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1.
Zhonghua Xue Ye Xue Za Zhi ; 41(2): 117-122, 2020 Feb 14.
Artigo em Chinês | MEDLINE | ID: mdl-32135627

RESUMO

Objective: To explore the efficacy and prognostic factors of hematopoietic stem cell transplantation (HSCT) for the treatment of patients with anaplastic large cell lymphoma (ALCL) . Methods: The clinical records of 33 ALCL patients after HSCT were collected and analyzed retrospectively to evaluate the rates of overall survival (OS) and recurrence after autologous (auto-HSCT) and allogeneic HSCT (allo-HSCT) and the factors influencing prognosis. Results: The median-age of this cohort of 33 ALCL cases at diagnosis was 31 (12-57) years old with a male/female ratio of 23/10, 24 cases (72.7%) were ALK(+) and 9 ones (27.3%) ALK(-). Of them, 25 patients (19 ALK(+) and 6 ALK(-)) underwent auto-HSCT and 8 cases (5 ALK(+) and 3ALK(-)) allo-HSCT with a median follow-up of 18.7 (4.0-150.0) months. Disease states before HSCT were as follows: only 6 patients achieved CR status and received auto-HSCT, 16 patients achieved PR (14 cases by auto-HSCT and 2 ones allo-HSCT) , the rest 11 cases were refractory/relapse (5 cases by auto-HSCT and 6 ones allo-HSCT) . There were 7 cases died of disease progression (5 after auto-HSCT and 2 allo-HSCT) and 5 cases treatment-related mortality (TRM) (2 after auto-HSCT and 3 allo-HSCT) , TRM of two groups were 8.0% and 37.5%, respectively. Both the median progression-free survival (PFS) and OS were 15 months after auto-HSCT, the median PFS and OS after allo-HSCT were 3.7 (1.0-90.0) and 4.6 (1.0-90.0) months, respectively. There was no statistically significant difference in terms of survival curves between the two groups (OS and PFS, P=0.247 and P=0.317) . The 2-year OS rates in auto-HSCT and allo-HSCT groups were 72% and 50%, respectively. The 5-year OS rates in auto-HSCT and allo-HSCT groups were 36% and 25%, respectively. Conclusion: ALCL treated by chemotherapy produced high rates of overall and complete responses. Chemotherapy followed by auto-HSCT remained to be good choice for patients with poor prognostic factors. High-risk patients should be considered more beneficial from allo-HSCT.


Assuntos
Transplante de Células-Tronco Hematopoéticas , Linfoma Anaplásico de Células Grandes , Adolescente , Adulto , Criança , Feminino , Humanos , Linfoma Anaplásico de Células Grandes/terapia , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Estudos Retrospectivos , Transplante Autólogo , Transplante Homólogo , Resultado do Tratamento , Adulto Jovem
2.
Zhonghua Zhong Liu Za Zhi ; 42(2): 139-144, 2020 Feb 23.
Artigo em Chinês | MEDLINE | ID: mdl-32135649

RESUMO

Objective: To evaluate the prognostic factors of T1-2N0M0 esophageal squamous cell carcinoma (ESCC) treated with definitive radiotherapy. Methods: The clinical data of 196 patients with T1-2N0M0 ESCC who were treated with definitive radiotherapy in 10 hospitals were retrospectively analyzed. All sites were members of Jing-Jin-Ji Esophageal and Esophagogastric Cancer Radiotherapy Oncology Group (3JECROG). Radiochemotherapy were applied to 78 patients, while the other 118 patients received radiotherapy only. 96 patients were treated with three-dimensional conformal radiotherapy (3DCRT) and 100 treated with intensity-modulated radiotherapy (IMRT). The median dose of plan target volume(PTV) and gross target volume(GTV) were both 60 Gy. The median follow-up time was 59.2 months. Log rank test and Cox regression analysis were used for univariat and multivariate analysis, respectively. Results: The percentage of normal lung receiving at least 20 Gy (V(20)) was (18.65±7.20)%, with average dose of (10.81±42.05) Gy. The percentage of normal heart receiving at least 30 Gy (V(30)) was (14.21±12.28)%. The maximum dose of exposure in spinal cord was (39.65±8.13) Gy. The incidence of radiation pneumonia and radiation esophagitis were 14.80%(29/196) and 65.82%(129/196), respectively. The adverse events were mostly grade 1-2, without grade 4 toxicity. Median overall survival (OS) and progression-free survival (PFS) were 70.1 months and 62.3 months, respectively. The 1-, 3- and 5-year OS rates of all patients were 75.1%、57.4% and 53.2%, respectively. The 1-, 3- and 5-year PFS rates were 75.1%、57.4% and 53.2%, respectively. Multivariate analysis demonstrated that patients'age (HR=1.023, P=0.038) and tumor diameter (HR=1.243, P=0.028)were the independent prognostic factors for OS, while tumor volume were the independent prognostic factor for PFS. Conclusions: Definitive radiotherapy is a promising therapeutic method in patients with T1-2N0M0 ESCC. Patients' age, tumor diameter and tumor volume may impact patients' prognosis.


