Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 268
Filtrar
Mais filtros










Intervalo de ano de publicação
1.
J Craniofac Surg ; 2020 Feb 07.
Artigo em Inglês | MEDLINE | ID: mdl-32049915

RESUMO

BACKGROUND: Intracranial fibrosarcoma is an extremely rare neoplasm in the central nervous system. Insofar there were only sporadic case reports describing its features. The purpose of this study is to review the clinical and surgical features of cases who were treated in our department. METHOD: The authors retrospectively reviewed and detailed the clinical and surgical data obtained from 5 patients with fibrosarcoma who underwent treatment at our institute between January 2009 and January 2019. RESULTS: There were 3 males and 2 females including 2 juvenile and 3 senior patients. The most frequent sign was intermittent pain and vomiting. The location of the tumor included middle fossa, thalamus and midbrain, sellar and suprasellar region and right parietal-occipital lobe. Surgical observation demonstrated the consistency of the tumor was tenacious with abundant blood supply. Gross total resection was achieved in 2 cases. Pathological analysis showed spindle cells in a herringbone form with positive Vimentin staining in all 5 cases, with the absence of GFAP or S-100. All 5 patients were deceased eventually after a varied period of time after the first surgery. CONCLUSION: Intracranial fibrosarcoma was a highly malignant entity presented in the central nervous system. Surgery still remains the first-line treatment followed by radiotherapy, however, the prognostic outcome was very poor. Future studies should be more focused on accumulation of the relevant information on this disease thus hopefully in assisting to developing more optimized treatment.

2.
BMJ Open ; 10(2): e032336, 2020 Feb 12.
Artigo em Inglês | MEDLINE | ID: mdl-32051302

RESUMO

OBJECTIVE: To evaluate physician risk-benefit preferences and trade-offs when making chemotherapy decisions for patients with non-small cell lung cancer (NSCLC). DESIGN: A discrete choice experiment (DCE). SETTINGS: Tertiary hospitals in Beijing, Shanghai, Guangzhou and Chengdu of China. PARTICIPANTS: The participants were 184 physicians (mean age of 37 years) with more than 1 year of NSCLC chemotherapy practice. OUTCOMES: The DCE survey was constructed by six attributes: progression-free survival (PFS), disease control rate (DCR), risk of moderate side effects, risk of severe side effects, mode of administration and out-of-pocket costs. Physicians' relative preferences and trade-offs in patient out-of-pocket costs for each attribute level were estimated using a mixed logit model, and interaction terms were added to the model to assess preferences variation among physicians with different sociodemographic factors. RESULTS: Physicians had the strongest preferences for improvements in PFS, followed by reducing the risk of severe side effects. The DCR, risk of moderate side effects and mode of administration were ranked in decreasing order of importance. There was little variation in preferences among physicians with different sociodemographic characteristics. Physicians were willing to trade $4814 (95% CI $4149 to $5480) of patient out-of-pocket costs per month for a chemotherapy that guaranteed 11 months of PFS, followed by $1908 (95% CI $1227 to $2539) for reducing the risk of severe side effects to 2%. CONCLUSIONS: With regard to chemotherapy for patients with NSCLC, prolonging PFS, reducing severe and moderate side effects were primary considerations for physicians in China. The mode of administration and treatment costs significantly influenced physicians' therapeutic decision. The current findings could add some evidence to inform NSCLC chemotherapy implementation and promote shared decision-making.

3.
Nanoscale ; 2020 Feb 13.
Artigo em Inglês | MEDLINE | ID: mdl-32053130

RESUMO

The key for graphene applications is the successful transfer of graphene from a growth metal substrate to a substrate for application without compromising its high quality. However, state-of-the-art polymethyl methacrylate (PMMA) assisted transfer methods introduce wrinkles, folds and cracks, which are exacerbated for porous substrates. Here we report a novel in situ technique to transfer graphene onto a porous substrate which resolves these issues. Using phase-inversion a porous substrate is grown onto a graphene film with strong adhesion that perfectly matches graphene's topography, and the growth metal substrate is subsequently etched away. We achieve 63 cm2 high-quality single-layered graphene with almost 100% coverage over the pores of the substrate and pore ratios up to 35%. Our study resolves the three main challenges of transferring graphene to porous substrates, which are matching the topographies between the graphene and the porous substrate, achieving high pore ratios and minimizing the stresses on the suspended graphene; this approach may therefore serve as a general guide for attaching graphene or other 2D materials to scaffold structures.

