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1.
J Exp Med ; 218(1)2021 Jan 04.
Artigo em Inglês | MEDLINE | ID: mdl-32991666

RESUMO

Neonatal hypoxic-ischemic encephalopathy (HIE) with the pathological characteristic of white matter injury often leads to lifelong cognitive and neurobehavioral dysfunction, but relevant therapies to promote remyelination are still unavailable. We found that histamine H2 receptor (H2R) negatively regulated the oligodendrocyte differentiation rate without affecting the oligodendrocytes at the oligodendrocyte precursor cell stage or mature stage following oxygen-glucose deprivation in vitro. Notably, selective deletion of the H2R gene (Hrh2) in differentiating oligodendrocytes (Hrh2fl/fl;CNPase-Cre) improved their differentiation, remyelination, and functional recovery following neonatal hypoxia-ischemia in mice. The regulation of oligodendrocyte differentiation by H2R is mediated by binding with Axin2, which leads to up-regulation of the Wnt/ß-catenin signaling pathway. Furthermore, H2R antagonists also promoted oligodendrocyte differentiation and remyelination and the recovery of cognition and motor functions following neonatal hypoxia-ischemia. Thus, histamine H2R in oligodendrocytes could serve as a novel and effective therapeutic target for the retard of oligodendrocyte differentiation and remyelination following neonatal hypoxia-ischemia. The H2R antagonists may have potential therapeutic value for neonatal HIE.

2.
Medicine (Baltimore) ; 99(45): e22632, 2020 Nov 06.
Artigo em Inglês | MEDLINE | ID: mdl-33157919

RESUMO

RATIONALE: Tumor lysis syndrome (TLS) is an oncologic emergency, but its incidence in MM is rare. To our knowledge, ixazomib has not been associated with TLS in MM. PATIENT CONCERNS: The patient developed TLS after 10 days of treatment with ixazomib, accompanied by renal failure of hyperuricemia, hyperkalemia, and hyperphosphatemia. DIAGNOSES: MM (type IgG λ) was diagnosed according to the diagnostic criteria established by the International Myeloma Working Group and classified stage IIA by the International Staging System. TLS was diagnosed after the patient met all three criteria of the Cairo-Bishop TLS scoring system. INTERVENTIONS: From April 8, 2017, the patient was treated with 3 courses of bortezomib, cyclophosphamide, and dexamethasone chemotherapy. From August 18, she received five courses of bortezomib combined with DCEP chemotherapy. On May 21, 2018 treatment was switched to lenalidomide, bortezomib, and dexamethasone for four courses. Ixazomib was started on October 10, 2018 with cyclophosphamide and dexamethasone. On October 19, 2018 vigorous intravenous hydration with sodium bicarbonate was initiated and peroral febuxostat was administered. OUTCOMES: On October 19, changes in hematological indicators raised concern for TLS worsening kidney function and decreasing urine output. She refused renal replacement treatment for TLS-induced acute kidney injury. On October 26th, the patient died of respiratory failure. LESSONS: This case highlights the need to vigilant for the occurrence of TLS in patients undergoing MM treatment with ixazomib. Higher baseline uric acid or creatinine, rapidly progressive anemia, and raised lactate dehydrogenase (LDH) and ß2-microglobulin may be surrogate markers of TLS.

3.
ACS Nano ; 2020 Nov 09.
Artigo em Inglês | MEDLINE | ID: mdl-33164493

RESUMO

Surfaces with under-water superoleophobicity or under-oil superhydrophobicity have attractive features due to their widespread applications. However, it is difficult to achieve under-liquid dual superlyophobic surfaces, that is, under-oil superhydrophobicity and under-water superoleophobicity coexistence, due to the thermodynamic contradiction. Herein, we report an approach to obtain the under-liquid dual superlyophobic surface through conformational transitions of surface self-assembled molecules. Preferential exposure of either hydrophobic or hydrophilic moieties of the hydroxythiol (HS(CH2)nOH, where n is the number of methylene groups) self-assembled monolayers to the surrounding solvent (water or oil) can be used to manipulate macroscopic wettability. In water, the surfaces modified with different hydroxythiols exhibit under-water superoleophobicity because of the exposure of hydroxyl groups. In contrast, surface wettability to water is affected by molecular orientation in oil, and the surface transits from under-oil superhydrophilicity to superhydrophobicity when n ≥ 4. This surface design can amplify the molecular-level conformational transition to the change of macroscopic surface wettability. Furthermore, on-demand oil/water separation relying on the under-liquid dual superlyophobicity is successfully demonstrated. This work may be useful in developing the materials with opposite superwettability.