Assuntos
Neoplasias Esofágicas/radioterapia , Carcinoma de Células Escamosas do Esôfago/radioterapia , Antineoplásicos/uso terapêutico , Quimiorradioterapia , Relação Dose-Resposta à Radiação , Neoplasias Esofágicas/tratamento farmacológico , Neoplasias Esofágicas/mortalidade , Neoplasias Esofágicas/patologia , Carcinoma de Células Escamosas do Esôfago/tratamento farmacológico , Carcinoma de Células Escamosas do Esôfago/mortalidade , Carcinoma de Células Escamosas do Esôfago/patologia , Humanos , Prognóstico , Dosagem Radioterapêutica , Radioterapia Conformacional , Radioterapia de Intensidade Modulada , Estudos Retrospectivos
3.
J Mech Behav Biomed Mater ; 103: 103552, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32090947

RESUMO

The development and progression of wrinkles from young to aged human skin relates to both structural and mechanical changes induced by aging. Here we aim to better understand the interaction of skin's layered morphology with dynamic wrinkles predicted in young and aged skin. First, we compare the predictions of wrinkling from 3-D finite element models of human skin including two to six distinct and anatomically motivated layers. Second, we perform parametric analyses using our six-layered model to determine how age-related changes in the architecture of human skin affect dynamic surface wrinkling. Specifically, we consider the following aging-related changes in the morphology of skin: flattening of the dermal-epidermal junction (DEJ) interface; thinning of both the viable epidermis (VE) and the reticular dermis (RD); and thickening of the papillary dermis (PD). We use skin compression to model dynamic, expressional wrinkles due to muscle contraction, and volumetric tissue loss to model effects of aging in wrinkling simulations. Our results highlight the role of skin's multi-layered structure in the modeling of wrinkling formation. Our six-layered model, consisting of all of the mechanical layers, predicts deep wrinkles with better fidelity than models including fewer layers. From our parametric study, applying our six-layered model, we conclude that: (1) the relative thicknesses of the layers in the epidermis or dermis significantly influences surface wrinkling in skin; and, (2) flattening of the DEJ with aging enhances surface wrinkling. Thinning of VE increases the relative stiffness of the epidermis and thus enhances dynamic wrinkling, while thickening of PD or thinning of RD has the same effect by reducing the equivalent stiffness of the substrate. Consequently, strategies to minimize wrinkling could maintain the undulating morphology of the DEJ, thereby delaying dynamic wrinkling and delaying the propagation of buckling into the deeper dermis or hypodermis. Additional strategies to minimize wrinkling could target preventing the VE and RD from thinning or preventing the PD from thickening.

4.
J Mech Behav Biomed Mater ; 105: 103694, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32090898

RESUMO

Skin wrinkling, especially in the facial area, is a prominent sign of aging and is a growing area of research aimed at developing cosmetics and dermatological treatments. To better understand and treat undesirable skin wrinkles, it is vitally important to elucidate the underlying mechanisms of skin wrinkling, a largely mechanical process. Human skin, a multi-layer composite, has six mechanically distinct layers: from the outermost inward they are the stratum corneum, viable epidermis, dermal-epidermal-junction, papillary dermis, reticular dermis, and hypodermis. To better address the through-thickness hierarchy, and the development of wrinkling within this complicated hierarchy, we established a six-layered model of human skin realized with finite element modeling, by leveraging available morphological and biomechanical data on human skin of the forehead. Exercising our new model we aimed to quantify the effects of three potential mechanisms of wrinkle formation: (1) skin compression due to muscle contraction (dynamic wrinkles); (2) age-related volumetric tissue loss (static wrinkles); and (3) the combined effects of both mechanisms. Since hydration of the stratum corneum significantly affects its stiffness we also aimed to quantify the influence its hydration with these three potential mechanisms of wrinkle formation. Our six-layered skin model, combined with the proposed wrinkling mechanisms, successfully predicts the formation of dynamic and static wrinkles in the forehead consistent with the experimental literature. We observed three wrinkling modes in the forehead where the deepest wrinkles could reach to the reticular dermis. With further refinement our new six-layered model of human skin can be applied to study other region-specific wrinkle types such as the "crow's feet" and the nasolabial folds.

