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1.
J Alzheimers Dis ; 2020 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-33216026

RESUMO

BACKGROUND: Patients with Alzheimer's disease (AD) experience various stressors that negatively impact well-being. Most studies have, however, small effect size and are limited by the experiences of severe patients. Therefore, we conducted a single-blind, randomized controlled trial, which has included patients at different stages. OBJECTIVE: The stressor-oriented multicomponent program was designed as an intervention for AD patients to enhance well-being. METHODS: Patients were randomly assigned to control or SOUL-P conditions according to disease severity. The SOUL-P group received 15 intensive sessions over 6 months and 6 maintenance sessions over a 6-month follow-up by a multidisciplinary team comprising psychologists, occupational therapists, and community nurses. The control group received a similar number of sessions by community nurses. Stress-related outcomes (primary stressors and well-being outcomes) were obtained from in-person baseline and follow-up interviews conducted at 6- and 12-months post-baseline. A treatment compliance survey was conducted at the intervention endpoint for patients. RESULTS: Of the 863 patients screened, 218 (25.3%) were eligible. At 6 months, compared to controls, SOUL-P patients had improved quality of life (QoL) (p <  0.001; Cohen d = 0.56), depression (p = 0.020; Cohen d = -0.33), neurobehavioral symptoms (p = 0.034; Cohen d = -0.30), perceived stress (p = 0.030; Cohen d = -0.31), and family conflict (p = 0.026; Cohen d = -0.32). QoL, depression, perceived stress, and family conflict were still significantly different at 12 months. Most patients were satisfied with SOUL-P, while caregivers in the SOUL-P group reported overloading tasks. CONCLUSION: SOUL-P may reduce perceived stress and improve psychological outcomes in AD patients. Stressor-based interventions, patient-oriented goals, and a multidisciplinary team are essential features for a successful SOUL-P.

2.
Disaster Med Public Health Prep ; : 1-11, 2020 Nov 19.
Artigo em Inglês | MEDLINE | ID: mdl-33208220

RESUMO

BACKGROUND: Health behavior was conducive to control the COVID-19 epidemic. This study aimed to determine the differences in health behaviors and related factors among rural-urban residents in China. METHODS: From February 14 to 22, 2020, the peak of COVID-19 epidemic in China, a total of 2449 participants(urban residents,1783(72.81%) and rural residents, 666 (27.19%)) were recruited by snowball sampling on WeChat and Tencent QQ social platforms. Data were collected through the Web-questionnaire guided by an information-motivation-behavioral skills model. Multiple-group structural equation model was applied to analyze the factors. RESULTS: Rural residents had lower health behavior scores than urban residents, even after adjusting demographic characteristics (33.86 vs. 34.29, P=0.042, total score was 40). In urban and rural residents, motivation, behavioral skills and health risk stress had significant direct positive and negative influences effects on health behaviors, respectively. Information and positive perception of interventions had direct effects on health behaviors in rural residents, but not in urban residents. All the factors were mediated by behavioral skills in rural and urban residents. CONCLUSIONS: This study suggest that the government should pay attention to substantial rural-urban disparities and implement different COVID-19 prevention and intervention policies for health behaviors targeting rural and urban residents.

