/patologia , Masculino , Camundongos , Neurônios/química , Neurônios/metabolismo , Neurônios/patologia , Ratos , Ratos Sprague-Dawley
11.
Genet Mol Res ; 14(2): 3862-8, 2015 Apr 22.
Artigo em Inglês | MEDLINE | ID: mdl-25966156

RESUMO

To investigate the value and essentiality of 6- and 24-h delay hepatobiliary scintigraphy in the differential diagnosis of biliary atresia (BA), we retrospectively analyzed 197 infants (121 boys/76 girls; age range, 3-205 days; average age, 63.9 days) admitted to Jiangxi Children's Hospital for persistent jaundice (> 2 weeks), hepatosplenomegaly, and abnormal liver function. After receiving anti-inflammatory treatment and cholagogic pre-treatment for 7-10 days without a clear diagnosis, the children underwent 99mTc-labeled diethylacetanilide-iminodiacetic acid hepatobiliary scintigraphy. BA and infant hepatitis syndrome were diagnosed in 107 and 90 infants, respectively after laparoscopic cholangiography, surgical pathology, or 6-month clinical follow-up. The diagnostic efficiencies of hepatobiliary scintigraphy for BA were evaluated within 50 min and at 6 and 24 h. The areas under the receiver operating characteristic curves within 50 min, at 6 and 24 h were 0.696, 0.829 , and 0.779 , suggesting poor diagnostic value within 50 min, but improvement at 6 and 24 h. The compliance rate of 6- and 24-h imaging for BA diagnosis was 89.34% (176/197; paired chi-square test Kappa value, 0.77; P > 0.05), signifying high consistency. The diagnostic efficiency values of 6-/24-h imaging for BA diagnosis were sensitivity (90.65/89.72%), specificity (74.44/78.89%), accuracy (83.25/84.77%), positive and negative predictive values (80.83/83.48% and 87.01/86.59%), with no significant difference (P > 0.05). To provide optimal treatment in early BA, the- 6-h hepatobiliary scintigraphy had practical value, especially when combined with tomographic or dynamic imaging; 24-h delay imaging was deemed unnecessary because it was not significantly superior.


Assuntos
Ductos Biliares/diagnóstico por imagem , Atresia Biliar/diagnóstico por imagem , Fígado/diagnóstico por imagem , Diagnóstico Diferencial , Feminino , Humanos , Lactente , Masculino , Cintilografia , Estudos Retrospectivos
12.
Genet Mol Res ; 14(2): 4469-76, 2015 May 04.
Artigo em Inglês | MEDLINE | ID: mdl-25966219

RESUMO

Genome-wide association studies in several ethnic groups have reported that polymorphisms of the telomerase reverse transcriptase (TERT) and cleft lip and palate transmembrane 1-like (CLPTM1L) genes, located on 5p15.33, are associated with susceptibility to lung cancer. However, whether genetic variants of TERT-CLPTM1L are associated with an increased risk of lung cancer in the Chinese Han population is unknown. This study examined associations between five single nucleotide polymorphisms (SNPs) of TERT-CLPTM1L (rs402710, rs401681, rs465498, rs4975616, and rs2736100) and lung cancer in a Chinese Han population in the Hubei Province. The five SNPs were detected using the Sequenom MassArray(®) iPLEX System in 304 lung cancer patients and 319 controls. Of the five SNPs, rs4975616 did not conform to Hardy-Weinberg equilibrium in the controls. Only rs2736100 was significantly (P = 0.034) associated with an increased risk of lung cancer. In the linkage disequilibrium analyses, a block of strong linkage disequilibrium was observed between rs401681 and rs465498 (D' = 0.986; r(2) = 0.546). No linkage disequilibrium between rs2736100 and the other three SNPs was found. In the haplotype analyses, the frequencies of the TTCT haplotype in rs402710, rs401681, rs465498, and rs2736100 differed significantly between case and control subjects (odds ratio = 0.56; 95% confidence interval, 0.36-0.88; P = 0.012). The results of this study suggested that rs2736100 on TERT-CLPTM1L indicates a poor prognosis for lung cancer in the Chinese Han population.


