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1.
Infection ; 2020 Apr 10.
Artigo em Inglês | MEDLINE | ID: mdl-32277408

RESUMO

BACKGROUND: Coronavirus disease 2019 (COVID-19) has been demonstrated to be the cause of pneumonia. Nevertheless, it has not been reported as the cause of acute myocarditis or fulminant myocarditis. CASE PRESENTATION: A 63-year-old male was admitted with pneumonia and cardiac symptoms. He was genetically confirmed as having COVID-19 according to sputum testing on the day of admission. He also had elevated troponin I (Trop I) level (up to 11.37 g/L) and diffuse myocardial dyskinesia along with a decreased left ventricular ejection fraction (LVEF) on echocardiography. The highest level of interleukin-6 was 272.40 pg/ml. Bedside chest radiographs showed typical ground-glass changes indicative of viral pneumonia. Laboratory test results for viruses that cause myocarditis were all negative. The patient conformed to the diagnostic criteria of the Chinese expert consensus statement for fulminant myocarditis. After receiving antiviral therapy and mechanical life support, Trop I was reduced to 0.10 g/L, and interleukin-6 was reduced to 7.63 pg/mL. Moreover, the LVEF of the patient gradually recovered to 68%. The patient died of aggravation of secondary infection on the 33rd day of hospitalization. CONCLUSION: COVID-19 patients may develop severe cardiac complications such as myocarditis and heart failure. This is the first report of COVID-19 complicated with fulminant myocarditis. The mechanism of cardiac pathology caused by COVID-19 needs further study.

2.
Hua Xi Kou Qiang Yi Xue Za Zhi ; 37(5): 505-508, 2019 Oct 01.
Artigo em Chinês | MEDLINE | ID: mdl-31721498

RESUMO

OBJECTIVE: To study the clinical features and treatments of congenital submandibular duct dilatation. METHODS: Seven children with congenital submandibular duct dilatation from January 2008 to March 2018 were included in this study, whose average age was 5 months and 22 days. The clinical manifestations are unilateral swelling of the mouth floor. All seven children underwent sublingual gland resection, submandibular gland dilatation catheter resection, and catheter reroute under general anesthesia. Intraoperatively, the orifice of the submandibular gland was constricted and part of the catheter was dilated. RESULTS: All seven patients had good healing without swelling or cyst formation. CONCLUSIONS: Congenital submandibular duct dilatation occurs at a young age. Early diagnosis and treatment can help prevent further expansion of the catheter and avoid gland atrophy, feeding difficulty, and breathing obstruction. Simultaneous excision of the sublingual gland can avoid the formation of postoperative sublingual cyst.


Assuntos
Rânula , Ductos Salivares , Criança , Dilatação , Humanos , Lactente , Glândula Sublingual , Glândula Submandibular
3.
Appl Microbiol Biotechnol ; 102(11): 4785-4797, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29610966

RESUMO

Avibacterium paragallinarum is a Gram-negative bacterium that causes infectious coryza in chicken. It was reported that the capsule polysaccharides extracted from Av. paragallinarum genotype A contained chondroitin. Chondroitin synthase of Av. paragallinarum (ApCS) encoded by one gene within the presumed capsule biosynthesis gene cluster exhibited considerable homology to identified bacterial chondroitin synthases. Herein, we report the identification and characterization of ApCS. This enzyme indeed displays chondroitin synthase activity involved in the biosynthesis of the capsule. ApCS is a bifunctional protein catalyzing the elongation of the chondroitin chain by alternatively transferring the glucuronic acid (GlcA) and N-acetyl-D-galactosamine (GalNAc) residues from their nucleotide forms to the non-reducing ends of the saccharide chains. GlcA with a para-nitrophenyl group (pNP) could serve as the acceptor for ApCS; this enzyme shows a stringent donor tolerance when the acceptor is as small as this monosaccharide. Then, UDP-GalNAc and GlcA-pNP were injected sequentially through the chip-immobilized chondroitin synthases, and the surface plasmon resonance data demonstrated that the up-regulated extent caused by the binding of the donor is one possibly essential factor in successful polymerization reaction. This conclusion will, therefore, enhance the understanding of the mode of action of glycosyltransferase. Surprisingly, high activity at near-zero temperature as well as weak temperature dependence of this novel bacterial chondroitin synthase indicate that ApCS was a cold-active enzyme. From all accounts, ApCS becomes the fourth known bacterial chondroitin synthase, and the potential applications in artificial chondroitin sulfate and glycosaminoglycan synthetic approaches make it an attractive glycosyltransferase for further investigation.


