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1.
Sci Total Environ ; 755(Pt 2): 142641, 2020 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-33049541

RESUMO

The microbial electrochemical system (MES) has great advantages in wastewater treatment for rapid chemical oxygen demand (COD) removal and low sludge yield rate. Herein, biocathode MES was proposed to remove COD from high-ammonia wastewater with low carbon­nitrogen ratio and regulate the nitrogen forms in effluent for ANAMMOX process. The biocathode was more sensitive to ammonia nitrogen (NH4+-N) than anode and determined the power generation of MES. With COD of 500-550 mg L-1 in influent, increasing NH4+-N from 50 to 150 mg L-1 improved maximum power output (Pmax) from 3.0 ± 0.2 to 3.4 ± 0.1 W m-3, which was then reduced with further increase of NH4+-N from 300 to 600 mg L-1. However, for the cathodic reductive current, the negative effects of ammonia only revealed with NH4+-N ≥ 450 mg L-1. The cathodic equilibrium potential drop determined the power degradation, because the increased reductive compounds (NH4+ and COD) in catholyte. The high NH4+-N reduced the abundance of denitrifiers, exoelectrogens and organic-degrading bacteria on electrodes, while that of nitrogen-fixing bacteria increased. External alkalinity addition achieved in-situ short-cut nitrification and nitrite accumulation. With comparable NH4+ and NO2-, limited NO3- and low COD, the biocathode MES effluent was then suitable for subsequence ANAMMOX process.

2.
Br J Cancer ; 2020 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-32901134

RESUMO

BACKGROUND: It is unclear whether bisphosphonates are associated with risk of cancers. Therefore, this meta-analysis aimed to evaluate the effect of bisphosphonates on overall cancers. METHODS: A search in Pubmed, Embase, Cochrane Library and Web of Science databases was conducted, from the inception date of each resource to September 26, 2019. The summarised effect estimates with 95% CIs were calculated using a random-effect model. Heterogeneity and publication bias were explored. RESULTS: Thirty-four articles were included in this study (4,508,261 participants; 403,196 cases). The results revealed that bisphosphonates significantly decreased the risk of colorectal cancer (RR = 0.89, 95% CI: 0.81-0.98), breast cancer (RR = 0.87, 95% CI: 0.82-0.93) and endometrial cancer (RR = 0.75, 95% CI: 0.61-0.94), but no significant association was observed in all-cause cancer. Furthermore, nitrogen-containing bisphosphonates only had protective effects both on breast cancer (RR = 0.94, 95% CI: 0.90-0.99) and endometrial cancer (RR = 0.70, 95% CI: 0.54-0.92). Non-nitrogen-containing bisphosphonates tended to increase the risk of liver cancer (RR = 2.14, 95% CI: 1.23-3.72) and pancreas cancer (RR = 1.75, 95% CI: 1.32-2.33). CONCLUSION: Bisphosphonates are significantly associated with risk reduction of colorectal, breast and endometrial cancer, especially nitrogen-containing bisphosphonates. It should be noted that non-nitrogen-containing bisphosphonates might increase the risk of liver and pancreas cancer. Large prospective cohort studies are needed to find the causal association between bisphosphonates and risk of cancers.