5.
Osteoarthritis Cartilage ; 28(2): 137-145, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31629022

RESUMO

OBJECTIVE: Tramadol has been widely used among patients with osteoarthritis (OA); however, there is paucity of information on its cardiovascular risk. We aimed to examine the association of tramadol with risk of myocardial infarction (MI) among patients with OA. DESIGN: Among OA patients aged 50-90 years without history of MI, cancer, or opioid use disorder in The Health Improvement Network database in the United Kingdom (2000-2016), three sequential propensity-score matched cohort studies were assembled, i.e., (1) patients who initiated tramadol or naproxen (negative comparator); (2) patients who initiated tramadol or diclofenac (positive comparator); and (3) patients who initiated tramadol or codeine (a commonly used weak opioid). The outcome was incident MI over six-months. RESULTS: Among tramadol and naproxen initiators (n = 33,024 in each cohort), 77 (4.8/1000 person-years) and 46 (2.8/1000 person-years) incident MI occurred, respectively. The rate difference (RD) and hazard ratios (HR) for incident MI with tramadol initiation were 1.9 (95% confidence interval [CI] 0.6 to 2.3)/1000 person-years and 1.68 (95% CI 1.16 to 2.41) relative to naproxen initiation, respectively. Among tramadol and diclofenac initiators (n = 18,662 in each cohort), 58 (6.4/1000 person-years) and 47 (5.1/1000 person-years) incident MIs occurred, respectively. The corresponding RD and HR for incident MI were 1.2 (95%CI -2.1 to 14.1)/1000 person-years and 1.24 (95%CI 0.84 to 1.82), respectively. Among tramadol and codeine initiators (n = 42,722 in each cohort), 127 (6.1/1000 person-years) and 103 (5.0/1000 person-years) incident MI occurred, respectively, and the corresponding RD and HR were 1.1 (95%CI:-0.3 to 2.5)/1000 person-years and 1.23 (95%CI:0.95 to 1.60), respectively. CONCLUSIONS: In this population-based cohort of patients with OA, the six-month risk of MI among initiators of tramadol was higher than that of naproxen, but comparable to, if not lower than, those of diclofenac or codeine.

6.
Clin Radiol ; 74(12): 918-925, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31471063

RESUMO

AIM: To investigate whether apparent diffusion coefficient (ADC) histogram parameters based on whole solid tumour volume could differentiate high-grade (HGSOC) from low-grade serous ovarian carcinoma (LGSOC) and to correlate those parameters with the Ki-67 proliferation index. MATERIALS AND METHODS: One hundred and seven patients with HGSOCs and 19 patients with LGSOCs confirmed at surgery and histology who underwent conventional magnetic resonance imaging (MRI) and diffusion-weighted imaging (DWI) were analysed retrospectively. ADC histogram parameters (including the mean, standard deviation [SD], 10th, 25th, 50th, 75th, and 90th percentiles, kurtosis, and skewness) were obtained using the whole solid tumour volume region of interest (ROI). The Mann-Whitney U test, Pearson's chi-square test, Fisher's exact test, kappa test, Spearman's correlation, and receiver operating characteristic (ROC) curves were used for statistical analyses. RESULTS: For ADC histogram parameters, the mean (p<0.001), SD (p=0.003), and all percentiles (10th, 25th, 50th, 75th, and 90th percentile; all p<0.001) were significantly lower in HGSOC than in LGSOC, and the area under the ROC curve (AUC) was 0.717-0.807. Skewness was significantly higher in HGSOC than in LGSOC (p<0.001, AUC = 0.773); however, kurtosis was not significantly different between HGSOC and LGSOC (p=0.140). The 25th and 75th percentiles, SD and 10th percentile, and 75th percentile showed the highest sensitivity of 91.6%, specificity of 79.0%, and accuracy of 88.1%, respectively. All histogram parameters (except for kurtosis) were poorly correlated with the Ki-67 index (|r| = 0.191-0.274, p<0.05). CONCLUSION: ADC histogram parameters based on whole solid tumour volume can be helpful for differentiating between HGSOC and LGSOC.

7.
Zhonghua Zhong Liu Za Zhi ; 41(8): 615-623, 2019 Aug 23.
Artigo em Chinês | MEDLINE | ID: mdl-31434454

RESUMO

Objective: To validate whether the prognostic stage groups by the 8th edition of the American Joint Committee on Cancer (AJCC) staging system provides improved prognostic accuracy in T1-2N1M0 postmastectomy breast cancer patients compared to 7th edition. Methods: a total of 1 823 female patients with T1-2N1M0 breast cancer who underwent mastectomy and axillary lymph node dissection without neoadjuvant chemotherapy were analyzed and restaged according to 8th edition. Univariate analysis of prognostic factors was evaluated by using log-rank test. Multivariate analysis was estimated by using the Cox proportional hazards model. The prognostic accuracy of the two staging systems was compared using receiver operating characteristic (ROC) analyses and the concordance index (C-index). Results: 5-year locoregional recurrence rate (LRR) for the whole group was 6.0%, 5-year distant metastasis (DM) rate was 11.5%, 5-year disease-free survival (DFS) was 85.0%, and 5-year overall survival (OS) was 93.1%. Cox analysis showed that 7th edition of the AJCC staging system and progesterone receptor status were independent risk factors for LRR, DM, DFS and OS (P<0.05). Compared with stage by 7th edition, 1 278(70.1%) were assigned to a different prognostic stage group: 1 088 (85.1%) to a lower stage and 190 (14.9%) to a higher stage. LRR, DM, DFS and OS were significantly different between prognostic stage ⅠA, ⅠB, ⅡA, ⅡB and ⅢA according to 8th edition of the AJCC staging system(P<0.001). Prognostic stage had significantly higher C-indexes and provided better estimation of prognosis compared to stage by 7th edition of the AJCC staging system (P<0.001). Conclusion: The prognostic stage groups of 8th edition AJCC staging system has superior prognostic accuracy compared to 7th edition in T1-2N1M0 breast cancer, and has better clinical therapeutic guidance value.