4.
Int J Clin Exp Pathol ; 13(10): 2599-2607, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33165428

RESUMO

Sclerosing pneumocytoma (SP) is a rare and benign tumor predominantly occurring in Asian women, easily misdiagnosed by imaging and pathologic frozen diagnosis during surgery because of its diverse histomorphology (4 structures, 2 types of cells). It may form multiple tumors. When SP is combined with carcinoid, adenoma, or other tumors (although rare), diagnosis is more complicated. SP mixed with carcinoid tumor is rare. At present, only 4 cases have been reported in English literature. Here, we report a case of sclerosing pneumocytoma combined not only with carcinoid, but also with clear cell adenoma of the lung. The patient was a 52-year-old female and CT found a nodule in the middle lobe of the right lung. SP was not excluded by intraoperative frozen section diagnosis. The above 3 components formed a 1.4 cm nodule. The related literature is reviewed to strengthen the understanding of SP, and aid clinicopathological diagnosis.

5.
Nanotechnology ; 2020 Nov 06.
Artigo em Inglês | MEDLINE | ID: mdl-33157542

RESUMO

In this paper, a 2D periodic structure made of tungsten(W) grating patch on a thin Al2O3 spacer and an opaque W film is proposed, as a broadband selective thermal emitter. We numerically investigated the spectral emissivity of the structure from the deep by finite-difference time-domain (FDTD) method. Geometric parameters effects on the emissivity are discussed and the mechanisms of magnetic polaritons in the structure are further analyzed in detail. In addition, by adding another metal-dielectric stack upon the pre-existing grating structure, the emissivity of the composite structure can be further enhanced, and the normal emissivity exceeds 0.95 in the wavelength range of 0.65~1.95 µm, some even close to unity. Furthermore, the composite structures are found to exhibit insensitivity to polar angle and polarization.

6.
Life Sci ; : 118711, 2020 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-33186566

RESUMO

We investigated the association between c-Src and the progression of hepatocellular carcinoma (HCC) and its underlying mechanisms. The relationship between c-Src expression and the occurrence and development of HCC was explored using GEPIA and further confirmed by western blotting analysis and real-time quantitative PCR. CCK-8, flow cytometry, Transwell, and wound-healing assays were conducted to analyze the effects of c-Src on the growth, cell cycle, apoptosis, migration, and infiltration of HCC cells. Mouse models of transplanted xenogeneic human tumors were constructed to explore the effects of c-Src on HCC tumor growth. Compared with that in adjacent normal liver tissues, the expression level of c-Src in HCC tissues was significantly increased and was negatively correlated with patient survival. These findings are consistent with those in the GEPIA database. Downregulation of c-Src expression can inhibit the growth, infiltration, and migration of HCC cells. c-Src impeded the translocation of YAP from the nucleus to the cytoplasm and promoted Yes-associated protein transcriptional activity. In vivo experiments showed that c-Src inhibition suppressed tumor growth in mice. We found that c-Src can promote the growth and tumorigenesis of HCC cells by activating the Hippo signaling pathway.

7.
World J Gastroenterol ; 26(40): 6250-6259, 2020 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-33177797

RESUMO

BACKGROUND: Pancreatic adenoma can potentially transform into adenocarcinoma, so it is recommended to be resected surgically or endoscopically. Endoscopic papillectomy is one of the main treatments for papillary adenoma, and bleeding, perforation, and pancreatitis are the most frequent and critical adverse events that restrict its wider use. There is no standard procedure for endoscopic papillectomy yet. The procedure is relevant to postoperative adverse events. AIM: To reduce the postoperative adverse event rates and improve patients' postoperative condition, we developed a standard novel procedure for endoscopic papillectomy. METHODS: The novel endoscopic papillectomy had two main modifications based on the conventional method: The isolation of bile from pancreatic juice with a bile duct stent and wound surface protection with metal clips and fibrin glue. We performed a single-center retrospective comparison study on the novel and conventional methods to examine the feasibility of the novel method for reducing postoperative adverse events. RESULTS: A total of 76 patients, of whom 23 underwent the novel procedure and 53 underwent the conventional procedure, were retrospectively evaluated in this study. The postoperative bleeding and pancreatitis rates of the novel method were significantly lower than those of the conventional method (0 vs 20.75%, P = 0.028, and 17.4% vs 41.5%, P = 0.042, respectively). After applying the novel method, the most critical adverse event, perforation, was entirely prevented, compared to a prevalence of 5.66% with the conventional method. Several postoperative symptoms, including fever, rapid pulse, and decrease in hemoglobin level, were significantly less frequent in the novel group (P = 0.042, 0.049, and 0.014, respectively). Overall, the total adverse event rate of the novel method was lower (0 vs 24.5%, P = 0.007) than that of the conventional method. CONCLUSION: Patients who underwent the novel procedure had lower postoperative adverse event rates. This study demonstrates the potential efficacy and safety of the novel endoscopic papillectomy in reducing postoperative adverse events.