3.
World J Clin Cases ; 8(14): 2959-2976, 2020 Jul 26.
Artigo em Inglês | MEDLINE | ID: mdl-32775378

RESUMO

BACKGROUND: Coronavirus disease 2019 (COVID-19) is an emerging, rapidly evolving disease that spreads through the respiratory system and is highly contagious. In March 2020, the World Health Organization declared the COVID-19 outbreak a pandemic. In China, the pandemic was controlled after 2 mo through effective policies and containment measures. Describing the detailed policies and containment measures used to control the epidemic in Chongqing will provide a reference for the prevention and control of COVID-19 in other areas of the world. AIM: To explore the effects of different policies and containment measures on the control of the COVID-19 epidemic in Chongqing. METHODS: Epidemiological data on COVID-19 in Chongqing were prospectively collected from January 21 to March 15, 2020. The policies and prevention measures implemented by the government during the epidemic period were also collected. Trend analysis was performed to explore the impact of the main policy measures on the effectiveness of the control of COVID-19 in Chongqing. RESULTS: As of March 15, the cumulative incidence of COVID-19 in Chongqing was 1.84/100000 (576 cases) and the infection fatality rate was 1.04% (6/576). The spread of COVID-19 was controlled by effective policies that involved establishing a group for directing the COVID-19 epidemic control effort; strengthening guidance and supervision; ensuring the supply of daily necessities and medical supplies and equipment to residents; setting up designated hospitals; implementing legal measures; and enhancing health education. Medical techniques were implemented to improve the recovery rate and control the epidemic. Policies such as "the lockdown of Wuhan", "initiating a first-level response to major public health emergencies", and "implementing the closed management of residential communities" significantly curbed the spread of COVID-19. Optimizing the diagnosis process, shortening the diagnosis time, and constructing teams of clinical experts facilitated the provision of "one team of medical experts for each patient" treatment for severe patients, which significantly improved the recovery rate and reduced the infection fatality rate. CONCLUSION: The prevention policies and containment measures implemented by the government and medical institutions are highly effective in controlling the spread of the epidemic and increasing the recovery rate of COVID-19 patients.

4.
Tob Induc Dis ; 18: 65, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32818028

RESUMO

INTRODUCTION: The help of healthcare professionals for smokers to quit is critically important to increase quit rates. In the future, internship nursing students will potentially become the largest population of medical professionals. This study explored the impact of the use and awareness of universal tobacco control auxiliary resources on nursing students' 5As behavior in helping patients to quit smoking during a 40-week clinical internship in the last year of nursing school in Chongqing, China. METHODS: A survey was conducted in 13 teaching hospitals selected from 29 in Chongqing, China, in 2019, by a random cluster sampling method. It investigated, by self-reported questionnaires, student 5As behavior in helping patients to quit smoking and use and knowledge of tobacco cessation auxiliary resources (tobacco cessation self-education manual, tobacco cessation guidelines, tobacco cessation drugs, tobacco cessation websites, and hotline). The relationship between tobacco cessation auxiliary resources and 5As behavior in helping patients to quit smoking was analyzed with a multivariate linear mixed-effect model. RESULTS: In all, 534 (39.3%) students, of a total of 1358, reported that the majority of internship units provided a tobacco control self-education manual; 674 (49.6%) ever skimmed through tobacco cessation guidelines; 641 (47.2%) browsed tobacco cessation websites; 738 (54.3%) knew some cessation-assistance drugs; and 93 (6.8%) knew of and could recall the tobacco cessation hotline. Except for tobacco cessation websites, tobacco cessation auxiliary resources affected nursing interns' 5As behavior in helping patients to quit (p<0.05). CONCLUSIONS: Tobacco cessation auxiliary resources influenced students' 5As behavior in helping patients to quit smoking. Students knew a little of tobacco cessation auxiliary resources. To improve students' 5As behavior for helping patients to quit, more tobacco cessation resources need to be developed and more students need to become acquainted with them.

5.
J Clin Neurol ; 16(3): 438-447, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32657065

RESUMO

BACKGROUND AND PURPOSE: Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is the most-common form of autoimmune encephalitis, but its early diagnosis is challenging. This study aimed to identify the risk factors for a poor prognosis in anti-NMDAR encephalitis and construct a prognostic composite score for obtaining earlier predictions of a poor prognosis. METHODS: We retrospectively analyzed the clinical data, laboratory indexes, imaging findings, and electroencephalogram (EEG) data of 60 patients with anti-NMDAR encephalitis. The modified Rankin Scale (mRS) scores of patients were collected when they were discharged from the hospital. The mRS scores were used to divide the patients into two groups, with mRS scores of 3-6 defined as a poor prognosis. Logistic regression analysis was used to analyze independent risk factors related to a poor prognosis. RESULTS: This study found that 23 (38.3%) and 37 (61.7%) patients had good and poor prognoses, respectively. Logistic regression analysis showed that age, disturbance of consciousness at admission, and ≥50% slow waves on the EEG were significantly associated with patient outcomes. An age, consciousness, and slow waves (ACS) composite score was constructed to predict the prognosis of patients with anti-NMDAR encephalitis at an early stage based on regression coefficients. CONCLUSIONS: Age, disturbance of consciousness at admission, and ≥50% slow waves on the EEG were independent risk factors for a poor prognosis. The ACS prognostic composite score could play a role in facilitating early predictions of the prognosis of anti-NMDAR encephalitis.

6.
Ophthalmology ; 2020 Jun 27.
Artigo em Inglês | MEDLINE | ID: mdl-32603727

RESUMO

PURPOSE: To compare the effects of the Ahmed glaucoma valve (AGV; New World Medical, Rancho Cucamonga, CA) with sulcus versus anterior chamber (AC) tube placement on the corneal endothelial density and morphology over time. DESIGN: Nonrandomized, interventional study. PARTICIPANTS: This study included 106 eyes from 101 pseudophakic patients who had the AGV tube placed in the AC (acAGV) and 105 eyes from 94 pseudophakic patients who had the AGV tube placed in the ciliary sulcus (sAGV). METHODS: All patients underwent preoperative specular microscopy, which was repeated postoperatively in 2019. The patients' demographic information, glaucoma diagnoses, and basic ocular information were obtained on chart review. Anterior segment OCT was conducted for patients who underwent sAGV to evaluate the sulcus tube position. Gonioscopy was performed to document peripheral anterior synechiae (PAS). Linear mixed-effects models were used to compare the different ocular and endothelial measurements between the 2 groups and to identify risk factors for endothelial cell density (ECD) loss over time. MAIN OUTCOME MEASURES: Monthly change in corneal endothelial measurements, including ECD and coefficient of variation (CV), calculated as the difference between preoperative and postoperative measurements divided by the number of months from the time of surgery to postoperative specular microscopy. RESULTS: The acAGV and sAGV groups were comparable in all baseline characteristics except that the acAGV group had longer follow-up (37.6 vs. 20.1 months, respectively, P < 0.001). Mean monthly loss in central ECD was significantly more in the acAGV group (mean ± standard deviation: 29.3±29.7 cells/mm2) than in the sAGV group (15.3±20.7 cells/mm2, P < 0.0001). Mean monthly change in CV was similar between the 2 groups (P = 0.28). Multivariate analyses revealed that younger age and tube location in the AC were associated with faster central ECD loss (P = 0.02, P < 0.0001, respectively). For patients with sAGV, while PAS was associated with faster central ECD loss (P = 0.002), a more forward tube position tenting the iris was not (P > 0.05). CONCLUSIONS: Compared with anterior segment placement, ciliary sulcus tube implantation may be a preferred surgery approach to reduce endothelial cell loss in pseudophakic patients.

7.
J Cell Mol Med ; 24(13): 7451-7459, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32501652

RESUMO

Numb is known as a cell fate determinant as it identifies the direction of cell differentiation via asymmetrical partitioning during mitosis. It is considered as a tumour suppressor, and a frequent loss of Numb expression in breast cancer is noted. Numb forms a tri-complex with p53 and E3 ubiquitin ligase HDM2 (also known as MDM2), thereby preventing the ubiquitination and degradation of p53. In this study, we examined Numb expression in 125 patients with triple-negative breast cancer (TNBC). The results showed that 61 (48.8%) patients presented with a deficient or decreased Numb expression. The percentage of Ki67 > 14% in the retained Numb group was significantly lower than that in the decreased and deficient Numb groups (86.00% vs. 98.40%, P = .0171). This study aimed to detect the expression and migration of Numb, HDM2 and p53 in the membrane, cytoplasmic and nuclear fractions of normal mammary epithelial cell line MCF-10A and basal-like TNBC cell line MDA-MB-231. We obtained the cell fractions to identify changes in these three protein levels after the re-expression of NUMB in the MDA-MB-231 cells and the knocking down of NUMB in the MCF-10A cells. Results showed that Numb regulates p53 levels in the nucleus where the protein levels of Numb are positively correlated with p53 levels, regardless if it is re-expressed in the MDA-MB-231 cells or knocked down in the MCF-10A cells. Moreover, HDM2 was remarkably decreased only in the membrane fraction of NUMB knock-down cells; however, its mRNA levels were increased significantly. Our results reveal a previously unknown molecular mechanism that Numb can migrate into the nucleus and interact with HDM2 and p53.

