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1.
Biomed Pharmacother ; 144: 112267, 2021 Oct 06.
Artigo em Inglês | MEDLINE | ID: mdl-34624679

RESUMO

Studies have shown that ursolic acid (UA) and empagliflozin (EM) exert therapeutic effects in the treatment of diabetic nephropathy (DN), but both drugs have disadvantages. This study explores the effect of combining these drugs compared to that of either monotherapy. A diabetic rat model was established by feeding a high-fat diet (HFD) with high-sugar content and administering a low dose of streptozotocin (STZ) via intraperitoneal injection. UA (50 mg/kg/day, po), EM (10 mg/kg/day, po) or both were administered for 8 weeks. The development of DN was determined by observing increases in urine protein, serum creatinine, urea nitrogen, and uric acid and abnormal changes in kidney morphology. UA and EM either alone or in combination can alleviate the increases in blood glucose, glycosylated haemoglobin, blood lipid levels, inflammatory factors (TNF-α, IL-1ß, IL-6), oxidation factors (SOD, MDA, GSH, CAT, NO), renal fibrosis and pro-fibrosis factors (FN, E-cad, MMP-9, TIMP-1, SMA-α, TGF-ß1, SMAD, MAPK). The treatments could also ameliorate DN by preventing the abnormal proliferation of glomerular mesangial cells under high-glucose conditions, aberrant apoptosis and excessive production of reactive oxygen species (ROS). In addition, UA reduces the increase in LDL-L, reverses abnormal bladder morphology and mitigates the increase in colony count caused by EM, and the combination treatment can overcome the disadvantages of the slow hypoglycaemic effect of UA. In short, UA combined with empagliflozin is more effective than either monotherapy in the treatment of DN and can cancel the adverse effects of each other. The protective effect of this regimen on the kidney may be related to reducing inflammation, oxidative stress and renal fibrosis.

2.
Front Public Health ; 9: 631411, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34513776

RESUMO

Background: Cytomegalovirus seroconversion during pregnancy is common and has a substantial risk of congenital infection with longterm sequale. Screening during pregnancy or vaccination have not been shown to be effective for eliminating congenital infections. Preconception screening policy has not been evaluated adequately in a large scale. This nationwide study aimed to investigate epidemiological features of cytomegalovirus seropositivity and its geographic variation among Chinese women planning a pregnancy to gather epidemiological evidence as an essential for developing novel prevention strategies. Method: This cross-sectional sero-epidemiological survey enrolled women intending to become pregnant within 6 months in mainland China during 2010-2012. The primary outcomes in this study were cytomegalovirus Immunoglobulin G and M seropositivity. Secondary outcomes were the associations between Immunoglobulin G and Immunoglobulin M, with socio-demographic characteristics, including age, occupation, education level, place of residence, and ethnicity. The overall seropositivity and regional disparity was analyzed on the individual and regional level, respectively. Results: This study included data from 1,564,649 women from 31 provinces in mainland China. Among participants, 38.6% (n = 603,511) were cytomegalovirus immunoglobulin G+, 0.4% (n = 6,747) were immunoglobulin M+, and 0.2% (n = 2,879) were immunoglobulin M+ and immunoglobulin G+. On individual level, participant's age, ethnicity, and residing region were significantly associated with IgG+, IgM+, and IgM+IgG+ (P < 0.001), while occupation, education level, and place of residence were not statistically significant (P > 0.05). On regional level, cytomegalovirus immunoglobulin G and immunoglobulin M seropositivity was highest in the eastern region (49.5 and 0.5%, respectively), and lowest in the western region (26.9 and 0.4%, respectively). This geographic variation was also noted at the provincial level, characterized by higher provincial immunoglobulin M+ and immunoglobulin G+ rates associated with higher immunoglobulin G seropositivity. In the subgroup analysis of immunoglobulin G seropositivity, areas of higher immunoglobulin G positivity had a higher rate of immunoglobulin M+, indicating an expected increased risk of reinfection and primary infection. Conclusions: A substantial proportion of women (>60%) were susceptible to cytomegalovirus in preconception period in China, and immunoglobulin G seropositivity was seen at a low-medium level with substantial geographic variation. Integration of cytomegalovirus antibody testing in preconception screening program based on regional immunoglobulin G seropositivity, should be considered to promote strategies directed toward preventing sero-conversion during pregnancy to reduce the risk of this congenital infection.


