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1.
Oncogene ; 2020 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-33191405

RESUMO

Although somatic mutations of DNA repair genes are frequent in mantle cell lymphoma (MCL), our understanding of their germline defects is limited. In a Chinese family with maternal Lynch syndrome and paternal B cell non-Hodgkin lymphoma, one sibling developed both Lynch syndrome and MCL. Lynch syndrome is caused by heterozygous mutations in mismatch repair (MMR) genes. To understand the genetic predispositions in the family, we performed exome sequencing and analyses of affected individuals and their tumor samples. A novel germline indel, MLH1 Gly101fsX1, was identified as the cause of Lynch syndrome, and unstable microsatellite loci and mutational signatures as evidence of defective MMR were revealed in the MCL sample. Furthermore, we included additional 15 MCL patients with early onset, and found by exome sequencing that 11 patients carried heterozygous germline variants of 20 DNA repair genes, including MSH2 in MMR. In the MCL with MSH2 Arg359fsX16, unstable microsatellite loci and defective MMR signatures were also found. In addition, five patients also had heterozygous germline variants of genes involved in B cell functions. Thus, our study found germline variants of genes in single-strand break repair, double-strand break repair, and Fanconi anemia pathway in early onset MCL; and for the first time we identified germline defects of MMR in two MCLs.

2.
Environ Pollut ; 268(Pt B): 115766, 2020 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-33039677

RESUMO

Dioxybenzone is widely used in cosmetics and personal care products and frequently detected in multiple environmental media and human samples. However, the current understanding of the metabolic susceptibility of dioxybenzone and the potential endocrine disruption through its metabolites in mimicking human estrogens remains largely unclear. Here we investigated the in vitro metabolism of dioxybenzone, detected the residue of metabolites in rats, and determined the estrogenic disrupting effects of these metabolites toward estrogen receptor α (ERα). In vitro metabolism revealed two major metabolites from dioxybenzone, i.e., M1 through the demethylation of methoxy moiety and M2 through hydroxylation of aromatic carbon. M1 and M2 were both rapidly detected in rat plasma upon exposure to dioxybenzone, which were then distributed into organs of rats in the order of livers > kidneys > uteri > ovaries. The 100 ns molecular dynamics simulation revealed that M1 and M2 formed hydrogen bond to residue Leu387 and Glu353, respectively, on ERα ligand binding domain, leading to a reduced binding free energy. M1 and M2 also significantly induced estrogenic effect in comparison to dioxybenzone as validated by the recombinant ERα yeast two-hybrid assay and uterotrophic assay. Overall, our study revealed the potential of metabolic activation of dioxybenzone to induce estrogenic disrupting effects, suggesting the need for incorporating metabolic evaluation into the health risk assessment of benzophenones and their structurally similar analogs.

3.
ChemSusChem ; 2020 Oct 21.
Artigo em Inglês | MEDLINE | ID: mdl-33089612

RESUMO

Interfacial solar evaporators have great potential for clean water production; however, their evaporation performance relies greatly on the solar illumination condition, which is restricted by daily sunshine time and climates. Here, a wood-based vapor generator in pyramid structure is fabricated to achieve efficient water evaporation under dark condition (0 kW m-2 ) through efficient extraction of environmental thermal energy. The microvessels of wood provide fast water transportation whereas the tailored pyramid surface structure enables efficient evaporative cooling for extracting energy from the environment. The method enables fast water evaporation without the need of solar heat input. We demonstrate a vapor generation rate of up to 2.15 kg m-2 h-1 under dark condition (0 kW m-2 ), which is even 1.4 times faster than the theoretical limit of conventional solar thermal evaporators working under 1 sun (1 kW m-2 ) illumination condition. During the 24-h continuous evaporation test, the evaporator presented a daily vapor generation rate of up to 50.8 kg m-2 day-1 and 60.7 kg m-2 day-1 on cloudy and sunny day, respectively, offering a novel approach for the development of 24-h full-time water evaporators for seawater desalination and wastewater treatment.