8.
Medicine (Baltimore) ; 99(25): e20831, 2020 Jun 19.
Artigo em Inglês | MEDLINE | ID: mdl-32569232

RESUMO

The objective was to investigate the association of different hydration doses and its effect on renal function in patients with primary osteoporosis treated with zoledronic acid.The subjects with primary osteoporosis treated with zoledronic acid at the First Affiliated Hospital of Chongqing Medical University, China, from January 2015 to December 2018 were included in this study. The subjects were classified according to different hydration doses. Renal function indexes before and after treatment were collected and adverse reactions recorded to analyze the changes in renal function associated with different hydration doses.The choice of the hydration dose treated with zoledronic acid deserves attention. The lower hydration dose is, the greater impact on renal function can be caused.


Assuntos
Conservadores da Densidade Óssea/uso terapêutico , Rim/fisiopatologia , Osteoporose/tratamento farmacológico , Soluções para Reidratação/uso terapêutico , Ácido Zoledrônico/uso terapêutico , Idoso , Conservadores da Densidade Óssea/efeitos adversos , Feminino , Taxa de Filtração Glomerular/efeitos dos fármacos , Humanos , Masculino , Osteoporose/fisiopatologia , Soluções para Reidratação/administração & dosagem , Estudos Retrospectivos , Ácido Zoledrônico/efeitos adversos
9.
Int J Hypertens ; 2020: 2374231, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32454994

RESUMO

Objective: The increased blood pressure level in children and adolescents is recognized as an essential predictor of adulthood cardiovascular disease. This study aimed to ascertain the prevalence and the urban-rural disparity of childhood hypertension in the southwest of China. Methods: Using stratified cluster sampling in urban and rural areas, a total of 13597 primary school children aged 6∼12 years living in the Southwest of China were included. The prevalence of hypertension was analyzed. The risk factors were collected by questionnaires, and the risk factors of childhood hypertension were analyzed by the logistic regression model. Results: The prevalence of hypertension was 13.75%, 9.02%, and 17.47% in total, urban, and rural children, respectively, and the urban-rural difference was 8.44% (95%CI: 7.32%, 9.56%). Children with obesity, maternal gestational hypertension, >10 months of breastfeeding, or low family income had a significantly increased prevalence of hypertension (29.4%, 20.00%, 16.31%, and 16.25%, respectively). Rural residence, intake of more pickle (in rural), maternal gestational hypertension (in urban), low birth weight (in rural), obesity, increased heart rate, and red blood cell counts were the risk factors of childhood hypertension. The adjusted R 2 values were 13.61%, 23.25%, 10.88%, 11.12%, 12.23%, and 25.04% in the full models excluding and including serum indexes for total, urban, and rural children, respectively. Conclusions: The prevalence of childhood hypertension is significant in the Southwest of China and alarming in rural areas, which requires community intervention. Children living in rural areas combined with obesity, low social economic status, dietary imbalance, and abnormal lipid metabolism were associated with an increased risk of hypertension, and routine care programs should be conducted to prevent childhood hypertension.

10.
Clin Interv Aging ; 15: 595-607, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32431493

RESUMO

Purpose: Perceived social support (PSS) is closely linked to health outcomes in dementia patients. However, its continuous benefits are unclear. This mixed-methods study examined the impact of social support perceptions and differentiation among patients and carers during disease progression. Patients and Methods: Persons with dementia (PWDs), family caregivers, and community family physicians were recruited from nine community health centers. Semi-structured interviews conducted with 12 PWDs (7 PWDs in mild dementia and 5 in moderate dementia), 12 family caregivers, and 6 community family physicians and conventional content analysis were used to explore social support perspectives at different dementia stages. A total of 470 PWDs were divided into mild (n=224), moderate (n=190), and severe (n=56) groups. Demographic, physical, and psychological factors related to PSS were examined by the group using multiple regression analysis. The group-based characteristics were entered into three prediction models. Results: In the qualitative study, three themes of social support were identified: two viewpoints refer to social support; different needs and preferences in each stage; non-personalized support services. Quantitatively, the mild group scored lowest in perceived social support, while the severe group scored highest (χ2=64.70, P<0.001). The mild group PSS was predicted by depression (ß=-0.07, P=0.04), cognitive capacity (ß=-0.18, P<0.001), and instrumental ability (ß=-0.78, P<0.001), which differed from the moderate and severe groups. Conclusion: This study provided comprehensive insight into PSS from PWDs' perspective at different stages of the disease. Results indicated the need for a stratified care approach and direction for further research on intervention.


Assuntos
Cuidadores/psicologia , Demência/psicologia , Apoio Social , Idoso , Idoso de 80 Anos ou mais , Medicina de Família e Comunidade , Feminino , Nível de Saúde , Humanos , Masculino , Saúde Mental , Pesquisa Qualitativa , Índice de Gravidade de Doença , Fatores Socioeconômicos
11.
Artigo em Inglês | MEDLINE | ID: mdl-32138263

RESUMO

While studies on human immunodeficiency virus self-testing (HIVST) continue to accumulate after the World Health Organization's recommendation of HIVST as an additional approach to HIV testing services in 2016, few studies have focused on men who have sex with men (MSM) in Chinese cities. A cross-sectional study was conducted to describe the HIVST status of MSM in Chongqing, China. MSM participants were recruited by random sampling, and qualified interviewers collected data, using confidential self-administered questionnaires. Blood specimens were collected for HIV antibody detection. The survey evaluated the uptake and accuracy of HIVST kits and identified factors that may be associated with HIVST. The proportion of HIVST uptake was 15.6%. The sensitivity and specificity of HIVST were 74.2% (95% confidence interval [CI] 66.6%-80.7%) and 99.0% (95% CI 96.9%-99.7%), respectively. The consistency between the HIVST kit and antibody detection results was 90.5% (95% CI 87.5%-93.0%), and the Kappa value was 0.777 (p < 0.001). The positive predictive value of self-testing kits is 80.9% and the negative predictive value is 17.7%. Having been tested ≥2 times in the last year, higher educational levels, and higher scores of basic HIV/AIDS knowledge facilitated higher uptake of HIVST. Self-reported existing barriers for HIVST uptake included older age, marital status, and having resided in Chongqing for more than two years.


Assuntos
Infecções por HIV , Homossexualidade Masculina , Programas de Rastreamento , Minorias Sexuais e de Gênero , Adolescente , Adulto , Idoso , Pré-Escolar , China , Estudos Transversais , Infecções por HIV/diagnóstico , Humanos , Masculino , Programas de Rastreamento/estatística & dados numéricos , Pessoa de Meia-Idade , Inquéritos e Questionários , Adulto Jovem
13.
Am J Mens Health ; 14(1): 1557988319899799, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32028826

RESUMO

This study aimed to determine the differences in condom use and related factors among rural-urban men who have sex with men (MSM) in Western China. A cross-sectional survey was conducted in Chongqing, Sichuan, and Guangxi, which recruited MSM by non-probability sampling. Data were collected through an anonymous, standardized, and self-reported questionnaire guided by an information-motivation-behavioral skills model. Structural equation model was applied to analyze the related factors. Out of the 1141 MSM included in this analysis, 856 (75%) and 285 (25%) were from urban and rural areas, respectively. The median age was 27 years for both groups. Self-reported consistent condom use for anal sex in the past 6 months was 57.58%. The rate of consistent condom use was lower in rural MSM than in urban MSM (50.88% vs. 59.81%, p = .008). Behavioral skills, HIV/AIDS intervention services, and response costs had direct positive and negative influences on condom use, respectively. By contrast, motivation and information exhibited indirect influence. All the factors were mediated by behavioral skills in rural and urban MSM, except for the information that had no effect among urban MSM but had an indirect effect among rural MSM. These findings suggest that service providers should pay attention to substantial rural-urban differences and design different AIDS prevention and intervention strategies targeting rural and urban MSM.