8.
Soft Matter ; 16(40): 9176-9182, 2020 Oct 21.
Artigo em Inglês | MEDLINE | ID: mdl-33084723

RESUMO

Water droplets are expected to be employed as animated soft matter to mimic the behaviours of both nonliving objects and small living organisms. Local water droplet motion has attracted considerable interest and has expanded into various application areas because of its close relationship with processes associated with life. However, few approaches have been capable of independently manipulating local droplet motion without loss on a substrate due to the difficulty in shaping and focusing the motion route. Here, we demonstrate a non-contact electrostatic-powered local water motion strategy. The gradient of electrostatic charges in space guides the local drop motion without liquid loss in a controlled motion path. The local droplet motion on surfaces with varied wettabilities is discussed and compared. A unipolar electrostatic field is theoretically simulated. This work can introduce a finger-directed surface charge pattern and local droplet motion as a new variable in many droplet robot schemes and inspire next-generation liquid devices.

9.
Artigo em Inglês | MEDLINE | ID: mdl-33048521

RESUMO

Quantum dot light-emitting diodes (QLEDs), particularly those capable of emitting light with tunable colors, have attracted the attention of researchers for their variability in lighting and displays. So far, various color-tunable QLEDs have been developed using techniques of inkjet printing or white light combining with color filters (CFs), which however suffered from difficulties in mass production. Here, by inserting an insulating resin layer between two conductive silver nanowire (AgNW) layers, a unique AgNWs/resin/AgNWs (A/R/A) sandwich-structured electrode was developed, showing rather small sheet resistances at both sides and high transparency. The as-prepared A/R/A electrode is applicable for making a large-area transparent red QLED with an external quantum efficiency (EQE) of 11.42% and a transmittance of 72.5%. Furthermore, the A/R/A electrode can be used as intermediate connecting electrodes to stack three single-colored QLEDs, forming a novel structured R/G/B tri-stacked QLED, which enables emission not only of primary colors red, green, and blue independently with the maximum EQE of 8.22, 8.07, and 2.28%, respectively, but also arbitrary hybrid colors that cover a 107% National Television System Committee (NTSC) color triangle. Such large-area full-color-tunable tri-stacked QLED offers new perspectives for the next-generation solid-state scene lighting and full-color displays.

10.
Adv Mater ; : e2001718, 2020 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-33058318

RESUMO

Smart control of wettability on superwetting surfaces has aroused much attention in the past few years. Compared with traditional strategies such as adjusting the surface chemistry, regulating the surface microstructure is more difficult, though it can bring lots of new functions. Recently, it was found that, based on the shape memory effect of a shape memory polymer, the surface microstructure can be controlled more easily and precisely. Here, recent developments in the smart control of wettability on superwetting shape memory microstructures and corresponding applications are summarized. The primary concern is the superhydrophobic surfaces that have demonstrated numerous attractive functions, including controllable droplet storage, transportation, bouncing, capture/release, and reprogrammable gradient wetting, under variation of the surface microstructure. Finally, some achievements in wetting control on other superwetting surfaces (such as superomniphobic surfaces and superslippery surfaces) and perspectives on future research directions are also discussed.