4.
Leuk Lymphoma ; : 1-7, 2020 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-33054458

RESUMO

Little is known regarding the outcome of lymphoma patients undergoing autologous hematopoietic stem cell transplantation (AHSCT) using inadequate hematopoietic stem cell (HSC) doses. Fifty-six patients were enrolled in the study, and the cohort was subdivided into two groups according to the infusion dose: < 1 × 106/kg (poor HSC group) and 1-2 × 106/kg (unfavorable HSC group). Compared with the unfavorable group, the poor HSC group had a longer median time to neutrophil (13 vs. 11 days, p = .007) and platelet engraftment (17 vs. 13 days, p = .024). CD34+ cell infusion dose of < 1 × 106/kg was the only risk factor for neutrophil and platelet engraftment. The expected 3-year progression-free survival and overall survival rates for the whole cohort were 53% and 66%, and no statistical difference was observed between two groups. In conclusion, inadequate HSC infusion dose did not negatively impact AHSCT patient survival but significantly prolonged the time to hematopoietic engraftment.

5.
J Nucl Med ; 2020 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-33008932

RESUMO

The world's first total-body PET scanner with an axial field-of-view (AFOV) of 194 cm is now in clinical and research use at our institution. The uEXPLORER PET/CT scanner, developed through a collaboration between the University of California, Davis (UC Davis) and United Imaging Healthcare (UIH), is the first commercially available total-body PET scanner. Here we present a detailed physical characterization of the uEXPLORER PET scanner based on NEMA NU-2-2018 along with a new set of measurements devised to appropriately characterize the total-body scanner. Methods: Sensitivity, count-rate performance, time-of-flight resolution, spatial resolution, and image quality were evaluated following the NEMA NU-2-2018 protocol. Additional measurements of sensitivity and count-rate capabilities more representative of total-body imaging were performed using extended geometry phantoms based on the world average human height (~165 cm). Lastly, image quality throughout the long AFOV was assessed with the NEMA image quality (IQ) phantom imaged at five axial positions and over a range of expected total-body PET imaging conditions (low dose, delayed imaging, short scan duration). Results: Our performance evaluation of the uEXPLORER PET system demonstrates that the scanner provides a very high sensitivity of 174 kcps/MBq, count-rate performance with a peak noise equivalent count-rate (NECR) of approximately 2 Mcps for total-body imaging, coupled with good spatial resolution capabilities for human imaging (≤ 3.0 mm FWHM near the center of the AFOV). Excellent image quality, contrast recovery, and low noise properties were illustrated across the AFOV in both NEMA IQ phantom evaluations and human imaging examples. Conclusion: In addition to standard NEMA NU-2-2018 characterization, a new set of measurements based on extending NEMA NU-2-2018 phantoms and experiments were devised to characterize the physical performance of the first total-body PET system. Rationale for these extended measurements was evident from differences in sensitivity, count-rate - activity relationships, and NECR limits imposed by differences in deadtime and randoms fraction between the NEMA NU-2 70 cm phantoms and the more representative total-body imaging phantoms. Overall, the total-body uEXPLORER PET system provides ultra-high sensitivity that supports excellent spatial resolution and image quality throughout the FOV in both phantom and human imaging.

6.
Gene ; : 145206, 2020 Oct 12.
Artigo em Inglês | MEDLINE | ID: mdl-33059030

RESUMO

microRNA (miRNA) is a small endogenous noncoding RNA molecule that plays multiple roles in regulating most biological processes. However, for China's national treasure giant panda, a world-famous rare and protected species, reports of its miRNA have been found only in blood and breast milk. To explore the miRNA expression differences between different giant panda tissues, here, we generated the miRNA profiles of five tissues (heart, liver, spleen, lung, and kidney) from four giant pandas with Illumina Hiseq 2500 platform, and filtered the differentially expressed miRNAs (DEmiRs) in each tissue, predicted the target genes of miRNA from each tissue based on the DEmiRs. Then, the GO and KEGG enrichment analysis were conducted using the target genes predicted from DEmiRs in each tissue. The RNA-seq generated an average of 0.718 GB base per sample. A total of 1,256 known miRNAs and 12 novel miRNAs were identified, and there were 215, 131, 185, 83, and 126 tissue-specific DEmiRs filtered in the heart, liver, spleen, lung, and kidney, respectively, including miR-1b-5p, miR-122-5p, miR-143, miR-126-5p, and miR-10b-5p, respectively. The predicted target genes, including MYL2, LRP5, MIF, CFD, and PEBP1 in the heart, liver, spleen, lung, and kidney, respectively, were closely associated with tissue-specific biological functions. The enrichment analysis results of target genes showed tissue-specific characteristics, such as the significantly enriched GO terms extracellular matrix in the heart and insulin-like growth factor binding in the liver. The miRNA profiles of the heart, liver, spleen, lung, and kidney of giant panda have been reported in this study, it reveals the miRNA expression differences between different tissues of the giant panda, and provides valuable genetic resources for the further related molecular genetic research of the rare and protected species giant panda and other mammals.

