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1.
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue ; 32(3): 313-318, 2020 Mar.
Artigo em Chinês | MEDLINE | ID: mdl-32385995

RESUMO

OBJECTIVE: To investigate the different outcomes of two types of acute kidney injury (AKI) according to standard of Kidney Disease: Improving Global Outcomes-AKI (KDIGO-AKI), and to analyze the risk factors that affect the prognosis of intensive care unit (ICU) patients in China. METHODS: A secondary analysis was performed on the database of a previous study conducted by China Critical Care Clinical Trial Group (CCCCTG), which was a multicenter prospective study involving 3 063 patients in 22 tertiary ICUs in 19 provinces and autonomous regions of China. The demographic data, scores reflecting severity of illness, laboratory findings, intervention during ICU stay were extracted. All patients were divided into pure AKI (PAKI) and acute on chronic kidney disease (AoCKD). PAKI was defined as meeting the serum creatinine (SCr) standard of KDIGO-AKI (KDIGO-AKISCr) and the estimated glomerular filtration rate (eGFR) at baseline was ≥ 60 mL×min-1×1.73 m-2, and AoCKD was defined as meeting the KDIGO-AKISCr standard and baseline eGFR was 15-59 mL×min-1×1.73 m-2. All-cause mortality in ICU within 28 days was the primary outcome, while the length of ICU stay and renal replacement therapy (RRT) were the secondary outcome. The differences in baseline data and outcomes between the two groups were compared. The cumulative survival rate of ICU within 28 days was analyzed by Kaplan-Meier survival curve, and the risk factors of ICU death within 28 days were screened by Cox multivariate analysis. RESULTS: Of the 3 063 patients, 1 042 were enrolled, 345 with AKI, 697 without AKI. The AKI incidence was 33.11%, while ICU mortality within 28 days of AKI patients was 13.91% (48/345). Compared with PAKI patients (n = 322), AoCKD patients (n = 23) were older [years old: 74 (59, 77) vs. 58 (41, 72)] and more critical when entering ICU [acute physiology and chronic health evaluation II (APACHE II) score: 23 (19, 27) vs. 15 (11, 22)], had worse basic renal function [eGFR (mL×min-1×1.73 m-2): 49 (38, 54) vs. 115 (94, 136)], more basic complications [Charlson comorbidity index (CCI): 3 (2, 4) vs. 0 (0, 1)] and higher SCr during ICU stay [peak SCr for diagnosis of AKI (µmol/L): 412 (280, 515) vs. 176 (124, 340), all P < 0.01]. The mortality and RRT incidence within 28 days in ICU of AoCKD patients were significantly higher than those of PAKI patients [39.13% (9/23) vs. 12.11% (39/322), 26.09% (6/23) vs. 4.04% (13/322), both P < 0.01], while no significant difference was found in the length of ICU stay. Kaplan-Meier survival curve analysis showed that the 28-day cumulative survival rate in ICU in AoCKD patients was significantly lower than PAKI patients (Log-Rank: χ 2 = 5.939, P = 0.015). Multivariate Cox regression analysis showed that admission to ICU due to respiratory failure [hazard ratio (HR) = 4.458, 95% confidence interval (95%CI) was 1.141-17.413, P = 0.032], vasoactive agents treatment in ICU (HR = 5.181, 95%CI was 2.033-13.199, P = 0.001), and AoCKD (HR = 5.377, 95%CI was 1.303-22.186, P = 0.020) were independent risk factors for ICU death within 28 days. CONCLUSIONS: Further detailed classification (PAKI, AoCKD) based on KDIGO-AKISCr standard combined with eGFR is related to ICU mortality in critical patients within 28 days.

2.
Org Lett ; 2020 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-32437166

RESUMO

A transition-metal-free indole synthesis using radical coupling of 2-halotoluenes and imines via the later-stage C-N bond construction was reported for the first time. It includes an aminyl radical generation by C-H cleaving addition of 2-halotoluenes to imines via the carbanion radical relay and an intramolecular coupling of aryl halides with aminyl radicals. One standard condition can be used for all halides including F, Cl, Br, and I. No extra oxidant or transition metal is required.

3.
World Neurosurg ; 2020 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-32438001

RESUMO

BACKGROUND: As a common non-neurologic complication following traumatic brain injury (TBI), acute kidney injury (AKI) is a risk factor of mortality. Some studies confirmed the predictive value of procalcitonin (PCT) on AKI in several clinical settings. We designed this study to explore the predictive value of PCT on AKI following TBI. METHODS: We retrospectively enrolled patients admitted to our hospital with TBI from February 2015 to June 2019. Multivariate logistic regression analysis was performed to find risk factors of AKI and construct predictive model for AKI. Receiver operating characteristics (ROC) curves were drawn to compare the predictive value of PCT and constructed model. RESULTS: A total of 214 patients was included in this study. The incidence of AKI following TBI was 25.70% in this study. Compared with non-AKI group, AKI group had higher age (P =0.031), lower GCS (P <0.001), higher incidence of coagulopathy (P <0.001) and shock (P <0.001). Moreover, patients complicated with AKI had higher in-hospital mortality (P <0.001) and worse 90-day outcome (P <0.001). Multivariate logistic regression analysis indicated that age (P =0.033), PCT (P =0.002), serum chlorine(P=0.011) and creatinine (P <0.001) were independent risk factors of AKI. We constructed predictive model using these four risk factors. The area under ROC curves (AUC) of predictive model was 0.928, which was significantly higher than that of single PCT value (AUC=0.833) (Z=2.395, P<0.05). CONCLUSIONS: PCT is valuable in predicting AKI following TBI. Try to avoid AKI following TBI, physicians can adjust treatment strategies according to the level of PCT.

4.
Pediatr Res ; 2020 Mar 30.
Artigo em Inglês | MEDLINE | ID: mdl-32225172

RESUMO

BACKGROUND: Oropharyngeal colostrum (OC) is a novel feeding strategy to prevent complications of prematurity. A meta-analysis was conducted to investigate whether very low birth weight infants (VLBWs) can benefit from OC. METHODS: Randomized controlled trials (RCTs) were searched from Embase, PubMed, Web of Science, and Cochrane Central Register of Controlled Trials from the date of inception until May 2019. RCTs were eligible if they used OC therapy on VLBW infants. The primary outcomes included ventilator-associated pneumonia (VAP), necrotizing enterocolitis (NEC), bronchopulmonary dysplasia (BPD), late-onset sepsis, and death. The secondary outcomes included the time of full enteral feeding and the length of stay. RESULTS: Eight RCTs involving 682 patients (OC group: 332; non-OC group: 350) were included in the meta-analysis. The results suggested that OC was associated with a significantly reduced incidence of VAP [odds ratio (OR) = 0.39, 95% confidence interval (CI): 0.17-0.88, P = 0.02] and full enteral feeding days (mean difference = -2.66, 95% CI: -4.51 to -0.80, P = 0.005), a potential significance of NEC (OR = 0.51, 95% CI: 0.26-0.99, P = 0.05), a trend toward downregulating mortality (OR = 0.60, 95% CI: 0.34-1.08, P = 0.09) and proven sepsis (OR = 0.64, 95% CI: 0.40-1.01, P = 0.06). CONCLUSIONS: OC could significantly reduce the occurrence of VAP, and consequently, its routine use should be considered for VLBWs to prevent infectious diseases. IMPACT: OC significantly reduces the occurrence of VAP and NEC in VLBW infants. OC may reduce the incidence of VAP and NEC by increasing IgA levels. Early OC therapy for mechanical ventilation of low-weight infants may prevent the occurrence of VAP.

8.
J Pharmacol Sci ; 2020 Mar 23.
Artigo em Inglês | MEDLINE | ID: mdl-32265105

RESUMO

Resveratrol has been extensively studied as the anti-cancer agent. A variety of resveratrol analogues have been developed with structural modification to improve its bioactivity. In this work, resveratrol analogues, compound 1-4, were designed and synthesized with the Stille-Heck reaction. These results showed compound 1-4 had better anticancer effect than that of parent resveratrol. Especially compound 1 ((E)-4,4'-(ethene-1,2-diyl)bis(3-methylphenol)) displayed the excellent cytotoxicity and high selectivity. The mechanism research indicated compound 1 inhibited cell proliferation by binary paths of cell cycle arrest in S phase regulated by cyclin A1/A2 and apoptosis induction mediated by Bax/Bcl2 in a prooxidant manner.

9.
Org Lett ; 2020 Mar 31.
Artigo em Inglês | MEDLINE | ID: mdl-32227906

RESUMO

We report a simple and efficient visible-light-induced transition-metal-free hydrogenation of aryl halides. The combined visible light and base system is used to initiate the desired radical-mediated hydrogenation. A variety of aryl fluorides, chlorides, bromides, and iodides could be reduced to the corresponding (hetero)arenes with excellent yields under mild conditions. Various functional groups and other heterocyclic compounds are tolerated.

