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1.
Zhonghua Liu Xing Bing Xue Za Zhi ; 42(4): 711-715, 2021 Apr 10.
Artigo em Chinês | MEDLINE | ID: mdl-34814456

RESUMO

Objective: To explore the HIV-1 drug resistance and subtypes in newly reported HIV/AIDS patients before antiretroviral therapy (ART) in Taizhou city. Methods: A cross-sectional study of HIV-1 drug resistance was conducted among newly reported HIV/AIDS patients before ART in Taizhou from January 2016 to December 2018. HIV-1 pol gene sequences were obtained by RT-PCR. The sequences were submitted to the Stanford University drug resistance database. The drug resistance mutation and the sensitivity of HIV-1 strains to antiretroviral drugs were determined according to WHO Guidelines on HIV drug resistance surveillance of 2014. Results: A total of 806 HIV-1 pol gene sequences were obtained successfully. The overall HIV-1 drug resistance rate was 2.9% (23/806), 1.9% for non-nucleoside reverse transcriptase inhibitors (NNRTIs), 0.6% for nucleoside reverse transcriptase inhibitors (NRTIs), and 0.0% for protease inhibitors (PIs), respectively. From 2016 to 2018, the HIV-1 drug resistance rate was 1.6%, 1.8%, and 4.8%, respectively. The resistance mutations of NNRTIs and NRTIs were mainly K103 N (0.7%) and M184I/V (0.5%). HIV-1 subtypes were mostly CRF01_AE (42.7%,344/806),CRF07_BC (28.9%,233/806) and CRF08_BC (11.2%,90/806).HIV-1 subtypes among homosexually transmitted infections were mostly CRF01_AE (53.3%, 136/255) and CRF07_BC (32.2%, 82/255), and HIV-1 subtypes among heterosexually transmitted infections were mainly CRF01_AE (37.7%, 203/539), CRF07_BC (27.5%, 148/539) and CRF08_BC (16.1%, 87/539). Conclusion: HIV-1 drug resistance rate among newly reported HIV/AIDS patients before ART remained low in Taizhou during 2016 to 2018, an increasing trend seemed to be notifiable and warrants continuous surveillance of HIV-1 drug resistance.


Assuntos
Infecções por HIV , HIV-1 , China/epidemiologia , Estudos Transversais , Farmacorresistência Viral/genética , Genes pol , Genótipo , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , HIV-1/genética , Humanos , Mutação , Filogenia
2.
Zhonghua Liu Xing Bing Xue Za Zhi ; 42(7): 1274-1279, 2021 Jul 10.
Artigo em Chinês | MEDLINE | ID: mdl-34814543

RESUMO

Objective: To establish a multi-state Markov model of type 2 diabetes mellitus (T2DM) patients and explore the transition rule between the cumulative number of different chronic complications, estimate the transition probability and intensity between status, and explore the possible factors affecting the transition between status. Methods: A retrospective cohort study of 33 575 patients with T2DM was conducted. According to the baseline and the cumulative number of chronic complications during the follow-up period, the patients were classified based on five status: T2DM, one complication, two complications, three complications, four and above complication, indicated by S0, S1, S2, S3 and S4, respectively. A time-continuous and state-discrete multi-state irreversible Markov model was used for statistical analysis. Results: The study included 33 575 T2DM patients, and their average age was 60 years old, the median of follow-up length was 8 years. In these patients, 32 653 had no baseline complications. At the end of follow-up, the transition probabilities of S0→S1, S1→S2, S2→S3 and S3→S4 were 16.4%, 32.4%, 45.6% and 25.9%, respectively. The results of multivariate analysis showed that being female (HR=0.919), less than 60 years old (HR=0.929), higher fasting plasma glucose (HR=1.601), lower high-density lipoprotein (HR=1.087), higher total cholesterol (HR=1.090),weekly exercise (HR=0.897), vegetarian diet (HR=0.852) and heavy diet (HR=1.887) were the risk factors for S0 to S1. And being female (HR=0.768), less than 60 years old (HR=0.859) and lower high-density lipoprotein (HR=1.160) were the risk factors for S1 to S2. Conclusions: The probability of multiple complications in T2DM patients increased over time, the transition intensity of S2→S3 was largest, followed by S1→S2. Therefore, we need to conduct both early and long-term indicators monitoring and disease prevention, strengthen the health education to improve patients' daily living habits at early stage of the illness, encourage patients to have moderate exercise and balanced diet, strengthen the monitoring of fasting blood- glucose, cholesterol and high-density lipoprotein levels to prevent the deterioration of the illness.