Assuntos
Predisposição Genética para Doença , Neoplasias Pulmonares/genética , Proteínas de Membrana/genética , Proteínas de Neoplasias/genética , Polimorfismo de Nucleotídeo Único , Telomerase/genética , Adulto , Idoso , Grupo com Ancestrais do Continente Asiático/genética , Estudos de Casos e Controles , China , Feminino , Estudos de Associação Genética , Haplótipos , Humanos , Desequilíbrio de Ligação , Masculino , Pessoa de Meia-Idade
13.
Oral Dis ; 21(2): 207-15, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-24724948

RESUMO

OBJECTIVE: Previous studies examining the association between genetic variations in prostaglandin pathway and risk of head and neck cancer (HNC) have only included polymorphisms in the PTGS2 (COX2) gene. This study investigated the association between genetic polymorphisms of six prostaglandin pathway genes (PGDS, PTGDS, PTGES, PTGIS, PTGS1 and PTGS2), and risk of HNC. METHODS: Interviews regarding the consumption of alcohol, betel quid, and cigarette were conducted with 222 HNC cases and 214 controls. Genotyping was performed for 48 tag and functional single-nucleotide polymorphisms (SNPs). RESULTS: Two tag SNPs of PTGIS showed a significant association with HNC risk [rs522962: log-additive odds ratio (OR) = 1.42, 95% confidence interval (CI): 1.01-1.99 and dominant OR = 1.58, 95% CI: 1.02-2.47; rs6125671: log-additive OR = 1.49, 95% CI: 1.08-2.05 and dominant OR = 1.96, 95% CI: 1.16-3.32]. In addition, a region in PTGIS tagged by rs927068 and rs6019902 was significantly associated with risk of HNC (global P = 0.007). Finally, several SNPs interacted with betel quid and cigarette to influence the risk of HNC. CONCLUSIONS: Genetic variations in prostaglandin pathway genes are associated with risk of HNC and may modify the relationship between use of betel quid or cigarette and development of HNC.


Assuntos
Carcinoma de Células Escamosas/genética , Carcinoma de Células Escamosas/metabolismo , Neoplasias de Cabeça e Pescoço/genética , Neoplasias de Cabeça e Pescoço/metabolismo , Prostaglandinas/biossíntese , Prostaglandinas/genética , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Predisposição Genética para Doença , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Polimorfismo de Nucleotídeo Único , Carcinoma de Células Escamosas de Cabeça e Pescoço , Adulto Jovem
14.
Indian J Cancer ; 52(3): 454-60, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26905168

RESUMO

BACKGROUND: Esophageal cancer is commonly treated with surgery, concurrent chemoradiotherapy (CCRT), or a combination of both. The correlation between the hematological parameters during CCRT and early survival of esophageal cancer has not been fully evaluated. MATERIALS AND METHODS: We analyzed the records of 65 esophageal cancer patients treated by CCRT between 2007 and 2010 retrospectively. The association between CCRT-associated myelosuppression, demographic variables, and survival rates were analyzed by univariate and multivariate analysis. RESULTS: The univariate analysis showed that tumor extent of T3-4, a higher stage of tumor, a lower albumin level, grade 3 or higher anemia and thrombocytopenia, and interruptions in treatment affected survival rates. Further, the multivariate analysis revealed that stage IV (P = 0.030) is an independently negative prognostic factor for a one-year survival rate. Stage IV (P = 0.035), tumor extent of T3-4 (P = 0.002), and grade 3-4 thrombocytopenia (P = 0.015) are independently negative prognostic factors for a two-year survival rate. CONCLUSIONS: Severe decrease in platelet count during CCRT independently affects survival of esophageal cancer patients in addition to stage of the tumor.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias Esofágicas/complicações , Neoplasias Esofágicas/tratamento farmacológico , Trombocitopenia/induzido quimicamente , Adulto , Idoso , Idoso de 80 Anos ou mais , Quimiorradioterapia , Neoplasias Esofágicas/mortalidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Taxa de Sobrevida , Trombocitopenia/terapia
15.
Pediatr Surg Int ; 31(2): 191-5, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25430524