Assuntos
Proteínas de Bactérias/genética , Proteínas de Bactérias/metabolismo , Gammaproteobacteria/enzimologia , Gammaproteobacteria/genética , N-Acetilgalactosaminiltransferases/genética , N-Acetilgalactosaminiltransferases/metabolismo , Especificidade por Substrato
4.
Medicine (Baltimore) ; 97(2): e9084, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29480822

RESUMO

Pituitary stalk interruption syndrome (PSIS) is associated with simultaneous or subsequent pituitary hormone deficiencies (PHDs). Although the clinical features of multiple PHDs are well known, the status of the thyrotrophic axis in PSIS has not been thoroughly investigated.The clinical data of 89 PSIS patients and 34 Sheehan syndrome (SS) patients were retrospectively analyzed.The prevalence of central hypothyroidism in the PSIS patients and the SS patients was 79.8% and 70.6%, respectively. The thyroid-stimulating hormone (TSH) levels in the PSIS patients were significantly higher in comparison with the SS patients (5.13 ±â€Š3.40 vs 1.67 ±â€Š1.20 mU/L, P < .05). TSH elevation (8.79 ±â€Š3.17 mU/L) was noticed in 29 of 71 (40.85%) hypothyroid PSIS patients but not in the 24 hypothyroid SS patients. The TSH levels in the hypothyroid PSIS patients were significantly higher in comparison with the euthyroid PSIS patients (5.42 ±â€Š3.67 vs 3.66 ±â€Š1.50 mU/L). Thyroid hormone replacement significantly reduced the TSH levels in the PSIS patients with elevated TSH levels from 7.24 ±â€Š0.98 to 1.67 ±â€Š1.51 mU/L (P < .05). The logistic regression analysis suggested that TSH level was not significantly associated with pituitary stalk status and height of the anterior pituitary gland.PSIS is a newly recognized cause of central hypothyroidism. The proportion and amplitude of TSH elevations are higher in PSIS than in other causes of central hypothyroidism.


Assuntos
Doenças da Hipófise/metabolismo , Tireotropina/metabolismo , Adulto , Feminino , Terapia de Reposição Hormonal , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Doenças da Hipófise/diagnóstico por imagem , Doenças da Hipófise/tratamento farmacológico , Doenças da Hipófise/epidemiologia , Hipófise/diagnóstico por imagem , Hipófise/efeitos dos fármacos , Hipófise/metabolismo , Prevalência , Estudos Retrospectivos , Tireotropina/administração & dosagem , Adulto Jovem
5.
Int Orthop ; 42(3): 601-607, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-29349503

RESUMO

PURPOSE: We present a systematic review of the recent literatures regarding the arthroscopic and open technique in fragment fixation for osteochondritis dissecans (OCD) of the humeral capitellum and an analysis of the subjective and objective outcomes between these two procedures. METHODS: PubMed and EMBASE were reviewed for suitable articles relating to fragment fixation for OCD, both open and arthroscopic. We included all studies reporting on the clinical outcomes of these two procedures that were published in the English language. Data extracted from each study included level of evidence, number of patients, surgical techniques, length of follow-up, clinical outcome measures including outcome scores, range of motion (ROM), return to sports, osseous union and complications. We analyzed each study to determine the primary outcome measurement. RESULTS: A total of ten studies met our inclusion criteria. Among all studies, 35 arthroscopic procedures and 107 open procedures were performed. After the procedure, 70 patients (86.4%) in the open group returned to their sports, and 32 patients (91.4%) in the arthroscopic group returned to their sports. In the arthroscopic group, patients gained 14.1 degrees of flexion and 9.5 degrees of extension after surgery. In the open group, patients gained 8 degrees of flexion and 5.7 degrees of extension. Five patients (4.7%) had complications in the open group. No complication was found in the arthroscopic group. CONCLUSIONS: Both open and arthroscopic lesion debridement with fragment fixation are successful in treating unstable OCD. The arthroscopic technique may be a better choice than the open procedure, but we need high-level evidence to determine the superiority of the open or arthroscopic techniques in treating elbow OCD. LEVEL OF EVIDENCE: Level III.


Assuntos
Artroscopia/métodos , Desbridamento/métodos , Úmero/cirurgia , Osteocondrite Dissecante/cirurgia , Adolescente , Artroscopia/efeitos adversos , Desbridamento/efeitos adversos , Articulação do Cotovelo/cirurgia , Feminino , Fixação Interna de Fraturas/efeitos adversos , Fixação Interna de Fraturas/métodos , Humanos , Úmero/patologia , Masculino , Complicações Pós-Operatórias/epidemiologia , Amplitude de Movimento Articular , Volta ao Esporte/estatística & dados numéricos , Resultado do Tratamento
6.
Biochim Biophys Acta Gen Subj ; 1862(3): 547-556, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29158133