7.
Mod Pathol ; 2020 Sep 24.
Artigo em Inglês | MEDLINE | ID: mdl-32973328

RESUMO

We report 17 cases of sinusoidal large B-cell lymphoma (SLBCL). Clinical, morphologic, immunophenotypic, and molecular features were detected and analyzed. All cases showed an obvious sinusoidal growth pattern, usually associated with residual atrophic lymphoid tissue. All tumors contained large pleomorphic lymphoid cells and one or more prominent nucleoli, with abundant amphophilic cytoplasms; 15/17 cases showed anaplastic morphologic features. The patient age ranged from 43 to 80 years (median 57 years), and 7 males and 10 females were included. Eleven of 15 (73.3%) patients had Ann Arbor stage III or IV disease, and 10/15 (66.6%) patients had an International Prognostic Index (IPI) score ≥3. Immunophenotypically, 16/17 (94.1%) cases displayed a nongerminal center B-cell (non-GCB) immunophenotype. Furthermore, 16/17 (94.1%) cases were positive for CD30, and p53 was expressed in 10/16 (62.5%) cases. In total, 12/14 (85.7%) cases expressed BCL2 and MYC simultaneously (double expression), and 11/14 (78.6%) cases showed PD-L1 positivity (6/11 had a PD-L1 tumor proportion score ≥50%). Cytogenetically, concurrent MYC and BCL2 and/or BCL6 abnormalities (break-apart or extra copy) were detected in 10/15 cases, and 7/13 (53.8%) cases harbored a PD-L1/L2 amplification. TP53 mutation was found in 7/13 (53.8%) cases by Sanger sequencing. Whole-exome and large-panel sequencing results revealed high mutation frequencies of TP53 (4/7), MYD88 (3/7), KMT2D (3/7), CREBBP (3/7), and PIM1 (3/7). Among the 13 patients with SLBCL treated with aggressive chemotherapy regimens, the median overall survival (OS) was 18 months, and the 2-year OS rate was 34.6%. The OS of patients with SLBCL was markedly worse than that of 35 control group patients with common diffuse large B-cell lymphoma (DLBCL) without sinusoidal features (P < 0.001). SLBCL may represent a specific type of DLBCL that has characteristic pathologic features. The cancer is aggressive in most clinical cases, and outcomes are poor. SLBCL and anaplastic DLBCL (A-DLBCL) have many overlapping clinicopathological and molecular features.

8.
Medicine (Baltimore) ; 99(33): e21628, 2020 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-32872023

RESUMO

RATIONABLE: Large cell neuroendocrine carcinoma of the lung is rare, especially in the area of the foramen magnum. No previous studies have reported metastatic large cell neuroendocrine lung cancer to the foramen magnum. This paper will be the first time to report this special case. PATIENT CONCERNS: A case of a 37-year-old woman presented with headache that had developed 20 days previously. Imaging examination revealed a circular abnormal signal at the posterior margin of the foramen magnum. DIAGNOSES: The patient we report was diagnosed with a metastatic intracranial tumor. INTERVENTIONS: The patient underwent occipital craniotomy. Pathological results showed metastatic neuroendocrine carcinoma of the brain. Whole body PET-CT examination showed that fusiform soft tissue shadows could be seen near the hilum of the lower lobe of the left lung. OUTCOMES: The final bronchoscopy pathological results showed the large cell neuroendocrine carcinoma of the lung. The patient underwent further chemotherapy and radiotherapy in the oncology department. LESSONS: Diagnosis and treatment of large cell neuroendocrine carcinoma of the lung are difficult. The prognosis is poorer, and effective treatment is urgently needed.


