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1.
Ann Palliat Med ; 10(3): 2958-2970, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33691439

RESUMO

BACKGROUND: The present study aimed to explore the effectiveness of electro-acupuncture (EA) in combination with a local anesthetic used in Western medicine in preventing the side effects of gastroscopy. METHODS: A sample group of 150 patients were divided into three groups based on treatment methods: an EA group, a dyclonine hydrochloride mucilage group, and a combined treatment group. In the EA group, EA stimulation was given at the Hegu, Neiguan, and Zusanli acupoints; in the dyclonine hydrochloride mucilage group, patients took 10 mL of dyclonine hydrochloride mucilage orally; in the combined treatment group, prevention of side effects was attempted by administration of both acupuncture and oral local anesthetic. The incidences of nausea, emesis, salivation, cough, restlessness, and breath holding during gastroscopy were observed and recorded for the three groups. Mean arterial pressure, heart rate, and oxygen saturation were recorded before the examination, and changes in these measures were recorded as the gastroscope passed through the pylorus and after the examination. The visual analogue scale (VAS) values of nausea and emesis, the rate of successful first-pass intubation, and the time of gastroscopy were also recorded. Statistical analysis was performed using R-3.5.3 software. RESULTS: Incidences of side effects (e.g., nausea, emesis, salivation, restlessness, and breath holding) during the examination were lower in the combined treatment group than in the EA group and the dyclonine hydrochloride mucilage group (P<0.05 and P<0.01, respectively). Furthermore, the changes in heart rate and oxygen saturation when the gastroscope passed through the pylorus and after the examination were better in the combined treatment group than in the EA group and dyclonine hydrochloride mucilage group (P<0.01). The VAS values of nausea and emesis, the first-pass success rate, and examination duration were also better for the combined treatment group than for the other two groups (P<0.05 and P<0.01). CONCLUSIONS: EA combined with local anesthesia with dyclonine hydrochloride mucilage can alleviate side effects during gastroscopy, reduce patient pain, and improve the efficiency of the procedure.

2.
BMJ Open ; 10(11): e041471, 2020 11 30.
Artigo em Inglês | MEDLINE | ID: mdl-33257492

RESUMO

OBJECTIVE: To delineate the characteristics and clinical significance of plasma inflammatory cytokines altered in COVID-19. DESIGN: Retrospective, single-centre cohort study. SETTING: Tongji Hospital in Wuhan, China. PARTICIPANTS: Among a cohort of 308 patients with a diagnosis of COVID-19, 138 patients died while 170 patients recovered and were discharged from the hospital. The data were collected until 27 February 2020. PRIMARY AND SECONDARY OUTCOME MEASURES: Clinical characteristics and laboratory findings were obtained from electronic medical records using data collection forms. RESULTS: The percentage of patients with elevated interleukin 2 receptor (IL-2R), IL-6, IL-8, IL-10 and tumour necrosis factor (TNF) increased with severity of disease (p<0.0001 for all). IL-2R (p<0.0001), IL-6 (p<0.0001), IL-8 (p=0.0001), IL-10 (p<0.0001) and TNF (p<0.0001) were also twofold to 20-fold higher in patients who died compared with those who recovered. Also, IL-6 and IL-10 increased in both the progressive patient groups: moderate (p=0.0026) and severe (p<0.0001). In multivariate analysis, higher levels of IL-2R (OR 1.001, 95% CI 1.000 to 1.002, p=0.031) and IL-6 (OR 1.013, 95% CI 1.003 to 1.024, p=0.015) on admission were associated with increasing odds of in-hospital death, independent of other covariates, including severity of disease and lymphocyte count. CONCLUSION: Increased proinflammatory and anti-inflammatory cytokines, including IL-2R, IL-6, IL-8, TNF and IL-10, showed an obvious association with both COVID-19 severity and in-hospital mortality. Thus, our study indicates that cytokines are valuable in predicting the severity of COVID-19 and helps in distinguishing critically ill patients from the less affected ones.

