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1.
Int J Pharm ; 578: 119101, 2020 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-32006622

RESUMO

smartPearls technology is one appropriate method to produce anti-psoriatic curcumin (Cur) topical delivery system. To prevent the sedimentation of loaded silica and release changing over the storage, which are disadvantages of smartPearls production, extra glycyrrhizic acid (GA) was added in classical smartPearls ingredients (active and porous material) to get an improved smartPearls production (Cur-GA-silica). The capacity of Cur-GA-silica to remain the gelation state after mixing with water was superior compared to that of the solid cluster without GA and that of the physical mixture of Cur, GA and silica. The Cur-GA-silica practically contained Cur with 1.68% ± 0.12% and showed significant difference with Cur raw drug powder in kinetic solubilities (4.55 ± 0.78 µg/mL vs 0 in 5 min; 3.26 ± 0.17 µg/mL vs 0 in 4 h) which was traceable to the amorphous state of Cur-GA-silica detected by X-ray diffractometer. With the amorphous Cur, two times as much penetrated Cur in Cur-GA-silica as in Cur raw drug powder was achieved on the imiquimod-induced psoriasis-like mice model. The anti-psoriatic efficacy of Cur-GA-silica was confirmed by Psoriasis Area and Severity Index (PASI) evaluation, histological evaluation and decreased IL-17A in the imiquimod-induced psoriasiform mouse skin analyzed by enzyme-linked immunosorbent assay. In conclusion, with the addition of GA, a stable amorphous curcumin topical vehicle fabricated by smartPearls technology without extra dermal matrix is available and facilitates penetration efficacy and anti-psoriatic capacity in imiquimod-induced psoriasiform mice.

2.
Nat Genet ; 2020 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-32024997

RESUMO

Mitochondria are essential cellular organelles that play critical roles in cancer. Here, as part of the International Cancer Genome Consortium/The Cancer Genome Atlas Pan-Cancer Analysis of Whole Genomes Consortium, which aggregated whole-genome sequencing data from 2,658 cancers across 38 tumor types, we performed a multidimensional, integrated characterization of mitochondrial genomes and related RNA sequencing data. Our analysis presents the most definitive mutational landscape of mitochondrial genomes and identifies several hypermutated cases. Truncating mutations are markedly enriched in kidney, colorectal and thyroid cancers, suggesting oncogenic effects with the activation of signaling pathways. We find frequent somatic nuclear transfers of mitochondrial DNA, some of which disrupt therapeutic target genes. Mitochondrial copy number varies greatly within and across cancers and correlates with clinical variables. Co-expression analysis highlights the function of mitochondrial genes in oxidative phosphorylation, DNA repair and the cell cycle, and shows their connections with clinically actionable genes. Our study lays a foundation for translating mitochondrial biology into clinical applications.

4.
Genome Biol ; 21(1): 43, 2020 Feb 20.
Artigo em Inglês | MEDLINE | ID: mdl-32079540

RESUMO

BACKGROUND: The initiation and subsequent evolution of cancer are largely driven by a relatively small number of somatic mutations with critical functional impacts, so-called driver mutations. Identifying driver mutations in a patient's tumor cells is a central task in the era of precision cancer medicine. Over the decade, many computational algorithms have been developed to predict the effects of missense single-nucleotide variants, and they are frequently employed to prioritize mutation candidates. These algorithms employ diverse molecular features to build predictive models, and while some algorithms are cancer-specific, others are not. However, the relative performance of these algorithms has not been rigorously assessed. RESULTS: We construct five complementary benchmark datasets: mutation clustering patterns in the protein 3D structures, literature annotation based on OncoKB, TP53 mutations based on their effects on target-gene transactivation, effects of cancer mutations on tumor formation in xenograft experiments, and functional annotation based on in vitro cell viability assays we developed including a new dataset of ~ 200 mutations. We evaluate the performance of 33 algorithms and found that CHASM, CTAT-cancer, DEOGEN2, and PrimateAI show consistently better performance than the other algorithms. Moreover, cancer-specific algorithms show much better performance than those designed for a general purpose. CONCLUSIONS: Our study is a comprehensive assessment of the performance of different algorithms in predicting cancer driver mutations and provides deep insights into the best practice of computationally prioritizing cancer mutation candidates for end-users and for the future development of new algorithms.