3.
Theranostics ; 10(23): 10619-10633, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32929370

RESUMO

Great progress has been made in the field of tumor immunotherapy in the past decade. However, the therapeutic effects of immune checkpoint blockade (ICB) against ovarian cancer are still limited. Recently, an inhibitor of cyclin-dependent kinases 4 and 6 (CDK4/6i) has been reported to enhance antitumor immunity in preclinical models. The combined use of CDK4/6i and ICB may be beneficial, but the effects of CDK4/6is on the tumor immune microenvironment and whether they can synergize with ICB in treating ovarian cancer remain unknown. Methods: In this study, we first assessed the antitumor efficacy of abemaciclib, an FDA-approved CDK4/6i, in a syngeneic murine ovarian cancer model. Then, immunohistochemistry, immunofluorescence and flow cytometry were performed to evaluate the number, proportion, and activity of tumor-infiltrating lymphocytes. Cytokine and chemokine production was detected both in vivo and in vitro by PCR array analysis and cytokine antibody arrays. The treatment efficacy of combined abemaciclib and anti-PD-1 therapy was evaluated in vivo, and CD8+ and CD4+ T cell activities were analyzed using flow cytometry. Lastly, the requirement for both CD8+ T cells and B cells in combination treatment was evaluated in vivo, and potential cellular mechanisms were further analyzed by flow cytometry. Results: We observed that abemaciclib monotherapy could enhance immune infiltration, especially CD8+ T cell and B cell infiltration, in the ID8 murine ovarian cancer model. Immunophenotyping analysis showed that abemaciclib induced a proinflammatory immune response in the tumor microenvironment. PCR array analysis suggested the presence of a Th1-polarized cytokine profile in abemaciclib-treated ID8 tumors. In vitro studies showed that abemaciclib-treated ID8 cells secreted more CXCL10 and CXCL13, thus recruiting more lymphocytes than control groups. Combination treatment achieved better tumor control than monotherapy, and the activities of CD8+ and CD4+ T cells were further enhanced when compared with monotherapy. The synergistic antitumor effects of combined abemaciclib and anti-PD-1 therapy depended on both CD8+ T cells and B cells. Conclusion: These findings suggest that combined treatment with CDK4/6i and anti-PD-1 antibody could improve the efficacy of anti-PD-1 therapy and hold great promise for the treatment of poorly immune-infiltrated ovarian cancer.

4.
Artigo em Inglês | MEDLINE | ID: mdl-32955852

RESUMO

Preventing ice formation and ice swift removal from the solid surface are essential in numerous application fields. Superhydrophobic coating is an effective way to delay the icing phenomenon. However, the superhydrophobic coating was wetted easily after icing-deicing cycles that led to the failure of anti-icing. In this study, a robust, amphiphobic coating consisted of fluorinated multiwalled carbon nanotubes (FMWCNTs) and commercial polyurethane was constructed by a simply spray process. Because of the addition of FMWCNTs, the coating demonstrated a good amphiphobic feature and highly efficient photothermal conversion, which endowed the coating surface with excellent deicing and defrosting characteristics under sunlight irradiation. In addition, self-cleaning and self-healing properties of the coating under sunlight ensured its efficient photothermal conversion and long service life. To further improve the photothermal deicing effect, a coating system containing a photothermal layer (P), thermal-conductive layer (C), and thermal-protective layer (P) was constructed. The heat generating from the photothermal layer can transfer the whole coating surface by the conductive layer, but with limited transmission to substrate materials by a thermal-protective layer. The coating system can still deice and defrost rapidly on the whole surface and only a small portion of photothermal coating was irradiated under extremely low temperature. The outdoor experiment has confirmed that the coating melted and removed snow rapidly in a winter environment. The multifunctional photothermal deicing coating may have a wide application in outdoor surrounding.

5.
Dalton Trans ; 49(32): 11192-11200, 2020 Aug 18.
Artigo em Inglês | MEDLINE | ID: mdl-32748922

RESUMO

Photodynamic therapy (PDT) has been widely used in conjunction with molecular oxygen to cause cancer cell death. Hypoxia, the inherent property in solid tumors, is the obstacle during the process of PDT. It is urgent to develop PDT photosensitizers independent of the oxygen concentration. Herein, triphenylamine-modified Ru(ii) complexes have been used as photosensitizers to produce superoxide anions (O2-˙) and hydroxyl radicals (˙OH) through a type I photochemical process. Ru(ii) complexes with triphenylamine can provide a possibility to drive the reactive oxygen species production through low oxidation potential and good light-harvesting abilities. The investigation on light-mediated radical production showed that Ru4 could produce abundant ˙OH and O2-˙ compared to Ru1-Ru3 under hypoxic environments owing to the strong absorption. These radicals exhibit potent toxicity, which can damage the neighbouring biomolecules and cause the apoptosis of cancer cells. The PDT effect was evaluated in vitro under hypoxia, suggesting that Ru4 could maintain excellent performance in inducing a sharp decrease in the activity of cancer cells.

