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1.
Artigo em Inglês | MEDLINE | ID: mdl-32109631

RESUMO

BACKGROUND & AIMS: Portal vein thrombosis (PVT) is a common and serious complication in patients with cirrhosis. However, little is known about PVT in patients with cirrhosis and acute decompensation (AD). We investigated the prevalence and clinical significance of PVT in nonmalignant patients with cirrhosis and AD. METHODS: We performed a retrospective study of 2 cohorts of patients with acute exacerbation of chronic liver disease who participated in the CATCH-LIFE study, established by the Chinese Chronic Liver Failure Consortium, from January 2015 through December 2016 (n = 2600 patients) and July 2018 through January 2019 (n = 1370 patients). We analyzed data on the prevalence, clinical manifestations, and risk factors of PVT from 2826 patients with cirrhosis, with and without AD. RESULTS: The prevalence of PVT in patients with cirrhosis and AD was 9.36%, which was significantly higher than in patients with cirrhosis without AD (5.24%) (P = .04). Among patients with cirrhosis and AD, 63.37% developed PVT recently (the first detected PVT with no indication of chronic PVT). Compared with patients without PVT, a significantly higher proportion of patients with PVT had variceal bleeding (47.33% vs 19.63%; P < .001) and patients with PVT had a significantly higher median serum level of D-dimer (2.07 vs 1.25; P < .001). Splenectomy and endoscopic sclerotherapy were independent risk factors for PVT in patients with cirrhosis and AD. The 1-year mortality rate did not differ significantly between patients with vs without PVT. CONCLUSIONS: In an analysis of data from 2826 patients with cirrhosis, a significantly higher proportion of those with AD had PVT than those without AD. PVT was associated with increased variceal bleeding, which would increase the risk for AD. Strategies are needed to prevent PVT in patients with cirrhosis, through regular screening, to reduce portal hypertension. ClinicalTrials.gov no: NCT02457637 and NCT03641872.

2.
Lab Invest ; 2019 Dec 02.
Artigo em Inglês | MEDLINE | ID: mdl-31792391

RESUMO

In this study, we screened potential natural compounds for the treatment of myocardial infarction (MI) and explored the underlying mechanisms. We built three machine learning models to screen the potential compounds. qPCR, flow cytometry, immunohistochemistry, and immunofluorescence analyses were applied to analyze the pharmacological effects of the compounds on macrophages/monocytes in vivo and in vitro. Arctigenin (AG) was selected as a candidate, and echocardiography, Masson's trichrome staining, and TUNEL staining were utilized to detect the effect of AG on MI in vivo. Transcriptome analysis and subsequent bioinformatics analyses were performed to predict the target of the selected compound. Western blot and luciferase reporter assays were used to confirm the target and mechanism of AG. The reversibility of the effects of AG were verified through overexpression of NFAT5. The results showed that AG can improve cardiac injury after MI by reducing infarct size, improving heart function, and inhibiting cardiac death. In addition, AG suppresses inflammatory macrophages/monocytes and proinflammatory cytokines in vivo and in vitro. Transcriptomic and biological experiments revealed that AG modulates macrophage polarization via the NFAT5-induced signaling pathway. Therefore, our data suggest that AG can improve MI by inhibiting the inflammatory phenotype of macrophages/monocytes through targeting of NFAT5.

3.
Cytokine ; 119: 37-46, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30875589

RESUMO

We examined the precise association between IL-10 levels and cardiovascular disease (CVD) prognosis and explored the pleiotropic role of IL-10 in different cardiac pathologies. We performed a meta-analysis of cross-sectional and longitudinal studies investigating IL-10 levels. Meta-regression analyses were used to determine the cause of the discrepancies. To assess publication bias, funnel plots were constructed, and Egger's tests were performed. Data from the GSE58015 dataset were used to investigate the levels of IL-10 under certain conditions. Because of substantial heterogeneity in the data used to compare the IL-10 levels between patients with CVD and healthy people, we could not determine the differences between the healthy controls and patients with ischemic or nonischemic pathologies (p > 0.05). The analysis of the association between IL-10 levels and CVD prognosis indicated that higher IL-10 levels were significantly associated with a poor prognosis in patients with nonischemic pathologies (HR = 1.10, 95% CI = 1.00-1.20, p = 0.043) but differentially associated with the prognosis of patients with ischemic pathologies based on the sampling time point (before percutaneous coronary intervention (PCI): HR = 4.90, 95% CI = 1.24-19.30, p < 0.001; after PCI: HR = 0.57, 95% CI = 0.43-0.75, p = 0.023). The meta-regression analysis showed that the pooled HR of the IL-10 levels was positively correlated with the IL-10/IL-6 ratio (ß = 0.644, p = 0.024). The funnel plots and Egger's tests revealed no statistically significant bias in our meta-analysis (p > 0.1). Furthermore, our data mining analysis supported our findings. Our analysis showed that IL-10 levels may be pleiotropically associated with the CVD prognosis possibly based on the type of pathology, disease stage and levels of other proinflammatory factors, such as IL-6.

4.
Zhen Ci Yan Jiu ; 41(3): 255-64, 2016 Jun 25.
Artigo em Chinês | MEDLINE | ID: mdl-29071916

RESUMO

OBJECTIVE: To systematically review the effectiveness and safety of heat-sensitive moxibustion (HSM) therapy in the treatment of lumbar disc herniation (LDH). METHODS: Papers of randomized clinical trials (RCTs) concerning the effectiveness and safety of HSM therapy for LDH published in both Chinese and English before November 17, 2015 were collected from PubMed, EMBase, Cochrane library, CNKI, CBM, WanFang Data and VIP databases according to the inclusion and exclusion criteria and by using key words of "thermal moxibustion" "heat-sensitive acupoint" "lumbar intervertebral disc herniation (LIDH)" "lumbar disc herniation (LDH)" and "lumbago backache", followed by screening, data extracting and methodological quality assessing. Then, the Meta-analysis was performed using RevMan 5.3 software. RESULTS: Twenty RCTs were included eventually, containing a total of 1 861 cases treated by HSM therapy in the treatment of LDH patients. The Meta-analysis shows that the effectiveness and safety of HSM therapy for LDH are superior to those of other therapies, which is drawn from total effective rate of treatment group[RR=1.13, 95%CI(1.09,1.18), P<0.001], M-JOA score[MD=-3.17, 95%CI(-3.88, -2.47), P<0.001], M-JOA score difference of various subgroups:daily life ability effect difference[MD=1.04, 95%CI(0.44, 1.64), P<0.001], subjective effect symptoms difference[MD=0.58, 95%CI (0.23, 0.92),P=0.001], objective effect symptoms difference[MD=1.12, 95%CI(0.58, 1.65),P<0.001], VAS score[MD=-1.17,95%CI(-1.78, -0.57), P<0.001], the recurrence rate[RR=0.54, 95%CI(0.37, 0.80), P=0.002], and no adverse reactions mentioned in the reported results. The sensitivity analysis showed a greater homogeneity in literature and the results were stable, but funnel plot analysis showed a publication bias. CONCLUSIONS: The HSM therapy is effective and safe in the treatment of LDH patients.


Assuntos
Deslocamento do Disco Intervertebral/terapia , Moxibustão , Pontos de Acupuntura , Temperatura Alta , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento
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