3.
Biomark Res ; 8: 42, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32944245

RESUMO

Abstract: Aging and average life expectancy have been increasing at a rapid rate, while there is an exponential risk to suffer from brain-related frailties and neurodegenerative diseases as the population ages. Alzheimer's disease (AD) is the most common neurodegenerative disease worldwide with a projected expectation to blossom into the major challenge in elders and the cases are forecasted to increase about 3-fold in the next 40 years. Considering the etiological factors of AD are too complex to be completely understood, there is almost no effective cure to date, suggesting deeper pathomechanism insights are urgently needed. Metabolites are able to reflect the dynamic processes that are in progress or have happened, and metabolomic may therefore provide a more cost-effective and productive route to disease intervention, especially in the arena for pathomechanism exploration and new biomarker identification. In this review, we primarily focused on how redox signaling was involved in AD-related pathologies and the association between redox signaling and altered metabolic pathways. Moreover, we also expatiated the main redox signaling-associated mechanisms and their cross-talk that may be amenable to mechanism-based therapies. Five natural products with promising efficacy on AD inhibition and the benefit of AD intervention on its complications were highlighted as well.

5.
Clin Infect Dis ; 2020 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-32649738

RESUMO

BACKGROUND: The outbreak of coronavirus disease (COVID-19) in 2019 has spread worldwide and continues to cause great threat to peoples' health as well as put pressure on the accessibility of medical systems. Early prediction of survival of hospitalized patients will help the clinical management of COVID-19, but such a prediction model which is reliable and valid is still lacking. METHODS: We retrospectively enrolled 628 confirmed cases of COVID-19 using positive RT-PCR tests for SARS-CoV-2 in Tongji Hospital in Wuhan, China. These patients were randomly grouped into a training cohort (60%) and a validation cohort (40%). In the training cohort, least absolute shrinkage and selection operator (LASSO) regression analysis and multivariate Cox regression analysis were utilized to identify prognostic factors for in-hospital survival of patients with COVID-19. A nomogram based on the three variables was built for clinical use. Areas under the ROC curves (AUC), concordance index (C-index) and calibration curve were used to evaluate the efficiency of the nomogram in both the training and validation cohorts. RESULTS: Hypertension, higher neutrophil-to-lymphocyte ratio and increased NT-proBNP value were found to be significantly associated with poorer prognosis in hospitalized patients with COVID-19. The three predictors were further used to build a prediction nomogram. The C-index of the nomogram in the training and validation cohorts was 0.901 and 0.892, respectively. The AUC in the training cohort was 0.922 for 14- day and 0.919 for 21-day probability of in-hospital survival, while in the validation cohort was 0.922 and 0.881, respectively. Moreover, the calibration curve for 14- day and 21-day survival also showed high coherence between the predicted and actual probability of survival. CONCLUSION: We managed to build a predictive model and constructed a nomogram for predicting in-hospital survival of patients with COVID-19. This model represents good performance and might be utilized clinically in the management of COVID-19.

6.
Zhongguo Zhong Yao Za Zhi ; 45(7): 1531-1535, 2020 Apr.
Artigo em Chinês | MEDLINE | ID: mdl-32489031

RESUMO

It is an essential task to discuss the death cases for clinicians. During the emergent public events, the report and analysis of death cases is of far-reaching significance. The epidemic of coronavirus disease 2019(COVID-19) has brought huge losses to China, and the medical system has been sustaining tremendous pressure. The best weapon to defeat the epidemic is medical data and related scientific research, of which the systematic analysis and efficient use of death cases is a key step. Based on the incomplete record of death case report, the lack of humanistic perspective and patient report, every department and institution is facing great challenge in terms of data management. Given that the relevant systems need to be improved, and that the integration of standardized reports and clinical research is not mature,as well as other problems, we put forward several methodological suggestions: ① Establish national medical and health data center and improve relevant laws and regulations. ② Increase investment in medical data management and start data collection and analysis as early as possible during the epidemic. ③ Refine the content of death case report and promote the standardization of report. ④ Pay close attention to the report of death cases, review, summary and analysis. More importantly, we should continue to build and improve platforms and programs related to disease control, carry out epidemic-associated scientific research, enhance the managing efficiency of public health data, elevate the anti-risk capability of our medical system, and promote the steady progress of the health China strategy.