10.
Phys Med Biol ; 2020 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-32235077

RESUMO

While many pre-defined computed tomographic (CT) measures have been utilized to characterize chronic obstructive pulmonary disease (COPD), it is still challenging to represent pathological alternations of multiple dimensions and highly spatial heterogeneity. Deep CNN transferred multiple instance learning (DCT-MIL) is proposed to identify COPD via CT images. After the lung is divided into 8 sections along the axial direction, one random axial CT image is taken out from each section as one instance. With one instance as the input, the activations of neural layers of AlexNet trained by natural images are extracted as features. After dimension reduction through principle component analysis (PCA), features of all instances are input into three MIL methods: Citation k-Nearest-Neighbor (Citation-KNN), multiple instance support vector machine, and expectation-maximization diverse density. Moreover, the performance dependence of the resulted models on the depth of the neural layer where activations are extracted and the number of features is investigated. The proposed DCT-MIL achieves an exceptional performance with an accuracy of 99.29% and area under curve of 0.9826 while using 100 principle components of features extracted from the fourth convolutional layer and Citation-KNN. It outperforms not only DCT-MIL models using other settings and the pre-trained AlexNet with fine-tuning by montages of 8 lung CT images, but also other state-of-art methods. Deep CNN transferred multiple instance learning is suited for identification of COPD using CT images. It can help finding subgroups with high risk of COPD from large populations through CT scans ordered doing lung cancer screening.

11.
Precis Clin Med ; 3(1): 14-21, 2020 Feb 04.
Artigo em Inglês | MEDLINE | ID: mdl-32330209

RESUMO

In December 2019, several patients with pneumonia of an unknown cause were detected in Wuhan, China. On 7 January 2020, the causal organism was identified as a new coronavirus, later named as the 2019 novel coronavirus (2019-nCoV). Genome sequencing found the genetic sequence of 2019-nCoV homologous to that of severe acute respiratory syndrome-associated coronavirus. As of 29 January 2020, the virus had been diagnosed in more than 7000 patients in China and 77 patients in other countries. It is reported that both symptomatic and asymptomatic patients with 2019-nCoV can play a role in disease transmission via airborne and contact. This finding has caused a great concern about the prevention of illness spread. The clinical features of the infection are not specific and are often indistinguishable from those of other respiratory infections, making it difficult to diagnose. Given that the virus has a strong ability to spread between individuals, it is of top priority to identify potential or suspected patients as soon as possible-or the virus may cause a serious pandemic. Therefore, a precision medicine approach to managing this disease is urgently needed for detecting and controlling the spread of the virus. In this article, we present such an approach to managing 2019-nCoV-related pneumonia based on the unique traits of the virus recently revealed and on our experience with coronaviruses at West China Hospital in Chengdu, China.

12.
Chem Commun (Camb) ; 56(29): 4063-4066, 2020 Apr 09.
Artigo em Inglês | MEDLINE | ID: mdl-32162642

RESUMO

In this work, CuSO4 is utilized as a practical redox catalyst for tandem dual annulation in the synthesis of indole-fused tetracyclic heteroacenes, which are important skeletons in both medicinal chemistry and materials chemistry. The preparation of such skeletons in a convenient and efficient manner is in high demand. This method realizes the modular synthesis of benzofuro-, benzothieno-, and indoloindoles from abundant feedstocks such as 2-halobenzyl halides and nitrile derivatives in up to 99% yields, providing a rapid access to diverse indole-fused heteroacenes with biological or optoelectronic properties.

13.
BMC Plant Biol ; 20(1): 122, 2020 Mar 18.
Artigo em Inglês | MEDLINE | ID: mdl-32188405

RESUMO

BACKGROUND: In Arabidopsis, the aluminum (Al) exclusion mechanism is mainly facilitated by ALMT1-mediated malate exudation and MATE-mediated citrate releases from the root. Recently, we have demonstrated that coordinated functioning between an ALMT1-mediated Al exclusion mechanism, via exudation of malate from the root tip, and a NIP1;2-facilitated internal detoxification mechanism, via removal of Al from the root cell wall and subsequent root-to-shoot Al translocation, plays critical roles in achieving overall Al resistance. However, the genetic relationship between ALMT1 and NIP1;2 in these processes remained unclear. RESULTS: Through genetic and physiological analyses, we demonstrate that unlike ALMT1 and MATE, which function independently and additively, ALMT1 and NIP1;2 show an epistatic relationship in Al resistance. These results indicate that ALMT1 and NIP1;2 function in the same biochemical pathway, whereas ALMT1 and MATE in different ones. CONCLUSION: The establishment of the epistatic relationship and the coordinated functioning between the ALMT1 and NIP1;2-mediated exclusion and internal detoxification mechanisms are pivotal for achieving overall Al resistance in the non-accumulating Arabidopsis plant. We discuss and emphasize the indispensable roles of the root cell wall for the implementation of the Al exclusion mechanism and for the establishment of an epistatic relationship between the ALMT1-mediated exclusion mechanism and the NIP1;2-facilitated internal detoxification mechanism.