5.
J Cancer Res Clin Oncol ; 146(2): 515-528, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31813005

RESUMO

PURPOSE: The present study aims to validate possible stage migration of lymph node metastasis related to the insufficient examined lymph node (ELN) count in pN3a gastric cancer (GC) patients. METHODS: 1976 pN3 patients who underwent the R0 surgery in three high-capacity institutions in China were enrolled to explore the stage migration of nodal involvement, and 3146 pN3 cases from the Surveillance, Epidemiology, and End Results (SEER) Program Registry were used as an external validation cohort. RESULTS: After the propensity score matching of the Chinese cohort, the ELN count, as an independent predictor for GC outcome, was confirmed to be associated with the stage migration of lymph node metastasis in pN3a patients based on the univariate and multivariate survival analyses. Logistic regress was adopted to elucidate that the ELN count was an independent factor related to the long-term survival status of GC patients after curative surgery. Likelihood ratio test showed that the ELN count had the smallest Bayesian information criterion value among the clinicopathologic variables, corresponding to an efficient model to predict outcomes. Subsequently, stage migration of lymph node metastasis was predominantly detected in pN3a patient sub-group with insufficient (less than 16) ELN count, who presented with similar prognosis as the pN3b patients (P = 0.463) as per the stratum analysis with Kaplan-Meier. These methods were further validated using data from the SEER cohort, and the similar promising results were obtained. CONCLUSION: pN3a patients with insufficient ELN count should be considered as pN3b cases to achieve accurate prognostic evaluation after curative gastrectomy.

6.
Nucleic Acids Res ; 48(D1): D34-D39, 2020 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-31586392

RESUMO

Alternative polyadenylation (APA) is an RNA-processing mechanism on the 3' terminus that generates distinct isoforms of mRNAs and/or other RNA polymerase II transcripts with different 3'UTR lengths. Widespread APA affects post-transcriptional gene regulation in mRNA translation, stability, and localization, and exhibits strong tissue specificity. However, no existing database provides comprehensive information about APA events in a large number of human normal tissues. Using the RNA-seq data from the Genotype-Tissue Expression project, we systematically identified APA events from 9475 samples across 53 human tissues and examined their associations with multiple traits and gene expression across tissues. We further developed APAatlas, a user-friendly database (https://hanlab.uth.edu/apa/) for searching, browsing and downloading related information. APAatlas will help the biomedical research community elucidate the functions and mechanisms of APA events in human tissues.

7.
Cancer Med ; 9(1): 151-159, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31724334

RESUMO

BACKGROUND: Monosialotetrahexosylganglioside (GM1) is a neuroprotective glycosphingolipid that repairs nerves. Oxaliplatin-based chemotherapy is neurotoxic. This study assessed the efficacy of GM1 for preventing oxaliplatin-induced peripheral neurotoxicity (OIPN) in colorectal cancer (CRC) patients receiving oxaliplatin-based chemotherapy. METHODS: In total, 196 patients with stage II/III CRC undergoing adjuvant chemotherapy with mFOLFOX6 were randomly assigned to intravenous GM1 or a placebo. The primary endpoint was the rate of grade 2 or worse cumulative neurotoxicity (NCI-CTCAE). The secondary endpoints were chronic cumulative neurotoxicity (EORTC QLQ-CIPN20), time to grade 2 neurotoxicity (NCI-CTCAE or the oxaliplatin-specific neuropathy scale), acute neurotoxicity (analog scale), rates of dose reduction or withdrawal due to OIPN, 3-year disease-free survival (DFS) and adverse events. RESULTS: There were no significant differences between the arms in the rate of NCI-CTCAE grade 2 or worse neurotoxicity (GM1: 33.7% vs placebo: 31.6%; P = .76) or neuropathy measured by the EORTC QLQ-CIPN20 or time to grade 2 neurotoxicity using NCI-CTCAE and the oxaliplatin-specific neuropathy scale. GM1 substantially decreased participant-reported acute neurotoxicity (sensitivity to cold items [P < .01], discomfort swallowing cold liquids [P < .01], throat discomfort [P < .01], muscle cramps [P < .01]). The rates of dose reduction or withdrawal were not significantly different between the arms (P = .08). The 3-year DFS rates were 85% and 83% in the GM1 and placebo arms, respectively (P = .19). There were no differences in toxicity between the arms. CONCLUSION: Patients receiving GM1 were less troubled by the symptoms of acute neuropathy. However, we do not support the use of GM1 to prevent cumulative neurotoxicity. (ClinicalTrials.gov number, NCT02251977).

