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1.
Bull Exp Biol Med ; 172(3): 345-351, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35001315

RESUMO

The mechanisms of the inhibitory action of ß-pinene, a pine needle oil monoterpene, on human adenovirus type 3 were studied using cytopathic inhibition test, MTT test, atomic force and laser confocal microscopy. ß-Pinene inhibited the viruses stronger that the reference antiviral medication ribavirin (p<0.05). Inhibition of viral cytopathic effect (CPE) increased with increasing the concentration of ß-pinene, which attested to direct elimination of adenovirus type 3. During viral reproduction phase, ß-pinene significantly inhibited proliferation of adenovirus type 3. Typical signs of adenoviral CPE as cell swelling and rounding were less pronounced in comparison with the control (ribavirin treatment). In addition, elevation of ß-pinene concentration significantly increased the cell survival rate (p<0.05). Laser confocal microscopy showed that fluorescence intensity in the ß-pinene group was significantly lower than in the control group (p<0.01), which was consistent with the results of MTT test, thereby providing additional arguments that ß-pinene affects the virus during the absorption phase. Thus, ß-pinene directly inactivates adenovirus type 3 and impedes its invasion into the cells, but produces no protective effects on cells. Understanding the mode of action of such monoterpenes as ß-pinene is of great importance for the development of new antiviral drugs.

2.
Zhonghua Liu Xing Bing Xue Za Zhi ; 42(12): 2125-2130, 2021 Dec 10.
Artigo em Chinês | MEDLINE | ID: mdl-34954975

RESUMO

Objective: To explore the mediating effect of physical activity on association between sedentary leisure-time and obesity indexes among hypertensive individuals. Methods: After excluding of those with a prior history of heart disease, stroke and cancer, a total of 20 178 hypertensive participants in the China Kadooire Biobank (CKB) study from Wuzhong district of Suzhou city were included. Mediating effect analysis was used to analyze the mediating effect of physical activity (PA) on correlation between sedentary leisure-time and body fat percentage (BFP), waist circumference (WC) and body mass index (BMI). Results: After adjusted for age, gender, smoking status, alcohol consumption, education levels, intake frequencies of meat and intake frequencies of fresh fruit, sedentary leisure-time (SLT) was negatively correlated with PA (ß=-0.246, P<0.001), but positively associated with BFP (ß=0.061, P<0.001), WC (ß=0.087, P<0.001) and BMI (ß=0.071, P<0.001). After including the mediator variable PA, the direct effect of SLT on obesity index was still significant. PA was negatively correlated with BFP, WC and BMI (ß=-0.052, -0.083 and -0.028, respectively, P<0.001). Analysis of mediating effect indicated that the association of SLT with BFP, WC and BMI were partly mediated by PA, the proportion of mediating effect was 20.820%, 23.421% and 9.915%. Stratified by gender, PA had mediating effect on SLT and all obesity indexes in women, while only on SLT and BFP and WC in men. Conclusions: There is a significant mediating effect of PA on correlation between SLT and obesity indexes among hypertensive individuals. Hypertensive patients should increase the level of physical activity and reduce sedentary behavior to achieve a profounder healthy effect.


Assuntos
Obesidade , Comportamento Sedentário , Índice de Massa Corporal , Estudos Transversais , Exercício Físico , Feminino , Humanos , Atividades de Lazer , Masculino , Obesidade/epidemiologia , Circunferência da Cintura
3.
Zhonghua Liu Xing Bing Xue Za Zhi ; 42(12): 2201-2207, 2021 Dec 10.
Artigo em Chinês | MEDLINE | ID: mdl-34954987

RESUMO

Real world data (RWD) refers to the data generated in routine clinical practices, daily life, and real work environment and has been widely used in clinical or public health research. Still, issues related to the quality of RWD, such as incompleteness, inconsistency, and inaccuracy, would affect the validity of real-world research. To overcome the challenges due to the lack of standardization of real world source data, case report form based on clinical data interchange standards consortium (CDISC-CRF) on certain diseases was developed to promote the ecology construction of RWD based on the data standards set by the CDISC which has been widely used. Firstly, we described how to apply data standards to make up the gap between RWD and real world evidence. Then, the process was designed to build RWD ecology based on CDISC-CRF, in which the development technology of CDISC-CRF form is mainly introduced. Finally, the application prospect and significance of building real-world data based on disease-specific CDISC-CRF are described. It is believed that the present paper can provide a new idea for promoting the ecology construction of RWD in China.