Assuntos
Infecções por Citomegalovirus , Citomegalovirus , China/epidemiologia , Estudos Transversais , Infecções por Citomegalovirus/epidemiologia , Feminino , Humanos , Gravidez , Estudos Soroepidemiológicos
3.
J Hazard Mater ; 423(Pt A): 127053, 2021 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-34523495

RESUMO

Nickel@MXene quantum dots (Ni@MQDs), as novel flower-like hybrid materials, were firstly prepared through a simple reduction method. The Ni@MQDs exhibited an outstanding catalytic performance for Cr (VI) reduction with a low activation energy (Ea = 18.9 kJ mol-1) and a high kinetic constant (k = 0.4779 min-1) in the presence of formic acid (HCOOH). Density functional theory calculations demonstrated that Ni@MQDs exhibited an upshift of d-band center of active Ni atoms to promote the adsorption of both HCOOH and active H atoms, as well as an improved conductivity to boost the catalytic reaction kinetics, leading to the most favorable catalytic performance. This work may open up a new avenue towards the design and synthesis of novel MQDs-based hybrid catalysts for wastewater treatment.

4.
BJOG ; 2021 Sep 24.
Artigo em Inglês | MEDLINE | ID: mdl-34559941

RESUMO

OBJECTIVE: To assess the current status of cesarean delivery (CD) in China, propose reference CD rates for China overall and by regions, investigate the main indications for CDs, and identify possible areas for safe reduction. DESIGN: A multi-center cross-sectional study. SETTING: A total of 94 hospitals across 23 provinces in China. POPULATION: A total of 73977 randomly selected deliveries. METHODS: We used a modified Robson classification to characterize CDs in subgroups and by regions, and the WHO C-Model to calculate reference CD rates. MAIN OUTCOME MEASURES: CD rates in China. RESULTS: In 2015 and 2016, the overall CD rate in China was 38.9% (95% CI: 38.6% to 39.3%). Considering the obstetric characteristics of the population, the multivariable model-based reference CD rate was estimated at 28.5% (95%CI: 28.3% to 28.8%). Accordingly, an absolute reduction of 10.4% (or 26.7% of relative reduction) may be considered. The CD rate varied substantially by regions. Previous CD was the most common indication in all regions, accounting for 38.2% of all CDs, followed by maternal request (9.8%), labor dystocia (8.3%), fetal distress (7.7%) and malpresentation (7.6%). 12.7% women had prelabor CDs, contributing to 32.8% of the total CDs. CONCLUSIONS: Nearly 39% of births were delivered by cesarean in China but a quarter of reduction may be considered. Repeat CD contributed more than one-third of total CDs. Given the large variation in maternal characteristics, region-specific or even hospital-specific reference CD rates are needed for precision management of CD.

5.
J Reprod Immunol ; 148: 103379, 2021 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-34534877

RESUMO

In the maternal-fetal crosstalk, fetal derived trophoblast cells can secret several molecules to regulate immune tolerance such as cytokines and chemokines, besides human leukocyte antigens (HLA) providing. However, the mechanism of these factors in pregnancy is still unknown. Our previous study showed that IL9 could be secreted by trophoblasts and exerted a positive effect on trophoblasts themselves through autocrine signaling. Given the immunoregulatory function of IL9 and its expression in trophoblasts, we hypothesize that IL9 contributes to maternal-fetal tolerance by regulating immune cells, especially CD14+ dendritic cells (DCs) and naïve CD4 + T cells who have essential roles in maternal-fetal immune tolerance. We performed a series of experiments, finding that HTR8/SVneo cells could secrete IL9 in vitro, and this secretion was decreased under hypoxia; both CD14 + DCs and naïve CD4 + T cells expressed IL9 receptors, indicating potential interactions among these cells. In CD14 + DCs, trophoblast-derived IL9 promoted the immature differentiation, and induced the secretion of Th2 cytokines, including IL4 and IL10, shifting the Th1/Th2 ratio to Th2. In naïve CD4 + T cells, IL9 also increased Foxp3 expression and promoted the secretion of Treg cytokines, including TGFß and IL10, inhibiting pro-inflammatory Th17. Therefore, trophoblasts may act as fetal-derived immune cells to maintain maternal-fetal tolerance by secreting IL9. Given that trophoblast derived IL9 is decreased in preeclampsia, our study provides a new insight into maternal-fetal immunology and immunological disorders in abnormal pregnancy.