8.
Int J Surg ; 74: 44-52, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31874262

RESUMO

OBJECTIVE: To examine the prognostic value of negative lymph node (NLN) count in stage III gastric cancer (GC) patients after curative gastrectomy. METHODS: The clinicopathological data of 2942 stage III patients who underwent curative gastrectomy between 2001 and 2011 were analyzed. Only patients with ≥16 examined lymph nodes (ELNs) were included. After cut-point survival analysis, the 2942 patients were divided into three subgroups with NLN counts of 0, 1-9, and ≥10. Survival differences among the subgroups were analyzed to assess the effects of NLN count on stage migration and overall survival (OS) in stage III GC patients. Spearman's correlation coefficient was used to assess the relationships between the ELN count and the positive lymph node (PLN) count, the ELN count and the NLN count, and the NLN count and the PLN count. RESULTS: Survival analyses revealed that the NLN count was significantly associated with OS (P = 0.001) and was an independent predictor (P < 0.01) of prognosis in stage III GC patients. Subgroup analysis showed that the prognostic evaluation accuracy was highest when the NLN count was ≥10 for stage III patients. Stage migrations were mainly detected in the following pathological tumor-node (pTN) subgroups: pT2N3a with 1-9 NLNs and pT2N3b with ≥10 NLNs, and pT3N3a with 1-9 NLNs and pT3N3b with ≥10 NLNs. NLN count was positively correlated with the ELN and the PLN counts for pT2N3 and pT3N3 stage GC patients (r = 0.694 and r = 0.881 for pT2N3 patients; r = 0.685 and r = 0.902 for pT3N3 patients, respectively; P < 0.001). These findings indicate that the NLN count may be a useful prognostic predictor in stage III GC patients. CONCLUSIONS: The NLN count may improve the prognostic prediction efficiency of the tumor-node-metastasis (TNM) classification for GC, especially for stage III patients, and should be recommended for clinical applications.

9.
Adv Exp Med Biol ; 1188: 113-147, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31820386

RESUMO

Reverse phase protein array (RPPA) is a functional proteomics technology amenable to moderately high throughputs of samples and antibodies. The University of Texas MD Anderson Cancer Center RPPA Core Facility has implemented various processes and techniques to maximize RPPA throughput; key among them are maximizing array configuration and relying on database management and automation. One major tool used by the RPPA Core is a semi-automated RPPA process management system referred to as the RPPA Pipeline. The RPPA Pipeline, developed with the aid of MD Avnderson's Department of Bioinformatics and Computational Biology and InSilico Solutions, has streamlined sample and antibody tracking as well as advanced quality control measures of various RPPA processes. This chapter covers RPPA Core processes associated with the RPPA Pipeline workflow from sample receipt to sample printing to slide staining and RPPA report generation that enables the RPPA Core to process at least 13,000 samples per year with approximately 450 individual RPPA-quality antibodies. Additionally, this chapter will cover results of large-scale clinical sample processing, including The Cancer Genome Atlas Project and The Cancer Proteome Atlas.


Assuntos
Análise Serial de Proteínas , Proteômica , Estudos Clínicos como Assunto , Humanos , Proteoma , Proteômica/instrumentação , Proteômica/métodos , Proteômica/tendências , Controle de Qualidade
10.
Adv Exp Med Biol ; 1188: 251-266, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31820393

RESUMO

Tumor cells and the tumor ecosystem rapidly evolve in response to therapy. This tumor evolution results in the rapid emergence of drug resistance that limits the magnitude and duration of response to therapy including chemotherapy, targeted therapy, and immunotherapy. Thus, there is an urgent need to understand and interdict tumor evolution to improve patient benefit to therapy. Reverse phase protein array (RPPA) provides a powerful tool to evaluate and develop approaches to target the processes underlying one form of tumor evolution: adaptive evolution. Tumor cells and the tumor microenvironment rapidly evolve through rewiring of protein networks to bypass the effects of therapy. In this review, we present the concepts underlying adaptive resistance and use of RPPA in understanding resistance mechanisms and identification of effective drug combinations. We further demonstrate that this novel information is resulting in biomarker-driven trials aimed at targeting adaptive resistance and improving patient outcomes.