Assuntos
Neoplasias da Mama/patologia , Neoplasias da Mama/cirurgia , Mastectomia , Feminino , Humanos , Estadiamento de Neoplasias , Prognóstico , Reprodutibilidade dos Testes , Estados Unidos
8.
Osteoarthritis Cartilage ; 27(6): 855-862, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30703543

RESUMO

OBJECTIVE: A recent randomized clinical trial reported that repeated intra-articular corticosteroids (IACs) were associated with a greater cartilage loss. This study aimed to examine the relation of IACs to knee radiographic osteoarthritis (ROA) progression in a real-world setting. DESIGN: A cohort that initiated IACs and a comparison cohort without IACs from participants with mild to moderate knee ROA in the Osteoarthritis Initiative (OAI) were assembled (from 0-month to 48-month). Two measures of knee ROA progression were assessed during the follow-up period: (1) an increase in Kellgren and Lawrence (KL) grade by ≥1 grade or having a knee replacement (i.e., KL grade worsening); and (2) a decrease in joint space width (JSW) by ≥0.7 mm or having a knee replacement (i.e., JSW worsening). The associations of IACs initiation using a propensity-score matched cohort study and continuous IACs using marginal structural models with the risk of knee ROA progression were examined. RESULTS: Among 684 propensity-score matched participants at baseline (148 IACs initiators, 536 comparators), 65 knees (21.7/100 person-years) in the IACs initiation cohort and 90 knees (7.1/100 person-years) in the comparison cohort experienced KL worsening. The hazard ratios (HRs) of KL worsening from IACs initiation and continuous IACs were 3.02 (95% confidence interval [CI], 2.19-4.16) and 4.67 (95% CI, 2.92-7.47), respectively. The corresponding HRs of JSW worsening were 2.93 (95% CI, 2.13-4.02) and 3.26 (95% CI, 1.78-5.96), respectively. All HRs for continuous use of IACs were further away from the null. CONCLUSIONS: IACs, especially continuous IACs, may be associated with an increased risk of knee ROA progression.

9.
Zhonghua Zhong Liu Za Zhi ; 41(1): 56-62, 2019 Jan 23.
Artigo em Chinês | MEDLINE | ID: mdl-30678418

RESUMO

Objective: To investigate the clinical and prognostic differences between primary nasopharyngeal natural killer (NK)/T-cell lymphoma (NP NKTCL) and extranodal NK/T-cell lymphoma of the nasal cavity with nasopharynx extension (N-NP NKTCL). Methods: A total of 89 patients with NP NKTCL and 113 patients with N-NP NKTCL from January 2000 to June 2015 were retrospectively analyzed. Clinical and pathological features, treatment responses and prognosis were compared between the two groups. Results: NP NKTCL patients showed similar clinicopathological features with those with N-NP NKTCL, except that the former had a relative low proportion of elevated lactate dehydrogenase (LDH) levels (28.1% vs. 41.6%; P=0.001). Both of two groups presented with high proportion of cervical lymph node involvement (55.1% and 42.5%; P=0.076). The 5-year overall survival (OS) rates in these two groups were 63.2% and 54.6%, respectively, whereas 5-year progress-free survival (PFS) rates were 50.7% and 45.6%, respectively. For the patients with stage Ⅰ and Ⅱ, the 5-year OS and PFS rates in these two groups were 68.8% and 55.7% as well as 55.6% and 47.2%, respectively. These were no statistically significant differences between two groups (all P>0.05). The complete response (CR) rate after initial chemotherapy in NP NKTCL group was 43.8%, which was significant higher than that of 19.6% in N-NP NKTCL group (P=0.006). Additionally, the CR rate after primary radiotherapy was 63.4% and 62.7%, respectively (P=0.629). The NP NKTCL patients with stage Ⅰ and Ⅱ who accepted radiotherapy with or without chemotherapy had similar survival times with chemotherapy alone, showing the 5-year OS rates of 70.5% and 33.3% (P=0.238), as well as the 5-year PFS rates of 56.7% and 33.3%, respectively (P=0.431). Similar results were found in N-NP NKTCL group, the 5-year OS rates for patients with radiotherapy with or without chemotherapy and chemotherapy alone were 57.4% and 33.3% (P=0.246), while the 5-year PFS rates were 49.3% and 16.7% (P=0.177), respectively. Besides, the relapse pattern of NP NKTCL and N-NP NKTCL groups was also similar, mainly involving the distant extra-nodal organs followed by lymph nodes. Conclusion: The patients with N-NP NKTCL and NP NKTCL showed similar clinical and prognostic features, however, the initial response to chemotherapy was different.