11.
Nat Commun ; 11(1): 5339, 2020 10 21.
Artigo em Inglês | MEDLINE | ID: mdl-33087718

RESUMO

Propionic acidemia/aciduria (PA) is an ultra-rare, life-threatening, inherited metabolic disorder caused by deficiency of the mitochondrial enzyme, propionyl-CoA carboxylase (PCC) composed of six alpha (PCCA) and six beta (PCCB) subunits. We herein report an enzyme replacement approach to treat PA using a combination of two messenger RNAs (mRNAs) (dual mRNAs) encoding both human PCCA (hPCCA) and PCCB (hPCCB) encapsulated in biodegradable lipid nanoparticles (LNPs) to produce functional PCC enzyme in liver. In patient fibroblasts, dual mRNAs encoded proteins localize in mitochondria and produce higher PCC enzyme activity vs. single (PCCA or PCCB) mRNA alone. In a hypomorphic murine model of PA, dual mRNAs normalize ammonia similarly to carglumic acid, a drug approved in Europe for the treatment of hyperammonemia due to PA. Dual mRNAs additionally restore functional PCC enzyme in liver and thus reduce primary disease-associated toxins in a dose-dependent manner in long-term 3- and 6-month repeat-dose studies in PA mice. Dual mRNAs are well-tolerated in these studies with no adverse findings. These studies demonstrate the potential of mRNA technology to chronically administer multiple mRNAs to produce large complex enzymes, with applicability to other genetic disorders.


Assuntos
Terapia de Reposição de Enzimas/métodos , Acidemia Propiônica/terapia , RNA Mensageiro/uso terapêutico , Animais , Modelos Animais de Doenças , Glutamatos/uso terapêutico , Humanos , Cinética , Lipídeos/química , Fígado/enzimologia , Metilmalonil-CoA Descarboxilase/química , Metilmalonil-CoA Descarboxilase/genética , Metilmalonil-CoA Descarboxilase/metabolismo , Camundongos , Camundongos Knockout , Camundongos Transgênicos , Mitocôndrias/enzimologia , Nanopartículas/administração & dosagem , Nanopartículas/química , Acidemia Propiônica/genética , Acidemia Propiônica/metabolismo , Subunidades Proteicas/química , Subunidades Proteicas/genética , RNA Mensageiro/administração & dosagem , RNA Mensageiro/genética
12.
EMBO Rep ; 21(11): e50085, 2020 Nov 05.
Artigo em Inglês | MEDLINE | ID: mdl-33043581

RESUMO

The cultured brown adipocytes can oxidize glucose in vitro, but it is still not fully clear whether brown adipose tissue (BAT) could completely oxidize glucose in vivo. Although positron emission tomography (PET) with 18 F-fluorodeoxyglucose (18 F-FDG) showed a high level of glucose uptake in the activated BAT, the non-metabolizable 18 F-FDG cannot fully demonstrate intracellular glucose metabolism. Through in vivo [U-13 C]glucose tracing, here we show that chronic cold exposure dramatically activates glucose oxidation in BAT and the browning/beiging subcutaneous white adipose tissue (sWAT). Specifically, chronic cold exposure enhances glucose flux into the mitochondrial TCA cycle. Metabolic flux analysis models that ß3-adrenergic receptor (ß3-AR) agonist significantly enhances the flux of mitochondrial pyruvate uptake through mitochondrial pyruvate carrier (MPC) in the differentiated primary brown adipocytes. Furthermore, in vivo MPC inhibition blocks cold-induced glucose oxidation and impairs body temperature maintenance in mice. Together, mitochondrial pyruvate uptake and oxidation serve an important energy source in the chronic cold exposure activated BAT and beige adipose tissue, which supports a role for glucose oxidation in brown fat thermogenesis.

13.
Biochem J ; 477(21): 4295-4312, 2020 Nov 13.
Artigo em Inglês | MEDLINE | ID: mdl-33094816

RESUMO

Ubiquitin-specific protease 19 (USP19) is a member of the deubiquitinating (DUB) enzymes that catalyze removing the ubiquitin signals from target proteins. Our previous research has demonstrated that USP19 up-regulates the protein level and aggregation of polyQ-expanded huntingtin through the involvement of heat shock protein 90 (HSP90). Here, we present solution structures of the CS1, CS2 and UbL domains of USP19 and structural insights into their domain interactions. We found that the tandem CS domains fold back to interact with the C-terminal USP domain (USPD) intra-molecularly that leads to inhibition of the catalytic core of USP19, especially CS1 interacts with the embedded UbL domain and CS2 does with the CH2 catalytic core. Moreover, CS2 specifically interacts with the NBD domain of HSP90, which can activate the DUB enzyme. A mechanism of auto-inhibition of USP19 and activation by HSP90 is proposed, on which USP19 modulates the protein level of polyQ-expanded huntingtin in cells. This study provides structural and mechanistic insights into the modulation of protein level and aggregation by USP19 with the assistance of HSP90.

