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1.
Osteoporos Int ; 31(4): 699-708, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32103279

RESUMO

Chronic kidney disease (CKD)-related osteoporosis is a major complication in patients with CKD, conferring a higher risk of adverse outcomes. We found that among those with diabetic kidney disease, this complication increased the risk of incident frailty, an important mediator of adverse outcomes. INTRODUCTION: Renal osteodystrophy and chronic kidney disease (CKD)-related osteoporosis increases complications for patients with diabetic kidney disease (DKD). Since musculoskeletal degeneration is central to frailty development, we investigated the relationship between baseline osteoporosis and the subsequent frailty risk in patients with DKD. METHODS: From the Longitudinal Cohort of Diabetes Patients in Taiwan (n = 840,000), we identified 12,027 patients having DKD with osteoporosis and 24,054 propensity score-matched controls having DKD but without osteoporosis. The primary endpoint was incident frailty on the basis of a modified FRAIL scale. Patients were prospectively followed-up until the development of endpoints or the end of this study. The Kaplan-Meier technique and Cox proportional hazard regression were used to analyze the association between osteoporosis at baseline and incident frailty in these patients. RESULTS: The mean age of the DKD patients was 67.2 years, with 55.4% female and a 12.6% prevalence of osteoporosis at baseline. After 3.5 ± 2.2 years of follow up, the incidence rate of frailty in patients having DKD with osteoporosis was higher than that in DKD patients without (6.6 vs. 5.7 per 1000 patient-year, p = 0.04). A Cox proportional hazard regression showed that after accounting for age, gender, obesity, comorbidities, and medications, patients having DKD with osteoporosis had a significantly higher risk of developing frailty (hazard ratio, 1.19; 95% confidence interval, 1.02-1.38) than those without osteoporosis. CONCLUSIONS: CKD-related osteoporosis is associated with a higher risk of incident frailty in patients with DKD.

2.
Eur Rev Med Pharmacol Sci ; 24(1): 238-248, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31957837

RESUMO

OBJECTIVE: Lung cancer is the main burden on human health, with high mortality and poor prognosis. The involvement of long non-coding RNAs (lncRNAs) in the development of cancer has attracted wide attention. This study aimed to investigate the role and novel mechanisms of lncRNA nicotinamide nucleotide transhydrogenase antisense RNA 1 (NNT-AS1) in the progression of lung cancer. MATERIALS AND METHODS: Quantitative Real Time-Polymerase Chain Reaction (qRT-PCR) was performed to detect the expression of NNT-AS1, microRNA-3666 (miR-3666), and E2F transcription factor 2 (E2F2). 3-(4, 5-dimethyl-2-thiazolyl)-2, 5-diphenyl-2-H-tetrazolium bromide (MTT) assay was used to analyze cell proliferation. Flow cytometry was carried out to investigate cell apoptosis. Transwell assay was conducted to observe cell invasion. The interaction between miR-3666 and NNT-AS1 or E2F2 was predicted by bioinformatics tool starBase v2.0 and verified by Dual-Luciferase reporter assay. The protein level of E2F2 was quantified by Western blot. RESULTS: NNT-AS1 and E2F2 were upregulated, but miR-3666 was downregulated in lung cancer tissues and cells. NNT-AS1 knockdown attenuated proliferation and invasion but enhanced apoptosis of lung cancer cells, while miR-3666 inhibition reversed these effects. It was confirmed that miR-3666 was a target of NNT-AS1 and it directly interacted with E2F2. The inhibitory proliferation and invasion, and acceleratory apoptosis of lung cancer cells, caused by miR-3666 enrichment, were overturned by E2F2 overexpression. Furthermore, E2F2 was regulated by NNT-AS1 through miR-3666. CONCLUSIONS: NNT-AS1 participated in the progression of lung cancer through NNT-AS1/miR-3666/E2F2 regulatory axis at least in part. Our study supplied a promising strategy for the treatment of lung cancer.

3.
Zhonghua Zhong Liu Za Zhi ; 41(9): 703-707, 2019 Sep 23.
Artigo em Chinês | MEDLINE | ID: mdl-31550862

RESUMO

Objective: To investigate the therapeutic effects of surgical management for local retroperitoneal recurrence of renal cell carcinoma after radical nephrectomy. Methods: Clinical and follow-up data of 33 cases of local recurrence after radical nephrectomy in Renji Hospital from January 2010 to April 2018 were retrospectively analyzed. Results: In these 33 patients, 25 was male and 8 was female; The median age was 54 years old. The pathological stage of radical nephrectomy included 14 cases of pT1-2N0M0 stage, 16 cases of pT3-4 N0M0 stage, and 3 cases of pN1 stage. Only 4 relapsing patients had symptoms, the others were all found to have recurrence by imaging examination during follow up period of postoperation.The median recurrence time for all patients was 30 months, and the median diameter of recurrent tumors was 4.5 cm.Twenty-nine patients underwent complete resection of local recurrent lesions, and 4 patients whose recurrent lesions could not be completely resected converted receive palliative surgery. The median intraoperative blood loss was 500 ml and the median hospital stay after surgery was 4 days. Clavien grade Ⅰ-Ⅱ complications occurred in 5 patients after surgery, and no serious complications of Clavien grade Ⅲ-Ⅴ complications occurred. Six patients received postoperative adjuvant target therapy and distant metastasis occurred in one patient.In the 27 patients without adjuvant target therapy, postoperative distant metastases occurred in 12 patients. The median survival time for all patients after local recurrence surgery was 31 months. The 1-year and 3-year survival rates were 86.8% and 36.9%, respectively. Conclusions: The rigorous imaging examination after radical nephrectomy can detect local recurrent lesions as early as possible in most relapsing patients and imaging examination can predict the integrity of surgical resection of local recurrence.Although intraoperative bleeding of resection of local recurrence is relatively high, the operation is safe and the postoperative complications are controllable. Postoperative adjuvant therapy may also provide better survival benefit for patients with local recurrence.