Assuntos
Diabetes Mellitus Tipo 2 , Colesterol , Diabetes Mellitus Tipo 2/epidemiologia , Jejum , Feminino , Humanos , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco
3.
Zhonghua Liu Xing Bing Xue Za Zhi ; 42(9): 1689-1694, 2021 Sep 10.
Artigo em Chinês | MEDLINE | ID: mdl-34814602

RESUMO

As an important branch of artificial intelligence, machine learning is widely used in various fields. Machine learning has similarity to classical statistical methods, but can solve many problems which are difficult for traditional statistics, so it is one of the important tools in epidemiological research. This paper introduced 9 common algorithms of machine learning and summarized their characteristics and applications in epidemiological research. Readers could choose appropriate machine learning method according to the research purpose for the better application of machine learning in epidemiological research.


Assuntos
Inteligência Artificial , Aprendizado de Máquina , Algoritmos , Estudos Epidemiológicos , Humanos
4.
Artigo em Inglês | MEDLINE | ID: mdl-34767957

RESUMO

OBJECTIVE: In knee cartilage from patients with osteoarthritis (OA), both preserved cartilage and damaged cartilage are observed. In this study, we aim to compare preserved with damaged cartilage to identify the molecule(s) that may be responsible for the mechanical loading-induced differences within cartilage degradation. METHODS: Preserved and damaged cartilage were harvested from the same OA knee joint. RNA Sequencing was performed to examine the transcriptomic differences between preserved and damaged cartilage cells. Estrogen receptor-α (ERα) was identified, and its function of was tested through gene knockin and knockout. The role of ERα in mediating chondrocyte response to mechanical loading was examined via compression of chondrocyte-laded hydrogel in a strain-controlled manner. Findings from the studies on human samples were verified in animal models. RESULTS: Level of estrogen receptor α (ERα) was significantly reduced in damaged cartilage compared to preserved cartilage, which were observed in both human and mice samples. Knockdown of ESR1, the gene encoding ERα, resulted in an upregulation of senescence- and OA-relevant markers in chondrocytes. Conversely, knockin of ESR1 partially reversed the osteoarthritic and senescent phenotype of OA chondrocytes. Using a three-dimensional (3D) culture model, we demonstrated that mechanical overload significantly suppressed ERα level in chondrocytes with concomitant upregulation of osteoarthritic phenotype. When ESR1 expression was suppressed, mechanical loading enhanced hypertrophic and osteogenic transition. CONCLUSION: Our study demonstrates a new estrogen-independent role of ERα in mediating chondrocyte phenotype and its response to mechanical loading, and suggests that enhancing ERα level may represent a new method to treat osteoarthritis.

5.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 33(5): 452-456, 2021 Oct 27.
Artigo em Chinês | MEDLINE | ID: mdl-34791841

RESUMO

OBJECTIVE: To develop a fluorescent recombinase-aided isothermal amplification (RAA)-based nucleic acid assay for detection of Leshimania. METHODS: Specific primers and probes were designed targeting Leishmania internal transcribed spacer 1 (ITS1) gene for RAA assay, and a fluorescent RAA assay was developed for detection of Leishmania following screening of primer pairs and optimization of primer and probe concentrations. The sensitivity of RAA assay for detection of Leishmania was evaluated using recombinant plasmid containing Leishmania ITS1 gene sequences at different copies and Leshimania genomic DNA at different concentrations as templates, and the specificity of RAA assay for detection of Leishmania was evaluated using the genomic DNA of transfusion-transmitted parasites, including Babesia microti, Toxoplasma gondii, Plamodium vivax, P. ovale, P. falciparum, P. malariae, L. donovani and L. infantum. RESULTS: After the optimal primer pair was screened from 9 pairs of primer combinations, the final primer and probe concentrations were optimized as 0.3 µmol/L and 0.08 µmol/L, respectively. Nucleic acid detection of Leishmania was completed by the fluorescent RAA assay at an isothermal temperature of 39 °C within 20 min. Remarkable florescent signals were seen within 5 min following RAA detection of genomic DNA of L. donovani and L. infantum, and no cross-reactions were observed with B. microti, T. gondii, P. vivax, P. ovale, P. falciparum or P. malariae. The lowest limitation of detection of the fluorescent RAA assay was 10 copies/µL recombinant plasmid containing Leishmania ITS1 gene sequences and 1 fg/µL Leishmania genomic DNA. CONCLUSIONS: A rapid, simple, sensitive and specific fluorescent RAA assay is successfully developed for detection of L. donovani and L. infantum, which is effective for field screening of leishmaniasis.