Assuntos
Betacoronavirus , Infecções por Coronavirus , Pandemias , Pneumonia Viral , Humanos
7.
Chin J Integr Med ; 26(12): 936-942, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32572781

RESUMO

OBJECTIVE: To systematically evaluate the efficacy and safety of Tanreqing Injection (, TRQI) combined with conventional treatment on clinical outcomes in the treatment of patients with influenza. METHODS: The electronic databases searched were Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library), MEDLINE (PubMed), EMbase (OvidSP), Chinese Bio-medical Literature and Retrieval System (Sinomed), China National Knowledge Infrastructure Database (CNKI), China Science and Technology Journal Database (VIP) and WanFang Data Knowledge Service Platform, and we checked the reference sections of the retrieved articles as well. The search was performed in October 2018, and we used the randomized controlled trials (RCTs) that corresponded to the new diagnostic criteria for influenza. Two review authors independently screened the internalized articles in accordance with the Preferred Reporting Items for Systematic review and Meta-Analysis (PRISMA) statement checklist. We evaluated the quality of the articles and extracted the data from the studies using the Revmen5.3 software. RESULTS: We included 12 RCTs of over 882 cases in this meta-analysis. Compared to conventional treatment, TRQI combined with conventional treatment could increase the total effective rate [9 RCTs, n=648, odds ratio (OR): 4.92, 95% confidence interval (CI): 2.94, 8.24, P<0.0001, random effects model], decrease the average time for fever clearance [7 RCTs, n=564, mean difference (MD): -1.08, 95% CI: -1.68, -0.48, P=0.0004, random effects model] and decrease the time for resolution of cough (5 RCTs, n=362, MD: -1.76, 95% CI: -2.63, -0.90, P<0.0001, random effects model). CONCLUSION: Based on this meta-analysis of RCTs, TRQI combined with conventional treatment had a statistically significant benefit in increasing the total effective treatment rate and reducing the time for fever clearance as well as time for resolution of cough.

8.
Zhongguo Zhong Yao Za Zhi ; 45(10): 2249-2256, 2020 May.
Artigo em Chinês | MEDLINE | ID: mdl-32495577

RESUMO

The study aimed to investigate the multi-constituent, multi-target mechanism of Xuanfei Baidu Tang(XFBD) in the treatment of coronavirus disease 2019(COVID-19), through exploring the main ingredients and effective targets of XFBD, as well as analyzing the correlation between XFBD targets and COVID-19. The compounds of each herb in XFBD were collected from TCM-PTD, ETCM, TCMSP and SymMap database. Next, the information of meridian tropisms was collected from Chinese Pharmacopoeia(2015 edition), and the target information of the major constituents of XFBD were obtained from TCM-PTD, ETCM, TCMSP and TargetNet database. Subsequently, the target network model and the major modules were generated by Cytoscape, and the functional enrichment analysis of XFBD targets were completed by DAVID and STRING. As a result, ten of the 13 herbs in XFBD belonged to the lung meridian, and 326 of the 1 224 putative XFBD targets were associated with the disease target of COVID-19, among which 109 targets were enriched in the disease pathways of viral infection and lung injury. The main biological pathways regulated by the key XFBD targets included viral infection, energy metabolism, immunity and inflammation, parasites and bacterial infections. In conclusion, the therapeutic mechanism of XFBD in COVID-19 showed a multi-herb, multi-constituent, multi-target pattern, with lung as the chief targeted organ. By regulating a series of biological pathways closely related to the occurrence and development of diseases, XFBD plays a role in balancing immunity, eliminating inflammation, regulating hepatic and biliary metabolism and recovering energy metabolism balance.


Assuntos
Betacoronavirus , Infecções por Coronavirus , Medicamentos de Ervas Chinesas/uso terapêutico , Pandemias , Pneumonia Viral , Infecções por Coronavirus/tratamento farmacológico , Humanos , Medicina Tradicional Chinesa , Pneumonia Viral/tratamento farmacológico
9.
Zhongguo Zhong Yao Za Zhi ; 44(20): 4354-4359, 2019 Oct.
Artigo em Chinês | MEDLINE | ID: mdl-31872645