6.
Br J Radiol ; : 20210589, 2021 Oct 05.
Artigo em Inglês | MEDLINE | ID: mdl-34558306

RESUMO

OBJECTIVE: The study was to investigate the feasibility and accuracy of assessment for living renal donors before transplantation by using 3.0 T non-contrast-enhanced magnetic resonance angiography (NCE-MRA). METHODS: 30 renal donors were investigated and underwent computed tomography angiography (CTA) and 3.0 T NCE-MRA before nephrectomy. Two radiologists independently assessed arterial and venous anatomy and potential kidney lesions. The image quality score, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), diameters and lengths of renal arteries and veins were compared between CTA and NCE-MRA. Imaging findings were compared with the surgical results served as reference standard. Agreement was assessed using κ test. The Wilcoxon test and paired sample t test were used for statistically significant differences. RESULTS: The results of image quality score for renal arteries and veins were highly consistent between the two radiologists in NCE-MRA (p < 0.001). There was no significant difference in the scores of renal arterial and venous branches between NCE-MRA and CTA (p > 0.05). The SNR and CNR of renal vessels were higher than CTA (p < 0.001). There were no statistically significant differences in the length of renal vessels measured by the two methods (p > 0.05), and the diameter was smaller than that of CTA (p < 0.05). The detection of normal renal arteries and early branches by both examination techniques was consistent with intraoperative findings. Both methods showed good consistency between the anatomical variation of renal vein and the intraoperative diagnosis (p < 0.001). CONCLUSION: 3.0 T NCE-MRA can be used for evaluation of main renal arteries and veins with high accuracy for anatomy and variation classification, and can be used for pre-operative vascular evaluation of living donor kidney transplantation. ADVANCES IN KNOWLEDGE: 3.0 T NCE-MRA can be used for evaluation of main renal arteries and veins with high accuracy for anatomy and variation classification, and can be used for pre-operative vascular evaluation of living donor kidney transplantation.

7.
Artigo em Inglês | MEDLINE | ID: mdl-34592686

RESUMO

The proliferation of chimeric antigen receptor (CAR) T cells is closely related to their efficacy, but it is still a great challenge to monitor and quantify CAR T cells in vivo. Based on the high affinity (Kd ≈ 10-15 M) of streptavidin (SA) and biotin, radiolabeled biotin may be used to quantify SA-transduced CAR T cells (SA-CAR T cells). Radio-thin-layer chromatography (radio-TLC) and positron emission tomography (PET) are highly sensitive for trace analysis. Our aim was to develop radio-TLC and PET methods to quantify SA-CAR T cells in vitro and in vivo. First, we developed [68Ga]-DOTA-biotin. Commercially available SA was used as a standard, and quantitative standard curves were established in vitro and in vivo by radio-TLC and PET. Furthermore, the feasibility of the method was verified in Raji model mice. The linear range of radio-TLC was 0.02 âˆ¼ 0.15 pmol/µL with R2 = 0.9993 in vitro. The linear range of PET was 0.02 âˆ¼ 0.76 pmol/µL with R2 = 0.9986 in vivo. SA in CAR T cells can also be accurately quantified in a Raji leukemia model according to PET imaging. The radio-TLC/PET method established in this study is promising for using in the dynamic monitoring and analysis of SA-CAR T cells during therapy.

8.
Sci China Life Sci ; 64(9): 1379-1391, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34351567

RESUMO

Oral leukoplakia is the most common type of oral potentially malignant disorders and considered a precursor lesion to oral squamous cell carcinoma. However, a predictor of oral leukoplakia prognosis has not yet been identified. We investigated whether copy number alteration patterns may effectively predict the prognostic outcomes of oral leukoplakia using routinely processed paraffin sections. Comparison of copy number alteration patterns between oral leukoplakia with hyperplasia (HOL, n=22) and dysplasia (DOL, n=21) showed that oral leukoplakia with dysplasia had a higher copy number alteration rate (86%) than oral leukoplakia with hyperplasia (46%). Oral leukoplakia with dysplasia exhibited a wider range of genomic variations across all chromosomes compared with oral leukoplakia with hyperplasia. We also examined a retrospective cohort of 477 patients with oral leukoplakia with hyperplasia with detailed follow-up information. The malignant transformation (MT, n=19) and leukoplakia recurrence (LR, n=253) groups had higher frequencies of aneuploidy events and copy number loss rate than the free of disease (FD, n=205) group. Together, our results revealed the association between the degree of copy number alterations and the histological grade of oral leukoplakia and demonstrated that copy number alteration may be effective for prognosis prediction in oral leukoplakia patients with hyperplasia.