Assuntos
Leishmania , Ácidos Nucleicos , Leishmania/genética , Técnicas de Amplificação de Ácido Nucleico , Recombinases , Sensibilidade e Especificidade
6.
Zhonghua Yi Xue Za Zhi ; 101(40): 3323-3328, 2021 Nov 02.
Artigo em Chinês | MEDLINE | ID: mdl-34758533

RESUMO

Objective: To retrospectively analyze the occurrence and treatment of perioperative complete atrioventricular block (CAVB) by transcatheter aortic valve implantation (TAVI). Methods: A total of 65 patients who underwent TAVI via femoral artery in the Heart Center of Henan People's Hospital from October 2017 to May 2021 were enrolled. Perioperative data of patients were recorded. The patients were divided into two groups according to whether complete atrioventricular block was occurred during TAVI: complete atrioventricular block group (Group CAVB) and non-complete atrioventricular block group (Group NCAVB). Multivariate logistic regression model was used to analyze the risk factors of complete atrioventricular block during transcatheter aortic valve implantation. The incidence of perioperative complications were recorded. Results: The patients age was (69.1±7.3) years old. and there were 35 males and 30 femals. There were 15 patients in group CAVB with complete atrioventricular block and 50 patients in group NCAVB. Multivariate analysis showed that preoperative right bundle branch block [OR (95%CI) vs 3.325 (2.132-13.061), P=0.005] and severe aortic valve calcification [OR (95%CI) vs 1.271 (1.052-3.326), P=0.030] were independent correlative factors for CAVB during TAVI perioperative period. The implantation rate of permanent pacemaker in group CAVB was 73.3% (11 cases), which was higher than 6.0% (3 cases) in group NCAVB (P<0.001). Conclusions: It indicated that preoperative right bundle branch block and severe aortic valve calcification are correlative factors for complete atrioventricular block for TAVI. The implantation rate of permanent pacemaker in complete atrioventricular block group increased significantly.


Assuntos
Estenose da Valva Aórtica , Bloqueio Atrioventricular , Próteses Valvulares Cardíacas , Marca-Passo Artificial , Substituição da Valva Aórtica Transcateter , Idoso , Valva Aórtica/cirurgia , Estenose da Valva Aórtica/cirurgia , Bloqueio Atrioventricular/etiologia , Bloqueio Atrioventricular/terapia , Eletrocardiografia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Resultado do Tratamento
7.
Nat Mater ; 2021 Nov 08.
Artigo em Inglês | MEDLINE | ID: mdl-34750539

RESUMO

Symmetry plays a central role in conventional and topological phases of matter, making the ability to optically drive symmetry changes a critical step in developing future technologies that rely on such control. Topological materials, like topological semimetals, are particularly sensitive to a breaking or restoring of time-reversal and crystalline symmetries, which affect both bulk and surface electronic states. While previous studies have focused on controlling symmetry via coupling to the crystal lattice, we demonstrate here an all-electronic mechanism based on photocurrent generation. Using second harmonic generation spectroscopy as a sensitive probe of symmetry changes, we observe an ultrafast breaking of time-reversal and spatial symmetries following femtosecond optical excitation in the prototypical type-I Weyl semimetal TaAs. Our results show that optically driven photocurrents can be tailored to explicitly break electronic symmetry in a generic fashion, opening up the possibility of driving phase transitions between symmetry-protected states on ultrafast timescales.

8.
Beijing Da Xue Xue Bao Yi Xue Ban ; 53(5): 995-1001, 2021 Oct 18.
Artigo em Chinês | MEDLINE | ID: mdl-34650308

RESUMO

OBJECTIVE: To compare the effects of different imaging methods on radio-opacity. Digital imaging and traditional film imaging were used to determine the radio-opacity of dental composite resin materials. METHODS: Fourteen dental composite resins commonly used in clinic were prepared for disc samples with thickness of 1 mm and diameter of 15 mm respectively. The aluminum step wedge was used as the reference and the disc samples were irradiated with X-rays by the traditional film imaging, phosphor imaging plate and charge-coupled device(CCD) intra-oral X-ray sensor respectively. Exposure was set at 65 kV and 7 mA, with 300 mm focus to film distance and the exposure time was 0.25 s. After developing and fixing the film, the optical density of the image of the sample and that of each step of the aluminum step wedge were measured using the densitometer. The digital image file was exported to grey scale analysis software of Adobe Photoshop® to measure the average grey value in the sample image and aluminum step wedge image. The curves were drawn corresponding to the optical density/gray value of each step of the aluminum step wedge and its thickness, and the equivalent thickness of the aluminum plate was calculated according to the optical density/gray value of the actual measured thickness of the sample, so as to evaluate the radio-opacity of dental composite resin material. RESULTS: For the same sample, the aluminum equivalent measured by traditional film imaging and two other digital imagings had significant differences among the 14 composite resins (P < 0.05), and the aluminum equivalent measured by the two digital imagings were greater than that of the traditional film. Moreover the aluminum equivalent measured by the two digital imagings was also different, and the aluminum equivalent measured by the CCD intra-oral X-ray sensor in most composite resins was larger than that measured by phosphor imaging plate. The same sample was photographed with the same imaging method, and the aluminum equivalent was different after three exposures. The standard deviation of aluminum equivalent measured by phosphor imaging plate was the largest, while that measured by CCD intra-oral X-ray sensor was the smallest. Among the 14 dental composite resin materials, the aluminum equivalent of Tetric N-Ceram and Te-Econom Plus measured by traditional film imaging and phosphor imaging plate was significantly higher than other composite resins. CONCLUSION: Based on clinical significance, three kinds of sensors designed to measure the radio-opacity of dental composite resin, the value of aluminum equivalent will change according to different types of sensors. The aluminum equivalent measured by CCD intra-oral X-ray sensor was higher than that measured by phosphor imaging plate, and the aluminum equivalent measured by phosphor imaging plate was higher than that measured by traditional film imaging. Moreover, even though the same sensor was used, the aluminum equivalent measured by multiple exposures was different. The standard deviation of the aluminum equivalent measured by phosphor imaging plate was greater than that measured by traditional film imaging and CCD intra-oral X-ray sensor. The three sensors in this study could be used for evaluating the radio-opacity of dental composite resin materials. But no matter what kind of sensor was used to measure the radio-opacity of dental composite resin, it complied to ISO 4049: 2019 standard, the materials were suitable for clinical use.