4.
Medicine (Baltimore) ; 99(5): e18916, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32000399

RESUMO

Acute pancreatitis (AP) is a rare complication of hemorrhagic fever with renal syndrome (HFRS), and is difficult to diagnose. In this study, we retrospectively analyzed the clinical characteristics of 7 cases of HFRS complicated with AP and 105 cases of acute biliary pancreatitis (ABP).Medical records of 83 hospitalized patients with HFRS and 105 hospitalized patients with ABP in the affiliated Yijishan Hospital of Wannan Medical College were reviewed. The comparative analysis of patients between the 2 groups was conducted in terms of sex, age, duration of hospital stay, fever, hemorrhage, proteinuria, oliguria, laboratory results, radiologic examinations, and prognosis.A total of 83 patients were diagnosed with HFRS during study period. Only 8.43% (7/83) of the total HFRS patients were diagnosed with AP. The differences in the gender, age, and duration of hospital stay between the 2 investigated groups of patients were not statistically significant. The major symptoms for all 7 patients with HFRS complicated with AP and 105 patients with ABP were fever and upper abdominal pain. During the disease course of HFRS complicated with AP, 6 patients experienced hemorrhaging, and 7 patients underwent an oliguric stage, but none of the ABP patients experienced hemorrhaging and oliguria. Among the laboratory results of all patients, the differences in alanine aminotransferase and glycemia were not statistically significant. The other laboratory results (leucocyte count, platelet count, amylase, lipase, total bilirubin, direct bilirubin, creatinine, blood urea nitrogen, prothrombin time, activated partial thromboplastin time, and serum calcium level) were significantly different during hospitalization. All 7 patients with HFRS complicated with AP received conservative medical treatment and hemodialysis. In the patients with ABP, 21 patients were discharged from the hospital after conservative treatment, 53 patients were treated by endoscopic invasive treatment after stabilization, and 31 patients were treated by surgery after stabilization.AP is not a frequent complication in patients with HFRS. There are differences in clinical manifestations and laboratory findings between the HFRS complicated with AP group and the ABP group; these differences may help in the differential diagnosis and treatment of these 2 types of pancreatitis.


Assuntos
Febre Hemorrágica com Síndrome Renal/complicações , Pancreatite/complicações , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
5.
J Clin Invest ; 2020 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-31990685

RESUMO

BACKGROUND: Preclinical experiments have shown that donor blood cells, modified in vitro by an alkylating agent (MIC, modified immune cells), induced long-term specific immunosuppression against the allogeneic donor. METHODS: In this phase-I trial, patients received either 1.5x106 MIC per kg b.w. on day -2 (N=3, group A), or 1.5x108 MIC per kg b.w. on day -2 (N=3, group B) or day -7 (N=4, group C) before living donor kidney transplantation in addition to post-transplant immunosuppression. Primary outcome measure was the frequency of adverse events (AE) until day 30 (study phase) with follow-up to day 360. RESULTS: MIC infusions were extremely well tolerated. During the study phase, a total of 69 AE occurred in 10 treated patients which were unlikely/not related to MIC infusion. No donor-specific human leukocyte antigen antibodies or rejection episodes were noted even though the patients received up to 1.3x1010 of donor mononuclear cells prior to transplantation. Group C patients with low immunosuppression during follow-up showed no in vitro reactivity against stimulatory donor blood cells on day 360 while reactivity against third party cells was preserved. Frequencies of CD19+CD24highCD38high transitional B lymphocytes (Breg) increased from a median of 6% before MIC infusion to 20% on day 180, which was 19- and 68-fold higher, respectively, than in two independent cohorts of transplanted controls. The majority of Breg produced immunosuppressive cytokine IL-10. MIC-treated patients showed the Immune Tolerance Network operational tolerance signature. CONCLUSION: MIC administration was safe and could be a future tool for the targeted induction of tolerogenic Breg.