RESUMO

BACKGROUND: The final structure of heparan sulfate chains is strictly regulated in vivo, though the biosynthesis is not guided by a template process. N-deacetylase/N-sulfotransferase (NDST) is the first modification enzyme in the HS biosynthetic pathway. The N-sulfo groups introduced by NDST are reportedly involved in determination of the susceptibility to subsequent processes catalyzed by C5-epimerse and 3-O-sulfotransferases. Understanding the substrate specificities of the four human NDST isoforms has become central to uncovering the regulatory mechanism of HS biosynthesis. METHODS: Highly-purified recombinant NDST-4 (rNDST-4) and a selective library of structurally-defined oligosaccharides were employed to determine the substrate specificity of rNDST-4. RESULTS: Full-length rNDST-4 lacks obvious N-deacetylase activity, and displays only N-sulfotransferase activity. Unlike NDST-1, NDST-4 did not show directional N-sulfotransferase activity while the N-deacetylase domain was inactive. CONCLUSION AND GENERAL SIGNIFICANCE: Individual NDST-4 could not effectively assume the key role in the distribution of N-S domains and N-Ac domains in HS biosynthesis in vivo.


Assuntos
Proteínas de Membrana/metabolismo , Oligossacarídeos/metabolismo , Sulfotransferases/metabolismo , Animais , Configuração de Carboidratos , Sequência de Carboidratos , Catálise , Glicosilação , Humanos , Oligossacarídeos/síntese química , Domínios Proteicos , Isoformas de Proteínas , Processamento de Proteína Pós-Traducional , Proteínas Recombinantes/química , Proteínas Recombinantes/metabolismo , Bibliotecas de Moléculas Pequenas , Spodoptera , Especificidade por Substrato , Ressonância de Plasmônio de Superfície , Espectrometria de Massas em Tandem
7.
Appl Microbiol Biotechnol ; 102(2): 751-761, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29159585

RESUMO

Capsule of Escherichia coli O5:K4:H4 is formed of a chondroitin-repeat disaccharide unit of glucuronic acid (GlcA)-N-acetylgalactosamine (GalNAc). This polysaccharide, commonly referred to as K4CP, is a potentially important source of precursors for chemoenzymatic or bioengineering synthesis of chondroitin sulfate. KfoA, encoded by a gene from region 2 of the K4 capsular gene cluster, shows high homology to the UDP-glucose-4-epimerase (GalE) from E. coli. KfoA is reputed to be responsible for uridine 5'-diphosphate-N-acetylgalactosamine (UDP-GalNAc) supply for K4CP biosynthesis in vivo, but it has not been biochemically characterized. Here, we probed the substrate specificity of KfoA by a capillary electrophoresis (CE)-based method. KfoA could epimerize both acetylated and non-acetylated substrates, but its k cat/K m value for UDP-GlcNAc was approximately 1300-fold that for UDP-Glc. Recombinant KfoA showed a strong preference for acetylated substrates in vitro. The conclusion that KfoA is a higher efficiency UDP-GalNAc provider than GalE was supported by a coupled assay developed based on the donor-acceptor combination specificity of E. coli K4 chondroitin polymerase (KfoC). Furthermore, residue Ser-301, located near the UDP-GlcNAc binding pocket, plays an important role in the determination of the conversion ratio of UDP-GlcNAc to UDP-GalNAc by KfoA. Our results deepen the understanding of the mechanism of KfoA and will assist in the research into the metabolic engineering for chondroitin sulfate production.


Assuntos
Sulfatos de Condroitina/biossíntese , Proteínas de Escherichia coli/metabolismo , Escherichia coli/enzimologia , UDPglucose 4-Epimerase/metabolismo , Acetilação , Escherichia coli/genética , Proteínas de Escherichia coli/genética , Glucose/metabolismo , Cinética , Engenharia Metabólica , Especificidade por Substrato , UDPglucose 4-Epimerase/genética
8.
Medicine (Baltimore) ; 96(13): e6380, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28353564

RESUMO

OBJECTIVE: The purpose of this meta-analysis is to comprehensively assess the accuracy of serum D-dimer for the diagnosis of acute intestinal ischemia. METHODS: Diagnostic studies of D-dimer for accurate diagnosis of acute intestinal ischemia were extracted from 6 databases, and prospective and retrospective studies that provided adequate data on sensitivity and specificity were included here. Sensitivity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR) were calculated. The overall diagnostic performance of D-dimer was assessed by plotting a summary receiver operating characteristic curve (SROC) and calculating the area under the curve (AUC). RESULTS: A total of 1300 patients with suspected acute intestinal ischemia from 12 studies met the inclusion criteria. The combined sensitivity, specificity, PLR, NLR, and DOR were 0.94 (95% CI: 0.87-0.97), 0.50 (95% CI: 0.40-0.61), 1.9 (95% CI: 1.5-2.3), 0.12 (95% CI: 0.05-0.26), and 16 (95% CI: 7-39), respectively. The AUC was 0.81 (95% CI: 0.78-0.84). CONCLUSION: The results of this meta-analysis suggested that plasma D-dimer detection might be a useful means of identifying patients with acute intestinal ischemia of the abdomen.