Assuntos
Neoplasias Encefálicas/secundário , Carcinoma Neuroendócrino/patologia , Forame Magno/patologia , Neoplasias Pulmonares/patologia , Adulto , Neoplasias Encefálicas/diagnóstico por imagem , Neoplasias Encefálicas/cirurgia , Carcinoma Neuroendócrino/diagnóstico por imagem , Carcinoma Neuroendócrino/terapia , Feminino , Humanos , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/terapia , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Tomografia Computadorizada por Raios X
9.
IEEE Trans Med Imaging ; PP2020 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-32746128

RESUMO

Automatic rib fracture recognition from chest X-ray images is clinically important yet challenging due to weak saliency of fractures. Weakly Supervised Learning (WSL) models recognize fractures by learning from large-scale image-level labels. In WSL, Class Activation Maps (CAMs) are considered to provide spatial interpretations on classification decisions. However, the high-responding regions, namely Supporting Regions of CAMs may erroneously lock to regions irrelevant to fractures, which thereby raises concerns on the reliability of WSL models for clinical applications. Currently available Mixed Supervised Learning (MSL) models utilize object-level labels to assist fitting WSL-derived CAMs. However, as a prerequisite of MSL, the large quantity of precisely delineated labels is rarely available for rib fracture tasks. To address these problems, this paper proposes a novel MSL framework. Firstly, by embedding the adversarial classification learning into WSL frameworks, the proposed Biased Correlation Decoupling and Instance Separation Enhancing strategies guide CAMs to true fractures indirectly. The CAM guidance is insensitive to shape and size variations of object descriptions, thereby enables robust learning from bounding boxes. Secondly, to further minimize annotation cost in MSL, a CAM-based Active Learning strategy is proposed to recognize and annotate samples whose Supporting Regions cannot be confidently localized. Consequently, the quantity demand of object-level labels can be reduced without compromising the performance. Over a chest X-ray rib-fracture dataset of 10966 images, the experimental results show that our method produces rational Supporting Regions to interpret its classification decisions and outperforms competing methods at an expense of annotating 20% of the positive samples with bounding boxes.

10.
Cell Death Dis ; 11(8): 668, 2020 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-32820151

RESUMO

Inter- and intratumoral heterogeneity is a hallmark of glioblastoma (GBM) that facilitates recurrence, treatment resistance, and worse prognosis. O6-methylguanine-DNA methyltransferase (MGMT) promoter methylation is a significant prognostic marker for Temozolomide (TMZ) resistance in GBM patients. YKL-40 is a molecular marker for the mesenchymal subtype of GBMs and is responsible for TMZ resistance. However, underlying mechanisms by which MGMT epigenetics impacts patient outcomes and the function of YKL-40 are not fully determined. Herein, we performed in vitro and in vivo experiments, six human IDH1/2 wild-type glioblastoma stem-like cells (GSCs) were established and studied to further determine a potential interaction of YKL-40 and MGMT promoter methylation. We demonstrated that YKL-40 functioned differently in human IDH1/2 wild-type GSCs. In MGMT promoter-methylated (MGMT-m) GSCs, it acted as a tumor suppressor gene. On the other hand, in MGMT promoter-unmethylated (MGMT-um) GSCs, it promoted tumorigenesis. Notably, the reason that YKL-40 played different roles in GSCs could not be interpreted by the molecular classification of each GSCs, but is a function of MGMT promoter methylation status and involves the RAS-MEK-ERK pathway. YKL-40 mediated TMZ sensitivity by activating DNA damage responses (DDRs) in MGMT-m GSCs, and it mediated resistance to TMZ by inhibiting DDRs in MGMT-um GSCs. Our report demonstrated that MGMT promoter methylation status might influence a gene's function in human cancer. Moreover, our data also highlight the point that gene function should be investigated not only according to the molecular tumor classification, but also the epigenetic signature.

11.
Int J Surg Pathol ; : 1066896920953906, 2020 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-32856508

RESUMO

We describe the clinicopathologic and molecular features of 2 cases of gastric monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL), which were first diagnosed from gastric biopsies, one was primary whereas the other was gastric involvement by MEITL. Both cases were older men with stomach ulcers. Case 1 was admitted for a hemorrhage in the upper digestive tract and case 2 for edema. Histology of both cases showed infiltrated monomorphic and medium-sized lymphocytes with lymphoid epithelial phenomenon. An inflammatory background and vascular hyperplasia were also observed likely due to the ulceration. Neoplastic cells expressed CD2, CD3, CD7, CD8, CD56, TIA-1, and MYC, not CD5, CD4, Granzyme B, CD20, CD30, TdT, or EBER. Both lymphomas showed TCRG gene rearrangement and c-MYC gains. Moreover, we first affirmed polysomy of chromosome 8 in case 2. For correct diagnosis of this rare tumor at the rare location, it is important that pathologists raise the possibility and exclude other differential diagnoses.