RESUMO

The formation of expert consensus statement is an indispensable part in the process of developing clinical practice guidelines. The Guidelines International Network believes that experts make group decisions for different stages and issues,and the process of gathering expert opinions is the process of reaching the consensus. GRADE system also requires that recommendations should be formed based on expert consensus in consideration of the risk and bias,patients' preferences and values,resources and other factors. At present,the main method for reaching consensus is the formal consensus method. According to the published clinical guidelines,most of them failed to report the specific methods and process of reaching expert consensus. Therefore,it is impossible to obtain an objective evaluation. This phenomenon is more common in the field of clinical practice guidelines of traditional Chinese medicine( TCM). There are two main reasons for this phenomenon. For one thing,the developers of the guidelines neglect the importance of transparency and objectivity in the implementation of expert consensus. For another,they know little about the methods and technical specifications for the formation of expert consensus. To solve them,based on the internationally recognized consensus-building methods,as well as the specific stages in the process of developing clinical practice guidelines of traditional Chinese medicine,it is of great significance to put forward the technical norms for TCM researchers to develop the expert consensus. This guide will provide detailed guidance for forming the expert consensus for TCM clinical practice guideline. This guideline has been approved and published by the Chinese Association of Traditional Chinese Medicine( No. T/CACM 1049-2017).


Assuntos
Medicina Tradicional Chinesa , Guias de Prática Clínica como Assunto , Consenso , Humanos
10.
Clin Chim Acta ; 499: 54-63, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31476302

RESUMO

Chronic kidney disease (CKD), characterized as renal dysfunction, is recognized as a major public health problem with high morbidity and mortality worldwide. Unfortunately, there are no obvious clinical symptoms in early stage disease until severe damage has occurred. Further complicating early diagnosis and treatment is the lack of sensitive and specific biomarkers. As such, novel biomarkers are urgently needed. Metabolomics has shown an increasing potential for identifying underlying disease mechanisms, facilitating clinical diagnosis and developing pharmaceutical treatments for CKD. Recent advances in metabolomics revealed that CKD was closely associated with the dysregulation of numerous metabolites, such as amino acids, lipids, nucleotides and glycoses, that might be exploited as potential biomarkers. In this review, we summarize recent metabolomic applications based on animal model studies and in patients with CKD and highlight several biomarkers that may play important roles in diagnosis, intervention and development of new therapeutic strategies.


Assuntos
Insuficiência Renal Crônica , Animais , Biomarcadores/análise , Biomarcadores/metabolismo , Humanos , Metabolômica , Insuficiência Renal Crônica/diagnóstico , Insuficiência Renal Crônica/tratamento farmacológico , Insuficiência Renal Crônica/metabolismo
11.
J Transl Med ; 17(1): 302, 2019 09 05.
Artigo em Inglês | MEDLINE | ID: mdl-31488157

RESUMO

The aryl hydrocarbon receptor (AhR) is a well-known ligand-activated cytoplasmic transcription factor that contributes to cellular responses against environmental toxins and carcinogens. AhR is activated by a range of structurally diverse compounds from the environment, microbiome, natural products, and host metabolism, suggesting that AhR possesses a rather promiscuous ligand binding site. Increasing studies have indicated that AhR can be activated by a variety of endogenous ligands and induce the expression of a battery of genes. AhR regulates a variety of physiopathological events, including cell proliferation, differentiation, apoptosis, adhesion and migration. These new roles have expanded our understanding of the AhR signalling pathways and endogenous metabolites interacting with AhR under homeostatic and pathological conditions. Recent studies have demonstrated that AhR is linked to cardiovascular disease (CVD), chronic kidney disease (CKD) and renal cell carcinoma (RCC). In this review, we summarize gut microbiota-derived ligands inducing AhR activity in patients with CKD, CVD, diabetic nephropathy and RCC that may provide a new diagnostic and prognostic approach for complex renal damage. We further highlight polyphenols from natural products as AhR agonists or antagonists that regulate AhR activity. A better understanding of structurally diverse polyphenols and AhR biological activities would allow us to illuminate their molecular mechanism and discover potential therapeutic strategies targeting AhR activation.