RESUMO

INTRODUCTION: Congenital diaphragmatic hernia is a potentially life-threatening neonatal condition which required surgical intervention. With the advances in endosurgical instruments and techniques, thoracoscopic approach is gaining popularity as a standard procedure in the treatment of this condition. In this study, we reviewed our two centres' experience with thoracoscopic repair of congenital diaphragmatic hernia in recent years. METHODS: All patients who underwent thoracoscopic repair of congenital diaphragmatic hernia between 2010 and 2013 at the two tertiary referral centres were identified. Medical records were retrospectively reviewed. Data including patients' demographics, peri-operative outcomes, length of hospitalisation and post-operative complications were extracted and analysed. RESULTS: 60 patients were identified over the study period, with 46 males and 14 females. 48 patients received operation within the first 7 days of life. There were seven patients with delayed presentation and were operated after 1 month old. The average body weight was 3.03 kg. Left-sided hernia was more prevalent (n = 50). The mean operative time was 88.5 min (range 31-194 min). No conversion to open thoracotomy or laparotomy was required in any of the patients. All patients except one were intubated and paralysed in neonatal intensive care units for at least 3 days after operation. Average hospital stay was 14.6 days. There was no mortality in this series. There were five recurrences, one being the patient without post-operative paralysis, and the others with deficient posterior muscle rim. No musculoskeletal deformity was noted on follow-up examination. CONCLUSION: Thoracoscopic repair of congenital diaphragmatic hernia can be performed safely in specialised centres. The post-operative recovery and cosmesis are excellent. Diaphragmatic hernia with large defect remains a challenge for surgeons.


Assuntos
Hérnias Diafragmáticas Congênitas/cirurgia , Toracoscopia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Estudos Retrospectivos
16.
Genet Mol Res ; 13(3): 7747-56, 2014 Sep 26.
Artigo em Inglês | MEDLINE | ID: mdl-25299088

RESUMO

Acrylonitrile (ACN) is a widely used chemical in the production of plastics, resins, nitriles, acrylic fibers, and synthetic rubber. Previous epidemiological investigations and animal studies have confirmed that ACN affects the lymphocytes and spleen. However, the immune toxicity mechanism is unknown. Lipid rafts are cell membrane structures that are rich in cholesterol and involved in cell signal transduction. The B cell lymophoma-10 (Bcl10) protein is a joint protein that is important in lymphocyte development and signal pathways. This study was conducted to examine the in vitro effects of ACN. We separated lipid rafts, and analyzed Bcl10 protein and caveolin. Western blotting was used to detect mitogen-activated protein kinase (MAPK) and phosphorylated MAPK levels. The results indicated that with increasing ACN concentration, the total amount of Bcl10 remained stable, but was concentrated mainly in part 4 to part 11 in electrophoretic band district which is high density in gradient centrifugation. Caveolin-1 was evaluated as a lipid raft marker protein; caveolin-1 content and position were relatively unchanged. Western blotting showed that in a certain range, MAPK protein was secreted at a higher level. At some ACN exposure levels, MAPK protein secretion was significantly decreased compared to the control group (P < 0.05). These results indicate that ACN can cause immune toxicity by damaging lipid raft structures, causing Bcl10 protein and lipid raft separation and restraining Ras-Raf-MAPK-extracellular signal-regulated kinase signaling pathways.


Assuntos
Acrilonitrila/farmacologia , Linfócitos/efeitos dos fármacos , Sistema de Sinalização das MAP Quinases/efeitos dos fármacos , Microdomínios da Membrana/efeitos dos fármacos , Quinases raf/metabolismo , Proteínas ras/metabolismo , Western Blotting , Humanos , Células Jurkat , Linfócitos/metabolismo
17.
J Clin Endocrinol Metab ; 99(10): E1957-66, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-25029423

