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1.
Medicine (Baltimore) ; 101(2): e28544, 2022 Jan 14.
Artigo em Inglês | MEDLINE | ID: mdl-35029212

RESUMO

RATIONALE: Postmortem imaging (PMI), including computed tomography (PMCT), postmortem computed tomography angiography (PMCTA), and postmortem magnetic resonance imaging (PMMRI), is rapidly becoming effective and a practical method in forensic medicine. This study aimed to present a specific forensic case in which the PMI approach and its applications were used. PATIENT CONCERNS: A 40-year-old male patient had moderate unilateral nose bleeding constantly 10 times after suffering from a head injury induced by a car accident. After a bilateral massive nose bleeding for the last time, he died from hemorrhagic shock. Traumatic internal carotid artery pseudoaneurysm (TICAP) was suspected in this patient. DIAGNOSIS, INTERVENTIONS, AND OUTCOMES: A whole-body scanning was performed using PMCT and PMMRI. Then, PMCTA using left ventricular cardiac puncture was also implemented. A water-soluble contrast agent was injected into the left ventricle and pumped toward the intracranial, followed by a repeated whole-body PMCT scan. The PMCT/PMMRI detected a high-density/signal mass inside the left sphenoid sinus. The PMCTA detected a distinct leakage of the contrast agent into the left sphenoid sinus from an adjacent aneurysm of the C3 section of the left internal carotid artery. Autopsy and histology confirmed a TICAP inside the sphenoid sinus. LESSONS: This case showed that the PMI was of great value for identifying the cause of death in special cases. When vascular lesions are suspected in the body, PMI and especially the PMCTA approach may be an effective detection method.


Assuntos
Falso Aneurisma/diagnóstico por imagem , Autopsia/métodos , Artéria Carótida Interna/diagnóstico por imagem , Meios de Contraste , Adulto , Falso Aneurisma/etiologia , Angiografia por Tomografia Computadorizada , Evolução Fatal , Hemorragia , Humanos , Masculino
2.
BMC Pulm Med ; 21(1): 233, 2021 Jul 13.
Artigo em Inglês | MEDLINE | ID: mdl-34256743

RESUMO

BACKGROUND: To explore the long-term trajectories considering pneumonia volumes and lymphocyte counts with individual data in COVID-19. METHODS: A cohort of 257 convalescent COVID-19 patients (131 male and 126 females) were included. Group-based multi-trajectory modelling was applied to identify different trajectories in terms of pneumonia lesion percentage and lymphocyte counts covering the time from onset to post-discharge follow-ups. We studied the basic characteristics and disease severity associated with the trajectories. RESULTS: We characterised four distinct trajectory subgroups. (1) Group 1 (13.9%), pneumonia increased until a peak lesion percentage of 1.9% (IQR 0.7-4.4) before absorption. The slightly decreased lymphocyte rapidly recovered to the top half of the normal range. (2) Group 2 (44.7%), the peak lesion percentage was 7.2% (IQR 3.2-12.7). The abnormal lymphocyte count restored to normal soon. (3) Group 3 (26.0%), the peak lesion percentage reached 14.2% (IQR 8.5-19.8). The lymphocytes continuously dropped to 0.75 × 109/L after one day post-onset before slowly recovering. (4) Group 4 (15.4%), the peak lesion percentage reached 41.4% (IQR 34.8-47.9), much higher than other groups. Lymphopenia was aggravated until the lymphocytes declined to 0.80 × 109/L on the fourth day and slowly recovered later. Patients in the higher order groups were older and more likely to have hypertension and diabetes (all P values < 0.05), and have more severe disease. CONCLUSIONS: Our findings provide new insights to understand the heterogeneous natural courses of COVID-19 patients and the associations of distinct trajectories with disease severity, which is essential to improve the early risk assessment, patient monitoring, and follow-up schedule.