Assuntos
Carcinoma de Células Renais/metabolismo , Nefropatias/metabolismo , Neoplasias Renais/metabolismo , Receptores de Hidrocarboneto Arílico/metabolismo , Animais , Humanos , Ligantes , Transdução de Sinais
12.
Neuroimage ; 200: 644-658, 2019 10 15.
Artigo em Inglês | MEDLINE | ID: mdl-31252056

RESUMO

Type 2 diabetes mellitus (T2DM) is a significant risk factor for mild cognitive impairment (MCI) and the acceleration of MCI to dementia. The high glucose level induce disturbance of neurovascular (NV) coupling is suggested to be one potential mechanism, however, the neuroimaging evidence is still lacking. To assess the NV decoupling pattern in early diabetic status, 33 T2DM without MCI patients and 33 healthy control subjects were prospectively enrolled. Then, they underwent resting state functional MRI and arterial spin labeling imaging to explore the hub-based networks and to estimate the coupling of voxel-wise cerebral blood flow (CBF)-degree centrality (DC), CBF-mean amplitude of low-frequency fluctuation (mALFF) and CBF- mean regional homogeneity (mReHo). We further evaluated the relationship between NV coupling pattern and cognitive performance (false discovery rate corrected). T2DM without MCI patients displayed significant decrease in the absolute CBF-mALFF, CBF-mReHo coupling of CBFnetwork and in the CBF-DC coupling of DCnetwork. Besides, networks which involved CBF and DC hubs mainly located in the default mode network (DMN). Furthermore, less severe disease and better cognitive performance in T2DM patients were significantly correlated with higher coupling of CBF-DC, CBF-mALFF or CBF-mReHo, especially for the cognitive dimensions of general function and executive function. Thus, coupling of CBF-DC, CBF-mALFF and CBF-mReHo may serve as promising indicators to reflect NV coupling state and to explain the T2DM related early cognitive impairment.


Assuntos
Encéfalo/fisiopatologia , Disfunção Cognitiva/fisiopatologia , Diabetes Mellitus Tipo 2/fisiopatologia , Neuroimagem Funcional/métodos , Rede Nervosa/fisiopatologia , Acoplamento Neurovascular/fisiologia , Biomarcadores , Encéfalo/diagnóstico por imagem , Disfunção Cognitiva/diagnóstico , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Rede Nervosa/diagnóstico por imagem
13.
Neuroimage Clin ; 22: 101802, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30991623

RESUMO

BACKGROUND: Previous studies presumed that the disturbed neurovascular coupling to be a critical risk factor of cognitive impairments in type 2 diabetes mellitus (T2DM), but distinct clinical manifestations were lacked. Consequently, we decided to investigate the neurovascular coupling in T2DM patients by exploring the MRI relationship between neuronal activity and the corresponding cerebral blood perfusion. METHODS: Degree centrality (DC) map and amplitude of low-frequency fluctuation (ALFF) map were used to represent neuronal activity. Cerebral blood flow (CBF) map was used to represent cerebral blood perfusion. Correlation coefficients were calculated to reflect the relationship between neuronal activity and cerebral blood perfusion. RESULTS: At the whole gray matter level, the manifestation of neurovascular coupling was investigated by using 4 neurovascular biomarkers. We compared these biomarkers and found no significant changes. However, at the brain region level, neurovascular biomarkers in T2DM patients were significantly decreased in 10 brain regions. ALFF-CBF in left hippocampus and fractional ALFF-CBF in left amygdala were positively associated with the executive function, while ALFF-CBF in right fusiform gyrus was negatively related to the executive function. The disease severity was negatively related to the memory and executive function. The longer duration of T2DM was related to the milder depression, which suggests T2DM-related depression may not be a physiological condition but be a psychological condition. CONCLUSION: Correlations between neuronal activity and cerebral perfusion maps may be a method for detecting neurovascular coupling abnormalities, which could be used for diagnosis in the future. Trial registry number: This study has been registered in ClinicalTrials.gov (NCT02420470) on April 2, 2015 and published on July 29, 2015.


Assuntos
Tonsila do Cerebelo/fisiopatologia , Disfunção Cognitiva/fisiopatologia , Diabetes Mellitus Tipo 2/fisiopatologia , Função Executiva/fisiologia , Neuroimagem Funcional/métodos , Substância Cinzenta/fisiopatologia , Hipocampo/fisiopatologia , Acoplamento Neurovascular/fisiologia , Adulto , Tonsila do Cerebelo/diagnóstico por imagem , Biomarcadores , Disfunção Cognitiva/diagnóstico por imagem , Disfunção Cognitiva/etiologia , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/diagnóstico por imagem , Feminino , Substância Cinzenta/diagnóstico por imagem , Hipocampo/diagnóstico por imagem , Humanos , Imagem por Ressonância Magnética , Masculino , Rememoração Mental/fisiologia , Pessoa de Meia-Idade
14.
Zhongguo Zhong Yao Za Zhi ; 44(3): 582-588, 2019 Feb.
Artigo em Chinês | MEDLINE | ID: mdl-30989926