Assuntos
Análise de Dados , China , Humanos
4.
Artigo em Inglês | MEDLINE | ID: mdl-34776313

RESUMO

The purpose of this study was to clarify the differences in the diagnosis and treatment outcomes between radioactive iodine-induced sialadenitis (RAIS) and chronic obstructive parotitis (COP). The study cohort comprised 47 consecutive patients diagnosed with RAIS and 50 patients with COP. All patients were treated by interventional endoscopy. Clinical, sialography, and endoscopy characteristics and treatment outcomes were compared between the two groups. Compared with the COP group, the RAIS group included more females (male:female ratio 1:8.4 vs 1:2.1; P = 0.011) and had a younger onset age (42 vs 50 years; P = 0.001) and shorter disease duration prior to hospital visit (5.4 vs 34.8 months; P < 0.001). In the RAIS group, sialography revealed obliteration of the main duct (20.4% vs 0%; P < 0.001), non-visualization of the main gland (23.7% vs 0%; P < 0.001), and incomplete contrast filling of the main gland (19.4% vs 6.4%; P = 0.008), which were scarcely observed in the COP group. Endoscopy revealed a higher percentage of duct atresia in RAIS compared to COP (20.4% vs 0%; P < 0.001). During follow-up, a higher percentage of RAIS patients had duct atresia and gland atrophy (49.5% vs 1.1%, P < 0.001). Compared with COP, RAIS more commonly involves younger females and has a shorter disease duration. Atresia of the main duct and atrophy of the gland parenchyma occur more often despite the use of interventional endoscopy.

5.
Biomaterials ; 279: 121202, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34749072

RESUMO

Red blood cells (RBCs) are biocompatible carriers that can be employed to deliver different bioactive substances. In the past few decades, many strategies have been developed to encapsulate or attach drugs to RBCs. Osmotic-based encapsulation methods have been industrialized recently, and some encapsulated RBC formulations have reached the clinical stage for treating tumors and neurological diseases. Inspired by the intrinsic properties of intact RBCs, some advanced delivery strategies have also been proposed. These delivery systems combine RBCs with other novel systems to further exploit and expand the application of RBCs. This review summarizes the clinical progress of drugs encapsulated into intact RBCs, focusing on the loading and clinical trials. It also introduces the latest advanced research based on developing prospects and limitations of intact RBCs drug delivery system (DDS), hoping to provide a reference for related research fields and further application potential of intact RBCs based drug delivery system.

6.
Zhonghua Yu Fang Yi Xue Za Zhi ; 55(11): 1287-1292, 2021 Nov 06.
Artigo em Chinês | MEDLINE | ID: mdl-34749470

RESUMO

Objective: To investigate the association between occupational hazard exposures and small airway function among middle-aged and elderly people. Methods: From July to December in 2015, a multistage cluster random sampling method was used to select 3 600 residents aged 40 years old and above from 6 chronic obstructive pulmonary disease surveillance points in Jiangsu province. A cross-sectional survey was conducted to collect relevant information. Multivariable linear regression model was performed to determine the relationship between occupational hazard exposures and small airway function. Results: A total of 3 347 participants were included in the final analysis, and 44.6% of participants had been exposed to occupational hazard exposures. Compared with participants without the exposure history of occupational hazards, the significantly lower post-bronchodilator FEF50%, FEF75% and MMEF levels were observed in those with the exposure history of occupational hazards (ß=-82.74, -55.43 and -91.57, respectively). Post-bronchodilator FEF75% and MMEF (ß=-51.78 and -79.47, respectively) in the participants with the exposure history of occupational dust and post-bronchodilator FEF50%, FEF75% and MMEF (ß=-96.84, -32.87 and -75.72, respectively) in the participants with the exposure history of occupational harmful gas all showed a lower level. Post-bronchodilator FEF75% was negatively associated with occupational hazard exposures in males (ßmale=-91.65 vs. ßfemale=-27.21, P for interaction=0.022). Conclusions: The small airway function is worse in the middle-aged and elderly population with the exposure history of occupational hazards, and it is more significant in the male population.