Assuntos
COVID-19 , Convalescença , Pneumonia Viral/sangue , Pneumonia Viral/diagnóstico , Adulto , Feminino , Humanos , Contagem de Linfócitos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Índice de Gravidade de Doença
3.
Artigo em Inglês | MEDLINE | ID: mdl-34232804

RESUMO

The study aimed to evaluate the effect of forced-air warming blanket combined with conventional thermal insulation measures on inadvertent perioperative hypothermia (IPH) in elderly patients undergoing laparoscopic radical resection of colorectal cancer. A total of 70 elderly patients undergoing laparoscopic radical resection of colorectal cancer with general anesthesia were included, and divided into conventional warming treatment (CT) group or forced-air warming treatment (FT) group. In the FT group, based on the conventional warming strategy, patients received prewarming with the forced-air warming blanket (38°C) for ≥20 minutes before induction of anesthesia, and received this treatment continuously during operation. The core body temperature, recovery time from anesthesia, extubating time, and length of stay in the postanesthesia care unit were recorded. The incidence of IPH and postoperative shivering was observed. The incidence of IPH was significantly lower, and average minimum body temperature during the operation was significantly higher in the FT group than that in the CT group (5.7% vs. 22.8% and 36.23°C vs. 35.89°C, respectively). The intraoperative body temperature decreased less (0.32°C vs. 0.69°C), the recovery time from anesthesia was faster (12.8 minutes vs. 17.1 minutes), and the incidence of postoperative shivering was less (2.8% vs. 28.6%) in the FT group than the CT group. In elderly patients undergoing laparoscopic radical resection of colorectal cancer, use of forced-air warming blankets combined with conventional warming measures is more effective to maintain normal body temperature during the perioperative period and reduce the incidence of IPH.

5.
Front Neurol ; 12: 757374, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-35095719

RESUMO

PURPOSE: Neuroimaging elucidations have shown structural and functional brain alterations in HIV-infected (HIV+) individuals when compared to HIV-negative (HIV-) controls. However, HIV- groups used in previous studies were not specifically considered for sexual orientation, which also affects the brain structures and functions. The current study aimed to characterize the brain alterations associated with HIV infection while controlling for sexual orientation. METHODS: Forty-three HIV+ and 40 HIV- homosexual men (HoM) were recruited and underwent resting-state MRI scanning. Group differences in gray matter volume (GMV) were assessed using a voxel-based morphometry analysis. Brain regions with the altered GMV in the HIV+ HoM group were then taken as regions of interest in a seed-based analysis to identify altered functional connectivity. Furthermore, the amplitude of low-frequency fluctuation (ALFF) and regional homogeneity values were compared between the two groups to evaluate the HIV-associated functional abnormalities in local brain regions. RESULTS: HIV+ HoM showed significantly increased GMV in the bilateral parahippocampal gyrus and amygdala, and decreased GMV in the right inferior cerebellum, compared with the HIV- HoM. The brain regions with increased GMV were hyper-connected with the left superior cerebellum, right lingual gyrus, and left precuneus in the HIV+ HoM. Moreover, the ALFF values of the right fusiform gyrus, and left parahippocampal gyrus were increased in the HIV+ HoM. The regional homogeneity values of the right anterior cingulate and paracingulate gyri, and left superior cerebellum were decreased in the HIV+ HoM. CONCLUSION: When the study population was restricted to HoM, HIV+ individuals exhibited structural alterations in the limbic system and cerebellum, and functional abnormalities in the limbic, cerebellum, and visual network. These findings complement the existing knowledge on the HIV-associated neurocognitive impairment from the previous neuroimaging studies by controlling for the potential confounding factor, sexual orientation. Future studies on brain alternations with the exclusion of related factors like sexual orientation are needed to understand the impact of HIV infection on neurocognitive function more accurately.

6.
J Thorac Dis ; 12(10): 5896-5905, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33209422

RESUMO

BACKGROUND: To retrospectively evaluate several clinical indicators related to the improvement of COVID-19 pneumonia on CT. METHODS: A total of 62 patients with COVID-19 pneumonia were included. The CT scores based on lesion patterns and distributions in serial CT were investigated. The improvement and deterioration of pneumonia was assessed based on the changes of CT scores. Grouped by using the temperature, serum lymphocytes and high sensitivity CRP (hs-CRP) on admission respectively, the CT scores on admission, at peak time and at discharge were evaluated. Correlation analysis was carried out between the time to onset of pneumonia resolution on CT images and the recovery time of temperature, negative conversion of viral nucleic acid, serum lymphocytes and hs-CRP. RESULTS: The CT scores of the fever group and lymphopenia group were significantly higher than those of normal group on admission, at peak time and at discharge; and the CT scores of normal hs-CRP group were significantly lower than those of the elevated hs-CRP group at peak time and at discharge (P all<0.05). The time to onset of pneumonia resolution on CT image was moderately correlated with negative conversion duration of viral nucleic acid (r =0.501, P<0.05) and the recovery time of hs-CPR (r =0.496, P<0.05). CONCLUSIONS: COVID-19 pneumonia patients with no fever, normal lymphocytes and hs-CRP had mild lesions on admission, and presented with more absorption and fewer pulmonary lesions on discharge. The negative conversion duration of viral nucleic acid and the recovery time of hs-CPR may be the indicator of the pneumonia resolution.