RESUMO

CONTEXT: Despite the absence of progesterone receptor protein in human endometrial endothelial cells (HEECs), endometria of women receiving long-acting progestin-only contraceptives (LAPCs) display reduced uterine blood flow, elevated reactive oxygen species generation, increased angiogenesis, and irregularly distributed, enlarged, fragile microvessels resulting in abnormal uterine bleeding. OBJECTIVE: We propose that paracrine factors from LAPC-treated human endometrial stromal cells (HESCs) impair HEEC functions by shifting the balance between HEEC viability and death in favor of the latter. DESIGN AND SETTING: Proliferation, apoptosis, and transcriptome analyses were performed in HEECs treated with conditioned medium supernatant (CMS) derived from HESCs treated with estradiol (E2) ± medroxyprogesterone acetate or etonogestrel under normoxia or hypoxia. Mass spectrometry interrogated the CMS secretome while immunostaining for neuronal pentraxin-1 (NPTX1), cleaved caspase-3, and cytochrome c was performed in cultured HEECs and paired endometria from women using LAPCs. MAIN OUTCOME: HEEC apoptosis and its underlying mechanism. RESULTS: HESC CMS from E2 + medroxyprogesterone acetate or E2 + etonogestrel incubations under hypoxia induced HEEC apoptosis (P < .05), whereas mass spectrometry of the CMS revealed increased NPTX1 secretion (P < .05). Endothelial cleaved caspase-3 and stromal NPTX1 immunoreactivity were significantly higher in LAPC-treated endometria (P < .001). Transcriptomics revealed AKT signaling inhibition and mitochondrial dysfunction in HEECs incubated with HESC CMS. In vitro analyses proved that CMS decreased HEEC AKT phosphorylation (P < .05) and that recombinant NPTX1 (P < .05) or NPTX1 + H2O2 (P < .001) increase HEEC apoptosis and cytosolic cytochrome c levels. CONCLUSIONS: LAPC-enhanced NPTX1 secretion and reactive oxygen species generation in HESCs impair HEEC survival resulting in a loss in vascular integrity, demonstrating a novel paracrine mechanism to explain LAPC-induced abnormal uterine bleeding.


Assuntos
Apoptose/efeitos dos fármacos , Proteína C-Reativa/metabolismo , Anticoncepcionais Femininos/administração & dosagem , Endométrio/efeitos dos fármacos , Proteínas do Tecido Nervoso/metabolismo , Progestinas/administração & dosagem , Células Estromais/efeitos dos fármacos , Caspase 3/metabolismo , Proliferação de Células/efeitos dos fármacos , Células Cultivadas , Anticoncepcionais Femininos/efeitos adversos , Meios de Cultivo Condicionados/farmacologia , Citocromos c/metabolismo , Endométrio/citologia , Células Endoteliais/citologia , Células Endoteliais/efeitos dos fármacos , Estradiol/efeitos adversos , Estradiol/farmacologia , Feminino , Humanos , Acetato de Medroxiprogesterona/efeitos adversos , Acetato de Medroxiprogesterona/farmacologia , Microvasos/metabolismo , Comunicação Parácrina/efeitos dos fármacos , Comunicação Parácrina/fisiologia , Progestinas/efeitos adversos , Espécies Reativas de Oxigênio/metabolismo , Células Estromais/metabolismo
18.
Eat Behav ; 15(2): 271-4, 2014 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-24854817

RESUMO

INTRODUCTION: Unhealthy weight loss practices are common among female college students. It is unknown if these practices are also most common among women in the subset of overweight or obese college students or if these practices are related to depression. We examined the relationship between gender, depression, and unhealthy weight loss practices among overweight or obese college students. METHODS: Students (body mass index between 25.0 and 34.9 kg/m(2)) from three Southern California universities (M(age) = 22 years, SD = 4; 70% women) were recruited from May 2011 to May 2012 for participation in a weight loss clinical trial (N = 404). Logistic regressions were performed with baseline data to assess the cross-sectional relationship between self-reported unhealthy weight loss practices and gender and depression as measured by the Center for Epidemiologic Studies Depression short form. RESULTS: Twenty-nine percent of participants reported engaging in at least one unhealthy weight loss behavior (e.g., fasting, purging) over the last 30 days, with no differences by gender. Self-report of at least one unhealthy weight loss behavior was associated with report of symptoms of depression (e(B) = 1.14 [confidence interval, CI: 1.08-1.20]), adjusting for potential confounders. Interactions between gender and depression were not significant (e(B) = 1.04 [CI: 0.93-1.16]). CONCLUSION: Among an overweight or obese sample of college students, unhealthy weight loss practices were equally common in both genders, and students with depressive symptomatology were at greatest risk. Obesity interventions targeting overweight or obese college students should educate both men and women about the dangers of unhealthy weight loss practices. In addition, screening for depression can help identify students who would benefit from additional supportive and coping strategies and resources.