Assuntos
Doenças Profissionais , Exposição Ocupacional , Doença Pulmonar Obstrutiva Crônica , Adulto , Idoso , Estudos Transversais , Poeira , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
7.
Phys Rev Lett ; 127(17): 172701, 2021 Oct 22.
Artigo em Inglês | MEDLINE | ID: mdl-34739292

RESUMO

We report the first (in)elastic scattering measurement of ^{25}Al+p with the capability to select and measure in a broad energy range the proton resonances in ^{26}Si contributing to the ^{22}Mg(α,p) reaction at type I x-ray burst energies. We measured spin-parities of four resonances above the α threshold of ^{26}Si that are found to strongly impact the ^{22}Mg(α,p) rate. The new rate advances a state-of-the-art model to remarkably reproduce light curves of the GS 1826-24 clocked burster with mean deviation <9% and permits us to discover a strong correlation between the He abundance in the accreting envelope of the photospheric radius expansion burster and the dominance of ^{22}Mg(α,p) branch.

9.
Artigo em Chinês | MEDLINE | ID: mdl-34624954

RESUMO

In order to improve the clinical attention to the poisoning of chlorfenapyr, the diagnosis and treatment strategy of chlorfenapyr poisoning were discussed. This paper collected 4 cases of chlorfenapyr in the emergency department of the Second Hospital of Hebei Medical University and 4 cases of literature review, summarized the clinical characteristics of pesticide poisoning cases containing chlorfenapyr in China, and summarized and analyzed the clinical data of the cases. Seven of the 8 patients died from poisoning by chlorfenapyr. Exposure to chlorfenapyr through respiratory tract and digestive tract showed high mortality. Fever, hyperhidrosis, elevated muscle enzymes and progressive central nerve damage were its prominent clinical characteristics. Most of the initial symptoms of exposure were not serious. Some patients, especially those with low exposure dose, had a relatively stable stage with or without clinical diagnosis and treatment. In case of sweating, obvious fever and disturbance of consciousness, the condition would deteriorate rapidly, respiratory and circulatory failure and eventually die. With the increase of production capacity and market launch, people have more opportunities to be exposed to chlorfenapyr. It is urgent to strengthen the basic and clinical research of chlorfenapyr poisoning; Attention should be paid to the observation and treatment in the initial stable stage of poisoning, which can be used as a reference for the treatment of oxidative phosphoric acid dissolving coupling agent (sodium pentachlorophenol) poisoning.


Assuntos
Inseticidas , Piretrinas , China/epidemiologia , Humanos
10.
Zhonghua Nei Ke Za Zhi ; 60(11): 946-953, 2021 Nov 01.
Artigo em Chinês | MEDLINE | ID: mdl-34689514

RESUMO

Rheumatic diseases are a kind of chronic inflammatory diseases mainly involving joints and surrounding tissues. Most patients with rheumatic diseases need long-term treatment, which is difficult to be avoided during pregnancy. Treatment efficacy, as well as maternal and fetal safety should be taken into account in the medical decision. Based on the domestic and foreign guidelines, consensus, diagnosis and treatment experience, Chinese Rheumatology Association developed the standardization of medication use in patients with rheumatic diseases preparing and during pregnancy, aiming on the application and precautions of commonly used medicines for rheumatic diseases in preparing pregnancy, pregnancy and lactation.


