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1.
Sci Rep ; 11(1): 20159, 2021 Oct 11.
Artigo em Inglês | MEDLINE | ID: mdl-34635711

RESUMO

Paraquat (PQ) is a widely used fast-acting pyridine herbicide. Accidental ingestion or self-administration via various routes can cause severe organ damage. Currently, no effective antidote is available commercially, and the mortality rate of poisoned patients is exceptionally high. Here, the efficacy of anthrahydroquinone-2-6-disulfonate (AH2QDS) was observed in treating PQ poisoning by constructing in vivo and ex vivo models. We then explored the detoxification mechanism of AH2QDS. We demonstrated that, in a rat model, the PQ concentration in the PQ + AH2QDS group significantly decreased compared to the PQ only group. Additionally, AH2QDS protected the mitochondria of rats and A549 cells and decreased oxidative stress damage, thus improving animal survival and cell viability. Finally, the differentially expressed genes were analysed in the PQ + AH2QDS group and the PQ group by NextGen sequencing, and we verified that Nrf2's expression in the PQ + AH2QDS group was significantly higher than that in the PQ group. Our work identified that AH2QDS can detoxify PQ by reducing PQ uptake and protecting mitochondria while enhancing the body's antioxidant activity.

2.
Am J Clin Nutr ; 2021 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-34477820

RESUMO

BACKGROUND: Lipid metabolism plays an important role in the pathogenesis of diabetes. There is little evidence regarding the prospective association of the maternal lipidome with gestational diabetes mellitus (GDM), especially in Chinese populations. OBJECTIVES: We aimed to identify novel lipid species associated with GDM risk in Chinese women, and assess the incremental predictive capacity of the lipids for GDM. METHODS: We conducted a nested case-control study using the Tongji-Shuangliu Birth Cohort with 336 GDM cases and 672 controls, 1:2 matched on age and week of gestation. Maternal blood samples were collected at 6-15 wk, and lipidomes were profiled by targeted ultra-HPLC-tandem MS. GDM was diagnosed by oral-glucose-tolerance test at 24-28 wk. The least absolute shrinkage and selection operator is a regression analysis method that was used to select novel biomarkers. Multivariable conditional logistic regression was used to estimate the associations. RESULTS: Of 366 detected lipids, 10 were selected and found to be significantly associated with GDM independently of confounders: there were positive associations with phosphatidylinositol 40:6, alkylphosphatidylcholine 36:1, phosphatidylethanolamine plasmalogen 38:6, diacylglyceride 18:0/18:1, and alkylphosphatidylethanolamine 40:5 (adjusted ORs per 1 log-SD increment range: 1.34-2.86), whereas there were inverse associations with sphingomyelin 34:1, dihexosyl ceramide 24:0, mono hexosyl ceramide 18:0, dihexosyl ceramide 24:1, and phosphatidylcholine 40:7 (adjusted ORs range: 0.48-0.68). Addition of these novel lipids to the classical GDM prediction model resulted in a significant improvement in the C-statistic (discriminatory power of the model) to 0.801 (95% CI: 0.772, 0.829). For every 1-point increase in the lipid risk score of the 10 lipids, the OR of GDM was 1.66 (95% CI: 1.50, 1.85). Mediation analysis suggested the associations between specific lipid species and GDM were partially explained by glycemic and insulin-related indicators. CONCLUSIONS: Specific plasma lipid biomarkers in early pregnancy were associated with GDM in Chinese women, and significantly improved the prediction for GDM.

3.
Diabetes Metab Res Rev ; : e3496, 2021 Sep 19.
Artigo em Inglês | MEDLINE | ID: mdl-34537998

RESUMO

AIMS: We prospectively evaluated the association of circulating retinol-binding protein 4 (RBP4) levels in early pregnancy and risk of incident gestational diabetes mellitus (GDM) in pregnant women. METHODS: A nested case-control study was conducted among 332 women who developed GDM and 664 matched controls based on the Tongji-Shuangliu Birth Cohort. GDM was diagnosed during 24-28 weeks of gestation according to the International Association of Diabetes and Pregnancy Study Group criteria. Serum RBP4 levels in early pregnancy (6-15 weeks of gestation) were determined by ELISA assay. Multivariable conditional logistic regression models were used to analyse the association and generated the odds ratio (OR) and 95% confidence interval (CI). EMBASE and PubMed were searched up to 30 November 2020 to identify studies investigating the association between blood RBP4 levels in early pregnancy and incident GDM. RESULTS: In the multivariable model with adjustment of potential risk factors, the OR comparing the extreme quartiles of serum RBP4 levels was 2.26 (95% CI: 1.34, 3.81; p for trend <0.001), and each standard deviation (SD) increment of RBP4 was associated with 1.39-fold (95% CI: 1.15, 1.69) higher risk of GDM. The results were confirmed in a meta-analysis that included additional four studies with an overall OR of 1.47 (95% CI: 1.18, 1.83) per 1-SD increment of RBP4. CONCLUSIONS: Serum RBP4 levels in early pregnancy, independent of metabolic risk factors, are positively associated with the risk of GDM in pregnant women. Our findings may provide new insights into the mechanisms underlying the aetiology of GDM.