Assuntos
Produtos de Degradação da Fibrina e do Fibrinogênio/metabolismo , Enteropatias/diagnóstico , Intestinos/irrigação sanguínea , Isquemia/diagnóstico , Biomarcadores/sangue , Humanos , Enteropatias/sangue , Isquemia/sangue
9.
Nutr J ; 16(1): 11, 2017 02 10.
Artigo em Inglês | MEDLINE | ID: mdl-28183318

RESUMO

BACKGROUND & AIMS: Early oral nutrition (EON) has been shown to improve recovery of gastrointestinal function, length of stay and mortality after abdominal surgery; however, early oral nutrition often fails during the first week after surgery. Here, a multi-modal early oral nutrition program is introduced to promote recovery of gastrointestinal function and tolerance of oral nutrition. METHODS: Consecutive patients scheduled for abdominal surgery were randomized to the multimodal EON group or a group receiving conventional care. The primary endpoint was the time of first defecation. The secondary endpoints were outcomes and the cost-effectiveness ratio in treating infectious complications. The rate of infectious-free patients was regarded as the index of effectiveness. RESULTS: One hundred seven patients were randomly assigned to groups. Baseline characteristics were similar for both groups. In intention-to-treat analysis, the success rate of oral nutrition during the first week after surgery in the multimodal EON group was 44 (83.0%) versus 31 (57.4%) in the conventional care group (P = 0.004). Time to first defecation, time to flatus, recovery time of bowel sounds, and prolonged postoperative ileus were all less in the multimodal EON group (P < 0.05). The median postoperative length of stay in the multimodal EON group was 8 days (6, 12) versus 10 days (7, 18) in the conventional care group (P < 0.001). The total cost of treatment and nutritional support were also less in the multi-modal early oral nutrition group (P < 0.001). The effectiveness was 84.9 and 79.9% in the multimodal EON and conventional care group, respectively (P = 0.475). However, the cost-effectiveness ratio was USD 537.6 (506.1, 589.3) and USD 637.8 (593.9, 710.3), respectively (P < 0.001). CONCLUSION: The multi-modal early oral nutrition program was an effective way to improve tolerance of oral nutrition during the first week after surgery, decrease the length of stay and improve cost-effectiveness after abdominal surgery. TRIAL REGISTRATION: Registration number: ChiCTR-TRC-14004395 . Registered 15 March 2014.


Assuntos
Abdome/cirurgia , Procedimentos Cirúrgicos do Sistema Digestório , Apoio Nutricional , Cuidados Pós-Operatórios/métodos , Idoso , Colectomia , Análise Custo-Benefício , Defecação/fisiologia , Determinação de Ponto Final , Feminino , Gastrectomia , Humanos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Estado Nutricional , Complicações Pós-Operatórias/prevenção & controle , Estudos Prospectivos , Tamanho da Amostra , Método Simples-Cego
10.
Nutr J ; 15(1): 78, 2016 08 19.
Artigo em Inglês | MEDLINE | ID: mdl-27543156

RESUMO

OBJECTIVE: To investigate the impact of nutritional support on clinical outcomes in patients at nutritional risk who receive nutritional support that meets guideline standards and those who do not. METHODS: This prospective cohort study enrolled hospitalized patients from the Second Affiliated Hospital of Kunming Medical University from February 2010 to June 2012. The research protocols were approved by the university's ethics committee, and the patients signed informed consent forms. The clinical data were collected based on nutritional risk screening, administration of enteral and parenteral nutrition, surgical information, complications, and length of hospital stay. RESULTS: During the study period, 525 patients at nutritional risk were enrolled in the cohorts. Among patients who received nutritional support that met the guideline standards (Cohort 1), the incidence of infectious complications was lower than that in patients who did not meet guideline standards (Cohort 2) (17.1 % vs. 26.9 %, P = 0.01). Subgroup analysis showed that individuals who received a combination of parenteral nutrition (PN) and enteral nutrition (EN) for 7 or more days had a significantly lower incidence of infectious complications (P = 0.001) than those who received only PN for 7 or more days or those who received nutritional support for less than 7 days or at less than 10 kcal/kg/d. Binary logistic regression analysis showed that, after adjusting for confounding factors, nutritional support that met guideline standards for patients with nutritional risk was a protective factor for complications (OR: 0.870, P < 0.002). CONCLUSIONS: In patients at nutritional risk after abdominal surgery, nutritional support that meets recommended nutrient guidelines (especially regimens involving PN + EN ≥ 7 days) might decrease the incidence of infectious complications and is worth recommending; however, well-designed trials are needed to confirm our findings. Nutritional support that does not meet the guideline standards is considered clinically undesirable.