RESUMO

To evaluate the efficacy and safety of huperzine in treating patients with mild cognitive impairment. The randomized controlled trials(RCT) were retrieved from EMbase, Cochrane Library, PubMed, CNKI, Wanfang and VIP. The methodology quality of the included studies was evaluated, and a Meta-analysis was performed using RevMan 5.3 software. A total of nine RCTs were included. The Meta-analysis results showed that compared with placebo, Huperzine significantly increased the scores of memory quotient(MQ) and mini-mental state examination(MMSE). However, there was no statistical difference between oral tablet and capsule. Compared with placebo, huperzine A was superior in the scores of MQ and MMSE. Huperzine is safe with mild side effects. Due to the low quality of original studies, more high-quality studies are needed to verify its efficacy.


Assuntos
Alcaloides/uso terapêutico , Disfunção Cognitiva/tratamento farmacológico , Sesquiterpenos/uso terapêutico , Humanos , Memória , Ensaios Clínicos Controlados Aleatórios como Assunto
15.
Ann Transl Med ; 7(6): 122, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31032277

RESUMO

Background: To develop the clinical practice guidelines for the treatment of sepsis with traditional Chinese medicine (TCM) therapy alone or TCM combined with antibiotics. Methods: The methods and process for developing the international clinical practice guidelines were fully consulted between a group of doctors. A total of 25 experts from 14 units were involved in the development of this guideline. The major clinical questions that needed to be solved were raised first, and the best available evidence to solve them was researched. Finally, according to the principle set by the GRADE system, the available evidence was graded with levels ranging from high to low. This formed the recommendation strengths, which included strong recommendation and weak recommendation, or an expert consensus recommendation. Results: The guideline identified the terms and definition for sepsis. For example, it identified its epidemiological characters, the advantages of TCM treatment on sepsis, the diagnosis and its features, the complications, and its rehabilitation and health maintenance. The guideline has put forward 14 recommendations, among which 4 were strong recommendations and 6 were weak recommendations, in addition to 4 expert consensus recommendations. Conclusions: The methods and processes for developing international clinical practice guidelines were fully consulted under the guide of relevant laws and regulations, and relevant technical documents. Based on the best existing evidence, and combined with the characteristics of TCM and the clinical realities, we developed Clinical practice guidelines for the treatment of sepsis with TCM therapy alone or TCM combined with antibiotics, with full reference to the experts' experience and patients' preferences.

16.
Clin Sci (Lond) ; 133(7): 905-917, 2019 04 15.
Artigo em Inglês | MEDLINE | ID: mdl-30957778

RESUMO

Gut microbiota alterations manifest as intermittent hypoxia and fragmented sleep, thereby mimicking obstructive sleep apnea-hypopnea syndrome (OSAHS). Here, we sought to perform the first direct survey of gut microbial dysbiosis over a range of apnea-hypopnea indices (AHI) among patients with OSAHS. We obtained fecal samples from 93 patients with OSAHS [5 < AHI ≤ 15 (n=40), 15 < AHI ≤ 30 (n=23), and AHI ≥ 30 (n=30)] and 20 controls (AHI ≤ 5) and determined the microbiome composition via 16S rRNA pyrosequencing and bioinformatics analysis of variable regions 3-4. We measured fasting levels of homocysteine (HCY), interleukin-6 (IL-6), and tumor necrosis factor α (TNF-α). Results revealed gut microbial dysbiosis in several patients with varying severities of OSAHS, reliably separating them from controls with a receiver operating characteristic-area under the curve (ROC-AUC) of 0.789. Functional analysis in the microbiomes of patients revealed alterations; additionally, decreased in short-chain fatty acid (SCFA)-producing bacteria and increased pathogens, accompanied by elevated levels of IL-6. Lactobacillus levels correlated with HCY levels. Stratification analysis revealed that the Ruminococcus enterotype posed the highest risk for patients with OSAHS. Our results show that the presence of an altered microbiome is associated with HCY among OSAHS patients. These changes in the levels of SCFA affect the levels of pathogens that play a pathophysiological role in OSAHS and related metabolic comorbidities.