6.
Surg Endosc ; 34(1): 408-416, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30972623

RESUMO

BACKGROUND AND AIMS: Endoscopic submucosal dissection (ESD) has become the primary option for the treatment of early gastric cancer (EGC). Thus, it is necessary to diagnose whether residual cancer cells exist in the ESD specimen margins, which can affect tumor recurrence and survival rates in the future. Multiphoton microscopy (MPM) can be suitably used for nondestructive imaging of biological tissue on a cellular level to enable real-time guidance during endoscopic therapy. Considering this, the objective of this study is to explore the practicality of MPM for the diagnosis of ESD specimen margins in the case of EGC. METHODS: First, a total of 20 surgical samples was imaged using the proposed MPM technique to obtain two-photo excited fluorescence signal from the intrinsic fluorescent substances within cells and second-harmonic generation signal from collagen; these signals were used to determine MPM pathological features for margin diagnosis. Then, a double-blind study of 50 samples was conducted to evaluate the diagnosis results based on the obtained MPM pathological features. RESULTS: Multiphoton microscopy can accurately identify the cytological and morphological differences between tissue in the negative and positive margin. The sensitivity, specificity, accuracy, negative predictive, and positive predictive values of MPM in the diagnosis of ESD specimen margins were 97.62, 75.00, 94.00, 95.35, and 85.71%, respectively. CONCLUSION: These results indicate that MPM can be used as an effective, real-time, and label-free novel method to determine intraoperative resection margins.

7.
J Orthop Surg Res ; 14(1): 439, 2019 Dec 13.
Artigo em Inglês | MEDLINE | ID: mdl-31836021

RESUMO

BACKGROUND: A detailed understanding of the blood supply to the femoral head is required to plan the surgery in the femoral neck and head area. However, information about the blood vessel networks in the femoral head is inadequate. METHODS: The surface of the femoral neck of 100 dry cadaveric adult femur specimens was scanned using a 3D scanner. The scanning distance was 200 mm, precision 0.01 mm, and measuring point 0.04 mm. The images were acquired at a resolution of 1,310,000 pixels. Digital imaging data were recorded from the femoral neck surface. The diameters of the nutrient foramina of the superior, inferior and anterior retinacular arteries, and the ligamentum teres arteries were determined and divided into five groups. RESULTS: The mean cumulative cross-sectional area of the nutrient foramina was as follows: canals of the superior, inferior, anterior, and ligamentum retinacular arteries were 15.59 mm2, 3.63 mm2, 4.32 mm2, and 1.58 mm2, respectively. Next, we analyzed the canals of the superior, inferior, anterior and ligamentum retinacular arteries, respectively, via 3D scanner. We found that the canals of the superior retinacular arteries appear to supply more blood to the femoral head than the canals of the other three types of arteries. CONCLUSIONS: Our results demonstrated that surgeries of the femoral neck and femoral head will be improved with prior 3D scanning and lead to better outcomes in surgeries involving the hip area.