Assuntos
Política Nutricional , Apoio Nutricional , Cuidados Pós-Operatórios , Abdome/cirurgia , Idoso , China/epidemiologia , Estudos de Coortes , Nutrição Enteral/métodos , Feminino , Humanos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Apoio Nutricional/normas , Nutrição Parenteral/métodos , Complicações Pós-Operatórias/epidemiologia , Guias de Prática Clínica como Assunto , Estudos Prospectivos , Fatores de Risco , Resultado do Tratamento
11.
Postgrad Med ; 128(8): 783-789, 2016 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-27437733

RESUMO

OBJECTIVE: To investigate the association between hypertriglyceridemic waist (HTGW) phenotype and arterial stiffness in a Chinese population without hypertension, diabetes and cardiovascular diseases. METHODS: A total number of 3028 subjects aged 40 years and over were enrolled in this cross-sectional study. All participants provided a clinical history and underwent a physical examination. Brachial-ankle pulse wave velocity (baPWV) was used to evaluate arterial stiffness. HTGW phenotype was defined as the simultaneous presence of waist circumference ≥90/80 cm and triglycerides ≥2.0/1.5 mmol/L in men/women. RESULTS: The prevalence of HTGW phenotype was 7.5% among healthy participants in China (Beijing), 7.4% in men and 7.5% in women. Women with HTGW phenotype had a higher level of baPWV compared with normal WC and normal triglyceride (NWNT) group (P < 0.05), but no significant difference was observed in men (P > 0.05). Multiple logistic regression analysis showed HTGW phenotype was significantly associated with baPWV after controlling for multiple factors in women. However, no significant relationship was observed in men. CONCLUSIONS: The present study supports that HTGW phenotype is associated with increased arterial stiffness in women but not in men.


Assuntos
Aterosclerose/epidemiologia , Cintura Hipertrigliceridêmica/epidemiologia , Rigidez Vascular/fisiologia , Adulto , Fatores Etários , Índice Tornozelo-Braço , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Fenótipo , Prevalência , Fatores Sexuais , Fatores Socioeconômicos , Triglicerídeos/sangue , Circunferência da Cintura
12.
BMC Endocr Disord ; 16(1): 20, 2016 May 03.
Artigo em Inglês | MEDLINE | ID: mdl-27142369

RESUMO

BACKGROUND: Type B insulin resistance is a rare autoimmune disease characterized by the presence of autoantibodies against the insulin receptor. Helicobacter pylori (H pylori) infection may play a causative role in the autoimmune diseases. CASE PRESENTATION: Here, we present a rare case of a 48-year old female patient, who had type B insulin resistance with systemic scleroderma and was successfully treated with multiple immune suppressants after eradication of Helicobacter pylori infection. CONCLUSION: The present case suggests H pylori infection-related pathological mechanism may contribute to type B insulin resistance syndrome and autoimmune disorders. Treatment toward H pylori may be helpful to relieve syndrome of type B insulin resistance for H pylori positive patients.


Assuntos
Doenças Autoimunes/tratamento farmacológico , Infecções por Helicobacter/tratamento farmacológico , Imunossupressores/uso terapêutico , Resistência à Insulina/imunologia , Receptor de Insulina/imunologia , Antibacterianos/uso terapêutico , Doenças Autoimunes/complicações , Doenças Autoimunes/metabolismo , Glicemia , Feminino , Infecções por Helicobacter/complicações , Helicobacter pylori , Humanos , Pessoa de Meia-Idade
13.
Zhongguo Zhong Yao Za Zhi ; 41(4): 659-665, 2016 Feb.
Artigo em Chinês | MEDLINE | ID: mdl-28871689

RESUMO

Salvianolic acids and tanshinones are main hydrophilic and lipophilic extracts from Salvia Miltiorrhiza with significant anti-pulmonary fibrosis effects. The aim of this study was to prepare a co-micronized salvianolic acids-tanshinones composite powder for inhalation using a planetary ball mill. The micronization process parameters were optimized by central composite design (CCD) and response surface methodology (RSM). Treatment time, rotation speed and the ball/sample weight ratio were selected as the independent variables, and the volume fraction of particle size in 1-5 µm was taken as the dependent variable. The powder properties were evaluated by scanning electron microscopy (SEM), laser diffraction and X-ray powder diffraction (XRPD). The powder flow and hygroscopicity were determined with repose angle, compressibility index and critical relative humidity(CRH). According to the results, the salvianolic acids-tanshinones composite powder produced in optimal conditions had a narrow and unimodal particle size distribution and a smaller D50 of 2.33 µm. The volume fraction of particle size in 1-5 µm was 80.82%. The repose angle was (50.60±1.13) °, and the critical relative humidity is about 77%. After being micronized, the particle size significantly reduced, and the number of amorphous substances slightly increased, with no significant changes in powder flow and hygroscopicity. These findings indicate that the grinding method with a planetary ball mill can be used to co-micronize various components with different properties and prepare composite drug powders for dry powder inhalation.