Assuntos
Carcinoma de Células Renais/cirurgia , Neoplasias Renais/cirurgia , Recidiva Local de Neoplasia/cirurgia , Neoplasias Retroperitoneais/cirurgia , Adulto , Idoso , Carcinoma de Células Renais/patologia , Feminino , Humanos , Neoplasias Renais/patologia , Masculino , Pessoa de Meia-Idade , Nefrectomia , Neoplasias Retroperitoneais/patologia , Estudos Retrospectivos , Resultado do Tratamento
4.
Artigo em Chinês | MEDLINE | ID: mdl-31434372

RESUMO

Objective: To analyze the clinical characteristics of two groups(vascular classification declines or not in narrow band imaging (NBI) of patients with advanced hypopharyngeal carcinoma after induced chemotherapy, to follow-up and compare the survival differences between the two groups, and to explore the effect of vascular changes on clinical prognosis after induced chemotherapy in patients with advanced hypopharyngeal carcinoma. Methods: Clinical data of 56 patients with advanced hypopharyngeal carcinoma from August 2014 to September 2016 in Beijing Tongren Hospital, Capital Medical University were collected. The patients were divided into two groups according to NBI vascular classification declines or not after induced chemotherapy. The survival of patients and the impact of different factors on the prognosis were retrospectively analyzed. SPSS 24.0 statistical software was used for analysis. Frequency data were compared between the two groups using χ(2) test. Kaplan-Meier method and Cox regression analysis were employed for survival analysis and Log-Rank test was used for inter-group comparison, P<0.05 was statistically significant. Results: There was significant difference in overall survival rate(OS) between two groups of patients with advanced hypopharyngeal carcinoma after induced chemotherapy (P<0.05). Multivariate analysis showed that NBI vascular classification changes after induced chemotherapy was the impact factor for prognosis of advanced hypopharyngeal carcinoma after induced chemotherapy. Conclusion: In addition to recurrence and metastasis, NBI vascular classification changes is the important impact factor for prognosis of advanced hypopharyngeal carcinoma after induced chemotherapy. Patients with NBI vascular classification declines have significant survival benefit. The patients with advanced hypopharyngeal carcinoma should be checked with NBI examination before and after induced chemotherapy. NBI should be included in the routine screening indicators for prognosis of advanced hypopharyngeal carcinoma.


Assuntos
Antineoplásicos/farmacologia , Carcinoma de Células Escamosas/tratamento farmacológico , Neoplasias Hipofaríngeas/tratamento farmacológico , Imagem de Banda Estreita , Veias/efeitos dos fármacos , Veias/diagnóstico por imagem , Antineoplásicos/uso terapêutico , Carcinoma de Células Escamosas/diagnóstico por imagem , Carcinoma de Células Escamosas/patologia , Humanos , Neoplasias Hipofaríngeas/diagnóstico por imagem , Neoplasias Hipofaríngeas/patologia , Quimioterapia de Indução , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Análise de Sobrevida
5.
Clin Radiol ; 74(8): 650.e1-650.e6, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31084972

RESUMO

AIM: To assess the diagnostic yield and complication rate of image-guided percutaneous rib biopsy, comparing ultrasonography (US) to fluoroscopy and computed tomography (CT)-guided biopsy techniques. MATERIALS AND METHODS: A retrospective review was conducted of patients who underwent image-guided percutaneous rib biopsy at a single tertiary-care academic centre between January 2007 and June 2017. The diagnostic yield and complication rates were calculated and compared between the three imaging methods. RESULTS: A total of 70 consecutive, image-guided percutaneous rib biopsies were performed in 67 patients (48 in males, 22 in females, mean age of 68.2 years, age range 31-92 years). The image guidance method utilised for biopsy was US in 64.3% (45/70), CT in 18.6% (13/70), and fluoroscopy in 17.1% (12/70). The diagnostic yield for all cases combined was 97.1% (68/70) and 97.8% (44/45) for US-guided biopsies specifically. A complication of pneumothorax was encountered in 4.3% (3/70) of all cases combined and in 4.4% (2/45) of US-guided biopsies specifically. DISCUSSION: US-guided percutaneous rib biopsy has a high diagnostic yield and low complication rate, comparable to fluoroscopy or CT-guided biopsy.

