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1.
Sichuan Da Xue Xue Bao Yi Xue Ban ; 50(3): 429-432, 2019 May.
Artigo em Chinês | MEDLINE | ID: mdl-31631613

RESUMO

Objective: To evaluate the clinical predictive ability of POSSUM and P-POSSUM scoring system in laparoscopic pancreatoduodenectomy (LPD). Methods: There were 132 consecutive LPD performed in West China Hospital of Sichuan University from February 2014 to July 2017. The clinical data were retrospective collected, including 12 preoperative physiological variables, 6 operative severity variables, and complications and mortality The postoperative expected mortality and morbidity were calculated by POSSUM and P-POSSUM score, and compared with measured morbidity and mortality. The clinical predictive ability of POSSUM and P-POSSUM system was evaluated by the receiver operating characteristic (ROC) curve and hierarchical analysis. Results: The area under ROC curve ( AUC) was 0.83. The preoperative physiological score (PS) and POSSUM score of the patients with complications were higher, and the difference was statistically significant ( P<0.01). For the prediction of complications after LPD, the expected value was the most accurate to the measured value when POSSUM score was >0.4-0.6. POSSUM scoring system had no significant difference in predicting the incidence of complications for benign and malignant lesions ( P>0.05), with a higher predictive value for malignant tumors. It was valuable in predicting the incidence of complications in male and female, and there was no significant difference in expected value between the sexes. Expected morbidity rate by POSSUM scoring system was 36.6% and measured morbidity rate was 33.3%. The expected and measured morbidities had no significantly differences. The expected mortality was 7.0% and measured mortality rate was 1.5%. The expected and measured mortality had no significantly differences. Expected mortality by P-POSSUM system was 1.6%, the expected and measured mortality had no significantly differences. Conclusion: POSSUM and P-POSSUM scoring system had high value for predicting LPD postoperative morbidity and mortality of LPD patients.


Assuntos
Laparoscopia/efeitos adversos , Pancreaticoduodenectomia/efeitos adversos , Complicações Pós-Operatórias/diagnóstico , China , Feminino , Humanos , Masculino , Morbidade , Mortalidade , Valor Preditivo dos Testes , Estudos Retrospectivos , Medição de Risco , Índice de Gravidade de Doença
2.
Int J Nanomedicine ; 14: 689-705, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30774330

RESUMO

Background: Intratumoral injection is a palliative treatment that aims at further improvement in the survival and quality of life of patients with advanced or recurrent carcinomas, or cancer patients with severe comorbidities or those with a poor performance status. Methods: In this study, a solvent-injection method was used to prepare paclitaxel-cholesterol complex-loaded lecithin-chitosan nanoparticles (PTX-CH-loaded LCS_NPs) for intratumoral injection therapy, and the physicochemical properties of NPs were well characterized. Results: The particle size and zeta potential of PTX-CH-loaded LCS_NPs were 142.83±0.25 nm and 13.50±0.20 mV, respectively. Release behavior of PTX from PTX-CH-loaded LCS_NPs showed a pH-sensitive pattern. The result of cell uptake assay showed that PTX-CH-loaded LCS_NPs could effectively enter cells via the energy-dependent caveolae-mediated endocytosis and macropinocytosis in company with the Golgi apparatus. Meanwhile, PTX-CH-loaded LCS_NPs had a better ability to induce cell apoptosis than PTX solution. The in vivo antitumor results suggested that PTX-CH-loaded LCS_NPs effectively inhibited mouse mammary cancer growth and metastasis to distant organs and significantly improved the survival rate of tumor-bearing mice by intratumoral administration. Conclusion: In general, our study demonstrated that PTX-CH-loaded LCS_NPs used for palliative treatment by intratumoral injection showed improved safety and antitumor efficacy, which provided an alternative approach in the field of palliative chemotherapy.


Assuntos
Antineoplásicos/uso terapêutico , Quitosana/química , Colesterol/química , Injeções Intralesionais , Lecitinas/química , Nanopartículas/química , Paclitaxel/uso terapêutico , Cuidados Paliativos , Animais , Apoptose/efeitos dos fármacos , Varredura Diferencial de Calorimetria , Linhagem Celular Tumoral , Sobrevivência Celular/efeitos dos fármacos , Liberação Controlada de Fármacos , Endocitose/efeitos dos fármacos , Fígado/patologia , Pulmão/patologia , Camundongos Endogâmicos BALB C , Recidiva Local de Neoplasia , Paclitaxel/química , Paclitaxel/farmacologia , Tamanho da Partícula , Polissorbatos/química , Análise de Sobrevida , Resultado do Tratamento
3.
Ann Transl Med ; 6(11): 211, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30023374

RESUMO

Annular pancreas is in adults is a rare congenital anomaly which incidence varied from 0.005% to 0.015%. Although 33% of the cases are symptomatic, the symptoms are most commonly associated with gastric outlet obstruction. Here we presented an adult diagnosed with annular pancreas treated by laparoscopic Roux-en-Y side to side duodenojejunostomy.

4.
Surg Laparosc Endosc Percutan Tech ; 28(1): 56-61, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29334528

RESUMO

BACKGROUND: Laparoscopic pancreaticoduodenectomy (LPD), a surgical option for nonpancreatic periampullary adenocarcinoma (NPPA), is a complex procedure that has become increasing popular. However, there is no consensus as to whether this technique should be performed routinely. Our aim was to evaluate the outcomes of LPD compared with open pancreaticoduodenectomy (OPD). MATERIALS AND METHODS: From October 2010 to September 2015, 58 LPDs were performed to treat NPPA and were compared with 58 OPDs, which can theoretically be carried out by laparoscopic approach. Patients were also matched based on their demographic data and pathologic diagnosis. Demographic information, intraoperative and postoperative data, pathologic data, and follow-up evaluation data were collected at our center. RESULTS: All patients had a median follow-up of 34 months (range, 8 to 60 mo). Overall median survival during the study between the groups was not different (P=0.760). No significant differences between the 2 groups were found in terms of patient demographics, short-term complications, pathologic outcomes, or tumor-node-metastasis stage. With regard to operative time, the LPD group was slightly longer than the OPD group (P<0.001). There were significant differences between groups in the time to the first passage of flatus and the time to oral intake (P<0.001). However, no differences were seen in blood loss, length of intensive care unit stay, node positive, or R0 resection between the laparoscopic and open groups. CONCLUSIONS: This study found that LPD is a feasible, safe, and effective method for the treatment of NPPA compared with OPD and may be a preferred method for surgeons to choose.


Assuntos
Adenocarcinoma/cirurgia , Ampola Hepatopancreática/cirurgia , Neoplasias do Ducto Colédoco/cirurgia , Laparoscopia/métodos , Pancreaticoduodenectomia/métodos , Adenocarcinoma/patologia , Adulto , Idoso , Ampola Hepatopancreática/patologia , China , Estudos de Coortes , Neoplasias do Ducto Colédoco/patologia , Feminino , Hospitais Universitários , Humanos , Estimativa de Kaplan-Meier , Laparotomia/métodos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica/patologia , Estadiamento de Neoplasias , Duração da Cirurgia , Prognóstico , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Taxa de Sobrevida , Resultado do Tratamento
5.
Chemosphere ; 184: 215-223, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28599150

RESUMO

In order to investigate long-term effect of cefalexin (CFX) on the performance of expanded granular sludge bed (EGSB) system and microbial community structure, two 1.47 L EGSB reactors E1 and E2 were designed and run for 224 days treating with synthetic antibiotic wastewater. For the purpose of comparison, E1 was fed with synthetic antibiotic industry wastewater with CFX added as the test reactor, while, E2 was fed without any CFX added as the control reactor (E2). The addition of CFX resulted in the continual increasing of soluble COD (sCOD) and accumulation of VFAs in the effluent of E1 system. Besides, it was found that the accumulation of CFX by-products D-1, D-2 and D-3 was negative correlation with sCOD removal efficiency. Furthermore, the microbial community structures were also investigated. For the bacterial community, Gelria and Syntrophorhabdus which can ferment propionate and other organic pollutants as their substrate were obviously enriched in E1 system. For the archaea, there was more functional diversity in E1 system than in E2 system. Furthermore, fungi also played an important role on the removal of complex organics in E1 system.


Assuntos
Antibacterianos/análise , Biodegradação Ambiental/efeitos dos fármacos , Cefalexina/análise , Eliminação de Resíduos Líquidos/métodos , Antibacterianos/toxicidade , Archaea , Reatores Biológicos/microbiologia , Cefalexina/toxicidade , Esgotos/química , Águas Residuárias , Microbiologia da Água
6.
Chemosphere ; 184: 951-959, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28655114

RESUMO

Over recent years, thermophilic digestion was constantly focused owing to its various advantage over mesophilic digestion. Notably, the startup approach of thermophilic digester needs to be seriously considered as unsuitable startup ways may result in system inefficiency. In this study, one-step temperature increase startup strategy from 37 °C to 55 °C was applied to establish a thermophilic anaerobic system treating terephthalic acid (TA) contained wastewater, meanwhile, the archaeal and bacterial community compositions at steady periods of 37 °C and 55 °C during the experimental process was also compared using Illumina Miseq Sequencing. The process operation demonstrated that the thermophilic TA degradation system was successfully established at 55 °C with over 95% COD reduction. For archaea community, the elevation of operational temperature from 37 °C to 55 °C accordingly increase the enrichment of hydrogenotrophic methanogens but decrease the abundance of the acetotrophic ones. While for bacterial community, the taxonomic analysis suggested that Syntrophorhabdus (27.40%) was the dominant genus promoting the efficient TA degradation under mesophilic condition, whereas OPB95 (24.99%) and TA06 (14.01%) related populations were largely observed and probably take some crucial role in TA degradation under thermophilic condition.


Assuntos
Ácidos Ftálicos/metabolismo , Anaerobiose , Archaea , Bactérias , Reatores Biológicos/microbiologia , Ácidos Ftálicos/análise , Ácidos Ftálicos/química , Esgotos/microbiologia , Temperatura Ambiente , Eliminação de Resíduos Líquidos/métodos , Águas Residuárias/análise , Águas Residuárias/química
7.
World J Gastroenterol ; 22(46): 10166-10179, 2016 Dec 14.
Artigo em Inglês | MEDLINE | ID: mdl-28028365

RESUMO

AIM: To investigate the diagnostic performance of liver stiffness measurement (LSM) by elastography point quantification (ElastPQ) in animal models and determine the longitudinal changes in liver stiffness by ElastPQ after splenectomy at different stages of fibrosis. METHODS: Liver stiffness was measured in sixty-eight rabbits with CCl4-induced liver fibrosis at different stages and eight healthy control rabbits by ElastPQ. Liver biopsies and blood samples were obtained at scheduled time points to assess liver function and degree of fibrosis. Thirty-one rabbits with complete data that underwent splenectomy at different stages of liver fibrosis were then included for dynamic monitoring of changes in liver stiffness by ElastPQ and liver function according to blood tests. RESULTS: LSM by ElastPQ was significantly correlated with histologic fibrosis stage (r = 0.85, P < 0.001). The optimal cutoff values by ElastPQ were 11.27, 14.89, and 18.21 kPa for predicting minimal fibrosis, moderate fibrosis, and cirrhosis, respectively. Longitudinal monitoring of the changes in liver stiffness by ElastPQ showed that early splenectomy (especially F1) may delay liver fibrosis progression. CONCLUSION: ElastPQ is an available, convenient, objective and non-invasive technique for assessing liver stiffness in rabbits with CCl4-induced liver fibrosis. In addition, liver stiffness measurements using ElastPQ can dynamically monitor the changes in liver stiffness in rabbit models, and in patients, after splenectomy.


Assuntos
Técnicas de Imagem por Elasticidade , Cirrose Hepática/diagnóstico por imagem , Fígado/diagnóstico por imagem , Esplenectomia , Animais , Biópsia , Tetracloreto de Carbono/toxicidade , Progressão da Doença , Fibrose , Fígado/patologia , Fígado/fisiopatologia , Cirrose Hepática/induzido quimicamente , Cirrose Hepática/patologia , Cirrose Hepática/fisiopatologia , Masculino , Coelhos
8.
Curr Microbiol ; 71(5): 551-8, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26223650

RESUMO

To well understand the community structure and composition of mesophilic microorganisms in anaerobic system fed with PTA wastewater, an up-flow anaerobic fixed bed reactor was continuously run at 33 and 37 °C for 75 and 60 days, respectively. Both fluorescence in situ hybridization analysis and 454-pyrosequencing were applied to investigate the microbial distinction within mesophilic ranges. A preferable performance was achieved at 37 than 33 °C. The taxonomic complexities of two samples were further compared at phylum, class, and genus levels. Notably, microbial diversity differed a lot and the change of populations was observed mainly in the shared OTUs. Genus level analysis showed that when temperature was increased to 37 °C, the abundance of Thauera and Hydrogenophaga (ß-Proteobacteria) decreased by 93.75 and 61.47 %, respectively, whereas that of Syntrophorhabdus (δ-Proteobacteria) increased from 4.93 to 16.01 %. Furthermore, the dominant archaeal Methanobacterium at both temperatures indicated the prevailing contribution of hydrogenotrophic methanogens in mesophilic anaerobic system.


Assuntos
Reatores Biológicos/microbiologia , Sequenciamento de Nucleotídeos em Larga Escala , Metagenoma , Microbiota , Águas Residuárias/microbiologia , Anaerobiose , Bactérias/classificação , Bactérias/genética , Hibridização in Situ Fluorescente , Filogenia , Esgotos/microbiologia , Temperatura Ambiente
9.
Water Res ; 61: 57-66, 2014 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-24952270

RESUMO

Performance and microbial community profiles in a hybrid anaerobic reactor treating synthetic PTA wastewater (contained the major pollutants terephthalate and benzoate) were studied over 220 days from 33 °C to 52 °C. Results indicated that PTA treatment process was highly sensitive to temperature variations in terms of COD removal. Operation at 37 °C showed the best performance as well as the most diverse microbial community revealed by 16S rRNA gene clone library and T-RFLP (terminal restriction fragment length polymorphism). Finally, the anaerobic process achieved a total COD removal of 77.4%, 91.9%, 87.4% and 66.1% at 33, 37, 43 and 52 °C. While the corresponding TA removal were 77.6%, 94.0%, 89.1% and 60.8%, respectively. Sequence analyses revealed acetoclastic Methanosaeta was preponderant at 37 °C, while hydrogenotrophic genera including Methanobrevibacter and Methanofollis were more abundant at other temperatures. For bacterial community, 16 classes were identified. The largely existent Syntrophorhabdus members (belonging to δ-Proteobacteria) at 37 °C was likely to play an important role in mesophilic anaerobic wastewater treatment system contained terephthalate. Meanwhile, ß-Proteobacteria seemed to be favored in an anaerobic system higher than 43 °C.


Assuntos
Bactérias/isolamento & purificação , Bactérias/metabolismo , Reatores Biológicos/microbiologia , Ácidos Ftálicos/metabolismo , Águas Residuárias/análise , Poluentes Químicos da Água/metabolismo , Anaerobiose , Bactérias/genética , DNA Bacteriano/genética , Dados de Sequência Molecular , Filogenia , Polimorfismo de Fragmento de Restrição , RNA Ribossômico 16S/genética , Análise de Sequência de DNA , Temperatura Ambiente
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