6.
Anim Biotechnol ; : 1-9, 2020 Jul 30.
Artigo em Inglês | MEDLINE | ID: mdl-32730101

RESUMO

Pou2F3 (POU class 2 homeobox 3) is found to be ubiquitously expressed in multiple epidermal layer cells to mediating proliferation. Although some POU factors exert a crucial regulation in mammary epithelial cells (MECs), the biological function of Pou2F3 is unclear. In this study, we aimed to investigate the endogenous potential effects of Pou2F3 on the proliferation and the roles of PI3K/AKT/mTOR signaling pathway in MECs. We used small interfering RNA to silence Pou2F3 expression. The interfering efficiency of Pou2F3 was confirmed by using RT-qPCR and Western blot. The cell viability and proliferation were indicated by Cell Counting Kit-8 and EdU assays. Flow cytometry was performed to evaluate the cell apoptosis in MECs. These results demonstrated that Pou2F3 potently suppressed the proliferation and induced the apoptosis of MECs. Consistently, the primary protein expressions of PI3K/AKT/mTOR signaling pathway were examined by Western blot. Pou2F3 silencing significantly increased the phosphorylation of PI3K, AKT and mTOR expressions. Moreover, Pou2F3 silencing reduced the ratio of BCL-2/BAX protein expression. Our findings show that Pou2F3 silencing can induce the proliferation of MECs and decrease the cell apoptosis, which suggest that Pou2F3 may serve as a potential upstream regulator of PI3K/AKT/mTOR signaling pathway in MECs.

7.
J Mater Chem B ; 8(33): 7356-7364, 2020 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-32648568

RESUMO

The preferable photoconversion tunability of conjugated polymers (CPs) is of great interest in cancer phototherapy. However, very few molecular design strategies have been developed for achieving CPs with highly efficient photoconversion performance. Herein, a rational design of near-infrared (NIR) Pt-acetylide conjugated polymer CP3 with highly efficient photoconversion behaviors for synergistic photodynamic therapy (PDT) and photothermal therapy (PTT) was demonstrated. CP3 containing boron dipyrromethene (BDP) units displayed intense absorption peaks in the NIR region, which were red-shifted approximately 60 nm compared to the corresponding small-molecule precursor of BDP. Compared with control polymers CP1 and CP2, after the introduction of Pt into CP3, the triplet state, which benefits the generation of reactive oxygen species for photodynamic therapy, was identified clearly in both CP3 and the prepared CP3 nanoparticles (CP3-NPs) by ultrafast femtosecond transient absorption (fs-TA) spectroscopy. Notably, different from the traditional nonradiative decay channel with lifetime of 1.1 ps in CP3, CP3-NPs possess an additional nonradiative decay channel with lifetime of 10 ps, both of which contribute to the superior photothermal conversion effect upon 808 nm irrradiation. All these photoconversion performances lead to excellent tumor ablation. This study elucidates the excited-state dynamics in Pt-acetylide CPs, which provide an insightful understanding and valuable guidelines for the future design of high-performance theranostic agents based on CPs for synergistic cancer phototherapy.

8.
J Colloid Interface Sci ; 579: 177-185, 2020 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-32590158

RESUMO

A direct Z scheme g-C3Nx/Bi2WO6 heterojunctions with enhanced photocatalytic performances were successfully prepared through nitrogen defect mediated method. HRTEM analyses illustrate Bi2WO6 nanoparticles are closely bonded with the g-C3Nx-0.05 nanosheets to form the g-C3Nx-0.05/Bi2WO6 heterogeneous structures. An outstanding visible light absorption ability is shown in the g-C3Nx-0.05/Bi2WO6 hybrid, which combines both the light absorption advantages of g-C3Nx-0.05 and Bi2WO6 together. In comparison with other photocatalysts the nitrogen defect mediated g-C3Nx-0.05/Bi2WO6 hybrid shows the best photocatalytic properties, whose degradation efficiency can reach 83%. PL results indicate that an obvious larger amount of ·OH radical is produced on the g-C3Nx-0.05/Bi2WO6 surface in the photocatalytic process. In the nitrogen defect mediated g-C3Nx-0.05/Bi2WO6 the binding energies of C and N shift positively to the larger binding energy and the Bi, W and O elements shift negatively compared with that of the pristine g-C3Nx-0.05 and Bi2WO6. The MS results show the g-C3Nx-0.05 has a more negative Ef than that of Bi2WO6. All the experimental results support the direct Z scheme charge transfer mechanism proposed in the g-C3Nx-0.05/Bi2WO6 photocatalyst. The developing of direct Z scheme g-C3Nx-0.05/Bi2WO6 hybrid with excellent photocatalytic performance through defect mediated method shows great potential for more photocatalytic fields.