Assuntos
/química , Alcenos/química , Química Farmacêutica/métodos , Medicamentos de Ervas Chinesas/química , Polifenóis/química , Salvia miltiorrhiza/química , Inaladores de Pó Seco , Microscopia Eletrônica de Varredura , Tamanho da Partícula , Pós/química , Molhabilidade , Difração de Raios X
14.
Am J Hypertens ; 29(5): 575-81, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-26304960

RESUMO

BACKGROUND: Parathyroid hormone (PTH) stimulates aldosterone secretion in human adrenocortex and is regulated by the renin-angiotensin-aldosterone system. We speculated that measurement of PTH may be a valuable aid in the diagnosis of aldosterone-producing adenoma (APA). METHODS: To test this hypothesis, we recruited 142 patients with adrenal adenoma, of whom 84 had an APA and 58 had a nonfunctioning adrenal adenoma (NFA). Plasma levels of intact PTH, serum potassium, sodium, calcium, phosphate, 25(OH) vitamin D, plasma aldosterone concentration (PAC), plasma renin activity (PRA), and aldosterone to renin ratio (ARR) were measured in every patient. Computed tomography (CT) scanning of the adrenal gland and adrenal hormone levels was used to evaluate the function of the adrenal adenoma. We also evaluated the impact of renin-angiotensin-aldosterone system (RAAS) components on PTH from the recumbent-upright test in 15 patients with APA and 30 patients with NFA. RESULTS: Compared with NFA, PTH levels were significantly increased in patients with APA, and serum calcium and phosphate were significantly decreased. When position was changed from supine to upright, the variation in PTH levels was significantly higher in APA patients compared with NFA patients. Receiver operator characteristic (ROC) curves identified the Youden index, which corresponded to the best tradeoff of combined marker (ARR and PTH) with a sensitivity and specificity of 89.3% and 93.1%, respectively. CONCLUSIONS: The baseline and positional variation of serum PTH levels were significant in APA, thus PTH may be a promising auxiliary index for the clinical diagnosis of APA.


Assuntos
Adenoma/diagnóstico , Neoplasias das Glândulas Suprarrenais/diagnóstico , Aldosterona/metabolismo , Biomarcadores Tumorais/sangue , Biomarcadores Tumorais/metabolismo , Hormônio Paratireóideo/sangue , Adenoma/sangue , Adenoma/metabolismo , Neoplasias das Glândulas Suprarrenais/sangue , Neoplasias das Glândulas Suprarrenais/metabolismo , Neoplasias das Glândulas Suprarrenais/urina , Adulto , Aldosterona/sangue , Aldosterona/urina , Área Sob a Curva , Biomarcadores Tumorais/urina , Técnicas Eletroquímicas , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Posicionamento do Paciente , Valor Preditivo dos Testes , Curva ROC , Reprodutibilidade dos Testes , Decúbito Dorsal , Tomografia Computadorizada por Raios X , Regulação para Cima
15.
Zhongguo Shi Yan Xue Ye Xue Za Zhi ; 21(2): 493-7, 2013 Apr.
Artigo em Chinês | MEDLINE | ID: mdl-23628062

RESUMO

Epidermal growth factor receptor pathway substrate 8 (Eps8) is one of crucial kinase substrates for the epidermal growth factor receptors. Eps8 is related to mitosis and differentiation of normal cells. In recent years, it has been demonstrated that Eps8 involves in proliferation, metastasis and prognosis of many malignant tumors. Experiments have shown that Eps8 involves in Ras-Rac pathway of EGFR signaling by forming Eps8-Abi1-Sos1 tri-complex or participates in endocytosis mediated by rab5. Furthermore, Eps8 has also been found to regulate cell cycle. In conclusion, it may become a monitor and a new target for the treatment of malignant tumors. This review briefly introduces molecular structure and physiological function of Eps8, focusing on its function and molecular mechanism in proliferation, metastasis and prognosis of malignant tumors.


Assuntos
Proteínas Adaptadoras de Transdução de Sinal/metabolismo , Neoplasias/patologia , Humanos , Metástase Neoplásica , Neoplasias/metabolismo , Prognóstico
16.
Zhonghua Yi Xue Za Zhi ; 92(34): 2410-4, 2012 Sep 11.
Artigo em Chinês | MEDLINE | ID: mdl-23158664

