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1.
Food Res Int ; 149: 110648, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34600650

RESUMO

Mounting evidence suggests a critical role of gut microbiota in human colon health. Early life is a key developmental growth period, especially for building up gut microbiota and strengthening the colonic barrier. The connection between host colon and gut microbiota especially during early life is an area of increasing interest to researchers, also polyphenols improve host health through modulating this complex relationship. Postweaning (three-week-old) and adult (six-week-old) mice kept under specific pathogen-free conditions were used to investigate how early-life grape polyphenols supplementation influence the association between host colon and gut microbiota. Before grape polyphenols supplementation, postweaning mice had a higher original absolute abundance of Lactobacillus compared to adult mice. A 2-week grape polyphenols supplementation significantly boosted the abundance of Akkermansia and Lactobacillus and increased Lactobacillus-secreted lactate in postweaning mice. Early-life grape polyphenols supplementation also promoted the bloom of goblet cells and mucin 2, which benefitted both Akkermansia growth and colonic barrier. Moreover, the grape polyphenols-modulated bone morphogenetic protein (BMP), Notch and Wnt3 pathways triggered the bloom of goblet cells in GPs-administrated postweaning mice, and the increase in lactate could modulate those pathways. Meanwhile, adult mice were not affected by grape polyphenols supplementation. These results suggested that early-life polyphenol supplementation promoted Akkermansia growth and colonic barrier, which was in association with the sufficient abundance of Lactobacillus during early life. This study also indicated that Lactobacillus interact with Akkermansia through changing the physiology of host colonic goblet cells.

2.
Plast Reconstr Surg ; 2021 Oct 13.
Artigo em Inglês | MEDLINE | ID: mdl-34644267

RESUMO

BACKGROUND: Exposure to ultraviolet radiation causes erythema, inflammation, and photoaging. Mechanical micronization of adipose tissue can concentrate functional cells and has great potential as an alternative for regenerative medicine. Stromal vascular fraction gel is produced by means of a series of mechanical processes of lipoaspirates and can be injected intradermally. This study aimed to assess the therapeutic effect of stromal vascular fraction gel on photoaging skin. METHODS: A photoaging model was established in nude mice. Photoaging mice received treatments of stromal vascular fraction gel, fat, tretinoin, or phosphate-buffered saline. Photoaging skin was characterized by histologic and immunohistochemical analyses. Expression of collagen synthesis-related or photoaging-related genes was assessed. RESULTS: Stromal vascular fraction gel, fat, and tretinoin reversed photoaging, whereas stromal vascular fraction gel demonstrated the greatest therapeutic effect. Treatment with stromal vascular fraction gel restored intradermal fat tissue content and increased dermal collagen density. Injection of stromal vascular fraction gel had the strongest effect on stimulating fibroblasts and increasing the expression of transforming growth factor ß1 (TGF-ß1), propeptide of type-I procollagen, and Smad 2, decreasing the expression of Smad 3, compared with fat and tretinoin. Expression of photoaging-related genes was significantly reduced, whereas expression of fibulin-5 was significantly increased after stromal vascular fraction gel treatment. CONCLUSIONS: Stromal vascular fraction gel demonstrated remarkable therapeutic effects in reversing photoaging skin. Stromal vascular fraction gel can be injected intradermally and survive within dermal layer after grafting. This product increased TGF-ß1 expression and activated fibroblasts to produce propeptide of type I procollagen, thus increasing the amount of collagen I, leading to thickening of the dermis of photoaging skin.

3.
Sci Rep ; 11(1): 20097, 2021 Oct 11.
Artigo em Inglês | MEDLINE | ID: mdl-34635719

RESUMO

Dysnatremia and dyskalemia are common problems in acutely hospitalized elderly patients. These disorders are associated with an increased risk of mortality and functional complications that often occur concomitantly with acute kidney injury in addition to multiple comorbidities. In a single-center prospective observational study, we recruited 401 acute geriatric inpatients. In-hospital outcomes included all-cause mortality, length of stay, and changes in functional status as determined by the Activities of Daily Living (ADL) scale, Eastern Cooperative Oncology Group (ECOG) performance, and Clinical Frailty Scale (CFS). The prevalence of dysnatremia alone, dyskalemia alone, and dysnatremia plus dyskalemia during initial hospitalization were 28.4%, 14.7% and 32.4%, respectively. Patients with electrolyte imbalance exhibited higher mortality rates and longer hospital stays than those without electrolyte imbalance. Those with initial dysnatremia, or dysnatremia plus dyskalemia were associated with worse ADL scores, ECOG performance and CFS scores at discharge. Subgroup analyses showed that resolution of dysnatremia was related to reduced mortality risk and improved CFS score, whereas recovery of renal function was associated with decreased mortality and better ECOG and CFS ratings. Our data suggest that restoration of initial dysnatremia and acute kidney injury during acute geriatric care may benefit in-hospital survival and functional status at discharge.

4.
Phys Rev Lett ; 127(14): 147401, 2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-34652196

RESUMO

Symmetries play a major role in identifying topological phases of matter and in establishing a direct connection between protected edge states and topological bulk invariants via the bulk-boundary correspondence. One-dimensional lattices are deemed to be protected by chiral symmetry, exhibiting quantized Zak phases and protected edge states, but not for all cases. Here, we experimentally realize an extended Su-Schrieffer-Heeger model with broken chiral symmetry by engineering one-dimensional zigzag photonic lattices, where the long-range hopping breaks chiral symmetry but ensures the existence of inversion symmetry. By the averaged mean displacement method, we detect topological invariants directly in the bulk through the continuous-time quantum walk of photons. Our results demonstrate that inversion symmetry protects the quantized Zak phase but edge states can disappear in the topological nontrivial phase, thus breaking the conventional bulk-boundary correspondence. Our photonic lattice provides a useful platform to study the interplay among topological phases, symmetries, and the bulk-boundary correspondence.

5.
Zhongguo Zhen Jiu ; 41(9): 1029-35, 2021 Sep 12.
Artigo em Chinês | MEDLINE | ID: mdl-34491654

RESUMO

OBJECTIVE: To investigate the mechanism of electroacupuncture (EA) with the involvement of sarcoplasmic reticulum Ca2+-ATPase2a (SERCA2a)/phospholamban (PLB) on the synergistic and attenuated effect of aconitine for heart failure. METHODS: Thirty SPF-ranked SD rats were randomly divided into a control group, a model group, an EA group, an aconitine group and an EA plus aconitine group, with 6 rats in each group. The rat model of acute heart failure was established by infusion of high-dose propranolol hydrochloride solution into the right femoral vein. After stabilized for 10 min in the modeled rats, EA was exerted at "Neiguan" (PC 6), with disperse-dense wave, 2 Hz/15 Hz in frequency, 3 mA in intensity, for 30 min in the EA group and the EA plus aconitine group; aconitine solution (10 µg/kg) was injected from the left femoral veins in the rats in the aconitine group and the EA plus aconitine group. Hemodynamic indexes such as the left ventricular systolic pressure (LVSP) and the maximum rate of increase/decrease of left ventricular pressure (±dp/dtmax) were detected and arrhythmia types were observed and scored. SERCA2a protein and PLB protein expressions in left ventricular myocardial tissue of rats were detected by multiplex fluorescence Western blot. RESULTS: Compared with the control group, LVSP and ±dp/dtmax all were decreased after modeling and at each time point after intervention in the model group (P<0.01). Compared with the model group, ±dp/dtmax was increased in the aconitine group and the EA group at 1 min after intervention (P<0.01, P<0.05), +dp/dtmax was increased at 10 to 60 min after intervention in the aconitine group and at 20 to 60 min after intervention in the EA group (P<0.01, P<0.05), LVSP was increased at 1 min after intervention in the EA group (P<0.01), while LVSP and ±dp/dtmax were all increased at 1 to 60 min after intervention in the EA plus aconitine group (P<0.01, P<0.05). Compared with the aconitine group, LVSP and +dp/dtmax were increased at 1 min after intervention in the EA group (P<0.01, P<0.05), LVSP and ±dp/dtmax at 1 min after intervention while +dp/dtmax at 20 to 60 min after intervention were all increased in the EA plus aconitine group (P<0.01, P<0.05). Compared with the EA group, +dp/dtmax was higher at 10 to 60 min after intervention in the EA plus aconitine group (P<0.01). Compared with the model group, arrhythmia score was higher in the aconitine group (P<0.01). Compared with the aconitine group, arrhythmia score was lower in the EA group and the EA plus aconitine group (P<0.01). As compared with the control group, the expression of SERCA2a protein in the left ventricular cardiomyocytes was decreased (P<0.01), while the expression of PLB protein was increased in the model group (P<0.01). Compared with the model group, the expression of SERCA2a protein was increased in both the EA group and the EA plus aconitine group (P<0.05, P<0.01), and PLB protein expression was decreased in each intervention group respectively (P<0.01, P<0.05). As compared with the EA group and the aconitine group, the expression of SERCA2a protein was increased and the expression of PLB protein was decreased in the EA plus aconitine group separately (P<0.05, P<0.01). CONCLUSION: The intervention with electroacupuncture achieves the synergism/ attenuation effect of aconitine for the improvements in heart failure probably by up-regulating the expression of SERCA2a and down-regulating the expression of PLB in myocardial tissue.


Assuntos
Eletroacupuntura , Insuficiência Cardíaca , Aconitina , Animais , Proteínas de Ligação ao Cálcio , Insuficiência Cardíaca/terapia , Ratos , Ratos Sprague-Dawley
6.
Artigo em Inglês | MEDLINE | ID: mdl-34495852

RESUMO

Though deep learning has shown successful performance in classifying the label and severity stage of certain diseases, most of them give few explanations on how to make predictions. Inspired by Koch's Postulates, the foundation in evidence-based medicine (EBM) to identify the pathogen, we propose to exploit the interpretability of deep learning application in medical diagnosis. By isolating neuron activation patterns from a diabetic retinopathy (DR) detector and visualizing them, we can determine the symptoms that the DR detector identifies as evidence to make prediction. To be specific, we first define novel pathological descriptors using activated neurons of the DR detector to encode both spatial and appearance information of lesions. Then, to visualize the symptom encoded in the descriptor, we propose Patho-GAN, a new network to synthesize medically plausible retinal images. By manipulating these descriptors, we could even arbitrarily control the position, quantity, and categories of generated lesions. We also show that our synthesized images carry the symptoms directly related to diabetic retinopathy diagnosis. Our generated images are both qualitatively and quantitatively superior to the ones by previous methods. Besides, compared to existing methods that take hours to generate an image, our second level speed endows the potential to be an effective solution for data augmentation.

7.
J Am Coll Cardiol ; 78(10): 1015-1024, 2021 Sep 07.
Artigo em Inglês | MEDLINE | ID: mdl-34474733

RESUMO

BACKGROUND: Heavy fine particulate matter with an aerodynamic diameter ≤2.5 µm (PM2.5) pollution events continue to occur frequently in developing countries. OBJECTIVES: The authors conducted a case-crossover study aimed at exploring the association between heavy PM2.5 pollution events and hospital admission for cardiovascular diseases. METHODS: Hospital admissions for cardiovascular diseases were observed by Beijing Municipal Commission of Health and Family Planning Information Center from 2013 to 2017. Air pollution data were collected from the Beijing Municipal Environmental Monitoring Center. Distinct definitions were used to identify heavy and extremely heavy fine particulate pollution events. A conditional logistic regression model was used. The hospital admission burdens for cardiovascular disease were also estimated. RESULTS: A total of 2,202,244 hospital admissions for cardiovascular diseases and 222 days of extremely heavy PM2.5 pollution events (PM2.5 concentration ≥150 µg/m3) were observed. The ORs associated with extremely heavy PM2.5 pollution events lasting for 3 days or more for total cardiovascular disease, angina, myocardial infarction, ischemic stroke, and heart failure were 1.085 (95% CI: 1.077-1.093), 1.112 (95% CI: 1.095-1.130), 1.068 (95% CI: 1.037-1.100), 1.071 (95% CI: 1.053-1.090), and 1.060 (95% CI: 1.021-1.101), respectively. The numbers and days of cardiovascular disease hospital admission annually related to extremely heavy PM2.5 pollution events lasting for 1 day or more were 3,311 (95% CI: 2,969-3,655) and 37,020 (95% CI: 33,196-40,866), respectively. CONCLUSIONS: Heavy and extremely heavy PM2.5 pollution events resulted in substantial increased hospital admission risk for cardiovascular disease. With higher PM2.5 concentration and longer duration of heavy PM2.5 pollution events, a greater risk of cardiovascular hospital admission was observed.

8.
Artigo em Inglês | MEDLINE | ID: mdl-34559637

RESUMO

This paper presents a photometric stereo method that works with unknown natural illumination without any calibration objects or initial guess of the target shape. To solve this challenging problem, we propose the use of an equivalent directional lighting model for small surface patches consisting of slowly varying normals, and solve each patch up to an arbitrary orthogonal ambiguity. We further build the patch connections by extracting consistent surface normal pairs via spatial overlaps among patches and intensity profiles. Guided by these connections, the local ambiguities are unified to a global orthogonal one through Markov Random Field optimization and rotation averaging. After applying the integrability constraint, our solution contains only a binary ambiguity, which could be easily removed. Experiments using both synthetic and real-world datasets show our method provides even comparable results to calibrated methods.

9.
Front Biosci (Landmark Ed) ; 26(9): 572-589, 2021 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-34590468

RESUMO

Introduction: The ambiguity of the drug target is one of the major factors restricting the development of traditional Chinese medicine (TCMs) and its bioactive constituents. The characteristics of "multiple components, multiple targets and multiple pathways" of TCMs make the research of drug targets extremely difficult. With the emergence of new theories, there are increasing technologies and strategies that can be used for the drug targets research of TCMs. In this paper, we summarize several techniques and methods applied to the study of TCM targets. Methods: Through consulting a large number of literature, research and summary, and finally summarized the application direction of the technical method, advantages and limitations. Results: The methods and techniques including computer aided drug design, network pharmacology, phage display, affinity fishing, drug affinity responsive target stability and cellular thermal shift assay were summarized, and their application directions, advantages and disadvantages were discussed. At the same time, a large number of application examples were given to provide reference for the research of TCM targets.

10.
Circulation ; 144(14): 1120-1129, 2021 Oct 05.
Artigo em Inglês | MEDLINE | ID: mdl-34510911

RESUMO

BACKGROUND: Vein graft occlusion is deemed a major challenge in coronary artery bypass grafting. Previous studies implied that the no-touch technique for vein graft harvesting could reduce occlusion rate compared with the conventional approach; however, evidence on the clinical benefit and generalizability of the no-touch technique is scare. METHODS: From April 2017 to June 2019, we randomly assigned 2655 patients undergoing coronary artery bypass grafting at 7 hospitals in a 1:1 ratio to receive no-touch technique or conventional approach for vein harvesting. The primary outcome was vein graft occlusion on computed tomography angiography at 3 months and the secondary outcomes included 12-month vein graft occlusion, recurrence of angina, and major adverse cardiac and cerebrovascular events. The generalized estimate equation model was used to account for the cluster effect of grafts from the same patient. RESULTS: During the follow-up, 2533 (96.0%) participants received computed tomography angiography at 3 months after coronary artery bypass grafting and 2434 (92.2%) received it at 12 months. The no-touch group had significantly lower rates of vein graft occlusion than the conventional group both at 3 months (2.8% versus 4.8%; odds ratio, 0.57 [95% CI, 0.41-0.80]; P<0.001) and 12 months (3.7% versus 6.5%; odds ratio, 0.56 [95% CI, 0.41-0.76]; P<0.001). Recurrence of angina was also less common in the no-touch group at 12 months (2.3% versus 4.1%; odds ratio, 0.55 [95% CI, 0.35-0.85]; P<0.01). Rates of major adverse cardiac and cerebrovascular events were of no significant difference between the 2 groups. The no-touch technique was associated with higher rates of leg wound surgical interventions at 3-month follow-up (10.3% versus 4.3%; odds ratio, 2.55 [95% CI, 1.85-3.52]; P<0.001). CONCLUSIONS: Compared with the conventional vein harvesting approach in coronary artery bypass grafting, the no-touch technique significantly reduced the risk of vein graft occlusion and improved patient prognosis. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT03126409.

11.
Plast Reconstr Surg ; 2021 Sep 20.
Artigo em Inglês | MEDLINE | ID: mdl-34546185

RESUMO

BACKGROUND: Large-volume fat grafting results in high absorption and complication rates. Low-density fat includes small numbers of viable cells and considerable oil, resulting in nodules and oil cysts. This study evaluated a strategy for large-volume fat grafting using a mechanical process to condense low-density fat and transplanting it with high-density fat. METHODS: Low-density fat, defined as the upper half of centrifuged lipoaspirates, was emulsified by intersyringe shifting and centrifuged to obtain condensed low-density fat. Fresh condensed low-density fat was analyzed by counting cells in the stromal vascular fraction, and by electron scanning and Western blotting. The retention rate and histologic changes of the product were analyzed using a fat grafting model in nude mice. Transplantation with a combination of condensed low-density fat and high-density fat was tested in patients undergoing breast reconstruction and breast augmentation. RESULTS: The condensed low-density fat derived from low-density fat contained a large number of stromal vascular fraction cells and collagens, comparable to high-density fat and much higher than low-density fat and Coleman fat. Retention rates 12 weeks after transplantation were higher for condensed low-density fat (55.0 ± 7.5 percent) than for low-density fat (31.1 ± 5.7 percent) and Coleman fat (41.1 ± 6.8 percent), with condensed low-density fat having fewer oil cysts and lower macrophage infiltration. Patients grafted with combined condensed low-density fat and high-density fat showed good long-term volume retention. CONCLUSIONS: Using mechanical methods to condense low-density fat to a level comparable to high-density fat is a practical method of improving fat graft retention and avoiding severe complications. This new strategy may improve the quality of lipoaspirates for patients requiring large-volume augmentation.

12.
Ecotoxicol Environ Saf ; 226: 112794, 2021 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-34592518

RESUMO

BACKGROUND: Scientific studies have identified various adverse effects of particulate matter (PM) on respiratory disease (RD) and type 2 diabetes (T2D). However, whether short-term exposure to PM triggers the onset of RD with T2D, compared with RD without T2D, has not been elucidated. METHODS: A two-stage time-series study was conducted to evaluate the acute adverse effects of PM on admission for RD and for RD with and without T2D in Beijing, China, from 2014 to 2020. District-specific effects of PM2.5 and PM10 were estimated using the over-dispersed Poisson generalized addictive model after adjusting for weather conditions, day of the week, and long-term and seasonal trends. Meta-analyses were applied to pool the overall effects on overall and cause-specific RD, while the exposure-response (E-R) curves were evaluated using a cubic regression spline. RESULTS: A total of 1550,154 admission records for RD were retrieved during the study period. Meta-analysis suggested that per interquartile range upticks in the concentration of PM2.5 corresponded to 1.91% (95% CI: 1.33-2.49%), 2.16% (95% CI: 1.08-3.25%), and 1.92% (95% CI: 1.46-2.39%) increments in admission for RD, RD with T2D, and RD without T2D, respectively, at lag 0-8 days, lag 8 days, and lag 8 days. The effect size of PM2.5 was statistically significantly higher in the T2D group than in the group without T2D (z = 3.98, P < 0.01). The effect sizes of PM10 were 3.86% (95% CI: 2.48-5.27%), 3.73% (95% CI: 1.72-5.79%), and 3.92% (95% CI: 2.65-5.21%), respectively, at lag 0-13 days, lag 13 days, and lag 13 days, respectively, and no statistically significant difference was observed between T2D groups (z = 0.24, P = 0.81). Significant difference was not observed between T2D groups for the associations of PM and different RD and could be found between three groups for effects of PM10 on RD without T2D. The E-R curves varied by sex, age and T2D condition subgroups for the associations between PM and daily RD admissions. CONCLUSIONS: Short-term PM exposure was associated with increased RD admission with and without T2D, and the effect size of PM2.5 was higher in patients with T2D than those without T2D.

13.
BMC Health Serv Res ; 21(1): 870, 2021 Aug 25.
Artigo em Inglês | MEDLINE | ID: mdl-34433448

RESUMO

BACKGROUND/PURPOSE: Early unplanned hospital readmissions are burdensome health care events and indicate low care quality. Identifying at-risk patients enables timely intervention. This study identified predictors for 14-day unplanned readmission. METHODS: We conducted a retrospective, matched, case-control study between September 1, 2018, and August 31, 2019, in an 1193-bed university hospital. Adult patients aged ≥ 20 years and readmitted for the same or related diagnosis within 14 days of discharge after initial admission (index admission) were included as cases. Cases were 1:1 matched for the disease-related group at index admission, age, and discharge date to controls. Variables were extracted from the hospital's electronic health records. RESULTS: In total, 300 cases and 300 controls were analyzed. Six factors were independently associated with unplanned readmission within 14 days: previous admissions within 6 months (OR = 3.09; 95 % CI = 1.79-5.34, p < 0.001), number of diagnoses in the past year (OR = 1.07; 95 % CI = 1.01-1.13, p = 0.019), Malnutrition Universal Screening Tool score (OR = 1.46; 95 % CI = 1.04-2.05, p = 0.03), systolic blood pressure (OR = 0.98; 95 % CI = 0.97-0.99, p = 0.01) and ear temperature within 24 h before discharge (OR = 2.49; 95 % CI = 1.34-4.64, p = 0.004), and discharge with a nasogastric tube (OR = 0.13; 95 % CI = 0.03-0.60, p = 0.009). CONCLUSIONS: Factors presented at admission (frequent prior hospitalizations, multimorbidity, and malnutrition) along with factors presented at discharge (clinical instability and the absence of a nasogastric tube) were associated with increased risk of early 14-day unplanned readmission.


Assuntos
Alta do Paciente , Readmissão do Paciente , Adulto , Estudos de Casos e Controles , Humanos , Estudos Retrospectivos , Fatores de Risco
14.
IEEE Trans Image Process ; 30: 7280-7291, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34403344

RESUMO

Since specular reflection often exists in the real captured images and causes deviation between the recorded color and intrinsic color, specular reflection separation can bring advantages to multiple applications that require consistent object surface appearance. However, due to the color of an object is significantly influenced by the color of the illumination, the existing researches still suffer from the near-duplicate challenge, that is, the separation becomes unstable when the illumination color is close to the surface color. In this paper, we derive a polarization guided model to incorporate the polarization information into a designed iteration optimization separation strategy to separate the specular reflection. Based on the analysis of polarization, we propose a polarization guided model to generate a polarization chromaticity image, which is able to reveal the geometrical profile of the input image in complex scenarios, e.g., diversity of illumination. The polarization chromaticity image can accurately cluster the pixels with similar diffuse color. We further use the specular separation of all these clusters as an implicit prior to ensure that the diffuse component will not be mistakenly separated as the specular component. With the polarization guided model, we reformulate the specular reflection separation into a unified optimization function which can be solved by the ADMM strategy. The specular reflection will be detected and separated jointly by RGB and polarimetric information. Both qualitative and quantitative experimental results have shown that our method can faithfully separate the specular reflection, especially in some challenging scenarios.

15.
J Tradit Chin Med ; 41(4): 624-629, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34392656

RESUMO

OBJECTIVE: To investigate the effect of entecavir plus Ganshuang granule (, GSG) on advanced fibrosis and cirrhosis in patients with chronic hepatitis B virus infection. METHODS: One hundred thirty-five patients were randomly assigned to one of two cohorts: GSG cohort (n = 69) or placebo cohort (n = 66). The GSG cohort received entecavir plus GSG and the placebo cohort received entecavir plus placebo for 48 weeks. Liver biopsy was performed at baseline and between weeks 44 and 48 during this placebo-controlled trial. We assessed histological improvement (greater than a two-point decrease using the Knodell in fl ammatory score and no worsening of the Ishak fibrosis score) and fibrosis regression (a decrease of at least one point in the Ishak fibrosis score). RESULTS: There were 95.7% of patients (66/69) in the GSG cohort and 66.7% (44/66) of patients in the placebo cohort who showed necroin fl ammation improvement. The mean reduction in the Knodell necroinflammatory score was 5.1 and 2.6, respectively. There were 89.9% (62/69) of patients in the GSG cohort and 31.8% (21/66) of patients in the placebo cohort who showed at least a one-point improvement in the Ishak fibrosis score. The mean reduction in the Ishak fibrosis score was 1.7 and 0.4, respectively. CONCLUSION: Patients with advanced fibrosis and cirrhosis caused by chronic hepatitis B showed more improvement in liver histology in a shorter time after treatment with entecavir plus GSG compared with entecavir plus placebo.

16.
Environ Pollut ; 289: 117858, 2021 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-34388554

RESUMO

Evidence on the relationship between particulate matter air pollution and urinary system disease (UD) is scarce. This study aims to evaluate the associations between short-term exposures to PM2.5 and PM10 and risk of daily UD inpatient hospital admissions through the emergency room (ER-admissions) in Beijing. We obtained 41,203 weekday UD ER-admissions for secondary and tertiary hospitals in all 16 districts in Beijing during 2013-2018 from the Beijing Municipal Health Commission Information Center and obtained district-level air pollution concentrations based on 35 fixed monitoring stations in Beijing. We conducted a two-stage time-series analysis, with district-specific generalized linear models for each of Beijing's 16 districts, followed by random effects meta-analysis to obtain pooled risk estimates. We evaluated lagged and cumulative associations up to 30 days. In single-pollutant models, for both PM2.5 and PM10, cumulative exposure averaged over the day of admission and the previous 10 days (lag 0-10 days) showed the strongest association, with per interquartile range increases of PM2.5 or PM10 concentrations associated with a 7.5 % (95 % confidence interval [CI]: 3.0 %-12.2 %) or 6.0 % (95 % CI: 1.1 %-11.2 %) increased risk of daily UD hospital admissions, respectively. The risk estimates were robust to adjustment for co-pollutants and to a variety of sensitivity analyses. However, due to the strong correlation between PM2.5 and PM10 concentrations, we were unable to disentangle the respective relationships between these two exposures and UD risk. In this study, we found that short-term exposures to PM2.5 and PM10 are risk factors for UD morbidity and that cumulative exposure to PM pollution over a period of one to two weeks (i.e., 11 days) could be more important for UD risk than transient exposure during each of the respective single days.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Poluentes Atmosféricos/análise , Poluição do Ar/análise , Pequim/epidemiologia , China/epidemiologia , Serviço Hospitalar de Emergência , Hospitais , Humanos , Material Particulado/análise , Fatores de Tempo
17.
Environ Res ; 202: 111634, 2021 Jul 06.
Artigo em Inglês | MEDLINE | ID: mdl-34242673

RESUMO

The complex interactions of contaminants with microplastics significantly affect ecological risk assessments. Studies of the sorption behavior of freely dissolved hydrophobic organic contaminants (HOCs) on microplastics are common. However, concentrations of HOCs in the actual aquatic environment sometimes exceed their water solubility. A possible explanation is that a microplastic-sol-water three-phase medium (TPM) is formed in the actual water environment. Both states HOCs (in solute and sol) have the potential to migrate to particles suspended in water. To confirm this view, four kinds of microplastics and eight halogenated polycyclic aromatic hydrocarbons (HPAHs) were selected to examine the partitioning of HPAHs between microplastics and water (sol and solute). Both monolayer and multilayer coverage of HPAHs onto microplastics occurred, and chemical sorption dominated the pseudo-sorption mechanism. The microplastic-water partition ratios of HPAHs (0.12-0.74) were approximately four to five orders of magnitude lower than their corresponding KOW values, suggesting that mechanisms other than sorption were involved. Apparently, the sol HPAHs contributed almost identically large increments to both microplastics and water, and closed the gap. For microplastic-supported HPAHs, the contribution of the sol fraction was more than triple that of the dissolved fraction; the key influencing factor was the water solubility of HPAHs.

18.
Soc Sci Med ; 283: 114210, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34274783

RESUMO

To reduce the heavy reliance of public hospitals on drug sales and use of advanced technologies and to contain the escalating medical expenditures, Beijing implemented two rounds of comprehensive public hospital reform in 2017 and 2019, respectively. The first round focused on separating drug sales from hospital revenue (reform1), and the second round extended to include zero markup on medical consumables and price adjustments for medical services (reform2). To estimate how these two rounds of reform have affected public hospitals' revenue structures, we used observational data of medical revenues from 2016 to 2019 covering 354 healthcare facilities. A Panel-interrupted time-series (PITS) model was used to analyze the effects. The results suggest that the reforms have changed the structure of public hospitals' revenues. The proportion of drug sales in hospital revenues fell from 43.96% in 2016 (pre-reform) to 34.08% in 2019 (post-reform); the proportions of medical consumables decreased by 0.73% after reform 2; and the proportion of medical consultation service fees increased from 15.16% in 2016 to 24.51% in 2019. PITS analysis showed that the proportion of drug sales dropped by 5.46% in the month of reform 1, and it dropped by 0.20% per month on average after reform 2(p < 0.001). The proportion of medical consumables decreased by 0.04% per month on average after reform 2 (p < 0.001). The proportion of medical consultation service increased by 7.13% in the month of reform 1, and it increased by 0.14% per month on average after reform 2(p < 0.001). Similar trends were seen in hospital revenue structures from both inpatient services and from outpatient and accident and emergency services. Thus, Beijing's reforms successfully contained rising medical expenditures and optimized hospitals' revenue structures. These reforms can provide a reference for further public hospital reforms in China and other countries with similar systems.


Assuntos
Custos de Medicamentos , Reforma dos Serviços de Saúde , Pequim , China , Gastos em Saúde , Hospitais Públicos , Humanos
19.
Plast Reconstr Surg ; 148(3): 549-558, 2021 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-34292915

RESUMO

BACKGROUND: Fat grafting is commonly used in treating soft-tissue defects. However, the basic biology behind fat grafting is still not fully understood. Evidence of adipose browning into beige adipose tissue after fat grafting was revealed, but its role in fat grafting remains unclear. METHODS: Induced beige adipocytes and adipose-derived stem cells were obtained from human lipoaspirates and labeled with green fluorescent protein. Nude mice were each injected with 300 mg of human lipoaspirate containing green fluorescent protein-labeled adipose-derived stem cells, green fluorescent protein-labeled induced beige adipocytes, or phosphate-buffered saline. Grafted fat was harvested after 1, 4, 8, and 12 weeks for immunohistochemistry and histologic examination. Graft retention, vascularization, and adipogenic gene expression were compared. RESULTS: After 7 days' induction, adipocytes achieved browning with multilocular lipid droplets, increased mitochondria, and up-regulated browning gene expression. Fat graft retention rates at week 12 were significantly higher after injection of induced beige adipocytes than after injection of phosphate-buffered saline (46.0 ± 4.9 percent versus 31.0 ± 3.6 percent; p = 0.01), but were similar after injection of induced beige adipocytes and adipose-derived stem cells (p > 0.05). Induced beige adipocytes underwent rewhitening into white adipocytes and showed up-regulation of peroxisome proliferator-activated receptor-γ expression. Induced beige adipocytes enhanced angiogenesis, but were not active in forming vessel structures. CONCLUSIONS: Induced beige adipocytes and adipose-derived stem cells were comparable in improving fat graft retention rates. Induced beige adipocytes promote angiogenesis in a paracrine manner and are prone to rewhitening after fat grafting.

20.
Neuroscience ; 471: 11-19, 2021 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-34302906

RESUMO

Death-associated protein kinase (DAPK) is a Ca2+/CaM-regulated protein kinase that is involved in cell death processes by multiple pathways. It has been reported that DAPK may play a role in brain ischemia-induced neuronal death, but this mechanism is not well understood. DANGER, a membrane-associated protein that binds to DAPK physiologically, inhibits DAPK activation. In the present study, we used a transient global brain ischemia and reperfusion (I/R) rat model to investigate whether the interaction between DAPK and DANGER is involved in neuronal cell death following brain ischemia, and to reveal the mechanism of action. Our results indicate that the DAPK/DANGER interaction in the hippocampal CA1 region was significantly reduced after I/R with a peak reduction at 6 h. We further demonstrate that the NMDA inhibitor MK-801, DAPK inhibitor, or calcineurin inhibitor FK-506 prevented the dissociation of DANGER from DAPK 6 h after I/R. This was accompanied by a significantly decreased I/R-induced dephosphorylation of DAPK(ser-308), inhibiting DAPK catalytic activity. Moreover, the expression of DANGER and the interaction between DANGER and IP3R on the endoplasmic reticulum was significantly increased at I/R 6 h, which may be related to a reduction of DAPK/DANGER binding under I/R condition. Furthermore, MK-801, DAPK inhibitor and FK-506 had neuroprotective effects against hippocampal CA1 neuronal death 5 days after I/R. In conclusion, our data suggest that the dissociation of DANGER from DAPK may mediate DAPK activation, which is involved in DAPK-related neuronal death following I/R injury.


Assuntos
Isquemia Encefálica , Fármacos Neuroprotetores , Traumatismo por Reperfusão , Animais , Região CA1 Hipocampal , Morte Celular , Proteínas Quinases Associadas com Morte Celular/farmacologia , Hipocampo , Neurônios , Fármacos Neuroprotetores/farmacologia , Ratos , Reperfusão
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