12.
Environ Chem Lett ; : 1-11, 2020 Jun 12.
Artigo em Inglês | MEDLINE | ID: mdl-32837481

RESUMO

The outbreak of coronavirus named COVID-19, initially identified in Wuhan, China in December 2019, has spread rapidly at the global scale. Most countries have rapidly stopped almost all activities including industry, services and transportation of goods and people, thus decreasing air pollution in an unprecedented way, and providing a unique opportunity to study air pollutants. While satellite data have provided visual evidence for the global reduction in air pollution such as nitrogen dioxide (NO2) worldwide, precise and quantitative information is missing at the local scale. Here we studied changes in particulate matter (PM2.5, PM10), carbon monoxide (CO), NO2, sulfur dioxide (SO2) and ozone (O3) at 10 urban sites in Hangzhou, a city of 7.03 million inhabitants, and at 1 rural site, before city lockdown, January 1-23, during city lockdown, January 24-February 15, and during resumption, February 16-28, in 2020. Results show that city lockdown induced a sharp decrease in PM2.5, PM10, CO, and NO2 concentrations at both urban and rural sites. The NO2 decrease is explained by reduction in traffic emissions in the urban areas, and by lower regional transport in rural areas during lockdown, as expected. SO2 concentrations decreased from 6.3 to 5.3 µg m-3 in the city, but increased surprisingly from 4.7 to 5.8 µg m-3 at the rural site: this increase is attributed both to higher coal consumption for heating and emissions from traditional fireworks of the Spring Eve and Lantern Festivals during lockdown. Unexpectedly, O3 concentrations increased by 145% from 24.6 to 60.6 µg m-3 in the urban area, and from 42.0 to 62.9 µg m-3 in the rural area during the lockdown. This finding is explained by the weakening of chemical titration of O3 by NO due to reductions of NOx fresh emissions during the non-photochemical reaction period from 20:00 PM to 9:00 AM (local time). During the lockdown, compared to the same period in 2019, the daily average concentrations in the city decreased by 42.7% for PM2.5, 47.9% for PM10, 28.6% for SO2, 22.3% for CO and 58.4% for NO2, which is obviously explained by the absence of city activities. Overall, we observed not only the expected reduction in some atmospheric pollutants (PM, SO2, CO, NO2), but also unexpected increases in SO2 in the rural areas and of ozone (O3) in both urban and rural areas, the latter being paradoxically due to the reduction in nitrogen oxide levels. In other words, the city lockdown has improved air quality by reducing PM2.5, PM10, CO, and NO2, but has also decreased air quality by augmenting O3 and SO2.

13.
Ann Palliat Med ; 9(5): 2853-2861, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32787352

RESUMO

BACKGROUND: Ventilator-associated pneumonia (VAP) is a severe complication that occurs within patients who must use ventilators in the intensive care unit (ICU). Ventilator care bundles (VCB) have been applied across many developed regions and have produced positive results in controlling VAP. In this study, we report on the implementation and effects of using VCBs to manage VAP in a general tertiary hospital in the Inner Mongolia Autonomous Region of China. METHODS: A targeted surveillance method was used to survey all the patients (n=4,716) in the ICU from June 1, 2017 to May 31, 2019. Patients from June 1, 2017 to May 31, 2018, and June 1, 2018, to May 31, 2019, were respectively divided into 2 groups: the control group (2,029 patients) and intervention group (2,687 patients). These dates were selected because VCB was implemented from June 1, 2018, in our institution. The variables that were associated with VCB and observed were the head-of-bed elevation, oral care, maintenance of the pressure for the cuff of the endotracheal tube, aspiration of subglottic secretion, daily sedation vacation protocol, daily extubation assessment results, and hand hygiene. After collecting the data, the compliance of VCB, ventilator use ratio, and the incidence rate of VAP in these 2 groups were compared. RESULTS: We observed that compliance with all of the intervention measures for VCB improved results in the intervention group compared to the control. Furthermore, the compliance rate of hand hygiene increased from 71.99% to 91.97%, and the head-of-bed elevation of 30°-45° increased from 62.02% to 85.96%. All differences between these two groups were statistically significant, according to the χ 2 -test. The ventilator use ratio was statistically and significantly lower in the intervention group (34.86%) compared to the control group (40.29%) (χ 2 =95.513, P<0.001). The incidence rate of VAP was statistically and significantly lower in the intervention group (13.70‰) compared to the control group (18.85‰) (χ 2 =5.471, P=0.019). CONCLUSIONS: Our results show that VCB prevents VAP. Therefore, personnel training, clinical supervision, and surveillance feedback could promote a reduction in intervention measures.