8.
J Orthop Surg Res ; 14(1): 464, 2019 Dec 27.
Artigo em Inglês | MEDLINE | ID: mdl-31881893

RESUMO

BACKGROUND: Follow-up after artificial joint replacement greatly helps achieve surgical outcomes. Mobile internet technology and mobile terminal equipment may increase the effectiveness of artificial joint replacement. However, only a few studies have evaluated the effectiveness of this technology. We aimed to analyze the reasons and outcomes of patients who used the instant messaging platform after undergoing artificial joint replacement. METHODS: Among the 548 cases of arthroplasty (250 hips, 298 knees) performed between December 2015 and June 2018 in the Department of Joint Surgery of our institution; 358 (164 hip joints, 194 knee joints) participated in instant messaging platform consultation, whereas the remaining 190 (86 hip joints, 104 knee joints) participated in traditional telephone consultation, as a control group. Follow-up time was from December 2015 to August 2018 (follow-up period was 2-32 months). Data on age, sex, type of surgery, date of surgery, date of discharge, and length of hospital stay were collected from electronic medical records. RESULTS: We analyzed the consultation contents of 358 patients who participated in instant messaging platform consultation. Counseling was mainly related to pain (13.6%), appointment review (12.4%), activity problems (10.5%), and incision problems (8.9%). Most problems were resolved through online guidance, with 8.4% of patients requiring only outpatient treatment and 2.5% of patients requiring rehospitalization. A total of 190 patients were followed up through traditional telephone consultation; 6.8% of patients required outpatient department treatment and 7.4% were eventually re-admitted. CONCLUSION: The instant messaging platform consultation service effectively informs patients of potential postoperative problems and helps resolve them. It allows early detection and management of postoperative adverse events, including problems related to medication, wound, and activity, thereby effectively reducing readmission rate.

9.
BMC Musculoskelet Disord ; 20(1): 552, 2019 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-31747958

RESUMO

BACKGROUND: Periprosthetic joint infection (PJI) is a challenging complication following total joint arthroplasty (TJA), and the diagnostic criteria remains controversial. The 2018 new definition proposed in May 2018 consists of new diagnostic criteria for PJI. We conducted a retrospective study and demonstrated that the new definition could improve the diagnostic efficiency in Chinese patients. However, missing data led to bias in the previous retrospective study. Therefore, this prospective study is designed to further validate the feasibility of 2018 new definition (and its modified version) for Chinese patients. METHODS/DESIGN: This is a single-centre, prospective diagnostic study with 1 year of follow-up. The patients enrolled in the trial will be divided into a PJI group and an Aseptic group based on the eligibility criteria. We will recruit at least 70 patients for each group from October 2019 to October 2020. Blood samples, synovial fluid samples and intraoperative variables of all the included patients will be collected to assess various indicators. We will integrate the results of the various tests and examine the diagnostic efficiency (sensitivity and specificity) of five diagnostic criteria. DISCUSSION: We design the prospective study in the hope of reducing the bias caused by missing data. Therefore, the prospective study will further support the conclusion of our preceding retrospective study. The results of this study will be submitted to a peer-reviewed journal for publication. CONCLUSION: Through this prospective study, we will validate the feasibility of the 2018 new PJI definition (and its modified version) for Chinese patients and determine the optimal method of PJI diagnosis. TRIAL REGISTRATION: Chinese Clinical Trial Registry, ChiCTR1900025395. Registered on 25 August 2019.

10.
World J Clin Cases ; 7(21): 3562-3568, 2019 Nov 06.
Artigo em Inglês | MEDLINE | ID: mdl-31750338

RESUMO

BACKGROUND: A recurrent valgus deformity was a common complication after total knee arthroplasty (TKA) in patients with valgus deformity. However, re-revision surgery for re-recurrent valgus deformity after revision TKA in patients with valgus deformity before primary TKA was uncommon. CASE SUMMARY: We reported a 72-year-old female patient with two recurrent valgus deformities after TKA for a valgus knee deformity who underwent two revision surgeries to rectify the deformity. In the re-revision surgery, bone defects were successfully reconstructed by the augments and cement in combination with screws and a sleeve. An appropriate neutral alignment of the lower limb was restored by the perfect femoral entry point and the long diaphyseal cementless stem. Adequate fixation of the metaphysis and diaphysis of the femur was obtained by the sleeve and long diaphyseal cementless stem. The patient was pain-free and deformity-free for 2.5 years. CONCLUSION: The management of bone defects, the choice of the stem and the femoral entry point were of vital importance in the revision or re-revision TKA for a recurrent valgus deformity.