9.
J Steroid Biochem Mol Biol ; 202: 105722, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32565247

RESUMO

PTX3, a member of the pentraxin protein family, plays important roles in ovulation as a marker of cumulus cell-oocyte complex expansion. However, the expression and function of PTX3 in goat ovarian GCs remain unclear. We isolated GCs from small and large follicles and found that PTX3 expression was significantly decreased and miR-29 mRNA expression was significantly increased during the growth of antral follicles. MiR-29 decreased PTX3 expression by targeting its 3' untranslated. Furthermore, miR-29 promoted GC proliferation, suppressed steroidogenesis and apoptosis by targeting PTX3 via the activation of the PI3K/AKT/mTOR and Erk1/2 signaling pathways. Treatment with inhibitors also verified these results. Meanwhile, we found that PI3K/AKT/mTOR and Erk1/2 signaling pathways had different role in secretion of E2 and P4 by regulating differently various steroidogenic enzyme (CYP19A1, CYP11A1, StAR and HSD3B) expression. These outcomes indicate the potential role of PTX3 in goat follicular growth and atresia.

10.
J Neurooncol ; 148(3): 555-567, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32506368

RESUMO

INTRODUCTION: A novel neurosurgical enhanced recovery after surgery (ERAS) program shortens postoperative hospital stay and accelerates functional recovery in elective craniotomy patients. There is a need to evaluate the impact of ERAS program on patients' health-related quality of life (HRQOL). METHODS: In a single-center randomized controlled trial, patients were randomized 1:1 to receive perioperative ERAS or conventional care. As a secondary outcome, HRQOL was measured with the EORTC QLQ-C30/BN20 prior to randomization (baseline), at discharge, and at 3- and 6-month follow-up. RESULTS: A total of 65 patients (ERAS: n = 36, conventional care: n = 29) with pathologically confirmed glioma (WHO grade 2-4) were included in the analysis. Progression-free survival at 6 months and HRQOL at baseline were similar between the two groups. Changes of scores did not vary significantly over time, but differed significantly between intervention groups. A clinically relevant better QoL (at 3-month follow-up), physical functioning (at 6-month follow-up) and role functioning (at discharge) was observed in patients in the ERAS group. Symptom scores of constipation (at discharge), motor dysfunction (at discharge, 3- and 6-month follow-up), drowsiness (at 3- and 6-month follow-up), weakness of legs (at 3-month follow-up), and nausea/vomiting (at discharge and 6-month follow-up) were significantly lower in the ERAS group. CONCLUSIONS: The neurosurgical ERAS program seems to improve functioning and symptoms scores in glioma patients within 6-month follow-up compared with conventional care. The intervention has a significant main effect HRQOL changes without significant interaction with time. Future well-powered multicenter studies are warranted to confirm this result and address long-term benefits. This study has been registered in the Chinese Clinical Trial Registry ( http://www.chictr.org.cn/showproj.aspx?proj=16480 ) with registration number ChiCTR-INR-16009662.

11.
Phys Chem Chem Phys ; 22(23): 13143-13153, 2020 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-32490855

RESUMO

Polymer dielectrics with high dielectric performances and superior discharge energy capability are highly desirable for advanced electrostatic capacitor applications. However, the paradoxical relationship between dielectric polarization and electric breakdown behavior generally hinder their further enhancement in energy storage performances. Herein, polymer blended composite films with high energy storage capability were successfully fabricated by blending together poly(vinylidene fluoride) (PVDF) polymer and poly(vinylidene fluoride-trifluoroethylene-chlorofluoroethylene) (P(VDF-TrFE-CFE)) terpolymer. The P(VDF-TrFE-CFE) terpolymer has a high dielectric constant to provide a large electric displacement under an applied electric field far below its breakdown field, which is anticipated to modulate the dielectric polarization behavior of PVDF polymer when blended in different proportions. Consequently, the polymer blended composite film consisting of 20 wt% (P(VDF-TrFE-CFE)) terpolymer exhibits a high discharge energy density of 13.63 J cm-3 at an enhanced breakdown strength of 480 MV m-1. This obtained high discharge energy density is 84% higher than the pure PVDF film and 582% higher than a commercialized biaxially oriented polypropylene (BOPP). Large interfacial polarization and strong interaction of polymer chains between the PVDF polymer and P(VDF-TrFE-CFE) terpolymer may contribute to the tunable dielectric constant and electric breakdown strength, thus promoting the energy storage capability. This work establishes a facile, but effective approach to achieve the high energy storage capability of PVDF polymer-based flexible composite films for capacitive energy storage applications.