Assuntos
Depressão/psicologia , Jejum/psicologia , Obesidade/psicologia , Sobrepeso/psicologia , Estudantes/psicologia , Vômito/psicologia , Perda de Peso , Adolescente , Adulto , California , Estudos Transversais , Feminino , Humanos , Masculino , Fatores de Risco , Fatores Sexuais , Estudantes/estatística & dados numéricos , Universidades , Adulto Jovem
19.
Contemp Clin Trials ; 37(1): 10-8, 2014 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-24215774

RESUMO

PURPOSE: To describe the theoretical rationale, intervention design, and clinical trial of a two-year weight control intervention for young adults deployed via social and mobile media. METHODS: A total of 404 overweight or obese college students from three Southern California universities (M(age) = 22( ± 4) years; M(BMI) = 29( ± 2.8); 70% female) were randomized to participate in the intervention or to receive an informational web-based weight loss program. The intervention is based on behavioral theory and integrates intervention elements across multiple touch points, including Facebook, text messaging, smartphone applications, blogs, and e-mail. Participants are encouraged to seek social support among their friends, self-monitor their weight weekly, post their health behaviors on Facebook, and e-mail their weight loss questions/concerns to a health coach. The intervention is adaptive because new theory-driven and iteratively tailored intervention elements are developed and released over the course of the two-year intervention in response to patterns of use and user feedback. Measures of body mass index, waist circumference, diet, physical activity, sedentary behavior, weight management practices, smoking, alcohol, sleep, body image, self-esteem, and depression occur at 6, 12, 18, and 24 months. Currently, all participants have been recruited, and all are in the final year of the trial. CONCLUSION: Theory-driven, evidence-based strategies for physical activity, sedentary behavior, and dietary intake can be embedded in an intervention using social and mobile technologies to promote healthy weight-related behaviors in young adults.


Assuntos
Terapia Comportamental/métodos , Aplicativos Móveis , Obesidade/terapia , Mídias Sociais , Programas de Redução de Peso/métodos , Adolescente , Adulto , Índice de Massa Corporal , Peso Corporal , Telefone Celular , Computadores de Mão , Correio Eletrônico , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Masculino , Sobrepeso/terapia , Apoio Social , Estudantes , Universidades , Circunferência da Cintura , Adulto Jovem
20.
Genet Mol Res ; 12(4): 5842-50, 2013 Nov 22.
Artigo em Inglês | MEDLINE | ID: mdl-24301953

RESUMO

ATP-binding cassette super family (ABC) proteins are considered key to oncology and pharmacology studies. We examined the effect of benzene on ABC pump protein levels in C57BL/6 mouse bone marrow mononuclear cells. After a 2-week gavage (200 mg/kg, 5 days per week), the number of peripheral leukocytes, lymphocytes and basophils dropped significantly; there was also a significant decrease in MDR1 and MRP1 gene expression. A significant reduction in expression of P-gp was found; however, there was no significant decrease in the expression of MRP1 and NF-κB p65. We conclude that regulation of membrane efflux transport protein could be a factor in benzene hematotoxicity.


Assuntos
Benzeno/toxicidade , Monócitos/efeitos dos fármacos , Proteínas Associadas à Resistência a Múltiplos Medicamentos/metabolismo , Fator de Transcrição RelA/metabolismo , Animais , Basófilos/efeitos dos fármacos , Basófilos/metabolismo , Linfócitos/efeitos dos fármacos , Linfócitos/metabolismo , Camundongos , Monócitos/metabolismo , Proteínas Associadas à Resistência a Múltiplos Medicamentos/genética , Fator de Transcrição RelA/genética
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