14.
Environ Sci Technol ; 54(19): 12335-12344, 2020 Oct 06.
Artigo em Inglês | MEDLINE | ID: mdl-32835475

RESUMO

Pentabromoethylbenzene (PBEB), as one of the novel brominated flame retardants (NFBRs), has caused increasing public concern for health risks. Till now, information regarding potential effects of PBEB on thyroid function remains unclear. Herein, we investigated thyroid disruption of PBEB in vitro and in silico and evaluated thyroid dysfunction induced by PBEB using Sprague-Dawley rats. PBEB showed thyroid receptor (TR) ß antagonistic activity with IC50 of 9.82 × 10-7 M in the dual-luciferase reporter gene assay and induced relative reorientation of helix 11 (H11) and H12 of the TR ligand binding domain as revealed by molecular dynamics simulations. PBEB (0.2, 2, 20 mg/kg BW/d) markedly altered the transcriptome profile of thyroid with induction of 17, 42, and 119 differentially expressed genes (DEGs) involved in thyroid hormone signaling and synthesis pathway, of which transthyretin and albumin are common DEGs. The 28-d exposure to PBEB significantly decreased the triiodothyronine level (from 7.23 to 5.67 ng/mL) and increased the thyrotropin level (from 7.88 to 12.86 mU/L) for female rats. PBEB consequently reduced thyroid weight and altered its morphology with more depleted follicles. Overall, our study provides the first account of evidence on PBEB exerted thyroid disruption, transcriptome aberration, and morphological alteration, facilitating health risk assessment of PBEB and structurally related NBFRs.

15.
Environ Int ; 144: 106012, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32771830

RESUMO

Per- and polyfluoroalkyl substances (PFASs) are ubiquitous in the environment, making it inevitable for humans to be exposed to these pollutants. The exposure begins while in utero and continues in infancy, during the potentially most sensitive early stages of life. This review summarizes the current knowledge on pre- and neo-natal exposures based on more than 200 articles published from 2000 to date. All relevant biological matrices used in the cited studies were included, such as maternal blood, umbilical cord blood, breast milk, placenta, amniotic fluid, fetal organs, newborns' dried blood spots, and infant serum. We show that such exposures are geographically global with significant discrepancies among countries and continents, and that while the levels of major legacy PFASs (PFOS and PFOA) have declined since 2000, those of others may have not. We also show that levels of PFOS and PFOA exceed those of some major environmental toxins, such as p,p'-DDE, BDE-47, PCB-153, PBB-153, and OH-PBDEs in maternal blood. Given that the behavior and potential effects have an origin in molecular structure, biomonitoring and research at the levels of isomers and enantiomers are critically important. Through critical analysis of these works, we summarize the major achievements, consensus, and the deficiencies of existing research. To our knowledge, this is the first review on the overall internal exposure status of mothers and infants to PFASs during pregnancy and lactation.

16.
Seizure ; 81: 63-70, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32759029

RESUMO

PURPOSE: To assess the performance of the Antibody Prevalence in Chinese Patients with Epilepsy and Encephalopathy (APE2-CHN) and Response to Immunotherapy in Chinese Patients with Epilepsy and Encephalopathy (RITE2-CHN) scores in Chinese patients with epilepsy of unknown etiology. METHODS: We conducted a retrospective study of selected patients from Xiangya Hospital, Central South University (01/01/2017-02/28/2019) whose serum and/or cerebrospinal fluid (CSF) samples were examined for autoimmune encephalitis antibodies. Of these, patients with diagnostic code of seizure or epilepsy were selected in our study. An APE2-CHN score was assigned to each patient and a RITE2-CHN score was calculated for each patient who received immunotherapy. Receiver-operating characteristic (ROC) curve was used to assess each score. RESULTS: 191 patients were enrolled in our study. 36 were identified with specific etiologies. The remaining 155 patients had unknown etiology. Central nervous system-specific antibodies were detected in 76 (49.0 %) patients, after excluding patients with only anti-thyroid peroxidase or glutamic acid decarboxylase antibodies. N-methyl-d-aspartate receptor (NMDAR) antibody (48.7 %, 37/76) was the most common subtype of our sample, followed by γ-aminobutyric acid type B receptor (GABAR) (14.5 %, 11/76). Clinical features including new-onset epilepsy, neuropsychiatric changes, speech disorder, movement disorder and inflammatory CSF profile correlated with positive antibody results. The sensitivity and specificity of APE2-CHN ≥ 5 in predicting the presence of neural-specific autoantibodies in our study were 85.5 % and 58.9 % respectively. In the subset of patients who received immunotherapy (n = 112), sensitivity and specificity of a RITE2 -CHN ≥ 8 in predicting favorable seizure outcome were 98.6 % and 63.2 % respectively. The area under the curve (AUC) of RITE2-CHN was greater than that of RITE2 (Z = 3.196, p < 0.05) while there was no significant difference in AUC between APE2 and APE2-CHN (Z = 1.058, p = 0.290). CONCLUSION: The APE2-CHN and RITE2-CHN scores may be useful screening tools in predicting positive antibody findings and prognosis of suspected autoimmune seizures or associated epilepsy in the Chinese population.

17.
Cardiovasc Toxicol ; 2020 Jul 18.
Artigo em Inglês | MEDLINE | ID: mdl-32683546

RESUMO

Anthracycline-related cardiotoxicity is an important dose-limiting toxicity for Hodgkin lymphoma (HL) treatment. This study aimed to assess the efficacy and safety of pegylated liposomal doxorubicin (PLD) for HL treatment. Patients with newly diagnosed HL treated with at least two cycles of PLD-containing chemotherapy were retrospectively analyzed. The dosing and scheduling of the PLD-containing regimen (the PBVD regimen) were as follows: PLD 25 mg/m2, vincristine 1.4 mg/m2 (maximum dose of 2 mg), bleomycin 10 mg/m2, and dacarbazine 375 mg/m2 at days l and 15, repeated every 28 days. Forty-six HL patients were analyzed. The median age was 41.5 years (range 12-77 years), with a male/female ratio of 0.9:1. Fourteen (30%) patients had an Eastern Cooperative Oncology Group (ECOG) performance status score > 1, and 32 (70%) had a history of cardiovascular disease (CVD) or related risk factors. The median chemotherapy cycle number with the PBVD regimen was 6 (range, 2-8). The overall response rate (ORR) was 91% for the whole cohort; 35 (76%) patients achieved complete remission (CR), and 7 (15%) achieved partial remission. The efficacy of the PBVD regimen was similar in patients with or without CVD or related risk factors (ORR 93% vs. 91%, P = 1.00; CR 86% vs. 72%, P = 0.46). With a median follow-up of 28.5 months, the 3-year progression-free survival (PFS) and overall survival (OS) rates were 70% and 82%, respectively, for the whole cohort. The differences in the PFS and OS rates between the groups with or without CVD or related risk factors were not significant. Cardiotoxicity was observed in 6 (13%) patients. All adverse events were grades 1-2. The PBVD regimen is an effective chemotherapy option with tolerable toxicity, and it could be a substitute in HL patients who cannot be treated with conventional doxorubicin, especially those with CVD or related risk factors.

18.
Int J Immunopathol Pharmacol ; 34: 2058738420941756, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32664812

RESUMO

Anaplastic lymphoma kinase (ALK)-positive anaplastic large cell lymphoma (ALK + ALCL) is most frequent in youth and possesses a broad morphologic spectrum. However, involvement in central nervous system (CNS) is definitely rare. The case we presented was a 12-year-old Chinese male who presented with headache and emesis for a couple of days. The neoplastic component was smaller cells resembling starry-sky growth pattern and immunohistochemical stained positively for CD30, ALK1, and CD56. Monoclonal T-cell receptor (TCRγ) gene rearrangement and gene translocation involving ALK identified by fluorescence in situ hybridization (FISH) using ALK break apart probe supported the diagnosis of ALK + ALCL. This case showed ALK + ALCL occur in a rare site with an abnormal CD56 expression. Awareness of this entity is important to distinguish it from other intracranial lymphoma.