Assuntos
Doenças Reumáticas , Reumatologia , Consenso , Feminino , Humanos , Gravidez , Doenças Reumáticas/tratamento farmacológico
11.
Zhonghua Yu Fang Yi Xue Za Zhi ; 55(10): 1245-1249, 2021 Oct 06.
Artigo em Chinês | MEDLINE | ID: mdl-34706512

RESUMO

Pseudomonas aeruginosa biofilm was established on PU and PVC's surface by Center of Disease Control (CDC) Biofilm Reactor, to evaluate the effectiveness of Slightly Acidic Hypochlorous water (SAHW) for removing Pseudomonas aeruginosa biofilm on Polyurethane (PU) or Polyvinyl Chloride (PVC), which are commonly used in dental unit waterlines (DUWL). The biofilms were treated with 10 mg/L SAHW, 40 mg/L SAHW and sterile distilled water (control group) by the continuous immersion method for 3, 7, and 10 days. The total viable count (TVC) and Confocal laser scanning microscopy (CLSM) were selected to evaluate the biofilm removal effect and calculate the biofilm reduction rate. The results of TVC showed that 99%-100% biofilm reduction could be achieved in 10 mg/L SAHW group and 40 mg/L SAHW group. The results of CLSM showed that 10 mg/L SAHW group and 40 mg/L SAHW group could reach 89%-100% biofilm reduction after 10 days of treatment.


Assuntos
Contaminação de Equipamentos , Água , Biofilmes , Contagem de Colônia Microbiana , Humanos , Microbiologia da Água
12.
Zhonghua Yi Xue Za Zhi ; 101(38): 3134-3140, 2021 Oct 19.
Artigo em Chinês | MEDLINE | ID: mdl-34674423

RESUMO

Objective: To explore the value of preoperative neutrophil-to-lymphocyte ratio (NLR) and γ-glutamyl transpeptidase-to-platelet ratio index (GPRI) for predicting the prognosis of patients with HBV-related intrahepatic cholangiocarcinoma (ICC) after radical resection. Methods: The data of 79 patients who underwent radical resection for HBV-related ICC in the Department of Hepatobiliary Surgery of the First Affiliated Hospital of Xi'an Jiaotong University from January 2010 to December 2018 were retrospectively analyzed. Among them, 48(60.8%) patients were male and 31 (39.2%) patients were female, (56.9±11.2) years old. X-Tile statistical software was used to determine the best cut-off values of NLR and GPRI. The χ2 test was conducted to analyze the relationship between preoperative NLR and GPRI and the clinicopathological characteristics, and the Cox proportional hazard regression model was conducted for multivariate analysis. A nomogram prognostic prediction model was established based on independent risk factors screened by Cox regression model. Results: The best cut-off values of NLR and GPRI were 3.13 and 1.31 determined by the X-Tile software, respectively. With the best cut-off value, 79 patients were divided into NLR≤3.13 group (45 cases) and NLR>3.13 group (34 cases). GPRI≤1.31 group (54 cases) and GPRI>1.31 group (25 cases). Compared with the preoperative NLR ≤3.13 group, the proportion of patients with liver cirrhosis and atrophy, poor pathological differentiation, tumor diameter>5 cm and late TNM stage was significantly increased in the NLR>3.13 group (all P<0.05); Compared with preoperative GPRI ≤1.31 group, the proportion of patients with liver cirrhosis and atrophy was significantly increased in the GPRI>1.31 group (P=0.025). The postoperative overall survival time of the included patients was 2 to 126 months, with the median survival time being 18 months, and the 1, 3-year overall survival rates were 63.3%, 32.8%, respectively. Multivariate analysis showed that NLR, GPRI, liver cirrhosis and atrophy, and lymphatic metastasis were independent risk factors affecting the overall survival of patients with HBV-related ICC after radical resection (P<0.05). A nomogram prediction model was established based on independent risk factors, with the C-index of 0.750, and the prediction effect was close to the actual survival outcome of the patients. Conclusion: Preoperative peripheral blood NLR and GPRI can be used to predict the prognosis of patients with HBV-related ICC after radical resection.