Assuntos
Linfoma Extranodal de Células T-NK , Cavidade Nasal , Neoplasias Nasofaríngeas , Neoplasias Nasais , Antineoplásicos/uso terapêutico , Humanos , L-Lactato Desidrogenase/sangue , Linfoma Extranodal de Células T-NK/tratamento farmacológico , Linfoma Extranodal de Células T-NK/enzimologia , Linfoma Extranodal de Células T-NK/mortalidade , Linfoma Extranodal de Células T-NK/patologia , Neoplasias Nasofaríngeas/tratamento farmacológico , Neoplasias Nasofaríngeas/enzimologia , Neoplasias Nasofaríngeas/mortalidade , Neoplasias Nasofaríngeas/patologia , Recidiva Local de Neoplasia , Neoplasias Nasais/tratamento farmacológico , Neoplasias Nasais/enzimologia , Neoplasias Nasais/mortalidade , Neoplasias Nasais/patologia , Prognóstico , Estudos Retrospectivos
10.
Osteoarthritis Cartilage ; 27(4): 603-610, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30597274

RESUMO

OBJECTIVE: To evaluate the etiologic heterogeneity between medial and lateral tibiofemoral radiographic osteoarthritis (ROA). METHODS: Knees without medial or lateral tibiofemoral ROA at baseline were followed for 60-month in Multicenter Osteoarthritis Study (MOST) and for 48-month in Osteoarthritis Initiative (OAI). We examined the relation of previously reported risk factors to incident medial and lateral tibiofemoral ROA separately and determined the etiology heterogeneity with a ratio of rate ratios (RRs) (i.e., the RR for medial tibiofemoral ROA divided by the RR for lateral tibiofemoral ROA) using a duplication method for Cox proportional hazard regression. RESULTS: Of 2,016 participants in MOST, 436 and 162 knees developed medial or lateral tibiofemoral ROA, respectively. Obesity and varus malalignment were 95% and 466% more strongly associated with incident medial tibiofemoral ROA than with lateral tibiofemoral ROA, respectively (ratios of RRs, 1.95 [95% confidence interval (CI):1.05-3.62] and 5.66 [95% CI:3.20-10.0]). In contrast, the associations of female sex and valgus malalignment with incident medial tibiofemoral ROA were weaker or in an opposite direction compared with lateral tibiofemoral Osteoarthritis (OA) (ratios of RRs, 0.40 [95% CI:0.26-0.63] and 0.20 [95% CI:0.12-0.34], respectively). Older age tended to show a weaker association with incident medial tibiofemoral ROA than with incident lateral tibiofemoral ROA. No heterogeneity was observed for the relation of race, knee injury, or contralateral knee ROA. These findings were closely replicated in OAI. CONCLUSION: Risk factor profiles for medial and lateral tibiofemoral ROA are different. These results can provide a framework for the development of targeted prevention and potential treatment strategies for specific knee OA subtypes.

11.
Clin Radiol ; 74(2): 165.e1-165.e9, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30415766

RESUMO

AIM: To evaluate the ability of arterial spin labelling (ASL) magnetic resonance imaging (MRI) in differentiating primary central nervous system lymphoma (PCNSL) from atypical high-grade glioma (HGG), as well as exploring the underlying pathological mechanisms. METHODS AND MATERIALS: Twenty-three patients with PCNSL and 17 patients with atypical HGG who underwent ASL-MRI were identified retrospectively. Absolute cerebral blood flow (aCBF) and normalised cerebral blood flow (nCBF) values were obtained, and were compared between PCNSL and atypical HGG using the Mann-Whitney U-test. The performance in discriminating between PCNSL and atypical HGG was evaluated using receiver-operating characteristics analysis and area-under-the-curve (AUC) values for aCBF and nCBF. The correlation between microvessel density (MVD) and aCBF was determined by Spearman's correlation analysis. RESULTS: Atypical HGG demonstrated significantly higher aCBF, nCBF, and MVD values than PCNSL (p<0.05). The diagnostic accuracy of discriminating PCNSL from atypical HGG showed AUC=0.877 (95% confidence interval [CI] 0.735-0.959) for aCBF, and AUC=0.836 (95% confidence interval [CI] 0.685-0.934) for nCBF. There was a moderate positive correlation between aCBF values of region of interest (ROI >30 mm2) in the enhanced area and MVD values (rho=0.579, p=0.0001), and a strong positive correlation between aCBF values MVD based on "point-to-point biopsy" (rho=0.83, p=0.0029). Interobserver agreements for aCBF and nCBF were excellent (ICC >0.75). CONCLUSIONS: ASL perfusion MRI is a useful imaging technique for the discrimination between atypical HGG and PCNSL, which may be determined by the difference of MVD between them.


Assuntos
Astrocitoma/diagnóstico por imagem , Neoplasias Encefálicas/diagnóstico por imagem , Glioblastoma/diagnóstico por imagem , Linfoma/diagnóstico por imagem , Imagem por Ressonância Magnética/métodos , Adulto , Astrocitoma/irrigação sanguínea , Encéfalo/diagnóstico por imagem , Neoplasias Encefálicas/irrigação sanguínea , Circulação Cerebrovascular , Diagnóstico Diferencial , Feminino , Glioblastoma/irrigação sanguínea , Humanos , Masculino , Microvasos/diagnóstico por imagem , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Estudos Retrospectivos , Marcadores de Spin
12.
Zhonghua Xue Ye Xue Za Zhi ; 39(6): 460-464, 2018 Jun 14.
Artigo em Chinês | MEDLINE | ID: mdl-30032560