19.
Ann Palliat Med ; 9(4): 1545-1555, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32692197

RESUMO

BACKGROUND: The objective of this study was to understand the distribution and drug resistance of healthcare-associated infection (HAI) pathogens in an intensive care unit (ICU) of a general tertiary hospital in Inner Mongolia, and to classify carbapenem-resistant Acinetobacter baumannii (CR-AB) in ICU patients and environmental samples. Additionally, this study aimed to provide scientific evidence for the use of clinical antibiotics and effective prevention and control measures for CR-AB outbreak. METHODS: The distribution and drug resistance of pathogens isolated from patient's samples in the ICU of 12 Hospitals from January to May 2019 were retrospectively analyzed. Meanwhile, CR-AB isolated from patients and environmental samples were collected and classified by pulsed-field gel electrophoresis (PFGE). RESULTS: The pathogens isolated from ICU samples, mainly Gram-negative bacteria (63.07%), were CR-AB, Klebsiella pneumoniae, and Pseudomonas aeruginosa; the main Gram-positive bacteria (22.13%) were Enterococcus faecium and Staphylococcus aureus; and fungi accounted for the remaining (14.80%). The samples mainly came from sputum (41.09%). Among non-fermenting bacteria, the resistance rates of CRAB to piperacillin, piperacillin/tazobactam, and other treatments were higher than those of Pseudomonas aeruginosa (P<0.05). Meanwhile, the resistance rates to ampicillin/sulbactam and compound sulfamethoxazole were lower than those of Pseudomonas aeruginosa (P<0.05). The resistance rates of Klebsiella pneumoniae to piperacillin/tazobactam, ceftazidime, and others were higher than those of Escherichia coli (P<0.05). Among Gram-positive bacteria, the resistance rates of Enterococcus faecium to erythromycin, clindamycin, and other treatment were higher than those of Staphylococcus aureus (P<0.05). A total of 62 bands were obtained from 63 strains of CR-AB by electrophoresis. Also, 16 clusters (A-P) were obtained with a 74% similarity coefficient, among which K, L, and N types (more than 9 strains) were more common. CONCLUSIONS: Gram-negative bacteria were the primary pathogens of HAI in the ICU, and their drug resistance was serious. There is homology in the PFGE typing of CR-AB. Therefore, hospitals should strengthen the surveillance of drug-resistant pathogenic bacteria. Additionally, further cleaning and disinfection measures are needed to improve environmental hygiene and prevent outbreaks of HAI.

20.
Ann Palliat Med ; 9(4): 1536-1544, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32692198

RESUMO

BACKGROUND: Healthcare-associated infection (HAI) is a crucial factor influencing medical quality. Studies about HAI management situations are rare, especially for the Inner Mongolia region of China. Therefore, this study aimed to investigate management procedures and the overall evaluation of HAI in order to inform HAI management improvement more scientifically. METHODS: A questionnaire was used to investigate HAI-related prevention and control indicators in tertiary hospitals in the Inner Mongolia region from July 2018 to June 2019. RESULTS: The survey showed that the mean incidence rate of HAI was 3.79%. The mean rate of hand hygiene compliance of healthcare workers (HCWs), inpatient's antibiotics-use rate, and the detection of the antibiotic ratio before therapy was 54.34%, 34.33%, and 25.40%, respectively. The mean of the surgical site infection (SSI) rate of the level I incision and the preventive antibiotics-use ratio of the level I incision was 1.31% and 28.89%, respectively. The mean of the multi-drug resistant organism (MDRO) infection rate was 0.40% and the mean of the MDRO detection rate was 18.55%. The mean of the central line-associated bloodstream infection rate was 2.24%, the ventilator-associated pneumonia (VAP) rate was 11.17%, and the catheter-associated urinary tract infection (CAUTI) rate was 1.95‰. As for the overall evaluation, 19 (35.85%) hospitals had a bad grade, 18 (33.96%) hospitals had a medium grade, and 16 (30.19%) hospitals had a good grade. CONCLUSIONS: The incidence rate of HAI in tertiary hospitals in the Inner Mongolia region is higher than the national level. Also, the overall evaluation of bad-grade hospitals and their deficiencies should be used as an example to improve the HAI management level.

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