Assuntos
Resistencia a Medicamentos Antineoplásicos , Neoplasias , Análise Serial de Proteínas , Evolução Biológica , Resistencia a Medicamentos Antineoplásicos/genética , Humanos , Imunoterapia , Microambiente Tumoral
11.
Chin J Cancer Res ; 31(5): 785-796, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31814682

RESUMO

Objective: Lymphovascular infiltration (LVI) is frequently detected in gastric cancer (GC) specimens. Studies have revealed that GC patients with LVI have a poorer prognosis than those without LVI. Methods: In total, 1,007 patients with curatively resected GC at Department of Gastric Cancer, Tianjin Medical University Cancer Institute and Hospital were retrospectively enrolled. The patients were categorized into two groups based on the LVI status: a positive group (PG; presence of LVI) and a negative group (NG; absence of LVI). The clinicopathological factors corrected with LVI and prognostic variables were analyzed. Additionally, a pathological lymphovascular-node (lvN) classification system was proposed to evaluate the superiority of its prognostic prediction of GC patients compared with that of the eighth edition of the N staging system. Results: Two hundred twenty-four patients (22.2%) had LVI. The depth of invasion and lymph node metastasis were independently associated with the presence of LVI. GC patients with LVI demonstrated a significantly lower overall survival (OS) rate than those without LVI (42.8% vs. 68.9%, respectively; P<0.001). In multivariate analysis, LVI was identified as an independent prognostic factor for GC patients (hazard ratio: 1.370; 95% confidence interval: 1.094-1.717; P=0.006). Using strata analysis, significant prognostic differences between the groups were only observed in patients at stage I-IIIa or N0-2. The lvN classification was found to be more appropriate to predict the OS of GC patients after curative surgery than the pN staging system. The -2 log-likelihood of lvN classification (4,746.922) was smaller than the value of pN (4,765.196), and the difference was statistically significant (χ2=18.434, P<0.001). Conclusions: The presence of LVI influences the OS of GC patients at stage I-IIIa or N0-2. LVI should be incorporated into the pN staging system to enhance the accuracy of the prognostic prediction of GC patients.

12.
Heart Rhythm ; 2019 Dec 19.
Artigo em Inglês | MEDLINE | ID: mdl-31866381

RESUMO

BACKGROUND: Female gender is associated with an increased recurrence of atrial fibrillation (AF) after catheter ablation (CA). Although AF is more common in men, women constitute a significant proportion with persistent atrial fibrillation (PsAF). OBJECTIVE: The purpose of this study was to determine whether multiple ablation procedures improves arrhythmia outcomes in females with PsAF compared to men. METHODS: We performed a multicenter observational study to determine long-term arrhythmia outcomes in patients undergoing >1 CA for PsAF. CA involved pulmonary vein (PV) isolation with additional ablation including linear, posterior wall isolation, electrogram-guided, or a combination of these. RESULTS: A total of 281 patients had >1 ablation procedure for PsAF and were included in this analysis (mean age 58.7 ± 9.3 years; 86 [30.6%] female; left atrial [LA] area 27.0 ± 5.3 cm2; PsAF duration 1.7 ± 1.7 years). At mean follow-up of 45.5 ± 31.8 months, freedom from recurrent AF was present in 148 patients(52.7%) after 2.2 ± 0.5 procedures. After multivariate analysis, female gender (hazard ratio [HR] 2.10; P <.001) and enduring PV isolation (HR 1.64; P = .01) were independently associated with AF recurrence. Enduring PV isolation was significantly higher in women than in men (33.7% vs 19.5%; P = .01). CONCLUSION: Female gender was independently and strongly associated with arrhythmia recurrence in patients undergoing multiple procedures for PsAF. PV reconnection was less likely, and fewer reconnected PVs occurred in women. Further studies are required to better understand the mechanisms responsible for AF in females to assist in closing the gender gap in the success of CA.