Assuntos
Neoplasias dos Ductos Biliares , Colangiocarcinoma , Idoso , Neoplasias dos Ductos Biliares/cirurgia , Ductos Biliares Intra-Hepáticos , Colangiocarcinoma/cirurgia , Feminino , Vírus da Hepatite B , Humanos , Linfócitos , Masculino , Pessoa de Meia-Idade , Neutrófilos , Prognóstico , Estudos Retrospectivos , gama-Glutamiltransferase
13.
Phys Rev Lett ; 127(15): 152702, 2021 Oct 08.
Artigo em Inglês | MEDLINE | ID: mdl-34678013

RESUMO

Fluorine is one of the most interesting elements in nuclear astrophysics, where the ^{19}F(p,α)^{16}O reaction is of crucial importance for Galactic ^{19}F abundances and CNO cycle loss in first generation Population III stars. As a day-one campaign at the Jinping Underground Nuclear Astrophysics experimental facility, we report direct measurements of the essential ^{19}F(p,αγ)^{16}O reaction channel. The γ-ray yields were measured over E_{c.m.}=72.4-344 keV, covering the Gamow window; our energy of 72.4 keV is unprecedentedly low, reported here for the first time. The experiment was performed under the extremely low cosmic-ray-induced background environment of the China JinPing Underground Laboratory, one of the deepest underground laboratories in the world. The present low-energy S factors deviate significantly from previous theoretical predictions, and the uncertainties are significantly reduced. The thermonuclear ^{19}F(p,αγ)^{16}O reaction rate has been determined directly at the relevant astrophysical energies.

14.
Artigo em Chinês | MEDLINE | ID: mdl-34521165

RESUMO

Objective: To explore the correlation between eosinophils (Eos) and the incidence of chronic sinusitis with nasal polyps (CRSwNP) in Xinjiang region of China by comparing the proportion of inflammatory cells in the pathological tissues and peripheral blood. Methods: Retrospective analysis was performed on 582 patients with CRSwNP who underwent endoscopic nasal surgery in the First Affiliated Hospital of Xinjiang Medical University from January 2012 to March 2018, including 367 males and 215 females, aged (45.5±13.4) years (x¯±s). Patients were divided into groups according to demographic characteristics, recurrence and complication of allergic rhinitis (AR). Preoperative blood routine and postoperative pathological section data of nasal polyps were collected to compare the ratio of inflammatory cells in pathological tissue and the ratio of peripheral blood Eos in each group. The correlation between the proportion of inflammatory cells in the pathological tissue of nasal polyps and the recurrence of CRSwNP was analyzed, as well as the distribution of (eosCRSwNP) in Uygur and Han CRSwNP patients in Xinjiang region. Statistical analysis was performed by SPSS 19.0 software. Results: Compared with non-recurrent CRSwNP patients, the ratio of Eos in nasal polyp tissue and peripheral blood was increased significantly, (Z value was -3.142 and -2.344, respectively, both P<0.05). Compared with CRSwNP patients without AR, the ratio of Eos in nasal polyps and peripheral blood was also increased significantly in patients with AR (Z value was -6.664 and -4.520, respectively, both P<0.05). There was a positive correlation between tissue Eos and CRSwNP recurrence (r=0.130, P=0.002). The majority of CRSwNP patients were both eosCRSwNP in Uygur and Han ethnic groups. Conclusions: Eos is associated with the recurrence of CRSwNP in Xinjiang region, and eosCRSwNP is the dominant factor in both Uygur and Han patients.


Assuntos
Pólipos Nasais , Rinite , Sinusite , China/epidemiologia , Eosinófilos , Feminino , Humanos , Masculino , Pólipos Nasais/complicações , Pólipos Nasais/epidemiologia , Estudos Retrospectivos , Rinite/complicações , Rinite/epidemiologia , Sinusite/complicações , Sinusite/epidemiologia
17.
Zhonghua Yi Xue Za Zhi ; 101(21): 1572-1582, 2021 Jun 08.
Artigo em Chinês | MEDLINE | ID: mdl-34098684