9.
Anim Biotechnol ; : 1-11, 2021 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-34392775

RESUMO

The purpose of this study was to evaluate the neuroprotective effect of leptin on a non-human primate model of cerebral ischemia. A total of 39 Guangxi macaques were used to establish the primate cerebral-ischemia model. HE staining was used to evaluated the pathological changes. Moreover, magnetic resonance imaging was used for the detection of embolic area. The measurements of behavior observation and cerebral infarction area were also performed. They all received autologous thrombus operation. Furthermore, western blot and RT-PCR were also used to detect the protein and mRNA expression levels of apoptosis-related factors. Our results showed that leptin could reduce the volume of cerebral infarction by about 35%. Behavioral defects can be significantly improved. In addition, mid-term and long-term behavioral deficiencies had been significantly improved by leptin. Moreover, leptin significantly decreased the expression levels of caspase-3 and Bax, and increased the expression levels of Bcl-2. In conclusion, leptin has neuroprotective effects on cerebral ischemia by effectively reducing the volume of cerebral infarction.

10.
Am J Obstet Gynecol ; 2021 Aug 10.
Artigo em Inglês | MEDLINE | ID: mdl-34389292

RESUMO

BACKGROUND: Low-dose aspirin has been the most widely studied preventive drug for preeclampsia. However, guidelines differ considerably from country to country regarding the prophylactic use of aspirin for preeclampsia. There is limited evidence from large trials to determine the effect of 100 mg of aspirin for preeclampsia screening in women with high-risk pregnancies, based on maternal risk factors, and to guide the use of low-dose aspirin in preeclampsia prevention in China. OBJECTIVE: The Low-Dose Aspirin in the Prevention of Preeclampsia in China study was designed to evaluate the effect of 100 mg of aspirin in preventing preeclampsia among high-risk pregnant women screened with maternal risk factors in China, where preeclampsia is highly prevalent, and the status of low-dose aspirin supply is commonly suboptimal. STUDY DESIGN: We conducted a multicenter randomized controlled trial at 13 tertiary hospitals from 11 provinces in China between 2016 and 2019. We assumed that the relative reduction in the incidence of preeclampsia was at least 20%, from 20% in the control group to 16% in the aspirin group. Therefore, the targeted recruitment number was 1000 participants. Women were randomly assigned to the aspirin or control group in a 1:1 allocation ratio. Statistical analyses were performed according to an intention-to-treat basis. The primary outcome was the incidence of preeclampsia, diagnosed along with a systolic blood pressure of ≥140 mm Hg or a diastolic blood pressure of ≥90 mm Hg after 20 weeks of gestation, with a previously normal blood pressure (systolic blood pressure of <140 mm Hg and diastolic blood pressure of <90 mm Hg), and complicated by proteinuria. The secondary outcomes included maternal and neonatal outcomes. Logistic regression analysis was used to determine the significance of difference of preeclampsia incidence between the groups for both the primary and secondary outcomes. Interaction analysis was also performed. RESULTS: A total of 1000 eligible women were recruited between December 2016 and March 2019, of which the final 898 patients were analyzed (464 participants in the aspirin group, 434 participants in the control group) on an intention-to-treat basis. No significant difference was found in preeclampsia incidence between the aspirin group (16.8% [78/464]) and the control group (17.1% [74/434]; relative risk, 0.986; 95% confidence interval, 0.738-1.317; P=.924). Likewise, adverse maternal and neonatal outcomes did not differ significantly between the 2 groups. Meanwhile, the incidence of postpartum hemorrhage between the 2 groups was similar (6.5% [30/464] in the aspirin group and 5.3% [23/434] in the control group; relative risk, 1.220; 95% confidence interval, 0.720-2.066; P=.459). We did not find any significant differences in preeclampsia incidence between the 2 groups in the subgroup analysis of the different risk factors. CONCLUSION: A dosage of 100 mg of aspirin per day, initiated from 12 to 20 gestational weeks until 34 weeks of gestation, did not reduce the incidence of preeclampsia in pregnant women with high-risk factors in China.