12.
J Inorg Biochem ; 209: 111106, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32470855

RESUMO

Singlet oxygen (1O2), as a highly reactive oxygen species, plays an important role in the physical, chemical and biomedical fields, especially during photodynamic therapy (PDT) process. In this work, two iridium(III) complexes containing an anthracene unit in their diimine ligand were designed and synthesized to monitor 1O2 in living cells. The complexes were weakly emissive owing to the photoinduced electron transfer process, but exhibited intense luminescence upon capturing 1O2, resulting from the formation of the corresponding endoperoxide analogues. The remarkable turn-on luminescence response was specific toward 1O2 and in preference to other reactive oxygen species. The utilization of one of the complexes for imaging 1O2 in living cells has also been demonstrated using three different cells lines. Cells incubated with the complexes were hardly emissive. Further light irradiation at 475 nm triggered intracellular emission turn on, indicative of the production of 1O2 photochemically. The emissive pattern was well colocalized with commercially available MitoTracker, suggesting the potential applications of the complexes for imaging mitochondria 1O2. The 1O2 capturing properties rendered the complexes low photocytotoxicity since 1O2-caused oxidative damage toward cellular molecules and structures was inhibited.

13.
Langmuir ; 2020 Apr 23.
Artigo em Inglês | MEDLINE | ID: mdl-32259452

RESUMO

Achieving high photocatalytic activity of titania-graphene composites calls for well-controlled titania size and efficient charge transfer interfaces. However, it is rather difficult because of easy restacking of graphene sheets and random nucleation and growth of titania nanoparticles in solution. Here, we reported a facile way to control the TiO2 sizes and interfaces by localizing the nucleation and growth of titania on graphene sheets, which prohibits both restacking of graphene and random growth of TiO2. As a result, a composite with controllably less than 10-nm-sized TiO2 nanoparticles evenly distributed on thin graphene sheets was achieved. Thanks to the small size of titania and efficient charge transfer interfaces, the TiO2/graphene composite exhibits a significant enhancement of photocatalytic H2 evolution activity, reaching 1.35 mmol g-1 h-1. Furthermore, the composite also shows high photocatalytic activity on dye degradation under visible light illumination.

14.
ACS Appl Mater Interfaces ; 12(18): 20180-20190, 2020 May 06.
Artigo em Inglês | MEDLINE | ID: mdl-32281784

RESUMO

The development of metallacycles with high stability and intense near-infrared (NIR) absorption is important for biomedical applications. However, very few molecular design strategies have been developed on such metallacycles. Herein, we report a new series of stable and well-defined NIR-absorbing metallacycles (M1-M3) through the Pt-acetylide coordination with highly efficient photoconversion performance for cancer phototherapy. The metallacycles showed high stability and strong NIR absorption, and the absorption peaks were red shifted approximately 30 nm in comparison with their corresponding precursors. The introduction of Pt into metallacycles promotes significant photoconversions, including the singlet-to-triplet and nonradiative transitions. Moreover, the fabricated M3 nanoparticles (M3-NPs) showed favorable photoconversions into both thermal effect and singlet oxygen generation upon NIR irradiation, achieving tumor ablation. This novel design of Pt-acetylide metallacycles possesses not only complex topological architectures but also a valuable paradigm for precise cancer phototherapy, which is important for grafting stimuli-responsive functional groups into metallacycles for the development of high-performance biomedical supramolecular materials.

15.
Mini Rev Med Chem ; 20(10): 908-920, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32116191

RESUMO

Inhibitors of monoamine oxidase (MAO) have shown therapeutic values in a variety of neurodegenerative diseases such as depression, Parkinson's disease and Alzheimer's disease. Heterocyclic compounds exhibit a broad spectrum of biological activities and vital leading compounds for the development of chemical drugs. Herein, we focus on the synthesis and screening of novel single heterocyclic derivatives with MAO inhibitory activities during the past decade. This review covers recent pharmacological advancements of single heterocyclic moiety along with structure- activity relationship to provide better correlation among different structures and their receptor interactions.