8.
Int J STD AIDS ; 31(8): 747-752, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32631212

RESUMO

The objective of this study was to evaluate whether combination antiretroviral therapy (cART) has an effect on the clinical manifestations, radiological characteristics, and disease severity of human immunodeficiency virus (HIV)-associated Talaromyces marneffei infection. The clinical manifestations, chest computed tomography (CT) images, and disease severity were compared between 14 patients with culture-confirmed T. marneffei infections who received cART and 38 patients who did not receive cART. Clinical manifestations included high fever (>38°C), cough, shortness of breath, chills, and skin rash. Chest CT scans were evaluated for the presence of ground-glass opacities, consolidation, miliary nodules, nodules, masses, cavitation, pericardial effusion, pleural effusion, mediastinal lymphadenitis, and the distribution of parenchymal abnormalities. Disease severity was estimated by clinical manifestations and chest CT findings. Fever (>38°C), cough, shortness of breath, and chills were significantly less frequent in patients who received cART than in those who did not receive cART (P < 0.05). The frequencies of miliary nodules, mediastinal lymphadenitis, and the proportion of diffuse lesions were significantly lower in patients who received cART than in those who did not receive cART (P < 0.05). The disease severity was significantly decreased in patients who received cART compared with patients who did not receive cART (P < 0.001). T. marneffei-infected patients who received cART had fewer clinical manifestations and decreased disease severity compared with those who did not receive this treatment. The use of cART is associated with modified chest CT characteristics in HIV-associated T. marneffei infections.


Assuntos
Infecções Oportunistas Relacionadas com a AIDS/tratamento farmacológico , Terapia Antirretroviral de Alta Atividade/métodos , Infecções por HIV/tratamento farmacológico , Micoses/complicações , Talaromyces/efeitos dos fármacos , Tórax/diagnóstico por imagem , Infecções Oportunistas Relacionadas com a AIDS/diagnóstico , Adulto , China/epidemiologia , Tosse/etiologia , Exantema , Feminino , Febre/etiologia , Infecções por HIV/complicações , Infecções por HIV/microbiologia , Humanos , Masculino , Pessoa de Meia-Idade , Micoses/epidemiologia , Micoses/microbiologia , Radiografia Torácica , Índice de Gravidade de Doença , Talaromyces/isolamento & purificação , Tomografia Computadorizada por Raios X
9.
Theranostics ; 10(12): 5613-5622, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32373235

RESUMO

Rationale: Some patients with coronavirus disease 2019 (COVID-19) rapidly develop respiratory failure or even die, underscoring the need for early identification of patients at elevated risk of severe illness. This study aims to quantify pneumonia lesions by computed tomography (CT) in the early days to predict progression to severe illness in a cohort of COVID-19 patients. Methods: This retrospective cohort study included confirmed COVID-19 patients. Three quantitative CT features of pneumonia lesions were automatically calculated using artificial intelligence algorithms, representing the percentages of ground-glass opacity volume (PGV), semi-consolidation volume (PSV), and consolidation volume (PCV) in both lungs. CT features, acute physiology and chronic health evaluation II (APACHE-II) score, neutrophil-to-lymphocyte ratio (NLR), and d-dimer, on day 0 (hospital admission) and day 4, were collected to predict the occurrence of severe illness within a 28-day follow-up using both logistic regression and Cox proportional hazard models. Results: We included 134 patients, of whom 19 (14.2%) developed any severe illness. CT features on day 0 and day 4, as well as their changes from day 0 to day 4, showed predictive capability. Changes in CT features from day 0 to day 4 performed the best in the prediction (area under the receiver operating characteristic curve = 0.93, 95% confidence interval [CI] 0.87~0.99; C-index=0.88, 95% CI 0.81~0.95). The hazard ratios of PGV and PCV were 1.39 (95% CI 1.05~1.84, P=0.023) and 1.67 (95% CI 1.17~2.38, P=0.005), respectively. CT features, adjusted for age and gender, on day 4 and in terms of changes from day 0 to day 4 outperformed APACHE-II, NLR, and d-dimer. Conclusions: CT quantification of pneumonia lesions can early and non-invasively predict the progression to severe illness, providing a promising prognostic indicator for clinical management of COVID-19.