11.
J Hazard Mater ; 421: 126754, 2021 Jul 28.
Artigo em Inglês | MEDLINE | ID: mdl-34388914

RESUMO

Developing a cost-effective, stable, and recyclable adsorbent with high adsorption capacity and rapid adsorption kinetics is highly demanded for water treatment but has been proven challenging. Herein, we report a one-step strategy to synthesize tough porous nanocomposite hydrogel, by introducing biochar nanoparticles and interconnected pores into a polyacrylamide hydrogel matrix as an exemplary system. The polyacrylamide hydrogel provides the overall mechanical strength to carry loads and facilitate recycling, the biochar provides adsorptive locus for high adsorption capacity, and the interconnected pores expedite solvent transport for rapid adsorption kinetics. Mechanical characterizations manifest that the porous biochar hydrogel possesses a tensile strength of 128 kPa, a stretchability of 5.9, and a toughness of 538 J m-2. Porous structure analysis reveals that the hydrogel contains an increscent specific surface area by 441% and an augmented pore volume by 279% compared to pure polyacrylamide hydrogel. Experiments pertaining to adsorption isotherms and kinetics, with methylene blue as the model adsorbate, indicate enhanced adsorption performances. The tough hydrogel also allows facile recycling and maintains mechanical robustness after five regeneration cycles. Furthermore, biocompatibility is endorsed by cytotoxicity test. The proposed method could open an ample space for designing and synthesizing tough porous nanocomposite hydrogels for water treatment.

12.
Artigo em Inglês | MEDLINE | ID: mdl-34351756

RESUMO

Driven by an ever-growing demand for environmentally benign cooling systems, the past decade has witnessed the booming development in the field of electrocaloric (EC) cooling technology, which is considered as a promising solid-state cooling approach. Multilayer ceramic chip capacitors (MLCCs) represent the optimum structure for EC cooling elements because of large breakdown strengths, low driving voltages, and high macroscopic volumes of active EC materials. However, fundamental relationships between the geometric parameters of MLCCs and the EC coefficient are less understood. In this study, 0.92Pb(Mg1/3Nb2/3)O3-0.08PbTiO3 (PMN-PT) MLCCs with controlled configurations, such as active/inactive layer thickness, number of layers, and active volume ratio, were fabricated, and their EC performance was evaluated. The electric properties of the MLCCs are confirmed to be closely related to the geometric structure, which influences not only the heat flow but also the internal stress, resulting in the variability of EC performance and reliability/breakdown strength. The internal stress arises due to the residual thermal stress originating from the densification-related shrinkage, thermal expansion mismatch during the sintering, and clamping stress arising from the inactive area due to the large strain from the active area under a high electric field. The geometric structure-based stress distribution and the magnitude of stress on the active layers in MLCCs were determined by finite element modeling (FEM) and correlated with the experimental EC coefficients. The results reveal that a low inactive volume percentage is beneficial toward increasing the breakdown field and enhancement of EC performance because of reduced clamping stress on active EC material.

13.
Artigo em Inglês | MEDLINE | ID: mdl-34368966

RESUMO

OBJECTIVE: To improve perinatal management for hypertensive disorders in pregnancy (HDP) using checklists. METHODS: A pre-post evaluation of the implementation of checklists was performed. The checklist for HDP was adapted for the local context through expert consultations and had been used within peripartum since September 2017. Data of 763 women with singleton pregnancies diagnosed with HDP were collected between April 2016 and March 2019 at the Obstetrics & Gynecology Hospital of Fudan University. The monitoring and control groups consisted of 394 and 369 cases, respectively. Analysis was carried out by intention-to-treat with respect to maternal and fetal complications and delivery outcomes. RESULTS: After the implementation of the checklists, patients had a significant reduction in anti-hypertensive treatment both orally (P = 0.028) and intravenously (P = 0.003), and increased utilization rate of MgSO4 management (P < 0.001). Gestation was prolonged in the expectant treatment (P = 0.012) and the rate of elective and intrapartum cesarean delivery decreased (P < 0.001 and P = 0.001, respectively). The neonates of these patients had a low rate of admission to the neonatal intensive care unit (P < 0.001). CONCLUSION: National clinical guidelines complied critically after the implementation of the checklists. These checklists could be used for improving the quality of the clinical strategy and treatment, which benefitted perinatal management.