16.
Diagn Cytopathol ; 48(7): 657-661, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32191820

RESUMO

Extramedullary multiple myeloma (EMM) involving the liver as a focal space-occupying lesion is very rare, especially in the patients with cirrhosis. Here, we report a case of EMM in the liver and periportal lymph node, diagnosed by endoscopic ultrasound guided-fine-needle aspiration (EUS-FNA). A 57-year-old male patient, with history of cirrhosis, presented with abdominal pain and pancytopenia. The abdominal magnetic resonance imaging (MRI) demonstrated a 6.5 cm left hepatic mass with a 1.1 cm malignant-appearing periportal lymph node and diffuse osseous lesions. The cytology specimens from the hepatic mass and the periportal lymph node were obtained through EUS-FNA without rapid on-site evaluation (ROSE). The thin-layer preparations (ThinPrep) showed abundant plasmacytoid cells, which were confirmed to be Kappa-restricted neoplastic plasma cells by the cell block preparations. Later, his serum level of Kappa light chain was found significantly elevated by flow cytometry, which was identified as monoclonal IgA Kappa light chain by serum protein electrophoresis (SPEP) with immunofixation. The patient was diagnosed as IgA multiple myeloma with extramedullary involvement of the liver and periportal lymph node. This is the first case showing the ThinPrep cytomorphologic features of EMM in the liver and periportal lymph node. This case highlights the importance of distinguishing plasma cells from being hepatocytes and lymphocytes on the ThinPrep and also emphasizes the utility of the cell block in the diagnosis of plasma cell neoplasm.

17.
ACS Appl Mater Interfaces ; 12(11): 12383-12394, 2020 Mar 18.
Artigo em Inglês | MEDLINE | ID: mdl-32091195

RESUMO

Drug-induced liver injury (DILI) is a widespread clinical problem. The pathophysiological mechanisms of DILI are complicated, and the traditional diagnostic methods for DILI have their limitations. Owing to its convenient operation, high sensitivity, and high specificity, luminescent sensing and imaging as an indispensable tool in biological research and clinical trials may provide an important means for DILI study. Herein, we report the rational design and preparation of a near-infrared dual-phosphorescent polymeric probe (P-ONOO) for exploring the DILI via specific imaging of peroxynitrite (ONOO-) elevation in vivo, which was one of early markers of DILI and very difficult to be detected due to its short half-life and high reactive activity. With the utilization of P-ONOO, the raised ONOO- was visualized successfully in the drug-treated hepatocytes with a high signal-to-noise ratio via ratiometric and time-resolved photoluminescence imaging. Importantly, the ONOO- boost in the acetaminophen-induced liver injury in real time was verified, and the direct observation of the elevated ONOO- production in ketoconazole-induced liver injury was achieved for the first time. Our findings may contribute to understanding the exact mechanism of ketoconazole-induced hepatotoxicity that is still ambiguous. Notably, this luminescent approach for revealing the liver injury works fast and conveniently.

18.
Acta Neurochir (Wien) ; 162(7): 1585-1595, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-31897729

RESUMO

BACKGROUND: In light of the controversies regarding the surgical treatment of adult Chiari malformation type I (CM-I) with syringomyelia, a retrospective study was conducted to evaluate the safety and efficacy of tonsillectomy followed by modified reconstruction of the cisterna magna with or without craniectomy. METHODS: Between 2008 and 2017, 78 adult CM-I patients (36 males and 42 females, mean age 40.6 years old) with syringomyelia were treated with posterior fossa decompression (PFD) with tonsillectomy and modified reconstruction of the cisterna magna. Patients were divided into two study groups: group A (n = 40) underwent cranioplasty with replacement of the bone flap; group B (n = 38) underwent suboccipital craniectomy. Neurological outcomes were evaluated by traditional physician assessment (improved, unchanged, and worsened) and the Chicago Chiari Outcome Scale (CCOS). Syringomyelia outcomes were assessed radiologically. RESULTS: The procedure was successfully performed in all patients, and restoration of normal cerebrospinal fluid (CSF) flow was confirmed by intraoperative ultrasonography. The median postoperative follow-up was 20.3 months (range 18-60 months). Clinical improvement was evident in 66 (84.6%) patients, with no significant differences between the two groups (85.0% vs. 84.2%, P = 0.897). According to the CCOS, 36 patients (90.0%) in group A were labeled as "good" outcome, compared with that of 34 (86.8%) in group B (P = 0.734). Improvement of syringomyelia was also comparable between the groups, which was observed in 35 (87.5%) vs. 33 (86.8%) patients (P = 0.887). The postoperative overall (7.5% vs. 23.7%, P = 0.048) and CSF-related (2.5% vs. 18.4%, P = 0.027) complication rates were significantly lower in group A than group B. CONCLUSIONS: Tonsillectomy with modified reconstruction of the cisterna magna without craniectomy seems to be a safe and effective surgical option to treat adult CM-I patients with syringomyelia, though future well-powered prospective randomized studies are warranted to validate these findings.