Assuntos
Infecções por Coronavirus/diagnóstico por imagem , Infecções por Coronavirus/patologia , Pulmão/patologia , Pneumonia Viral/diagnóstico por imagem , Pneumonia Viral/patologia , Adulto , Idoso , Algoritmos , Inteligência Artificial , Betacoronavirus , COVID-19 , China , Progressão da Doença , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Pulmão/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Pandemias , Prognóstico , Estudos Retrospectivos , SARS-CoV-2 , Tomografia Computadorizada por Raios X
10.
J Clin Virol ; 128: 104431, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32442756

RESUMO

BACKGROUND: Despite the death rate of COVID-19 is less than 3%, the fatality rate of severe/critical cases is high, according to World Health Organization (WHO). Thus, screening the severe/critical cases before symptom occurs effectively saves medical resources. METHODS AND MATERIALS: In this study, all 336 cases of patients infected COVID-19 in Shanghai to March 12th, were retrospectively enrolled, and divided in to training and test datasets. In addition, 220 clinical and laboratory observations/records were also collected. Clinical indicators were associated with severe/critical symptoms were identified and a model for severe/critical symptom prediction was developed. RESULTS: Totally, 36 clinical indicators significantly associated with severe/critical symptom were identified. The clinical indicators are mainly thyroxine, immune related cells and products. Support Vector Machine (SVM) and optimized combination of age, GSH, CD3 ratio and total protein has a good performance in discriminating the mild and severe/critical cases. The area under receiving operating curve (AUROC) reached 0.9996 and 0.9757 in the training and testing dataset, respectively. When the using cut-off value as 0.0667, the recall rate was 93.33 % and 100 % in the training and testing datasets, separately. Cox multivariate regression and survival analyses revealed that the model significantly discriminated the severe/critical cases and used the information of the selected clinical indicators. CONCLUSION: The model was robust and effective in predicting the severe/critical COVID cases.


Assuntos
Doença das Coronárias/diagnóstico , Infecções por Coronavirus/diagnóstico , Complicações do Diabetes/diagnóstico , Diabetes Mellitus/diagnóstico , Surtos de Doenças , Hipertensão/diagnóstico , Pneumonia Viral/diagnóstico , Adulto , Fatores Etários , Idoso , Área Sob a Curva , Betacoronavirus , Biomarcadores/sangue , Complexo CD3/sangue , COVID-19 , Estudos de Coortes , Doença das Coronárias/sangue , Doença das Coronárias/complicações , Doença das Coronárias/mortalidade , Infecções por Coronavirus/sangue , Infecções por Coronavirus/complicações , Infecções por Coronavirus/mortalidade , Complicações do Diabetes/sangue , Complicações do Diabetes/mortalidade , Diabetes Mellitus/sangue , Diabetes Mellitus/mortalidade , Feminino , Glutationa/sangue , Humanos , Hipertensão/sangue , Hipertensão/complicações , Hipertensão/mortalidade , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/sangue , Pneumonia Viral/complicações , Pneumonia Viral/mortalidade , Prognóstico , Curva ROC , SARS-CoV-2 , Índice de Gravidade de Doença , Máquina de Vetores de Suporte , Análise de Sobrevida , Tiroxina/sangue
11.
J Med Virol ; 92(10): 1922-1931, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32297985

RESUMO

The aim of our study was to evaluate the therapeutic effect of antiviral drugs on coronavirus disease 2019 (COVID-19) pneumonia. Patients confirmed with COVID-19 pneumonia were enrolled and divided into seven groups according to the treatment option. Information including age, sex, and duration from illness onset to admission, clinical manifestations, and laboratory data at admission, and length of hospital stay were evaluated. The chest computed tomography (CT) imaging obtained at admission and after a 5-day treatment cycle were assessed. The clinical symptoms and laboratory tests at discharge were also assessed. At admission, no significant differences were found among the groups, including the duration from illness onset to admission, clinical symptoms, and main laboratory results. No significant differences were found among the groups in terms of the proportion of patients with pneumonia resolution (P = .151) after treatment or the length of hospital stay (P = .116). At discharge, 7 of 184 (4%) patients had a mild cough while their other symptoms had disappeared, and the proportion of patients with abnormal liver function and with increased leukocytes, neutrophils or erythrocyte sedimentation rate among the 184 patients were close to those at admission. According to the results, the inclusion of antiviral drugs in therapeutic regimens based on symptomatic treatment had no significant additional impact on the improvement in COVID-19 patients. In addition, the results of chest CT imaging, clinical manifestations, and laboratory tests at discharge were not completely consistent.


Assuntos
Antivirais/uso terapêutico , COVID-19/tratamento farmacológico , Pneumonia Viral/tratamento farmacológico , COVID-19/virologia , China , Feminino , Hospitalização , Humanos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/virologia , Estudos Retrospectivos , SARS-CoV-2/efeitos dos fármacos
13.
Radiology ; 295(1): 210-217, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32027573

RESUMO

BackgroundThe chest CT findings of patients with 2019 Novel Coronavirus (2019-nCoV) pneumonia have not previously been described in detail.PurposeTo investigate the clinical, laboratory, and imaging findings of emerging 2019-nCoV pneumonia in humans.Materials and MethodsFifty-one patients (25 men and 26 women; age range 16-76 years) with laboratory-confirmed 2019-nCoV infection by using real-time reverse transcription polymerase chain reaction underwent thin-section CT. The imaging findings, clinical data, and laboratory data were evaluated.ResultsFifty of 51 patients (98%) had a history of contact with individuals from the endemic center in Wuhan, China. Fever (49 of 51, 96%) and cough (24 of 51, 47%) were the most common symptoms. Most patients had a normal white blood cell count (37 of 51, 73%), neutrophil count (44 of 51, 86%), and either normal (17 of 51, 35%) or reduced (33 of 51, 65%) lymphocyte count. CT images showed pure ground-glass opacity (GGO) in 39 of 51 (77%) patients and GGO with reticular and/or interlobular septal thickening in 38 of 51 (75%) patients. GGO with consolidation was present in 30 of 51 (59%) patients, and pure consolidation was present in 28 of 51 (55%) patients. Forty-four of 51 (86%) patients had bilateral lung involvement, while 41 of 51 (80%) involved the posterior part of the lungs and 44 of 51 (86%) were peripheral. There were more consolidated lung lesions in patients 5 days or more from disease onset to CT scan versus 4 days or fewer (431 of 712 lesions vs 129 of 612 lesions; P < .001). Patients older than 50 years had more consolidated lung lesions than did those aged 50 years or younger (212 of 470 vs 198 of 854; P < .001). Follow-up CT in 13 patients showed improvement in seven (54%) patients and progression in four (31%) patients.ConclusionPatients with fever and/or cough and with conspicuous ground-glass opacity lesions in the peripheral and posterior lungs on CT images, combined with normal or decreased white blood cells and a history of epidemic exposure, are highly suspected of having 2019 Novel Coronavirus (2019-nCoV) pneumonia.© RSNA, 2020.


Assuntos
Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/diagnóstico por imagem , Pulmão/diagnóstico por imagem , Pneumonia Viral/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Adolescente , Adulto , Fatores Etários , COVID-19 , Teste para COVID-19 , China/epidemiologia , Técnicas de Laboratório Clínico , Infecções por Coronavirus/complicações , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/patologia , Tosse/etiologia , Feminino , Febre/etiologia , Humanos , Contagem de Leucócitos , Pulmão/patologia , Masculino , Pessoa de Meia-Idade , Pneumonia Viral/complicações , Pneumonia Viral/patologia , Reação em Cadeia da Polimerase em Tempo Real , Estudos Retrospectivos , SARS-CoV-2 , Adulto Jovem
14.
Front Neurosci ; 14: 614012, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33390894

RESUMO

PURPOSE: Previous studies have revealed increased frontal brain activation during speech comprehension in background noise. Few, however, used tonal languages. The normal pattern of brain activation during a challenging speech-in-nose task using a tonal language remains unclear. The Mandarin Hearing-in-Noise Test (HINT) is a well-established test for assessing the ability to interpret speech in background noise. The current study used Mandarin HINT (MHINT) sentences and functional magnetic resonance imaging (fMRI) to assess brain activation with MHINT sentences. METHODS: Thirty native Mandarin-speaking subjects with normal peripheral hearing were recruited. Functional MRI was performed while subjects were presented with either HINT "clear" sentences with low-level background noise [signal-to-noise ratio (SNR) = +3 dB] or "noisy" sentences with high-level background noise (SNR = -5 dB). Subjects were instructed to answer with a button press whether a visually presented target word was included in the sentence. Brain activation between noisy and clear sentences was compared. Activation in each condition was also compared to a resting, no sentence presentation, condition. RESULTS: Noisy sentence comprehension showed increased activity in areas associated with tone processing and working memory, including the right superior and middle frontal gyri [Brodmann Areas (BAs) 46, 10]. Reduced activity with noisy sentences was seen in auditory, language, memory and somatosensory areas, including the bilateral superior and middle temporal gyri, left Heschl's gyrus (BAs 21, 22), right temporal pole (BA 38), bilateral amygdala-hippocampus junction, and parahippocampal gyrus (BAs 28, 35), left inferior parietal lobule extending to left postcentral gyrus (BAs 2, 40), and left putamen. CONCLUSION: Increased frontal activation in the right hemisphere occurred when comprehending noisy spoken sentences in Mandarin. Compared to studies using non-tonal languages, this activation was strongly right-sided and involved subregions not previously reported. These findings may reflect additional effort in lexical tone perception in this tonal language. Additionally, this continuous fMRI protocol may offer a time-efficient way to assess group differences in brain activation with a challenging speech-in-noise task.