6.
Clin Radiol ; 74(2): 166.e15-166.e21, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30503642

RESUMO

AIM: To determine whether dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) quantitative parameters increase the detectability of MRI-invisible residual cervical cancer after conisation. MATERIALS AND METHODS: This retrospective study included 59 patients with MRI-invisible cervical cancer, but positive conisation pathology. Thirty-five patients were confirmed to have residual cervical cancer, and 24 patients showed non-residual cervical cancer. DCE-MRI quantitative parameters were calculated in the anterior or posterior cervix according to the conisation position. Receiver operating characteristic (ROC) analysis was used to find the threshold of DCE-MRI parameters in differentiate residual cervical cancer patients from non-residual cervical cancer patients after conisation. RESULTS: For patients with residual cervical cancer, the Ktrans and Ve values were significantly higher than in their counterparts with non-residual cervical cancer (0.610±0.395 versus 0.366±0.305/min, p=0.013; and 0.703±0.270 versus 0.540±0.280%, p=0.028; respectively). The Ktrans showed the highest area under the ROC curve (AUC) of 0.705 (p=0.004) with a sensitivity of 67.6% and specificity of 68%. CONCLUSION: DCE-MRI quantitative parameters increased the detectability of MRI-invisible residual cervical cancer after conisation.


Assuntos
Conização , Meios de Contraste , Aumento da Imagem/métodos , Imagem por Ressonância Magnética/métodos , Neoplasias do Colo do Útero/diagnóstico por imagem , Neoplasias do Colo do Útero/patologia , Adulto , Colo do Útero/diagnóstico por imagem , Colo do Útero/patologia , Feminino , Humanos , Pessoa de Meia-Idade , Neoplasia Residual , Estudos Retrospectivos , Sensibilidade e Especificidade
7.
Phys Rev Lett ; 123(25): 255501, 2019 Dec 20.
Artigo em Inglês | MEDLINE | ID: mdl-31922810

RESUMO

Deformation twinning plays a vital role in accommodating plastic deformation of hexagonal-close-packed (hcp) metals, but its mechanisms are still unsettled under high strain rate shock compression. Here we investigate deformation twinning in shock-compressed Mg as a typical hcp metal with in situ, ultrafast synchrotron x-ray diffraction. Extension twinning occurs upon shock compression along ⟨112[over ¯]0⟩ and ⟨101[over ¯]0⟩, but only upon release for loading along ⟨0001⟩. Such deformation mechanisms are a result of the polarity of deformation twinning, which depends on directionality and relative magnitude of resolved shear stress and may be common for Mg and its alloys in a wide range of strain rates.

8.
Zhonghua Jie He He Hu Xi Za Zhi ; 41(12): 942-948, 2018 Dec 12.
Artigo em Chinês | MEDLINE | ID: mdl-30522191

RESUMO

Objective: To investigate the characteristics of respiratory viral infections, and correlation between inflammatory cytokines and respiratory virus infections in patients with acute exacerbations of chronic obstructive pulmonary disease (COPD). Methods: A prospective cohort of patients with acute exacerbations of COPD was enrolled. The sputum of all patients were collected, and 15 respiratory viruses were detected using multi-channel real-time fluorescence quantitative PCR. The clinical characteristics associated with viral infections were analyzed. The peripheral blood of the patients was collected and cytokines including IL-6, IL-8, RANTES, IP-10, sIL-2R, IFN-γ, TNF-α in the serum were detected by ELISA. Association of these cytokines with respiratory viral infections was evaluated and a discriminant model was established. Results: A total of 99 patients with acute exacerbations of COPD were enrolled in this study. Thirty-four cases (34.3%, 34/99) were positive for viral detection. Among them, the positive rate of influenza A virus was the highest (38.2%, 13/34), followed by rhinovirus (35.3%, 12/34). Multifactor logistic regression analysis showed that, fever, COPD assessment test (CAT) score in stable stage, serum IP-10 and TNF-α levels were correlated with respiratory viral infections in patients with acute exacerbations of COPD. The levels of serum IP-10 and sIL-2R increased significantly in patients with influenza A virus. Conclusions: Respiratory viral infections were common in acute exacerbations of COPD. Influenza A virus and rhinovirus were the two most common viruses. Fever was a common symptom. Patients with severe respiratory symptoms at stable stage were susceptible to viral infection. Viral infection was associated with an increase in systemic inflammatory levels, most significantly in influenza virus infection. A discriminant model composed of fever, CAT score in stable stage, serum IP-10 and TNF-α levels can be used to predict respiratory viral infections in acute exacerbations of COPD.


Assuntos
Citocinas , Mediadores da Inflamação/metabolismo , Pacientes Internados , Doença Pulmonar Obstrutiva Crônica/imunologia , Doença Pulmonar Obstrutiva Crônica/virologia , Infecções Respiratórias/imunologia , Viroses/complicações , Doença Aguda , Humanos , Estudos Prospectivos , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Infecções Respiratórias/diagnóstico , Infecções Respiratórias/virologia , Viroses/diagnóstico , Viroses/imunologia
9.
Zhonghua Zhong Liu Za Zhi ; 40(5): 384-389, 2018 May 23.
Artigo em Chinês | MEDLINE | ID: mdl-29860767

RESUMO

Objective: To investigate the efficacy and drug related adverse reactions of sorafenib and sunitinib as first-line tyrosine-kinase inhibitors (TKIs) for patients with metastatic renal cell carcinoma (mRCC) and analyze the clinical prognostic factor for survival. Methods: The data of 271 patients with metastatic renal cell carcinoma who had complete clinicopathological data were retrospectively analyzed, including 174 cases in sorafenib group and 97 cases in sunitinib group, to access patients' overall survival (OS) and progression-free survival (PFS). Prognostic values of all characteristics were determined by using univariate and multivariate Cox regression models. Results: The objective response rates (ORR) of the sorafenib and sunitinib groups were 14.9% and 19.6%, respectively, and the disease control rates (DCR) were 85.1% and 88.6%, respectively. No significant difference was found between the sorafenib and sunitinib group in ORR (P=0.325) or DCR (P=0.408). The most common grade 3 to 4 adverse events in the sorafenib group were hand-foot syndrome (6.7%), diarrhea (2.3%), and rash (2.3%). The most common grade 3 to 4 adverse events in the sunitinib group were neutropenia (6.2%), hand-foot syndrome (6.2%), and thrombocytopenia (4.6%). During the follow-up, 97 cases death occurred and 81 cases disease progression occurred in sorafenib group. The median PFS was 12 months (95% CI: 9-15 months), and the median OS was 25 months (95% CI: 21-29 months) in sorafenib group. While 74 cases death occurred and 40 cases disease progression occurred in sunitinib group, the median PFS was 12 months (95% CI: 10-12 months) and the median OS was 23 months (95% CI: 20-32 months) in sunitinib group. No significant difference was found between the sorafenib and the sunitinib group in PFS (P=0.771) or OS (P=0.548). Multivariate analysis showed Fuhrman grades (HR=1.358, 95%CI: 1.004-1.835), number of metastatic sites (HR=1.550, 95%CI: 1.143-2.101) and MSKCC risk grade (Intermediate risk group: HR=1.621, 95%CI: 1.117-2.232; Poor risk group: HR=2.890, 95%CI: 1.942-4.298) were independent prognostic factors for PFS. Fuhrman grades (HR=2.135, 95%CI: 1.533-2.974), number of metastatic sites (HR=1.774, 95%CI: 1.279-2.461) and MSKCC risk grade (Intermediate risk group: HR=1.415, 95%CI: 1.002-1.998; Poor risk group: HR=3.161, 95%CI: 2.065-4.838) were independent prognostic factors for OS. Conclusions: The results of this study indicate that sorafenib and sunitinib are both effective as the first-line TKIs for mRCC patients and sorafenib has comparable efficacy to sunitinib. But they have differences in the incidence of adverse effects. Fuhrman grades, number of metastatic sites and MSKCC risk grade are independent prognostic factors for mRCC patients.


Assuntos
Antineoplásicos/uso terapêutico , Carcinoma de Células Renais/tratamento farmacológico , Carcinoma de Células Renais/secundário , Indóis/uso terapêutico , Neoplasias Renais/tratamento farmacológico , Niacinamida/análogos & derivados , Compostos de Fenilureia/uso terapêutico , Pirróis/uso terapêutico , Antineoplásicos/efeitos adversos , Carcinoma de Células Renais/mortalidade , Diarreia/induzido quimicamente , Progressão da Doença , Intervalo Livre de Doença , Síndrome Mão-Pé/etiologia , Humanos , Indóis/efeitos adversos , Neoplasias Renais/mortalidade , Neoplasias Renais/patologia , Análise Multivariada , Neutropenia/induzido quimicamente , Niacinamida/efeitos adversos , Niacinamida/uso terapêutico , Compostos de Fenilureia/efeitos adversos , Prognóstico , Modelos de Riscos Proporcionais , Pirróis/efeitos adversos , Estudos Retrospectivos , Fatores de Risco , Sorafenibe , Sunitinibe , Trombocitopenia/induzido quimicamente , Resultado do Tratamento
10.
Stud Mycol ; 90: 161-189, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29632417

RESUMO

Lophiostoma bipolare was taxonomically revised based on the morphological observations and phylogenetic analyses of molecular data from nuclear rDNA SSU-ITS-LSU, TUB, tef1, and rpb2 genes. Twenty-nine strains were morphologically similar to Lo. bipolare. A total of 174 sequences were generated from the Lo. bipolare complex. Phylogenetic analyses based on TUB sequence revealed 11 distinct species within the Lo. bipolare complex. Morphological features of the ascospores and the anatomical structure of the ascomata from both field collections as well as axenic culture, which have been reported previously as variable features at intraspecific levels, were compared to evaluate the taxonomic reliability of these features. To clarify the generic position of the 11 species, phylogenetic analyses were done on SSU-ITS-LSU-tef1-rpb2 gene sequences. The Lo. bipolare complex shared phylogenetic relationships with Pseudolophiostoma and Vaginatispora, and formed an additional five distinct clades from other members of Lophiostomataceae. According to its phylogenetic position, Lo. bipolare sensu stricto was distantly related to Lophiostoma s. str., and formed an independent clade within Lophiostomataceae. Lophiostoma bipolare s. str. could be distinguished from the other lophiostomataceous genera by the clypeus around the ostiolar neck and by the thin and uniformly thick peridium. A novel genus described as Lentistoma was established to accommodate this species, and the epitypification of Lentistoma bipolare (basionym: Massarina bipolaris) was proposed. Other lineages of the Lo. bipolare complex could not be separated on the basis of the ascospore size and sheath variations, but were distinguished based on ascomatal features, such as the existence of the clypeus, brown hyphae surrounding the peridium, and the contexture of the peridium, which were stable indicators of generic boundaries in Lophiostomataceae. Four additional new genera with five new species were recognised based on these morphological differences: Crassiclypeus (C. aquaticus), Flabellascoma (F. cycadicola and F. minimum), Leptoparies (Lep. palmarum), and Pseudopaucispora (Pseudop. brunneospora). Three new species were added to Pseudolophiostoma (Pseudol. cornisporum, Pseudol. obtusisporum, and Pseudol. tropicum) and two new species were added to Vaginatispora (V. amygdali and V. scabrispora). The re-evaluation of the validity of several previously recognised genera resulted in the introduction of two new genera with new combinations for Lophiostoma pseudoarmatisporum as Parapaucispora pseudoarmatispora and Vaginatispora fuckelii as Neovaginatispora fuckelii.

11.
Zhonghua Liu Xing Bing Xue Za Zhi ; 39(2): 142-149, 2018 Feb 10.
Artigo em Chinês | MEDLINE | ID: mdl-29495196

RESUMO

Objective: From the perspective of actual service suppliers regarding cancer screening, this study aimed to assess the long-term sustainability of cancer screening programs in China. Methods: Based on a Cancer Screening Program in Urban China (CanSPUC), our survey focused on all the hospitals, centers for disease control and prevention (CDC) and community service centers across 16 provinces in China which participated in the programs between 2013 and 2015. All the managers (institutional/department level) and professional staff involved in the program were interviewed using either paper-based questionnaire or online approach. Results: A total of 4 626 participants completed the interview. It showed that the main gains from providing screening service emphasized promotion in social value (63.6%), local reputation (35.9%), and professional skills (30.6%), whereas difficulties encountered included inadequate compensation (30.9%) and discordance among information systems (28.3%). When the service remuneration amounts to about 50 Chinese Yuan per screening item, those professional staff self-reported that they would like to work overtime. More than half (63.7%) of the staff expressed willingness to provide routine screening service, the main expectations were to promote their reputation to the local residents (48.7%) and to promote professional skills (43.1%). Those who were not willing to provide screening services were worried about the potential heavy workload (59.8%) or being interfered with their routine work (49.8%). Further detailed results regarding the different organization types and program roles were presented in the following detailed report. Conclusions: Findings of gains and difficulties showed that if cancer screening is expected to become a long-term running, incentive mechanism from the program, external promotion and advocacy as well as capacity building should be strengthened; furthermore, rewards to staff's screening services should be raised according to the local situations. Results regarding the "willingness to provide service" showed that management of the program should also be strengthened, including information system building and inter-agency and inter-department coordination at the government levels.


Assuntos
Atitude do Pessoal de Saúde , Detecção Precoce de Câncer , Neoplasias/diagnóstico , China , Recursos em Saúde , Humanos , Entrevistas como Assunto , Motivação , Neoplasias/prevenção & controle , Inquéritos e Questionários , Estados Unidos , População Urbana , Carga de Trabalho
12.
Zhonghua Liu Xing Bing Xue Za Zhi ; 39(2): 157-164, 2018 Feb 10.
Artigo em Chinês | MEDLINE | ID: mdl-29495198

RESUMO

Objective: From an actual cancer screening service demanders' perspective, we tried to understand the preference on screening frequency and willingness-to-pay for the packaging screening program on common cancers and to evaluate its long-term sustainability in urban populations in China. Methods: From 2012 to 2014, a multi-center cross-sectional survey was conducted among the actual screening participants from 13 provinces covered by the Cancer Screening Program in Urban China (CanSPUC). By face-to-face interview, information regarding to preference to screening frequency, willingness-to-pay for packaging screening program, maximum amount on payment and related reasons for unwillingness were investigated. Results: A total of 31 029 participants were included in this survey, with an average age as (55.2±7.5) years and median annual income per family as 25 000 Chinese Yuan. People's preference to screening frequency varied under different assumptions ( " totally free" and "self-paid" ). When the packaging screening was assumed totally free, 93.9% of residents would prefer to take the screening program every 1 to 3 years. However, the corresponding proportion dropped to 67.3% when assuming a self-paid pattern. 76.7% of the participants had the willingness-to-pay for the packaging screening, but only 11.2% of them would like to pay more than 500 Chinese Yuan (the expenditure of the particular packaging screening were about 1 500 Chinese Yuan). The remaining 23.3% of residents showed no willingness-to-pay, and the main reasons were unaffordable expenditure (71.7%) and feeling'no need'(40.4%). Conclusions: People who participated in the CanSPUC program generally tended to choose high-frequency packaging screening program, indicating the high potential acceptance for scale-up packaging screening, while it needs cautious assessments and rational guidance to the public. Although about seven in ten of the residents were willing to pay, the payment amount was limited, revealing the necessity of strengthening individual's awareness of his or her key role in health self-management, and a reasonable payment proportion should be considered when establishing co-compensation mechanism.


Assuntos
Detecção Precoce de Câncer/economia , Honorários e Preços , Programas de Rastreamento/estatística & dados numéricos , Neoplasias/diagnóstico , Aceitação pelo Paciente de Cuidados de Saúde , China , Estudos Transversais , Detecção Precoce de Câncer/estatística & dados numéricos , Feminino , Humanos , Renda , Neoplasias/economia , Neoplasias/prevenção & controle , Inquéritos e Questionários , População Urbana
13.
Zhonghua Liu Xing Bing Xue Za Zhi ; 39(2): 165-172, 2018 Feb 10.
Artigo em Chinês | MEDLINE | ID: mdl-29495199

RESUMO

Objective: To explore the sustainability of cancer screening strategy from potential demander's perspective in Chinese country, we conducted a study on the use of cancer screening services and willingness-to-pay among the urban community residents. All the participants of this study had not been on the Cancer Screening Program in Urban China (CanSPUC) or any other national level cancer screening projects. Methods: Target communities and populations were selected from the 16 project provinces in China which were on the program between 2014 and 2015, by using the multi-center cross-sectional convenience sampling method. Chi-square was used to compare the rates on the utilization of service and willingness-to-pay across the different subgroups. Logistic progression was conducted to examine factors that associated with the service utilization and willingness-to-pay. Results: A total of 16 394 participants were included in this study. Among them, 12.1% (1 984/16 394) had ever been on a cancer screening program. Populations with following characteristics as: being elderly (60-69 years, OR=1.27, 95% CI: 1.13-1.43), female (male, OR= 0.56, 95%CI: 0.50-0.62), having had higher education (high school/specialized secondary school, OR= 1.51, 95%CI: 1.35-1.70; college or over, OR=2.10, 95%CI: 1.36-3.25), working for public (OR=2.85, 95% CI: 2.26-3.59), enterprises or self-employed agencies (OR=1.32, 95% CI: 1.06-1.64), having higher income (60 000-150 000 Chinese Yuan, OR=1.55, 95%CI: 1.39-1.73; ≥150 000 Chinese Yuan, OR=2.57, 95% CI: 2.09-3.15), under basic medical insurance programs for urban employees/for government servants'(OR=1.15, 95% CI: 1.01-1.32), on basic medical insurance set for urban residents'/on commercial medical insurance programs etc. (OR=1.01, 95%CI: 0.84-1.22), were in favor of the services. When neglecting the fee for charge, 65.8% (10 795/16 394) of the participants said that they could accept the cancer screening program, particularly in those who had already been on the screening program (P<0.05). 61.2% (10 038/16 392) of all the participants showed the willingness-topay for a long-term packaging screening services, particularly in those who were relatively younger (60-69 years, OR=0.80, 95%CI: 0.74-0.87), working for public (OR=1.76, 95%CI: 1.56-1.98) or enterprise sectors or self-employed households (OR=1.32, 95%CI: 1.18-1.47), having higher income (60 000-150 000 Chinese Yuan, OR=1.51, 95%CI: 1.40-1.63; ≥150 000 Chinese Yuan,OR= 1.95, 95% CI: 1.60-2.38), utilized screening services (OR=2.18, 95% CI: 1.94-2.46). Conclusions: The rate of using the cancer screening services should be improved. Factors including age, gender, education, occupation, income and insurance appeared as major factors related to the use of cancer screening services. Willingness-to-pay seemed relatively high, but the amount of payment they could afford was limited. Factors including age, occupation, income and insurance appeared as major factors to the willingness-to-pay.


Assuntos
Detecção Precoce de Câncer/economia , Detecção Precoce de Câncer/estatística & dados numéricos , Neoplasias/diagnóstico , Aceitação pelo Paciente de Cuidados de Saúde , População Urbana , Idoso , China , Estudos Transversais , Honorários e Preços , Feminino , Pesquisas sobre Serviços de Saúde , Humanos , Renda , Masculino , Neoplasias/prevenção & controle , Inquéritos e Questionários
14.
Zhonghua Jie He He Hu Xi Za Zhi ; 41(2): 95-99, 2018 Feb 12.
Artigo em Chinês | MEDLINE | ID: mdl-29429214

RESUMO

Objective: To evaluate the correlation between N-terminal probrainnatriuretic peptide (NT-proBNP) and the prognosis of death in hospitalized patients with acute exacerbation of chronic obstructive pulmonary disease(COPD). Methods: A cohort study of 169 patients with acute exacerbations COPD. According to the age and NT-proBNP value measured on admission, cases were divided into 3 groups. The risk ratio of mortality among the three group were analyzed. Results: Thirty-two patients died within 1 year. There are 93 cases in group A (NT-proBNP < 300 ng/L), 45 cases in group B (aged 75 and below with NT-proBNP 300-900 ng/L, older than 75 with NT-proBNP 300-1 800 ng/L), 31 cases in group C (aged 75 and below with NT-proBNP>900 ng/L, older than 75 with NT-proBNP>1 800 ng/L); The in-hospital mortalities were 3.2%, 11.1% and 32.3%respectively, and mortalities within a year were 5.4%, 17.8% and 61.3% . The risk ratio (RR) and 95%CI for dying in hospital of group C to group A and B were 10.00 (3.61-56.50) and 2.90 (1.15-12.60), RR and 95%CI for dying within 1 years after hospitalization were 11.40 (8.78-88.46) and 3.45 (2.56-20.97, P<0.05). Conclusion: The NT-proBNP values measured at admission were associated with the short-term and long-term prognosis of patients with AECOPD.