RESUMO

OBJECTIVE: To compare the different establishing conditions of hyperinsulinemic-euglycemic clamp technique among the groups of normal glucose tolerance (NGT), hyperinsulinemia with normal glucose (HINS) and impaired glucose tolerance (IGT). METHODS: The hyperinsulinemic-euglycemic clamp technique was applied to the study of methodology in 10 NGT, 11 HINS and 10 IGT subjects. Different establishing conditions were compared through variance analysis (ANOVA) among three groups. And the influencing factors resulting in these differences were analyzed through stepwise regression analysis. RESULTS: The serum insulin concentration of three groups were acutely raised and maintained at above 100 mU/L. During the steady stage, the blood glucose level remained stable and all coefficient variations were under 5%. The secretion of endogenous insulin and hepatic glucose production were completely inhibited during the test. Under these steady-state hyperinsulinemic-euglycemic conditions, the glucose infusion rate (M value) was equal to glucose disposal rate by all tissues in body, M value of three groups were as follows: (11.6 ± 1.7), (6.1 ± 1.9) and (6.0 ± 1.5) mg×kg(-1)×min(-1). During clamping, the peak and steady-state serum insulin concentrations of IGT and HINS groups were significantly higher than those of NGT group. Although the peak and steady-state serum insulin concentration of HINS group were higher than those of IGT group, the differences had no statistical significance (P = 0.34, 0.11). The independent influencing factor of peak serum insulin concentration was waist-to-hip ratio (WHR) while the independent influencing factors of steady-state serum insulin concentration included insulin metabolic clearance rate (MCR) and body mass index (BMI). The peak and steady-state serum insulin concentrations were not the independent influencing factors of M value. CONCLUSION: During the establishment of hyperinsulinemic-euglycemic clamp technique, the differences in peak and steady-state serum insulin concentrations existed among NGT, HINS and IGT groups. But the differences do not influence the use of M value in the evaluation of insulin resistance.


Assuntos
Glicemia/metabolismo , Técnica Clamp de Glucose , Intolerância à Glucose/metabolismo , Hiperinsulinismo/metabolismo , Adulto , Idoso , Feminino , Humanos , Insulina/sangue , Resistência à Insulina , Masculino , Pessoa de Meia-Idade , Adulto Jovem
17.
PLoS One ; 7(6): e39025, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22720021

RESUMO

Most of magnetic resonance imaging (MRI) studies about post-traumatic stress disorder (PTSD) focused primarily on measuring of small brain structure volume or regional brain volume changes. There were rare reports investigating cortical thickness alterations in recent onset PTSD. Recent advances in computational analysis made it possible to measure cortical thickness in a fully automatic way, along with voxel-based morphometry (VBM) that enables an exploration of global structural changes throughout the brain by applying statistical parametric mapping (SPM) to high-resolution MRI. In this paper, Laplacian method was utilized to estimate cortical thickness after automatic segmentation of gray matter from MR images under SPM. Then thickness maps were analyzed by SPM8. Comparison between 10 survivors from a mining disaster with recent onset PTSD and 10 survivors without PTSD from the same trauma indicates cortical thinning in the left parietal lobe, right inferior frontal gyrus, and right parahippocampal gyrus. The regional cortical thickness of the right inferior frontal gyrus showed a significant negative correlation with the CAPS score in the patients with PTSD. Our study suggests that shape-related cortical thickness analysis may be more sensitive than volumetric analysis to subtle alteration at early stage of PTSD.


Assuntos
Córtex Cerebral/patologia , Transtornos de Estresse Pós-Traumáticos/patologia , Ferimentos e Lesões/patologia , Humanos , Imagem por Ressonância Magnética , Masculino
18.
Zhonghua Yi Xue Za Zhi ; 91(26): 1805-8, 2011 Jul 12.
Artigo em Chinês | MEDLINE | ID: mdl-22093778

RESUMO

OBJECTIVE: To investigate the expression of tumor necrosis factor-alpha (TNF-α) and cyclooxygenase-2 (COX-2) mRNA and evaluate the status of histone H3 acetylation at TNF-α and COX-2 promoter in peripheral blood mononuclear cells (PBMCs) from type 2 diabetics. METHODS: The PBMCs from 12 type 2 diabetics and 12 healthy controls were isolated by Ficoll-Hypaque density gradient centrifugation. The differential expression of TNF-α and COX-2 mRNA was measured by real-time PCR (polymerase chain reaction). Chromatin immunoprecipitation analysis was used to detect the status of H3 acetylation at TNF-α and COX-2 promoter region. RESULTS: TNF-α and COX-2 mRNA were overexpressed in PBMCs from Type 2 diabetics as compared with normal controls (2.28 ± 0.09 fold and 2.78 ± 0.26 fold).(P < 0.05). Compared with normal controls, H3 acetylation at the TNF-α (1.54 ± 0.43 vs 0.97 ± 0.39, P = 0.0094) and COX-2 (1.20 ± 0.58 vs 0.64 ± 0.21, P = 0.0161) gene promoter region was elevated in PBMCs from Type 2 diabetic patients. CONCLUSION: Increased H3 acetylation at TNF-α and COX-2 promoter in PBMCs from type 2 diabetics may contribute to the pathogenesis of type 2 diabetes through the elevated expressions of TNF-α and COX-2.