14.
Reprod Sci ; 2021 Jul 06.
Artigo em Inglês | MEDLINE | ID: mdl-34231168

RESUMO

Current methods of early diagnosis and prevention of pre-eclampsia (PE) are limited; the only available definite treatment is the initiation of delivery and complete removal of the placenta. Inappropriate activation of the immune system is thought to play considerable roles in PE. T cell immunoglobulin mucin-3 (Tim-3) has been reported to regulate immune responses and play important roles in maternal-fetal tolerance during early pregnancy. In this study, we investigated the functional regulation of Tim-3 in the maternal-fetal crosstalk during 3rd-trimester healthy pregnancy and its possible role in the pathogenesis of PE. We found that Tim-3 expression on decidual immune cells was associated with production of anti-inflammatory cytokines. Tim-3 pathway blockade resulted in higher IFN-γ but lower IL-4 and IL-10 production. Using a tube formation assay between HTR8/SVneo cells and human umbilical vein endothelial cells, we found that Tim-3 pathway blockade inhibits tube formation and reversed by addition of recombinant IL-4 and/or IL-10. Pre-eclamptic patients showed reduced Tim-3 expression on both decidual and peripheral immune cells (especially on peripheral CD8+T cells). Therefore, we proposed that abnormal Tim-3 signal resulted in immunological imbalance at the maternal-fetal interface and may be involved in the progress of PE by affecting uterine spiral artery remodeling. Our study expanded the regulatory function of Tim-3 signaling pathway to the 3rd-trimester pregnancy and provided a new target for early warning and therapeutic strategies of PE.

15.
Hypertens Pregnancy ; : 1-9, 2021 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-34264790

RESUMO

INTRODUCTION: Interleukin-25 is a Th2 interleukin and has been shown to influence cell behavior. This study aims to illustrate its affection on extravillous trophoblasts function and association with PE. Methods qPCR and immunohistochemistry demonstrate IL-25 and IL-17RB expression. CCK-8 test and transwell were to access the behavior of HTR8 in the presence or absence of IL-25, IL-25 neutralization antibody. Results EVTs and HTR8 express IL-25 and IL-17RB. IL-25 promotes proliferation and invasion (p< 0.05),which was abolished in the presence of IL-25Ab (p< 0.05). Conclusion: IL-25 may contribute to promote trophoblast invasion and proliferation and abnormal decline of IL-25 might be associated with PE. METHODS: qPCR and immunohistochemistry (IHC) were used to demonstrate IL-25 and its receptor IL-17RB expression in primary human trophoblasts of normal first- and third- trimester, as well as third-trimester of PE. CCK-8 test and transwell invasion system in vitro were applied separately to access the behavior of trophoblast cell line (HTR8) in the presence or absence of IL-25, IL-25 neutralization antibody (IL-25 Ab). RESULTS: EVTs and HTR8 express IL-25 and IL-17RB. The expressions increase in third-trimester during normal pregnancy. In PE, both of IL-25 and IL-17RB expressions decrease (p< 0.05). IL-25 for 24 h promoted HTR8 proliferation and invasion (p< 0.05). The effect was abolished in the presence of IL-25Ab (p< 0.05). CONCLUSION: This study demonstrates that IL-25 may contribute to promote trophoblast invasion and proliferation and abnormal decline of IL-25 might be associated with PE.