11.
Math Biosci Eng ; 16(6): 7808-7828, 2019 08 27.
Artigo em Inglês | MEDLINE | ID: mdl-31698641

RESUMO

Objective: To evaluate the influence of drilling sites for benign lesions in femoral head and neck with curettage, bone-grafting and internal fixation. Methods: Twelve paired formalin-fixed human cadaveric femora were grouped randomly into 2 groups of 6 pairs each, which were group 1 and group 2, and one of each pair of femora was grouped randomly to drill an oval-shaped hole in the anterior femoral neck, and the contralateral femur was assigned to drill an oval-shaped hole in the lateral of the proximal femur. Group 1 femora were simulated the operation of curettage, bone-grafting and internal fixation, and group 2 femora were simulated the operation of curettage. Besides, finite element models corresponding to mechanical testing were simulated according to one of the twelve femora, then finite element analysis were done. Wilcoxon signed-rank test was used for statistical analysis, with a p value < 0.05 indicating statistical significance. Results: The simulated operation of curettage decreased the axial stiffness and torsional stiffness of the intact proximal femur significantly, while there was no statistical difference on the degree of the decline between different drilling sites. Although the simulated operation of bone-grafting and internal fixation in different drilling sites increased the axial stiffness and torsional stiffness, only in the case of implanting bones and internal fixation for the lateral cortical drilled hole increased the axial stiffness greatly and made a statistical difference, even more stiff than the intact proximal femur model. Conclusion: Compared with drilling in the anterior femoral neck, a bigger stability could be obtained after drilling in the lateral proximal femur for benign lesions in femoral head and neck with curettage, bone-grafting and internal fixation.

12.
Patient Prefer Adherence ; 13: 1701-1709, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31631985

RESUMO

Objective: The study aims to quantify patients' risk-benefit preferences for chemotherapy in the treatment of non-small cell lung cancer (NSCLC), and to elicit their willingness to pay (WTP) for treatment outcomes. Methods: A face-to-face discrete choice experiment (DCE) was conducted on NSCLC patients in four tertiary hospitals each from Beijing, Shanghai, Guangzhou and Chengdu in China. Patients were invited to complete choice questions that constructed by seven attributes: progression-free survival (PFS), disease control rate (DCR), rash, nausea and vomiting, tiredness, mode of administration and out-of-pocket costs. A mixed logit model was used to evaluate the choice model. Estimates of relative preferences and marginal willingness to pay for each attribute were then explored. Results: A total of 361 patients completed the survey. Improvements in PFS (10, 95% CI: 8.4-11.6) were the most important attribute for patients, followed by increase in DCR (4.6, 95% CI: 3.4-5.8). Tiredness (3.9, 95% CI: 2.9-5.1) was judged to be the most important risk. While remaining attributes were ranked in decreasing order of importance: nausea and vomiting (1.9, 95% CI: 0.9-3.0), mode of administration (0.8, 95% CI: 0.2-1.4) and rash (0.5, 95% CI: -0.6-1.5). There was little variation in preferences among patients with different sociodemographic characteristics. Patients were monthly willing to pay $2304 (95% CI, $1916-$2754) that guaranteed 11 months of PFS, followed by $1465 (95% CI, $1163-$1767) per month to improve their disease control rate by 90%. Conclusion: The results suggested that efficacy was the most important attribute for patients. Side effects, mode of administration and treatment cost significantly influenced patient preferences. Patient engagement in prioritizing their treatment preferences should be emphasized during the clinical decision-making process and regimen implementation.

13.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi ; 33(10): 1254-1259, 2019 Oct 15.
Artigo em Chinês | MEDLINE | ID: mdl-31544435