RESUMO

Objective: To explore the risk factors for carbapenem-resistant Enterobacterales (CRE) infection and death. Methods: A case-control analysis of 482 inpatients in 18 secondary or tertiary hospitals in Beijing in 2018 was conducted. Patients infected by CRE were selected as the case group (n=247), and infected by carbapenem susceptible Enterobacterales (CSE) as the control group (n=235). The risk factors and clinical prognosis of CRE infection were analyzed by single factor analysis and multivariate logistic regression analysis. Results: CRE were resistant to most antimicrobials, but were highly sensitive to colistin and tigecycline, with sensitivity of 94.0% and 99.5%, respectively. Multivariate analysis showed that prior 30-day tracheal intubation (OR=2.607, 95%CI: 1.655-4.108, P<0.001), empirical treatment using third or fourth generation cephalosporins (OR=2.339, 95%CI: 1.438-3.803, P=0.001), carbapenems (OR=2.468, 95%CI: 1.610-3.782, P<0.001) and quinolones (OR=2.042, 95%CI: 1.268-3.289, P=0.003) were independent risk factors for CRE infection. Mechanical ventilation (OR=3.390, 95%CI: 1.454-7.904, P=0.005), heart failure (OR=4.679, 95%CI: 1.975-11.083, P<0.001), moderate or severe liver disease (OR=3.057, 95%CI: 1.061-8.806, P=0.038), prior 30-day quinolones exposure (OR=2.882, 95%CI: 1.241-6.691, P=0.014) and septic shock (OR=7.772, 95%CI: 3.505-17.233, P<0.001) were independent risk factors for death after CRE infection. Conclusions: Reducing the use of antimicrobials and invasive procedures such as prior 30-day tracheal intubation may reduce the probability of CRE infection. Grading the severity of the underlying disease in patients with CRE infection, as well as predicting and preventing the occurrence of septic shock will help reduce the risk of death.


Assuntos
Enterobacteriáceas Resistentes a Carbapenêmicos , Infecção Hospitalar , Infecções por Enterobacteriaceae , Antibacterianos/uso terapêutico , Carbapenêmicos , Infecções por Enterobacteriaceae/tratamento farmacológico , Infecções por Enterobacteriaceae/epidemiologia , Humanos , Prognóstico , Fatores de Risco
18.
Artigo em Inglês | MEDLINE | ID: mdl-34090309

RESUMO

OBJECTIVE: Our retrospective study aimed to assess the prenatal clinical utility of chromosome microarray (CMA) and the correlations of pathogenic copy number variants (CNVs) with different types of renal abnormalities detected by prenatal ultrasound screening and help to guide the optimal management for the relative late invasive diagnostic approach for renal abnormalities. METHODS: Fetus at 14-36 weeks of gestation were routinely screened for renal and other structural abnormalities at the Maternal and Child Health Hospital of Guangxi Autonomous Region. 877 fetuses with abnormal renal sonographic findings identified over a period of more than five years were subjected for CMA analysis using materials obtained from chorionic villi sampling, amniocentesis or cordocentesis. RESULTS: Renal abnormal cases that were subjected for CMA test constituted 2.44% (877/35,884) of all ultrasound abnormal fetus that were tested by CMA in this single center. The anomalies were diagnosed rather late in this series as 64% of isolated renal anomalies performed cordocentesis rather than CVSs. Ten types of overlapping renal anomalies were reported by prenatal ultrasound screening. Fetal pyelectasis was the most common renal ultrasound finding, it accounted for a third (34.32%, 301/877) of all fetuses with renal anomalies but only 3.65% (isolated case: 2.36% (4/169) and non-isolated case: 5.30% (7/132)) of them harbored pathogenic CNV. Hyperechogenic kidneys accounted for 5.47% of fetuses with renal anomalies, 39.58% (isolated case: 44.44% (16/36) and non-isolated case: 25.00% (3/12)) had pathogenic CNV findings, the highest diagnostic yield among all groups. Renal agenesis which accounted for 9.92% of all abnormal renal cases had a CMA diagnostic yield of 12.64% (isolated case: 11.53% (9/78) and non-isolated case: 22.22% (2/9), unilateral case:11.39% (9/79) and bilateral case: 25.0% (2/8)), whereas multicystic dysplastic kidney (n=110), renal cyst (n=34), renal dysplasia (n=27), crossed fused renal ectopia (n=31), hydronephrosis (n=98), renal duplication (n=42) and ectopic kidney (n=99) had an overall diagnostic rate of 11.81%, 11.76%, 7.40%, 6.45%, 6.12% , 4.76% and 3.03% respectively. The live-and-well infant rate was significantly higher in CMA negative fetuses with isolated fetal pyelectasis and ectopic kidney whereas the rate was significantly lower in fetuses with isolated renal agenesis, multicystic dysplastic kidney and sever hydronephrosis. The most common pathogenic CNV was 17q12 deletion (n=22), which accounted for 30.13% (22/73) of all positive CMA findings with a rate of 2.50% (22/877) among fetus with all abnormal renal findings. Fetuses with 17q12 deletion exhibited a wide range of renal phenotypes. Other recurrent CNVs associated with prenatal renal ultrasound abnormalities were 22q11.2, Xp21.1, Xp22.31, 2q13, 16p11.2, 1q21 which collectively accounted for 2.16% (19/877) of the fetuses with prenatal renal anomalies. CONCLUSION: We retrospectively reviewed the CMA findings for a large cohort of fetus with different types of renal ultrasound abnormalities. The CNV detection rate varied significantly (3.03%-39.58%) among groups. The most consistent ultrasound indication for CMA test would be hyperechogenic kidney. Our data provided specific guidance for ordering prenatal genetic testing for fetus with renal ultrasound findings. Specifically it is more appropriate to perform CMA test for isolated fetal pyelectasis postnatally rather than prenatally via cordocentesis at the third trimester. This article is protected by copyright. All rights reserved.

20.
J Eur Acad Dermatol Venereol ; 35(10): 1976-1986, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34077578

RESUMO

Several approaches to active immunotherapy for melanoma, including peptide-based vaccines (PVs), autologous tumour cell vaccines (TCVs), allogeneic TCVs and autologous dendritic cell vaccines (DCVs), have been investigated in clinical trials. However, comprehensive evidence comparing these interventions remains unavailable. The objective of this study was to expand previous work to compare and rank the immunotherapeutic strategies for melanoma in terms of overall survival and toxic effects with a Bayesian network meta-analysis. Methodologically, we performed a network meta-analysis of head-to-head randomized controlled trials comparing and ranking cancer vaccine approaches for patients with melanoma. PubMed, MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, the WHO International Clinical Trials Registry Platform and ClinicalTrials.gov were searched up to 31 July 2020. We estimated summary hazard ratios for death and risk ratios for toxicity. The effects of the underlying prognostic variable on survival benefits were examined by meta-regression. We performed subgroup analysis for the outcomes based on metastatic categories. Overall, we identified 4776 citations, of which 15 head-to-head randomized controlled trials (3162 participants) were included in the analysis. In terms of efficacy, allogeneic tumour cell vaccines plus immunotherapy adjuvants, peptide-based vaccines plus immunotherapy adjuvants and standard therapy were more effective than peptide vaccines. The proportion of women was inversely associated with mortality risk. For safety, all treatments were inferior to allogeneic tumour cell vaccines except for allogeneic tumour cell vaccines plus chemotherapy. Peptide vaccines plus immunotherapy adjuvants led to an increased risk of adverse events compared to allogeneic tumour cell vaccines plus immunotherapy adjuvants. These results suggest that allogeneic TCV and autologous DCV are better than standard therapy. PV plus immune modulators are the most effective strategy among all comparable strategies but is associated with increased toxicity. Any combination regimens for cancer therapeutic vaccines need to be balanced between risk and benefit profiles.


Assuntos
Vacinas Anticâncer , Melanoma , Teorema de Bayes , Feminino , Humanos , Imunoterapia , Melanoma/terapia , Metanálise em Rede
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