13.
Nat Commun ; 10(1): 5385, 2019 Nov 26.
Artigo em Inglês | MEDLINE | ID: mdl-31772231

RESUMO

The disproportionately high prevalence of male cancer is poorly understood. We tested for sex-disparity in the functional integrity of the major tumor suppressor p53 in sporadic cancers. Our bioinformatics analyses expose three novel levels of p53 impact on sex-disparity in 12 non-reproductive cancer types. First, TP53 mutation is more frequent in these cancers among US males than females, with poorest survival correlating with its mutation. Second, numerous X-linked genes are associated with p53, including vital genomic regulators. Males are at unique risk from alterations of their single copies of these genes. High expression of X-linked negative regulators of p53 in wild-type TP53 cancers corresponds with reduced survival. Third, females exhibit an exceptional incidence of non-expressed mutations among p53-associated X-linked genes. Our data indicate that poor survival in males is contributed by high frequencies of TP53 mutations and an inability to shield against deregulated X-linked genes that engage in p53 networks.

14.
JACC Clin Electrophysiol ; 5(11): 1265-1277, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31753431

RESUMO

OBJECTIVES: This study sought to determine the impact of rate and direction on left atrial (LA) substrate. BACKGROUND: The extent to which substrate mapped in sinus rhythm varies according to cycle length and direction of wave front propagation is unknown. METHODS: A total of 73 consecutive patients with atrial fibrillation (AF) underwent electroanatomic LA mapping before pulmonary vein isolation using multipolar catheter during distal coronary sinus (CS) pacing at 600 ms and 300 ms. Additional maps were created during left superior pulmonary vein pacing at 300 ms. Bipolar voltage, conduction velocity (CV), and complex signals were determined. RESULTS: Mean age was 61 ± 9 years, 67% were men, and 53% had persistent AF. Global mean voltage was lower with CS pacing at 300 ms compared with 600 ms (1.56 ± 0.47 mV vs. 1.74 ± 0.48 mV; p < 0.001). This was seen in all LA segments. Global CV was reduced (30.4 ± 13.0 cm/s vs. 38.6 ± 14.0 cm/s; p < 0.001) with greater complex signals at 300 ms (8.9% vs. 5.3%; p < 0.005). Compared with CS pacing, left superior pulmonary vein pacing demonstrated highly regional changes with decreased voltage (1.04 ± 0.43 mV vs. 1.47 ± 0.53 mV; p = 0.01) and CV (24.4 ± 13.0 cm/s vs. 39.9 ± 16.6 cm/s; p = 0.008), and greater complex signals posteriorly. Longer AF duration in paroxysmal AF (p = 0.02) and shorter duration in persistent AF (p = 0.015) and left ventricular ejection fraction (p = 0.016) were independent predictors of voltage change. CONCLUSIONS: In patients with AF, variation in cycle length and direction of wave front activation produce both generalized and regional changes in voltage, CV, and complex fractionation, resulting in significant changes in substrate maps. This study highlights the potential limitations of static low-voltage maps to identify the AF ablation target zone.

15.
J Clin Invest ; 129(12): 5343-5356, 2019 Dec 02.
Artigo em Inglês | MEDLINE | ID: mdl-31682236

RESUMO

Both miRNAs and A-to-I RNA editing, a widespread nucleotide modification mechanism, have recently emerged as key players in cancer pathophysiology. However, the functional impact of RNA editing of miRNAs in cancer remains largely unexplored. Here, we focused on an ADAR2-catalyzed RNA editing site within the miR-379-5p seed region. This site was under-edited in tumors relative to normal tissues, with a high editing level being correlated with better patient survival times across cancer types. We demonstrated that in contrast to wild-type miRNA, edited miR-379-5p inhibited cell proliferation and promoted apoptosis in diverse tumor contexts in vitro, which was due to the ability of edited but not wild-type miR-379-5p to target CD97. Importantly, through nanoliposomal delivery, edited miR-379-5p mimics significantly inhibited tumor growth and extended survival of mice. Our study indicates a role of RNA editing in diversifying miRNA function during cancer progression and highlights the translational potential of edited miRNAs as a new class of cancer therapeutics.