14.
Med Eng Phys ; 78: 29-38, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32115353

RESUMO

Patellofemoral instability is a motion related disease, featured as the patella dislocating from the trochlear groove. Four dimensional computed tomography (4DCT) enables full assessment of the patellofemoral movement. Nevertheless, the quantitative measurements of patellofemoral instability are still under research and currently of limited practical use. The aim of this study is to develop a robust and semi-automatic workflow to quantitatively describe the patellofemoral movement in a patient group of eight suffering from patellofemoral instability. The initial results show agreement with manual observations of the tibial tubercle - trochlear groove (TT-TG) distance in routine practice, and the possibility to evaluate both TT-TG distance and patellar centre - trochlear groove (PC-TG) distance dynamically during active flexion-extension-flexion movement of the knee.

16.
World Neurosurg ; 137: 183-186, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32035204

RESUMO

BACKGROUND: An 11-year-old girl had undergone posterior spinal fusion surgery for scoliosis. The surgery was complicated by intraoperative bleeding, and hemostasis was achieved by topically applying gelatin sponges. CASE DESCRIPTION: She developed acute pulmonary embolism and cardiac arrest during the surgery, which was confirmed by transesophageal echocardiography. CONCLUSIONS: Autopsy shortly after revealed that her death was associated with unintended intravascular entry of gelatin sponge fragments, resulting in an embolic event and secondary cardiopulmonary collapse.

17.
Biosci Rep ; 40(2)2020 Feb 28.
Artigo em Inglês | MEDLINE | ID: mdl-32022229

RESUMO

Radiation therapy is a widely used treatment for esophageal cancer. However, radiation resistance might result in a poor prognosis. Overexpression of HER2 has been related to adaptive radiation resistance. Pyrotinib is a HER2 inhibitor that shows an anti-tumor effect in breast cancer. The present study aims to explore the influence of pyrotinib combined with radiotherapy on HER2-positive esophageal cancer cells and explore the underlying mechanism. We screened two cell lines (TE-1 and KYSE30) that highly express HER2 from several human esophageal cancer cell lines. Cells were treated with pyrotinib or/and radiation. Cell proliferation, cell cycle distribution, and cell migration were measured. The protein levels involved in cell cycle and DNA repair were measured by Western blot. Results showed that pyrotinib inhibited HER2 activation and exerted an anti-proliferative effect in TE-1 and KYSE30 cells. Furthermore, it enhanced the anti-proliferative effect of radiation in these two cell lines. These effects might be via inhibiting HER2 phosphorylation, inducing G0/G1 arrest, and reducing EMT and DNA repair. Our results indicated that pyrotinib sensitivitied HER2 positive esophageal cancer cells to radiation treatment through various mechanisms. These findings may provide a new therapeutic strategy for treating HER2 positive esophageal cancer.

18.
J Org Chem ; 2020 Feb 25.
Artigo em Inglês | MEDLINE | ID: mdl-32069404

RESUMO

Salicylaldehyde is established as an efficient visible light photocatalyst for the first time. Compared to other simple aldehyde analogies, salicylaldehyde has a unique deprotonative red-shift from 324 to 417 nm and gives rise to the remarkable increase of fluorescence quantum from 0.0368 to 0.4632, thus enabling salicylaldehyde as a visible light (>400 nm) photocatalyst. The experimental investigations suggest that the reactive radical species are generated by sensitization of the substrates by the deprotonated salicylaldehyde through an energy-transfer pathway. Consequently, the C-C cleaving alkylation reactions of N-hydroxyphthalimide esters proceed smoothly in the presence of as low as 1 mol % of salicylaldehyde under the visible-light irradiation, affording desired alkylation products with up to 99% yields. Application in visible-light induced aerobic oxidation of N-alkylpyridinium salts is also reported.

19.
J Org Chem ; 85(5): 3942-3948, 2020 Mar 06.
Artigo em Inglês | MEDLINE | ID: mdl-31973531

RESUMO

An organocatalyzed aerobic benzylic C-H oxidation of alkyl and aryl heterocycles has been developed. This transition metal-free method is able to overcome the electron-withdrawing effect as well as product-inhibition effects in heterobenzylic radical oxidation. A variety of ketones bearing N-heterocyclic groups could be prepared under relatively mild conditions with moderate to high yields.

20.
Org Lett ; 22(3): 965-969, 2020 Feb 07.
Artigo em Inglês | MEDLINE | ID: mdl-31971810

RESUMO

A regioselective Wacker-Tsuji oxidation of internal olefins in tBuOH has been developed using oxygen as the terminal oxidant and tert-butyl nitrite as the simple organic redox cocatalyst without the involvement of hazardous cocatalysts or harsh reaction conditions. A series of internal olefins bearing various functional groups can be oxidized to the corresponding substituted ketones in generally good yields with high regioselectivities.

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