15.
J Nanosci Nanotechnol ; 20(3): 1351-1357, 2020 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-31492294

RESUMO

Arginine-glycine-aspartic acid (RGD) peptide sequences exist in a variety of biological extracellular matrices and can specifically bind the cell-surface integrin αvß3, which is overexpressed in cancer cells and plays important roles in tumor growth and invasion. Quantum dots (QDs) have been applied in the field of cell biology and can be physically conjugated to the surface of cancer cells for imaging. In this research, we developed QDs-RGD nanoparticles and investigated its application in pancreatic cancer cell imaging and its influence on the biological behavior of pancreatic cancer cells. The results of flow cytometric analysis showed that the αvß3 receptor was markedly overexpressed on pancreatic cancer cells. In cellular uptake studies, the fluorescence signal of QDs-RGD nanoparticles in pancreatic cancer cells was higher than that of QDs without RGD conjugation, as determined by an inverted fluorescence microscope. Furthermore, the biological behavior of pancreatic cancer cells was affected by QDs-RGD nanoparticles, which inhibited proliferation, migration and invasion and induced G2-phase cell cycle arrest. With integrin αvß3 as a target, QDs-RGD nanoparticles can generate high-quality images of pancreatic cancer cells and have immense potential for use in the targeted diagnosis and therapy of pancreatic cancer.


Assuntos
Neoplasias Pancreáticas , Pontos Quânticos , Humanos , Integrina alfaVbeta3 , Imagem Óptica , Neoplasias Pancreáticas/diagnóstico por imagem , Peptídeos
16.
J Thorac Dis ; 10(4): 2365-2376, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29850142

RESUMO

Background: Coronary computed tomographic angiography is a robust non-invasive method to assess coronary artery disease (CAD) and analyze coronary plaque stability, especially for the non-calcified plaques. The aim of this study was to investigate the differential characteristics between the unstable coronary plaques and the stable coronary plaques using multi-slice computed tomography (MSCT). Methods: Sixty patients with coronary heart disease (37 unstable plaques and 31 stable plaques) were included. The napkin ring thickness, napkin-ring sign, plaque CT attenuation and degree of lumen stenosis were retrospectively analyzed. The diagnostic performances of MSCT were determined to predict the unstable plaques. The difference was statistically significant if P<0.05. Results: The napkin ring thickness of the unstable plaques was thinner than that of the stable plaques (P<0.05). The napkin-ring sign was more frequently observed in the unstable group (89.2%) than the stable group (22.6%, P<0.05). The average CT value of the unstable plaques (26.8±17.8 HU) was lower than that of the stable plaques (68.5±25.5 HU, P<0.05). The unstable plaques had more severe lumen stenosis or occlusion (70.3%) than the stable plaques (41.9%, P<0.05). The measurable napkin ring thickness of the plaques with a cutoff value of 0.8 mm and an accuracy of 89.5% was one independent factor to predict unstable plaques. The optimal combined threshold of the napkin-ring sign and/or the plaque CT value of 53 HU with an accuracy of 80.9% was to predict unstable plaques. Conclusions: The optimal combined threshold of the napkin-ring sign and/or the plaque CT value ≤53 HU may be a good indicator to predict the unstable plaques in patients with CAD. The subgroup of measurable napkin ring thickness of the non-calcified plaques may also be an independent factor to predict the unstable plaques in patients with CAD.