Assuntos
Bactérias/isolamento & purificação , Microbioma Gastrointestinal , Intestinos/microbiologia , Doenças Metabólicas/microbiologia , Apneia Obstrutiva do Sono/microbiologia , Adulto , Biomarcadores/sangue , Estudos de Casos e Controles , Comorbidade , Disbiose , Fezes/microbiologia , Feminino , Homocisteína/sangue , Interações Hospedeiro-Patógeno , Humanos , Masculino , Doenças Metabólicas/sangue , Doenças Metabólicas/diagnóstico , Doenças Metabólicas/epidemiologia , Pessoa de Meia-Idade , Apneia Obstrutiva do Sono/sangue , Apneia Obstrutiva do Sono/diagnóstico , Apneia Obstrutiva do Sono/epidemiologia
17.
Int J Mol Med ; 43(2): 839-849, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30483753

RESUMO

In the present study, the function of microRNA (miR)­140­5p on oxidative stress in mice with atherosclerosis was investigated. A reverse transcription­quantitative polymerase chain reaction assay was used to determine the expression of miR­140­5p. Oxidative stress kits and reactive oxygen species (ROS) kits were used to analyze alterations in oxidative stress and ROS levels. The alterations in protein expression were determined using western blot analysis and an immunofluorescence assay. miR­140­5p expression was increased in mice with atherosclerosis with hypertension. Consistently, miR­140­5p expression was also increased in mice with atherosclerosis. Upregulation of miR­140­5p increased oxidative stress and ROS levels by suppressing the protein expression of nuclear factor erythroid 2­related factor 2 (Nrf2), sirtuin 2 (Sirt2), Kelch­like enoyl­CoA hydratase­associated protein 1 (Keap1) and heme oxygenase 1 (HO­1) in vitro. By contrast, downregulation of miR­140­5p decreased oxidative stress and ROS levels by activating the protein expression of Nrf2, Sirt2, Keap1 and HO­1 in vitro. Sirt2 agonist or Nrf2 agonist inhibited the effects of miR­140­5p on oxidative stress in vitro. Collectively, these results suggested that miR­140­5p aggravated hypertension and oxidative stress of mice with atherosclerosis by targeting Nrf2 and Sirt2.


Assuntos
Aterosclerose , Hipertensão , MicroRNAs/biossíntese , Animais , Aterosclerose/genética , Aterosclerose/metabolismo , Aterosclerose/fisiopatologia , Linhagem Celular , Células Cultivadas , Heme Oxigenase-1/metabolismo , Células Endoteliais da Veia Umbilical Humana , Humanos , Hipertensão/genética , Masculino , Camundongos , MicroRNAs/genética , Fator 2 Relacionado a NF-E2/agonistas , Fator 2 Relacionado a NF-E2/metabolismo , Estresse Oxidativo/genética , Espécies Reativas de Oxigênio/metabolismo , Sirtuína 2/metabolismo
18.
Front Neurol ; 9: 856, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30450072

RESUMO

Background: Resting-state functional magnetic resonance imaging (fMRI) studies have uncovered the disruptions of functional brain networks in primary insomnia (PI) patients. However, the etiology and pathogenesis underlying this disorder remains ambiguous, and the insomnia related symptoms are influenced by a complex network organization in the brain. The purpose of this study was to explore the abnormal intrinsic functional hubs in PI patients using a voxel-wise degree centrality (DC) analysis and seed-based functional connectivity (FC) approach. Methods: A total of 26 PI patients and 28 healthy controls were enrolled, and they underwent resting-state fMRI. Degree centrality was measured across the whole brain, and group differences in DC were compared. The peak points, which significantly altered DC between the two groups, were defined as the seed regions and were further used to calculate FC of the whole brain. Later, correlation analyses were performed between the changes in brain function and clinical features. Results: Primary insomnia patients showed DC values lower than healthy controls in the left inferior frontal gyrus (IFG) and middle temporal gyrus (MTG) and showed a higher DC value in the right precuneus. The seed-based analyses demonstrated decreased FC between the left MTG and the left posterior cingulate cortex (PCC), and decreased FC was observed between the right precuneus and the right lateral occipital cortex. Reduced DC in the left IFG and decreased FC in the left PCC were positively correlated with the Pittsburgh sleep quality index and the insomnia severity index. Conclusions: This study revealed that PI patients exhibited abnormal intrinsic functional hubs in the left IFG, MTG, and the right precuneus, as well as abnormal seed-based FC in these hubs. These results contribute to better understanding of how brain function influences the symptoms of PI.