4.
Front Public Health ; 9: 702146, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34447736

RESUMO

Background: Policymakers must promote the development of public health education and human resources. As a feature of the political environment, public opinion is essential for policy-making, but virtually the attitudes of Chinese citizens toward human resources development in public health is unknown. Methods: This study conducted a crosssectional survey from February 4, 2021 to February 26, 2021 in China. We adopted a convenient sampling strategy to recruit participators. Participants filled out the questions, which assess the attitudes of the expanding public health professionals. A logistic regression analysis was given to identify the predictors associated with the attitudes of the subjects. Results: There were 2,361 residents who have finished our questionnaire. Chinese residents who lived in urban (OR = 1.293, 95% CI = 1.051-1.591), "themselves or relatives and friends have participated in relevant epidemic prevention work" (OR = 1.553, 95% CI = 1.160-2.079), "themselves or family members engaged in medical-related work" (OR = 1.468, 95% CI = 1.048-2.056), and those who "were aware of public health before the outbreak of COVID-19" (OR = 1.428, 95% CI = 1.125-1.812) were more likely to support the promotion of public health education and training. Conclusions: The present study found that 74.50% of Chinese citizens supported the promotion of public health education and training in China, in which economic status, personal perception, and comprehension are the crucial factors that influence public opinion. COVID-19 has aroused the attention of Chinese residents to public health education, with only 22.11% of residents being aware of public health before the outbreak of COVID-19. The COVID-19 pandemic has profound implications for human society. Literally, this impact will feed back into future public health policies based on public opinion. This innovative perspective will also help us better understand the potential social impact of COVID-19 on human resources and development for health in the modern world.


Assuntos
COVID-19 , Pandemias , China/epidemiologia , Educação em Saúde , Humanos , Motivação , Opinião Pública , SARS-CoV-2
5.
PLoS One ; 16(8): e0256387, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34411194

RESUMO

Linear aggregation is present in some animals, such as the coordinated movement of ants and the migration of caterpillars and spinylobsters, but none has been reported on rotifers. The rotifers were collected and clone cultured in the laboratory at 25 ± 1°C, under natural light (light intensity ~130 lx, L:D = 14:10). The culture medium(pH = 7.3) was formulated as described by Suga et al., and rotifers were fed on the micro algae Scenedesmus obliquus grown in HB-4 medium to the exponential growth stage. When density was high (150 individuals ml-1), the behavior of rotifers was observed using a stereo microscope (Motic ES-18TZLED). In this paper, linear aggregation in Brachionus calyciflorus was found for the first time, and experiments were carried out to verify the correlation between linear aggregation and culture density of B. calyciflorus. With the increase of density, the number of aggregations increase, the number of individuals in the aggregation increased, and the maintenance time of the aggregation was also increased. Therefore, we speculate that the formation of aggregates is related to density and may be a behavioral signal of density increase, which may transmit information between density increase and formation of dormant eggs.

6.
BMC Psychiatry ; 21(1): 353, 2021 07 14.
Artigo em Inglês | MEDLINE | ID: mdl-34261458

RESUMO

BACKGROUND: Effort-reward imbalance is an adverse psychological response to working conditions that has several negative effects on nurses. However, there is little research on effort-reward imbalance and its influencing factors among nurses in emergency departments. This study aimed to understand the current situation of effort-reward imbalance and explore its influencing factors among emergency department nurses in China. METHODS: From July to August 2018, a structured online questionnaire survey was conducted among emergency department nurses in China. Data were collected from emergency department nurses employed in hospitals providing pre-hospital care in China. The questionnaire consisted of sociodemographic characteristics, work-related factors and effort-reward imbalance. A descriptive analysis and a binary logistic regression were conducted to explore the effort-reward imbalance and its influencing factors among emergency department nurses. RESULTS: The study involved 17,582 emergency department nurses; notably, the prevalence of effort-reward imbalance was 59.66%. The participating nurses who were males, aged 25 to 34 years, whose educational level was a bachelor degree or above, who had a junior or above title, who had longer years of service, and who had suffered verbal or physical violence in the past year had a higher risk of effort-reward imbalance. Furthermore, the nurses with a high monthly income, who believed that the number of nurses met the department's demand had a lower risk of effort-reward imbalance. CONCLUSIONS: Effort-reward imbalance was prevalent among emergency department nurses in China. Measures such as adjusting the night shift frequency, increasing the number of nurses, raising salaries and reducing workplace violence should be considered to reduce the level of effort-reward imbalance.