17.
Int J Nanomedicine ; 12: 5135-5148, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28790821

RESUMO

Quantum dots (QDs) have been considered to be promising probes for biosensing, bioimaging, and diagnosis. However, their toxicity issues caused by heavy metals in QDs remain to be addressed, in particular for their in vivo biomedical applications. In this study, a parallel comparative investigation in vitro and in vivo is presented to disclose the impact of synthetic methods and their following surface modifications on the toxicity of QDs. Cellular assays after exposure to QDs were conducted including cell viability assessment, DNA breakage study in a single cellular level, intracellular reactive oxygen species (ROS) receptor measurement, and transmission electron microscopy to evaluate their toxicity in vitro. Mice experiments after QD administration, including analysis of hemobiological indices, pharmacokinetics, histological examination, and body weight, were further carried out to evaluate their systematic toxicity in vivo. Results show that QDs fabricated by the thermal decomposition approach in organic phase and encapsulated by an amphiphilic polymer (denoted as QDs-1) present the least toxicity in acute damage, compared with those of QDs surface engineered by glutathione-mediated ligand exchange (denoted as QDs-2), and the ones prepared by coprecipitation approach in aqueous phase with mercaptopropionic acid capped (denoted as QDs-3). With the extension of the investigation time of mice respectively injected with QDs, we found that the damage caused by QDs to the organs can be gradually recovered. This parallel comparative investigation suggests that synthetic methods and their resulting surface microenvironment play vital roles in the acute toxicity profiles of QDs. The present study provides updated insights into the fabrication and surface engineering of QDs for their translational applications in theranostics.


Assuntos
Pontos Quânticos/química , Pontos Quânticos/toxicidade , Testes de Toxicidade/métodos , Ácido 3-Mercaptopropiônico/química , Animais , Sobrevivência Celular/efeitos dos fármacos , Dano ao DNA/efeitos dos fármacos , Feminino , Glutationa/química , Camundongos Endogâmicos BALB C , Microscopia Eletrônica de Transmissão , Espécies Reativas de Oxigênio/metabolismo
18.
Exp Ther Med ; 13(4): 1592-1597, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-28413514

RESUMO

To the best of our knowledge, the effect of pre-emptively blocking pain transmission on acute postoperative cognitive dysfunction (POCD) has not yet been assessed. Therefore, the present study aimed to investigate the effect of pre-emptive analgesia via a continuous femoral nerve block (CFNB) on postoperative pain and early cognitive function following total knee arthroplasty (TKA) surgery in elderly patients. CFNB was performed prior to TKA surgery in the pre-emptive analgesia group (n=30) and following TKA surgery in the control group (n=30). POCD was defined as a two-point reduction in the postoperative score compared with the preoperative score in the mini-mental state examination. The visual analog scale (VAS) was used to evaluate the intensity of pain at rest and during exercise. The intraoperative dose of remifentanil in the pre-emptive analgesia group was significantly lower than in the control group (P<0.01). In the preemptive analgesia group, VAS scores at three days post-surgery were lower than those in the control group (P<0.01). The incidence of POCD on the third postoperative day was slightly lower in the pre-emptive analgesia group compared with the control group. In conclusion, the results demonstrate that pre-emptive analgesia by CFNB may promote the recovery of early cognitive function following TKA in elderly patients.

19.
Neurol Res ; 38(10): 929-36, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27687719

RESUMO

OBJECTIVES: Remifentanil may induce hyperalgesia. Recent studies implicate a close relationship between post-surgical hyperalgesia and phosphorylation and activation of p38 mitogen-activated protein kinase (p38MAPK) in the spinal microglia. This study aimed to investigate whether the combination of post-surgical and remifentanil-induced hyperalgesia worsens post-operative pain and whether phosphorylated p38MAPK (phospho-p38MAPK) in the spinal dorsal horn in rats is involved in remifentanil-induced postoperative hyperalgesia. METHODS: Sprague-Dawley rats were randomly divided into six groups: control, incision only, remifentanil only, remifentanil + incision, remifentanil + incision + SB203580, and remifentanil + incision + DMSO. The p38MAPK inhibitor SB203580 and DMSO were injected intrathecally. A right plantar surgical incision was performed in the incision groups, and remifentanil was infused for 60 min in the remifentanil groups. Mechanical paw withdrawal threshold (PWT) and thermal paw withdrawal latency (PWL) of the bilateral hind paws were measured and the number of phospho-p38MAPK-positive cells in rat spinal dorsal horn sections was counted. RESULTS: Intravenous remifentanil infusion decreased bilateral plantar PWL values from 1 h to 3 days after surgery, however there was no additive effect with incision-induced values. There was a significant increase in the number of dorsal horn phospho-p38MAPK-positive cells in the remifentanil + incision group compared to the incision group, but no increase in the number of these cells when remifentanil was given alone. Intrathecal pretreatment with SB203580 attenuated remifentanil + incision-induced postoperative hyperalgesia and significantly reduced activation of phospho-p38MAPK in spinal dorsal horn. CONCLUSIONS: Incision-induced and remifentanil-induced increases in hyperalgesia were not additive when incision and remifentanil were used together. Data on phospho-38MAPK activation in remifenanil-induced hyperalgesia were contradictory and need further clarification.