16.
Environ Pollut ; 287: 117629, 2021 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-34182393

RESUMO

Preterm birth (PTB), defined as live birth before the 37th week of gestation, is believed to have profound impacts on the infant's health in later life. Air pollution has been suggested to be a potential risk factor of PTB, but the evidence was inconsistent. In this multicenter birth cohort study, we aimed to examine the association between fine particulate matter (PM2.5) exposure during pregnancy and PTB in China. A total of 5976 live births were identified between Jan. 2009 and Feb. 2011 from 8 provinces in China. Residential exposures to PM2.5 were assigned based on satellite remote sensing estimates. Cox proportional hazards regressions were employed to explore the correlation for each trimester as well as the entire pregnancy. A total of 443 (7.4%) preterm births were observed. The average PM2.5 during pregnancy was 57.2 ± 8.8 µg/m3. We found exposure to PM2.5 during the whole pregnancy (hazard ratio, HR = 1.262; 95% CI: 1.087-1.465) and in the first trimester (HR = 1.114; 95% CI: 1.007-1.232) was associated with higher risk of PTB. The associations of PM2.5 were stronger for subjects with older maternal or paternal age, lower maternal pre-pregnancy BMI, and lower family income. This study adds supports to the cumulating evidence linking PM2.5 exposure and elevated PTB risk. Measures of air pollution reduction are needed during pregnancy, especially at early stage of pregnancy to prevent adverse birth outcomes.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Nascimento Prematuro , Poluentes Atmosféricos/efeitos adversos , Poluentes Atmosféricos/análise , Poluição do Ar/efeitos adversos , Poluição do Ar/análise , China/epidemiologia , Estudos de Coortes , Feminino , Humanos , Recém-Nascido , Exposição Materna , Material Particulado/efeitos adversos , Material Particulado/análise , Gravidez , Nascimento Prematuro/epidemiologia
17.
Front Endocrinol (Lausanne) ; 12: 653407, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34113317

RESUMO

Pregnancy is a complex state with many endocrinological challenges to a woman's physiology. Gestational Hypothyroidism (GHT) is an emerging condition where insufficiency of the thyroid gland has developed during pregnancy in a previously euthyroid woman. It is different to overt hypothyroidism, where marked elevation of thyroid-stimulating hormone with corresponding reduction in free thyroxine levels, is well known to cause detrimental effects to both the mother and the baby. During the past couple of decades, it has been shown that GHT is associated with multiple adverse maternal and fetal outcomes such as miscarriage, pre-eclampsia, placental abruption, fetal loss, premature delivery, neurocognitive and neurobehavioral development. However, three randomized controlled trials and a prospective cohort study performed within the last decade, show that there is no neurodevelopmental improvement in the offspring of mothers who received levothyroxine treatment for GHT. Thus, the benefit of initiating treatment for GHT is highly debated within the clinical community as there may also be risks associated with over-treatment. In addition, regulatory mechanisms that could possibly lead to GHT during pregnancy are not well elucidated. This review aims to unravel pregnancy induced physiological challenges that could provide basis for the development of GHT. During pregnancy, there is increased renal clearance of iodine leading to low iodine state. Also, an elevated estrogen level leading to an increase in circulating thyroglobulin level and a decrease in free thyroxine level. Moreover, placenta secretes compounds such as human chorionic gonadotropin (hCG), placental growth factor (PIGF) and soluble FMS-like tyrosine kinase-1 (s-Flt1) that could affect the thyroid function. In turn, the passage of thyroid hormones and iodine to the fetus is highly regulated within the placental barrier. Together, these mechanisms are hypothesized to contribute to the development of intolerance of thyroid function leading to GHT in a vulnerable individual.

18.
Int J Oral Sci ; 13(1): 21, 2021 06 30.
Artigo em Inglês | MEDLINE | ID: mdl-34188021

RESUMO

Ossifying fibroma (OF) and fibrous dysplasia (FD) are two fibro-osseous lesions with overlapping clinicopathological features, making diagnosis challenging. In this study, we applied a whole-genome shallow sequencing approach to facilitate differential diagnosis via precise profiling of copy number alterations (CNAs) using minute amounts of DNA extracted from morphologically correlated microdissected tissue samples. Freshly frozen tissue specimens from OF (n = 29) and FD (n = 28) patients were obtained for analysis. Lesion fibrous tissues and surrounding normal tissues were obtained by laser capture microdissection (LCM), with ~30-50 cells (5 000-10 000 µm2) per sample. We found that the rate of recurrent CNAs in OF cases was much higher (44.8%, 13 of 29) than that in FD cases (3.6%, 1 of 28). Sixty-nine percent (9 of 13) of the CNA-containing OF cases involved segmental amplifications and deletions on Chrs 7 and 12. We also identified eight CNA-associated genes (HILPDA, CALD1, C1GALT1, MICALL2, PHF14, AIMP2, MDM2, and CDK4) with amplified expression, which was consistent with the copy number changes. We further confirmed a jaw lesion with a previous uncertain diagnosis due to its ambiguous morphological features and the absence of GNAS mutation as OF based on the typical Chr 12 amplification pattern in its CNA profile. Moreover, analysis of a set of longitudinal samples collected from an individual with a cellular lesion in suspicion of OF at the first surgery, recurrence and the latest malignant transformation revealed identical CNA patterns at the three time points, suggesting that copy number profiling can be used as an important tool to identify borderline lesions or lesions with malignant potential. Overall, CNA profiling of fibro-osseous lesions can greatly improve differential diagnosis between OF and FD and help predict disease progression.