19.
World J Pediatr ; 14(5): 437-447, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30280313

RESUMO

BACKGROUND: Hand, foot, and mouth disease (HFMD) is a common infectious disease in childhood caused by an enterovirus (EV), and which is principally seen in children under 5 years of age. To promote diagnostic awareness and effective treatments, to further standardize and strengthen the clinical management and to reduce the mortality of HFMD, the guidelines for diagnosis and treatment have been developed. METHODS: National Health Commission of China assembled an expert committee for a revision of the guidelines. The committee included 33 members who are specialized in diagnosis and treatment of HFMD. RESULTS: Early recognition of severe cases is utmost important in diagnosis and treatment of patients with HFMD. The key to diagnosis and treatment of severe cases lies in the timely and accurate recognition of stages 2 and 3 of HFMD, in order to stop progression to stage 4. Clinicians should particularly pay attention to those EV-A71 cases in children aged less than 3 years, and those with disease duration less than 3 days. The following indicators should alert the clinician of possible deterioration and impending critical disease: (1) persistent hyperthermia; (2) involvement of nervous system; (3) worsening respiratory rate and rhythm; (4) circulatory dysfunction; (5) elevated peripheral WBC count; (6) elevated blood glucose and (7) elevated blood lactic acid. For treatment, most mild cases can be treated as outpatients. Patients should be isolated to avoid cross-infection. Intense treatment modalities should be given for those severe cases. CONCLUSION: The guidelines can provide systematic guidance on the diagnosis and management of HFMD.


Assuntos
Controle de Doenças Transmissíveis/organização & administração , Infecções por Coxsackievirus/diagnóstico , Doença de Mão, Pé e Boca/diagnóstico , Doença de Mão, Pé e Boca/terapia , Isolamento de Pacientes/métodos , Criança , Pré-Escolar , Terapia Combinada , Infecções por Coxsackievirus/epidemiologia , Infecções por Coxsackievirus/terapia , Feminino , Doença de Mão, Pé e Boca/epidemiologia , Humanos , Incidência , Lactente , Masculino , Guias de Prática Clínica como Assunto , Prognóstico , Medição de Risco , Estações do Ano , Índice de Gravidade de Doença , Taxa de Sobrevida , Resultado do Tratamento
20.
Front Aging Neurosci ; 10: 167, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29922151

RESUMO

Background: Recently, there have been many reports about abnormalities regarding structural and functional brain connectivity of the patients with primary insomnia. However, the alterations in functional interaction between the left and right cerebral hemispheres have not been well understood. The resting-state fMRI approach, which reveals spontaneous neural fluctuations in blood-oxygen-level-dependent signals, offers a method to quantify functional interactions between the hemispheres directly. Methods: We compared interhemispheric functional connectivity (FC) between 26 patients with primary insomnia (48.85 ± 12.02 years) and 28 healthy controls (49.07 ± 11.81 years) using a voxel-mirrored homotopic connectivity (VMHC) method. The patients with primary insomnia and healthy controls were matched for age, gender, and education. Brain regions, which had significant differences in VMHC maps between the primary insomnia and healthy control groups, were defined as seed region of interests. A seed-based approach was further used to reveal significant differences of FC between the seeds and the whole contralateral hemisphere. Results: The patients with primary insomnia showed higher VMHC than healthy controls in the anterior cingulate cortex (ACC) bilaterally. The seed-based analyses demonstrated increased FC between the left ACC and right thalamus (and the right ACC and left orbitofrontal cortex) in patients with primary insomnia, revealing abnormal connectivity between the two cerebral hemispheres. The VMHC values in the ACC were positively correlated with the time to fall asleep and Self-Rating Depression Scale scores (SDS). Conclusions: The results demonstrate that there is abnormal interhemispheric resting-state FC in the brain regions of patients with primary insomnia, especially in the ACC. Our finding demonstrates valid evidence that the ACC is an area of interest in the neurobiology of primary insomnia.

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