Assuntos
Enfermeiras e Enfermeiros , Recursos Humanos de Enfermagem no Hospital , China , Estudos Transversais , Serviço Hospitalar de Emergência , Humanos , Satisfação no Emprego , Masculino , Recompensa , Inquéritos e Questionários
7.
Glob Heart ; 16(1): 34, 2021 05 04.
Artigo em Inglês | MEDLINE | ID: mdl-34040947

RESUMO

Background: In November 2017, the American College of Cardiology/American Heart Association (ACC/AHA) updated their definition of hypertension from 140/90 mm Hg to 130/80 mm Hg. Objectives: We sought to assess the situation of hypertension and the impact of applying the new threshold to a geographically and ethnically diverse population. Methods: We analyzed selected data on 237,142 participants aged ≥40 who had blood pressure taken for the 2014 China National Stroke Screening and Prevention Project. Choropleth maps and logistic regression analyses were performed to estimate the prevalence, geographical distribution and risk factors of hypertension using both 2017 ACC/AHA guidelines and 2014 evidence-based guidelines. Results: The present cross-sectional study showed the age- and sex-standardized prevalence of hypertension was 37.08% and 58.52%, respectively, according to 2014 evidence-based guidelines and 2017 ACC/AHA guidelines. The distribution of hypertension and risk factors changed little between guidelines, with data showing a high prevalence of hypertension around Bohai Gulf and in south central coastal areas using either definition. The age- and sex-standardized prevalence of newly labeled as hypertensive was 21.44%. Interestingly, the high prevalence region of newly labeled as hypertensive was found in the north China. Conclusion: The prevalence of hypertension increased significantly on 2017 ACC/AHA guidelines compared to the prevalence when using 2014 evidence-based guidelines, with high prevalence areas of newly labeled as hypertensive now seen mainly in north China. There need to be correspondingly robust efforts to improve health education, health management, and behavioral and lifestyle interventions in the north.

8.
Pharmacol Res Perspect ; 9(3): e00764, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33929082

RESUMO

Xanthine oxidase (XO) competes with thiopurine S-methyltransferase (TPMT) and hypoxanthine guanine phosphoribosyltransferase (HPRT) to metabolize azathioprine (AZA)/6-mercaptopurine (6-MP) in vivo. A retrospective investigation was performed to detect the activity of XO in thiopurine curative Chinese inflammatory bowel disease (IBD) patients. We also evaluated whether a relationship between XO activity and incidence of thiopurine-induced adverse effects (AEs) existed. Clinical data and blood samples were collected from 140 IBD patients before receiving AZA/6-MP therapy, and the erythrocyte XO activity was measured. The XO activities of all patients were 20.29 ± 4.43 U/g Hb. No sex difference in XO activity was observed (p = .728), and the XO activity showed no difference between the UC and CD patients (p = .082). AEs were observed in 41 (29.3%) patients including leukopenia (26, 18.57%), gastrointestinal intolerance (11, 7.86%), flu-like symptom (5, 3.57%), alopecia (5, 3.57%), and hepatotoxicity (1, 0.71%). XO activity was significantly lower in the patients with AEs than in those without AEs (18.40 ± 3.73 vs. 21.07 ± 4.48 U/g Hb, p = .001), especially in the patients with leukopenia (18.29 ± 3.68 vs. 21.07 ± 4.48 U/g Hb, p = .004). However, no significant difference in XO activity was found between patients with and without other AEs. Decreased XO activity was observed in the patients who developed flu-like symptoms (17.58 ± 3.50 U/g Hb) and alopecia (18.67 ± 2.91 U/g Hb) compared to those who did not, although the differences did not reach statistical significance. These findings suggested that patients with low XO expression might have a high risk of thiopurine-induced toxicity.

9.
Nutr Metab Cardiovasc Dis ; 31(5): 1391-1400, 2021 05 06.
Artigo em Inglês | MEDLINE | ID: mdl-33812733

RESUMO

BACKGROUND AND AIMS: Obesity has been linked to the development of hypertension, but the comparison of relationships between different obesity parameters with hypertension are scarcely studied with nationally representative Chinese adults samples. We sought to compare the predictive strengths of different obesity indicators to hypertension. METHODS AND RESULTS: Data in this study were obtained from the Chinese National Stroke Prevention Project with a nationally representative sample of Chinese aged 40 years and older. A total of 162,880 individuals were included. Multi-level analyses and Receiver Operating Characteristic (ROC) curves were used to examine the risk of hypertension in relation to different obesity parameters, including body mass index (BMI), waist circumference (WC), lipid accumulation product index (LAP), visceral adiposity index (VAI), and body adiposity index (BAI). As results, the BMI, WC, LAP, VAI, and BAI were positively associated with the risk of hypertension (P < 0.001). In total, BMI had the strongest association with hypertension when compared with other obesity indicators, and one SD up of BMI would increase the risk of hypertension by 53.9% (95% CI: 1.514-1.566). For men, WC was most associated with hypertension, and one SD up of WC would increase the risk of hypertension by 73.3% (95% CI: 1.685-1.782). For women, BMI showed the strongest predictive power, one SD up of BMI would increase the risk of hypertension by 51.0% (95% CI: 1.479-1.543). CONCLUSIONS: BMI, WC, LAP, VAI, and BAI are all positively corrected to hypertension, but gender disparities should be considered in predicting hypertension by obesity indicators.


Assuntos
Adiposidade , Antropometria , Pressão Sanguínea , Hipertensão/epidemiologia , Obesidade/diagnóstico , Adulto , Idoso , China , Estudos Transversais , Feminino , Disparidades nos Níveis de Saúde , Humanos , Hipertensão/diagnóstico , Hipertensão/fisiopatologia , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Obesidade/fisiopatologia , Valor Preditivo dos Testes , Prevalência , Prognóstico , Medição de Risco , Fatores de Risco , Fatores Sexuais
10.
Ann Palliat Med ; 10(4): 3715-3725, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33691453

RESUMO

BACKGROUND: A major challenge in clinical research is population heterogeneity and we need to consider both historical response and current condition of an individual in considering medical decision making. The idea of precise medicine cannot be fully accounted for in traditional randomized controlled trials. Reinforcement learning (RL) is developing rapidly and has found its way into various fields including clinical medicine in which RL is employed to find an optimal treatment strategy. The key idea of RL is to optimize the treatment policy depending on the current state and previous treatment history, which is consistent with the idea behind dynamic programming (DP). DP is a prototype of RL and can be implemented when the system dynamics can be fully quantified. METHODS: The present article aims to illustrate how to perform DP algorithm in a clinical scenario of Sepsis resuscitation. The state transition dynamics are constructed in the framework of Markov Decision Process. The state space is defined by mean arterial pressure (MAP) and lactate; the action space is comprised of fluid administration and vasopressor. The implementation of policy evaluation, policy improvement and iteration are explained with R code. RESULTS: the DP algorithm was able to find the optimal treatment policy depending on the current states and previous conditions. The iteration process converged at finite steps. We defined several functions such as nextStep(), policyEval() and policy_iteration() to implement the DP algorithm. CONCLUSIONS: This article illustrates how DP can be used to solve a clinical problem. We show that DP is a potential useful tool to tailor treatment strategy to patients with different conditions/states. Potential audience of the paper are those who are interested in using DP for solving clinical problems with dynamic changing states.


Assuntos
Algoritmos , Sepse , Tomada de Decisão Clínica , Humanos , Cadeias de Markov , Sepse/terapia
11.
J Gen Intern Med ; 36(3): 622-631, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33140279

RESUMO

BACKGROUND: Most previous studies of the family doctor contract services (FDCS) evaluated its quality by using residents' signing rates, awareness, and satisfaction. We hypothesize that renewal willingness could be another important indicator to examine the quality of FDCS. OBJECTIVE: To measure residents' willingness to maintain contracts with family doctors and examine the influencing factors. DESIGN: Cross-sectional study. PARTICIPANTS: 11,250 residents in 31 provincial administrative regions across China. MAIN METHODS: A multistage stratified random sampling method was used to recruit participants. Univariate analysis, mixed-effect regression model analysis, and stepwise multivariate logistic regression analysis were performed to determine the influencing factors of residents' willingness to maintain contracts with family doctors. KEY RESULTS: About 71.3% participants who contracted with and received healthcare services from family doctors were willing to maintain contracts with family doctors in China. Residents registering as local households (OR = 1.192, 95% CI = 1.039-1.368), enrolled in medical insurance (OR = 1.299, 95% CI = 1.011-1.668), reporting better health (OR = 1.246, 95% CI = 1.100-1.413), with shorter walking time to the nearest healthcare center (compared with > 30 min walking time, < 15 min: OR = 1.209, 95% CI = 1.003-1.458; 15-30 min: OR = 1.288, 95% CI = 1.124-1.475), and trusting in (OR = 4.403, 95% CI = 3.849-5.036) and satisfied with (OR = 18.514, 95% CI = 16.195-21.165) their family doctors had significantly higher willingness to maintain contracts with family doctors. CONCLUSIONS: Residents' willingness to maintain contracts with family doctors could be another evaluation indicator of the quality of FDCS in China. Improving the accessibility and quality of healthcare services from family doctors may increase residents' willingness to keep contracts with family doctors and promote the implementation of FDCS.


Assuntos
Serviços Contratados , Serviços de Saúde , China , Estudos Transversais , Humanos , Inquéritos e Questionários
12.
J Affect Disord ; 280(Pt A): 7-10, 2021 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-33197782

RESUMO

OBJECTIVES: To assess the psychological status of college students in China during the COVID-19 outbreak, and offer some theoretical evidence for psychological intervention of college students. METHODS: An online survey was conducted from May 10, 2020 to June 10, 2020. Anxiety symptoms were measured by the Generalized Anxiety Disorder 7-Item Scale (GAD-7). Categorical data were reported as number and percentage, while continuous data were reported as mean ± SD. Multivariate logistic regression models were used to evaluate the association between different factors and anxiety symptoms. RESULTS: A total of 89,588 college students participated in the current study, among which 36,865 students (41.1%) reported anxiety symptoms. Multivariate logistic regression analysis revealed that the risk factors for anxiety symptoms included the age of 26-30 (OR=1.456), sophomore (OR=1.038), junior (OR=1.087) and senior grades (OR=1.161), a higher paternal education level (OR=1.055), low economic status (OR=1.520), and low social support (OR=1.542). CONCLUSIONS: About two-fifths of Chinese college students experienced anxiety symptoms during the COVID-19 epidemic. Timely and appropriate psychological interventions for college students should be implemented to reduce the psychological harm caused by COVID-19 epidemic.


Assuntos
COVID-19/psicologia , Saúde Mental/estatística & dados numéricos , Adolescente , Adulto , Ansiedade/psicologia , COVID-19/epidemiologia , COVID-19/virologia , China/epidemiologia , Estudos Transversais , Depressão/epidemiologia , Depressão/psicologia , Depressão/virologia , Feminino , Humanos , Masculino , Fatores de Risco , SARS-CoV-2/isolamento & purificação , Estudantes/psicologia , Inquéritos e Questionários , Universidades/estatística & dados numéricos , Adulto Jovem
13.
Chem Commun (Camb) ; 57(5): 619-622, 2021 Jan 21.
Artigo em Inglês | MEDLINE | ID: mdl-33346300

RESUMO

We developed a novel electrochemical biosensor for ultrasensitive Hg2+ detection via a triple signal amplification strategy of a DNA dual cycle, organic-inorganic hybrid nanoflowers (Cu3(PO4)2 HNFs) and gold nanoparticle (AuNP) probe. The DNA dual cycle was triggered by exonuclease III (Exo III) in the presence of Hg2+, and Cu3(PO4)2 HNFs were synthesized as an AuNP probe carrier. The electrochemical biosensor displayed high stability, high sensitivity and excellent specificity, which was improved by up to seven orders of magnitude compared to the World Health Organization (WHO) allowed Hg2+ levels in drinking water. This signal amplification strategy could be easily modified and extended to detect other hazardous heavy metals and nucleic acids.


Assuntos
Técnicas Biossensoriais , DNA/genética , Técnicas Eletroquímicas , Mercúrio/análise , Técnicas de Amplificação de Ácido Nucleico , DNA/química , DNA/metabolismo , Exodesoxirribonucleases/metabolismo , Ouro/química , Nanopartículas Metálicas/química , Sondas Moleculares/química , Tamanho da Partícula
14.
BMC Fam Pract ; 21(1): 246, 2020 11 30.
Artigo em Inglês | MEDLINE | ID: mdl-33250045

RESUMO

BACKGROUND: General practitioners (GPs) are the foundation of any primary healthcare system. Their quality and quantity are directly associated with the effectiveness and quality of the health services of a nation. GPs' shortage and turnover have become an important issue in developed and developing countries. An accurate estimate of turnover intention prevalence among GPs would have important health policy implications, but the overall prevalence is unknown. We aimed to summarize the global prevalence of turnover intention and associated factors among GPs. METHODS: We systematically reviewed the PubMed, Embase, Web of Science and China National Knowledge Infrastructure (CNKI) databases from their inception up to May 2020, as well as the reference lists of all included studies. We included observational studies that reported data on turnover intention or their prevalence rate among GPs could be calculated based on the information provided. The prevalence rate of the turnover intentions was estimated using a random-effects meta-analysis. The heterogeneity was evaluated using I2 statistic. Differences by study level characteristics were estimated via subgroup analysis and meta-regression. RESULTS: A total of 25 cross-sectional studies were included (a total of 27,285 participants). The prevalence of turnover intention was 0.47 (95% CI: 0.39-0.55). Those having a lower level of salary (OR = 1.38, 95% CI: 1.13-1.63) and job satisfaction (OR = 1.35, 95% CI: 1.12-1.70) or having lower level of morale (OR = 2.68, 95% CI: 1.56-3.80) had a higher intention. In contrast, GPs with a lower level of professional title had a lower turnover intention (OR = 0.81, 95% CI: 0.65-0.98). CONCLUSIONS: In this systematic review, approximately half of the GPs had the intention to leave their current posts worldwide. The factors associated with turnover intention were higher professional title, lower income level, lower job satisfaction and lower morale.

15.
Top Stroke Rehabil ; : 1-11, 2020 Nov 13.
Artigo em Inglês | MEDLINE | ID: mdl-33186090

RESUMO

Background: The prevalence of suicidal ideation (SI) among stroke survivors has been the subject of several studies, but systematic review data regarding the prevalence of SI among stroke patients are still scarce.Objectives: To estimate the pooled prevalence of SI among stroke survivors.Methods: A comprehensive search strategy was established across the following electronic databases; Web of Science, PubMed, the Cochrane Library, Chinese Wanfang database and Chinese National Knowledge Infrastructure (CNKI). The 95% confidence interval (CI) given in each identified study was used to assess the outcomes. Cochran's Q test and I2 statistic were used to evaluate heterogeneity. The quality of the final evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. We calculated the pooled prevalence of SI among stroke survivors before subgroup analysis and meta-regression was used to find the partial source of heterogeneity.Results: Twenty-one studies with a total of 17,189 participants were included in this study and the pooled prevalence of SI among stroke survivors was 12.25% (95%CI: 9.91-15.07%). Substantial heterogeneity was detected in the estimation of prevalence. The evidence was graded as very low for the overall outcome and the single item subgroup, while it was graded as low for the stable scale subgroup.Conclusions: This meta-analysis suggests a high prevalence of SI among stroke survivors. Routine screening of SI after stroke is needed to plan interventions aimed at reducing suicide risk.

16.
Nat Commun ; 11(1): 5917, 2020 11 20.
Artigo em Inglês | MEDLINE | ID: mdl-33219229

RESUMO

Stringent COVID-19 control measures were imposed in Wuhan between January 23 and April 8, 2020. Estimates of the prevalence of infection following the release of restrictions could inform post-lockdown pandemic management. Here, we describe a city-wide SARS-CoV-2 nucleic acid screening programme between May 14 and June 1, 2020 in Wuhan. All city residents aged six years or older were eligible and 9,899,828 (92.9%) participated. No new symptomatic cases and 300 asymptomatic cases (detection rate 0.303/10,000, 95% CI 0.270-0.339/10,000) were identified. There were no positive tests amongst 1,174 close contacts of asymptomatic cases. 107 of 34,424 previously recovered COVID-19 patients tested positive again (re-positive rate 0.31%, 95% CI 0.423-0.574%). The prevalence of SARS-CoV-2 infection in Wuhan was therefore very low five to eight weeks after the end of lockdown.


Assuntos
Betacoronavirus/genética , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Programas de Rastreamento , Ácidos Nucleicos/análise , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Anticorpos Antivirais/imunologia , Infecções Assintomáticas/epidemiologia , COVID-19 , Criança , China/epidemiologia , Infecções por Coronavirus/imunologia , Emprego , Feminino , Geografia , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/imunologia , Prevalência , SARS-CoV-2 , Adulto Jovem
17.
Medicine (Baltimore) ; 99(47): e22702, 2020 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-33217793

RESUMO

This study aimed to assess the predictive value of velocity time integral (VTI) of the left ventricular outflow tract (LVOT) on volume expansion test (VET) as an indicator of volume responsiveness in septic shock patients. Septic shock patients undergoing mechanical ventilation were recruited. The hemodynamic parameters before and after VE were monitored by pulse indicated continuous cardiac output (PiCCO) and echocardiography. Heart rate, cardiac index (CI), mean arterial pressure (MAP), central venous pressure, stroke volume variation (SVV), CI and variation of pulse pressure (PPV), and the changes in cardiac parameters (Dheart rate, Dmean arterial pressure, Dcentral venous pressure, DSVV, DCI, and DPPV) were determined. The relationships of hemodynamic parameters and their changes with DVTI were further evaluated with Pearson relation analysis. The value of these parameters in fluid responsiveness prediction was evaluated by using the receiver operating characteristic (ROC) curve analysis. Results showed that 44 VETs were performed in 44 septic shock patients with responsiveness in 24 patients and non-responsiveness in 20. The CI increased by ≥ 15% in responsive patients, but by<15% in non-responsive patients after VET. There were significant differences in the SVV and PPV after VET between responsive and non-responsive groups. DSVV, DPPV, and DCI were positively related to DVTI. The area under ROC curve (AUC) for SVV in fluid responsiveness prediction was 0.80, and the sensitivity and specificity of SVV were 66.5% and 95%, respectively, when the cut-off value was 24.8%. The AUC for PPV in fluid responsiveness prediction was 0.843, and the sensitivity and specificity of PPV were 83.3% and 75%, respectively, when the cut-off value was 25.8%. The AUC for DVTILVOT in fluid responsiveness prediction was 0.956, and the sensitivity and specificity were 87.5% and 95%, respectively, when the cut-off value was 15.9%. In conclusion, DVTILVOT is effective to predict fluid responsiveness after VET in mechanical ventilation patients with septic shock. It may serve as a new, noninvasive and functional hemodynamic parameter with the same accuracy to SVV.


Assuntos
Hidratação/métodos , Hemodinâmica , Choque Séptico/fisiopatologia , Choque Séptico/terapia , APACHE , Pressão Arterial , Pressão Sanguínea , Débito Cardíaco , Ecocardiografia Doppler em Cores , Feminino , Frequência Cardíaca , Humanos , Masculino , Pessoa de Meia-Idade , Escores de Disfunção Orgânica , Estudos Prospectivos , Respiração Artificial , Sensibilidade e Especificidade , Volume Sistólico
18.
Artigo em Inglês | MEDLINE | ID: mdl-33082817

RESUMO

Background: Colitis-associated colorectal cancer (CAC) develops from active colonic inflammation, which is characterized by the production of proinflammatory cytokines that can induce mutations. IL-6 is produced by multiple cell types located within the tumor microenvironment including tumor-infiltrating immune cells, stromal cells, and the tumor cells themselves. The aim of our study was to explore the mechanism of Feng-Liao-Chang-Wei-Kang (FLCWK) and 5-fluorouracil (5-FU) in treating CAC. Method: HCT116 cells were treated with 5-FU in the absence or presence of FLCWK. Cell proliferation was assayed by MTT assays. Apoptosis and the cell cycle phases were detected by flow cytometry. Western blotting and Q-PCR assays were used to detect the expression levels of proteins and genes related to the IL-6/STAT3 signalling pathway. A mouse model for CAC was established by treating animals with 12.5 mg/kg azoxymethane (AOM) followed by 3 cycles of 2.5% dextran sodium sulphate (DSS). The associated pathological changes were determined after haematoxylin and eosin (H&E) staining. The expression of related proteins and genes in various tissues was examined using immunofluorescence techniques. Results: FLCWK enhanced the ability of 5-FU to promote apoptosis by inhibiting the proliferation of HCT116 cells and blocking the IL-6/STAT3 pathway. FLCWK combined with 5-FU reduced the number and size of colon tumors in mice with CAC and significantly increased their survival rate. In the CAC model, FLCWK synergized with 5-FU to inhibit the phosphorylation of STAT3, preventing IL-6/STAT3 signal transduction and thus further inducing apoptosis and inhibition of colon cancer cell proliferation. Conclusion: FLCWK can inhibit the activation of STAT3 by reducing the production of IL-6, thereby increasing the occurrence of colitis-related colorectal cancer with 5-FU.

19.
Front Immunol ; 11: 1829, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32903604

RESUMO

Sepsis is the leading cause of death in intensive care units. MicroRNA-34a (miR-34a) is involved in sepsis progression, while its underlying mechanisms on sepsis-induced lung injury remain obscure. Oxidative stress, pyroptosis, and inhibition of autophagy can result in organ injury. MiR-34a has been reported to regulate oxidative stress and autophagy via inhibiting silent information regulator T1 (SIRT1) and autophagy gene 4B (ATG4B) signaling. This study aimed at identifying the function of miR-34a in oxidative stress, inflammation, pyroptosis, and autophagy in sepsis-induced lung injury. Male 8-week-old C57BL/6 mice were subjected to cecal ligation and puncture and treated with miR-34a antagomir/agomir. Survival (n = 10), histopathological changes (n = 6), and lung wet-to-dry ratio (n = 6) were recorded and assayed. Other detection (n = 6) was performed to investigate the level of oxidative stress, inflammation, pyroptosis, and autophagy in lung tissues. Results showed that miR-34a down-regulation ameliorated lung injury in septic mice as reflected by decreased lung injury scores (decrease from 3.00 ± 0.32 to 2.00 ± 0.32) and wet-to-dry ratio (0.36-fold decrease). MiR-34a down-regulation also decreased reactive oxygen species accumulation (0.36-fold decrease), and promoted superoxide dismutase activity and the expression of SIRT1 (1.24-fold increase), heme oxygenase-1 and nuclear factor erythroid 2 like 2 to inhibit oxidative stress in septic mice. Moreover, miR-34a down-regulation suppressed inflammatory response and pyroptosis in septic mice, as evidenced by decreased level of pro-inflammatory factors including tumor necrosis factor α, interleukin-6 (IL-6), IL-1ß, and IL-18, activity of caspase-1 (0.51-fold decrease) and expression of nucleotide-binding domain and leucine-rich repeat protein-3 (0.48-fold decrease), apoptosis-associated speck-like protein containing a CARD, cleaved-caspase-1, and cleaved-gasdermin D (0.36-fold decrease), and increased level of anti-inflammatory factors IL-10. MiR-34a down-regulation also enhanced autophagy in septic mice as evidenced by more autolysosomes and elevated expressions of ATG4B (0.90-fold increase), beclin1, ATG9, and LC3 II/I. Among these experiments, miR-34a up-regulation showed opposite effects on oxidative stress, inflammatory response, pyroptosis, and autophagy in septic mice. Additionally, miR-34a could bind to the 3'-untranslated region of SIRT1 and ATG4B. In conclusion, our findings demonstrated that miR-34a was implicated in oxidative stress, inflammation, pyroptosis, and autophagy in the development of sepsis. MiR-34a inhibition had a potential to alleviate sepsis-induced lung injury.


Assuntos
Lesão Pulmonar Aguda/metabolismo , Lesão Pulmonar Aguda/patologia , MicroRNAs/antagonistas & inibidores , Lesão Pulmonar Aguda/imunologia , Animais , Autofagia/imunologia , Ceco/lesões , Modelos Animais de Doenças , Inflamação/imunologia , Inflamação/metabolismo , Ligadura , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Estresse Oxidativo/fisiologia , Punções , Piroptose/imunologia , Sepse/complicações , Sepse/imunologia , Sepse/metabolismo
20.
Sleep Med ; 74: 199-203, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32861011

RESUMO

OBJECTIVES: Sleep status can affect the body's immune status and mental health. This study aims to investigate the sleep status of Chinese residents during the outbreak of Coronavirus Disease 2019 (COVID-19) and to evaluate its related risk factors. METHODS: This research carried out a cross-sectional survey in February 2020 (during the COVID-19 outbreak) to investigate the sleep status of residents nationwide in the form of an online questionnaire. Of the 8151 respondents, 6437 were eventually included in the analysis. Logistic regression is applied to analyze the associated factors affecting residents' sleep quality. RESULTS: During the COVID-19 outbreak, the incidence of sleep disturbances in residents was 17.65%. Increased risk of sleep disturbances was found to be associated with older age, female gender, and poor self-reported health status. Moreover, the odds ratios (ORs) were 1.42 (95% CI: 1.1-2.64), 1.35 (95% CI: 1.16-1.59), 5.59 (95% CI: 4.32-7.23), respectively. Those residents who believed COVID-19 had caused a high number of deaths or who thought COVID-19 was not easy to cure were more likely to experience sleep disorders, and the ORs were 1.73 (95% CI: 1.43-2.09), 1.57 (95% CI: 1.29-1.91), respectively. Regular exercise was a protective factor for sleep disturbances, OR = 0.77 (95% CI: 0.63-0.93). CONCLUSIONS: During the outbreak of COVID-19, nearly one-fifth of participants had sleep disorders. It is necessary to pay more attention to people at high risk for sleep disturbances during the outbreak, adopt effective risk communication methods, enhance residents' rational understanding of COVID-19, and develop practical indoor exercise programs for general public to improve sleep quality.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Surtos de Doenças , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , Transtornos do Sono-Vigília/epidemiologia , Transtornos do Sono-Vigília/psicologia , Adulto , Conscientização/fisiologia , COVID-19 , China/epidemiologia , Estudos Transversais , Surtos de Doenças/prevenção & controle , Exercício Físico/fisiologia , Exercício Físico/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , SARS-CoV-2 , Inquéritos e Questionários , Adulto Jovem
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