Assuntos
Resinas Compostas , Radiografia Dentária Digital , Alumínio
9.
Zhonghua Yu Fang Yi Xue Za Zhi ; 55(9): 1129-1132, 2021 Sep 06.
Artigo em Chinês | MEDLINE | ID: mdl-34619932

RESUMO

In 2019, the rate of primary tooth caries rate among 1 598 preschool children in Shinan District and Shibei District of Qingdao was 59.4%. The multivariate logistic regression model showed that compared with children ≤ 2 years old with history of iron deficiency anemia (IDA), suffering IDA, breastfeeding to 2 years old and no tooth melanin, children ≤ 2 years old without history of IDA, not suffering IDA, breastfeeding to less than 2 years old and heavy tooth melanin had a lower risk of primary tooth caries, with OR (95%CI) values about 0.328 (0.197-0.549), 0.354 (0.208-0.603), 0.636 (0.437-0.926) and 0.301 (0.143-0.635), respectively.


Assuntos
Cárie Dentária , Pré-Escolar , Cárie Dentária/epidemiologia , Humanos , Modelos Logísticos , Prevalência , Dente Decíduo
10.
Zhonghua Jie He He Hu Xi Za Zhi ; 44(8): 711-716, 2021 Aug 12.
Artigo em Chinês | MEDLINE | ID: mdl-34645137

RESUMO

Objective: To evaluate the diagnostic value of bronchoalveolar lavage fluid pathogen detection combined with cryptococcal antigen test(CrAg) for pulmonary cryptococcosis(PC). Methods: A retrospective case analysis was performed on non-acquired immunodeficiency syndrome patients admitted to Ninghai First Hospital for suspected PC from January 2018 to December 2019. Fifty-nine patients were included. Sixteen cases (8 males and 8 females) were diagnosed with PC, aged from 18 to 76 years[an average age of (52±14) years], while 43 cases were diagnosed as having Non-PC. All patients had undergone both serum CrAg test and BALF pathogen detection(cultures and direct examination) combined with BALF-CrAg test. The sensitivity and specificity of the combined method of BALF was evaluated, and a parallel comparison of the diagnostic efficiencies of the two methods were made. Results: Of the 16 confirmed PC cases, serum CrAg tests were positive in 11 and negative in 5 cases, while the combined method showed that 14 were positive and 2 were negative. Compared with the clinical final diagnosis, the sensitivity, specificity, positive predictive value and negative predictive value showed that the serum CrAg tests were 68.8% (11/16), 97.7% (42/43), 91.7% (11/12), 89.3% (42/47) respectively, versus 87.5% (14/16), 100.0% (43/43), 100% (14/14), 95.6% (43/45) by the combined method of BALF. The results displayed no statistical difference between the two diagnostic methods (P =1.000). Among the 5 initially serum CrAg-negative cases, 4 were later confirmed as proven PC via the combined method of BALF and the other one by percutaneous lung biopsy. Conclusion: The combined method of BALF pathogen detection with BALF-CrAg showed a similar statistical efficiency rate for diagnosing pulmonary cryptococcosis compared with serum CrAg tests. It may serve as an efficient diagnosis method for PC cases with negative serum CrAg tests.