14.
Proc Natl Acad Sci U S A ; 117(44): 27154-27161, 2020 Nov 03.
Artigo em Inglês | MEDLINE | ID: mdl-33087567

RESUMO

Titanium carbide (Ti3C2Tx) MXene has great potential for use in aerospace and flexible electronics due to its excellent electrical conductivity and mechanical properties. However, the assembly of MXene nanosheets into macroscopic high-performance nanocomposites is challenging, limiting MXene's practical applications. Here we describe our work fabricating strong and highly conductive MXene sheets through sequential bridging of hydrogen and ionic bonding. The ionic bonding agent decreases interplanar spacing and increases MXene nanosheet alignment, while the hydrogen bonding agent increases interplanar spacing and decreases MXene nanosheet alignment. Successive application of hydrogen and ionic bonding agents optimizes toughness, tensile strength, oxidation resistance in a humid environment, and resistance to sonication disintegration and mechanical abuse. The tensile strength of these MXene sheets reaches up to 436 MPa. The electrical conductivity and weight-normalized shielding efficiency are also as high as 2,988 S/cm and 58,929 dB∙cm2/g, respectively. The toughening and strengthening mechanisms are revealed by molecular-dynamics simulations. Our sequential bridging strategy opens an avenue for the assembly of other high-performance MXene nanocomposites.

15.
Nat Commun ; 11(1): 5228, 2020 10 16.
Artigo em Inglês | MEDLINE | ID: mdl-33067442

RESUMO

Two major treatment strategies employed in non-small cell lung cancer, NSCLC, are tyrosine kinase inhibitors, TKIs, and immune checkpoint inhibitors, ICIs. The choice of strategy is based on heterogeneous biomarkers that can dynamically change during therapy. Thus, there is a compelling need to identify comprehensive biomarkers that can be used longitudinally to help guide therapy choice. Herein, we report a 18F-FDG-PET/CT-based deep learning model, which demonstrates high accuracy in EGFR mutation status prediction across patient cohorts from different institutions. A deep learning score (EGFR-DLS) was significantly and positively associated with longer progression free survival (PFS) in patients treated with EGFR-TKIs, while EGFR-DLS is significantly and negatively associated with higher durable clinical benefit, reduced hyperprogression, and longer PFS among patients treated with ICIs. Thus, the EGFR-DLS provides a non-invasive method for precise quantification of EGFR mutation status in NSCLC patients, which is promising to identify NSCLC patients sensitive to EGFR-TKI or ICI-treatments.


Assuntos
Carcinoma Pulmonar de Células não Pequenas/diagnóstico por imagem , Aprendizado Profundo , Neoplasias Pulmonares/diagnóstico por imagem , Inibidores de Proteínas Quinases/administração & dosagem , Idoso , Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Carcinoma Pulmonar de Células não Pequenas/genética , Carcinoma Pulmonar de Células não Pequenas/mortalidade , Receptores ErbB/genética , Receptores ErbB/metabolismo , Feminino , Humanos , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pulmonares/genética , Neoplasias Pulmonares/mortalidade , Masculino , Pessoa de Meia-Idade , Mutação , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Intervalo Livre de Progressão
16.
ACS Appl Mater Interfaces ; 12(45): 51036-51043, 2020 Nov 11.
Artigo em Inglês | MEDLINE | ID: mdl-33112597

RESUMO

Hydrogel hybrids are one of the key factors in life activities and biomimetic science; however, their development and utilization are critically impeded by their inadequate adhesive strength and intricate process. In nature, barnacles can stick to a variety of solid surfaces firmly (adhesive strength above 300 kPa) using a hydrophobic interface, which inspires us to firmly combine hydrogels and polymers through introducing an adhesive layer. By spreading a hydrophobic liquid membrane directly, tough combination of a hydrogel and a polymer substrate could be achieved after one-step polymerization. The fracture energy of the hydrogel attached to the surface of polyvinyl chloride was up to 1200 J m-2 and the tensile strength reached 1.21 MPa. Furthermore, the adhesion samples with this method exhibit an antifatigue performance, having withstood large bends and twists. It should be pointed out that this approach can also be applied to a variety of complicated surfaces. This work may expand the application range of hydrogels and provides an inspiration for hydrogel adhesion.