Assuntos
Analgésicos Opioides/efeitos adversos , Hiperalgesia/induzido quimicamente , Hiperalgesia/patologia , Piperidinas/efeitos adversos , Corno Dorsal da Medula Espinal/efeitos dos fármacos , Proteínas Quinases p38 Ativadas por Mitógeno/metabolismo , Análise de Variância , Animais , Anti-Inflamatórios não Esteroides/farmacologia , Modelos Animais de Doenças , Ativação Enzimática/efeitos dos fármacos , Imidazóis/farmacologia , Masculino , Medição da Dor , Limiar da Dor/efeitos dos fármacos , Dor Pós-Operatória/tratamento farmacológico , Piridinas/farmacologia , Ratos , Ratos Sprague-Dawley , Remifentanil , Fatores de Tempo
20.
Zhonghua Zhong Liu Za Zhi ; 37(1): 57-62, 2015 Jan.
Artigo em Chinês | MEDLINE | ID: mdl-25877321

RESUMO

OBJECTIVE: To analyze the value of MR imaging in diagnosis of intraductal papillary neoplasm of the bile duct (IPN-B). METHODS: Fourteen patients with intraductal papillary neoplasms of the bile duct confirmed by surgical pathology were included in this study. The patients underwent MR routine plain scanning and enhancement scanning (including T1WI, T2WI with fat suppression, FALSH T1WI, and three-phase enhancement scanning), diffusion weighted imaging(DWI) and magnetic resonance cholangiopancreatography (MRCP) before operation. The imaging data were reviewed and analyzed retrospectively in comparison with the surgical and pathological results. RESULTS: In these patients, 7 cases had tumors located in the left lobe, 2 cases had tumors in both the left and right lobes, 2 cases in the hepatic hilum, 2 cases in the common bile duct, and 1 case in both the right lobe and the common bile duct. Solitary or multiple intraductal masses could be found in 12 cases, with 11 cases appeared as papillary masses and one case as flat mass. In the other two cases the tumor was not visible (one case had too many stones, and in another case the tumor was too small). The tumors in the 12 cases showed hypointensity on T1WI and hyperintensity on T2WI. On the dynamic contrast-enhanced MRI, 11 cases showed mild and one showed moderate enhancement in arterial phase, and all the cases showed mildly and gradually delayed enhancement. On DWI, the lesion areas showed high signal intensity in all the cases, and the ADC value of the tumor area (1.697×10(-3)mm(2)/s) was significantly lower than that of the normal bile (3.973×10(-3)mm(2)/s) (t = -10.94, P < 0.05). Twelve cases demonstrated filling defects on primary MRCP coronary thin section images. On 3D-reconstruction MRCP images, 7 cases exhibited diffuse bile duct dilatation with the tumor areas more prominent, 3 cases exhibited aneurysmal bile dilatation, while the rest 4 cases exhibited segmental or lobar bile duct dilatation ( including 2 with invisible tumors ). In the 3 cases with aneurysmal bile dilatation, the multiple directions of MRCP images helped to find the communication between the aneurysmal dilatation and the bile duct. All the cases showed significant proximal bile duct dilatation (the extent of dilatation >100%), and 9 cases also showed distal bile duct dilatation. Bile duct stones were noted in 6 cases, 4 at the tumor area, and the other 2 away from the tumor area. No adjacent tissue invasion and no distal tissue or lymph node metastasis were observed. CONCLUSION: Intraductal papillary neoplasms of the bile ducts have characteristic imaging appearances on MRI, and MRI is an important method helpful to making correct diagnosis.


Assuntos
Neoplasias dos Ductos Biliares/diagnóstico , Ducto Colédoco , Ductos Biliares , Colangiopancreatografia por Ressonância Magnética , Diagnóstico por Imagem , Imagem de Difusão por Ressonância Magnética , Humanos , Imageamento por Ressonância Magnética , Estudos Retrospectivos
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