19.
World Neurosurg ; 136: e542-e552, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31954884

RESUMO

OBJECTIVE: To evaluate the safety and efficacy of an enhanced recovery after surgery (ERAS) program for intraspinal tumors in a single-institutional prospective randomized controlled trial. METHODS: A multimodal and multidisciplinary ERAS protocol for intraspinal tumor surgery was developed. A total of 94 enrolled patients were randomized into 2 groups: 48 were managed following the ERAS protocol (ERAS group), and 46 received conventional perioperative care (control group). The primary end point was postoperative length of stay (LOS). The secondary outcomes included postoperative pain score and pain medication use, urinary catheterization, ambulation, mortality, reoperation/readmission rates, complication rates, patient satisfaction, and overall cost. RESULTS: A significant reduction in LOS was achieved in patients undergoing ERAS protocol compared with the controls (5 vs. 8 days; P < 0.0001). Moreover, patients in the ERAS group had better postoperative pain scores (1.0 ± 1.3 vs. 1.9 ± 1.3; P = 0.007), decreased use of patient-controlled analgesia (4.2% vs. 19.6%; P = 0.020) and oral opioid (37.5% vs. 58.7%; P = 0.040), early urinary catheter removal (58.3% vs. 6.5%; P < 0.0001), greater ambulation (68.8% vs. 17.4%; P < 0.0001), and higher satisfaction scores (91.8 ± 4.4 vs. 88.2 ± 6.8; P = 0.022) than did the control group. There were no deaths or 30-day readmission/reoperation in both groups, nor did the postoperative complication rates differ between groups. CONCLUSIONS: The ERAS protocol for intraspinal tumor surgery seems to be feasible, effective, and safe in shortening postoperative LOS, improving postoperative pain control with reduced opioid use, and accelerating functional recovery without increasing rates of complications or reoperation/readmission. Adoption of spine ERAS programs could be encouraged in practice, although validation with larger-scale multicenter trials is warranted.


Assuntos
Recuperação Pós-Cirúrgica Melhorada , Neoplasias da Coluna Vertebral/cirurgia , Adulto , Idoso , Antineoplásicos/uso terapêutico , Feminino , Humanos , Tempo de Internação/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Medição da Dor , Dor Pós-Operatória/etiologia , Satisfação do Paciente , Assistência Perioperatória/métodos , Estudos Prospectivos , Resultado do Tratamento
20.
Cell Death Dis ; 11(1): 25, 2020 01 13.
Artigo em Inglês | MEDLINE | ID: mdl-31932581

RESUMO

Salt-inducible kinase 2 (SIK2) has been established as a regulator of diverse biological processes including cell metabolism. A recent study has reported that SIK2 is required for adipocyte-induced ovarian cancer (OC) survival through facilitating fatty acid oxidation. However, whether SIK2 also plays a role in the lipid synthesis in OC cells remains elusive. Here, we showed that SIK2 significantly promoted the lipid synthesis in OC cells. On the one hand, SIK2 enhanced fatty acid synthesis through upregulating the expression of sterol regulatory element binding protein 1c (SREBP1c) and thus the transcription of major lipogenic enzyme FASN. On the other hand, SIK2 promoted cholesterol synthesis through upregulating the expression of sterol regulatory element binding protein 2 (SREBP2) and thus the transcription of major cholesterol synthesis enzymes HMGCR. Moreover, PI3K/Akt signaling pathway was found to be involved in the upregulation of SREBP1c and SREBP2 in OC cells. Moreover, in vitro and in vivo assays indicated that the SIK2-regulated fatty acid and cholesterol synthesis played a critical role in the growth of OC cells. Our findings demonstrate that SIK2 is a critical regulator of lipid synthesis in OC cells and thus promotes OC growth, which provides a strong line of evidence for this molecule to be used as a therapeutic target in the treatment of this malignancy.

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