Assuntos
Criptococose , Adulto , Idoso , Antígenos de Fungos , Líquido da Lavagem Broncoalveolar , Criptococose/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Sensibilidade e Especificidade
11.
Zhonghua Yu Fang Yi Xue Za Zhi ; 55(2): 194-199, 2021 Feb 06.
Artigo em Chinês | MEDLINE | ID: mdl-34645179

RESUMO

Objective: To investigate the effect of hourly ambient temperature exposure on emergency calls in Xuchang city and Zhengzhou city. Methods: The hourly meteorological data, air pollution data and emergency calls of Xuchang city and Zhengzhou city were collected from January 1, 2017 to October 31, 2019. A distributed lag non-linear model was used to calculate the excess relative risk (ERR). The lag effect and cumulative effect of extreme temperature exposure on emergency calls were evaluated. Results: The relationship between hourly temperature exposure and emergency calls was a U-shaped curve. In Xuchang city and Zhengzhou city, both low and high temperatures would increase the number of hourly emergency calls. The earliest effect of low temperature occurred at a lag of 22 h and 52 h, with ERR values (95%CI) about 0.20% (0.00%, 0.39%) and 0.11% (0.00%, 0.22%), respectively. The earliest effect of high temperature occurred at a lag of 0 h with ERR values about 1.59% (1.09%, 2.09%) and 1.45% (1.22%, 1.69%), respectively. High temperature had the greatest impact on the number of emergency calls of cardiovascular disease at a lag of 4-8 h. The cumulative ERR values (95%CI) of the two cities were 8.70% (4.98%, 12.75%) and 3.89% (2.61%, 5.22%), respectively. Conclusion: High temperature exposure could increase the number of emergency calls within a few hours, while the effect of low temperature would not occur until 22 hours later.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Poluentes Atmosféricos/análise , Poluição do Ar/análise , China , Cidades , Serviço Hospitalar de Emergência , Humanos , Temperatura
12.
Int J Radiat Oncol Biol Phys ; 111(3S): e320-e321, 2021 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-34701176

RESUMO

PURPOSE/OBJECTIVE(S): Surgery remains the foundation of curative therapy for non-metastatic breast cancer, but a substantial proportion of patients do not undergo surgery. Evidence is limited regarding overall survival (OS) outcomes and factors associated with lack of surgery. We sought to measure OS among patients with breast cancer who do not undergo surgery, and assess factors for association with lack of surgery and OS. MATERIALS/METHODS: Retrospective cohort study of patients in the US National Cancer Data Base from 2004-2016. The dataset comprised 2,696,734 patients; excluding patients with unknown surgical status or stage IV, cT0, cTx, or pIS, metastatic or recurrent disease resulted in 1,192,294 patients for analysis. Descriptive statistics were used to summarize patient characteristics. Chi-square tests and Wilcoxon rank-sum were used to test for differences between variables between groups. OS was analyzed utilizing the Kaplan-Meier method for non-surgical patients diagnosed in 2010-2015 to account for receptor status (Median follow-up time 34 months). The Cox proportional hazards model was used to assess association of risk factors with OS. RESULTS: Of the 1,192,294 patients, 50,626 (4.3%) did not undergo surgery. Socioeconomic factors that were more prevalent in the non-surgical cohort were Black race, age > 50 years, lower income, uninsured or public insurance, and lower education; this group was also more likely to have more comorbidities, higher disease stage, and more aggressive disease biology. Only 3,689 non-surgical patients (7.3%) received radiation therapy (RT). Median OS time for all patients who did not have surgery was 58 months (3-year and 5-year OS rates 63% and 49%). Median OS times were longer for patients who received chemotherapy (80 vs 50 months) and RT (85 vs 56 months). On multivariate analysis, age, race, income, insurance status, comorbidity score, disease stage, tumor subtype treatment facility type and location, and receipt of RT were associated with OS. On subgroup analysis, receipt of chemotherapy improved OS for patients with high-risk (triple-negative, HER2+) disease, whereas receipt of RT led to improved OS for patients with ER+ and favorable (ER+, early-stage, age > 60) disease. CONCLUSION: More than 4% of women with non-metastatic breast cancer do not undergo surgery for their cancer, particularly those with more aggressive disease, of minority race/ethnicity and lower socioeconomic status. Despite its known benefits, RT was significantly underused. This study provides one of the first benchmarks of survival outcomes for patients who do not undergo surgery for breast cancer, and highlights a potential role for increased use of RT. Additionally this report highlights significant disparities effecting women of minority race/ethnicity and lower socioeconomic status.

13.
Int J Radiat Oncol Biol Phys ; 111(3S): e44, 2021 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-34701459

RESUMO

PURPOSE/OBJECTIVE(S): Definitive chemoradiation is essential in non-operative thoracic esophageal cancer. Concerns have posed onto the possible radiation-induced lymphopenia and correlation with different survival outcomes. Neutrophil to lymphocyte ratio (NLR) is a simple way to surrogate the inflammation-immunity status and predict survival. We aim to evaluate the clinical variables and radiation dosimetric parameters associated with hematologic variables changes. MATERIALS/METHODS: Between 2010 and 2015, we identified 93 newly diagnosed thoracic esophageal squamous-cell cancer patients who had completed definitive concurrent chemoradiotherapy (CCRT). Patients' clinical, dosimetric, and hematological data, including absolute neutrophil count, absolute lymphocyte count, and NLR were analyzed at baseline and during CCRT. Cox regression model and Kaplan-Meier analyses were used to validate different survival outcomes. The possible relationships between clinical, hematologic, and dosimetric variables were tested using Spearman's rank or Pearson correlation coefficients, and a further multivariable logistic regression model was created to verify these significant variables. RESULTS: The participant group (mean age = 58.6 y) predominantly comprised males (94%) with 27% stage II (n = 25) and 73% stage III (n = 68). Median overall survival (OS) was 13 months (95% confidence interval: 10.304-15.696). We confirmed that baseline NLR (NLR-b) and highest NLR during CCRT (NLR-h) significantly predicted OS, progression-free survival, disease-specific survival, and freedom from distant metastasis. Dichotomized NLR-b with > 3.68 or ≤3.68 also predicted the survival outcomes. Primary esophageal tumor length (Spearman's correlation coefficient r = 0.324, P = 0.011) and baseline body weight (Spearman's r = -0.251, P = 0.019) were significantly correlated with baseline NLR > 3.68. In multivariable logistic regression, primary esophageal tumor length (OR = 1.345, P = 0.021) remained associated with a higher NLR-b. For NLR-h, lung V5 (Pearson r = 0.254, P = 0.014) and V10 (Pearson r = 0.317, P = 0.002) were significantly correlated. In the percentage of ALC nadir decreased during CCRT, lung V5 (Pearson r = 0.299, P = 0.005) and heart V10 (Pearson r = 0.273, P = 0.011) were significantly correlated. CONCLUSION: Inflammation predicts survival outcomes and is correlated with tumor size. Low-dose thoracic irradiation affects inflammation-immunity dynamics because lung V5 and V10 are related to NLR-h; lung V5 and heart V10 with extent of lymphocyte decrease. A novel approach to decrease these unnecessary exposures may further improve survival outcomes in esophageal cancer treated with CCRT.

14.
Int J Radiat Oncol Biol Phys ; 111(3S): e514, 2021 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-34701634

RESUMO

PURPOSE/OBJECTIVE(S): A novel O-ring Linac (ORL) offers a fully enclosed gantry with a single energy (6 MV) flattening filter-free photon beam, improved kV CBCT, a maximum treatment length of 36 cm (dual-isocenter setup), and a translation-only 3DOF couch for IGRT. The purpose of this study was to evaluate the viability of this ORL for use in a single-room clinic setting and to assess implementation challenges. MATERIALS/METHODS: Treatment statistics of the single-energy ORL over a 1-year period from our main campus (5-linac lineup) were used to develop a ORL machine utilization model; 2 years of treatment statistics from 3 single-room locations with multi-energy C-arm Linac were analyzed to generate a population-based disease distribution model for a typical single-room center. A percentage frequency distribution of key anatomical sites is summarized in Table 1. The ORL utilization model was then extended to the network disease distribution model to assess the percentage of patients in network that can be treated using the ORL. RESULTS: Table 1 shows the 9 anatomical sites accounting for ∼96% of network cases, all of which have corresponding active treatment protocols using the ORL at our main campus. Some 2D/3D treatments required modifications to planning workflow based on technical limitations of the ORL. Less than 1% of treatments at network locations required field sizes exceeding 36 cm, which is the ORL's limit. Electron treatments constitute ∼10% of network cases, of which 74% were for breast boost treatments. Considering 80% of breast boost treatments at our main campus were delivered on ORLs, over half of network electron cases can be safely treated on an ORL with photons. kV-CBCT is required for all ORL daily treatments. Despite the lack of 6DOF couch, ∼80% of ORL treatment fractions did not require manual repositioning for rotational corrections. Averaged appointment durations were reduced from 20 min on C-Arm Linac to 14 min on ORL. CONCLUSION: Our model indicated that approximately 95% of the patient population at a single-Linac clinic can be treated using the ORL photon-only system. Streamlined IGRT workflow improved the ORL's overall efficiency compared to C-Arm Linac. Although some modifications to planning workflows are required, the ORL improves overall efficiency and is in general suitable for a single-room clinic.

15.
Int J Radiat Oncol Biol Phys ; 111(3S): e515, 2021 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-34701637

RESUMO

PURPOSE/OBJECTIVE(S): Heart failure remains a major source of morbidity and mortality worldwide. Left ventricular assist devices (LVADs) provide mechanical circulatory support and offer superior outcomes to medical therapy in patients with end-stage heart failure. LVADs can be used as a bridge to cardiac transplantation but are now more commonly used as destination therapy. While the safety of photon beam and older proton beam therapy (PBT) techniques have been established in patients with LVADs, data evaluating the safety of pencil beam scanning (PBS) PBT techniques are lacking. In this study, we evaluated the dose tolerance of an LVAD to PBS proton irradiation. We hypothesized that proton irradiation would affect the function of the LVAD. MATERIALS/METHODS: We conducted three experiments in which we exposed elements of separate LVADs to a proton beam whose Spread Out Bragg Peak (SOBP) had a range of 100 mm and a width of 60 mm. The LVAD was placed in a water-based phantom with a wall of water-equivalent thickness of 11.59 mm at a depth of 5 cm. In the first experiment, we delivered escalating doses of proton beam radiation to the device pump, starting at 5 GyE and increasing in increments of 5 GyE up to 70 GyE. In replicative second and third experiments, we delivered proton beam radiation continuously to a dose of 70 GyE (prescribed to the middle of the SOBP) to the pump and driveline, respectively. Optical stimulated luminescent dosimeters (OSLDs) were utilized to monitor dose to the battery and controller, which were located outside of the field of radiation. Our institutional review board deemed this study exempt. RESULTS: The pump showed no significant operational changes after irradiation in the first and second experiments. However, during continuous irradiation of the driveline in the third experiment, communication between the pump and monitor was lost at 30 GyE (confirmed on the device's log files). While the pump continued to run during this time, the monitor displayed a low flow alarm. OSLD measurements were 0.02 cGy for the monitor and 0.069 cGy for the battery after the completion of the third experiment. No mechanical damage was noted to the components of the LVAD after any of the three experiments. CONCLUSION: The pump and driveline of the LVAD exhibited no structural damage after direct irradiation by a proton beam. The pump tolerated escalating doses of up to 70 GyE, which is consistent with prior published data. However, when the driveline was irradiated continuously, the controller and pump lost connection at 30 GyE, and a low flow alarm was generated. These results suggest that while the LVAD pump can tolerate clinically significant doses of PBS PBT, further study is necessary to assess the resilience of the driveline to fractionated PBT.

16.
Int J Radiat Oncol Biol Phys ; 111(3S): e543, 2021 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-34701709

RESUMO

PURPOSE/OBJECTIVE(S): During lung cancer radiotherapy, tumor motion magnitude may change, resulting in either inadequate margins or non-ideal dose conformality (margins are unnecessarily too big). To predict large motion change using only patient-specific clinical information and the simulation 4DCT images, we proposed an ensemble learning model (ELM) with robust feature selection (FS). For this specific study, we minimized the false negative prediction so that we will not miss patients who might have a subsequent large change in tumor motion. Thus, we employed positive predictive values (PPV) as the evaluation metric instead of commonly used accuracy scores. MATERIALS/METHODS: Seventeen features were collected including both clinical factors and imaging features. The motion change is defined by motion difference in SI direction between the simulation 4DCT and mid-course repeat 4DCT with the clinical threshold set as 3 mm. The dataset consisted of 140 patients, where 31 showed large tumor motion change. Four hundred seventy-two sets of 4DCT images were analyzed in this study. The ELM adopts 5 conventional predictive models (logistic regression (LR), decision tree (DT), support vector machine (SVM), random forest (RF), and XGBoost (XGB)) as base predictors. Then, the results are employed as inputs for a two-layer neural network to obtain a final prediction. To enhance the feature sensitivity and to reduce data noise, we developed a robust FS strategy with sequential backward selection. Each criterion score is an average from 5-fold cross-valuation, and the target feature of each round is based on 1000 repeated experiments. The peak of the criterion score after sequential removal of the least sensitive features was used to select the optimal feature set. RESULTS: By employing PPV as the criterion function, all the base predictors ranked initial SI tumor motion as the most important feature. ROC curve with selected sensitive features consistently outperformed the one with all features. For ELM, the AUCs (mean std. ± dev.) were 0.63 ± 0.04 when all features were included and increased to 0.72 ± 0.02 for PPV-based selected features only. The prediction comparisons were performed for all base predictors and ELM with 100 repetitions. The PPV results (Table 1) demonstrated the proposed ELM obtained superior performance than each base predictor. CONCLUSION: We proposed an ELM to identify patients with potential large tumor motion change using only information prior to the first treatment. The ELM showed superior performance with PPV-driven metrics. We also developed a feature selection strategy for each base predictor, and the consistent superiority was demonstrated by ROC results. In future work, additional information from on-treatment evaluation CTs may further improve the prediction.

17.
Poult Sci ; 100(11): 101428, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34601439

RESUMO

Considering the value of guinea fowl keets, successful incubation of eggs is particularly desirable in this poultry species. This study evaluated the effect of egg storage duration on egg quality, heat production, hematological parameters during embryonic development and post hatch performance of guinea fowl broilers. A total of 800 hatching eggs of guinea fowl were used for this study. Before incubation, 12 eggs per treatment were used to analyse egg quality. Then, eggs were numbered, weighed, and assigned to 2 treatment groups of 400 eggs each according to storage duration of 5, and 10 d at a temperature of 18°C. The eggs were set for incubation at 37.7°C and 55% relative humidity for 28 d in a forced-draft incubator. To determine heat production as a measure of metabolism, 60 eggs in each replicate were transferred to respiratory cages post hatch two 12 wk old guinea fowl were also used to determine heat production. CO2 and O2 were recorded to calculate heat production at internal pipping, hatch and at 12 wk of age. The hatched keets were reared for 12 wk and data were collected on feed intake, body weight and feed conversion ratio. Blood samples were collected at hatch and at 12 wk of age from 24 guinea fowls per treatment to analyze haematological parameters. The results showed that embryos and guinea fowls at 12 wks of age from eggs stored for 5 d had higher (P ˂ 0.05) heat production and body weights. However, a significant higher (P ˂ 0.05) level of basophile, eosinophils, and lymphocytes was observed in guinea fowls from 10 d storage egg. It was concluded that extended duration of egg storage negatively influenced the metabolic rate of embryos. It also impacted hematological parameters which may suggest influence on immune response during embryonic and post-hatch growth.


Assuntos
Galinhas , Galliformes , Animais , Peso Corporal , Desenvolvimento Embrionário , Óvulo
18.
Zhonghua Liu Xing Bing Xue Za Zhi ; 42: 1-5, 2021 Aug 09.
Artigo em Chinês | MEDLINE | ID: mdl-34404154

RESUMO

With the rapid development of Internet technology and the continuous advancement of medical informatization, big data in healthcare has gradually become an important resource to innovate health management and meet the growing health needs of people and the application of big data in healthcare has been one of the indispensable parts of national big data strategy in China. Based on the established healthcare big data platform and the application of big data technology, Yinzhou district has made innovative efforts to explore a new model driven by big data for the prevention and control of communicable and non-communicable diseases and the management of vaccination programs. It is expected that the "Internet plus healthcare" model will strengthen the disease prevention and control and public health management in local area, create a new business form and provide strong support for Healthy China 2030. This article introduces this new model driven by big data in Yinzhou and discusses the preliminary efficiency of this model in public health practice.

19.
Gen Comp Endocrinol ; 313: 113876, 2021 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-34371009

RESUMO

Lipopolysaccharide (LPS) induces profound anorexia in birds. However, the neuronal regulatory network underlying LPS-provoked anorexia is unclear. To determine whether any cross talk occurs among hypothalamic mechanistic target of rapamycin (mTOR) and LPS in the regulation of appetite, we performed an intracerebroventricular injection of rapamycin (an mTOR inhibitor) on LPS-treated chicks. The results indicate that peripheral administrations of LPS decreased the agouti-related protein (AgRP) mRNA level, but increased the phosphorylated mTOR and nuclear factor-кB (NF-кB) protein level. Blocking mTOR significantly attenuated LPS-induced anorexia, AgRP suppression, and p-NF-кB increase. Thus, the results suggest that LPS causes anorexia via the mTOR-AgRP signaling pathway, and mTOR signaling is also associated with the regulation of LPS in p-NF-кB.

20.
J Travel Med ; 2021 Aug 05.
Artigo em Inglês | MEDLINE | ID: mdl-34350966

RESUMO

Rationale for review: Giardiasis is one of the most common human protozoal infections worldwide. First line therapy of giardiasis includes nitroimidazole antibiotics. However, treatment failure with nitroimidazoles is increasingly reported with up to 45% of patients not responding to initial treatment. There is no clear consensus on the approach to the management of nitroimidazole refractory giardiasis. This systematic review aims to summarize the literature on pharmacotherapy for nitroimidazole refractory giardiasis. METHODS: We conducted a systematic review of the literature to determine the optimal management strategies for nitroimidazole refractory giardiasis. We searched Pubmed/MEDLINE, Embase, and Cochrane library using the following search terms 'Giardia' AND 'treatment failure' OR 'refractory giardia' OR 'resistant giardia' with date limits of January 1, 1970 to June 30, 2021. We included all reports on humans which described clinical outcomes of individuals with treatment refractory giardiasis, including case series and case reports. A descriptive synthesis of the data was conducted with pooling of data for interventions. KEY FINDINGS: Included in this review were 5 prospective studies, 3 retrospective studies, 7 case series and 9 case reports. Across these reports, a wide heterogeneity of treatment regimens was employed, including re-treatment with an alternative nitroimidazole, combination therapy with a nitroimidazole and another agent, and monotherapy with non-nitroimidazole regimens including quinacrine, paromomycin and nitazoxanide. Retreatment with a nitroimidazole was not an effective therapy for refractory giardiasis. However, treatment with a nitroimidazole in combination with albendazole had a cure rate of 66.9%. In the included studies, quinacrine monotherapy was administered to a total of 179 patients with a clinical cure rate of 88.8%. Overall, quinacrine was fairly well tolerated. CONCLUSIONS: Reports on the treatment of nitroimidazole refractory giardiasis demonstrate a heterogeneous approach to treatment. Of these, quinacrine appeared to be highly effective though more data on its safety is needed.

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