16.
Medicine (Baltimore) ; 98(44): e17800, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31689859

RESUMO

RATIONALE: Human papillomavirus (HPV)-related oropharyngeal cancer is becoming more common, the primary cancer AQ4 usually occult and appearing only as cystic cervical lymph node (LN) metastasis. Distinguishing between a benign cystic lesion and cystic LN metastasis is challenging given their similar radiologic and histologic appearances. PATIENT CONCERNS: A 54-year-old man presented with a bulging cystic mass measuring 6.4cm on the right side of neck. DIAGNOSES: Postexcision diagnosis was second branchial cleft cyst. After 2 years, the cystic mass recurred, and HPV-related tonsillar squamous cell carcinoma with cystic metastatic LNs was confirmed after wide tonsillectomy and neck dissection. The previous cystic lesion proved to be a cystic metastatic LN from the same malignancy with additional p16 immunostain. INTERVENTIONS: The patient was treated with adjuvant concurrent chemoradiation therapy. OUTCOMES: The patient was followed up in the outpatient department with no evidence of recurrence after 1 year. LESSONS: When an adult has a cystic mass in the upper neck, we must rigorously exclude it as a cystic metastatic LN of occult HPV-related oropharyngeal cancer. Additional p16 staining might be helpful.


Assuntos
Branquioma/diagnóstico , Carcinoma de Células Escamosas/diagnóstico , Metástase Linfática/diagnóstico , Neoplasias Císticas, Mucinosas e Serosas/diagnóstico , Neoplasias Primárias Desconhecidas/diagnóstico , Neoplasias Orofaríngeas/diagnóstico , Carcinoma de Células Escamosas/secundário , Carcinoma de Células Escamosas/virologia , Diagnóstico Diferencial , Humanos , Linfonodos/patologia , Linfonodos/virologia , Masculino , Pessoa de Meia-Idade , Pescoço/patologia , Pescoço/virologia , Esvaziamento Cervical , Neoplasias Císticas, Mucinosas e Serosas/secundário , Neoplasias Císticas, Mucinosas e Serosas/virologia , Neoplasias Primárias Desconhecidas/patologia , Neoplasias Primárias Desconhecidas/virologia , Neoplasias Orofaríngeas/secundário , Neoplasias Orofaríngeas/virologia , Papillomaviridae , Infecções por Papillomavirus/complicações , Infecções por Papillomavirus/virologia , Neoplasias Tonsilares/diagnóstico , Neoplasias Tonsilares/patologia , Neoplasias Tonsilares/virologia
17.
Front Oncol ; 9: 846, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31632900

RESUMO

Background: The objective of this study is to identify independent risks and protective factors and to construct a mortality prediction model for gastrectomy in the Chinese population. Study design: This is a population-based prospective cohort at an institutional level. Seventy-two participating hospitals reported their annual gastrectomy data between 2014 and 2016, while 44 variables covering the institution and surgical information were included in the analysis. We used R software to encode and complete data pre-processing. The first difference model was applied to build the risk model. Data from 2014 and 2015 were assigned to risk model development, while data from 2016 was used for validation. Results: In the included centers with 94,277 gastric cancer cases, the in-hospital mortality rate was 0.32%. The regression model revealed that provinces with low-middle GDP, hospitals with annual gastrectomy volume between 100 and 500, greater volume of urgent surgeries performed, larger proportion of males, and a higher proportion of liver metastasis were independent risk factors for mortality following gastric surgeries, while higher laparoscopic resection volume, greater volume of distal gastrectomy with B2 reconstruction, and larger proportion of palliative surgery were independent protective factors (p < 0.05, respectively). In the prediction test, the mean square error of the training set was 0.948, while that of the test set was 0.728, demonstrating the effectiveness of this model. Conclusions: We constructed the first mortality risk prediction model for gastric cancer surgery in the Chinese population. The identified risk factors will help with the therapy selection, while further informing Chinese medical policy decision-makers.