Assuntos
Mortalidade Hospitalar , Peptídeo Natriurético Encefálico/sangue , Fragmentos de Peptídeos/sangue , Doença Pulmonar Obstrutiva Crônica/sangue , Doença Pulmonar Obstrutiva Crônica/mortalidade , Doença Aguda , Idoso , Biomarcadores/sangue , Estudos de Coortes , Humanos , Prognóstico , Doença Pulmonar Obstrutiva Crônica/diagnóstico
15.
Transplant Proc ; 49(8): 1855-1863, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28923637

RESUMO

INTRODUCTION: Studies focusing on the efficacy and safety of ledipasvir (LDV) + sofosbuvir (SOF) therapy in liver transplant (LT) recipients with hepatitis C virus (HCV) recurrence are still limited. Therefore, the aim of our work was to perform a systematic review and meta-analysis to evaluate outcome data of LDV + SOF therapy in LT recipients. METHODS: Multiple databases were systematically searched for eligible studies. We included studies reporting sustained virological response 12 weeks after treatment (SVR12) and treatment-related adverse events (AEs) in LT recipients treated with LDV + SOF ± ribavirin (RBV) for HCV recurrence. All statistical analyses were conducted by using R version 3.3.1 (The R Foundation for Statistical Computing, Vienna, Austria). RESULTS: Twelve studies with a total of 994 LT recipients were included, most of which were diagnosed with HCV genotype 1 infection. The overall SVR12 reached 96.3% (95% confidence interval [CI]: 94.9%-97.5%) and no significant heterogeneity was observed (Q statistic = 10.63, P = .47; I2 = 0%). No difference was found in SVR12 between treatments for 12 weeks and 24 weeks (P = .18). Patients treated with LDV + SOF + RBV (n = 525) exhibited an SVR12 rate of 95.1% (95% CI 92.8%-96.6%), which showed no difference from the findings in the LDV + SOF treatment group (n = 314) with an SVR12 reaching 94.9% (95% CI 91.5%-97.0%; P = .92). There was a tendency for a higher SVR12 in patients without cirrhosis than those with cirrhosis (P < .05). The most common AEs were listed as following: anemia 41.9% (n = 203 of 484), fatigue 39.1% (n = 207 of 530), headache 24.2% (n = 128 of 530), nausea 21.9% (n = 106 of 484), and diarrhea 19.0% (n = 92 of 484). CONCLUSION: LDV + SOF-based treatment is highly effective and well tolerated in LT recipients with HCV reinfection.


Assuntos
Antivirais/uso terapêutico , Benzimidazóis/uso terapêutico , Fluorenos/uso terapêutico , Hepatite C Crônica/tratamento farmacológico , Uridina Monofosfato/análogos & derivados , Humanos , Recidiva , Ribavirina/uso terapêutico , Uridina Monofosfato/uso terapêutico
16.
Zhonghua Liu Xing Bing Xue Za Zhi ; 38(4): 542-546, 2017 Apr 10.
Artigo em Chinês | MEDLINE | ID: mdl-28468079

RESUMO

Objective: To investigate the characteristics, underlying patterns of disease and treatments on middle-aged and elderly patients who suffered from community-acquired pneumonia (CAP) and factors related to the duration of hospitalization of this disease. Methods: Descriptive study was conducted to depict the characteristics, underlying disease patterns and treatments on patients who were older than 40 years of age. Data was collected through medical records of the patients, retrospectively. Multivariate logistic regression analysis was conducted to explore those factors that affecting the duration of hospitalization. Results: A total of 6 231 cases, with 3 583 (57.5%) males were involved. Mean age of the patients was 69.87±12.32. Underlying diseases would include hypertension (31.8%) and diabetes (16.6%), with most pathogens bacteria (25.4%) or fungus (14.9%) related. 97.7% of the patients received antibiotics. Factors as age (OR=1.005, 95%CI: 1.001-1.009), smoking habit (OR=1.292, 95% CI: 1.159-1.441), tumor (OR=1.217, 95% CI: 1.022-1.449), congestive heart failure (OR=1.323, 95% CI: 1.076-1.626), glucocorticoid treatment (OR=1.744, 95% CI: 1.545-1.969) and ICU admission (OR=2.724, 95%CI: 2.031-3.654) were significantly related to the duration of hospitalization. Conclusions: Patients above the age of 40 who suffered from community-acquired pneumonia were often accompanied by underlying diseases. Factors as age, smoking habit, tumor, congestive heart failure, glucocorticoid treatment and ICU admission would affect the duration of hospitalization.


Assuntos
Infecções Comunitárias Adquiridas/epidemiologia , Tempo de Internação/estatística & dados numéricos , Pneumonia/epidemiologia , Idoso , Antibacterianos/uso terapêutico , Infecções Comunitárias Adquiridas/tratamento farmacológico , Feminino , Insuficiência Cardíaca , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , Pneumonia/tratamento farmacológico , Estudos Retrospectivos , Fumar/epidemiologia , Resultado do Tratamento
17.
Am J Transplant ; 17(1): 103-114, 2017 01.
Artigo em Inglês | MEDLINE | ID: mdl-27575845

RESUMO

Solid organ transplant recipients (SOTRs) are at increased risk of developing and dying from cancer. However, controversies exist around cancer screening in this population owing to reduced life expectancy and competing causes of death. This systematic review assesses the availability, quality and consistency of cancer screening recommendations in clinical practice guidelines (CPGs). We systematically searched bibliographic databases and gray literature to identify CPGs and assessed their quality using AGREE II. Recommendations were extracted along with their supporting evidence. Thirteen guidelines were included in the review. CPGs for kidney recipients were the most frequent source of screening recommendations, and recommendations for skin cancer screening were most frequently presented. Some screening recommendations differed from those for the general population, based on literature demonstrating higher cancer incidence among SOTRs versus direct evidence of screening effectiveness. Relevant stakeholders such as oncology specialists, primary care providers and public health experts were not involved in the formulation of the screening recommendations. In conclusion, although several guidelines make recommendations for cancer screening in SOTRs, the availability of cancer screening recommendations varied considerably by transplanted organ. More studies are required to inform cancer screening recommendations in SOTRs, and guideline development should involve transplant patients, oncologists and cancer screening specialists.


Assuntos
Neoplasias/diagnóstico , Transplante de Órgãos/efeitos adversos , Guias de Prática Clínica como Assunto/normas , Detecção Precoce de Câncer , Humanos , Neoplasias/etiologia , Neoplasias/prevenção & controle , Prognóstico , Transplantados
18.
Epidemiol Infect ; 145(3): 451-461, 2017 02.
Artigo em Inglês | MEDLINE | ID: mdl-27873572

RESUMO

Dengue fever (DF) is the most prevalent and rapidly spreading mosquito-borne disease globally. Control of DF is limited by barriers to vector control and integrated management approaches. This study aimed to explore the potential risk factors for autochthonous DF transmission and to estimate the threshold effects of high-order interactions among risk factors. A time-series regression tree model was applied to estimate the hierarchical relationship between reported autochthonous DF cases and the potential risk factors including the timeliness of DF surveillance systems (median time interval between symptom onset date and diagnosis date, MTIOD), mosquito density, imported cases and meteorological factors in Zhongshan, China from 2001 to 2013. We found that MTIOD was the most influential factor in autochthonous DF transmission. Monthly autochthonous DF incidence rate increased by 36·02-fold [relative risk (RR) 36·02, 95% confidence interval (CI) 25·26-46·78, compared to the average DF incidence rate during the study period] when the 2-month lagged moving average of MTIOD was >4·15 days and the 3-month lagged moving average of the mean Breteau Index (BI) was ⩾16·57. If the 2-month lagged moving average MTIOD was between 1·11 and 4·15 days and the monthly maximum diurnal temperature range at a lag of 1 month was <9·6 °C, the monthly mean autochthonous DF incidence rate increased by 14·67-fold (RR 14·67, 95% CI 8·84-20·51, compared to the average DF incidence rate during the study period). This study demonstrates that the timeliness of DF surveillance systems, mosquito density and diurnal temperature range play critical roles in the autochthonous DF transmission in Zhongshan. Better assessment and prediction of the risk of DF transmission is beneficial for establishing scientific strategies for DF early warning surveillance and control.


Assuntos
Dengue/epidemiologia , Mosquitos Vetores/crescimento & desenvolvimento , Tempo (Meteorologia) , Animais , China/epidemiologia , Humanos , Incidência , Modelos Estatísticos , Medição de Risco , Temperatura Ambiente , Fatores de Tempo
19.
J Phys Condens Matter ; 28(39): 396002, 2016 10 05.
Artigo em Inglês | MEDLINE | ID: mdl-27485370

RESUMO

The enhanced 2D layered structure single crystalline TlCo2Se2 has been successfully fabricated, which exhibits field-induced 3D spin-flop phase transitions. In the case of the magnetic field parallel to the c-axis (B//c), the applied magnetic field induces the evolution of the noncollinear helical magnetic coupling into a ferromagnetic (FM) state with all the magnetization of the Co ion parallel to the c-axis. A striking variation of the field-induced strain within the ab-plane is noticed in the magnetic field region of 20-30 T. In the case of the magnetic field perpendicular to the c-axis (B ⊥ c), the inter-layer helical antiferromagnetic (AFM) coupling may transform to an initial canted AFM coupling, and then part of it transforms to an intermediate metamagnetic phase with the alignment of two-up-one-down Co magnetic moments and finally to an ultimate FM coupling in higher magnetic fields. The robust noncollinear AFM magnetic coupling is completely destroyed above 30 T. In combination with the measurements of magnetization, magnetoresistance and field-induced strain, a complete magnetic phase diagram of the TlCo2Se2 single crystal has been depicted, demonstrating complex magnetic structures even though the crystal geometry itself gives no indication of the magnetic frustration.

20.
Rev Sci Instrum ; 87(5): 053903, 2016 05.
Artigo em Inglês | MEDLINE | ID: mdl-27250438

RESUMO

We develop a mini gas gun system for simultaneous, single-pulse, x-ray diffraction and imaging under high strain-rate loading at the beamline 32-ID of the Advanced Photon Source. In order to increase the reciprocal space covered by a small-area detector, a conventional target chamber is split into two chambers: a narrowed measurement chamber and a relief chamber. The gas gun impact is synchronized with synchrotron x-ray pulses and high-speed cameras. Depending on a camera's capability, multiframe imaging and diffraction can be achieved. The proof-of-principle experiments are performed on single-crystal sapphire. The diffraction spots and images during impact are analyzed to quantify lattice deformation and fracture; fracture is dominated by splitting cracks followed by wing cracks, and diffraction peaks are broadened likely due to mosaic spread. Our results demonstrate the potential of such multiscale measurements for studying high strain-rate phenomena at dynamic extremes.

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