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1.
Clin Epigenetics ; 13(1): 31, 2021 Feb 10.
Artigo em Inglês | MEDLINE | ID: mdl-33568199

RESUMO

BACKGROUND: Transcription factor B cell lymphoma 6 (BCL6) is a master regulator of T follicular helper (Tfh) cells, which play a crucial role in the pathogenesis of systemic lupus erythematosus (SLE). However, the mechanisms by which BCL6 expression is regulated are poorly understood. Ubiquitin-like with PHD and RING finger domains 1 (UHRF1) is an important epigenetic factor that regulates DNA methylation and histone modifications. In the present study, we assessed whether UHRF1 can regulate BCL6 expression and influence the differentiation and proliferation of Tfh cells. RESULTS: Compared to healthy controls, the mean fluorescence intensity of UHRF1 (UHRF1-MFI) in Tfh cells from SLE patients was significantly downregulated, whereas that of BCL6 (BCL6-MFI) was significantly upregulated. In vitro, UHRF1 knockdown led to BCL6 overexpression and promoted Tfh cell differentiation. In contrast, UHRF1 overexpression led to BCL6 downregulation and decreased Tfh cell differentiation. In vivo, conditional UHRF1 gene knockout (UHRF1-cKO) in mouse T cells revealed that UHRF1 depletion can enhance the proportion of Tfh cells and induce an augmented GC reaction in mice treated with NP-keyhole limpet hemocyanin (NP-KLH). Mechanistically, UHRF1 downregulation can decrease DNA methylation and H3K27 trimethylation (H3K27me3) levels in the BCL6 promoter region of Tfh cells. CONCLUSIONS: Our results demonstrated that UHRF1 downregulation leads to increased BCL6 expression by decreasing DNA methylation and H3K27me3 levels, promoting Tfh cell differentiation in vitro and in vivo. This finding reveals the role of UHRF1 in regulating Tfh cell differentiation and provides a potential target for SLE therapy.

2.
Medicine (Baltimore) ; 100(7): e24801, 2021 Feb 19.
Artigo em Inglês | MEDLINE | ID: mdl-33607842

RESUMO

RATIONALE: Orbital schwannoma is a relatively rare orbital tumor, and calcification of the lesion is rarely found in the orbit. We report a case of orbital schwannoma which was characterized by calcification in the orbital muscle cone, and was cured by intracapsular excision. PATIENT CONCERNS: A 54-year-old female with a complaint of a mass in the left orbit during a magnetic resonance imaging examination and symptom of dizziness 6 months before, presented with painless exophthalmos and vision decline in the left eye. DIAGNOSES: According to clinical manifestations, imaging examinations and postoperative immunohistochemical examinations, the diagnosis was orbital schwannoma, with calcification in the muscle cone. INTERVENTIONS: The patient was treated by intracapsular excision of the left orbit. We removed the intracapsular mass and most part of the cyst wall in order to prevent orbital apex syndrome. OUTCOMES: The diagnosis of schwannoma with calcification was confirmed finally through histological and immunohistochemical exam. The patient was followed up for 28 months and the orbital CT scan showed that there were no significant lesions found in the orbital muscle cone. LESSONS: Understanding clinical, imaging diagnostic, and histopathological features of rare orbital schwannoma with calcification will facilitate timely diagnosis and treatment of this condition. The intracapsular excision can help in avoiding complications.


Assuntos
Calcinose/cirurgia , Neurilemoma/cirurgia , Neoplasias Orbitárias/cirurgia , Calcinose/complicações , Calcinose/diagnóstico por imagem , Calcinose/patologia , Feminino , Humanos , Imagem por Ressonância Magnética , Pessoa de Meia-Idade , Neurilemoma/complicações , Neurilemoma/diagnóstico por imagem , Neurilemoma/patologia , Músculos Oculomotores/diagnóstico por imagem , Músculos Oculomotores/patologia , Neoplasias Orbitárias/complicações , Neoplasias Orbitárias/diagnóstico por imagem , Neoplasias Orbitárias/patologia
3.
BMC Musculoskelet Disord ; 22(1): 185, 2021 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-33588805

RESUMO

BACKGROUND: The purpose of the study was to investigate whether pelvic incidence (PI) will affect the occurrence of PJK in Lenke 5 AIS patients after correction surgery and try to explore a better surgical scheme based on PI. METHODS: Lenke 5C AIS patients that underwent correction surgery with a minimum of a 2-year follow-up were identified. Demographic and radiographic data were collected preoperatively, postoperatively, and at the final follow-up. The comparison between the PJK and the Non-PJK group was conducted and the subgroup analysis was performed based on the preoperative value of PI to investigate the potential mechanism of PJK. Clinical assessments were performed using the Scoliosis Research Society (SRS)-22 questionnaire. RESULTS: The mean preoperative Cobb angle of the TL/L curve was 53.4°±8.6. At the final follow-up, the mean TL/L Cobb angle was drastically decreased to 7.3°±6.8 (P < 0.001). The incidence of PJK in Lenke 5 AIS was 18.6 %, 21.9 % (7/32) in the low PI group (PI < 45°) and 15.8 % (6/38) in the high PI group (PI ≥ 45°), and there was no statistical difference between the two groups (χ2 = 0.425, P = 0.514). For low PI patients, there is no significant difference where the UIV is located with regards to the TK apex between the PJK and Non-PJK subgroups (χ2 = 1.103, P = 0.401). For high PI patients, PJK was more likely to occur when UIV was cephalad to than caudal to the TK apex (31.25 % vs. 4.7 %, P = 0.038). There was no significant difference in the selection of LIV between the two groups. CONCLUSIONS: There is no difference in the incidence of PJK between the Lenke 5 AIS patients with low PI (< 45°) and high PI (≥45°), but the main risk factor of PJK should be different. For patients with low PI, overcorrection of LL should be strictly avoided during surgery. For patients with high PI, the selection of UIV should not be at or cephalad to the apex of thoracic kyphosis to retain more mobile thoracic segments.

4.
BMC Musculoskelet Disord ; 22(1): 152, 2021 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-33546648

RESUMO

BACKGROUND: Patient compliance is essential to the effectiveness of brace treatment for adolescent idiopathic scoliosis (AIS) patients. Subjective measurements like questionnaires and inquiries proved to be arguably inaccurate. Although some scholars have applied temperature/force monitors to measuring patient compliance objectively, few studies to date could monitor patient compliance in real time. The objective of this study is to describe and evaluate a compliance real-time monitoring system of the brace usage in AIS patients. METHODS: A compliance real-time monitoring system (specifically consisting of a compliance monitor, a WeChat Mini Program, a cloud-based storage system and a website backstage management system) was designed to manage the brace treatment. Thirty patients receiving brace treatment were enrolled. They were told to upload the data at least once a day. Clinicians downloaded the compliance data and communicated with the patients online based on their analysis of data at least once every 3 months. The measured force, quality compliance (measured force / baseline force), measured time, and quantity compliance (measured time/ prescribed time) were used to evaluate patient compliance. Patients were also asked to rate their satisfaction at the final follow-up. RESULTS: Twenty-eight patients were included in the final analysis. The mean baseline force was 1.23 ± 0.28 N. The mean measured force was 0.79 ± 0.29 N. The mean quality compliance was 64.8 ± 22.2%. The prescribed time of all patients was 23 h. The mean measured time was 14.1 ± 2.9 h. The mean quantity compliance was 61.3 ± 12.6%. Both the quality and quantity compliance during the first 3 months of treatment was significantly lower than the latter 3 months. In this study, 96.4% (27/28) patients were satisfied with the use of the monitoring system, among whom 21.4% (6/28) are very satisfied and 75.0% (21/28) are somewhat satisfied. CONCLUSIONS: The compliance real-time monitoring system, without evaluating the clinical and radiographic outcomes for now, has already shown some feasibility and effectiveness for the management of the brace usage in AIS patients. This system, as a useful tool for online patient management and patient-clinician communication, would be potentially employed on a large scale in future for clinicians to improve the compliance and satisfaction of AIS patients who have received brace treatment.

5.
BMC Musculoskelet Disord ; 22(1): 144, 2021 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-33546654

RESUMO

PURPOSE: We previously reported anterior release, posterior internal distraction, and subsequent spinal fusion (ARPIDF) for the correction of severe scoliosis with a satisfactory correction rate. However, surgical procedures were completed in 2-3 stages. Here we compare Cobb angle of ≥90° in scoliosis correction between a novel posterior multiple screws distraction reducer (MSDR) system and ARPIDF. METHODS: Thirty-six patients with severe scoliosis treated by MSDR or ARPIDF (n = 18 in both groups). We retrospectively analyzed and compared outcome measures between the two groups over a minimum follow-up duration of 2 years. The following variables were compared between the two groups: age at surgery, sex, etiology, flexibility of the main thoracic curve, number of fused segments and screws, operation time, estimated blood loss, hospitalization time, follow-up duration, various radiological parameters, complication rate, and Scoliosis Research Society-30 score. RESULTS: There were no significant between-group differences with respect to age, sex, etiology, flexibility of the main thoracic curve, number of fused segments and screws, and follow-up duration. Further, there was no significant difference in terms of preoperative, postoperative, and final follow-up findings of the radiographic data. However, the ARPIDF group had longer operation and hospitalization times and greater blood loss. In the ARPIDF group, 4 patient developed complications (infection, intraoperative neuromonitoring changes, transient dyspnea); none of these events occurred in the MSDR group. CONCLUSION: The use of MSDR helped achieve greater scoliosis correction with a shorter operation time, lower blood loss, and lower complication rate than the use of ARPIDF. MSDR facilitates safer and easier correction of severe scoliosis without increasing surgical risk.

6.
Small ; : e2004453, 2021 Feb 03.
Artigo em Inglês | MEDLINE | ID: mdl-33538108

RESUMO

Single atomic Pt catalysts exhibit particularly high hydrogen evolution reaction (HER) activity compared to conventional nanomaterial-based catalysts. However, the enhanced mechanisms between Pt and their coordination environment are not understood in detail. Hence, a systematic study examining the different types of N in the support is essential to clearly demonstrate the relationship between Pt single atoms and N-doped support. Herein, three types of carbon nanotubes with varying types of N (pyridine-like N, pyrrole-like N, and quaternary N) are used as carbon support for Pt single atom atomic layer deposition. The detailed coordination environment of the Pt single atom catalyst is carefully studied by electron microscope and X-ray absorption spectra (XAS). Interestingly, with the increase of pyrrole-like N in the CNT support, the HER activity of the Pt catalyst also improves. First principle calculations results indicate that the interaction between the dyz and s orbitals of H and sp3 hybrid orbital of N should be the origin of the superior HER performance of these Pt single atom catalysts (SACs).

7.
Photodiagnosis Photodyn Ther ; : 102129, 2021 Jan 13.
Artigo em Inglês | MEDLINE | ID: mdl-33453421

RESUMO

BACKGROUND: Retinal nonperfusion (NP) is a biomarker for assessment of the severity of diabetic retinopathy and retinal vein occlusion. However, various conditions mimic the retinal NP flow void signals that are observed in optical coherence tomography angiography (OCTA). METHODS: In this review, the possible mechanisms for these similar void flow signals in OCTA were summarized, and the discrepancies between the evaluations of retinal NP with fluorescein angiography and OCTA were also investigated and evaluated in terms of size and morphology. RESULTS AND CONCLUSION: Vascular occlusion, resulting in retinal ischemia, leads to a flow void signal, indicating retinal NP in OCTA images. In addition, displacement of retinal vessels secondary to cystoid macular edema presents a false NP signal and produces a flow void signal similar to that of retinal NP in OCTA. Finally, various pathological conditions can coexist in the same retinal disease, with one of these factors playing a major role. Understanding the various causes of retinal NP in OCTA will be beneficial in conducting appropriate pathological investigations and making appropriate treatment and management choices.

8.
BMC Musculoskelet Disord ; 22(1): 54, 2021 Jan 09.
Artigo em Inglês | MEDLINE | ID: mdl-33422037

RESUMO

BACKGROUND: PIA has been proven to be a predictor for postoperative dysphagia in patients who undergo occipitospinal fusion. However, its predictive effect for postoperative dysphagia in patients who undergo OCF is unknown. The aim of this study was to evaluate the predictive ability of the pharyngeal inlet angle (PIA) for the occurrence of postoperative dysphagia in patients who undergo occipitocervical fusion (OCF). METHODS: Between 2010 and 2018, 98 patients who had undergone OCF were enrolled and reviewed. Patients were divided into two groups according to the presence of postoperative dysphagia. Radiographic parameters, including the atlas-dens interval (ADI), O-C2 angle (O-C2a), occipital and external acoustic meatus to axis angle (O-EAa), C2 tilting angle (C2Ta), C2-7 angle (C2-7a), PIA and narrowest oropharyngeal airway space (nPAS), were measured and compared. Simple linear regression and multiple regression analysis were used to evaluate the radiographic predictors for dysphagia. In addition, we used PIA = 90° as a threshold to analyze its effect on predicting dysphagia. RESULTS: Of the 98 patients, 26 exhibited postoperative dysphagia. Preoperatively, PIA in the dysphagia group was significantly higher than that in the nondysphagia group. We detected that O-C2a, O-EAa, PIA and nPAS all decreased sharply in the dysphagia group but increased slightly in the nondysphagia group. The changes were all significant. Through regression analyses, we found that PIA had a similar predictive effect as O-EAa for postoperative dysphagia and changes in nPAS. Additionally, patients with an increasing PIA exhibited no dysphagia, and the sensitivity of PIA <90° in predicting dysphagia reached 88.5%. CONCLUSIONS: PIA could be used as a predictor for postoperative dysphagia in patients undergoing OCF. Adjusting a PIA level higher than the preoperative PIA level could avoid dysphagia. For those who inevitably had decreasing PIA, preserving intraoperative PIA over 90° would help avert postoperative dysphagia. TRIAL REGISTRATION: This trial has been registered in the Medical Ethics Committee of West China Hospital, Sichuan University. The registration number is 762 and the date of registration is Sep. 9 th, 2019.

9.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi ; 35(1): 33-38, 2021 Jan 15.
Artigo em Chinês | MEDLINE | ID: mdl-33448196

RESUMO

Objective: To compare the predictive abilities of O-C2 angle (O-C2a), O-EA angle (O-EAa), and Oc-Ax angle (Oc-Axa) for development of dysphagia in patients after occipitocervical fusion (OCF). Methods: Between April 2010 and May 2019, 114 patients who underwent OCF and met the selection criteria were selected as the research objects. Among them, 54 were males and 60 were females; they were 14-76 years old, with an average of 50.6 years old. The follow-up time was 13-122 months (median, 60.5 months). The O-C2a, O-EAa, Oc-Axa, and the narrowest oropharyngeal airway space (nPAS) were measured by the lateral X-ray films before operation and at last follow-up, and the differences before and after operation (dO-C2a, dO-EAa, dOc-Axa, and dnPAS) were calculated. Patients were divided into two groups according to whether they had developed postoperative dysphagia. The general data including age, gender, fixed segment, proportion of patients with rheumatoid arthritis (RA), atlantoaxial subluxation (AS), and combined with anterior release surgery (ARS), and imaging indicators were compared between the two groups. The correlations between dO-C2a, dO-EAa, and dOc-Axa and dnPAS in 114 patients were analyzed to further compare the predictive value of three imaging indicators for occurrence of dysphagia after OCF. Results: Dysphagia occurred after OCF in 31 cases with the incidence of 27.2%. There was significant difference in gender between the dysphagia group and the non-dysphagia group ( χ 2=7.940, P=0.005). There was no significant difference between the two groups in age, fixed segment, the proportion of patients with RA, the proportion of patients with AS, and the proportion of patients combined with ARS ( P>0.05). There was no significant difference in O-C2a and Oc-Axa of 114 patients before operation and at last follow-up ( P>0.05). The differences in O-EAa and nPAS were significant ( P<0.05). There was no significant difference in preoperative O-EAa, Oc-Axa, and nPAS between the dysphagia group and the non-dysphagia group ( P>0.05); the difference in the O-C2a was significant ( t=2.470, P=0.016). At last follow-up, the differences in the above imaging indicators were significant ( P<0.05). There were significant differences in the dO-C2a, dO-EAa, dOc-Axa, and dnPAS between the two groups ( P<0.05). Correlation analysis showed that the dO-C2a, dO-EAa, dOc-Axa were all positively correlated with dnPAS ( P<0.05). The dO-C2a≤-5°, postoperative O-EAa≤100°, postoperative Oc-Axa≤65° were all related to postoperative dysphagia ( P<0.05), and the highest risk factor suffering postoperative dysphagia was dO-C2a ≤-5° with a significant OR of 14.4. Conclusion: The dO-C2a, postoperative O-EAa, and postoperative Oc-Axa can be used as the predictive indexes of dysphagia after OCF, among which dO-C2a has the highest predictive value.


Assuntos
Transtornos de Deglutição , Luxações Articulares , Fusão Vertebral , Adolescente , Adulto , Idoso , Vértebras Cervicais/diagnóstico por imagem , Vértebras Cervicais/cirurgia , Transtornos de Deglutição/etiologia , Feminino , Humanos , Luxações Articulares/diagnóstico por imagem , Luxações Articulares/cirurgia , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Período Pós-Operatório , Estudos Retrospectivos , Fusão Vertebral/efeitos adversos , Adulto Jovem
10.
J Transl Med ; 19(1): 14, 2021 Jan 06.
Artigo em Inglês | MEDLINE | ID: mdl-33407627

RESUMO

BACKGROUND: Currently, there are limited reports regarding investigation of the biological properties of polyetheretherketone (PEEK) coated with titanium (Ti) and hydroxyapatite (HA) in human. The objective of this study is to evaluate the in vivo response of the PEEK cages coated with Ti and HA versus uncoated PEEK cages after anterior cervical discectomy and fusion (ACDF) in patients with single-level cervical degenerative disc disease (CDDD). METHODS: Twenty-four patients with PEEK cages coated with Ti and HA (PEEK/Ti/HA group) were matched one-to-one with patients with uncoated PEEK cages (PEEK group) based on age, gender, and operative segment. All patients had been followed up for more than 2 years. Radiological assessments included intervertebral height (IH), C2-7 angle (C2-7a), segmental alignment (SA), and fusion rate. Clinical parameters included Visual Analogue Scale (VAS) and Japanese Orthopedic Association (JOA) scores. RESULTS: There was no statistical difference in SA, IH, and C2-7a between the two groups before and after surgery and all these parameters were restored postoperatively. The fusion rate of PEEK/Ti/HA group was significantly higher than PEEK group at 3-month post-operation (87.5% vs. 62.5%). At the last follow-up, the fusion rate of the both groups achieved 100%. The VAS and JOA scores were comparable between two groups and improved postoperatively. CONCLUSIONS: In patients with single-level ACDF, PEEK cage coated with Ti and HA provided a higher fusion rate than uncoated PEEK cage at 3-month post-operation, while both two cages could achieve solid osseous fusion at the last follow up. Compared with the uncoated PEEK cage, PEEK/Ti/HA cage yielded similar favorable segmental and overall cervical lordosis, IH, and clinical outcomes after the surgery.

11.
Respiration ; 100(2): 116-126, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33486496

RESUMO

BACKGROUND: There is still no clinical evidence available to support or to oppose corticosteroid treatment for coronavirus disease 2019 (COVID-19) pneumonia. OBJECTIVE: To investigate the efficacy and safety of corticosteroid given to the hospitalized patients with COVID-19 pneumonia. METHODS: This was a prospective, multicenter, single-blind, randomized control trial. Adult patients with COVID-19 pneumonia who were admitted to the general ward were randomly assigned to either receive methylprednisolone or not for 7 days. The primary end point was the incidence of clinical deterioration 14 days after randomization. RESULTS: We terminated this trial early because the number of patients with COVID-19 pneumonia in all the centers decreased in late March. Finally, a total of 86 COVID-19 patients underwent randomization. There was no difference of the incidence of clinical deterioration between the methylprednisolone group and control group (4.8 vs. 4.8%, p = 1.000). The duration of throat viral RNA detectability in the methylprednisolone group was 11 days (interquartile range, 6-16 days), which was significantly longer than that in the control group (8 days [2-12 days], p = 0.030). There were no significant differences between the 2 groups in other secondary outcomes. Mass cytometry discovered CD3+ T cells, CD8+ T cells, and NK cells in the methylprednisolone group which were significantly lower than those in the control group after randomization (p < 0.05). CONCLUSIONS: From this prematurely closed trial, we found that the short-term early use of corticosteroid could suppress the immune cells, which may prolong severe acute respiratory syndrome coronavirus 2 shedding in patients with COVID-19 pneumonia. TRIAL REGISTRATION: ClinicalTrials.gov, NCT04273321.

12.
Life Sci ; 266: 118891, 2021 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-33310047

RESUMO

AIMS: Intervertebral disc (IVD) degeneration (IDD), a common musculoskeletal disease with limited self-healing ability, is challenging to treat. The development of innovative therapies to reverse IDD depends on the elucidation of its regulatory mechanisms. Therefore, the role of Src homology region 2-containing protein tyrosine phosphatase 2 (SHP2) in the pathogenesis of IDD and the therapeutic effect of its small-molecule inhibitor, SHP099, were investigated. MATERIALS AND METHODS: The expression of SHP2 by nucleus pulposus (NP) cells in IVD was investigated in vitro and in vivo, and its molecular mechanism in IDD was explored using transfection technology. Injectable N-isopropylacrylamide-based thermosensitive hydrogels were synthesized for SHP099 delivery. KEY FINDINGS: SHP2 was highly expressed in degenerated IVDs, where its overexpression in NP cells inhibited the expression of Sry-related HMG box-9 (Sox9), leading to the decreased expression of key proteins (collagen II and aggrecan) and consequently to IDD. SHP099 reversed the degeneration of NP cells in vitro. Moreover, its administration in rats via the injectable thermosensitive hydrogel had a therapeutic effect on IDD. SIGNIFICANCE: Our results suggest that SHP2 is a key factor in IDD progression, and SHP099 inhibits both its expression and NP cell degeneration. Therefore, SHP099 delivery via injectable thermosensitive hydrogels is a potential treatment strategy for IDD.


Assuntos
Hidrogéis/administração & dosagem , Degeneração do Disco Intervertebral/tratamento farmacológico , Núcleo Pulposo/efeitos dos fármacos , Piperidinas/administração & dosagem , Proteína Tirosina Fosfatase não Receptora Tipo 11/antagonistas & inibidores , Pirimidinas/administração & dosagem , Animais , Feminino , Hidrogéis/química , Degeneração do Disco Intervertebral/patologia , Núcleo Pulposo/metabolismo , Piperidinas/química , Pirimidinas/química , Ratos , Ratos Sprague-Dawley , Temperatura
13.
Arch Gerontol Geriatr ; 92: 104227, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-32979552

RESUMO

OBJECTIVES: Little is known about the magnitude of catastrophic health expenditure (CHE) attributable to critical disease, especially in the middle-aged and elderly population. This research aimed to exploring the key aspects of how the health insurance fails to protect the middle-aged and elderly against CHE in the past five years. And propose corresponding measures to improve. METHODS: Data were obtained from the 2011 to 2015 China Health and Retirement Longitudinal Study. The method was adapted from WHO to calculate the catastrophic health expenditure (CHE) and impoverishment by medical expense (IME), and use Generalized Linear Mixed Models (GLMMs) to comprehensively analyze the risk factors that cause middle-aged and elderly people to fall into CHE. RESULTS: The incidence of CHE of China's middle-aged and elderly population has been rose in the five years from 2011 (10.5 %) to 2013 (17.5 %) to 2015 (19.7 %). The CHE of richest families was almost 6 times from 2011 to 2015. Urban Employee Medical Insurance Scheme, the incidence of CHE was up 10 percentage from 2011 to 2015. According to the GLMMs, families have inpatient cares as the most important factor to CHE. The incidence of CHE increased by 2.25 times compared with those who did not use inpatient services. CONCLUSIONS: The health system needs to control the irrational growth of health expenses and reduce residents' overuse of health services. Government should take supplementary measures to comprehensively strengthen the advantages of health insurance. Raise residents' awareness of health care, enhance citizens' physical fitness, and avoid unnecessary waste of health resources.


Assuntos
Gastos em Saúde , Seguro Saúde , Idoso , China/epidemiologia , Serviços de Saúde , Humanos , Estudos Longitudinais , Pessoa de Meia-Idade
14.
ACS Appl Mater Interfaces ; 12(51): 56924-56934, 2020 Dec 23.
Artigo em Inglês | MEDLINE | ID: mdl-33317266

RESUMO

The use of polyetheretherketone (PEEK) has grown exponentially in the biomedical field in recent decades because of its outstanding biomechanical properties. However, its lack of bioactivity/osteointegration remains an unresolved issue toward its wide use in orthopedic applications. In this work, graphene nanosheets have been incorporated into PEEK to obtain multifunctional nanocomposites. Because of the formation of an electrical percolation network and the π-π* conjugation between graphene and PEEK, the resulting composites have achieved 12 orders of magnitude enhancement in their electrical conductivity and thereby enabled electrophoretic deposition of a bioactive/antibacterial coating consisting of stearyltrimethylammonium chloride-modified hydroxyapatite. The coated composite implant shows significant boosting of bone marrow mesenchymal stem cell proliferation in vitro. In addition, the strong photothermal conversion effect of the graphene nanofillers has enabled laser-induced heating of our nanocomposite implants, where the temperature of the implant can reach 45 °C in 150 s. The unique multifunctionality of the implant has also been demonstrated for photothermal applications such as enhancing bacterial eradication and tumor cell inhibition, as well as bone tissue regeneration in vivo. The results suggest the strong potential of our multifunctional implant in bone repair applications as well as multimodal therapy of challenging bone diseases such as osteosarcoma and osteomyelitis.

15.
Technol Cancer Res Treat ; 19: 1533033820970667, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33327867

RESUMO

BACKGROUND: MicroRNAs (miRNAs) have been shown to play a key role in regulating the progression of cervical cancer (CC). This study aimed to develop a circulating miRNA-based molecular signature for the diagnosis and prognosis prediction of early-stage CC. METHODS: This study included 112 patients diagnosed with early-stage CC, 45 patients confirmed with cervical intraepithelial neoplasia (CIN) and 90 healthy subjects. Compared to the normal controls, the expression level of miR-21 was increased, while the levels of miR-125b and miR-370 were decreased in CC in both GSE30656 and The Cancer Genome Atlas (TCGA) cohort. The expression levels and diagnostic value of these candidate miRNAs were then validated through qRT-PCR. Their diagnostic and prognostic values for early-stage CC were further explored. RESULTS: Compared to the patients with CIN and healthy subjects, serum miR-21 was increased, while serum miR-125b and serum miR-370 were reduced in early-stage CC. In addition, combining these molecules yielded good performance for differentiating early-stage CC from CIN or healthy subjects. Moreover, strong association was found between serum miR-21 and lymph node metastasis (LNM) as well as recurrence-free survival of early-stage CC. Similar observations were found for serum miR-125b and serum miR-370. Patients with simultaneously high serum miR-21 + low serum miR-125b + low serum miR-370 suffered a high risk of LNM and recurrence, while those with low serum miR-21 + high serum miR-125b + high serum miR-370 had little risk for LNM and recurrence. CONCLUSIONS: Combining serum miR-21, miR-125b and miR-370 as a miRNA-based signature is promising for the detection and prognosis prediction of early-stage CC.

16.
Sci Adv ; 6(50)2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33310848

RESUMO

Osteoporotic fractures are prevalent in society, and their incidence appears to be increasing as the worldwide population ages. However, conventional bone repair materials hardly satisfy the requirements for the repair of pathological fractures. Here, we developed a biomimetic polyetherketoneketone scaffold with a functionalized strontium-doped nanohydroxyapatite coating for osteoporotic bone defect applications. The scaffold has a hierarchically porous architecture and mechanical strength similar to that of osteoporotic trabecular bone. In vitro and in vivo studies demonstrated that the scaffold could promote osteoporotic bone regeneration and delay adjacent bone loss via regulating both osteoblasts and osteoclasts. In addition, the correlations between multiple preimplantation and postimplantation parameters were evaluated to determine the potential predictors of in vivo performance of the material. The current work not only develops a promising candidate for osteoporotic bone repair but also provides a viable approach for designing other functional biomaterials and predicting their translational value.

17.
World J Clin Cases ; 8(20): 4908-4916, 2020 Oct 26.
Artigo em Inglês | MEDLINE | ID: mdl-33195660

RESUMO

BACKGROUND: The global pandemic of coronavirus disease 2019 pneumonia poses a particular challenge to the emergency surgical treatment of elderly patients with high-risk acute abdominal diseases. Elderly patients are a high-risk group for surgical treatment. If the incarceration of gallstones cannot be relieved, emergency surgery is unavoidable. CASE SUMMARY: We report an 89-year-old male patient with acute gangrenous cholecystitis and septic shock induced by incarcerated cholecystolithiasis. He had several coexisting, high-risk underlying diseases, had a history of radical gastrectomy for gastric cancer, and was taking aspirin before the operation. Nevertheless, he underwent emergency laparoscopic cholecystectomy, with maintenance of postoperative heart and lung function, successfully recovered, and was discharged on day 8 after the operation. CONCLUSION: Emergency surgery for elderly patients with acute abdominal disease is safe and feasible during the coronavirus disease 2019 pandemic, the key is to abide strictly by the hospital's epidemic prevention regulations, fully implement the epidemic prevention procedure for emergency surgery, fully prepare before the operation, accurately perform the operation, and carefully manage the patient postoperatively.

18.
Stem Cell Res Ther ; 11(1): 479, 2020 Nov 11.
Artigo em Inglês | MEDLINE | ID: mdl-33176855

RESUMO

BACKGROUND: Intrauterine adhesions (IUAs) are manifestations of endometrial fibrosis characterized by inflammation and fibrinogen aggregation in the extracellular matrix (ECM). The available therapeutic interventions for IUA are insufficiently effective in the clinical setting for postoperative adhesion recurrence and infertility problems. In this study, we investigated whether si-SNHG5-FOXF2 can serve as a molecular mechanism for the inhibition of IUA fibrosis ex vivo. METHODS: FOXF2, TGF-ß1 and collagen expression levels were measured by microarray sequencing analysis in three normal endometrium groups and six IUA patients. We induced primary human endometrial stromal cells (HESCs) into myofibroblasts (MFs) to develop an IUA cell model with various concentrations of TGF-ß1 at various times. Downstream target genes of FOXF2 were screened by chromatin immunoprecipitation combined with whole-genome high-throughput sequencing (ChIP-seq). We investigated ECM formation, cell proliferation and Wnt/ß-catenin signalling pathway-related proteins in primary HESCs with FOXF2 downregulation by quantitative reverse transcription-polymerase chain reaction (qRT-PCR), western blotting (WB), immunohistochemistry (IHC), flow cytometry, ethylenediurea (EdU) and CCK8 assays. We identified long noncoding RNAs (lncRNA) SNHG5 as the upstream regulatory gene of FOXF2 through RNA immunoprecipitation (RIP), RNA pulldown and fluorescence in situ hybridization (FISH). Finally, we examined FOXF2 expression, ECM formation, cell proliferation and Wnt/ß-catenin signalling pathway-related proteins in primary HESCs upon FOXF2 downregulation. RESULTS: FOXF2 was highly expressed in the endometrium of patients with IUA. Treatment of primary HESCs with 10 ng/ml TGF-ß1 for 72 h was found to be most effective for developing an IUA cell model. FOXF2 regulated multiple downstream target genes, including collagen, vimentin (VIM) and cyclin D2/DK4, by ChIP-seq and ChIP-PCR. FOXF2 downregulation inhibited TGF-ß1-mediated primary HESC fibrosis, including ECM formation, cell proliferation and Wnt/ß-catenin signalling pathway-related protein expression. We identified lncRNA SNHG5 as an upstream gene that directly regulates FOXF2 by RIP-seq, qRT-PCR, WB and FISH. SNHG5 downregulation suppressed FOXF2 expression in the IUA cell model, resulting in synergistic repression of the Wnt/ß-catenin pathway, thereby altering TGF-ß1-mediated ECM aggregation in endometrial stromal cells ex vivo. CONCLUSIONS: Regulation of the Wnt/ß-catenin signalling pathway and ECM formation by si-SNHG5-FOXF2 effectively inhibited the profibrotic effect of TGF-ß1 on primary HESCs. This finding can provide a molecular basis for antagonizing TGF-ß1-mediated fibrosis in primary HESCs.

19.
Nanoscale Horiz ; 5(11): 1453-1466, 2020 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-33103682

RESUMO

The substantial capacity gap between available anode and cathode materials for commercial Li-ion batteries (LiBs) remains, as of today, an unsolved problem. Oxygen vacancies (OVs) can promote Li-ion diffusion, reduce the charge transfer resistance, and improve the capacity and rate performance of LiBs. However, OVs can also lead to accelerated degradation of the cathode material structure, and from there, of the battery performance. Understanding the role of OVs for the performance of layered lithium transition metal oxides holds great promise and potential for the development of next generation cathode materials. This review summarises some of the most recent and exciting progress made on the understanding and control of OVs in cathode materials for Li-ion battery, focusing primarily on Li-rich layered oxides. Recent successes and residual unsolved challenges are presented and discussed to stimulate further interest and research in harnessing OVs towards next generation oxide-based cathode materials.

20.
Neurosurg Rev ; 2020 Oct 23.
Artigo em Inglês | MEDLINE | ID: mdl-33097988

RESUMO

The pathophysiology behind the instigation and progression of scoliosis in Chiari malformation type I (CMI) patients has not been elucidated yet. This study aims to explore the initiating and progressive factors for scoliosis secondary to CMI. Pediatric patients with CMI were retrospectively reviewed for radiological characteristics of tonsillar herniation, craniocervical anomaly, syrinx morphology, and scoliosis. Subgroup analyses of the presence of syrinx, scoliosis, and curve progression were also performed. A total of 437 CMI patients were included in the study; 62% of the subjects had syrinx, and 25% had scoliosis. In the subgroup analysis of 272 CMI patients with syrinx, 78 of them (29%) had scoliosis, and multiple logistic regression analysis showed that tonsillar herniation ≥ 10 mm (OR 2.13; P = 0.033) and a clivus canal angle ≤ 130° (OR 1.98; P = 0.025) were independent risk factors for scoliosis. In the subgroup analysis of 165 CMI patients without syrinx, 31 of them (19%) had scoliosis, and multiple logistic regression analysis showed that a clivus canal angle ≤ 130° (OR 3.02; P = 0.029) was an independent risk factor for scoliosis. In the subgroup analysis of curve progression for 97 CMI patients with scoliosis, multiple logistic regression analysis showed that anomalies of the craniocervical junction and syrinx were not risk factors for curve progression. Many complex factors including craniocervical angulation, tonsillar herniation, and syrinx might participate in the instigation of scoliosis for CMI patients, and the relationship between craniocervical angulation and scoliosis deserves further study.

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