14.
Cytokine ; 128: 155000, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-31982701

RESUMO

BACKGROUND: Infections are leading causes of morbidity and mortality in neonates and may also have severe long-term consequences. As early diagnosis of neonatal sepsis improves prognosis, identification of new or complementary biomarkers is of great importance. In this study, we have evaluated the diagnostic value of progranulin (PGRN) in early-onset neonatal sepsis (EOS) and compare its effectiveness with other commonly used biomarkers, such as procalcitonin (PCT) and C-reactive protein (CRP). METHODS: A total of 121 infants with gestational age of >34 weeks admitted with suspected EOS were included in this study. Before initiating therapy, blood samples for whole blood count, CRP, PCT and PGRN were obtained from all neonates. Receiver-operating characteristic (ROC) curve and multivariate logistic regression analyses were performed. RESULTS: Serum PGRN level of infected group was significantly higher than uninfected group (median 47.72 vs. 37.86 ng/ml, respectively; Mann-Whitney p < 0.0001). The ROC area under the curve (AUC) was 0.786 [95% confidence interval (CI) 0.706-0.867; p < 0.0001] for PGRN, 0.699 (95% CI 0.601-0.797; p = 0.0001) for age adjusted PCT, and 0.673 (95% CI 0.573-0.773; p = 0.0007) for CRP. With a cut-off value of 37.89 ng/ml, the diagnostic sensitivity and negative predictive value of PGRN were 94.34% and 91.7%, respectively. PGRN could significantly predict EOS independently of PCT (p < 0.0001), and the combined use of PGRN and PCT could significantly improve diagnostic performance for EOS (0.806; 95% CI 0.73-0.88; p < 0.0001), with a specificity of 89.06% and a positive predictive value of 81.10%. CONCLUSIONS: PGRN may be used as a promising biomarker for the diagnosis of EOS, and the combined use of PGRN and PCT could improve the diagnosis of sepsis.

15.
J Cell Mol Med ; 24(2): 1399-1412, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31809000

RESUMO

Liver plays an essential role in regulating lipid metabolism, and chronically disturbed hepatic metabolism may cause obesity and metabolic syndrome, which may lead to non-alcoholic fatty liver disease (NAFLD). Increasing evidence indicates long non-coding RNAs (lncRNAs) play an important role in energy metabolism. Here, we investigated the role of lncRNA H19 in hepatic lipid metabolism and its potential association with NAFLD. We found that H19 was up-regulated in oleic acid-induced steatosis and during the development of high-fat diet (HFD)-induced NAFLD. Exogenous overexpression of H19 in hepatocytes induced lipid accumulation and up-regulated the expression of numerous genes involved in lipid synthesis, storage and breakdown, while silencing endogenous H19 led to a decreased lipid accumulation in hepatocytes. Mechanistically, H19 was shown to promote hepatic steatosis by up-regulating lipogenic transcription factor MLXIPL. Silencing Mlxipl diminished H19-induced lipid accumulation in hepatocytes. Furthermore, H19-induced lipid accumulation was effectively inhibited by PI3K/mTOR inhibitor PF-04691502. Accordingly, H19 overexpression in hepatocytes up-regulated most components of the mTORC1 signalling axis, which were inhibited by silencing endogenous H19. In vivo hepatocyte implantation studies further confirm that H19 promoted hepatic steatosis by up-regulating both mTORC1 signalling axis and MLXIPL transcriptional network. Collectively, these findings strongly suggest that H19 may play an important role in regulating hepatic lipid metabolism and may serve as a potential therapeutic target for NAFLD.

16.
J Hum Hypertens ; 34(2): 151-164, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31666662

RESUMO

The prevalence of childhood hypertension is recognized as an important parameter of cardiovascular risk in adults. This retrospective study aimed to ascertain the prevalence and risk factors for hypertension from birth through childhood as of 2014. Stratified cluster sampling was used to select 17,007 participants (5971 with biochemical indexes available) aged 6-12 years on two avenues per region in urban, suburban, and rural areas. The prevalence of hypertension was 12.55%; children with obesity combined with rural residence, low family income, birth weight (<3000 g) (BWP25) or >10 months of breastfeeding had a significantly elevated prevalence of hypertension (37.06%, 30.41%, 30.04%, and 30.84%, respectively). Obesity and heart rate were the significant anthropometric determinants; gestational hypertension, BWP25 and >10 months of breastfeeding were the significant perinatal determinants; rural residence was the significant socioeconomic determinant; fasting blood glucose, triglycerides, and low-density lipoprotein cholesterol were the significant serum biochemical determinants; and red blood cell counts and platelet counts were the significant haematological determinants of childhood hypertension. The adjusted R2 values were 14.45% and 24.88% in the full models excluding and including serum indexes, respectively. We observed a notable prevalence of hypertension in a large paediatric sample. Obesity, high heart rate, BWP25, >10 months of breastfeeding, low family income, rural residence, abnormal lipid metabolism, and abnormal blood counts were associated with an increased risk of hypertension.