18.
Zhen Ci Yan Jiu ; 44(10): 747-51, 2019 Oct 25.
Artigo em Chinês | MEDLINE | ID: mdl-31657165

RESUMO

OBJECTIVE: To observe the prewarming effect of transcutaneous acupoint electrical stimulation (TAES) preconditioning of Dazhui (GV14) and Mingmen (GV4) in patients undergoing elective video-assisted thoracoscopic lobectomy, so as to determine whether TAES can improve intraoperative hypothermia. METHODS: A total of 80 patients undergoing elective video-assisted thoracoscopic lobectomy were randomly divided into TAES group (40 cases) and control group (40 cases). Before surgery, all the patients were transferred to the fixed area of an anesthetic preparation room by using a surgery cart carrying the same temperature sheets and quilts before surgery. TAES (2 Hz/100 Hz, 20-30 mA) was applied to Dazhui (GV14) and Mingmen (GV4) for 30 min for patients of the TAES group and the same sheet electrodes of EA stimulator were only attached to GV14 and GV 4 without electrical current transmission for patients in the control group. Then, these patients in the two groups were transferred to the operation room and treated by total intravenous anesthesia, and their anesthetic depth was monitored with bispectral index (BIS, between 45-60) and end-tidal carbon dioxide tension (PETCO2, between 30-45 mmHg). The auricular tympanic temperature was monitored, and when the temperature was below 35.5 ℃, forced-air blanket was used to warm the patient as the remedial measure. The same temperature of operation room, surgical drape, infusion solution and pleural lavage fluid were controlled. The patients' body temperature in the preparation room and operation room during surgery, incidence of hypothemia, blood pressure (BP), heart rate (HR), duration of anesthesia, duration of operation, blood loss volume, urine output, total infusion volume, recovery (awaking) time, and chills during recovery were recorded. RESULTS: The body temperature of patients in the TAES group was significantly higher than that in the control group at the time of entering the operation room (P<0.05). The incidence of chills during recovery was obviously lower in the TAES group (3/40,7.5%) than in the control group (7/40, 17.5%, P<0.05), and the recovery time was significantly shorter in the TAES group than in the control group (P<0.05). There were no significant differences between the two groups in the incidence of intraoperative hypothermia, the duration of anesthesia and operation, blood loss volume, urine output, total infusion volume, BP and HR (P>0.05). CONCLUSION: TAES preconditioning of GV14 and GV4 can produce prewarming effect before anesthesia, shorten the awaking time and reduce the incidence of chills in the recovery period in patients undergoing elective video-assisted thoracoscopic lobectomy.


Assuntos
Anestésicos , Estimulação Elétrica Nervosa Transcutânea , Pontos de Acupuntura , Anestesia Geral , Estimulação Elétrica , Humanos
19.
Med Sci Monit ; 25: 8061-8068, 2019 Oct 27.
Artigo em Inglês | MEDLINE | ID: mdl-31655846

RESUMO

BACKGROUND Hospitalizations in patients with systemic lupus erythematosus (SLE) have been reported from different regions in the world. This study aimed to evaluate the annual hospitalization rate, causes of hospitalization, and potential factors associated with frequency of hospitalization in Chinese patients. MATERIAL AND METHODS We performed an ambispective cohort study for hospitalized patients with SLE in a Chinese single center. Data on demographics, organ involvements, laboratory abnormities, clinical treatments, causes of hospitalization, and survival outcomes were recorded at the time of SLE diagnosis and during a follow-up period. Poisson regression models were created to identify the potential factors associated with frequency of hospitalization. RESULTS Of 526 patients with SLE, 242 patients (46%) had 1 or more admissions amounting to a total of 449 times during a median follow-up period of 4.73 years. The annual hospitalization rate was 18% and death occurred in 2.5% of total admissions. SLE flare, infection and pregnancy-related morbidity were the most common causes of hospitalization. Besides, the multivariate Poisson regression analysis revealed that decreased albumin, decreased renal function, and high disease damage were the risk factors for more frequency of hospitalization, whereas positive anti-SSA antibody and use of hydroxychloroquine were protective factors. CONCLUSIONS Nearly half of patients (46%) with SLE experience 1 or more hospitalizations, mainly due to SLE flare, infection, and pregnancy-related morbidity. Lupus patients with decreased albumin, decreased renal function, and high disease damage are more susceptible to have frequent hospitalization.

20.
Cancer Lett ; 466: 35-38, 2019 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-31541696

RESUMO

Sex is a key biological factor affecting the development of many cancer types. There are considerable differences between male and female subpopulations in terms of cancer incidence, prognosis and mortality. Recent studies have extensively characterized the sex-biased molecular changes in cancer patients. Further efforts should be made to develop sex-specific cancer prevention and therapeutic strategies.

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