17.
Adv Mater ; : e2005039, 2020 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-33124744

RESUMO

The high-performance unidirectional manipulation of microdroplets is crucial for many vital applications including water collection and bioanalysis. Among several actuation methods (e.g., electric, magnetic, light, and thermal actuation), mechanical vibration is pollution-free and biocompatible. However, it suffers from limited droplet movement mode, small volume range (VMax /VMin  < 3), and low transport velocity (≤11.5 mm s-1 ) because the droplet motion is a sliding state caused by the vertical vibration on the asymmetric hydrophobic microstructures. Here, an alternative strategy is proposed-horizontal vibration for multimode (rolling, bouncing/reverse bouncing, converging/diffusing, climbing, 90o turning, and sequential transport), large-volume-range (VMax /VMin  ≈ 100), and high-speed (≈22.86 mm s-1 ) unidirectional microdroplet manipulation, which is ascribed to the rolling state on superhydrophobic slant microwall arrays (SMWAs) fabricated by the one-step femtosecond laser oblique ablation. The unidirectional transport mechanism relies on the variance of viscous resistance induced by the difference of contact area between the microdroplet and the slant microwalls. Furthermore, a circular, curved, and "L"-shaped SMWA is designed and fabricated for droplet motion with particular paths. Finally, sequential transport of large-volume-range droplets and chemical mixing microreaction of water-based droplets are demonstrated on the SMWA, which demonstrates the great potential in the field of microdroplet manipulation.

18.
ACS Nano ; 2020 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-32970408

RESUMO

Recently, smart liquid permeation has aroused much attention. However, existing strategies to achieve such a goal are often based on reversibly controlling hydrophobicity/hydrophilicity on static porous structures, which are unsuitable for oils with low surface tension, and meanwhile they cannot realize tunable permeation flux since the pore sizes are constant. Herein, we report a superlyophilic shape memory porous sponge (SSMS) that can demonstrate tunable pore size from about 28 nm to 900 µm as the material's shape is changed. Based on the controllability in pore size, not only ON/OFF penetration but also precisely tunable permeation flux can be obtained for both water and oil. Furthermore, by using the SSMS, an application in accurate release of small-molecule rhodamine B was also demonstrated. This work reports a material with tunable pore size for controllable liquid permeation, which provides some ideas for designing smart superwetting permeation materials.

19.
Sci Adv ; 6(37)2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32917681

RESUMO

Natural creatures use their surface structures to control directional liquid dynamics for survival. Learning from nature, artificial superwetting materials have triggered technological revolutions in many disciplines. To improve controllability, researchers have attempted to use external fields, such as thermal, light, magnetic, and electric fields, to assist or achieve controllable liquid dynamics. Emerging directional liquid transport applications have prosperously advanced in recent years but still present some challenges. This review discusses and summarizes the field of directional liquid dynamics on natural creatures and artificial surfaces with superwettabilities and ventures to propose several potential strategies to construct directional liquid transport systems for fog collection, 3D printing, energy devices, separation, soft machine, and sensor devices, which are useful for driving liquid transport or motility.

20.
Artigo em Inglês | MEDLINE | ID: mdl-32919775

RESUMO

OBJECTIVES: To compare short- and long-term outcomes between sleeve lobectomy and pneumonectomy for lung cancer in a single center during a 15-year period. METHODS: One thousand nine hundred eighty-one patients who underwent either a sleeve lobectomy (n = 964; 48.7%) or a pneumonectomy (n = 1017; 51.3%) from January 2003 to December 2017 at the Shanghai Pulmonary Hospital, were matched according to a propensity score to produce 2 groups of 665 patients each. The study period was divided into 3 5-year subperiods. RESULTS: Sleeve lobectomy was associated with a lower 30- and 90-day mortality (0.60% and 0.90% vs 1.5% and 3.91%; P = .177 and P = .001, respectively, after matching), lower morbidity (4.36% vs 8.16%; P = .005 before matching, 3.61% vs 8.72%; P < .001 after matching), improved 5-year survival (62.7% vs 43.1%; P < .001 before matching and 61% vs 44.7%; P < .001 after matching), and 5-year disease-free survival after matching (56.6% vs 46.2%; P < .001). The sleeve lobectomy to pneumonectomy ratio increased by 78%, whereas 90-day mortality decreased by 66.81% between the first and the last subperiods. CONCLUSIONS: Sleeve lobectomy is associated with improved short- and long-term outcomes and should be the resection of choice for centrally located lung cancers, when feasible.

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