Assuntos
Fibroma Ossificante , Displasia Fibrosa Óssea , Variações do Número de Cópias de DNA , Diagnóstico Diferencial , Fibroma Ossificante/diagnóstico , Fibroma Ossificante/genética , Displasia Fibrosa Óssea/diagnóstico , Displasia Fibrosa Óssea/genética , Galactosiltransferases , Humanos , Arcada Osseodentária , Recidiva Local de Neoplasia , Proteínas Nucleares
19.
Artigo em Inglês | MEDLINE | ID: mdl-34101166

RESUMO

OBJECTIVE: To investigate the relationship between mild congenital pulmonary airway malformation (CPAM) and its long-term prognosis in childhood and to explore whether surgery is necessary. METHODS: We conducted a retrospective cohort of fetuses with mild CPAM diagnosed prenatally with available long-term outcomes in childhood from 2004 to 2016. The patients were divided into two groups according to the fetal CPAM-to-volume ratio (CVR) of less than 1.0 and 1.0-1.6. The primary outcome was a postnatal composite outcome including CPAM-associated respiratory symptoms and surgical resection of the lesion. The secondary outcomes included neonatal asphyxia, perinatal morbidity and mortality. RESULTS: Forty-two fetuses were identified as having CVR <1.0 or CVR-1.0-1.6 respectively (n = 37 vs n = 5; 88.1% vs 11.9%), with the median duration of follow up 2.15 years (0.3-10.8 years). Of 42 patients, 32 (76%) remained asymptomatic without recurrent respiratory symptoms or surgical resection; the other 10 with CVR <1.0 had respiratory symptoms. Of 10 symptomatic cases, five recovered after expectant treatment, and five underwent resection, for an increase in lesion size and recurrent respiratory infection. CONCLUSION: Patients with CVR <1.0 still need to be closely observed after birth. Conservative management is a reasonable option in asymptomatic cases, but surgery might be necessary in some.

20.
Adv Healthc Mater ; : e2100883, 2021 Jun 16.
Artigo em Inglês | MEDLINE | ID: mdl-34137218

RESUMO

Osteoarthritis (OA) is a disabling joint disease associated with chronic inflammation. The polarization of macrophages plays the key role in inflammatory microenvironment of joint which is a therapeutic target for OA treatment. Herein, a boronate-stabilized polyphenol-poloxamer assembled dexamethasone nanodrug with reactive oxygen species (ROS)-responsive drug release behavior and ROS scavenging ability is prepared. Thanks to that, the nanodrug can efficiently inhibit the ROS and nitric oxide production in lipopolysaccharide-activated RAW264.7 macrophages and modulate macrophages M2 polarization at a much lower concentration than free drug dexamethasone. Furthermore, the monosodium iodoacetate-induced OA mice treated with this nanodrug is very similar with the normal mice with the evaluation of body weight and scores including clinical arthritis scores, claw circumference, and kinematics score. The inflammation associated angiogenesis is also reduced which revealed by 68 Ga-labeled arginine-glycine-aspartic acid peptide micro-positron emission tomography imaging. Cartilage degradation and bone erosion in the joints are also inhibited by the nanodrug, along with the inhibition of proinflammatory cytokines. In addition, the biosafety of this nanodrug is also verified. This nanodrug with excellent immunomodulation properties can be used not only for OA therapy but also for other inflammatory diseases associated with excess oxidative stress and macrophage polarization.

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