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1.
Transfus Med Hemother ; 382: 1-13, 2022 Apr 25.
Artigo em Inglês | MEDLINE | ID: mdl-35665313

RESUMO

Background: The outbreak of COVID-19 has resulted in more than 200 million infections and 4 million deaths. The blood derivative therapy represented by intravenous immunoglobulin (IVIG) and convalescent plasma (CP) therapy may be the promising therapeutics for COVID-19. Methods: A systematic article search was performed for eligible studies published up to August 3, 2021, through the PubMed, Embase, Cochrane Library. The included articles were screened by using rigorous inclusion and exclusion criteria. All analyses were conducted using Review Manager 5.4. Quality of studies and risk of bias were evaluated. Results: A total of 5 IVIG therapy and 13 CP therapy randomized controlled trials were included with a sample size of 13,696 subjects diagnosed with COVID-19. IVIG could reduce the mortality compared with the control group (RR 0.65, 95% CI: 0.46-0.93, p = 0.02). The use of CP did not effectively reduce the mortality (RR 0.97, 95% CI: 0.91-1.03, p = 0.38), the length of hospital stay (MD -0.47, 95% CI: -4.13 to 3.20, p = 0.80), and the mechanical ventilation use (RR = 0.98, 95% CI: 0.89-1.07, p = 0.62) of the patients with COVID-19. Treatment with IVIG or CP was not significantly associated with an increase in reported adverse events (RR 1.07, 95% CI: 0.94-1.22, p = 0.28). Conclusions: Treatment with IVIG could be effective and safe to improve survival for patients with COVID-19. But the benefit of CP in the treatment of COVID-19 is limited. The certainty of the evidence was moderate for all outcomes.

2.
Orthop Surg ; 2022 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-35656704

RESUMO

OBJECTIVE: To compare the effect of percutaneous endoscopic lumbar discectomy (PELD) using a double-cannula guide tube (DGT), traditional PELD, and open lumbar discectomy (OLD) to treat large lumbar disc herniations (LLDHs). METHODS: Seventy patients who presented with LLDH without cauda equina syndrome and were treated with surgery in our hospital from October 2015 to October 2017 were included. The detailed index included the visual analog scale (VAS) for back and radicular leg pain and the Oswestry Disability Index (ODI) in the immediate preoperative period and at the final follow-up. The operation time, radiation exposure time, surgical satisfaction rate, and modified MacNab criteria score were also recorded. RESULTS: The leg and back pain of the patients in these groups improved significantly in the postoperative period. No significant differences were observed in leg pain improvement between the other two groups; however, patients in the PELD group (with or without DGT) presented with significantly higher improvement in back pain than the OLD group (t = 9.965, p < 0.001). The final ODI scores were 12.1 ± 4.9, 11.2 ± 2.9, and 16.4 ± 3.6 in the PELD, PELD-DGT, and OLD groups, respectively. Patients in the PELD and PELD-DGT groups presented with significantly lower postoperative ODI scores than those in the OLD group (t = 20.834, p < 0.001). The mean postoperative hospital stays were significantly shorter in the PELD group and PELD with DGT group than in the OLD group (t = 46.688, p < 0.001). The mean operation time was significantly shorter in the PELD-DGT group than those in the PELD group (t = 25.281, p = 0.001). No perioperative complications were observed in either group. Based on the modified MacNab criteria, excellent and good outcomes were achieved in 20 out of 21 patients (95.2%) in the PELD group, 23 out of 24 patients (95.8%) in the PELD-DGT group, and 22 out of 25 patients (88.0%) in the OLD group. The rates of excellent and good outcomes were higher in the PELD and PELD-DGT groups than in the OLD group, but there were no significant differences (χ2  = 1.454, p = 0.835). CONCLUSIONS: PELD using DGT is a safe and effective option for LLDH and features advantages such as improvements in back pain, a lower hospitalization cost than OLD, a shorter operation time, and less fluoroscopy than traditional PELD.

3.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi ; 36(6): 660-664, 2022 Jun 15.
Artigo em Chinês | MEDLINE | ID: mdl-35712921

RESUMO

Objective: To summarize the progress of percutaneous endoscopic lumbar interbody fusion in the treatment of lumbar degenerative diseases. Methods: The relevant literature about percutaneous endoscopic lumbar interbody fusion at home and abroad in recent years was reviewed, the approaches, technical characteristics, short- and long-term effectiveness, and complications of different surgical procedures were summarized. Results: Percutaneous endoscopic lumbar interbody fusion is a safe and reliable treatment. At present, the main surgical methods in clinical application can be roughly summarized as percutaneous endoscopic posterior transforaminal lumbar interbody fusion (Endo-PTLIF), percutaneous endoscopic transforaminal lumbar interbody fusion (Endo-TLIF), percutaneous endoscopic oblique lumbar interbody fusion (Endo-OLIF), percutaneous endoscopic lumbar interbody fusion/Z's percutaneous endoscopic lumbar interbody fusion (Endo-LIF/ZELIF), and unilateral biportal endoscopic transforaminal lumbar interbody fusion (UBE-TLIF). Each surgical method has its own technical characteristics and development. Conclusion: Percutaneous endoscopic lumbar interbody fusion is a kind of combined technology based on the individualization of the patient's anatomical structure and the technical differentiation of the surgeon. Surgical experience, choosing adaptive indication and operative way reasonably are the key for the success.


Assuntos
Fusão Vertebral , Endoscopia/métodos , Humanos , Vértebras Lombares/cirurgia , Região Lombossacral , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Estudos Retrospectivos , Fusão Vertebral/métodos , Resultado do Tratamento
4.
J Adv Res ; 2022 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-35700918

RESUMO

INTRODUCTION: With the mounting number of cancer survivors, the complications following cancer treatment become novel conundrums and starve for countermeasures. Intravenous immunoglobulin (IVIg) is a purified preparation for immune-deficient and autoimmune conditions. OBJECTIVES: Here, we investigated whether IVIg could be employed to fight against radiation injuries and explored the underlying mechanism. METHODS: Hematopoietic or gastrointestinal (GI) tract toxicity was induced by total body or abdominal local irradiation. High-throughput sequencing was performed to analyze the gut microbiota configurations and gene expression profile of small intestine. The untargeted metabolomics of gut microbiome was assessed by liquid chromatography coupled to tandem mass spectrometry (LC-MS/MS) analyses. Hydrodynamic-based gene delivery was used to knockdown the target genes in vivo. RESULTS: Intravenous injection of IVIg protected against radiation-induced hematopoietic and GI tract toxicity in female mice but not in males. IVIg structured sex-characteristic gut microbiota configurations in abdominal irradiated mice. The irradiation enriched gut Lachnospiraceae in female mice but reduced those in males. IVIg injection combined with oral gavage of Lachnospiraceae or its metabolite hypoxanthine, alleviated radiation toxicity in male mice however, Lachnospiraceae or hypoxanthine alone failed to ameliorate the injuries. Abdominal local irradiation drove sex-distinct gene expression signatures in small intestine. Mechanistic investigation showed that replenishment of Lachnospiraceae or hypoxanthine offset abdominal radiation-reduced PLD1 expression in male mice. In females, irradiation elevated PLD1 expression. Deletion of PLD1 in GI tract of female mice erased the radioprotective effects of IVIg. CONCLUSION: IVIg battles against radiation injuries in a sex-specific, gut microbiome-dependent way through Lachnospiraceae/hypoxanthine/PLD1 axis. Our findings provide a sex-precise therapeutic avenue to improve the prognosis of cancer patients with radiotherapy in pre-clinical settings.

5.
J Cancer Res Ther ; 18(2): 418-425, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35645109

RESUMO

Background: We retrospectively evaluated the safety and efficacy of percutaneous microwave ablation (MWA) using combined computed tomography (CT) and ultrasound (US)-guided imaging in patients with Barcelona Clinic Liver Cancer (BCLC)-A1-3 hepatocellular carcinoma (HCC). Methods: We included 88 consecutive patients with single HCC who were treated with transcatheter arterial chemoembolization (TACE) using our database. The patients were divided into three groups. The combination group received MWA under the guidance of nonenhanced CT and US, CT group received MWA under the guidance of nonenhanced CT alone and US group received MWA under the guidance of US alone. The study endpoints included the treatment time, number of puncture, local recurrence rate, and adverse events. Results: The median treatment time and mean puncture number were 38.6 (30-45) min, 1.2 (1-2) times (combination group); 45.8 (35-56) min, 4.2 (3-7) times (CT group); and 36.7 (30-47) min, 1.1 (1-2) times (US group), respectively. The median puncture number was significantly less than in the CT group. The local recurrence rate in the combination group was significantly inferior to that in the US group. There was a statistically significant difference between the combination group and CT group in Grade C complication rate. Conclusions: Combining CT-and US-guide MWA in patients with BCLC-A1-3 HCC appeared to be much better than the use of guidance of CT or US alone.


Assuntos
Carcinoma Hepatocelular , Quimioembolização Terapêutica , Neoplasias Hepáticas , Carcinoma Hepatocelular/diagnóstico por imagem , Carcinoma Hepatocelular/cirurgia , Quimioembolização Terapêutica/efeitos adversos , Quimioembolização Terapêutica/métodos , Humanos , Neoplasias Hepáticas/diagnóstico por imagem , Neoplasias Hepáticas/cirurgia , Micro-Ondas/efeitos adversos , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Ultrassonografia de Intervenção
6.
Artigo em Inglês | MEDLINE | ID: mdl-35627552

RESUMO

Previous studies have suggested that physical activity may decrease academic procrastination; however, few studies have explored the underlying mechanisms of how physical activity exerts an effect on academic procrastination. This study aimed to examine the mediating effects of self-control and self-efficacy in the relationship between physical activity and academic procrastination among Chinese university students. METHODS: A cross-sectional design was used in this study. The sample comprised 564 university students from a university in Zhejiang, China. The physical activity rating scale-3 (PARS-3), self-control scale (SCS), generalized self-efficacy scale (GSES), and procrastination assessment scale-students (PASS) were used to investigate university students' physical activity, self-control, self-efficacy, and academic procrastination respectively. The Percentile-Bootstrap technique was performed to examine the mediating effects of self-control and self-efficacy on the association between physical activity and academic procrastination. RESULTS: Physical activity significantly predicted higher levels of self-control and self-efficacy, as well as lower levels of academic procrastination. Self-control and self-efficacy were significant mediators between physical activity and academic procrastination. CONCLUSION: This study indicated that physical activity interventions targeting the improvement of self-control and self-efficacy may reduce academic procrastination in university students.


Assuntos
Procrastinação , Autocontrole , China , Estudos Transversais , Exercício Físico , Humanos , Autoeficácia , Estudantes , Universidades
7.
Front Bioeng Biotechnol ; 10: 858862, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35573227

RESUMO

Cementless total knee arthroplasty (TKA) can achieve long-term biological fixation, but its application is limited by the risk of early aseptic loosening. One of the important reasons for early aseptic loosening is that mechanical osteotomy tools cannot achieve ideal bone preparation because of poor accuracy and serious bone tissue damage produced by them. Therefore, we designed an ultra-pulsed CO2 laser osteotomy system to solve these problems. To reveal the safety at the tissue and cell levels of the ultra-pulsed CO2 laser osteotomy system, a series of experiments on distal femur osteotomy in animals were performed. Then, the bone surface characteristics were analyzed through scanning electron microscopy, and the bone thermal and mechanical damage was evaluated via histological analysis. Finally, mesenchymal stem cells (MSCs) were inoculated on the bone surfaces prepared by the two osteotomy tools, and the effect of cell adhesion was analyzed through a confocal laser scanning microscope (CLSM). We successfully achieved TKA bone preparation of animal knees with the ultra-pulsed CO2 laser osteotomy system. Moreover, the biological evaluation results indicated that compared with the traditional mechanical saw, the laser can preserve the natural bone structure and cause no thermal damage to the bone. In addition, CLSM examination results showed that the laser-cut bone surface was more conducive to cell adhesion and infiltration than the bone surface cut by a mechanical saw. Overall, these results indicate that ultra-pulsed CO2 laser can achieve non-invasive bone cutting, which can be a new option for TKA bone preparation and has the potential to lead in the future.

8.
Int J Mol Sci ; 23(10)2022 May 18.
Artigo em Inglês | MEDLINE | ID: mdl-35628477

RESUMO

Rice blast is one of the main diseases in rice and can occur in different rice growth stages. Due to the complicated procedure of panicle blast identification and instability of panicle blast infection influenced by the environment, most cloned rice resistance genes are associated with leaf blast. In this study, a rice panicle blast resistance gene, Pb2, was identified by genome-wide association mapping based on the panicle blast resistance phenotypes of 230 Rice Diversity Panel 1 (RDP1) accessions with 700,000 single-nucleotide polymorphism (SNP) markers. A genome-wide association study identified 18 panicle blast resistance loci (PBRL) within two years, including 9 reported loci and 2 repeated loci (PBRL2 and PBRL13, PBRL10 and PBRL18). Among them, the repeated locus (PBRL10 and PBRL18) was located in chromosome 11. By haplotype and expression analysis, one of the Nucleotide-binding domain and Leucine-rich Repeat (NLR) Pb2 genes was highly conserved in multiple resistant rice cultivars, and its expression was significantly upregulated after rice blast infection. Pb2 encodes a typical NBS-LRR protein with NB-ARC domain and LRR domain. Compared with wild type plants, the transgenic rice of Pb2 showed enhanced resistance to panicle and leaf blast with reduced lesion number. Subcellular localization of Pb2 showed that it is located on plasma membrane, and GUS tissue-staining observation found that Pb2 is highly expressed in grains, leaf tips and stem nodes. The Pb2 transgenic plants showed no difference in agronomic traits with wild type plants. It indicated that Pb2 could be useful for breeding of rice blast resistance.


Assuntos
Magnaporthe , Oryza , Resistência à Doença/genética , Estudo de Associação Genômica Ampla , Chumbo/metabolismo , Magnaporthe/genética , Proteínas NLR/metabolismo , Nucleotídeos/metabolismo , Oryza/genética , Oryza/metabolismo , Melhoramento Vegetal , Doenças das Plantas/genética , Proteínas de Plantas/genética , Proteínas de Plantas/metabolismo
9.
J Xray Sci Technol ; 2022 Apr 16.
Artigo em Inglês | MEDLINE | ID: mdl-35466921

RESUMO

BACKGROUND: X-ray image quality relies heavily on the emitted X-ray photon number depending on X-ray tube current and exposure time. To accurately estimate the absorbed dose in an imaging protocol, it is better to simulate the X-ray imaging with a Monte Carlo platform such as GATE (Geant4 Application for Tomographic Emission). Although input of GATE is the X-ray photon number of the simulated X-ray tube, it lacks a good way to setup the photon number for a desired X-ray tube current setting. OBJECTIVE: To provide a method to correlate the experimental X-ray tube current exposure time and the X-ray photon number in GATE. METHODS: The accumulated radiation dose of a micro-computed tomography (CT) X-ray tube at different current exposure times was recorded with a general-purpose ion chamber. GATE was used to model the experimental microCT imaging system and record the total absorbed dose (cGy) in the sensitive volume of the ion chamber with different X-ray photon numbers. Linear regression models are used to establish a correlation between the estimated X-ray photon number and the X-ray tube settings. At first, one model establishes the relationship between the experimentally measured dose and the X-ray tube setting. Then, another model establishes a relationship between the simulated dose and the X-ray number in GATE. At last, by correlating these two models, a regression model to estimate the X-ray output number from an experimental X-ray tube setting (mAs) is obtained. RESULTS: For a typical micro-CT scan, the X-ray tube is operated at 50 kVp and 0.5 mA for a 500 ms exposure time per projection (0.25 mAs). For these X-ray imaging parameters, the X-ray number per projection is estimated to be 3.918×106 with 1.0 mm Al filter. CONCLUSION: The findings of this work provide an approach to correlate the experimental X-ray tube current exposure time to the X-ray photon number in the GATE simulation of the X-ray tube to more accurately determine radiation dose for an imaging protocol.

10.
BMC Neurol ; 22(1): 156, 2022 Apr 26.
Artigo em Inglês | MEDLINE | ID: mdl-35468774

RESUMO

BACKGROUND AND PURPOSE: Hemorrhagic transformation (HT) is the most alarming complication of acute ischemic stroke. We aimed to identify risk factors for HT in Chinese patients and attempted to develop a nomogram to predict individual cases. METHODS: A retrospective study was used to collect the demographic and clinical characteristics of ischemic stroke patients at the Second Affiliated Hospital of Chongqing Medical University (development cohort) and Chongqing Sanbo Changan Hospital (validation cohort) from October 2013 to August 2020. Univariate analysis and multivariate analysis were used to identify the risk factors of patients in the development cohort. The nomogram was generated, and internal validation was performed. We used the area under the receiver-operating characteristic curve (AUC-ROC) to assess the discrimination and used the Hosmer-Lemeshow test to calibrate the model. To further verify the predictability and accuracy of the model, we performed an external validation of the patients in the validation cohort. RESULTS: A total of 570 patients were used to generate the nomogram. After univariate analysis and multivariate logistic regression, the remaining 7 variables (diabetes mellitus, atrial fibrillation, total cholesterol, fibrous protein, cerebral infarction area, NIHSS score and onset-to-treatment) were independent predictors of HT and used to compose the nomogram. The area under the receiver-operating characteristic curve of the model was 0.889 (95% CI, 0.841-0.938), and the calibration was good (P = 0.487 for the Hosmer-Lemeshow test). The model was validated externally with an AUC-ROC value of 0.832 (95% CI, 0.727-0.938). CONCLUSIONS: The nomogram prediction model in this study has good predictive ability, accuracy and discrimination, which can improve the diagnostic efficiency of HT in patients with acute ischemic stroke.


Assuntos
AVC Isquêmico , Acidente Vascular Cerebral , Humanos , AVC Isquêmico/complicações , AVC Isquêmico/diagnóstico , AVC Isquêmico/epidemiologia , Nomogramas , Estudos Retrospectivos , Fatores de Risco , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/epidemiologia
11.
Bioact Mater ; 15: 29-43, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35386360

RESUMO

Low back pain, mainly caused by intervertebral disc degeneration (IVDD), is a common health problem; however, current surgical treatments are less than satisfactory. Thus, it is essential to develop novel non-invasive surgical methods for IVDD treatment. Here, we describe a therapeutic strategy to inhibit IVDD by injecting hydrogels modified with the extracellular matrix of costal cartilage (ECM-Gels) that are loaded with cartilage endplate stem cells (CESCs). After loaded with CESCs overexpressing Sphk2 (Lenti-Sphk2-CESCs) and injected near the cartilage endplate (CEP) of rats in vivo, ECM-Gels produced Sphk2-engineered exosomes (Lenti-Sphk2-Exos). These exosomes penetrated the annulus fibrosus (AF) and transported Sphk2 into the nucleus pulposus cells (NPCs). Sphk2 activated the phosphatidylinositol 3-kinase (PI3K)/p-AKT pathway as well as the intracellular autophagy of NPCs, ultimately ameliorating IVDD. This study provides a novel and efficient non-invasive combinational strategy for IVDD treatment using injectable ECM-Gels loaded with CESCs that express Sphk2 with sustained release of functional exosomes.

12.
Acta Biomater ; 145: 62-76, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35381396

RESUMO

Bone-tendon interface (BTI), also called enthesis, is composed of the bone, fibrocartilage, and tendon/ligament with gradual structural characteristics. The unique gradient structure is particularly important for mechanical stress transfer between bone and soft tissues. However, BTI injuries result in fibrous scar repairs and high incidences of re-rupture, which is attributed to the lack of local stem cells with tenogenic and osteogenic potentials. In the rat model, we identified unique stem cells from costal cartilage (CDSCs) with a high in situ regeneration potential of BTI structures. Compared to bone-marrow mesenchymal stem cells (BMSCs), CDSCs exhibit higher self-renewal capacities, better adaptability to low-oxygen and low-nutrient post-transplantation environments, as well as strong bi-potent differentiation abilities of osteogenesis and tenogenesis. After transplantation, CDSCs can survive, proliferate, and in situ gradually regenerate BTI structures. Therefore, CDSCs have a great potential for tissue engineering regeneration in BTI injuries, and have future clinical application prospects. STATEMENT OF SIGNIFICANCE: Tissue engineering is a promising technique for bone-to-tendon interface (BTI) regeneration after injury, but it is still a long way from clinical application. One of the major reasons is the lack of suitable seed cells. This study found an ideal source of seed cells derived from costal cartilages (CDSCs). Compared to the traditional seed cell BMSCs, CDSCs have higher proliferation ability, strong chondrogenic and tenogenic differentiation potential, and better adaptability to low-oxygen and low nutrient conditions. CDSCs were able to survive, proliferate, and regenerate BTI structures in situ, in contrast to BMSCs. CDSCs transplantation showed strong BTI structures regeneration potential both histologically and biomechanically, making it a suitable seed cell for the tissue engineering regeneration of BTI.


Assuntos
Cartilagem Costal , Células-Tronco Mesenquimais , Traumatismos dos Tendões , Animais , Diferenciação Celular , Oxigênio , Ratos , Traumatismos dos Tendões/patologia , Tendões , Engenharia Tecidual/métodos
13.
BMC Musculoskelet Disord ; 23(1): 252, 2022 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-35292011

RESUMO

BACKGROUND: Enhance recovery after surgery (ERAS) is a new and promising paradigm for spine surgery. The purpose of this study is to investigate the effectiveness and safety of a multimodal and evidence-based ERAS pathway to the patients undergoing anterior cervical discectomy and fusion (ACDF). METHODS: The patients treated with the ACDF-ERAS pathway were compared with a historical cohort of patients who underwent ACDF before ERAS pathway implementation. Primary outcome was length of stay (LOS). Secondary outcomes included cost, MacNab grading, complication rates and 90-day readmission and reoperation. And perioperative factors and postoperative complications were reviewed. RESULTS: The ERAS protocol was composed of 21 components. More patients undergoing multi-level surgery (n ≥ 3) were included in the ERAS group. The ERAS group showed a shorter LOS and a lower cost than the conventional group. The postoperative satisfaction of patients in ERAS group was better than that in conventional group. In addition, the rate of overall complications was significantly higher in the conventional group than that in the ERAS group. There were no significant differences in operative time, postoperative drainage, or 90-day readmission and reoperation. CONCLUSIONS: The ACDF-tailored ERAS pathway can reduce LOS, cost and postoperative complications, and improve patient satisfaction without increasing 90-day readmission and reoperation.


Assuntos
Recuperação Pós-Cirúrgica Melhorada , Alta do Paciente , Vértebras Cervicais/cirurgia , Discotomia/efeitos adversos , Humanos , Tempo de Internação
14.
Front Neurol ; 13: 814654, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35242099

RESUMO

BACKGROUND: Cilostazol is often used in Asia-Pacific countries for stroke prevention. The current systematic review and meta-analysis aimed to evaluate the effectiveness, safety, and adverse outcomes of cilostazol monotherapy compared to aspirin monotherapy for secondary stroke prevention. METHODS: The researchers conducted a comprehensive research in multiple databases (PubMed, Embase, and Cochrane library) of randomized controlled trials from conception to December 2020. The primary efficacy outcome was the occurrence of any stroke, the primary safety outcome was the bleeding risk, and the primary adverse outcome was the rate of headache and dizziness. The Mantel-Haenszel method was used to calculate a random-effects prediction. Cilostazol and aspirin were compared using a pooled risk assessment with 95% CIs. RESULTS: Six studies involving 5,617 patients were included in this review. Compared with aspirin monotherapy, cilostazol was associated with significantly lower rates of any strokes (RR: 0.67; 95% CI: 0.55-0.82) and significantly lower bleeding rates [risk ratio (RR): 0.53; 95% CI: 0.37-0.74]. However, compared with aspirin monotherapy, cilostazol was associated with significantly higher rates of headache (RR: 1.77; 95% CI: 1.41-2.20) and dizziness (RR: 1.28; 95% CI: 1.08-1.52). CONCLUSIONS: Consistent with previous studies, cilostazol monotherapy is superior to aspirin monotherapy in reducing the rate of any strokes and the bleeding risk after having a stroke. However, the use of cilostazol monotherapy is associated with several adverse life outcomes such as headaches and dizziness.

15.
Cancer Biol Ther ; 23(1): 89-95, 2022 12 31.
Artigo em Inglês | MEDLINE | ID: mdl-35230928

RESUMO

This study aimed to compare the treatment efficacy and tolerance between drug-eluting beads transarterial chemoembolization (DEB-TACE) and conventional transarterial chemoembolization (cTACE) in hepatocellular carcinoma (HCC) patients with arterioportal fistula (APF). A total of 44 HCC patients with APF scheduled for DEB-TACE (N = 24, as DEB-TACE group) or cTACE (N = 20, as cTACE group) were recruited. Treatment response, hepatic function, and adverse events were assessed or recorded. Besides, progression-free survival (PFS) and overall survival (OS) were calculated. Total treatment response was better in the DEB-TACE group compared with the cTACE group (P = .012). Meanwhile, the objective response rate (87.5% versus 60.0%) was higher (P = .013), while the disease control rate (95.8% versus 85.0%) was similar in the DEB-TACE group compared to the cTACE group (P = .213). Besides, PFS (mean value: 12.2 (95%CI: 9.9-14.6) months versus 7.8 (95%CI: 5.6-10.0) months) (P = .037), but not OS (mean value: 20.0 (95%CI: 18.1-21.9) months versus. 18.6 (95%CI: 15.4-21.8) months) (P = .341) was prolonged in DEB-TACE group compared with cTACE group. Regarding the safety, Child-Pugh stage, albumin level, and bilirubin level after treatment were all similar between the DEB-TACE group and cTACE group (all P > .05); moreover, no difference was found in the occurrence of adverse events during or after treatment between the two groups (all P > .05). Moreover, subsequent analyses found that embolic materials for APF (microspheres) in the DEB-TACE group did not affect the treatment efficacy (all P > .05). DEB-TACE promotes treatment response and PFS compared with cTACE and shows good safety in HCC patients with APF.


Assuntos
Carcinoma Hepatocelular , Quimioembolização Terapêutica , Fístula , Neoplasias Hepáticas , Carcinoma Hepatocelular/patologia , Quimioembolização Terapêutica/efeitos adversos , Fístula/terapia , Humanos , Neoplasias Hepáticas/patologia , Estudos Retrospectivos , Resultado do Tratamento
16.
Environ Pollut ; 304: 119201, 2022 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-35341816

RESUMO

Exposure of Bisphenol A (BPA) is closely associated with an increased prevalence of obesity-related metabolic syndrome. However, the potential mechanism of BPA-induced adipogenesis remains to be fully elucidated. Herein, potential mechanisms of BPA-induced adipogenesis in 3T3-L1 preadipocytes were evaluated using RNA-Seq. Then, using an early-life BPA exposure model, we further evaluated the effects of BPA exposure on lipid and glucose homeostasis. The results showed that lipid content in 3T3-L1 adipocytes was significantly increased after BPA exposure (p < 0.01) and male C57BL/6 mice with the dose of 500 µg/kg/day BPA by once-a-day oral administration for 8 weeks displayed a NAFLD-like phenotype. RNA-Seq analysis of preadipocytes showed that BPA exposure affected multiple biological processes including glycosphingolipid biosynthesis, regulation of lipolysis in adipocytes, PPAR signaling pathway and fatty acid metabolism. The dysregulation in a series of genes of mice was associated to de novo lipogenesis and lipid transport, which was linked to obesity. Importantly, we also found a significant expression increase of stearoyl-CoA desaturase 1 (SCD1) and a significant decrease of apolipoprotein D (APOD) in both fat (p < 0.01) and livers (p < 0.01) of male mice. Besides, the dysregulation of pro-inflammatory genes (TNF-α,IL-6 and SAA3) showed that BPA exposure promoted progression of hepatic inflammation. In conclusion, this study elucidated a novel mechanism in which obesity associated with BPA exposure by targeting SCD1. Exposure to BPA should be carefully examined in the chronic liver metabolic diseases.


Assuntos
Compostos Benzidrílicos , Metabolismo dos Lipídeos , Obesidade , Fenóis , Estearoil-CoA Dessaturase , Animais , Compostos Benzidrílicos/toxicidade , Homeostase , Lipídeos , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Obesidade/induzido quimicamente , Fenóis/toxicidade , Estearoil-CoA Dessaturase/genética , Estearoil-CoA Dessaturase/metabolismo , Regulação para Cima
17.
J Infect Dev Ctries ; 16(1): 222-225, 2022 01 31.
Artigo em Inglês | MEDLINE | ID: mdl-35192541

RESUMO

Clostridium perfringens causes pyogenic liver abscesses, which are rare but rapidly fatal infections. These abscesses often occur in patients with immunodeficiency due to malignancy, liver cirrhosis, diabetes mellitus, or organ transplantation. The identification of gram-positive bacilli in septicemia, the presence of gas-forming liver damage and intravascular hemolysis are manifestations of Clostridium perfringens infection. Clostridioides toxin A hydrolyzes phospholipids in erythrocyte membranes, causing spherocytosis and subsequent intravascular hemolysis, resulting in rapid deterioration and a high mortality rate. A 62-year-old man with recurrent hepatocellular carcinoma complained of a high fever and abdominal pain one day after microwave ablation. Abdominal computed tomography revealed gas-containing lesions in the liver. His condition was complicated with massive hemolysis. Laboratory examinations revealed low hemoglobin, high serum lactate dehydrogenase, and elevated indirect bilirubin levels, suggesting massive intravascular hemolysis. Although aggressive treatment was applied, he died within 16 hours after onset of the infection. After the patient died, a blood culture indicated Clostridium perfringens positivity. Clostridium perfringens-induced septicemia with massive hemolysis is rare but rapidly leads to a severe prognosis. It is important to identify Clostridium perfringens infection early and initiate effective treatment, especially abscess aspiration, which should be performed as soon as possible.


Assuntos
Carcinoma Hepatocelular , Infecções por Clostridium , Abscesso Hepático , Neoplasias Hepáticas , Carcinoma Hepatocelular/complicações , Carcinoma Hepatocelular/diagnóstico , Carcinoma Hepatocelular/cirurgia , Infecções por Clostridium/diagnóstico , Clostridium perfringens , Evolução Fatal , Humanos , Abscesso Hepático/diagnóstico , Abscesso Hepático/etiologia , Neoplasias Hepáticas/complicações , Neoplasias Hepáticas/diagnóstico , Neoplasias Hepáticas/cirurgia , Masculino , Micro-Ondas , Pessoa de Meia-Idade
18.
Cell Death Discov ; 8(1): 54, 2022 Feb 08.
Artigo em Inglês | MEDLINE | ID: mdl-35136042

RESUMO

Cumulative evidence suggests that pyroptosis, a new sort of programmed cell death, is closely related to cerebral ischemia/reperfusion (I/R) injury. Our previous studies have testified that vagus nerve stimulation (VNS) was involved in many different neuroprotective and neuroplasticity pathways via α7 nicotinic acetylcholine receptor (α7nAchR), a vital node of the cholinergic anti-inflammatory pathway during cerebral I/R injury. We aimed to determine the neuroprotective effects of VNS through α7nAchR-mediated inhibition of pyroptosis. Focal cerebral ischemic stroke rat models were obtained by middle cerebral artery occlusion for 120 min. Expression of the NLRP3 inflammasome was evaluated using western blotting and immunofluorescence (IF) staining. The neurological deficit score, infarct volume, TUNEL staining findings, transmission electron microscopy findings, and expression of inflammatory cytokines were assessed 3 days after I/R injury. Our findings suggested that the protein expression levels of NLRP3, GSDMD-N, cleaved caspase-1, and ASC gradually increased until they peaked on day 3 after I/R injury. VNS inhibited the expression of pyroptosis-related molecules and decreased the number of pyroptotic cells and membrane pores. Administration of α7nAchR-antagonist and agonist helped in further assessment of the role of α7nAchR in pyroptosis. α7nAchR-agonist mimicked VNS's neuroprotective effects on the improvement of neurological deficits, the reduction of infarct volumes, and the inhibition of neuronal pyroptosis after cerebral I/R injury. Conversely, the neuroprotection provided by VNS could be reversed by the administration of α7nAchR-antagonist. In conclusion, VNS-induced neuroprotection via inhibition of neuronal pyroptosis was α7nAchR-dependent, highlighting the pivotal role of α7nAChR in suppressing cellular pyroptosis and neuroinflammation. These findings may allow a better understanding of treatment principles for cerebral I/R injury.

19.
Neural Regen Res ; 17(8): 1809-1813, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35017442

RESUMO

Transcutaneous auricular vagus nerve stimulation (ta-VNS) is a novel noninvasive treat-ment for stroke that directly stimulates the peripheral auricular branch of the vagus nerve. There have been recent reports that ta-VNS combined with conventional rehabilitation training promotes the recovery of neurological function of patients with acute stroke. However, these were small-sample-sized studies on the recovery of neurological function in patients after percutaneous vagus nerve stimulation in the subacute and chronic phases after stroke. This double-blinded randomized controlled trial involved 60 acute ischemic or hemorrhagic stroke patients aged 18-80 years who received treatment in the Second Affiliated Hospital of Chongqing Medical University. The subjects were randomly assigned to receive ta-VNS or sham ta-VNS combined with conventional rehabilitation training. The follow-up results over 1 year revealed that ta-VNS combined with conventional rehabilitation training greatly improved the recovery of motor and sensory functions and emotional responses compared with sham ta-VNS combined with conventional rehabilitation training. There were no obvious side effects. These findings suggest that ta-VNS combined with conventional rehabilitation training for the treatment of acute ischemic or hemorrhagic stroke patients is safe and effective.

20.
Sensors (Basel) ; 22(1)2022 Jan 02.
Artigo em Inglês | MEDLINE | ID: mdl-35009872

RESUMO

With the rapid development of land mobile satellite (LMS) systems, large scale sensors and devices are willing to request wireless services, which is a challenge to the quality of service requirement and spectrum resources utilization on onboard LMS systems. Under this situation, the non-orthogonal multiple access (NOMA) is regarded as a promising technology for improving spectrum efficiency of LMS systems. In this paper, we analyze the ergodic capacity (EC) of NOMA-based multi-antenna LMS systems in the presence of imperfect limitations, i.e., channel estimation errors, imperfect successive interference cancellation, and co-channel interference. By considering multiple antennas at the satellite and terrestrial sensor users, the closed-form expression for EC of the NOMA-based LMS systems with imperfect limitations is obtained. Monte Carlo simulations are provided to verify theoretical results and reveal the influence of key parameters on system performance.

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