RESUMO

Objective: To investigate the three-dimensional structure of proximal femoral trabeculae, analyze the formation mechanism, and explore its relationship with the occurrence and treatment of proximal femoral fractures. Methods: Six cadaver adult femur specimens were harvested and the gross specimens containing both trabecular system and cortical bone were established by hand scraping. All samples were scanned by micro-CT and the CT images were input into Mimics18.0 software to establish the digital proximal femoral model containing trabecular structure. The spatial distribution of trabecular system was observed, and the relations between trabecular bone and the proximal femur surface and related anatomical landmarks were analyzed in digital models. Results: The gross specimen and digital models of trabecular system were successfully established. The trabecular system of proximal femur could be divided into two groups: the horizontal and vertical trabecular. The horizontal trabecular arose from the base of greater trochanter, gone along the direction of femoral neck, and terminated at the center of femoral head. The vertical trabecular began from the base of lesser trochanter and femoral calcar, gone radically upward, and reached the femoral head. The average distance of the horizontal trabecular to the greater trochanter was 22.66 mm (range, 17.3-26.8 mm). In the femoral head, the horizontal trabecula and the vertical trabecula were fused into a kind of sphere, and the distances from the horizontal trabecula to the surface of the femoral head vary in different sections. The average distance of trabecular ball to the femoral head surface was 6.88 mm (range, 6.3-7.2 mm) in sagittal plane, 6.32 mm (range, 5.8-7.6 mm) in coronal plane, and 6.30 mm (range, 5.6-6.3 mm) in cross section. The vertical and horizontal trabeculae intersect obliquely, and the average angle of horizontal trabecular and vertical one was 140.67° (range, 129-150°). Conclusion: The trabecular system exhibits a unique spatial configuration, which is the main internal support of proximal femur. Restoration of the integrity of trabecular structure is the important goal of proximal femoral fractures.


Assuntos
Colo do Fêmur , Fêmur/anatomia & histologia , Adulto , Cabeça do Fêmur , Humanos , Processamento de Imagem Assistida por Computador , Microtomografia por Raio-X
14.
Cancer Imaging ; 19(1): 60, 2019 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-31455432

RESUMO

OBJECTIVES: To explore the feasibility of diagnosing microvascular invasion (MVI) with radiomics, to compare the diagnostic performance of different models established by each method, and to determine the best diagnostic model based on radiomics. METHODS: A retrospective analysis was conducted with 206 cases of hepatocellular carcinoma (HCC) confirmed through surgery and pathology in our hospital from June 2015 to September 2018. Among the samples, 88 were MVI-positive, and 118 were MVI-negative. The radiomics analysis process included tumor segmentation, feature extraction, data preprocessing, dimensionality reduction, modeling and model evaluation. RESULTS: A total of 1044 sets of texture feature parameters were extracted, and 21 methods were used for the radiomics analysis. All research methods could be used to diagnose MVI. Of all the methods, the LASSO+GBDT method had the highest accuracy, the LASSO+RF method had the highest sensitivity, the LASSO+BPNet method had the highest specificity, and the LASSO+GBDT method had the highest AUC. Through Z-tests of the AUCs, LASSO+GBDT, LASSO+K-NN, LASSO+RF, PCA + DT, and PCA + RF had Z-values greater than 1.96 (p<0.05). The DCA results showed that the LASSO + GBDT method was better than the other methods when the threshold probability was greater than 0.22. CONCLUSIONS: Radiomics can be used for the preoperative, noninvasive diagnosis of MVI, but different dimensionality reduction and modeling methods will affect the diagnostic performance of the final model. The model established with the LASSO+GBDT method had the optimal diagnostic performance and the greatest diagnostic value for MVI.


Assuntos
Carcinoma Hepatocelular/diagnóstico por imagem , Processamento de Imagem Assistida por Computador/métodos , Neoplasias Hepáticas/diagnóstico por imagem , Tomografia por Emissão de Pósitrons/métodos , Carcinoma Hepatocelular/patologia , Feminino , Humanos , Neoplasias Hepáticas/patologia , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica
15.
Int J Cancer ; 2019 Aug 29.
Artigo em Inglês | MEDLINE | ID: mdl-31465111