17.
Aging (Albany NY) ; 11(23): 11520-11540, 2019 12 12.
Artigo em Inglês | MEDLINE | ID: mdl-31831718

RESUMO

Liver has numerous critical metabolic functions including lipid metabolism, which is usually dysregulated in obesity, the metabolic syndrome, and non-alcoholic fatty liver disease (NAFLD). Increasing evidence indicates bone morphogenetic proteins (BMPs) play an important role in adipogenesis and thermogenic balance in adipogenic progenitors and adipose tissue. However, the direct impact of BMPs on hepatic steatosis and possible association with NAFLD are poorly understood. Here, we found that BMP4 was up-regulated in oleic acid-induced steatosis and during the development of high fat diet (HFD)-induced NAFLD. Exogenous BMP4 reduced lipid accumulation and up-regulated the genes involved in lipid synthesis, storage and breakdown in hepatocytes. Exogenous BMP4 inhibited hepatic steatosis, reduced serum triglyceride levels and body weight, and alleviated progression of NAFLD in vivo. Mechanistically, BMP4 overexpression in hepatocytes down-regulated most components of the mTORC1 signaling axis. Collectively, these findings strongly suggest that BMP4 may play an essential role in regulating hepatic lipid metabolism and the molecular pathogenesis of NAFLD. Manipulating BMP4 and/or mTORC1 signaling axis may lead to the development of novel therapeutics for obesity, metabolic syndrome, and NAFLD.


Assuntos
Proteína Morfogenética Óssea 4/metabolismo , Hepatócitos/metabolismo , Alvo Mecanístico do Complexo 1 de Rapamicina/metabolismo , Animais , Proteína Morfogenética Óssea 4/genética , Proteína Morfogenética Óssea 4/farmacologia , Células Cultivadas , Fígado Gorduroso , Feminino , Regulação da Expressão Gênica/efeitos dos fármacos , Proteínas de Fluorescência Verde , Humanos , Metabolismo dos Lipídeos , Masculino , Alvo Mecanístico do Complexo 1 de Rapamicina/genética , Camundongos , Hepatopatia Gordurosa não Alcoólica/induzido quimicamente , Hepatopatia Gordurosa não Alcoólica/metabolismo , Transdução de Sinais/efeitos dos fármacos , Transdução de Sinais/fisiologia , Regulação para Cima
18.
CNS Neurosci Ther ; 25(10): 1189-1194, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31542897

RESUMO

PURPOSE: We hypothesize delayed perihematomal edema (DHE) leads to secondary injury after spontaneous intracerebral hemorrhage (sICH) with a poor prognosis. Hence, we need to investigate the risk factors of DHE and identify whether DHE will predict the poor outcome of sICH. METHODS: We retrospectively recruited 121 patients with sICH admitted to the Department of Neurology from January 2014 to August 2018. After dividing all these patients into DHE group and non-DHE group, we analyzed the potential risk factors and outcome of DHE using a multivariate logistic regression model. RESULTS: We conclude DHE after sICH associates with age, hospitalization time, hematoma shape, blood pressure upon admission, alcohol consumption, blood sodium level, and baseline hematoma volume within 24 hours after symptom onset, among which differences were statistically significant (P < .05). Logistic regression analysis finally identified that age (OR = 0.958, 95% CI = 0.923-0.995) and the baseline hematoma volume (OR = 1.161, 95% CI = 1.089-1.238) were the most significant risk factors for DHE, and moreover, the DHE (OR = 3.062, 95% CI = 1.196-7.839) was also a risk factor for poor prognosis in sICH patients. CONCLUSION: We suggest DHE is a clinical predictor of secondary injury following sICH and poor prognosis. In addition, age and baseline hematoma volume are considered significant high-risk factors for DHE in patients with sICH.