Assuntos
Ciclo-Oxigenase 2/metabolismo , Diabetes Mellitus Tipo 2/metabolismo , Histonas/metabolismo , Fator de Necrose Tumoral alfa/metabolismo , Acetilação , Estudos de Casos e Controles , Ciclo-Oxigenase 2/genética , Feminino , Histonas/genética , Humanos , Masculino , Pessoa de Meia-Idade , Regiões Promotoras Genéticas , RNA Mensageiro/genética , Fator de Necrose Tumoral alfa/genética
19.
Chin Med J (Engl) ; 124(22): 3613-7, 2011 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-22340212

RESUMO

BACKGROUND: Fulminant type 1 diabetes (F1D) is a complex disease. Microarray analysis was used to identify gene expression changes and obtain understanding of the underlying mechanisms. METHODS: Microarray analysis was performed on peripheral blood mononuclear cells from six F1D patients and six matched healthy subjects. Real-time polymerase chain reaction was used to verify the differentially expressed genes. NK cell activity was detected by methyl thiazoleterazolium assay. RESULTS: Microarray analysis identified 759 genes differing in expression between F1D patients and controls at a false discovery rate of 0.05. Expression of TLR9, ELF4 and IL1RAP were verified and consistent with changes in microarray results. NK cell activity was decreased in F1D. With use of a knowledge base, differentially expressed genes could be placed within different pathways with predicted functions including interleukin-1, and tumor necrosis factor-α signaling. CONCLUSIONS: These results identify several genes indicating possible mechanisms in F1D. NK cell dysfunction resulting from changes in expression of TLR9, ELF4 and IL1RAP, and pathways of interleukin-1 and tumor necrosis factor-α signaling might be involved in F1D through inducing ß-cell dysfunction.


Assuntos
Diabetes Mellitus Tipo 1/metabolismo , Adulto , Diabetes Mellitus Tipo 1/genética , Feminino , Perfilação da Expressão Gênica , Humanos , Masculino , Pessoa de Meia-Idade , Análise de Sequência com Séries de Oligonucleotídeos , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Adulto Jovem
20.
Zhonghua Nei Ke Za Zhi ; 49(5): 405-9, 2010 May.
Artigo em Chinês | MEDLINE | ID: mdl-20646415

RESUMO

OBJECTIVES: To explore the effect of transient continuous subcutaneous insulin infusion (CSII) on ß cell function, insulin resistance and vascular endothelial injury in newly diagnosed type 2 diabetic patients and its potential mechanism. METHODS: Ten patients with newly diagnosed type 2 diabetes mellitus (T2DM) accepted CSII for two weeks. Intravenous glucose tolerance test (IVGTT) and hyperinsulinemia euglycemia clamp test were performed before and after CSII. Serum soluble E-selectin (sE-selectin) was used to evaluate the injury of vascular endothelial cell, while serum high sensitivity C reactive protein (hsCRP) and soluble CD14 (sCD14) were both used to assess inflammatory condition. RESULTS: (1) Compared with those before treatment, the blood glucose levels of IVGTT, the area under the curve of the blood glucose, glycosylated hemoglobin, TC and LDL-C in the patients were decreased after CSII (P < 0.05 or 0.01). (2) Compared with those before treatment, the insulin levels of IVGTT (except the fasting insulin), the area under the curve of insulin and acute insulin response were all increased after CSII (P < 0.05 or 0.01). (3) Compared with that before treatment, the glucose infusion ratio in the clamp test [(3.46 ± 1.66) mg x kg⁻¹ x min⁻¹ increased to (7.14 ± 2.37) mg x kg⁻¹ x min⁻¹] and HOMA-beta elevated, while HOMA-IR declined (P < 0.05 or 0.01 in all). (4) Compared with those before treatment, the levels of serum sE-selectin, sCD14 and hsCRP were decreased (P < 0.01, except for hsCRP). CONCLUSION: Transient intensive insulin therapy in patients with newly diagnosed T2DM is useful to restore beta cell function, attenuate insulin resistance, repair vascular endothelial injury and improve the disorder of blood sugar and lipid. The mechanism may be related with the inhibition of inflammation in patients.


Assuntos
Diabetes Mellitus Tipo 2/tratamento farmacológico , Hipoglicemiantes/uso terapêutico , Células Secretoras de Insulina/efeitos dos fármacos , Insulina/uso terapêutico , Adulto , Glicemia/metabolismo , Diabetes Mellitus Tipo 2/metabolismo , Diabetes Mellitus Tipo 2/fisiopatologia , Células Endoteliais/efeitos dos fármacos , Células Endoteliais/metabolismo , Endotélio Vascular/citologia , Feminino , Teste de Tolerância a Glucose , Humanos , Hipoglicemiantes/administração & dosagem , Injeções Subcutâneas , Insulina/administração & dosagem , Resistência à Insulina , Lipídeos/sangue , Masculino , Pessoa de Meia-Idade
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