RESUMO

Chemotherapy-induced peripheral neuropathy (CIPN) is a significant side effect of chemotherapeutics. The mechanisms of CIPN remain substantially unidentified, although inflammation-induced peripheral sensitization has been indicated as an important factor. Here, we aimed to illustrate the role of the matrix metalloproteinase (MMP)-9-related signaling pathway in the process of CIPN. Oxaliplatin (L-OHP) was administered to mice to establish the CIPN model. Gelatin zymography was used to measure MMP-9/2 activities. Western blotting and immunohistochemistry were used to measure the expression of high-mobility group box-1 (HMGB-1), calcitonin gene-related peptide and ionized calcium-binding adapter molecule 1. Mechanical withdrawal was measured by von Frey hairs testing. Raw 264.7 cells and SH-SY5Y cells were cultured to investigate cell signaling in vitro. Here, we report that L-OHP-induced mechanical pain in mice with significant MMP-9/2 activation in dorsal root ganglion (DRG) neurons. MMP-9 inhibition or knockout alleviated the occurrence of CIPN directly. MMP-9/2 were released from macrophages and neurons in the DRG via the HMGB-1-toll-like receptor 4 (TLR4)-phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt) axis, because MMP-9/2 activities could be reduced by macrophage scavengers or PI3Kγ knockout in CIPN mice. The in vitro data revealed that induced MMP-9 activity by recombinant HMGB-1 could be abolished by TLR4, PI3K or Akt inhibitors. Finally, it was shown that N-acetyl-cysteine (NAC) could reduce MMP-9/2 activities and attenuate CIPN effectively and safely. The HMGB-1-TLR4-PI3K/Akt-MMP-9 axis is involved in the crosstalk between macrophages and neurons in the pathological process of CIPN in mice. Direct inhibition of MMP-9 by NAC may be a potential therapeutic regimen for CIPN treatment.

16.
Biomicrofluidics ; 13(4): 041503, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31431816

RESUMO

Early cancer detection, its monitoring, and therapeutical prediction are highly valuable, though extremely challenging targets in oncology. Significant progress has been made recently, resulting in a group of devices and techniques that are now capable of successfully detecting, interpreting, and monitoring cancer biomarkers in body fluids. Precise information about malignancies can be obtained from liquid biopsies by isolating and analyzing circulating tumor cells (CTCs) or nucleic acids, tumor-derived vesicles or proteins, and metabolites. The current work provides a general overview of the latest on-chip technological developments for cancer liquid biopsy. Current challenges for their translation and their application in various clinical settings are discussed. Microfluidic solutions for each set of biomarkers are compared, and a global overview of the major trends and ongoing research challenges is given. A detailed analysis of the microfluidic isolation of CTCs with recent efforts that aimed at increasing purity and capture efficiency is provided as well. Although CTCs have been the focus of a vast microfluidic research effort as the key element for obtaining relevant information, important clinical insights can also be achieved from alternative biomarkers, such as classical protein biomarkers, exosomes, or circulating-free nucleic acids. Finally, while most work has been devoted to the analysis of blood-based biomarkers, we highlight the less explored potential of urine as an ideal source of molecular cancer biomarkers for point-of-care lab-on-chip devices.

17.
J Biophotonics ; 12(12): e201900065, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31162811

RESUMO

Amyloid-like peptides are an ideal model for the mechanistic study of amyloidosis, which may lead to many human diseases, such as Alzheimer disease. This study reports a strong second harmonic generation (SHG) effect of amyloid-like peptides, having a signal equivalent to or even higher than those of endogenous collagen fibers. Several amyloid-like peptides (both synthetic and natural) were examined under SHG microscopy and shown they are SHG-active. These peptides can also be observed inside cells (in vitro). This interesting property can make these amyloid-like peptides second harmonic probes for bioimaging applications. Furthermore, SHG microscopy can provide a simple and label-free approach to detect amyloidosis. Lattice corneal dystrophy was chosen as a model disease of amyloidosis. Morphological difference between normal and diseased human corneal biopsy samples can be easily recognized, proving that SHG can be a useful tool for disease diagnosis.