Assuntos
Edema Encefálico/diagnóstico por imagem , Edema Encefálico/fisiopatologia , Hemorragia Cerebral/diagnóstico por imagem , Hemorragia Cerebral/fisiopatologia , Hematoma/diagnóstico por imagem , Hematoma/fisiopatologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Fatores de Tempo , Adulto Jovem
19.
Int J Mol Med ; 44(5): 1653-1666, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31485603

RESUMO

Although a number of experimental models have been developed for liver research, each has its own advantages and disadvantages. The present study attempted to develop a simple and effective 3­dimensional mouse liver microsphere tissue culture (LMTC) model in vitro for the analysis of hepatic functions. Hepatic characteristics and potential applications of this model were compared with that of mouse model in vivo and mouse primary hepatocytes in vitro. Using freshly­perfused mouse liver tissue passed through 80­mesh sift strainer (sift80), it was demonstrated that under the optimal culture conditions, the sift80 microsphere tissue cultured in 2% bovine calf serum medium remained viable with marked proliferating cell nuclear antigen and anti­Myc proto­oncogene protein expression, exhibited normal hepatic functions including indocyanine green (ICG) uptake/release and periodic acid­Schiff staining, and expressed hepatocyte­specific genes for up to 2 weeks. The microsphere tissue was responsive to bone morphogenic protein 9 (BMP9) stimulation leading to upregulation of downstream targets of BMP9 signaling. Furthermore, 3 commonly­used liver­damaging drugs were indicated to effectively inhibit hepatic ICG uptake, and induce the expression of hepatotoxicity­associated genes. Therefore, this simplified LMTC model may be a useful in vitro tissue culture model to investigate drug­induced liver injury and metabolism, and hepatocyte­based cell singling.


Assuntos
Doença Hepática Induzida por Substâncias e Drogas/metabolismo , Fígado/metabolismo , Transdução de Sinais/fisiologia , Animais , Bovinos , Técnicas de Cultura de Células/métodos , Diferenciação Celular/fisiologia , Linhagem Celular Tumoral , Células Cultivadas , Regulação para Baixo/fisiologia , Expressão Gênica/fisiologia , Fator 2 de Diferenciação de Crescimento/metabolismo , Células HCT116 , Células HEK293 , Hepatócitos/efeitos dos fármacos , Hepatócitos/metabolismo , Humanos , Verde de Indocianina/metabolismo , Fígado/efeitos dos fármacos , Camundongos , Camundongos Endogâmicos C57BL , Microesferas , Transdução de Sinais/efeitos dos fármacos , Regulação para Cima/fisiologia
20.
Exp Ther Med ; 17(1): 847-856, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30651871

RESUMO

Mild-to-moderate closed-head injury (mmCHI) is an acute disease induced by high-altitudes. It is general practice to transfer patients to lower altitudes for treatment, but the pathophysiological changes at different altitudes following mmCHI remain unknown. The present study simulated acute high-altitude exposure (6,000 m above sea level) in rats to establish a model of mmCHI and recorded their vital signs. The rats were then randomly assigned into different altitude exposure groups (6,000, 4,500 and 3,000 m) and neurological severity score (NSS), body weight (BW), brain magnetic resonance imaging (MRI), brain water content (BWC) and the ratio of BW/BWC at 6, 12 and 24 h following mmCHI, and the glial fibrillary acidic protein levels were analysed in all groups. The results revealed that within the first 24 h following acute high-altitude exposure, mmCHI induced dehydration, brain oedema and neuronal damage. Brain injury in rats was significantly reversed following descent to 4,500 m compared with the results from 6,000 or 3,000 m. The results indicated that subjects should be transported as early as possible. Furthermore, avoiding large-span descent altitude was beneficial to reduce neurological impairment. The examination of brain-specific biomarkers and MRI may further be useful in determining the prognosis of high-altitude mmCHI. These results may provide guidance for rescuing high altitude injuries.

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