RESUMO

Objective: To evaluate the impact of KIT D816 mutation on the salvage therapy in relapsed acute myeloid leukemia (AML) with t(8;21) translocation. Method: The characteristics of the first relapsed AML with t(8;21) translocation from 10 hospitals were retrospectively collected, complete remission (CR(2)) rate after one course salvage chemotherapy and the relationship between KIT mutation and CR(2) rate was analyzed. Results: 68 cases were enrolled in this study, and 30 cases (44.1%) achieved CR(2). All patients received KIT mutation detection, and KIT D816 mutation was identified in 26 cases. The KIT D816 positive group had significantly lower CR(2) compared with non-KIT D816 group (23.1% vs 57.1%, χ(2)=7.559, P=0.006), and patients with longer CR(1) duration achieved significantly higher CR(2) than those with CR(1) duration less than 12 months (74.1% vs 31.9%, χ(2)=9.192, P=0.002). KIT D816 mutation was tightly related to shorter CR(1) duration. No significant difference of 2 years post relapse survival was observed between KIT D816 mutation and non-KIT D816 mutation group. Conclusion: KIT D816 mutation at diagnosis was an adverse factor on the salvage therapy in relapsed AML with t(8;21) translocation, significantly related to shorter CR1 duration, and can be used for prediction of salvage therapy response. KIT D816 mutation could guide the decision-making of salvage therapy in relapsed AML with t(8;21) translocation.


Assuntos
Leucemia Mieloide Aguda/terapia , Terapia de Salvação , Protocolos de Quimioterapia Combinada Antineoplásica , Citarabina , Humanos , Prognóstico , Estudos Retrospectivos
13.
Zhonghua Yi Xue Za Zhi ; 98(48): 3941-3945, 2018 Dec 25.
Artigo em Chinês | MEDLINE | ID: mdl-30669799

RESUMO

Objective: To evaluate the results of pars plana vitrectomy (PPV) with peeling of the inner limiting membrane (ILM) in patients with laser-induced macular hole. Methods: The clinical data of 11 patients (12 eyes) with decreased visual acuity due to laser-induced macular hole from January 2014 to December 2017 were retrospectively studied.All patients underwent routine examination, fundus photography and optical coherence tomography (OCT). Patients were observed every two weeks. PPV with ILM peeling was performed when macular hole was enlarged. Closure of macular hole, pre- and post-operation visual acuity were observed. Results: A total of 11 male patients (12 eyes)aged (18±4) years were included in the study.Laser instruments which lead to macular hole consisted of laser toy (3 eye), laser pen (4 eye), laser torch (1 eye) and cosmetic laser instrument (4 eyes). All patients were followed up every two weeks and evaluated by OCT. None of the macular hole was spontaneously closed in this study. All Macular holes were enlarged in 1-3 months of follow-up and underwent PPV with ILM peeling immediately. All of the macular hole with PPV and ILM peeling were completely closed. During follow-up, the best-corrected visual acuity(BCVA) of 10 eyes (10/12) were found to increase above 3 lines and BCVA of 7 eyes(7/12) were found to be more than 0.5. Only 1 eye maintained the same visual acuity after the surgery which might be due to long course, large macular hole diameter (850 µm) and serious retinal pigment epithelium (RPE) damage. Conclusion: Early PPV with ILM peeling for laser induced macular hole might benefit for the closure rate of macular hole and better visual acuity prognosis.


Assuntos
Perfurações Retinianas , Vitrectomia , Adolescente , Membrana Epirretiniana , Humanos , Masculino , Perfurações Retinianas/cirurgia , Estudos Retrospectivos , Tomografia de Coerência Óptica , Resultado do Tratamento , Adulto Jovem
15.
Clin Microbiol Infect ; 24(7): 780.e5-780.e8, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29138101

RESUMO

OBJECTIVES: To explore the characteristics of Helicobacter pylori resistance in China and the association between antibiotic resistance and several clinical factors. METHODS: H. pylori strains were collected from patients in 13 provinces or cities in China between 2010 and 2016. Demographic data including type of disease, geographic area, age, gender and isolation year were collected to analyse their association with antibiotic resistance. Antibiotic resistance was detected using the Etest test and the Kirby-Bauer disc diffusion method. RESULTS: H. pylori were successfully cultured from 1117 patients. The prevalence of metronidazole, clarithromycin (CLA), azithromycin, levofloxacin (LEV), moxifloxacin, amoxicillin (AMO), tetracycline and rifampicin resistance was 78.2, 22.1, 23.3, 19.2, 17.2, 3.4, 1.9 and 1.5%, respectively. No resistance to furazolidone was observed. The resistance rates to LEV and moxifloxacin were higher in strains isolated from patients with gastritis compared to those with duodenal ulcer and among women. Compared to patients ≥40 years old, younger patients exhibited lower resistance rates to CLA, azithromycin, LEV and moxifloxacin. The resistance rates to CLA and AMO were higher in strains isolated more recently, and we also found that the prevalence of resistance to metronidazole, CLA, azithromycin and AMO were significantly different among different regions of China. CONCLUSIONS: The resistance rates to metronidazole, CLA and LEV were high in China. Patient age, gender, disease and location were associated with the resistance of H. pylori to some antibiotics. Furazolidone, AMO and tetracycline are better choices for H. pylori treatment in China.


Assuntos
Antibacterianos/farmacologia , Farmacorresistência Bacteriana/fisiologia , Infecções por Helicobacter/microbiologia , Helicobacter pylori/efeitos dos fármacos , Helicobacter pylori/fisiologia , Adulto , China , Claritromicina/farmacologia , Farmacorresistência Bacteriana/efeitos dos fármacos , Feminino , Helicobacter pylori/isolamento & purificação , Humanos , Levofloxacino/farmacologia , Masculino , Metronidazol/farmacologia , Testes de Sensibilidade Microbiana , Viabilidade Microbiana/efeitos dos fármacos , Fatores de Risco
16.
Acta Physiol (Oxf) ; 222(2)2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-28771943

RESUMO

AIM: To understand the role of the collagen-binding integrin α11 in vivo, we have used a classical approach of creating a mouse strain overexpressing integrin α11. A transgenic mouse strain overexpressing α11 in muscle tissues was analysed in the current study with special reference to the heart tissue. METHODS: We generated and phenotyped integrin α11 transgenic (TG) mice by echocardiography, magnetic resonance imaging and histology. Wild-type (WT) mice were subjected to aortic banding (AB) and the expression of integrin α11 was measured in flow cytometry-sorted cardiomyocytes and non-myocytes. RESULTS: TG mice developed left ventricular concentric hypertrophy by 6 months, with increased collagen deposition and reactivation of mRNA encoding foetal genes associated with cardiovascular pathological remodelling compared to WT mice. Masson's trichrome staining revealed interstitial fibrosis, confirmed additionally by magnetic resonance imaging and was found to be most prominent in the cardiac septum of TG but not WT mice. TG hearts expressed increased levels of transforming growth factor-ß2 and transforming growth factor-ß3 and upregulated smooth muscle actin. Macrophage infiltration coincided with increased NF-κB signalling in TG but not WT hearts. Integrin α11 expression was increased in both cardiomyocytes and non-myocyte cells from WT AB hearts compared to sham-operated animals. CONCLUSION: We report for the first time that overexpression of integrin α11 induces cardiac fibrosis and left ventricular hypertrophy. This is a result of changes in intracellular hypertrophic signalling and secretion of soluble factors that increase collagen production in the heart.


Assuntos
Cadeias alfa de Integrinas/metabolismo , Miocárdio/patologia , Animais , Fibrose , Hipertrofia Ventricular Esquerda/metabolismo , Hipertrofia Ventricular Esquerda/patologia , Masculino , Camundongos , Camundongos Transgênicos , Miocárdio/metabolismo
18.
Zhonghua Zhong Liu Za Zhi ; 39(11): 841-849, 2017 Nov 23.
Artigo em Chinês | MEDLINE | ID: mdl-29151291

RESUMO

Objective: To establish a risk-adapted postmastectomy radiotherapy strategy based on local-regional recurrence for intermediate-risk breast cancer (T1~2N1M0 stage). Methods: A total of 2413 patients with T1-2N1M0 breast cancer were retrospectively reviewed. Of them, 588 patients (24.4%) received postmastectomy radiotherapy (PMRT), while 1 825 (75.6%) patients did not. A comprehensive comparative study was performed by using multivariable and propensity score-matched (PSM) analyses. Results: The median follow-up time was 67.0 months, the 5-year local region recurrence free-survival (LRRFS), disease-free survival (DFS) and overall survival (OS) were 93.8%, 85.7% and 93.3%, respectively. The 5-year local region recurrence (LRR) was 6.1%. For patients without PMRT, multivariable analysis indicated that age, tumor localization, molecular subtype, pathologic T stage and number of positive lymph node were independent factors for LRRFS (all of P<0.05). Patients with T1-2N1 breast cancer were classified into low-risk group (0-1 risk factor, 768 patients), intermediate-risk group (2 risk factors, 690 patients) and high-risk groups (≥3 risk factors, 544 patients) based on the five independent factors mentioned above. The 5-year LRRFS, DFS and OS were significantly different among the three groups (P<0.001). In low- and intermediate-risk groups, there were no significant differences in LRRFS, DFS and OS of patients who received PMRT or not (P>0.05). In high-risk group, the DFS of patients received PMRT or not were 79.8% and 74.4%, respectively (P=0.127), the OS of them were 86.8% and 87.1%, respectively (P=0.174), and the LRRFS were 93.3% and 84.3%, respectively (P=0.002). After PSM adjustment, no significant differences in LRRFS, DFS and OS were observed between PMRT-received subgroup and no PMRT subgroup of low-risk group (P>0.05). In intermediate-risk group, the LRRFS of patients received PMRT or not were 95.2% and 91.0%, respectively (P=0.037). However, in the high-risk group, the LRRFS, DFS and OS of patients received PMRT were 93.3%, 79.7% and 86.6%, respectively, while those of patients did not receive PMRT were 78.5% (P<0.001), 69.5% (P=0.038) and 85.7% (P=0.080), respectively. Conclusions: The local-regional recurrence risks of patients with pT1-2N1 breast cancer are viable and risk-adapted PMRT is available for them. Better prognoses can be achieved by the patients of intermediate and high-risk group. More samples on this subject are needed to validate the results.


Assuntos
Neoplasias da Mama/radioterapia , Recidiva Local de Neoplasia/radioterapia , Neoplasias da Mama/mortalidade , Neoplasias da Mama/patologia , Neoplasias da Mama/cirurgia , Intervalo Livre de Doença , Feminino , Humanos , Mastectomia , Análise Multivariada , Recidiva Local de Neoplasia/mortalidade , Estadiamento de Neoplasias , Período Pós-Operatório , Prognóstico , Pontuação de Propensão , Radioterapia Adjuvante , Estudos Retrospectivos , Fatores de Risco
19.
Aliment Pharmacol Ther ; 46(9): 773-779, 2017 11.
Artigo em Inglês | MEDLINE | ID: mdl-28892184

RESUMO

BACKGROUND: Up-to-date information regarding the recurrence rate of Helicobacter pylori (H. pylori) after eradication therapy is not available. AIM: To evaluate the global recurrence rate following H. pylori eradication therapy and confirm its association with socioeconomic and sanitary conditions. METHODS: A systematic search of PubMed, EMBASE and the Cochrane library was performed to identify potentially relevant publications using the following keywords: "Helicobacter pylori" or "H. pylori" or "Hp" and "recurrence" or "recrudescence" or "reinfection" or "recurrent" or "recurred" or "re-infect*" or "relapse*." RESULTS: A total of 132 studies (53 934 patient-years) were analysed. Each study was weighted according to the duration of patient-years. The global annual recurrence, reinfection and recrudescence rate of H. pylori were 4.3% (95% CI, 4-5), 3.1% (95% CI, 2-5) and 2.2% (95% CI, 1-3), respectively. The H. pylori recurrence rate was inversely related to the human development index (HDI) (ie, 3.1% [95% CI, 2-4], 6.2% [95% CI, 4-8] and 10.9% [95% CI, 6-18] in countries with a very high, high and medium or low HDI) (P <.01) and directly related to H. pylori prevalence (10.9% [95% CI, 7-16], 3.7% [95% CI, 3-5], 3.4% [95% CI, 2-5] and 1.6% [95% CI, 0.5-3] in countries with a very high, high, medium or low local H. pylori prevalence) (P <.01). Global recurrence rates remained relatively stable between 1990s, 2000s and 2010s but varied across different regions (P <.05). CONCLUSIONS: H. pylori recurrence remains a problem closely associated with socioeconomic and sanitary conditions. Methods to reduce recurrence in developing countries are needed.


Assuntos
Infecções por Helicobacter/epidemiologia , Países em Desenvolvimento , Saúde Global , Infecções por Helicobacter/tratamento farmacológico , Helicobacter pylori , Humanos , Prevalência , Recidiva , Saneamento , Fatores Socioeconômicos
20.
Eur Rev Med Pharmacol Sci ; 21(15): 3389-3396, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28829503

RESUMO

OBJECTIVE: MicroRNAs (miRNAs) act as critical regulators of genes expression involved in tumor biological processes. The study aimed to investigate the clinical significance and biological role of miR-124 in gastric cancer (GC). PATIENTS AND METHODS: MiR-124 expression was analyzed from 88 GC tissues and adjacent normal tissues by quantitative Real-time PCR (qRT-PCR). Kaplan-Meier curves and log-rank test was used to evaluate the association between miR-124 and the over survival (OS) time of GC patients. MTT assays and transwell invasion assays were performed to assess cell proliferation and invasion. The relationship between miR-124 and Snail2 expression was analyzed by dual luciferase reporter assay. Western blot analyses were performed to detect the relative protein expression. RESULTS: We found that miR-124 expression was significantly reduced in GC tissue samples when compared to the adjacent normal tissues (p<0.05). Lower miR-124 was found to be associated with tumor size (p=0.001), lymphatic metastasis (p=0.008) and TNM stage (p=0.015). Furthermore, patients who have lower miR-124 predicted poor OS time (p<0.05). Function studies suggested that cell proliferation and invasion ability of GC cells were inhibited by up-regulation of miR-124 expression. Moreover, we demonstrated that Snail2 was a direct target of miR-124. Meanwhile, miR-124 inhibited Epithelial-Mesenchymal Transition (EMT) process by repressing the Snail2 expression in GC cells. CONCLUSIONS: MiR-124 acted as a tumor suppressor in GC and may be a useful target for GC treatment.


Assuntos
Transição Epitelial-Mesenquimal/efeitos dos fármacos , MicroRNAs/farmacologia , Invasividade Neoplásica/prevenção & controle , Fatores de Transcrição da Família Snail/antagonistas & inibidores , Neoplasias Gástricas/genética , Linhagem Celular Tumoral , Proliferação de Células , Marcação de Genes , Humanos , Estimativa de Kaplan-Meier , Metástase Linfática/genética , Fatores de Transcrição da Família Snail/biossíntese , Fatores de Transcrição da Família Snail/genética , Neoplasias Gástricas/patologia , Análise de Sobrevida
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