18.
Clin Biomech (Bristol, Avon) ; 68: 73-79, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31158592

RESUMO

BACKGROUND: This study aimed to analyze the effects of intracapsular pressure (IAP) on blood flow in the femur after a femoral neck fracture. METHODS: Four simplified vascular models were used to measure the effect of vessel length on arterial blood flow in 10 New Zealand white rabbits. Ten models were evaluated under 10 different blood pressures. FINDINGS: IAP increased following fracture of the femoral neck, and deformation had the greatest potential effect on blood flow in the retinacular artery. When blood pressure was fixed at 60 mm Hg, an increase in IAP caused a reduction in blood flow. When the IAP was relatively high (above 60 mm Hg), and higher than the blood pressure, blood flow continued to drop as intracapsular pressure increased. Shortening of blood vessels had no significant effect on blood supply. However, the p-value was uniformly significant (<0.05) when stretched and twisted blood vessels were compared with normal blood vessels. INTERPRETATION: The results of computational fluid-structure interaction similarly indicated that a smaller blood vessel diameter and twisted blood vessels will result in decreased flow velocity when IAP increases. This study also revealed a close relationship between IAP and the hip joint's position and traction.

19.
Med Eng Phys ; 70: 55-61, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31229383

RESUMO

The calcanail system is a novel intramedullary approach for calcaneal fractures but is believed to be insufficient to treat complex fractures. We propose a modified Calcanail technique by adding a transfixation screw to improve stability. The aim of this study was to evaluate the biomechanical stability of the modified Calcanail system and compare it with the traditional Calcanail system and plate fixation. A Sanders type-IIIAB calcaneal fracture model was built and simulated fixation with the three implants. A vertical loading of 700 N was applied to the subtalar joint surfaces, and the posteroinferior calcaneal tuberosity was fixed. Construct stiffness, fracture migration, and von Mises stress were assessed. The results showed the modified Calcanail system demonstrated the highest construct stiffness, smallest migration, and lowest von Mises stress among three fixations. The study suggested that the modified Calcanail system can provide comparatively sufficient stability, that makes it preferable to treat complex calcaneal fractures.

20.
Front Immunol ; 10: 547, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30949182

RESUMO

CD56bri natural killer (NK) cells play an important role in the pathogenesis of graft-vs. -host disease (GVHD) and immune defense in the early period after allogeneic hematopoietic stem cell transplantation. Extracorporeal photopheresis (ECP) as an immunomodulating therapy has been widely used for GVHD treatment. However, the mechanism of action of ECP still remains to be elucidated, particularly the influence of ECP on NK cells. Thirty-four patients with steroid-refractory/resistant acute GVHD (aGVHD) ≥ °II and moderate to severe chronic GVHD (cGVHD) received ECP therapy. Patient samples obtained during intensive and long-term treatment were analyzed. Immunomonitoring with respect to cell phenotype and function was performed on rested peripheral blood mononuclear cells (PBMCs) using multiparametric flow cytometry. NK activity in terms of cytokine release was analyzed by intracellular cytokine staining after co-culture with K562 cells. Moreover, the proliferative capacity of NK cells, CD4+, and CD8+ T cells was determined by carboxyfluorescein succinimidyl ester (CFSE) staining. Clinically, 75% of aGVHD and 78% of cGVHD patients responded to ECP therapy. Moreover, our data show that aGVHD, cGVHD patients and healthy donors (HDs) present distinct NK patterns: aGVHD patients have a higher frequency of CD56bri NK subsets with stronger NKG2D and CD62L expression, while CD56-CD16+ NK cells with higher expression of CD57 and CD11b stand out as a signature population for cGVHD. ECP therapy could significantly decrease CD56briCD16- NK cells with shifting the quality from a cytotoxic to a regulatory pattern and additionally mature CD56dim NK cells via upregulation of CD57 in complete responding aGVHD patients. Moreover, ECP could keep the anti-viral and anti-leukemic effects intact via maintaining specialized anti-viral/leukemic CD57+NKG2C+CD56dim NK cells as well as remaining the quality and quantity of cytokine release by NK cells. The proliferative capacity of effector cells remained constant over ECP therapy. In conclusion, ECP represents an attractive option to treat GVHD without compromising anti-viral/leukemic effects. Shaping of CD56bri NK cell compartment by downregulating the cytotoxic subset while upregulating the regulatory subset contributes to the mechanisms of ECP therapy in aGVHD.

SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA